Ability of Anthropometric Measurements to Predict Metabolic Health among Patients in Alberta: A Cross-sectional Study in Primary Care.

Purpose: This study compared anthropometric and body fat percent (BF%) equations in relation to measures of metabolic health.Methods: BF% calculations (Bergman, Fels, and Woolcott) and anthropometric measurements were used to determine obesity among a sample of patients attending primary care in Alberta, Canada. Anthropometric variables included body mass index (BMI), waist circumference, waist:hip ratio, waist:height ratio, and calculated BF%. Metabolic Z-score was computed as the average of the individual Z-scores of triglycerides, total cholesterol, and fasting glucose and the number of standard deviations from the sample mean.Results: Five hundred and fourteen individuals were included (41.2% male, age: 53 ± 16y, BMI: 27.4 ± 5.7 kg/m2). BMI ≥ 30 kg/m2 detected the smallest number of participants (n = 137) as having obesity, while Woolcott BF% equation categorized the largest number of participants as having obesity (n = 369). No anthropometric or BF% calculation predicted metabolic Z-score in males (all p ≥ 0.05). In females, age-adjusted waist:height ratio had the highest prediction power (R2 = 0.204, p < 0.001), followed by age-adjusted waist circumference (R2 = 0.200, p < 0.001) and age-adjusted BMI (R2 = 0.178, p < 0.001).Conclusions: This study did not find evidence that BF% equations more strongly predicted metabolic Z-scores than other anthropometric values. In fact, all anthropometric and BF% variables were weakly related to metabolic health parameters, with apparent sex differences.

Association between adherence to plant-based dietary patterns and obesity risk: a systematic review of prospective cohort studies.

The worldwide prevalence of obesity and its comorbidities is staggering, and elevated body mass index represents a leading risk factor of death globally. Consistent evidence demonstrates a high-quality plant-based diet as an effective intervention for weight management, although it may be particularly challenging to adopt in its entirety for habitual meat consumers or individuals with especially poor-quality diets. Plant-based diets are increasingly studied using indices such as the overall plant-based diet index (PDI), healthful PDI, and unhealthful PDI, which offer more flexibility than a binary classification of vegetarianism and better facilitate translation into dietary recommendations. We summarized these recently accumulated studies to comprehensively evaluate plant-based diets in relation to obesity risk. We searched Medline, Embase, and CINAHL databases through January 2022 and identified 9 prospective adult cohorts. Reporting of results was consistent with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and certainty of the evidence was assessed using domains from GRADE. The PDI had a protective association with body weight gain and adiposity. Emphasis of healthful plant foods strengthened this association and emphasis of unhealthful plant foods demonstrated either a positive or null association. The certainty of the evidence was considered moderate. These findings have wide application to inform dietary interventions and sustainable policy recommendations. (Prospero ID: CRD42020198143).

Diet, Lifestyle Behaviours and Other Risk Factors Associated With Type 2 Diabetes Beyond Body Mass Index: A Mendelian Randomization Study.

OBJECTIVES: Our aim in this study was to identify promising targets for the prevention of type 2 diabetes in addition to weight loss. We conducted a Mendelian randomization (MR) study to investigate the body mass index (BMI)-independent associations of 16 risk factors, including diet, lifestyle behaviours and others, with type 2 diabetes. METHODS: We selected genetic variants as instrumental variables for diet, sleep traits, smoking, physical activity, education and blood pressure (BP) from European-descent genome-wide association studies (GWASs). Summary statistics for type 2 diabetes were derived from a recent GWAS with 74,124 European cases and 824,006 European controls. The inverse-variance weighted MR method was used to assess the associations of the risk factors with type 2 diabetes, followed by validation of robustness using different MR methods in sensitivity analyses. RESULTS: Genetically predicted insomnia (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.06 to 1.15), smoking initiation (OR, 1.14; 95% CI, 1.06 to 1.21), educational level (OR, 0.69; 95% CI, 0.65 to 0.74), hypertension (OR, 6.50; 95% CI, 3.13 to 13.50), systolic BP (OR, 1.02; 95% CI, 1.02 to 1.03) and diastolic BP (OR, 1.03; 95% CI, 1.02 to 1.03) had BMI-independent effects on type 2 diabetes risk. In addition, alcohol dependence (OR, 1.10; 95% CI, 1.05 to 1.16; BMI-adjusted OR, 1.04; 95% CI, 0.98 to 1.09) and vegetarian diet (OR, 0.50; 95% CI, 0.33 to 0.74; BMI-adjusted OR, 0.78; 95% CI, 0.57 to 1.06) appeared to be correlated with type 2 diabetes via a BMI-mediated pathway. Sensitivity analyses further confirmed the relationship between these factors and type 2 diabetes. CONCLUSIONS: In this systematic MR study, insomnia, smoking, education and BP had BMI-independent causal effects on the risk of type 2 diabetes, whereas alcohol dependence and vegetarian diet were associated with type 2 diabetes through BMI.

[Place of biomarkers in the renutrition of patients with serious Covid-19 infection: discussion around a clinical case]. / Place des biomarqueurs dans la renutrition des patients ayant une infection grave à Covid-19 : discussion autour d'un cas clinique.

