Association between triglyceride-glucose related indices and all-cause and cause-specific mortality in the general population: a cohort study.

BACKGROUND: Although triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance and cardiometabolic disease, its effectiveness in predicting mortality risk has not been adequately validated. We aimed to investigate the association between the TyG-related indices and all-cause and cause-specific mortality in the general population. METHODS: A total of 27,642 individuals were included from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Three indicators were constructed, including the TyG index, TyG combined with waist-to-height ratio (TyG-WHtR), and TyG combined with waist circumference (TyG-WC). Mortality data was acquired through the linkage of NHANES data with National Death Index records. Weighted Cox proportional hazards models were used to estimate the independent association between the TyG-related indices and mortality. Nonlinear associations were explored using restricted cubic splines. RESULTS: Multivariable adjusted models showed a progressive increase in all-cause and cause-specific mortality across quartiles of the TyG-related indices. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios of 1.26 (95% CI 1.04-1.52) for all-cause mortality, 1.38 (1.04-1.74) for cardiovascular mortality, and 1.23 (1.01-1.50) for non-cardiovascular mortality, respectively. For the TyG-WHtR index, the corresponding hazard ratios were 1.60 (1.25-2.05), 1.86 (1.26-2.50), and 1.48 (1.10-1.99), respectively. For the TyG-WC index, the corresponding hazard ratios were 1.42 (1.11-1.75), 1.48 (1.04-1.96), and 1.38 (1.05-1.72), respectively. The associations between the three TyG-related indices and all-cause, cardiovascular and non-cardiovascular mortality were J-shaped. Interaction tests revealed significant effect modification by age, low-density lipoprotein cholesterol (LDL-C) level, and statin use (all P values < 0.05). CONCLUSIONS: The TyG-related indices were independent predictors of all-cause and cause-specific mortality in the general population. Young individuals should be particularly vigilant, whereas low LDL-C levels and statin use are potentially protective.

Screening the risk of obstructive sleep apnea by utilizing supervised learning techniques based on anthropometric features and snoring events.

Objectives: Obstructive sleep apnea (OSA) is typically diagnosed by polysomnography (PSG). However, PSG is time-consuming and has some clinical limitations. This study thus aimed to establish machine learning models to screen for the risk of having moderate-to-severe and severe OSA based on easily acquired features. Methods: We collected PSG data on 3529 patients from Taiwan and further derived the number of snoring events. Their baseline characteristics and anthropometric measures were obtained, and correlations among the collected variables were investigated. Next, six common supervised machine learning techniques were utilized, including random forest (RF), extreme gradient boosting (XGBoost), k-nearest neighbor (kNN), support vector machine (SVM), logistic regression (LR), and naïve Bayes (NB). First, data were independently separated into a training and validation dataset (80%) and a test dataset (20%). The approach with the highest accuracy in the training and validation phase was employed to classify the test dataset. Next, feature importance was investigated by calculating the Shapley value of every factor, which represented the impact on OSA risk screening. Results: The RF produced the highest accuracy (of >70%) in the training and validation phase in screening for both OSA severities. Hence, we employed the RF to classify the test dataset, and results showed a 79.32% accuracy for moderate-to-severe OSA and 74.37% accuracy for severe OSA. Snoring events and the visceral fat level were the most and second most essential features of screening for OSA risk. Conclusions: The established model can be considered for screening for the risk of having moderate-to-severe or severe OSA.

Association of lipid accumulation product with type 2 diabetes mellitus, hypertension, and mortality: a systematic review and meta-analysis.

Purpose: Novel anthropometric measures are simple, applicable, and inexpensive tools for cardiovascular risk assessment. This study evaluates the association of lipid accumulation product (LAP) with hypertension, type 2 diabetes mellitus (T2DM), and all-cause mortality, and compares it with other anthropometric measures. Methods: PubMed, Web of Science, EMBASE, and Scopus were systematically searched for articles published until May 15, 2021. We included all the studies that had measured LAP predictability for T2DM, all-cause mortality, and hypertension with no limitation in comorbidities and follow-up duration. We assessed the predictability measures of LAP for the aforementioned outcomes. We also performed a meta-analysis on four articles on mortality using an inverse variance method by the "meta" package in R software. Results: Twenty-nine studies were included in the review after applying the eligibility criteria. The hazard ratio for all-cause mortality per one standard deviation increment of LAP was 1.24 (95% confidence interval [CI]: 1.00-1.53; P = 0.0463) in females, and 1.07 (95% CI: 0.74-1.57; P = 0.709) in males. All included studies found a direct association between LAP with T2DM and hypertension. However, studies used different cut-off points for LAP. Most studies found that LAP was superior in predicting T2DM and hypertension compared to conventional indices, e.g., body mass index and waist circumference. We found that LAP may have higher prognostic significance in females compared to males. Conclusion: LAP is an inexpensive method to evaluate the risk of all-cause mortality, T2DM, and hypertension, and could outperform conventional anthropometric indices in this regard. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01114-z.

Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life.

Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.

Effects of Nordic Walking Training on Anthropometric, Body Composition and Functional Parameters in the Middle-Aged Population.

Nordic walking (NW) is an easy physical exercise that is usually proposed for clinical populations and for the elderly. The aim of the present study was to examine the effects of a period of NW training in a non-clinical middle-aged population on anthropometric, body composition and functional parameters. A pre-test/post-test study design was conducted on 77 participants: 56 women (72.7%, age 55.53 ± 9.73 years) and 21 men (27.3%, age 60.51 ± 8.15 years). The measurements were carried out with physical tests at the baseline and at the follow up. Participants did two weekly NW training sessions of about 60 min each. A questionnaire was administered to evaluate their feelings after the training period. Paired Students' test was carried out to evaluate the pre-post differences, and the analysis of variance was performed to evaluate the questionnaire. Participants had significantly less stress and anxiety after the NW training. Body fat parameters showed a significant decrease, especially for women. Phase angle and strength of lower body presented a significant increase in both sexes after the training period. In conclusion, NW shows many potential benefits also for the nonclinical population and could be an important exercise to remain active and to maintain a good health condition.

Clustering of obesity-related characteristics: A latent class analysis from the Canadian Longitudinal Study on Aging.

Measures of obesity, including body mass index (BMI) and waist circumference (WC), do not fully capture the complexity of obesity-related health risks. This study identified distinct classes of obesity-related characteristics and evaluated their associations with BMI, WC, and percent body fat (%BF) using cross-sectional data from 30,096 participants aged 45-85 in the Canadian Longitudinal Study on Aging (2011-2015). Sixteen obesity-related variables, including behavioural, metabolic, physical health, and mental health/social factors, were included in a latent class analysis to identify distinct classes of participants. Adjusted odds ratios (OR) were estimated from logistic regression for associations between each class and obesity defined by BMI, WC and %BF. Six latent classes were identified: "low-risk" (39.8%), "cardiovascular risk" (19.4%), "metabolic risk" (16.9%), "sleep and mental health risk" (12.1%), "multiple and complex risk" (6.7%), and "cardiometabolic risk" (5.1%). Compared to "low-risk", all classes had increased odds of BMI-, WC- and %BF-defined obesity. For example, the "complex and multiple risk" class was associated with obesity by BMI (OR: 10.70, 95% confidence interval (CI): 9.51, 12.04), WC (OR: 9.21, 95% CI: 8,15, 10,41) and %BF (OR: 7.54, 95% CI: 6.21, 9.16). Distinct classes of obesity-related characteristics were identified and were strongly associated with obesity defined by multiple measures.

The Effects of Irvingia gabonensis Seed Extract Supplementation on Anthropometric and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis.

Background: It has been hypothesized that Irvingia gabonensis can promote weight loss by increasing fatty acid breakdown and inhibiting fatty acid synthesis.Objective: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of Irvingia gabonensis seed extract supplementation on weight-related health outcomes.Methods: Literature searches were conducted in 4 databases from January 2018 to identify randomized controlled trials (RCTs) investigating the effects of Irvingia gabonensis seed extract supplementation on anthropometric measures and cardiovascular biomarkers. Two investigators independently performed abstract screenings, full-text screenings, data extraction, and risk of bias (ROB) assessments. Random effects meta-analyses were performed when 3 or more RCTs reported the same outcome.Results: Five RCTs met the eligibility criteria for this systematic review. Four of the 5 RCTs were rated as having a high ROB, and only one RCT was rated as having a low ROB. Random-effects meta-analysis of the 5 RCTs showed that a significant decrease in body weight, body fat, and waist circumference was observed in relation to Irvingia gabonensis seed extract supplementation. However, the only one low-ROB trial did not have significantly different outcomes. Meta-analysis also showed beneficial effects of Irvingia gabonensis seed extract supplementation on total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Only the low-ROB trial showed a trend of increasing HDL-cholesterol levels (net percent change = 11.61%; 95% confidence interval (CI: -6.12%, 29.34%) and decreasing triglyceride levels (net percent change = -29%; 95% CI: -76%, 19%). The reported adverse events were minor in these 5 RCTs.Conclusions: Overall efficacy of Irvingia gabonensis seed extract supplementation on weight loss seems positive but is limited due to poor methodological quality and the insufficient reporting of the clinical trials. Further high quality RCTs are needed to determine the effectiveness of Irvingia gabonensis seed extract supplement on the weight-related health outcomes.

