Central Obesity is an Independent Determinant of Advanced Fibrosis in Lean Patients With Nonalcoholic Fatty Liver Disease.

Background: The current definition of lean is based on body mass index (BMI). However, BMI is an imperfect surrogate for adiposity and provides no information on central obesity (CO). Hence, we explored the differences in clinical profile and liver disease severity in lean patients with nonalcoholic fatty liver disease (NAFLD) with and without CO. Methods: One hundred seventy lean patients with NAFLD (BMI <23 kg/m2) were divided into two groups depending upon the presence or absence of CO (waist circumference ≥80 cm in females and ≥90 cm in males). Noninvasive assessment of steatosis was done by ultrasound and controlled attenuation parameter (CAP), while fibrosis was assessed with FIB-4 and liver stiffness measurement (LSM). FibroScan-AST (FAST) score was used for non-invasive prediction of NASH with significant fibrosis. Results: Of 170 patients with lean NAFLD, 96 (56.5%) had CO. Female gender (40.6% vs. 17.6%, P = 0.001), hypertriglyceridemia (58.3% vs. 39.2%, P = 0.01) and metabolic syndrome (23.9% vs. 4.1%, P < 0.001) were more common in the CO group. There was a poor correlation between BMI and waist circumference (r = 0.24, 95% CI: 0.09-0.38). Grade 2-3 steatosis on ultrasound was significantly more common in CO patients (30% vs. 12.3%, P = 0.007). CAP [312.5 (289.8-341) dB/m vs. 275 (248-305.1) dB/m, P = 0.002], FAST score [0.42 (0.15-0.66) vs. 0.26 (0.11-0.39), P = 0.04], FIB-4 and LSM were higher in those with CO. Advanced fibrosis was more prevalent among CO patients using FIB-4 (19.8% vs 8.1%, P = 0.03) and LSM (9.5% vs. 0, P = 0.04). CO was independently associated with advanced fibrosis after adjusting for BMI and metabolic risk factors (aOR: 3.11 (1.10-8.96), P = 0.03). Among these 170 patients, 142 fulfilled metabolic dysfunction associated steatotic liver disease (MASLD) criteria. CO was also an independent risk factor for advanced fibrosis in MASLD (3.32 (1.23-8.5), P = 0.02). Conclusion: Lean patients with NAFLD or MASLD and CO have more severe liver disease compared to those without CO.

The impact of dietary interventions on polycystic ovary syndrome patients with a BMI ≥25 kg/m2: A systematic review and meta-analysis of randomized controlled trials.

Background: Dietary interventions, recommended as a primary approach globally, benefit women with polycystic ovary syndrome (PCOS) by inducing weight loss and improving clinical symptoms, metabolism, and pregnancy results. However, the impact of diet on PCOS in individuals with BMI ≥ 25 kg/m2 is unclear. The aim of this review was to offer dietary guidance for these patients. Methods: Six databases, CNKI, Wanfang, VIP, PubMed, Cochrane Library, and Web of Science, were searched systematically from inception to December 2023 for clinical randomized controlled trials (RCT) on dietary interventions for PCOS. Two researchers independently screened and extracted data following pre-defined inclusion criteria, with bias assessment using the Cochrane Handbook and Review Manager (version 5.4) software. Results: Nine RCTs with 559 participants were included. Among women with PCOS and obesity, compared to the control group, individuals who underwent dietary interventions experienced improvements in weight-related Indicators, glycolipid metabolism, hormone-related indicators, and fertility-related outcomes. Subgroup analysis indicated that calorie-restricted diets (CRDs) and low-energy-low-carb combined diets had advantages over other dietary interventions. Moreover, the overweight period was the optimal intervention period. Conclusions: Dietary interventions can improve the clinical manifestations of PCOS and pregnancy rates in patients with a BMI ≥ 25 kg/m2. Particularly, CRDs, low-calorie-low-carb combined diets, and low-calorie-extract combined diets are recommended.

Correlation between BMI, amount of aspirated fat and post-operative complications in VASER liposuction: A single centre experience.