Covid-19 infection is a potentially serious disease. Overweight, obesity, and diabetes are comorbidities frequently found in the severe form of the disease. Appropriate nutritional management of the patient is an integral part of care. We will discuss the renutrition of a 76-year-old, obese (BMI = 35kg/m2), malnourished patient, according to the 2021 Haute Autorité de santé criteria, with Covid-19 infection, admitted to the intensive care unit at the Bordeaux University Hospital for an acute respiratory distress syndrome. Adaptation of nutritional intakes was achieved by clinical and biological monitoring. A refeeding syndrome was treated on the first day of hospitalization in the intensive care unit. After thiamine supplementation and when kalemia and phosphatemia have been normalized, renutrition was started. Parenteral nutrition as a complement to oral nutrition was used. Parenteral nutrition was well tolerated; recommended caloric and protein intakes were achieved by the fourth day of hospitalization. The clinical evolution was favorable. In conclusion, patients with Covid-19 infection should be considered malnourished when admitted to the intensive care unit. Macro and micronutrient intakes adapted to metabolically stressed patients are essential. Biological monitoring including monitoring of ionogram, phosphate, uremia, creatinine, liver function tests and blood glucose is essential in the nutritional management of patients with serious Covid-19 infection.

Associations Between Obesity and Kidney Disease in Chinese Men and Women With Type 2 Diabetes: A Retrospective Cohort Study.

BACKGROUND: Our aim in this study was to explore the risk factors for kidney disease in Chinese men and women with type 2 diabetes (T2D) and to clarify the relationship between obesity and the risk of chronic kidney disease (CKD). METHODS: This retrospective study included 3,194 patients with T2D. Among 2,574 T2D patients without CKD at baseline, 753 with follow-up records of at least 12 months were included in the retrospective cohort. Logistic regression and Cox regression were used to evaluate the risk for CKD in men and women. A restricted cubic spline model was used to analyze the association of body mass index (BMI) and waist circumference (WC) with CKD risk. RESULTS: Multivariate logistic regression analysis suggested that obesity was a risk factor for T2D with CKD in men but not in women. After a median follow-up period of 2.8 years, the incidence of CKD in men with obesity was significantly higher than that in men with obesity with T2D (p=0.039), but there was no statistically significant difference between women with obesity and women without obesity with T2D (p=0.825). In the restricted cubic spline model analysis, BMI and WC were associated with CKD risk in a nonlinear fashion in males and females. The risk of CKD was higher in males with a BMI of ≥29.5 kg/m2 or a WC of ≥100 cm, whereas there was no difference observed in females. CONCLUSIONS: Obesity was strongly related to T2D with CKD in men. Male diabetes patients with obesity, especially abdominal obesity, are more likely to develop CKD.

[Obesity affects the chances of birth after frozen-thawed blastocyst transfer]. / L'obésité affecte les chances de naissance après transfert de blastocystes congelés.

OBJECTIVES: Both the number of frozen-thawed embryo transfers and the incidence of obesity have increased sharply in recent years in Assisted Reproductive Technology (ART) centers. The objective of our study is therefore to evaluate the impact of female obesity on pregnancy outcomes for frozen-thawed embryo transfer at blastocyst stage. METHODS: This is a single-center retrospective study conducted between January 1, 2016, and December 31, 2019, in our Assisted Reproduction Center in Calais. All consecutive cycles of frozen embryo transfers at blastocyst stage with artificial cycle were included. A total of 296 cycles could be included corresponding to 220 cycles realized in normal Body Mass Index (BMI) patients (18.5-24.9kg/m2) and 76 in obese patients (BMI≥30kg/m2). RESULTS: Live birth rates and implantation rates were significantly lower in obese patients compared with patients with a normal BMI (respectively 9.2 % vs. 22.3 % and 10 % vs. 20.8 %, P=0.01 and P<0.01). CONCLUSIONS: Therefore, our study showed that obesity is associated with a lower rate of live birth and implantation following frozen-thawed blastocyst transfers in artificial cycles. This could be explained by different factors that can be both embryonic and/or extra-embryonic.

Is recipient's body mass index a determinant of short term complications in early renal transplantation?

OBJECTIVES: Obesity prevalence has increased over the past 20 years in the general population and among kidney transplant recipients. General surgical belief is that obesity increases surgical difficulty. The aim of this study was to assess the impact of Body Mass Index (BMI) on perioperative complications. METHODS: All kidney transplantations performed in adults in our centre from 2006 to 2011 were analysed. Data on patients' characteristics, surgical protocol, intra and postoperative complications and renal function were collected. Patients were divided into 4 groups as follows: underweight (BMI<18.5kg/m2), normal weight (18.5kg/m2≤BMI<25kg/m2), overweight (25kg/m2≤BMI<30kg/m2) and obese (BMI≥30kg/m2). We also studied the impact of BMI on complications using it as a continuous variable to identify potential threshold values. RESULTS: Among 694 patients included, 52% had normal BMI, 7%, 31% and 9% were underweight, overweight and obese, respectively. In multivariate analysis, overweight was significantly associated with longer operative time compared to normal-weight patients (estimated mean difference of 10,4min, 95% confidence interval (CI) [4.0; 16.9]) and obesity was associated with an increased risk of wound dehiscence (odds ratio 3.1, 95%CI [1.3; 7.3] compared with normal-weight patients). Considering BMI as a continuous variable, the risk of parietal dehiscence significantly increased beyond a BMI of 26kg/m2, intraoperative blood loss and the risk of ureteral stenosis beyond 32kg/m2 and the risk of abdominal wall hematoma beyond a BMI of 34kg/m2. CONCLUSIONS: We found BMI thresholds above which intraoperative blood loss and the risk of parietal dehiscence, ureteral stenosis, and parietal hematoma significantly increased. LEVEL OF EVIDENCE: 3.

