Edmonton Obesity Staging System: association with weight history and mortality risk

We sought to determine whether the Edmonton Obesity Staging System (EOSS), a newly proposed tool using obesity-related comorbidities, can help identify obese individuals who are at greater mortality risk. Data from the Aerobics Center Longitudinal Study (n = 29 533) were used to assess mortality risk in obese individuals by EOSS stage (follow-up (SD), 16.2 (7.5) years). The effect of weight history and lifestyle factors on EOSS classification was explored. Obese participants were categorized, using a modified EOSS definition, as stages 0 to 3, based on the severity of their risk profile and conditions (stage 0, no risk factors or comorbidities; stage 1, mild conditions; and stages 2 and 3, moderate to severe conditions). Compared with normal-weight individuals, obese individuals in stage 2 or 3 had a greater risk of all-cause mortality (stage 2 hazards ratio (HR) (95% CI), 1.6 (1.3–2.0); stage 3 HR, 1.7 (1.4–2.0)) and cardiovascular-related mortality (stage 2 HR, 2.1 (1.6–2.8); stage 3 HR. 2.1 (1.6–2.8)). Stage 0/1 was not associated with higher mortality risk. Lower self-ascribed preferred weight, weight at age 21, cardiorespiratory fitness, reported dieting, and fruit and vegetable intake were each associated with an elevated risk for stage 2 or 3. Thus, EOSS offers clinicians a useful approach to identify obese individuals at elevated risk of mortality who may benefit from more attention to weight management. Further research is necessary to determine what EOSS factors are most predictive of mortality risk, and whether these findings can be generalized to other obese populations.

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Ketogenic Diet Acts on Body Remodeling and MicroRNAs Expression Profile

MicroRNA ◽

10.2174/2211536608666181126093903 ◽

2019 ◽

Vol 8 (2) ◽

pp. 116-126 ◽

Cited By ~ 7

Author(s):

Roberto Cannataro ◽

Mariarita Perri ◽

Luca Gallelli ◽

Maria Cristina Caroleo ◽

Giovambattista De Sarro ◽

...

Keyword(s):

Ketogenic Diet ◽

Staging System ◽

Biochemical Parameter ◽

Blood Biochemical ◽

Low Carbohydrate ◽

Obese Subjects ◽

Biochemical Mechanisms ◽

Edmonton Obesity Staging System ◽

Stage 1 ◽

Obesity Staging

Background: The Ketogenic Diet (KD) promotes metabolic changes and optimizes energy metabolism. It is unknown if microRNAs (miRs) are influenced by KD in obese subjects. The screening of circulating miRs was performed with the FDA approved platform n-counter flex and blood biochemical parameters were dosed by ADVIA 1800. </P><P> Objectives: The aim of this study was to evaluate mir profile under 6 weeks of biphasic KD in obese subjects. We enrolled 36 obese subjects (18 females and 18 males) in stage 1 of Edmonton Obesity Staging System (EOSS) parameter. </P><P> Result: Any correlation was found between biochemical parameter and three miRs, hsa-let-7b-5p, hsa-miR-143-3p and hsa-miR-504-5p influenced in an equal manner in both sexes. The KD resulted safe and ameliorate both biochemical and anthropometric factors in obese subjects re-collocating them into stage 0 of EOSS parameters. Conclusion: The miRs herein identified under KD might be a useful tool to monitor low carbohydrate nutritional regimens which reflect indirectly the regulatory biochemical mechanisms and cell signaling that orchestrate metabolic and signaling pathways.

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The utility of the Edmonton Obesity Staging System for the prediction of COVID-19 outcomes: a multi-centre study

International Journal of Obesity ◽

10.1038/s41366-021-01017-8 ◽

2022 ◽

Author(s):

Marcela Rodríguez-Flores ◽

Eduardo W. Goicochea-Turcott ◽

Leonardo Mancillas-Adame ◽

Nayely Garibay-Nieto ◽

Malaquías López-Cervantes ◽

...

