Endoscopic gastric plication for the treatment of GERD and underlying class I obesity

OBJECTIVE: The apparent survival benefit of being overweight or obese in critically ill patients (the obesity paradox) remains controversial. Our aim is to report on the epidemiology and outcomes of obesity within a large heterogenous critically ill adult population. DESIGN: Retrospective observational cohort study. SETTING: Intensive care units (ICUs) in Australia and New Zealand. PARTICIPANTS: Critically ill patients who had both height and weight recorded between 2010 and 2018. OUTCOME MEASURES: Hospital mortality in each of five body mass index (BMI) strata. Subgroups analysed included diagnostic category, gender, age, ventilation status and length of stay. RESULTS: Data were available for 381 855 patients, 68% of whom were overweight or obese. Increasing level of obesity was associated with lower unadjusted hospital mortality: underweight (11.9%), normal weight (7.7%), overweight (6.4%), class I obesity (5.4%), and class II obesity (5.3%). After adjustment, mortality was lowest for patients with class I obesity (adjusted odds ratio, 0.78; 95% CI, 0.74– 0.82). Adverse outcomes with class II obesity were only seen in patients with cardiovascular and cardiac surgery ICU admission diagnoses, where mortality risk rose with progressively higher BMIs. CONCLUSION: We describe the epidemiology of obesity within a critically ill Australian and New Zealand population and confirm that some level of obesity is associated with lower mortality, both overall and across a range of diagnostic categories and important subgroups. Further research should focus on potential confounders such as nutritional status and the appropriateness of BMI in isolation as an anthropometric measure in critically ill patients.

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Effect of very low-calorie ketogenic diet in combination with omega-3 on inflammation, satiety hormones, body composition, and metabolic markers. A pilot study in class I obese subjects

Endocrine ◽

10.1007/s12020-021-02860-5 ◽

2021 ◽

Author(s):

Mariangela Rondanelli ◽

Simone Perna ◽

Zahra Ilyas ◽

Gabriella Peroni ◽

Philip Bazire ◽

...

Keyword(s):

Body Composition ◽

Visceral Fat ◽

Mean Difference ◽

Fat Free Mass ◽

Class I ◽

Omega 3 ◽

Open Label ◽

Metabolic Markers ◽

High Loss ◽

Class I Obesity

Abstract Purpose This study aims to evaluate the effects of a VLCKD combined with omega-3 supplementation (VLCKD diet only lasted for some weeks, and it was followed by a non-ketogenic LCD for the rest of the study period) on body composition, visceral fat, satiety hormones, inflammatory and metabolic markers. Methods It has been performed a pilot open label study lasted 90 days, in a cohort of 12 women with class I obesity aged 18 to 65 years. Data on body composition (evaluated by Dual X-Ray Absorptiometry—DXA), visceral fat, satiety hormones, inflammatory and metabolic markers were recorded. Results This study showed a body weight reduction mean difference over time of −13.7 kg and the waist circumference mean difference decrease of −13.3 cm. Also, the fat mass (FM) decreased—9.1 kg and visceral adipose tissue (VAT)—0.41 kg. No effects on fat-free mass (FFM) have been reported. Improvements were observed in the satiety hormones, with increased ghrelin and decreased leptin, and also in the metabolic profiles. Conclusions A VLCKD combined with omega-3 supplementation appears to be an effective strategy for promoting an high loss of FM with preservation of FFM in patients with class I obesity.

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How Safe is Bariatric Surgery in Patients with Class I obesity (BMI 30-35 kg/m2)?

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2018.09.480 ◽

2018 ◽

Vol 14 (11) ◽

pp. S9-S10

Author(s):

Xiaoxi Feng ◽

Amin Andalib ◽

Stacy A Brethauer ◽

Philip R Schauer ◽

Ali Aminian

Keyword(s):

Bariatric Surgery ◽

Class I ◽

Class I Obesity

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Evaluating the safety of bariatric surgery for weight loss in class I obesity: A propensity-matched analysis of North American data

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2019.01.024 ◽

2019 ◽

Vol 15 (4) ◽

pp. 629-635 ◽

Cited By ~ 2

Author(s):

Gary Gamme ◽

Jerry T. Dang ◽

Noah Switzer ◽

Richdeep Gill ◽

Daniel W. Birch ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

North American ◽

Class I ◽

Class I Obesity ◽

North American Data

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Overweight and Class I Obesity Are Associated with Lower 10-Year Risk of Mortality in Brazilian Older Adults: The Bambuí Cohort Study of Ageing

PLoS ONE ◽

10.1371/journal.pone.0052111 ◽

2012 ◽

Vol 7 (12) ◽

pp. e52111 ◽

Cited By ~ 19

Author(s):

Alline M. Beleigoli ◽

Eric Boersma ◽

Maria de Fátima H. Diniz ◽

Maria Fernanda Lima-Costa ◽

Antonio L. Ribeiro

Keyword(s):

Older Adults ◽

Cohort Study ◽

Class I ◽

Class I Obesity ◽

Risk Of Mortality

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Bariatric Surgery in Class I Obesity

Obesity Surgery ◽

10.1007/s11695-014-1214-1 ◽

2014 ◽

Vol 24 (4) ◽

pp. 487-519 ◽

Cited By ~ 63

Author(s):

Luca Busetto ◽

John Dixon ◽

Maurizio De Luca ◽

Scott Shikora ◽

Walter Pories ◽

...