Acide hyaluronique intra articulaire dans la gonarthrose: une étude long-terme, ouverte, de Phase IV, avec analyse détaillée par stade de Kellgren-Lawrence.

INTRODUCTION: Les injections intra articulaires (IA) d'acide hyaluronique (HA) désignées sous le nom de viscosupplémentation (VS), sont fréquemment utilisées dans le traitement symptomatique de la gonarthrose (OA), une affection ostéo-articulaire chronique douloureuse et handicapante, qui touche une fraction importante de la population âgée. La sévérité de la gonarthrose est en général décrite par la classification en stades radiologiques de Kellgren-Lawrence (KL). La VS a été largement étudiée à travers de nombreux essais cliniques; cependant, les résultats sont rarement analysés en détail, en fonction du stade KL. MÉTHODE: Une étude ouverte importante, portant sur 1 177 patients souffrant de gonarthrose, fut réalisée de 2004 à 2007. Chaque patient a reçu un traitement de VS consistant en 3 injections d'ARTHRUM H 2% (LCA Pharmaceutical, Chartres, France). A l'inclusion, les patients ont été décrits par leur profil démographique, leur indice de masse corporelle (IMC), leur stade KL et leur état clinique selon les sous-scores douleur et fonction de l'indice Western Ontario and McMaster Universities (WOMAC). Les visites de suivi étaient à M3, M6 et M9 (mois) après la VS. Cette large base de données a été entièrement retraitée en 2019, de manière à fournir une analyse séparée par stade KL, et fut complétée par l'évaluation des taux de patients répondeurs (%) au traitement, selon l'Outcome Measures in Rheumatoid Arthritis Clinical Trials & Osteoarthritis Research Society International (OMERACT-OARSI). L'analyse fut menée à la fois sur les populations en intention de traiter (ITT) et per protocole (PP) ayant terminé l'étude. RÉSULTATS: En analyse ITT du critère principal, les variations du sous-score WOMAC A (douleur) depuis l'inclusion jusqu'à la fin de l'étude, ont été respectivement de 19,8 ; 19,8 ; 17,8 et 14,2, sur une échelle de 0-100, pour les patients des stades KL I à KL IV. En analyse PP dans les mêmes conditions, ces variations ont été de 20,6 ; 19,9 ; 17,1 et 11,7. Tous ces résultats étaient significatifs par rapport aux valeurs à l'inclusion (p<0.001) et cliniquement pertinents à chaque stade KL. Des améliorations significatives ont été également observées pour le sous-score WOMAC C (fonction), et pour les autres critères secondaires. Le taux de répondeurs OMERACT-OARSI variait de 72 à 82% pour les patients KL I à III à M6 et M9. Pour les patients KL IV, le maximum atteint a été 47.7% à M6. Les autres paramètres tels que le sexe, l'IMC ou l'âge, ne furent pas identifiés comme des facteurs de pronostic pour la réponse à la VS. CONCLUSIONS: L'analyse détaillée par stade KL d'une large cohorte de patients suivis en ouvert, suggère le traitement de VS avec ARTHRUM H 2% est applicable à une grande variété de patients gonarthrosiques.

Age, body mass index, and weight gain do not increase sympathetic activity during pregnancy.

Associations between prepregnancy body mass index, gestational weight gain, maternal age, and basal sympathetic nervous system activity (SNA) in normotensive pregnant women have not been explored. Retrospective analysis of microneurography records from 74 normotensive pregnant women during their third trimester indicated that although pregnancy is associated with rapid weight gain, this does not influence SNA. There were also no associations between maternal age and SNA, but more studies are needed to confirm this interpretation. Novelty Neither age nor excessive weight gain appears to influence sympathetic activity during normotensive pregnancy.

