Weight loss and clinical characteristics of young adults patients seeking treatment at medical centers: Data from the QUOVADIS Study

Objective We aimed to describe the clinical characteristics of chronic pancreatitis (CP) and patient quality of life (QOL) in a resource-limited setting. Methods We performed a cross-sectional study including patients with clinical and radiological features of CP. We collected clinical data and assessed QOL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire. Results We included 103 patients (median age 44 years, 84 men). Median age at symptom onset was 36 (4–78) years. Around 70% of patients had diabetes mellitus and 62.1% had consumed alcohol; 36 (35%) were current smokers. The mean overall global QOL score was 68.7. Most patients (91.3%) sought treatment from multiple centers. Nineteen (18.5%) had pancreatic stone disease, 38 (36.9%) had persistent abdominal pain (median severity 7.8/10, 59 (57.3%) had steatorrhea, and 56 (54.4%) had jaundice. Poor QOL was significantly associated with weight loss, loss of appetite, and intractable pain. No correlation with age, sex, or alcohol consumption was noted. Conclusion A considerable proportion of patients with CP had troublesome symptoms. Intractable pain, loss of appetite, and weight loss were significantly associated with poor QOL. Further assessment is needed of patients’ psychosocial well-being and its association with QOL.

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Weight loss early after discharge predicts the risk of rehospitalization in non-obese patients with heart failure preserved ejection fraction

European Heart Journal ◽

10.1093/ehjci/ehaa946.0863 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Kamisaka ◽

K Kamiya ◽

K Iwatsu ◽

N Iritani ◽

Y Iida ◽

...

Keyword(s):

Heart Failure ◽

Weight Loss ◽

Regression Analysis ◽

Ejection Fraction ◽

Associated Factors ◽

Clinical Characteristics ◽

Obese Patients ◽

Preserved Ejection Fraction ◽

Kaplan Meier ◽

Worse Prognosis

Abstract Background Weight loss (WL) has been considered as a prognostic factor in heart failure with reduced ejection fraction (HFrEF). However, the prognosis and associated factors of WL in heart failure with preserved ejection fraction (HFpEF) have remained unclear. Purpose This study aimed to examine the prevalence, prognosis, and clinical characteristics of worse prognosis based on the identified WL after discharge in HFpEF. Methods The study was conducted as a part of a multicenter cohort study (Flagship). The cohort study enrolled ambulatory HF who hospitalized due to acute HF or exacerbation of chronic HF. Patients with severe cognitive, psychological disorders or readmitted within 6-month after discharge were excluded in the study. WL was defined as ≥5% weight loss in 6-month after discharge and HFpEF was defined as left ventricular ejection fraction (LVEF) ≥50% at discharge. Age, gender, etiology, prior HF hospitalization, New York Heart Association (NYHA) class, brain natriuretic peptide (BNP) or N-terminal-proBNP (NT-proBNP), anemia (hemoglobin; male <13g/dL, female <12g/dL), serum albumin, Geriatric Depression Scale, hand grip strength and comorbidities were collected at discharge. Patients were stratified according to their body mass index (BMI) at discharge as non-obese (BMI <25) or obese (BMI ≥25). We analyzed the association between WL and HF rehospitalization from 6 month to 2 years after discharge using Kaplan-Meier curve analysis and Cox regression analysis adjusted for age and gender, and clinical characteristics associated to worse prognosis in WL using logistic regression analysis adjusted for potential confounders in HFpEF. Results A total of 619 patients with HFpEF were included in the analysis. The prevalence of WL was 12.9% in 482 non-obese and 15.3% in 137 obese patients. During 2 years, 72 patients were readmitted for HF (non-obese: 48, obese: 24). WL in non-obese independently associated with poor prognosis (hazard ratio: 2.2: 95% confidence interval: 1.13–4.25) after adjustment for age and sex, while WL in obese patients did not. Logistic regression analysis chose age (odds ratio 1.02 per 1 year; 1.00–1.05), anemia (2.14; 1.32–3.48), and BNP ≥200pg/mL or NT-proBNP ≥900pg/mL (1.83; 1.18–2.86) as independent associated factors for worse prognosis of WL in non-obese patients. Conclusion In HFpEF, WL in early after discharge in non-obese elderly patients may be a prognostic indicator for HF rehospitalization. HF management including WL prevention along with controlling anemia is likely to improve prognosis in this population. Kaplan Meier survival curves Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): A Grant-in-Aid for Scientific Research (A) from the Japan Society for the Promotion of Science

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FRI0443 CLINICAL CHARACTERISTICS AND RELATED FACTORS OF COMMON RHEUMATIC DISEASES COMPLICATED WITH TUBERCULOSIS INFECTION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3717 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 819.1-819