Background: Vibration amplification of sound energy at resonance (VASER) liposuction is an innovative technique that allows surgeons to selectively remove fat and shape desired areas of the body, resulting in more precise and controlled outcomes compared to traditional liposuction techniques. VASER liposuction offers several advantages, including targeted action that reduces trauma to the surrounding tissues, limiting pain, swelling and recovery time. Purpose: This study compared the complication rates among patients who underwent VASER liposuction in relation to their body mass index (BMI) and the amount of fat aspirated. Methods: The authors reviewed the medical records of all patients who underwent VASER liposuction at Scalera Clinic in Naples, dividing them into two groups: the first with BMI < 24.9 kg/m2 and second with BMI >25.0 kg/m2. Results: The authors examined 117 patients who were operated on within a year (2022/2023), with 48 of them having BMIs < 24.9 kg/m2 and 69 showing BMIs >25.0 kg/m2. In patients with a BMI >25 kg/m2, the most common complications were contusion, hematomas and abnormal skin retraction, whereas no complications were observed in the patients with normal-weight. Conclusions: To minimise post-operative complications and maximise results, it is advisable to select patients based on their BMI assessment, the anatomy of the treated body area and the volume of fat to be removed. This approach aims to ensure that the patients are suitable for the procedure and the achieved results align with their aesthetic expectations.

Analysis of the Factors Affecting the Male-Female Sex Ratio of Babies Born through Assisted Reproductive Technology.

BACKGROUND: Until now, the sex ratio in a population is believed to be relatively stable with no male/female preponderance. There has been an increasing amount of evidence to suggest that assisted conception may significantly impact on sex ratio (SR). Several factors have been suggested to affect SR such as parental variables (paternal race, maternal age, and body mass index-(BMI), methods of fertilisation (in-vitro fertilisation/intracytoplasmic sperm injection), stage of embryo transfer (cleavage/blastocyst), type of IVF cycle (fresh/cryopreserved), medications used for controlled ovarian stimulation, poor sperm motility, and even culture media. OBJECTIVES: This study aims to investigate the potential impact of the different ART procedures on sex ratio. It will also explore the relationship between paternal race, maternal age and body mass index BMI on sex ratio. METHODS: A retrospective cohort study from January 2017 to December 2023. Participants were women who had successful ART and delivery at Ninewells Assisted Conception Unit (NACU) Dundee and ART centre of Lagos University Teaching Hospital, Nigeria. RESULTS: Overall, 294 (66.2%) of the case records and 150 (33.8%) were evaluated from NACU and LUTH respectively. More male infants 244 (66.8%) were delivered following pregnancies conceived with blastocyst embryo stage transfer when compared with female infants which stood at 121 (33.2%). Concerning cleavage embryo stage transfer, 56 (70.9%) were in favour of female newborns while males accounted for 23 (29.1%). CONCLUSION: The study revealed that there is an increase in the proportion of male babies born following certain assisted conception techniques such as blastocyst stage embryo transfer and IVF while more female babies were born when cleavage stage embryos were transferred or when ICSI was used as a method of fertilisation.

CONTEXTE: Jusqu'à présent, le rapport de masculinité au sein d'une population est considéré comme relativement stable, sans prépondérance masculine/féminine. De plus en plus de preuves suggèrent que la procréation assistée peut avoir un impact significatif sur la sex-ratio (SR). Plusieurs facteurs ont été suggérés pour affecter la SR, tels que les variables parentales (race paternelle, âge maternel et indice de masse corporelle-IMC), les méthodes de fécondation (fécondation in vitro/injection intracytoplasmique de spermatozoïdes), le stade du transfert d'embryon (clivage/blastocyste), le type de Cycle de FIV (frais/cryoconservé), médicaments utilisés pour une stimulation ovarienne contrôlée, mauvaise motilité des spermatozoïdes et même milieux de culture. OBJECTIFS: Cette étude vise à étudier l'impact potentiel des différentes procédures de TAR sur le sex-ratio. Il explorera également la relation entre les variables parentales telles que la race paternelle, l'âge de la mère et l'indice de masse corporelle (IMC) sur le sex-ratio. Méthodes : Une étude rétrospective de janvier 2017 à décembre 2023. Les participantes étaient des femmes qui ont eu un TAR et un accouchement réussis à l'unité de conception assistée de Ninewells (NACU) de Dundee et au centre de TAR de l'hôpital universitaire de Lagos, au Nigeria. RESULTATS: Au total, 294 (66,2 %) des dossiers de cas et 150 (33,8 %) ont été évalués respectivement par le NACU et le LUTH. Un plus grand nombre de nourrissons de sexe masculin, 244 (66,8 %), ont accouché à la suite de grossesses conçues avec transfert de stade embryonnaire de blastocyste, par rapport aux nourrissons de sexe féminin, qui s'élevaient à 121 (33,2 %). Concernant le transfert de stades embryonnaires par clivage, 56 (70,9%) étaient en faveur des nouveau-nés de sexe féminin tandis que les mâles représentaient 23 (29,1%). CONCLUSION: L'étude a révélé qu'il y a une augmentation de la proportion de bébés mâles nés suite à certaines techniques de procréation assistée telles que le transfert d'embryons au stade blastocyste et la FIV, tandis qu'un plus grand nombre de bébés femelles sont nés lorsque des embryons au stade clivage ont été transférés ou lorsque l'ICSI a été utilisée comme méthode de fertilisation. MOTS-CLÉS: Ratio de sexes, ICSI, FIV, Blastocyste, Clivage, Race, IMC, Embryon congelé/frais.