Comparación entre la percepción corporal y el índice de masa corporal en estudiantes de secundaria de dos municipios de Yucatán / Comparison between body perception and body mass index in secondary students from two municipalities of Yucatan / Comparação entre percepção corporal e índice de massa corporal em estudantes do ensino médio de dois municipios de Yucatán / Comparaison entre la perception corporelle et l'indice de masse corporelle chez des élèves du secondaire de deux municipalités du Yucatán

Resumen Objetivo Comparar la relación de la Percepción de la Imagen Corporal y el Índice de Masa Corporal en estudiantes de secundaria de dos municipios de Yucatán. Material y Métodos Estudio cuantitativo y transversal, en 462 estudiantes de 11 a 17 años pertenecientes a escuelas de los municipios de Abalá y Chacsinkín, Yucatán. Se tomó el peso corporal y la talla, se calculó el Índice de Masa Corporal (IMC)/edad, de acuerdo a los patrones de la Organización Mundial de la Salud (OMS) para adolescentes. Se determinó la percepción de la imagen corporal mediante el instrumento Análisis de la Percepción de la Imagen Corporal (APC), propuesta por Stunkard y Stellard, modificado por Collins. Para el análisis estadístico inferencial se utilizó la prueba Chi-cuadrara con un valor de significancia estadística de 5%. Resultados 62.9% de los adolescentes, tienen un Índice de Masa Corporal normal, mientras que 35.6% presentan una prevalencia combinada de obesidad y sobrepeso. En cuanto a Percepción de la Imagen Corporal, 28.8 % de los adolescentes se percibieron de acuerdo con su IMC real; 25.3% se percibieron con IMC mayor al real y 45.9% se percibieron con IMC menor al que tienen en realidad Conclusiones En el municipio de Abala, los adolescentes presentaron mayor prevalencia de normo peso y exceso de peso; frecuencia mayor de concordancia entre la percepción corporal y el IMC real y sobre estimación de su IMC, a diferencia de la mayor frecuencia de subestimación que se presentó en los adolescentes del municipio de Chacsinkín Los adolescentes de ambos municipios con exceso de peso, subestimaron su IMC y no lo identifican como un problema de salud, lo que representa un área de oportunidad para el trabajo del equipo multidisciplinario de salud.

Abstract Objective To compare the relationship between the Perception of the Body Image and the Body Mass Index in secondary school students of two municipalities of Yucatán. Material and Methods Quantitative and cross-sectional study, with a population of 462 students aged from 11 to 17 belonging to schools in the municipalities of Abalá and Chacsinkin, Yucatán. Body weight and height were taken; Body Mass Index (BMI) by age was calculated according to the patterns of the World Health Organization (WHO) for adolescents. Body image perception was determined by means of the Body Image Perception Analysis (BPI) instrument proposed by Stunkard and Stellard and modified by Collins. For the inferential statistical analysis, the Chi-square test with a statistical significance value of 5% was used. Results 62.9% of adolescents have a normal Body Mass Index; while 35.6% have a combined prevalence of obesity and overweight. Regarding Perception of Body Image, 28.8% of adolescents were perceived according to their real BMI; 25.3% were perceived with BMI greater than the real and 45.9% were perceived with BMI lower than they actually have Conclusions In the municipality of Abalá, adolescents presented a higher prevalence of normal weight and excess weight; higher frequency of concordance between body perception and real BMI and overestimation of their BMI, unlike the higher frequency of underestimation that occurred in adolescents in the municipality of Chacsinkin Adolescents in both municipalities with excess weight underestimated their BMI and they did not identify it as a health problem, which represents an area of opportunity for the work of the multidisciplinary health team.

Sumário Objetivo Comparar a relação entre a percep9áo da imagem corporal e o índice de massa corporal em estudantes do ensino médio de dois municipios de Yucatán. Material e Métodos Estudo quantitativo e transversal, em 462 alunos de 11 a 17 anos pertencentes a escolas dos municipios de Abalá e Chacsinkin, Yucatán. O peso corporal e a altura foram medidos, calculado o Índice de Massa Corporal (IMC) / idade, de acordo com os padrões da Organização Mundial da Saúde (OMS) para adolescentes. A percepção da imagem corporal foi determinada utilizando o instrumento Body Image Perception Analysis (APC), proposto por Stunkard e Stellard, modificado por Collins. O teste do qui-quadrado com valor de significância estatística de 5% foi utilizado para a análise estatística inferencial. Resultados 62,9% dos adolescentes têm um Índice de Massa Corporal normal, enquanto 35,6% têm uma prevalência combinada de obesidade e sobrepeso. Em relação a percepção da imagem corporal, 28,8% dos adolescentes foram percebidos de acordo com o IMC real; 25,3% foram percebidos com IMC maior que o real e 45,9% foram percebidos com IMC menor do que realmente Conclusões No municipio de Abala, os adolescentes apresentaram maior prevalência de peso normal e excesso de peso; maior frequência de concordância entre a percepção corporal e o IMC real e superestimação do IMC, diferentemente da maior frequência de subestimação que ocorreu em adolescentes no município de Chacsinkín. Os adolescentes dos dois municípios com excesso de peso subestimaram seu IMC e não o identificam como um problema de saúde, o que representa uma área de oportunidade para o trabalho da equipe multiprofissional de saúde.