Keyword(s):

Staging System ◽

Normal Weight ◽

Overweight And Obesity ◽

Class Iii ◽

Multi Centre Study ◽

Adjusted Risk ◽

Increased Risk ◽

Classification Tool ◽

Edmonton Obesity Staging System ◽

Obesity Staging

Abstract Background Patients with obesity have an increased risk for adverse COVID-19 outcomes. Body mass index (BMI) does not acknowledge the health burden associated this disease. The performance of the Edmonton Obesity Staging System (EOSS), a clinical classification tool that assesses obesity-related comorbidity, is compared with BMI, with respect to adverse COVID-19 outcomes. Methods 1071 patients were evaluated in 11 COVID-19 hospitals in Mexico. Patients were classified into EOSS stages. Adjusted risk factors for COVID-19 outcomes were calculated and survival analysis for mechanical ventilation and death was carried out according to EOSS stage and BMI category. Results The risk for intubation was higher in patients with EOSS stages 2 and 4 (HR 1.42, 95% CI 1.02–1.97 and 2.78, 95% CI 1.83–4.24), and in patients with BMI classes II and III (HR 1.71, 95% CI 1.06–2.74, and 2.62, 95% CI 1.65–4.17). Mortality rates were significantly lower in patients with EOSS stages 0 and 1 (HR 0.62, 95% CI 0.42–0.92) and higher in patients with BMI class III (HR 1.58, 95% CI 1.03–2.42). In patients with a BMI ≥ 25 kg/m2, the risk for intubation increased with progressive EOSS stages. Only individuals in BMI class III showed an increased risk for intubation (HR 2.24, 95% CI 1.50–3.34). Mortality risk was increased in EOSS stages 2 and 4 compared to EOSS 0 and 1, and in patients with BMI class II and III, compared to patients with overweight. Conclusions EOSS was associated with adverse COVID-19 outcomes, and it distinguished risks beyond BMI. Patients with overweight and obesity in EOSS stages 0 and 1 had a lower risk than patients with normal weight. BMI does not adequately reflect adipose tissue-associated disease, it is not ideal for guiding chronic-disease management.

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Modulation of MicroRNAs Linked to Pain-migraine by Ketogenic Diet (P14-007-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz052.p14-007-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 2

Author(s):

Roberto Cannataro ◽

Mariarita Perri ◽

Maria Cristina Caroleo ◽

Luca Gallelli ◽

Giovambattista De Sarro ◽

...

Keyword(s):

Ketogenic Diet ◽

Target Genes ◽

Staging System ◽

Obese Patients ◽

Circulating Micrornas ◽

Funding Sources ◽

Before And After ◽

Edmonton Obesity Staging System ◽

Stage 1 ◽

Obesity Staging

Abstract Objectives Migraine is a neurovascular disorder with complex pathophysiology. The ketogenic diet (KD) it is well recognized to treat epilepsy drug-resistant as well as other neurological disorder including migraine. Our previous study showed that six weeks of biphasic KD influences circulating microRNAs (miRs) linked to energy metabolism (Cannataro R., Perri M. et al. MicroRNA (2019) 8: 1). At the end of the study, six female obese patients self-reported to had a better outcome of pain-migraine and migraine attack. Therefore, we analyzed miRs associated with pain-migraine. Methods The KD was planned depending on the dietary diary recorded by each subject for 14 days before starting the KD program and was set with less than 30 g of carbohydrate per day. Six female obese patients in stage 1 of the Edmonton Obesity Staging System (EOSS) parameter self-reporting suffering of migraine were analyzed for miRs linked to pain-migraine. 200 microL of blood/serum was used for the extraction of miRs and their expression profile was achieved by direct hybridization using the multiplexed NanoString nCounter-flex system. In silico bioinformatics approach (using miRWalk, miR target link, and target scan) were employed to detect target genes and miRNA-regulated biological function. Results The six female obese patients whose reduce their weight during the biphasic KD program, self-reported that migraines attack disappeared only during, and not outside, the cycles of biphasic KD program. Among the 7 miRs linked to pain-migraine (Gallelli L. et al. MicroRNA (2017) 6: 152), 6 were found substantially at the same levels before and after the KD program (Table 1). Even, the brain-enriched hsa-382–5p was confirmed to be unchanged according to previous finding (Andersen H.H. et al. Mol Neurobiol. (2016) 53: 1494) (Table 1). While the has-miR-590–5p and the emerging hsa -miR-660–3p were strongly affected by KD (Fig 1A-B). The validated target gene of this three latter miRs were 3, 2 and any respectively (Table 2). Conclusions KD thought miRs modulation could contribute to restore brain excitability and metabolism and to counteract neuroinflammation and pain-migraine, although the precise mechanism is still unclear. Funding Sources Fund was obtained from Calabria Regional Council POR FSE 2007/2013 to EC. Supporting Tables, Images and/or Graphs

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