Keyword(s):

Bariatric Surgery ◽

Class I ◽

Class I Obesity

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Postprandial GLP-2 Levels Are Increased After Biliopancreatic Diversion in Diabetic Individuals with Class I Obesity: a Prospective Study

Obesity Surgery ◽

10.1007/s11695-017-2554-4 ◽

2017 ◽

Vol 27 (7) ◽

pp. 1809-1814 ◽

Cited By ~ 7

Author(s):

Everton Cazzo ◽

José Carlos Pareja ◽

Bruno Geloneze ◽

Elinton Adami Chaim ◽

Maria Rita Lazzarini Barreto ◽

...

Keyword(s):

Prospective Study ◽

Biliopancreatic Diversion ◽

Class I ◽

Class I Obesity ◽

A Prospective Study

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ROLE OF FIBRINOLYTIC ACTIVITY OF BLOOD IN PATHOGENESIS OF NON-ALCOHOLIC FATTY LIVER DISEASE AND CHRONIC KIDNEY DISEASE (ORIGINAL RESEARCH)

Eastern Ukrainian Medical Journal ◽

10.21272/eumj.2019;7(4):316-322 ◽

2019 ◽

Vol 7 (4) ◽

pp. 316-322

Author(s):

A. A. Antoniv

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Fatty Liver ◽

Fibrinolytic Activity ◽

Class I ◽

Circulation System ◽

Original Research ◽

Alcoholic Fatty Liver ◽

Class I Obesity ◽

Ckd Stage

The aim of the research − to find out of changes fibrinolytic activity of blood in patients with non-alcoholic fatty liver on the background of obesity, depending on the presence of comorbid chronic kidney disease. Material and methods of research: 444 patients were examined: 84 of them were with NAFLD and class I obesity (group 1), which contained 2 subgroups: 32 patients with non-alcoholic steatosis (NAS) and 52 patients with non-alcoholic steatohepatitis (NASH); 270 patients with NAFLD with comorbid class I obesity and CKD І–ІІІ stage (group 2), including 110 patients with NAS and 160 patients with NASH. The control group consisted of 90 patients with CKD of І–ІІІ stage with normal body weight (group 3). To determine the dependence of the NAFLD course on the form and stage of the CKD, the group of patients was randomized according to age, sex, degree of obesity, and activity of NASH. Research results. The study of fibrinolytic activity of blood showed that total fibrinolytic activity (TFA) of blood plasma in patients of all groups was significantly lower than the control indexes: in patients with NAS – by 7.1%, patients with NAS with CKD – by 14.9%, patients with NASH – by 17.2%, patients with NASH with CKD – by 18.9%, patients with CKD – by 10.6% (p <0.05) with the presence of a probable intergroup difference between groups with comorbidity and isolated course of CKD (p <0.05). The suppression of TFA occurred through the decrease of EF: in patients with NAS the index is significantly lower than that in the controls by 1.2 times, in patients with NAS with CKD – by 1.4 times, in patients with NASH – by 1.7 times, in the group of patients with NASH and CKD – by 1.9 times, while in the group of patients with CKD, the suppression of EF was registered – 1.3 times (p <0.05). At the same time, the NEF in patients of all groups increased in comparison with the AHP group: in patients with NAS – by 1.2 times, in patients with NAS with CKD – by 1.3 times, in patients with NASH – by 1.4 times, in the group of patients with NASH with CKD – 1.5 times, while in the group of patients with CKD the activation of NEF was registered 1.2 times (p <0.05), with the presence of a probable difference between the groups with comorbidity and isolated course of CKD (p <0.05). Conclusion. Analysis of hemostasis and fibrinolysis indices in examined patients with NASH, depending on the stage of CKD showed that with the growth of the CKD stage, the activity of the cohort increases, with the exception of the fibrinogen content (most likely due to coagulopathy consumption), the activity of the anti-coagulants decreases, the total and enzymatic activity of fibrinolysis is reduced, and non-enzymatic compensator increases. Thus, metabolic intoxication, oxidative stress, which accompany the flow of NAFLD with obesity and CKD, promote the activation of the kallikrein-kinin system, the formation of plasma and thrombin, with subsequent disturbance of equilibrium between them, the development of stasis, slag phenomenon, the formation of platelet and erythrocyte aggregates in blood circulation system. The consequence of significant activation of hemocoagulation against the suppression of total fibrinolytic activity (TFA) is the local clotting of blood in the arteries.