Résumé Objectif Comparer la relation entre la Perception de l'Image Corporelle et l'Indice de Masse Corporelle chez des élèves du secondaire de deux municipalités du Yucatan. Matériel et méthodes Étude quantitative et transversale, avec une population de 462 élèves, de 11 a 17 ans, inscrits dans des écoles des municipalités d'Abalá et de Chacsinkin, Yucatán. Le poids et la taille ont été relevés, et l'Indice de Masse Corporelle en fonction de l'âge (IMC-pour-l'âge) a été calculé selon les normes de l'Organisation Mondiale de la Santé (OMS) pour adolescents. La Perception de l'Image Corporelle a été déterminée a l'aide de l'instrument Analyse de la Perception de l'Image Corporelle (BPA) proposé par Stunkard et Stellard et modifié par Collins. Le test du Khi-deux avec une valeur de signification statistique de 5 % a été utilisé pour l'analyse statistique inférentielle. Résultats 62,9 % des adolescents ont un Indice de Masse Corporelle normal alors qu'il existe une prévalence combinée d'obésité et de surpoids de 35,6 %. La Perception de l'Image Corporelle a été en accord à l'IMC réel dans 28,8 % des cas. 25,3 % se sont per9us comme ayant un IMC supérieur à leur IMC réel et 45,9 % comme ayant un IMC inférieur à leur IMC réel. Conclusions Dans la municipalité d'Abala, les adolescents ont présenté une prévalence plus élevée de poids normal et de surpoids, une fréquence plus élevée de concordance entre leur perception corporelle et l'IMC réel et une surestimation de leur IMC, en comparaison avec la fréquence plus élevée de sous-estimation chez les adolescents de la municipalité de Chacsinkin. Les adolescents des deux municipalités ayant un excès de poids ont sous-estimé leur IMC et ne l'ont pas identifié comme un problème de santé, ce qui constitue un champs d'opportunités pour le travail de l'équipe de santé multidisciplinaire.

Elevated body mass index during pregnancy and gestational weight gain in HIV-infected and HIV-uninfected women in Cape Town, South Africa: association with adverse birth outcomes.

OBJECTIVES: To examine the association between maternal body mass index (BMI) and gestational weight gain (GWG) and adverse birth outcomes in HIV-infected and HIV-uninfected women. METHODS: In an urban South African community, 2921 consecutive HIV-infected and HIV-uninfected pregnant women attending primary healthcare services were assessed at their first antenatal visit. A subset of HIV-infected women enrolled in a longitudinal study was assessed three times during pregnancy. All women had birth outcome data from medical records and study questionnaires. In analyses, the associations between BMI, GWG, maternal factors and adverse birth outcomes were assessed with logistic regression models. RESULTS: The estimated pre-pregnancy BMI median was 29 kg/m2 (IQR, 24-34) overall, 29 kg/m2 (IQR, 24-34) for HIV-uninfected and 28 kg/m2 (IQR, 24-34) for HIV-infected women; HIV prevalence was 38%. In adjusted models, increased BMI in the overall cohort was positively associated with age, haemoglobin and parity at first antenatal visit. Maternal obesity was associated with increased likelihood of having high birthweight (aOR 2.54, 95% CI 1.39-4.66) and large size for gestational age (aOR 1.66, 95% CI 1.20-2.31) infants. In the subset cohort, GWG was associated with increased likelihood of spontaneous preterm delivery (aOR 4.35, 95% CI 1.55-12.21) and high birthweight (aOR 3.00, 95% CI 1.22-7.34) infants. CONCLUSION: Obesity during pregnancy is prevalent in this setting and appears associated with increased risk of adverse birth outcomes in both HIV-infected and HIV-uninfected women. Weight management interventions targeting women of child-bearing age are needed to promote healthy pregnancies and reduce adverse birth outcomes.

OBJECTIFS: Examiner l'association entre l'indice de masse corporelle maternelle (IMC) et le gain de poids gestationnel (GPG) et les résultats de naissance défavorables chez les femmes infectées et non infectées par le VIH. MÉTHODES: Dans une communauté urbaine sud-africaine, 2921 femmes enceintes consécutives infectées et non infectées par le VIH visitant les services de soins de santé primaires ont été évaluées lors de leur première visite prénatale. Un sous-ensemble de femmes infectées par le VIH inscrites à une étude longitudinale a été évalué trois fois pendant la grossesse. Toutes les femmes avaient des données sur les résultats à la naissance provenant des dossiers médicaux et des questionnaires d'étude. Dans les analyses, les associations entre l'IMC, le GPG, les facteurs maternels et les résultats de naissance défavorables ont été évalués en utilisant des modèles de régression logistique. RÉSULTATS: L'IMC médian estimé avant la grossesse était globalement de 29 kg/m2 (IQR, 24-34) pour les femmes non infectées par le VIH et 28 kg/m2 (IQR, 24 -34) pour celles infectées par le VIH; La prévalence du VIH était de 38%. Dans les modèles ajustés, l'augmentation de l'IMC dans la cohorte globale était positivement associée à l'âge, à l'hémoglobine et à la parité lors de la première visite prénatale. L'obésité maternelle a été associée à une augmentation de la probabilité d'avoir un nourrisson avec un poids élevé à la naissance (ORa 2,54, IC95%: 1,39-4,66) et une grande taille pour l'âge gestationnel (ORa 1,66, IC95%: 1,20-2,31). Dans la cohorte du sous-ensemble, le GPG était associé à une probabilité accrue d'accouchement prématuré spontané (aOR 4,35, IC95%: 1,55-12,21) et à des nourrissons avec un poids de naissance élevé (aOR 3,00, IC95%: 1,22-7,34). CONCLUSION: L'obésité pendant la grossesse est répandue dans ce contexte et semble associée à un risque accru d'accouchements défavorables chez les femmes infectées et non infectées par le VIH. Des interventions de prise en charge du poids ciblant les femmes en âge de procréer sont nécessaires pour promouvoir des grossesses saines et réduire les issues de naissance défavorables.