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study.

This study evaluated the predictive ability of 11 obesity- and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), "A" body-shape index (ABSI), conicity index (CI), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles (p < 0.001). The TyG index was best able to identify prediabetes in either sex (AUC and optimal cut-off = 0.700 and 8.72, and 0.695 and 8.92 for men and women, respectively), suggesting that compared to the other parameters, the TyG index has the best discriminative power to predict prediabetes in the whole population. Thus, we propose the TyG index be used as a complementary marker for assessing prediabetes in older adults.

Accuracy of self-reported anthropometric measures - Findings from the Finnish Twin Study.

OBJECTIVE: To determine the accuracy of self-reported height, weight, body mass index (BMI) and waist circumference (WC) compared to the measured values, and to assess the similarity between self-reported and measured values within dizygotic (DZ) and monozygotic (MZ) twin pairs. METHODS: The data on self-reported and measured height, weight and WC values as well as measured hip circumference (HC) were collected from 444 twin individuals (53-67 years old, 60% women). Accuracies between self-reported and measured values were assessed by Pearson's correlation coefficients, Cohen's kappa coefficients and Bland-Altman 95% limits of agreement. Intra-class correlation was used in within-pair analyses. RESULTS: The correlations between self-reported and measured values were high for all variables (r=0.86-0.98), although the agreement assessed by Bland-Altman 95% limits had relatively wide variation. The degree of overestimating height was similar in both sexes, whereas women tended to underestimate and men overestimate their weight. Cohen's kappa coefficients between self-reported and measured BMI categories were high: 0.71 in men and 0.70 in women. Further, the mean self-reported WC was less than the mean measured WC (difference in men 2.5cm and women 2.6cm). The within-pair correlations indicated a tendency of MZ co-twins to report anthropometric measures more similarly than DZ co-twins. CONCLUSIONS: Self-reported anthropometric measures are reasonably accurate indicators for obesity in large cohort studies. However, the possibility of more similar reporting among MZ pairs should be taken into account in twin studies exploring the heritability of different phenotypes.

Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA: simple tools for a critical measure.

OBJECTIVE: In resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas). DESIGN: Cross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457). SETTING: National Children's Study-Formative Research in Anthropometry (2011-2012). SUBJECTS: Multi-racial/ethnic infants and children aged <6 years (n 1473). RESULTS: Developed Models 1-4 had high predictive precision (R 2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas (-1·7, 9·2 and -4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods. CONCLUSIONS: Ulna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.

Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women.

Obesity, defined by body mass index (BMI), is a well-established risk factor of type 2 diabetes, but BMI has been criticized for its inability to discriminate fat mass and lean body mass. We examined the association between predicted fat mass and type 2 diabetes risk in two large US prospective cohorts, and compared the magnitude of the association with BMI and other obesity indicators. Validated anthropometric prediction equations previously developed from the National Health and Nutrition Examination Survey were used to estimate predicted fat mass and percent fat for 97,111 participants from the Health Professionals Follow-up Study (1987-2012) and the Nurses' Health Study (1986-2012) who were followed up for type 2 diabetes. Multivariable-adjusted hazard ratios for type 2 diabetes across quintiles of predicted fat mass were 1.00, 1.96, 2.96, 3.90, and 8.38 for men and 1.00, 2.20, 3.50, 5.73, and 12.1 for women; of BMI were 1.00, 1.69, 2.45, 3.54, and 6.94 for men and 1.00, 1.76, 2.86, 4.88, and 9.88 for women. Predicted FM showed the strongest association with type 2 diabetes in men followed by waist circumference (WC), waist-to-height ratio (WHtR), predicted percent fat, BMI, Waist-to-hip ratio (WHR), and a body shape index (ABSI). For women, the strongest association was shown for WHtR, followed by WC, predicted percent fat, predicted fat mass, BMI, ABSI, and WHR. Compared to BMI, predicted fat mass demonstrated consistently stronger association with type 2 diabetes risk. However, there was inconclusive evidence to suggest that predicted fat mass is substantially superior to other obesity indicators.

Are body mass index and waist circumference significant predictors of diabetes and prediabetes risk: Results from a population based cohort study.

