P–634 The effect of bariatric surgery on PCOS patients’ obstetrical and neonatal outcomes: A population based study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Bazarah ◽  
H Baghlaf ◽  
A Badeghiesh ◽  
H Dahan
Keyword(s):  
Bariatric Surgery ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Multivariate Logistic Regression Analysis ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
History Of

Abstract Study question Does bariatric surgery (BS) decrease the occurrence of adverse obstetrical and neonatal outcomes in morbidly obese women with polycystic ovarian syndrome (PCOS)? Summary answer Patients with PCOS who underwent BS were at lower risk for gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH), than other women with PCOS. What is known already Studies have shown that PCOS in pregnancy is associated with the occurrence of GDM, preeclampsia, PIH, preterm birth (PTB), cesarean section, miscarriage, hypoglycemia, and neonatal death. Patients with PCOS may have an increased risk of obesity compared to the general population, which magnifies the inherent insulin resistance many fold. PCOS patients who underwent bariatric surgery have a marked improvement in menstrual irregularities, hirsutism, T2DM, hypertension, and dyslipidemia. The benefit of bariatric surgery for PCOS patients and the improvement of pregnancy related complications has not been adequately studied, with most studies being small. Study design, size, duration This is a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) database from 2004 to 2014. Using multivariate logistic regression analysis, we compared women with PCOS who underwent BS with a control group consisting of pregnant patients with PCOS of all BMIs who had not had weight reduction operations regarding pregnancy, delivery, and neonatal outcomes. Participants/materials, setting, methods The study group included pregnant PCOS patients who underwent BS and the control group consisted of pregnant patients with PCOS; who delivered between 2004 and 2014. Demographic and clinical characteristics, pregnancy, delivery, and neonatal outcomes were compared. Multivariate logistic regression analysis was performed to control for all statistically different (P < 0.05) confounding effects. Each subject was included once per delivery. Main results and the role of chance We identified 9,096,788 pregnancies during the study period. 141 patients had a history of PCOS and underwent BS. The control group was composed of 14,741 patients with PCOS who didn’t undergo BS. Prevalence of PCOS patients who underwent BS increased from 0/1,000 in 2004 to 14.6/1,000 in 2014(p = 0.001). Those who underwent BS were more likely to be older than 35-years(42.6% vs. 18.7%, p < 0.0001), obese at delivery(44.7% vs. 22%, p < 0.0001) and have a history of previous cesarean sections (24.8% vs. 18.2%, p = 0.045). Differences in pre-gestational diabetes (7.1% vs. 4.1%, p = 0.086) and hypertension (12% vs. 8.4%, p = 0.125) .The BS group was less likely to develop PIH (aOR–0.39, 95%CI–0.21–0.72) and GDM( aOR–0.40, 95%CI–0.23–0.70) when compared to the control group. When comparing the PCOS with and without BS; differences in gestational hypertension(95%CI–0.22–1.30), preeclampsia(95%CI–0.19–1.15), spontaneous vaginal delivery (95%CI 0.58–1.3), operative vaginal delivery (95%CI 0.34–1.8), Cesarean section (95%CI 0.79–1.79), post partum hemorrhage (95%CI–0.12–1.94), transfusion (95%CI–0.1–5.22), preterm delivery (95%CI–0.56–1.75) and maternal infection (95%CI–0.27–2.07) were similar. Regarding neonatal outcomes of PCOS with and without BS: small for gestational age babies (95%CI–0.26–2.68), and congenital anomalies (95%CI–0.09–4.52) were similar. Limitations, reasons for caution Limitations of our study include its retrospective design. Information regarding the time interval between the surgical intervention and pregnancy wasn’t available. Nor was information on the type of gastric bypass performed. Wider implications of the findings: Our study demonstrated an association between bariatric surgery in the setting of PCOS patients and a reduced risk of GDM and PIH. Although no differences were noted in other delivery and neonatal outcomes, data was not compared to a group of strictly obese PCOS controls. Trial registration number Not applicable

scholarly journals Increased Serum Levels of Asymmetric Dimethylarginine and Symmetric Dimethylarginine and Decreased Levels of Arginine in Sudanese Patients with Essential Hypertension

2020 ◽  
Vol 45 (5) ◽  
pp. 727-736
Author(s):  
Sahar Gamil ◽  
Jeanette Erdmann ◽  
Edzard Schwedhelm ◽  
Khalid Hussein Bakheit ◽  
Ihab B.B. Abdalrahman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Essential Hypertension ◽  
Amino Acid ◽  
Asymmetric Dimethylarginine ◽  
Multivariate Logistic Regression Analysis ◽  
Serum Levels ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Symmetric Dimethylarginine

