Association between COVID-19 morbidity, mortality, and gross domestic product, overweight/ obesity, non-communicable diseases, vaccination rate: A cross-sectional study.

BACKGROUND: The spread of COVID-19 depends on a lot of social and economic factors. THE AIM: to study the influence of country's gross domestic product, population prevalence of overweight/ obesity, NCD mortality, and vaccination on COVID-19 morbidity and mortality rates. METHODS: A cross-sectional study with two phases: correlation-regression interrelations in 1) all world countries; 2) all world non-island countries. The study includes the following data from 218 world countries: COVID-19 morbidity/mortality rates, GDP per capita, the prevalence of overweight/ obesity, NCD mortality among adults (both sexes), people fully vaccinated against COVID-19. RESULTS: An average percentage of the prevalence of overweight among adults in world countries by 2019 was 47.31 ± 15.99%, obesity 18.34 ± 9.64%, while the prevalence by 2016 were 39% and 13%, respectively. Overweight and obesity among adults during three years grew by 21.2% and 40.8%, respectively. Data from the world countries provide significant correlations (p < 0.0001) between COVID-19 morbidity, and: GDP (r = 0.517), overweight (r = 0.54), obesity (r = 0.528), NCD mortality (r = 0.537); COVID-19 mortality, and: GDP (r = 0.344), overweight (r = 0.514), obesity (r = 0.489), NCD mortality (r = 0.611); GDP, and: overweight (r = 0.507), obesity (r = 0.523), NCD mortality (r = 0.35), fully vaccinated people (r = 0.754). An increase in fully vaccinated people, from 3% to 30% of world population, decreases new confirmed COVID-19 cases, although the dependence was not significant (p = 0.07). Data from non-island world countries provides more highly significant correlations (p < 0.0001) between COVID-19 morbidity, and: GDP (r = 0.616), overweight (r = 0.581), obesity (r = 0.583); COVID-19 mortality, and: GDP (r = 0.43), overweight (r = 0.556), obesity (r = 0.539); GDP, and: overweight (r = 0.601), obesity (r = 0.633). The differences of correlation coefficients between data of 176 world countries and data of 143 world non-island countries were not significant (Z-scores<1.29; p > 0.05). CONCLUSION: The study provides evidence of a significant impact of overweight/obesity prevalence on the increase in COVID-19 morbidity/mortality. Countries with higher GDP have a high overweight/obesity prevalence and possibility to get vaccinated.

Isocitrate dehydrogenase 1 mutation is associated with reduced levels of inflammation in glioma patients.

Background: Glioma patients with mutant isocitrate dehydrogenase have improved survival; this could be in part due to the suppressive effect of mutant IDH on the level of chronic inflammation. This study aimed to prospectively analyze the association of IDH1 mutation status with preoperative levels of blood inflammatory markers: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), and red cell distribution width (RDW) in gliomas. Patients and methods: Receiver operating characteristic curves for cutoff value determination, various bivariate tests, and survival analyses (Kaplan-Meier curves and Cox regression) were performed. Results: Patients with mutant IDH1 had reduced levels of NLR (P<0.032) and CRP (P<0.008). Moreover, these patients showed better median overall survival compared to those without IDH1 mutation (P<0.000). In univariate analysis, IDH1 mutation status (P<0.000), NLR (P<0.000), PLR (P<0.008), and CRP (P<0.001) were among the factors associated with survival. By multivariate analysis, IDH1 mutation (P<0.044) and NLR<2.65 (P<0.022) remained independent factors associated with better survival; other independent variables were tumor grade (P<0.000) and location in noneloquent area (P<0.015). Conclusion: The obtained results show that IDH1 mutation is associated with lower levels of chronic inflammation that could account for an improved prognosis in this group of patients.

Severe nonalcoholic steatohepatitis and type 2 diabetes: liver histology after weight loss therapy in a randomized clinical trial.

OBJECTIVE: To evaluate the effectiveness of the fast weight loss method on liver steatosis, fibrosis, inflammation, glycemic and lipid features and body composition in patients with severe nonalcoholic steatohepatitis (NASH) and type 2 diabetes (T2D). METHODS: A 24 week open prospective randomized controlled clinical trial including 80 adult patients (aged 40-65 years) was performed. The patients after randomization were divided into two groups: the main group followed the fast weight loss method; the control group received conventional drug treatment. The fast weight loss method included calorie restriction, salt intake, walking and sexual self-restraint. The conventional drug therapy included vitamin E, orlistat, pioglitazone hydrochloride, atorvastatin, lisinopril, benzodiazepines and anti-inflammatory agents. Primary endpoints were: ultrasound and histology suggestive of steatohepatitis, hepatic enzymes, weight loss, 2 hour oral glucose tolerance test and glycosylated hemoglobin A1C (HbA1c). Secondary endpoints were: blood pressure and lipids. RESULTS: A total of 83% patients completed the study. In the main group weight lost was 7-16 kg (10-20% from baseline) for 8-10 weeks. In this group weight was lost due to reduction of fat mass only. The main vs. control group showed higher decrease in fat mass from baseline (p < .001). Ultrasound imaging and liver histological scoring system evidenced significant improvement in liver steatosis/fibrosis in the main group (p < .001). In the main vs. control group weight lost at 24 weeks led to positive laboratory changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), 2 hour oral glucose tolerance test (OGTT), HbA1c, Homeostasis Model Assessment insulin resistance indexes (HOMA-IR), blood pressure (BP), cholesterol, triglycerides, bilirubin total and blood hemoglobin (p = .01). The fast weight loss in the patients adequately led to decrease in symptomatic drugs up to complete abolition. CONCLUSIONS: The study showed benefits of the fast weight loss method improving in steatosis/fibrosis and biochemical/metabolic outcomes in patients with severe NASH and T2D.

Pregnancy in women after successful acromegaly treatment, including surgical removal of pituitary adenoma and postoperative therapy using lanreotide acetate.

Acromegaly is one of the most common syndromes in pituitary adenomas. Naturally, women with this condition have trouble with their reproductive function. The difficulty in diagnosing acromegaly progression in pregnancy is that there is also production of placental growth hormone observed, making it impossible to differentiate from neoplastic growth hormone production using conventional methods of investigation. This article is about a clinical case of acromegaly in a 22 years old woman who was operated on using transnasal transsphenoidal approach and received postoperative treatment with somatostatin analog - lanreotide acetate autogel - for six months. The woman became pregnant in the course of the treatment. During pregnancy, the GH and IGF-I levels in serum remained within normal limits. Lanreotide acetate therapy was discontinued. The woman successfully gave birth to a healthy baby. There was a remission of the disease after pregnancy.