Safety of Doacs in Patients of Extreme Weight

Abstract Direct Oral Anticoagulants (DOACs), specifically factor Xa inhibitors, have been approved for VTE treatment, VTE prophylaxis after hip and knee replacement, and stroke prevention in non-valvular atrial fibrillation. The DOACs are fast replacing warfarin for these indications due to their ease of administration, fixed dosing, and fast onset and offset of action. However, there are no specific dosing recommendations for DOACs in patient with extreme body weight because these agents were not well represented in the clinical trials, and no specific trials examining safety or efficacy in patients of extreme weight have been conducted. A recent analysis of clinical trials data by the ISTH suggests that while data is limited, the available data suggests that DOACs are safe in patients less than 120 kg at standard doses, and are not recommended in patients greater than 120 kg unless specific concentration levels are obtained to assess their efficacy. To better understand the safety of DOACs in patients of extreme weights, we performed a retrospective analysis of a random sample of patients of low weight (<60 kg), normal weight (60-120 kg), and extreme weight (>120 kg). A random sample of 113 charts was extracted from the medical record; 34 patients were excluded due to missing data, and 79 patients were included with 27 in the <60 kg group, and 26 in both the normal and obese weight groups. Data was collected on patients from May 2011 through April 2016. Baseline patient characteristics, bleeding events, documented clot progression, and several laboratory values (hemoglobin, platelet count, creatinine and INR at commencement of anticoagulation, hemoglobin and INR at discharge or closest follow up appointment) were recorded. The outcomes assessed were rates of bleeding and clot progression. Thirty-five (44.30%) patients were male. The average age in each group was 64, 65, and 64, respectively. Forty-eight (60.76%) patients received apixaban, and the remaining patients were given rivaroxaban. Thirty-six (45.57%) patients received anticoagulation for atrial fibrillation, 26 (32.91%) had deep vein thrombosis, 13 (16.46%) had pulmonary embolism, and 4 (5.06%) had other reasons, such as peripheral arterial disease or arterial thrombus. In the low weight group, 9 patients had a documented bleeding episode (33.33%, p=0.1289), versus 4 patients in the normal weight group (15.38%) and 9 patients in the overweight group (27.85%, p=0.1091). There was no major bleeding in patients of normal weight but bleeding occurred in 4 in the underweight group 14.81%, p=.0413) and 3 in the overweight group (11.54%, p=.0744). In total, 22 of 79 patients (27.85%) had a bleeding episode. Two patients in the underweight group had clot progression (7.41%, p=0.9681), versus 2 patients in the normal weight group and no patients in the overweight group. There was no significant difference between patients who bled and those who did not bleed in creatinine, hemoglobin, platelet count or INR at the time of initiation of DOAC. We did not find a significant difference in rates of bleeding in low weight or overweight patients when compared to normal weight individuals; however there was a trend toward significance in both groups. Patients received either 5 mg bid of apixaban or 20 mg daily of rivaroxaban in both groups, therefore the difference was not attributable to different prescribing patterns. Neither group had a significant number of patients with clot progression. It is intriguing that both low weight and overweight patients had similar rates of bleeding (33.33 and 34.62%, respectively).The PK/PD data referenced by the ISTH raised the concern that overweight patients may actually be underdosed if given standard doses of DOACs. Our data, though limited by the small number of patients, poses very interesting and clinically relevant questions about DOAC use in both weight extremes: are we overdosing DOACs for underweight patients? Why are overweight patients bleeding at similar rates? We plan on formulating a prospective study to answer these questions, utilizing drug-specific peak and trough levels to ascertain sub-, supra-, and therapeutic levels in patients who bleed on DOAC therapy. Table Table. Disclosures No relevant conflicts of interest to declare.

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The Association between Childhood Overweight and Reflux Esophagitis

Journal of Obesity ◽

10.1155/2010/136909 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Nirav R. Patel ◽

Mary J. Ward ◽

Debra Beneck ◽

Susanna Cunningham-Rundles ◽

Aeri Moon

Keyword(s):