Introduction: Essential hypertension (EH) is a disease caused by various environmental and genetic factors. Nitric oxide (NO) is important for the functional integrity of the endothelium. It is produced in endothelial cells by endothelial NO synthase (eNOS) that mediates the conversion of the amino acid arginine into NO and citrulline. Asymmetric dimethylarginine (ADMA) acts as an inhibitor of eNOS. In contrast, symmetric dimethylarginine (SDMA) has no direct effect on eNOS but plays an important role competing with arginine for transport across the amino acid transporter. ADMA and SDMA have been found to play a central role in the development of cardiovascular diseases. Serum ADMA levels may serve as a future diagnostic marker and a target of therapy in hypertensive patients in the Sudanese population. This study aimed to investigate the relation between serum arginine, ADMA, and SDMA levels with EH in the Sudanese population. Methods: Patients (n = 260) with established hypertension and controls (n = 144) with normal blood pressure were included in this case-control study. Serum blood samples were analyzed for arginine, ADMA, and SDMA, using high-performance liquid chromatography-tandem mass spectrometry. Other laboratory data were measured using routine methods. Mann-Whitney’s U test and χ2 tests were used for continuous and categorical data, respectively. A multivariate logistic regression analysis was conducted to investigate the independent effect of multiple variables on the development of hypertension. Results: Serum arginine levels were significantly lower in the patient group than in the control group (p < 0.001). ADMA and SDMA levels were significantly higher in the patient group than the control group (p < 0.001, p = 0.001, respectively). Multivariate logistic regression analysis showed that only older age, being a male, and arginine levels are independent factors controlling the development of hypertension (p < 0.001, p < 0.001, and p = 0.046, respectively). ADMA and SDMA levels were not independent factors for the development of hypertension. Conclusions: This study demonstrated increased serum levels of ADMA and SDMA and decreased arginine levels in Sudanese patients with EH. Lowering serum ADMA levels or increasing the arginine levels might be a novel therapeutic target in these individuals.

scholarly journals Factors associated with medial meniscal subluxation in knees with medial meniscus tears: a cross-sectional study

2020 ◽  
Author(s):  
Xinguang Liu ◽  
Ran Ding ◽  
Chen Liu ◽  
Bin Yang ◽  
Weiguo Wang
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Medial Meniscus ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Independent Factor ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Meniscus Tears

Abstract Background Previous studies have indicated that medial meniscal subluxation (MMS) is associated with special types of medial meniscus tears (MMT) and chondral lesions. However, most of these studies lacked arthroscopic findings and did not adjust for possible confounders. The purpose of this study was to explore factors associated with MMS in patients with MMT using multivariate logistic regression analysis. Methods A retrospective analysis of 115 patients who underwent arthroscopic surgery for MMT was conducted. The medial meniscal extrusion (MME) distance was measured on a single mid-coronal magnetic resonance (MR) image, and the MMS group included patients with MME distance ≥3 mm (55 patients with 55 knees). Other patients were included as the control group (60 patients with 60 knees). Demographic and clinical data were collected as variates. A multivariate logistic regression analysis was performed to identify factors associated with MMS. Results In a univariate analysis, the Outerbridge classification (P=0.002) and the type of MMT (P<0.001) were significantly different between the MMS group and the control group. According to unadjusted and age- and body mass index (BMI)-adjusted multivariate logistic regression analysis, the type of MMT was an independent factor associated with MMS. Compared with horizontal tears, radial tears, posterior medial meniscus root tears (PMMRT) and complex tears had approximately 6-fold (adjusted OR 6.468, 95% CI 1.509–27.718, P=0.012), 10-fold (adjusted OR 10.324, 95% CI 1.719–61.989, P=0.011) and 4-fold (adjusted OR 4.458, 95% CI 1.602–12.408, P=0.004) higher associations with MMS, respectively. Conclusion The type of MMT was an independent factor associated with MMS in knees with MMT. Radial tears, PMMRT and complex tears were more likely than horizontal tears to result in MMS. The results suggest that MMT combined with MMS should be noted when managing MMT, especially radial tears, PMMRT and complex tears. Moreover, the results indicate that we must not only preserve the meniscus as much as possible but also restore its position to as close to normal as possible.

scholarly journals Glenoid Orientation and Profile in Atraumatic or Microtraumatic Posterior Shoulder Instability: Morphological Analysis Using Computed Tomography Arthrogram

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098296
Author(s):  
Yon-Sik Yoo ◽  
Jeehyoung Kim ◽  
Wooyoung Im ◽  
Jeung Yeol Jeong
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Shoulder Instability ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Posterior Shoulder Instability ◽  
Multivariate Logistic Regression ◽  
Glenoid Version ◽  
Posterior Shoulder