AIM: To determine the predictive role of body mass index (BMI) and waist circumference (WC) for diabetes and prediabetes risk in future in total sample as well as in men and women separately. METHODS: In a population based cohort study, 1765 with mean ± SD age: 42.32 ± 6.18 healthy participants were followed up from 2003 till 2013 (n = 960). Anthropometric and biochemical measures of participants were evaluated regularly during the follow up period. BMI and WC measures at baseline and diabetes and prediabetes status of participants at 2013 were determined. Multivariable logistic regression analysis was used for determining the risk of diabetes and prediabetes considering important potential confounding variables. Receiver operating characteristic curve analysis was conducted to determine the best cut of values of BMI and WC for diabetes and prediabetes. RESULTS: At 2013, among participants who had complete data, 45 and 307 people were diabetic and prediabetic, respectively. In final fully adjusted model, BMI value was a significant predictor of diabetes (RR = 1.39, 95%CI: 1.06-1.82 and AUC = 0.68, 95%CI: 0.59-0.75; P < 0.001) however not a significant risk factor for prediabetes. Also, WC was a significant predictor for diabetes (RR = 1.2, 95%CI: 1.05-1.38 and AUC = 0.67, 95%CI: 0.6-0.75) but not significant risk factor for prediabetes. Similar results were observed in both genders. CONCLUSION: General and abdominal obesity are significant risk factors for diabetes in future.

Influence of body habitus on feasibility and outcome of laparoscopic liver resections: a prospective study.

BACKGROUND: The aim of the present study was to prospectively investigate whether the anthropometric measures of A Body Shape Index (ABSI, taking into account waist circumference adjusted for height and weight) affects feasibility and outcome of laparoscopic liver resections. METHODS: One hundred patients undergoing laparoscopic liver resection were prospectively included in the study (2014-2015). Preoperative clinical parameters, including body mass index (BMI) and ABSI were evaluated for associations with intraoperative outcome and postoperative results (morbidity, mortality and functional recovery). RESULTS: Twenty-two and 78 patients underwent major and minor hepatectomies, respectively. Conversion rate was 9%, mean blood loss was 210 ± 115 ml. Postoperative morbidity was 15% and mortality was nil. Mean length of stay was 4 days. When considering the entire series, ABSI was not associated with intra and postoperative outcome. After stratification of patients according to difficulty score, Pearson's correlation demonstrated an association between ABSI and intraoperative blood loss (P = 0.03) and time for functional recovery (P = 0.05) in patients undergoing resections with high score of difficulty. CONCLUSION: Body habitus has an influence on outcome of laparoscopic liver resections with high degree of difficulty, while feasibility and outcome of low difficulty resections seem not to be affected by anthropometric measures.

Validity of silhouette showcards as a measure of body size and obesity in a population in the African region: A practical research tool for general-purpose surveys.

BACKGROUND: The purpose of this study is to validate the Pulvers silhouette showcard as a measure of weight status in a population in the African region. This tool is particularly beneficial when scarce resources do not allow for direct anthropometric measurements due to limited survey time or lack of measurement technology in face-to-face general-purpose surveys or in mailed, online, or mobile device-based surveys. METHODS: A cross-sectional study was conducted in the Republic of Seychelles with a sample of 1240 adults. We compared self-reported body sizes measured by Pulvers' silhouette showcards to four measurements of body size and adiposity: body mass index (BMI), body fat percent measured, waist circumference, and waist to height ratio. The accuracy of silhouettes as an obesity indicator was examined using sex-specific receiver operator curve (ROC) analysis and the reliability of this tool to detect socioeconomic gradients in obesity was compared to BMI-based measurements. RESULTS: Our study supports silhouette body size showcards as a valid and reliable survey tool to measure self-reported body size and adiposity in an African population. The mean correlation coefficients of self-reported silhouettes with measured BMI were 0.80 in men and 0.81 in women (P < 0.001). The silhouette showcards also showed high accuracy for detecting obesity as per a BMI ≥ 30 (Area under curve, AUC: 0.91/0.89, SE: 0.01), which was comparable to other measured adiposity indicators: fat percent (AUC: 0.94/0.94, SE: 0.01), waist circumference (AUC: 0.95/0.94, SE: 0.01), and waist to height ratio (AUC: 0.95/0.94, SE: 0.01) amongst men and women, respectively. The use of silhouettes in detecting obesity differences among different socioeconomic groups resulted in similar magnitude, direction, and significance of association between obesity and socioeconomic status as when using measured BMI. CONCLUSIONS: This study highlights the validity and reliability of silhouettes as a survey tool for measuring obesity in a population in the African region. The ease of use and cost-effectiveness of this tool makes it an attractive alternative to measured BMI in the design of non-face-to-face online- or mobile device-based surveys as well as in-person general-purpose surveys of obesity in social sciences, where limited resources do not allow for direct anthropometric measurements.