Early Recognition ◽

Retrospective Chart Review ◽

Childhood Overweight ◽

Normal Weight ◽

Weight Group ◽

Normal Weight Group ◽

Significant Difference ◽

Overweight Group ◽

And Gender ◽

Overweight Subjects

Background. In adults, it has been shown that obesity is associated with gastroesophageal reflux disease (GERD) and GERD-related complications. There are sparse pediatric data demonstrating associations between childhood overweight and GERD.Objective. To investigate the association between childhood overweight and RE.Methods. We performed a retrospective chart review of 230 children (M : : 116) who underwent esophagogastroduodenoscopy (EGD) with biopsies between January 2000 and April 2006. Patient demographics, weight, height, clinical indications for the procedure, the prevalence of BMI classification groups, the prevalence of RE and usage of anti-reflux medications were reviewed. For these analyses, the overweight group was defined to include subjects with 85th percentile. The normal weight group was defined to include subjects with BMI 5th to 85th percentile.Results. Among the 230 subjects, 67 (29.1%) had BMI percentiles above the 85th percentile for age and gender. The prevalence of RE in the overweight group did not differ significantly from that in the normal weight group (23.9% versus 24.5%, resp.). Overweight subjects taking anti-reflux medications clearly demonstrated a higher prevalence of biopsy-proven RE compared to overweight subjects not taking anti-reflux medications (34.1% versus 7.7%, ).Conclusions. There was no significant difference in the prevalence of biopsy-proven RE in the overweight group compared to the normal weight group. However, the prevalence of RE was significantly higher in overweight subjects on anti-reflux medications compared to overweight subjects not taking anti-reflux medications. This finding emphasizes the importance of early recognition and treatment of GERD for the overweight pediatric patients with symptoms in conjunction with weight loss program for this population to reduce long-term morbidities associated with GERD.

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Frequency of Selenomonas Noxia in Oral Microbiota of Obese and Normal Weight People in Duhok-Iraq

Science Journal of University of Zakho ◽

10.25271/sjuoz.2019.7.4.674 ◽

2019 ◽

Vol 7 (4) ◽

pp. 120-124

Author(s):

Roshna M. Qadir ◽

Mahde S. Abdulrahman

Keyword(s):

Oral Bacteria ◽

Normal Weight ◽

Oral Microbiome ◽

Oral Microbiota ◽

Obese People ◽

Overweight People ◽

Significant Difference ◽

Overweight Group ◽

Oral Carriage ◽

Selenomonas Noxia

Obesity represents one of the major problematic health issues worldwide. Recent evidences suggest that obesity is related with the alteration of the oral microbiome. The aim of this study was to measure the salivary bacterial Selenomonas noxia in Duhok population. A total of 155 saliva samples were collected from individuals (aged between 19-35 years) of both genders (86 females and 69 males). The individuals were divided into three groups (obese, overweight, and normal weight) based on their body mass index. Bacterial genomic DNA was extracted from saliva samples. Molecular detections of Selenomonas noxia were performed by the polymerase chain reaction. Among the 155 participants, 34.1% were obese, 26.4% overweight and 39.3% normal weight individuals. The prevalence rate of oral S. noxia among all people was 82.6%. The highest rate of S. noxia was in obese people (86.8%), followed by overweight (85.4%) and normal weight people (77%). The prevalence of S. noxia in overweight people was statistically significant in compare with the normal weight people (p<0.0001). Moreover, the oral carriage of S. noxia was highest among the overweight females (94.5%) followed by obese females (88.9%). However, no significant difference was found compared to males. The result revealed that it is possible to assume that the expansion of S. noxia in saliva is due to obesity. Moreover, the composition of salivary microbiome may lead to the risk that the overweight group is at risk of future obesity. However, further investigations are required with larger sample and participants with different socioeconomic status in order to address the exact link between obesity and oral bacteria. This could lead to a new and promising therapeutic way for improving human's health.

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Efficacy of Yttrium-90 Zevalin Outside of Clinical Trials: Preliminary Results of a Retrospective Bi-Center Study

Blood ◽

10.1182/blood.v112.11.5015.5015 ◽

2008 ◽

Vol 112 (11) ◽

pp. 5015-5015

Author(s):