[Low Body Mass Index and impact of antiretroviral therapy on nephrotoxicity, chronic renal disease among HIV-infected patients in Brazzaville, Congo]. / Faible indice de masse corporelle et impact des antirétroviraux sur la néphrotoxicité, la maladie rénale chronique chez les patients infectés par le VIH à Brazzaville, Congo.

OBJECTIVE: To describe the incidence and risks factors of ART induced nephrotoxicity and chronic kidney disease in HIV-1-infected adults with low body mass index (<18.5kg/m2). METHODS: A retrospective cohort study at the Ambulatory Treatment Center in Brazzaville, Congo. Patients with estimated glomerular filtration rate decrease by 25% compared to baseline or a 0.5mg/dL increase in serum creatinine above baseline were classified as having nephrotoxicity, and chronic kidney disease was defined as a value less than 60mL/min/1.73m2. We used Cox proportional hazards regression models to determine factors associated with nephrotoxicity and chronic kidney disease. RESULTS: Of 325 patients, 73.23% were women. Median values were an age 37.55 years (IQR: 33.51-44.96), weight 45kg (IQR: 41-49), CD4 count 137.5 cells/µL (42-245). In the first 24-months, follow-up on ART incidence rate of nephrotoxicity and chronic kidney disease was 27.95 and 7.44 per 100 persons-year respectively. Multivariate analysis identified as a risk factor of nephrotoxicity, baseline haemoglobin below or equal 8g/dL (aHR=2.25; 95%CI 1.28-3.98; P=0.005) and the use of tenofovir (aHR=1.51; 95%CI 1.01-2.27; P=0.04). DFG between 60-80 mL/min/1.73 m2 (aHR=0.35; 95%CI 0.21-0.59; P<0.001) and 45-59mL/min/1.73 m2 (aHR=0.10; 95%CI 0.01-0.72; P=0.02) was not a contraindication for initiating antiretroviral therapy. Each 10-year older age was associated with an increased risk of developing chronic kidney disease (aHR=1.95; 95%CI 1.2-3.17; P=0.007). CONCLUSION: Incidence of nephrotoxicity and chronic kidney disease were high. African HIV-positive patient with low body mass index at baseline need close monitoring of their renal function when treated with tenofovir.

GeoLaus, une étude de l'influence des caractéristiques géo-environ- nementales sur la santé.

GeoLaus, a Study on the Influence of Geo-Environmental Characteristics on Population Health Abstract. Geographic information on risk factors for health or disease is increasingly being used to understand the determinants of health. GeoLaus is a project initiated in 2015 that studies the impact of living spaces and socio-economic situation, on physical and mental health and on different lifestyle habits. This paper discusses and illustrates the use of spatial information in CoLaus to understand the determinants of obesity and daytime sleepiness. The first results of the GeoLaus study open new perspectives on population health.

Résumé. Des informations géographiques sur les facteurs de risque pour la santé ou sur la maladie sont de plus en plus utilisées dans le but de mieux comprendre les déterminants de la santé. GeoLaus est un projet initié en 2015 qui étudie l'impact des lieux de vie et de la situation socio-économique sur la santé physique, mentale et sur les différentes habitudes de vie. Cet article discute et illustre l'utilisation de l'information spatiale dans CoLaus pour mieux comprendre les déterminants de l'obésité et de la somnolence. Les premiers résultats de l'étude GeoLaus ouvrent des nouvelles perspectives en matière de santé populationnelle.

Association between dietary flavonoid intake and obesity among adults in Korea.

This study aimed to investigate the association between dietary flavonoid intake and the prevalence of obesity using body mass index (BMI), waist circumference, and percent body fat (%BF) according to sex among Korean adults. Based on the Korean Health and Nutrition Examination Survey 2008-2011, 23 118 adults in Korea were included. Dietary intakes were obtained using 24-h dietary recall data. A higher total intake of flavonoid was associated with a lower prevalence of obesity in women, based on %BF (odds ratio [95% confidence interval] = 0.82 [0.71-0.94]), and abdominal obesity (0.81 [0.71-0.92]). The intake of flavonols (0.88 [0.78-0.99]), flavanones (0.81 [0.72-0.92]), flavanols (0.85 [0.74-0.97]), isoflavones (0.85 [0.75-0.96]), and proanthocyanidins (0.81 [0.71-0.92]) was inversely associated with abdominal obesity, and a higher intake of flavanones (0.87 [0.76-0.99]) and proanthocyanidins (0.85 [0.75-0.98]) was associated with a lower prevalence of obesity, with respect to %BF in women. In contrast, the intake of flavonols (1.16 [1.02-1.33]), flavanones (1.18 [1.04-1.35]), and anthocyanidins (1.27 [1.11-1.46]) was positively associated with obesity based on BMI in men. In conclusion, high intake of dietary flavonoids may be associated with a decreased prevalence of abdominal obesity and obesity, based on %BF, among women. Novelty Higher flavonoid intake was associated with decreased prevalence of abdominal obesity and obesity based on %BF in Korean women. However, in men, the intake of flavonols, flavanones, and anthocyanidins was positively associated with obesity as given by BMI.