Impact of anthropometric measures and serum leptin on severity of gastroesophageal reflux disease.

The aim of this prospective study was to evaluate the impact of obesity, determined by different anthropometric measures, on clinical and endoscopic severity of GERD and the relation between serum leptin and clinical and endoscopic severity of GERD in Egyptian patients. The study was carried out at Ain Shams University Hospitals and Theodor Bilharz Research Institute, Cairo, Egypt. A total of 60 patients with clinically and endoscopically evident gastroesophageal reflux disease (GERD) were enrolled in this study as well as 20 healthy subjects matched for age and gender serving as the control group. Patients were divided according to their body mass index (BMI) into two groups: group 1 (n = 30): overweight and obese (BMI ≥ 25 and/or waist-to-height ratio [WHtR] ≥ 0.5) and group 2 (n = 30): normal weight (BMI ≥ 18 to < 25 and/or WHtR ≥ 0.4 to < 0.5). Upper gastrointestinal endoscopy, anthropometric measures, and symptom severity score questionnaire were done for all patients. Serum leptin hormone was assessed for patients and control groups.The evidence revealed statistically significant difference between the two groups in terms of different anthropometric measures (P < 0.00) except the height (P < 0.9), abdominal fat depot equations (P < 0.00), endoscopic findings according to Los Angeles classification (P < 0.001), symptom severity score (P < 0.00), and serum leptin hormone (43.96 ± 23.50 in group 1 vs. 7.5133 ± 8.18294 in group 2 and 6.98 ± 5.90 in the control group) (P = 0.00). Obesity in general and central (abdominal) obesity specifically has significant impact on clinical and endoscopic severity of GERD. Increased leptin hormone level is associated with clinical and endoscopic severity of GERD. Future trial on larger number of patients is emphasized.

Very early anthropometric changes after antiretroviral therapy predict subsequent survival, in karonga, Malawi.

BACKGROUND: Antiretroviral (ART) scale-up in Malawi has been achieved on a large scale based mainly on clinical criteria. Simple markers of prognosis are useful, and we investigated the value of very early anthropometric changes in predicting mortality. PRINCIPAL FINDINGS: Adult patients who initiated ART in Karonga District, northern Malawi, between September 2005 and August 2006 were included in a prospective cohort study, and followed for up to one year. We used Cox regression to examine the association between anthropometric changes at 2 and 6 weeks and deaths within the first year. 573 patients were included, of whom 59% were women; the median age at initiation was 37 and 64% were in WHO stage 4. Both body mass index (BMI) and mid-upper arm circumference (MUAC) increased linearly with increased time on ART, and were closely correlated with each other. There were 118 deaths. After 2 weeks on ART, a BMI increase of <0.5 kg/m(2) (HR 2.47, 95%CI 1.24-4.94, p=0.005) or a MUAC increase of <0.5cm (HR 2.79, 95%CI 1.19-6.55, p=0.008) were strong predictors of death, and these associations were stronger after adjusting for baseline charactertistics. Similar results were found after 6 weeks on ART. CONCLUSIONS: Very early anthropometric changes, after 2 and 6 weeks on ART, are strong predictors of survival, independent of baseline characteristics. This should help identify patients requiring more detailed assessment where facilities are limited. MUAC is particularly valuable, requiring the simplest equipment and being appropriate for patients who have problems standing.

Serum level of ghrelin in umbilical cord in small and appropriate for gestational age newborn infants and its relationship to anthropometric measures.

OBJECTIVE: To compare the cord blood ghrelin level in (SGA) infants with the level in appropriate for gestational age (AGA) infants, and determine its relationship to anthropometric measurements at delivery. MATERIALS AND METHODS: Fifty newborn infants (30 SGA newborns and 20 AGA infants) were included in the study and were subjected to complete clinical examinations, anthropometric measurement, and ghrelin assays. RESULTS: The cord blood ghrelin level in SGA infants was significantly higher than that in AGA infants. Cord ghrelin level correlated negatively with gestational age, weight, length, and body mass index in SGA group. CONCLUSION: Cord ghrelin concentration increased in SGA infants due to state of prolonged undernutrition the source of ghrelin unknown may be from the mother placenta or fetal tissues.