Background: Posterior shoulder instability (PSI) is a relatively uncommon condition that occurs in about 10% of patients with shoulder instability. PSI is usually associated with dislocations due to acute trauma and multidirectional instability, but it can also occur with or without recognizable recurrent microtrauma. The infrequency of atraumatic or microtraumatic PSI and the lack of a full understanding of the pathoanatomy and the knowledge of management can lead to misdiagnosis or delayed diagnosis. Purpose: To evaluate the morphologic factors of the glenoid that are associated with atraumatic or microtraumatic PSI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Enrolled in this study were patients who underwent arthroscopic posterior labral repair between January 2013 and March 2017 and were diagnosed with posterior glenohumeral instability by means of preoperative computed tomography arthrography (CTA) (n = 39; PSI group). These patients did not have any significant dislocation or subluxation episodes. The morphologic factors of the glenoid as revealed using CTA were compared with the CTA images from a sex-matched control group (n = 117) of patients without PSI who had been diagnosed with adhesive capsulitis in an outpatient clinic. The glenoid version and shape were evaluated between the 2 groups using the CTA findings, and the degree of centricity of the humeral head to the glenoid was assessed in the PSI group. Multivariate logistic regression analysis was performed to identify factors associated with PSI. Results: The results of the multivariate logistic regression analysis indicated no statistically significant difference between the PSI and control groups regarding glenoid version or a flat-shaped glenoid. However, statistically significant between-group differences were found regarding convex glenoid shape, with an odds ratio of 5.39 (95% CI, 1.31-23.35; P = .0207). The proportion of eccentricity was significantly higher in the PSI group (21/39; 54%) versus the control group (47/117; 40%) ( P = .031). Conclusion: The presence of convex glenoid shape was significantly associated with atraumatic or microtraumatic PSI. Humeral head eccentricity accounted for a high percentage of convex glenoid shape. However, there was no significant correlation between PSI and glenoid retroversion.

scholarly journals Factors associated with medial meniscal subluxation in knees with medial meniscus tears: a cross-sectional study

2020 ◽  
Author(s):  
Xinguang Liu ◽  
Ran Ding ◽  
Chen Liu ◽  
Bin Yang ◽  
Weiguo Wang
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Medial Meniscus ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Median Distance ◽  
Meniscus Tears

Abstract Background Previous studies have indicated that medial meniscal subluxation (MMS) was associated with special types of medial meniscus tears (MMT) and chondral lesions. However, most of these studies lacked arthroscopic findings and had not adjusted for possible confounders. The purpose of this study was to explore the factors associated with MMS in patients with MMT using multivariate logistic regression analysis. Methods A retrospective analysis of 115 patients who underwent arthroscopic surgery for MMT was conducted. The medial meniscal extrusion (MME) distance was measured on a single mid-coronal MR image, and the MMS group included patients with MME ≥3 mm (55 patients with 55 knees). Other patients were included as the control group (60 patients with 60 knees). Demographic and clinical data were collected as variates. A multivariate logistic regression analysis was performed to identify the factors associated with MMS. Results The MME distance was significantly higher in the MMS group (median distance: 3.5 mm, interquartile range: 3.3–4.1 mm) than in the control group (median distance: 1.8 mm, interquartile range: 1.3–2.3 mm, P<0.001). The Outerbridge classification (P=0.002) and the type of MMT (P=0.001) were significantly different between the MMS group and the control group. According to the multivariate logistic regression analysis, the type of MMT (P=0.015) was the independent factor associated with MMS after adjusting for other variates. Compared with horizontal tears, radial tears, PMMRT and complex tears had an approximately 8-fold (OR 7.592, 95 % CI 1.681–34.295, P=0.008), 11-fold (OR 11.451, 95 % CI 1.763–74.379, P=0.011) and 4-fold (OR 4.387, 95 % CI 1.558–12.355, P=0.005) higher association with MMS, respectively. Conclusion The type of MMT was an independent factor associated with MMS in knees with MMT. Radial tears, PMMRT and complex tears were more likely than horizontal tears to result in MMS. These results suggest that MMT combined with MMS should be noticed when managing MMT, especially radial tears, PMMRT and complex tears. We must not only preserve the meniscus as much as possible but also restore its position to as close to normal as possible.

scholarly journals Controlling energetic intake based on a novel logistic regression model for the metabolic syndrome in a Chinese population

2010 ◽  
Vol 105 (2) ◽  
pp. 256-262
Author(s):  
Lv Yangmei ◽  
Miao Yanxia ◽  
Qiao Liangmei ◽  
Zhang Jinhui ◽  
Hua Yu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Energy Requirement ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
The Metabolic Syndrome ◽  
Requirement Model