The sarcoplasmic reticulum and SERCA: a nexus for muscular adaptive thermogenesis.

We are currently facing an "obesity epidemic" worldwide. Promoting inefficient metabolism in muscle represents a potential treatment for obesity and its complications. Sarco(endo)plasmic reticulum (SR) Ca2+-ATPase (SERCA) pumps in muscle are responsible for maintaining low cytosolic Ca2+ concentration through the ATP-dependent pumping of Ca2+ from the cytosol into the SR lumen. SERCA activity has the potential to be a critical regulator of body mass and adiposity given that it is estimated to contribute upwards of 20% of daily energy expenditure. More interestingly, this fraction can be modified physiologically in the face of stressors, such as ambient temperature and diet, through its physical interaction with several regulators known to inhibit Ca2+ uptake and muscle function. In this review, we discuss advances in our understanding of Ca2+-cycling thermogenesis within skeletal muscle, focusing on SERCA and its protein regulators, which were thought previously to only modulate muscular contractility. Novelty ATP consumption by SERCA pumps comprises a large proportion of resting energy expenditure in muscle and is dynamically regulated through interactions with small SERCA regulatory proteins. SERCA efficiency correlates significantly with resting metabolism, such that individuals with a higher resting metabolic rate have less energetically efficient SERCA Ca2+ pumping in muscle (i.e., lower coupling ratio). Futile Ca2+ cycling is a versatile heat generating mechanism utilized by both skeletal muscle and beige fat.

Higher baseline fat oxidation promotes gynoid fat mobilization in response to a 12-week exercise intervention in sedentary, obese black South African women.

This 12-week exercise intervention study assessed changes in cardiorespiratory fitness (CRF), energy expenditure (EE), and substrate utilisation at rest and during exercise in obese, black South African (SA) women and explored associations with changes in body composition. Black SA women (body mass index: 30-40 kg·m-2, age: 20-35 years) were randomised into control (CTL; n = 15, maintaining usual activity) or exercise (EXE; n = 20; 12 weeks, 4 days·week-1, 40-60 min·day-1 at >70% peak heart rate) groups. Pre- and post-intervention testing included peak oxygen consumption, resting and steady state (50% peak oxygen consumption) EE, respiratory exchange, and body composition (dual-energy X-ray absorptiometry). Dietary intake (4-day) and daily step-count (ActivPAL, activPAL3c; PAL Technologies Ltd, Glasgow, UK) was collected at pre-testing and at 4, 8, and 12 weeks. EXE increased peak oxygen consumption (24.9 ± 2.4 to 27.6 ± 3.4 mL·min-1·kg-1; p < 0.001) and steady state fat oxidation rates (7.5 ± 2.5 to 9.0 ± 2.7 mg·min-1·kg-1 fat-free soft tissue mass; p = 0.003) (same relative exercise intensity). CTL remained unchanged (p > 0.05). EXE reduced proportional gynoid fat mass (percentage total fat mass, p = 0.002). Baseline resting carbohydrate oxidation rates (p = 0.036) and steady state fat oxidation rates (p = 0.021) explained 60.6% of the variability in Δgynoid fat mass (p < 0.001) in EXE. This 12-week exercise intervention improved CRF and steady state fat oxidation rates. Greater reliance on fat oxidation at baseline promoted proportional reductions in gynoid, not visceral, fat mass in response to exercise training. Novelty Combined exercise training in obese black South African women increased cardiorespiratory fitness and rates of fat oxidation during steady state exercise. Exercise training reduced proportional gynoid, not visceral, fat, potentially representing an ethnic/sex-specific response. Baseline substrate utilisation (resting and steady state exercise (50% peak oxygen uptake)) predicted changes in gynoid fat mass.

Menstrual blood losses and body mass index are associated with serum ferritin concentrations among female varsity athletes.

Preventing and treating iron deficiency are important components in the nutritional care of female varsity athletes, as these interventions may improve aerobic endurance and athletic performance. We examined the factors associated with ferritin concentration in 30 female varsity athletes (18-30 years) at the University of British Columbia in Vancouver, Canada. Biochemical indicators of iron and inflammation status, dietary intake, supplementation practices, weight, height, and menstrual blood losses were assessed. Iron deficiency prevalence was 20% (n = 6/30; inflammation-adjusted ferritin <15 µg/L). Multiple linear regression was used to assess the associations of a number of independent explanatory variables with log-transformed serum ferritin (µg/L) as the continuous outcome variable. A 1-unit increase in body mass index (BMI; kg/m2) was associated with 22% (95% CI: 9%-37%) higher mean ferritin concentrations, and a 1-point increase in menstrual loss score was associated with 1% (95% CI: 1%-2%) lower ferritin concentrations. Hemoglobin and hepcidin concentrations, inflammation biomarkers, consumption of iron supplements in any form or dose for ≥3 days/week, and age were not significantly associated with ferritin concentrations in the final adjusted model. Novelty Estimated monthly menstrual losses and BMI were associated with serum ferritin concentrations in female athletes in our study. These are easy-to-measure, noninvasive measurements that should be considered in the assessment of risk of iron deficiency in female athletes.