Author(s):

L. Long ◽

G. Tang ◽

Y. Han ◽

Q. Peng ◽

J. Liu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Weight Loss ◽

Risk Factor ◽

High Risk ◽

Rheumatic Diseases ◽

Clinical Characteristics ◽

Control Group ◽

Average Dose ◽

Systemic Lupus ◽

Infection Group

Background:Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and syndrome(SS) are common rheumatic diseases with high incidence. Patients with those rheumatic diseases are at high risk of tuberculosis (TB) infection. However, manifestations can be atypical and easily confused with those of rheumatic disease itself. For those patients, diagnosis is usually much more difficult and further make treatment delayed. Sometimes it may lead to mistreatment. Therefore, it is important to recognize the clinical characteristics of those patients.Objectives:To explore the clinical characteristics and high risk factors of common systemic rheumatism complicated with tuberculosis infection.Methods:A total of 3,906 cases of RA, SLE, and SS common systemic rheumatism diagnosed in the People’s Hospital of Sichuan Province from January 2007 to January 2017 were collected with carefully exclusion with other infectious diseases and neoplastic disease. One hundred and five patients with TB were included as infection group, including 42 cases of RA, 41 cases of SLE, and 22 cases of SS. In the control group, 84 patients with RA, 82 patients with SLE, and 44 patients with SS were randomly selected from the corresponding rheumatoid non-infected patients hospitalized during the same period.Results:Fever was the most common symptom among 42 cases of RA, 41 cases of SLE, and 22 cases of SS with TB, accounting for 83.3%, 92.7%, and 68.2%, respectively. Cough, weight loss or fatigue was less common. For 41 cases of SLE and 22 cases of SS with TB, the proportion of pulmonary was 46.3%, 59.01%, respectively.In TB infection group, 27 cases of RA, 21 cases of SLE, and 13 cases of SS with TB had two or more chest CT findings, accounting for 59%, 57%, 62%, respectively. Lesions located in the posterior or posterior segment which TB usually affected were 9 cases(33.3%),9cases(42.9%),6cases(27.2%),respectively.The daily average dose of hormones within 1 year in TB infection group was higher than that in the control group (P<0.05). For SLE patients, lower counts of CD4+TL were found in TB infection group (P<0.05), while no such differences were found in RA and SS group.Conclusion:Patients with RA who have TB infection are mainly pulmonary TB. For SLE and SS patients, the chance of pulmonary tuberculosis and extra-pulmonary tuberculosis is similar.Symptoms of RA, SLE, SS with TB, such as fever, cough, weight loss, fatigue, are similar with the primary disease or other infection. Chest imaging is diversity. It is difficult to diagnose.Daily average dose of hormone within one year may be a common risk factor for RA, SLE and SS patients with TB. Decreased CD4+TL may also be a risk factor for SLE patients with TB.References:[1]Cantini F, Nannini C, Niccoli L, et al. Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics[J]. Mediators of Inflammation, 2017, 2017(6):1-15.[2]Ruangnapa K, Dissaneewate P, Vachvanichsanong P. Tuberculosis in SLE patients: rare diagnosis, risky treatment.[J]. Clinical & Experimental Medicine, 2015, 15(3):429-432.[3]Manuela D F, Bruno L, Martina S, et al. Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections[J]. International Journal of Molecular Sciences, 2017, 18(2):293-315.[4]Disseminated tuberculosis masquerading as a presentation of systemic lupus erythematosus.Li JC, Fong W, Wijaya L, Leung YY.Int J Rheum Dis. 2017 Oct 2. doi: 10.1111/1756-185X.13195.[5]Handa R, Upadhyaya S, Kapoor S, et al. Tuberculosis and biologics in rheumatology: India – A special situation[J]. International Journal of Rheumatic Diseases, 2017, 51(2):115.Disclosure of Interests:None declared

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89. Experience of Weight Loss Among Young Adults Who Underwent Bariatric Surgery as Adolescents: A Mixed-Methods Approach

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2020.12.098 ◽

2021 ◽

Vol 68 (2) ◽

pp. S47-S48

Author(s):

Annalyn S. DeMello ◽

Darlene E. Acorda ◽

David Allen ◽

Rahema Aman ◽

Stephanie Sisley

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Young Adults ◽

Mixed Methods ◽

Mixed Methods Approach

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Abstract MP009: Changes in Aldosterone are Associated With Changes in Obesity-Related Factors in Normotensive Overweight/Obese Young Adults Undergoing Lifestyle Modification