Dietary eggs, egg nutrients, polygenic score for body mass index, "Western pattern" diet, and weight change, a prospective analysis in the Women's health initiative.

BACKGROUND & AIMS: Eggs contain nutrients which could help enrich the diets of postmenopausal women. Egg consumption and elevated body weight have been associated with elevated risk of serious chronic disease. It is possible that elevated body weight mediates between egg consumption and serious chronic disease. However, few studies exist on the link between egg consumption and body weight in post-menopausal women, and none of them accounted for genetic weight gain predispositions. Our objective was to examine associations between egg consumption, body weight, and genetic predisposition for an elevated Body Mass Index (BMI), in postmenopausal women. METHODS: We analyzed data from 4439 healthy Women's Health Initiative participants of European descent during a 6-year follow up using multivariable generalized linear mixed models to prospectively evaluate egg and egg-nutrient intake (measured by a food frequency questionnaire) against body weight and a BMI polygenic score (PGS-BMI) derived from GWAS meta-analysis effect-allele frequencies. RESULTS: We found a positive prospective association between change in egg intake and body weight during the 6-year follow up. For instance, at year 3, women whose intake had increased by 2.0 eggs/week had gained 0.70 kg (95%CI: 0.34, 1.07, p = 0.0002) more than women whose intake had decreased by 2.4 eggs/week, p-linear <0.0001. Cholesterol-intake and choline-intake, but not betaine-intake, showed similar significant associations. Exploratory analysis revealed that: 1) women only demonstrated these significant associations if they exhibited higher intakes of "Western-pattern" foods including processed and red meats, French fries, sweets and deserts, sugar-sweetened beverages, fried foods, and dietary fat, and dietary energy; and 2) there was a significant positive prospective association between PGS-BMI and body-weight change, but only in the top quintile of egg-intake change. CONCLUSIONS: We found significant positive prospective associations between weight change and changes in egg intake, cholesterol intake, and choline intake among healthy postmenopausal women of European ancestry in the Women's Health Initiative. Exploratory analyses revealed that: 1) these significant associations only obtained among women who ate large amounts of "Western-pattern" foods; and 2) women with a higher genetic susceptibility for an elevated BMI gained more weight only if they increased their egg intake considerably. Our results require confirmation.

Effect of body mass index on semen quality, sperm chromatin integrity and sperm DNA methylation.

Obesity represents a growing problem due to its impacts on human health and reproduction. In this study, we analysed semen quality, sperm DNA integrity and gene-specific CpG methylation in 116 healthy men from normal population. The men were divided into three groups according to their body mass index (BMI), and their ejaculates were analysed using standard methods, sperm chromatin structure assay (SCSA), methylation next generation sequencing (NGS) and amplicon sequencing. The sperm methylation NGS revealed six significantly differentially methylated regions (DMRs). Using subsequent targeted amplicon sequencing in 116 men, two of the DMRs were proved as differentially methylated in sperm of men with normal BMI vs. BMI ≥ 25. The DMRs were located in the EPHA8 and ANKRD11 gene. Also, we detected a significant decline in the EPHA8, ANKRD11 and CFAP46 gene methylation in association with increasing BMI values. The genes EPHA8 and ANKRD11 are involved in the nervous system and brain development; the CFAP46 gene plays a role in a flagellar assembly and is associated with sperm motility. Significantly lower rates of motile and progressive motile sperm were observed in men with BMI ≥ 30. Our results show that excess body weight can modify CpG methylation of specific genes, affect sperm motility, and compromise sperm chromatin integrity. These factors can stand behind the observed reduced fertility in men with obesity. The methylation changes might be transmitted to their offspring through sperm, and become a basis for possible developmental and reproductive issues in the next generation.

Dual Cross-Linked Networks Reinforced Polyimide Foams with Outstanding Piezoelectric Properties and Heat Resistance Performance.