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Association and Time-Varying Effects of Body Mass Index on All-Cause Mortality in Patients With Hypertension

10.21203/rs.3.rs-101453/v1 ◽

2020 ◽

Author(s):

jingjing zhu ◽

Xiaohua Liu ◽

Jinling Zhang ◽

Jun Li ◽

Linli Chen ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Class Ii ◽

Class I ◽

Time Varying ◽

Protective Effects ◽

Class I Obesity ◽

Significant Difference ◽

All Cause Mortality

Abstract BackgroundThe relationship between body mass index (BMI) and mortality in hypertension patients remains controversial. This study aimed to evaluate the association and the time-varying effects of different BMI categories on the risk of all-cause mortality in hypertension patients. MethodsThis retrospective cohort study was conducted among 212,394 Chinese people with hypertension. All deaths were identiﬁed based on Shanghai Vital Statistics. Cox model combined with time-by-covariate interactions was used to estimate the association and the time-varying effects of BMI on the risk of all-cause mortality. The potential non-linear effects across follow-up period for BMI were examined by the application of restricted cubic spline (RCS).ResultsOverall, 31,130 deaths occurred (14.7%) within an average follow-up of 8.24 years. Underweight (<18.5 kg/m2) showed a progressively weakening negative effect on all-cause mortality over time. For both sexes, overweight (23.0-24.9 kg/m2) and class I obesity (25.0-29.9 kg/m2) showed protective effects within 5 years after registration, but these became insignificant in later years. There was no significant difference in the effect on all-cause mortality between class II obesity (≥30.0 kg/m2) and normal weight. in the elderly patients, overweight, class I obesity and class II obesity had continuous protective effects on mortality.ConclusionsAlthough the effect of baseline body mass index on the risk of all-cause mortality varied at different follow-up periods, underweight persistently remained a risk factor for all-cause mortality in hypertension, whereas overweight and class I obesity had protective effects. Thus, in the long-term management of hypertension, more attention should be given to underweight patients.

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COVID-19: Impact of Obesity and Diabetes in Disease Severity

10.1101/2020.05.24.20111724 ◽

2020 ◽

Cited By ~ 4

Author(s):

Salman Al-Sabah ◽

Mohannad Al-Haddad ◽

Sarah Al-Youha ◽

Mohammad Jamal ◽

Sulaiman Almazeedi

Keyword(s):

Morbid Obesity ◽

Univariate Analysis ◽

Patient Characteristics ◽

Multivariate Regression Analysis ◽

Class I ◽

Obesity Class ◽

Class I Obesity ◽

Obesity And Diabetes ◽

Patients With Diabetes ◽

Poor Outcomes

AbstractBackgroundThe Coronavirus disease 2019 (COVID-19) pandemic is straining the healthcare system, particularly for patients with severe outcomes who require admittance to the intensive care unit (ICU). This study aimed to investigate the potential associations of obesity and diabetes with COVID-19 severe outcomes, assessed as ICU admittance.SubjectsDemographic and patient characteristics from a retrospective cohort of 1158 patients hospitalized with COVID-19 in a single center in Kuwait, along with their medical history, were analyzed. Univariate and multivariate analyses were performed to explore the associations between different variables and ICU admittance.ResultsFrom the 1158 hospitalized patients, 271 (23.4%) had diabetes, 236 (20.4%) had hypertension and 104 (9%) required admittance into the ICU. From patients with available measurements, 157 (21.6%) had body mass index (BMI)≥25 kg/m2. Univariate analysis showed that overweight (BMI=25.0–29.9 kg/m2), obesity class I (BMI=30–34.9 kg/m2) and morbid obesity (BMI≥40 kg/m2) associated with ICU admittance (odds ratio (OR) [95% confidence intervals (CI)]: 2.45 [1.26–4.74] p-value=0.008; OR [95% CI]: 3.51 [1.60–7.69] p-value=0.002; and OR [95% CI]: 5.18 [1.50–17.85] p-value=0.009], respectively). Patients with diabetes were more likely to be admitted to ICU (OR [95% CI]: 9.38 [5.49–16.02]). Two models for multivariate regression analysis were used, assessing either BMI or diabetes on ICU outcomes. In the BMI model, class I obesity and morbid obesity were associated with ICU admittance (adjusted OR (AOR) [95% CI]: 2.7 [1.17–6.20] p-value=0.019 and AOR [95% CI]: 3.95 [1.00–15.20] p-value=0.046, respectively). In the diabetes model, diabetes was associated with higher ICU admittance (AOR [95% CI]: 5.49 [3.13–9.65] p-value<0.001) whereas hypertension had a protective effect on ICU admittance (AOR [95% CI]: 0.51 (0.28–0.91).ConclusionsIn our cohort, overweight, obesity and diabetes in patients with COVID-19 were associated with ICU admittance, putting these patients at higher risk of poor outcomes.

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