Injections intra articulaires (IA) d'acide hyaluronique (AH) dans le traitement symptomatique de la gonarthrose : une méta-analyse des injections uniques (mono-injections).

INTRODUCTION: La viscosupplémentation du liquide synovial par injections intra articulaires (IA) d'acide hyaluronique (AH), est un traitement symptomatique bien connu dans la gonarthrose. La question se pose de savoir si les traitements par injection unique (mono-injection) peuvent présenter autant d'efficacité que les multi-injections (3 à 5). MÉTHODES: Une méta-analyse des résultats publiés pour les essais de mono-injections IA de AH a été réalisée. Le critère d'efficacité retenu a été le sous-score douleur de l'indice Western Ontario and MacMaster universities (WOMAC A). Toutes les conceptions d'études ont été admises, depuis les essais randomisés contrôlés jusqu'aux études observationnelles ouvertes à simple bras. Une recherche extensive a été effectuée à partir de PubMed, Google, Google Scholar, et des listes de références trouvées dans les méta-analyses récentes, pour obtenir tous les articles publiés avant fin avril 2018. Les profils des populations furent analysés en termes d'âge, de sexe, d'indice de masse corporelle (IMC) et de stade radiologique selon Kellgren-Lawrence (KL). Les résultats d'injection IA unique de placebo, ont été pris en compte pour créer une base permettant des comparaisons post-hoc. Chaque bras AH IA étudié a été comparé à un bras placebo IA (seul ou mixé), de manière à présenter un profil KL similaire, contrôlé à l'aide du test Chi2. Les tailles de l'effet (ES) avec intervalles de confiance (IC 95%) et p-valeurs furent calculées et synthétisées pour chacune des visites de contrôle à 1, 2, 3 et 6 mois. En parallèle, une approche globale a été utilisée afin de représenter les variations par rapport à la baseline, pour chacun des sous-groupes étudiés. RÉSULTATS: En partant de 1 547 citations, 28 études ont été incluses dans la méta-analyse, décrivant 4 129 patients traités par mono-injection: 3 360 ont reçu de l'AH IA et 769 patients ont reçu du placebo IA. Le patient moyen (SD) traité par AH IA était âgé de 61,2 (9,6) ans dont 63% de femmes, avec un IMC de 28,0 (4,1) kg/m2, et un stade radiologique à 47% KL III pour 3% KL IV. Un bon appariement du profil KL a été obtenu pour 26 des 31 bras AH IA. Sur l'ensemble de la population AH IA, ES = 0,30 (0,25; 0,35) à 3 mois et ES = 0,39 (0,33; 0,44) à 6 mois. Dans une analyse restreinte, après élimination des cas aberrants, des KL mal appariés et des bras actifs < 30 patients, les résultats sont restés inchangés, ES = 0,29 (0,23; 0,34) et ES = 0,40 (0,34; 0,45) à 3 et 6 mois respectivement, tandis que l'hétérogénéité était améliorée. DISCUSSION: Il existe certainement des limites à la méthode de comparaison post-hoc versus placebo, appliquée à des essais individuels. Mais pour chaque synthèse par sous-groupe ou groupe, les résultats ont été confirmés en utilisant plusieurs approches statistiques et différentes méthodes de pondération. Cette méta-analyse suggère que les résultats des mono-injections sont similaires à ceux des multi-injections d'acide hyaluronique intra articulaire en termes de soulagement de la douleur, dans le traitement de la gonarthrose.

Influence of body mass index on health-related quality of life after surgical treatment of intra-articular distal radius fractures. A retrospective 7-year follow-up study.

Morbid obesity is associated with reduced health-related quality of life (HRQOL), increased morbidity and mortality. Little is known about the correlation between obesity and complex distal radius fractures (DRF). The purpose of this study was to examine the effect of being overweight on postoperative HRQOL after surgically treated intra-articular DRF. Fifty-three patients were included in this retrospective study with 7 years' mean follow-up (mean 7.2±0.4, range 6.4-7.9 years) after volar plating of an intra-articular DRF (AO-type C). All patients were categorized by their body mass index (BMI) into two study groups: group 1 (normal weight) with a BMI<25 (n=24); group 2 (obese) with a BMI≥25 (n=29). HRQOL and functional outcomes were assessed through range of motion (ROM) and four different scores - the 36-item short form health survey (SF-36), the disability of arm and shoulder score (DASH), the Gartland and Werley score and the Castaing score - along with X-rays to measure volar tilt, radial inclination, radial length and articular congruity. All HRQOL assessments and clinical outcomes were correlated to BMI by comparing group 1 versus group 2. There was no difference in terms of postoperative ROM. The group of normal weight patients achieved slightly better but non-significant results for the Gartland and Werley score. No differences were seen in the DASH score or SF-36. There were also no differences regarding the Castaing score. Overall, normal and obese patients had no significant differences their HRQOL and functionality after volar plating of DRF.