Francesco Cicone ◽

Francesco Scopinaro ◽

Sebastien Baechler ◽

Nicolas Ketterer ◽

Franz Buchegger ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Setting ◽

Patient Population ◽

Statistical Significance ◽

University Hospital ◽

Low Grade ◽

Number Of Patients ◽

Significant Difference ◽

Routine Clinical Setting

Abstract Background and Aim: Due to limited data regarding the efficacy of Radioimmunotherapy with 90Y-Zevalin (RIT-Z) outside of controlled clinical trials, we carried out a biinstitutional, international retrospective study to assess the efficacy of RIT-Z in a routine clinical setting. The relationship between the number of previous therapies and outcomes as well as the response to the last therapy was assessed. Possible differences in outcomes for patients treated in the two different centers were also analyzed. Materials and Methods: Forty-three consecutive patients treated at the University Hospital of Lausanne (CHUV, Switzerland) and at S. Andrea University Hospital of Rome (Italy) were evaluated, none of which had been previously included in clinical trials. Only 31 patients entered the final analysis: patients lost at follow up, undergoing autologous transplantation (ASCT), or treated within the last 3 months were excluded. Efficacy of therapy was evaluated in terms of Overall Survival (OS), Progression Free Survival (PFS), and Time to Next Treatment (TTNT). Survival curves were obtained with the Kaplan- Meier method (statistical significance = p<0.05). Results: Characteristics of the patient population are listed in Table 1. Although 50% of the patients had aggressive histologies, patients treated at S. Andrea had slightly more favorable features than those treated at CHUV. Fourteen patients (45%) had received at least 4 previous treatments, and all had received Rituximab. Fourteen patients (45%) had not responded to the last therapy, while 6 (19%), all treated at S.Andrea, were considered disease-free at the time of RIT-Z, which was administered for consolidation. Median follow up time was 20 months (11.5 vs. 25 months for S.Andrea and CHUV, respectively). Median PFS and TTNT were similar. After achieving a partial response, 2 patients were referred to Rituximab maintenance after RIT-Z and remain progression-free. Median OS was still not attained. Although not statistically significant, a trend towards better outcomes for S. Andrea patients was found. In comparing patients with indolent and aggressive lymphoma, only PFS was found to be significantly different (median PFS: 10 vs. 5 months, p<0.05). In patients with <4 and ≥ 4 previous therapies, twenty month OS was 88% vs. 53.6% (p=0.02), respectively; median TTNT was 22 vs. 5 months (p=0.013), while differences in PFS did not attain statistical significance. The duration of response in non-responders to their last therapy was shorter than in responders: 20-month OS- 44% vs. 94% (p=0.0015), median PFS and TTNT- 3.5 vs. 15 months (p=0.0002) and 4 vs. 15 months (p=0.0001), respectively. Median PFS and TTNT after RIT-Z did not differ from those found after the last therapy. A significant difference in outcomes for heavily pretreated or refractory patients was found in those with low grade follicular lymphoma. Conclusions: Poorer outcomes were found in our patient population treated in a routine clinical setting compared to those enrolled in clinical trials. This may be related to greater heterogeneity of our study cohort which included more patients with unfavorable conditions (e.g. aggressive NHL, ≥4 treatment courses including rituximab in all, and ASCT in 25%). Our results suggest that the best benefit may be expected with RIT-Z either for consolidation or relatively earlier in the course of NHL treatment. Table 1. Total CHUV S. Andrea Population Analyzed (72%) Number of patients 43 23 20 31 Median Age 61 63 58,5 62 Aggressive Histology (FL grade 3 or DLBCL) 18 (41,8%) 8 (34,7%) 10 (50%) 11 (35,5%) Indolent Histology (FL grade 1 or 2) (%) 25 (58,2%) 15 (65,3%) 10 (50%) 20 (64,5%) Patients with ≥4 previous treatments 19 (44,2%) 12 (52,1%) 7 (35%) 14 (45,2%) Patients with previous ASCT 11 (25,6%) 6 (26%) 5 (25%) 8 (25%)

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Obesity Does Not Preclude Safe and Effective Myeloablative Hematopoietic Cell Transplantation (HCT) for Acute Myeloid Leukemia (AML) in Adults

Blood ◽

10.1182/blood.v112.11.51.51 ◽

2008 ◽

Vol 112 (11) ◽

pp. 51-51

Author(s):

Willis H. Navarro ◽

Manza-A Agovi ◽

Brent Logan ◽

Andrea Bacigalupo ◽

Karen K Ballen ◽

...

Keyword(s):