Circulation ◽

10.1161/circ.125.suppl_10.amp009 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Jennifer Cooper ◽

Linda Fried ◽

Ping Tepper ◽

Emma Barinas-Mitchell ◽

Kim Sutton-Tyrrell

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Weight Loss ◽

Young Adults ◽

Lifestyle Modification ◽

Urinary Sodium ◽

Dietary Sodium ◽

Related Factor ◽

Related Factors ◽

Aldosterone Antagonists

Background: Elevated aldosterone promotes inflammation, insulin resistance, and hypertension. These effects are particularly important in obesity because adipocytes secrete factors that increase aldosterone production. Weight loss is thought to lower aldosterone levels, but little longitudinal data is available. We aimed to determine if, independent of changes in sodium intake, reductions in circulating aldosterone are associated with weight loss and improvements in inflammation, adipokines, insulin resistance, and blood pressure in normotensive overweight and obese young adults undergoing lifestyle modification. Methods: Participants were overweight/obese adults aged 20–45 years (20% male, 15% black) from the Slow Adverse Vascular Effects of excess weight trial, a study evaluating the relationships between weight loss, dietary sodium, and vascular health. Subjects were randomly assigned to a regular or reduced sodium diet, and all received a one-year nutrition and physical activity intervention. For this study, individuals providing valid baseline 24hr urine collections were included (n=281). Linear mixed models were used to evaluate associations between changes in aldosterone and changes in weight, blood pressure, and obesity-related factors. Results: Weight loss was significant at 6 months (∼7%), 12 months (∼6%), and 24 months (∼4%) (p<0.0001 for all). Within-subject decreases in aldosterone were associated with decreases in C-reactive protein, leptin, and homeostasis assessment of insulin resistance (HOMA-IR) and with increases in adiponectin (p<0.01 for all) in models including baseline age, sex, race, intervention arm, time since baseline, and baseline and concurrent changes in BMI, urinary sodium and potassium, and the obesity-related factor of interest. Decreases in aldosterone were associated with weight loss only in the subgroup (n=98) with metabolic syndrome (MetS) at baseline (MetS x percent weight loss p=0.02); a 10% weight reduction in this subgroup was associated with a 9% (95% CI 1–16) reduction in aldosterone. Though no association was detected between changes in aldosterone and mean arterial pressure (MAP), a significant association was found between reductions in MAP and 24hr urinary sodium in those with MetS (MetS x urinary sodium reduction p=0.02). Independent of weight loss, a 30% reduction in urinary sodium was associated with a 0.9 mm Hg (95% CI 0.2–1.6) decrease in MAP in those with MetS. Conclusions: Changes in aldosterone are associated with changes in obesity-related factors in overweight/obese normotensive young adults. In persons with MetS, weight loss and dietary sodium restriction are particularly useful to reduce aldosterone and MAP respectively. Given the adverse effects of excess aldosterone on cardiac and vascular remodeling, future studies should investigate the benefits of aldosterone antagonists in individuals with MetS.

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Abstract P249: A Behavioral Weight Loss Intervention is Effective for Change in CVD Risk Factors in Young Adults: The IDEA Study

Circulation ◽

10.1161/circ.131.suppl_1.p249 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

John M Jakicic ◽

Kelliann K Davis ◽

Bethany Barone Gibbs ◽

Diane Helsel ◽

Wendy C King ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Young Adults ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Introduction: Few studies have examined behavioral weight loss interventions with respect to change in cardiovascular disease risk factors in young adults (aged 18 to 35 years). Hypothesis: We tested the hypothesis that a 6 month behavioral weight loss intervention resulted in significant improvements in selective cardiovascular disease risk factors in young adults. Methods: Data are presented as median [25 th , 75 th percentiles]. 470 participants (age: 30.9 [27.8, 33.7] years); BMI: 31.2 [28.4, 34.3] kg/m 2 ) were enrolled in a 6 month behavioral weight loss intervention that included weekly group sessions and prescribed an energy restricted diet and moderate-to-vigorous physical activity. Assessments included weight using a standardized protocol, resting blood pressure, and fasting lipids, glucose, and insulin. Statistical significance of change was according to tests of symmetry or the Wilcoxon matched pairs signed ranks test. Results: The primary outcome (weight) was available for 424 of the 470 participants (90.2%). Weight significantly decreased (-7.8 kg [-12.2, -3.7]) (p<0.0001). Systolic (-4.0 mmHg [-8.5, 0.5] and diastolic blood pressure (-3.0 mmHg [-6.5, 1.0]) decreased (p<0.0001). Total cholesterol (-13 mg/dl [-28.0, 2.0]), LDL cholesterol (-9.5 mg/dl [-21.7, 2.0]), triglycerides (-8.5 mg/dl [-44.0, 9.0]), glucose (-4.0 mg/dl [-8.0, 1.0]), and insulin (-2.6 mIU/L [-5.9, 0.7]) decreased (p<0.0001, n=416). There was not a significant change in HDL cholesterol (p=0.72). Conclusions: In conclusion, after 6 months, weight loss was observed in young adults assigned to this behavioral intervention that focused on physical activity and diet modification. They tended to also have improved cardiovascular disease risk factors. This may demonstrate an approach to reducing cardiovascular disease risk in young adults. Supported by NIH (U01HL096770) and AHA (12BGIA9410032)