The application of traditional isocyanate-based polyimide (PI) foams is highly hindered due to limited flame retardancy, poor mechanical properties, and relatively single functionality. Herein, we propose an effective method to fabricate dual cross-linked polyimide/bismaleimide (PI-BMI) foams with outstanding heat resistance and enhanced mechanical properties by incorporating bis(3-ethyl-5-methyl-4-maleimidophenyl)methane (ME-BMI) as the interpenetrating network. The results show that the prepared PI-BMI composite foams exhibit enhanced mechanical properties with lightweight characteristics (23-80 kg·m-3). When the ME-BMI loading reached 120 wt %, the tensile and compressive strength of PI-BMI composite foam can reach 1.9 and 7.8 MPa, which are 9.6 and 63.3 times higher than that of pure PI foam, respectively. In comparison with PIF-0, the 10% heat loss temperature (Td,10%) of PIF-90 improved by 156 °C. Moreover, the PI-BMI foam piezoelectric sensor containing fluorine groups presents a short response time (14.22 ms), high sensitivity (0.266 V/N), and outstanding stability (10 000 cycles). Besides, the sensor can accurately monitor human activity in different states. This work provides a promising strategy for designing multifunctional PI foams, making them suitable for applications in aerospace and microelectronics.

Transvaginal natural orifice transluminal endoscopic surgery hysterectomy in patients with body mass index >50: An Asian experience.

We present two cases of patients with body mass index (BMI) >50 undergoing transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for gynecological indications. Case 1 involves a 52-year-old woman with post-menopausal bleeding and suspicion of ovarian torsion, while case 2 describes a patient with newly diagnosed endometrial adenocarcinoma. Both cases highlight the feasibility and challenges of vNOTES in this patient population. To date, this is the first paper to describe the use of vNOTES in patients of Asian ethnicity, with BMI >50.

Nutrient intake and food selectivity in children with Tourette syndrome.

Objectives: Children with Tourette syndrome (TS) have been shown to exhibit high levels of food selectivity; however, its association with nutritional status has yet to be explored. The current study explored macro and micronutrient intake and food selectivity among children with and without TS, using 24-hour dietary recall and the Child Eating Behaviour Questionnaire.Method: Parents of 43 children diagnosed with TS and 38 age-matched children without a clinical diagnosis completed an online 24-hour food diary.Results: Fifty-eight per cent of children with TS were identified as falling outside of the healthy BMI range (underweight = 24.2%; overweight = 27.3%; obese = 6.1%). Children with TS also consumed fewer portions of fruit and vegetables along with meeting the daily reference nutrient intake guidelines significantly less often for vitamins B3, B6 and C, selenium and phosphorus compared to children without TS.Conclusions: Understanding the nutritional risk of children with TS relative to other children is important to clinicians and health care professionals who oversee nutritional inspection in primary care, and caregivers who are worried about the impact of limited or restricted diets.

Risk and determinants of sarcopenia in people with diabetes: a case-control study from Qatar Biobank cohort.

BACKGROUND: Diabetes is associated with impairments in muscle mass and quality increasing the risk of sarcopenia. Thus, this study aimed to investigate the odds of sarcopenia and its associated risk factors among Qatari adults (> 18 years), while exploring the modulating effects of health and lifestyle factors. METHODS: Using a case-control design, data from 767 participants (481 cases with diabetes and 286 controls without diabetes) was collected from Qatar Biobank (QBB). Sociodemographic, lifestyle factors including dietary intake, anthropometric and biochemical measures were analyzed. Handgrip strength, Dual X-ray absorptiometry (DXA), and Bio-impedance were used to assess muscle strength, muscle mass and muscle quality, respectively. The risk of sarcopenia was estimated using the European consensus on definition and diagnosis of sarcopenia. RESULTS: Cases with diabetes were older (55 vs. 36 years; P < 0.001), had higher BMI (31.6 vs. 28.3 kg/m2; P < 0.001), lower cardiorespiratory fitness (50.0% "Moderate" fitness for cases, 62.9% "High" fitness for controls), and consumed less total (59.0 vs. 64.0; P = 0.004) and animal protein (39.0 vs. 42.0; P = 0.001), compared to controls based on a computed score. Participants with diabetes also had lower appendicular lean mass/BMI, handgrip strength, and higher probability of sarcopenia/probable sarcopenia (P < 0.005). Adjusted multiple logistic regression revealed that elevated cardiorespiratory fitness (ß = 0.299, 95%CI:0.12-0.74) and blood triglycerides (ß = 1.475, 95% CI: 1.024-2.124), as well as being a female (ß = 0.086, 95%CI: 0.026-0.288) and having higher BMI (ß = 0.908, 95%CI: 0.852-0.967) and ALM/BMI (ß = 0.000, 95% CI: 0.000-0.007) are independent predictors (p < 0.05) of sarcopenia risk. CONCLUSIONS: This study highlights the intricate relationship between diabetes and sarcopenia, revealing modifiable risk factors. Individuals with diabetes were found to have a higher likelihood of sarcopenia, which was associated with lower fitness levels and higher blood triglycerides. Protective factors against sarcopenia included being female and having higher BMI and ALM/BMI ratios.