The present study was designed to develop a novel method of energy calculation for controlling energetic intake in patients with the metabolic syndrome. Demographics and dietary data were recorded for 2582 obese subjects. Nutritional education was applied to all the patients. One year later, the data on age, sex, activity intensity coefficient, waistline, environmental temperature and BMI in subjects who lost ≥ 5 % body weight were entered into a multivariate logistic regression analysis model. Energy requirement was calculated from the results of multivariate logistic regression. Four hundred and thirty-four metabolic syndrome patients were then randomly divided into the treated group (216) and the control group (218). The energetic intake in the experimental group was controlled based on the new energy requirement model. The traditional energy exchange method was used in the control group. The independent factors predicting metabolic syndrome prognosis, such as age, sex, activity intensity coefficient, waistline, environmental temperature and BMI, were identified by multivariate logistic regression analysis. The energy requirement model was then constructed by logistic regression analysis. After 6 months of energetic intake control based on the new model, the parameters of the experimental group were significantly different from those of the controls (all P < 0·05): waistline, 89·65 (sd 5·54) v. 91·97 (sd 4·78) cm; BMI, 24·67 (sd 3·54) v. 25·87 (sd 2·65) kg/m2; fasting blood glucose, 6·9 (sd 3·6) v. 8·7 (sd 4·6) mmol/l; 2 h PG, 8·7 (sd 5·7) v. 10·7 (sd 4·5) mmol/l; HbA1c, 7·7 (sd 1·6) v. 8·9 (sd 2·6) %; homoeostasis model insulin resistance index, 3·14 (sd 1·62) v. 4·32 (sd 2·25). The new energy requirement model can effectively improve the clinical outcomes of controlling energetic intake in metabolic syndrome patients.

scholarly journals Predictive factors for preeclampsia in pregnant women: a unvariate and multivariate logistic regression analysis.

2012 ◽  
Vol 59 (4) ◽  
Author(s):  
Ashraf Direkvand-Moghadam ◽  
Afra Khosravi ◽  
Kourosh Sayehmiri
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Demographic Variables ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
History Of

Several risk factors have been used to predict preeclampsia. The role of some risk factors as predictors associated with preeclampsia among Iranian women was analyzed in the present study using logistic regression. 610 women attending the obstetric ward of Mustafa hospital in Ilam were enrolled in this study. Demographic variables such as age, Body Mass Index (BMI), medical and obstetrics variables such as education, number of pregnancy, abortion and parity from May to September 2010 were analyzed. We used the unvaried and multiple logistic regression analyses to predict preeclampsia. The history of preeclampsia, hypertension, and infertility showed to be good independent predicator variables for preeclampsia using multivariate logistic regression analysis (OR was 5.46, 2.34 and 3.07 respectively). Area Under the Receiver Operation Character (AUROC) was estimated to be 0.67 (95% CI 0.59-0.67, p

scholarly journals Dyslipidemia Is Negatively Associated With the Cumulative Live-Birth Rate in Patients Without PCOS Following IVF/ICSI

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhenteng Liu ◽  
Jianxiang Cong ◽  
Xuemei Liu ◽  
Huishan Zhao ◽  
Shoucui Lai ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Live Birth ◽  
Birth Rate ◽  
Multivariate Logistic Regression Analysis ◽  
Live Birth Rate ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth

Objective: To evaluate the effect of dyslipidemia on the cumulative live-birth rate (cLBR) in patients without polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection–embryo transfer (IVF/ICSI–ET) cycles.Methods: A total of 1,132 patients from the Yantai Yuhuangding Hospital Affiliated to Qingdao University from January 2016 to December 2017 were retrospectively included. The subjects were distributed into two groups based on their lipid profiles, namely, dyslipidemia group (n = 195) and control group (n = 937). The clinical and laboratory parameters of the two groups were analyzed, and a multivariate logistic regression analysis of the cLBR was conducted. In addition, subgroup analysis was carried out to avoid deviation according to the body mass index (BMI).Results: Patients with dyslipidemia had significantly greater BMI and longer duration of infertility, as well as lower antral follicle count and basal follicle-stimulating hormone level compared with patients without dyslipidemia. Stratified analysis showed that dyslipidemia was associated with a significantly higher total gonadotrophin dosage required for ovarian stimulation as well as lower number of oocytes retrieved, independent of obesity. The live-birth rate in fresh cycle and cLBR were higher in the control group, although the difference between the groups was not significant (54.9% vs. 47.3%, p = 0.116; 67.6% vs. 62.1%, p = 0.138). However, multivariate logistic regression analysis adjusting for potential confounders showed that dyslipidemia was negatively associated with cLBR (OR, 0.702, 95% CI, 0.533–0.881, p = 0.044).Conclusion: Our findings demonstrate for the first time that dyslipidemia has a deleterious impact on cLBR, independent of obesity, in non-PCOS population considered to have good prognosis. Assessment of serum lipid profiles as well as the provision of nutritional counseling is essential for increasing successful outcomes in assisted reproductive techniques.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

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