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Inclusion of fish or fish oil in weight-loss diets for young adults: effects on blood lipids

International Journal of Obesity ◽

10.1038/ijo.2008.64 ◽

2008 ◽

Vol 32 (7) ◽

pp. 1105-1112 ◽

Cited By ~ 42

Author(s):

I Gunnarsdottir ◽

H Tomasson ◽

M Kiely ◽

J A Martinéz ◽

N M Bandarra ◽

...

Keyword(s):

Weight Loss ◽

Young Adults ◽

Fish Oil ◽

Blood Lipids

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Clinical Characteristics, Short- and Long-term Outcome of Acute Coronary Syndrome in Young Adults

The American Journal of Cardiology ◽

10.1016/j.amjcard.2013.01.202 ◽

2013 ◽

Vol 111 (7) ◽

pp. 80B

Author(s):

Keiji Yamada ◽

Satoru Sakuragi ◽

Kota Okabe ◽

Takashi Fuziwara ◽

Takashi Miki ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Young Adults ◽

Clinical Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

Coronary Syndrome ◽

Short And Long Term

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Weight loss through a 12‐week weight management program improves anthropometric and clinical characteristics

The FASEB Journal ◽

10.1096/fasebj.26.1_supplement.819.14 ◽

2012 ◽

Vol 26 (S1) ◽

Author(s):

Ae Jin Lee ◽

Kyeong Jin Jeon ◽

Sung Nim Han

Keyword(s):

Weight Loss ◽

Weight Management ◽

Clinical Characteristics ◽

Management Program ◽

Weight Management Program

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Abstract 13776: The Impact of Race on In-hospital Quality of Care Among Young Adults With Acute Myocardial Infarction

Circulation ◽

10.1161/circ.142.suppl_3.13776 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Diana Benea ◽

Valeria Raparelli ◽

hassan behlouli ◽

Louise Pilote ◽

Rachel Dryer

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Young Adults ◽

Quality Of Care ◽

Clinical Characteristics ◽

Hospital Quality ◽

P Value ◽

White Race

Introduction: The extent to which race influences in-hospital quality of care among young adults with acute myocardial infarction (AMI) is unknown. We examined racial differences in in-hospital quality of AMI care in young adults and described the patient and/or clinical characteristics associated with potential disparities in care. Methods: Data from the GENESIS-PRAXY (Canada) and the VIRGO (U.S.) prospective cohorts of young adults with AMI were analyzed. Among a total of 4,048 adults with AMI (≤55 years) (median=49 years [IQR 44-52], 22% non-white, 58% women), we calculated an in-hospital quality of care score (QCS) for AMI (quality indicators divided by total, with higher scores indicating better care) based on AHA quality of care standards, reporting data disaggregated by race. We categorized race as white versus non-white, which included Black, Asian and North American Indigenous populations. Results: This cohort was comprised of 906 non-white individuals and 3142 white individuals. Non-white adults exhibited a clustering of adverse cardiac risk factors, psychosocial risk factors and comorbidities versus whites; they had higher rates of hypertension, diabetes, alcohol abuse and prior AMI and lower rates of physical activity. They were more likely to have a low SES and receive low social support, and were less likely to be employed, a primary earner, or married/living with a partner. Non-white individuals were also more likely to experience a NSTEMI and less likely to receive cardiac rehabilitation, smoking cessation counseling as well as dual antiplatelet therapy at discharge. Furthermore, non-white individuals had a lower crude QCS than whites (QCS=69.99 vs 73.29, P-value<0.0001). In the multivariable model adjusted for clinical and psychosocial factors, non-white race (LS Mean Difference=-1.49 95%CI -2.87, -0.11, P-value=0.0344) was independently associated with a lower in-hospital QCS. Conclusion: Non-white individuals with AMI exhibited higher rates of adverse psychosocial and clinical characteristics than white individuals yet non-white race was independently associated with lower in-hospital quality of care. Interventions are needed to improve quality of AMI care in non-white young adults.

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