Treatment Failure ◽

Normal Weight ◽

Overweight And Obesity ◽

Weight Group ◽

Risk Of Death ◽

Increased Risk ◽

Significant Difference ◽

Underweight Patients ◽

Autologous Hct ◽

Weight Groups

Abstract INTRODUCTION: Obesity is increasingly common in the US and is frequently associated with co-morbid medical conditions that may increase the risk of HCT, often the optimal treatment for AML. HCT risk and outcomes for AML on the basis of body mass index (BMI) have not been well-characterized. Using data from the Center for International Blood and Marrow Transplant Research (CIBMTR), we have previously shown no significant difference in outcomes for autologous HCT for lymphoma among normal weight, overweight, and obese patients (pts) but worse outcomes for underweight pts (Navarro et al, BBMT 2006, 12(5): 541–51). Here, we compare outcomes by weight groups for AML patients who underwent autologous, related, or unrelated HCT. METHODS: Our final population included patients age ≥ 18 who underwent myeloablative unpurged autologous or allogeneic HCT for AML in 1st or 2nd complete remission, primary induction failure, or 1st relapse reported to the CIBMTR from 1995 to 2004. Cord blood HCTs were excluded. Four weight groups were defined based on BMI (BMI=weight (kg)/ height (m2)): underweight <18; normal=18–25; overweight >25–30; and obese >30. Treatment-related mortality (TRM), relapse, leukemia-free survival (LFS), and overall survival (OS) were compared using multivariable proportional hazards regression analysis accounting for patient, disease and HCT-related variables. RESULTS: We included 373 autologous, 2041 related, and 1801 unrelated transplant recipients. Patient-, disease-, and transplant characteristics were well-matched across weight groups and transplant types. Multivariable analysis examining risks (95% confidence intervals) relative to the normal weight group are: HCT Type Normal Underweight Overweight Obese -- =not done due to insufficient number of pts; NS=not significant; treatment failure = death or recurrence of disease. Autologous n=164 n=5 n=112 n=81 Death -- NS NS Treatment failure -- NS NS Relapse -- NS NS TRM -- NS NS Related Allogeneic n=1161 n=31 n=543 n=268 Death 1.86 (1.24–2.78) NS 1.23 (1.04–1.47) Treatment failure 2.08 (1.37–3.15) NS 1.19 (1.00–1.42) Relapse 2.02 (1.18–3.47) NS NS TRM 2.22 (1.17–4.22) NS 1.32 (1.02–1.70) Unrelated Allogeneic n=846 n=31 n=523 n=368 Death NS NS NS Treatment failure NS NS NS Relapse NS 0.82 (0.68–0.99) 0.76 (0.60–0.96) TRM NS NS NS CONCLUSIONS: There were no significant differences in risk of TRM, LFS, relapse or OS for normal weight, overweight or obese patient groups who received autologous HCT. Obese recipients of related HCT for AML had increased risk of death, treatment failure, and TRM, though the magnitude was small, an effect was not seen in the unrelated HCT group. Underweight patients who received a related, but not unrelated HCT, fared substantially worse than normal weight patients for all outcomes. It may be that the higher risk of the unrelated HCT procedure masks important but less obvious risks associated with being underweight whereas in the related donor HCT setting, such risks become manifest. Small numbers of patients limit the ability to better characterize this finding in underweight patients. Disproportionately, fewer transplants have been reported in underweight patients which suggest they experience disease and patient-related factors that preclude transplantation. No differences were observed for incidence of acute or chronic GVHD for any weight group. Overweight and obesity should not be a barrier to HCT; however, caution should be exercised in selecting underweight patients for HCT.

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Acquisition Protocols to Optimize 68Ga-DOTA-NOC Position Emission Tomography/Computer Tomography Image Quality Based on Patient Body Mass Index and Injected Dose

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.2968 ◽

2020 ◽

Vol 10 (2) ◽

pp. 508-514

Author(s):

Lei Xu ◽

Lei Lei Zhou ◽

Zhenyu Zhao ◽

Qingle Meng ◽

Rui Yang ◽

...

Keyword(s):

Image Quality ◽

Dose Group ◽

Group Versus ◽

Normal Weight ◽

Emission Tomography ◽

Acquisition Time ◽

Position Emission Tomography ◽

Weight Group ◽

Pet Ct ◽

Overweight Group

Background: The choice of 68Ga-DOTA-1-Nal3-octreotide (68Ga-DOTA-NOC) injected dose and Position emission tomography/computer tomography (PET/CT) acquisition time is still a challenge for obtaining consistently high-quality PET image. Objective: To determine the optimal acquisition protocols based on patient body mass index (BMI) and the injected dose per kilogram for 68Ga-DOTA-NOC PET/CT imaging. Patients and Methods: This was a retrospective analysis of 51 patients (21 males and 30 females) who underwent clinical 68Ga-DOTANOC PET/CT imaging from November 2016 to March 2018 in Nanjing first hospital, the average BMI of these patients was 23.18 ± 3.45 kg/m2 with injected dose of 39.55–110.11 MBq. The study population was classified into groups based on Chinese standard BMI and injected dose. PET image quality and acquisition time were evaluated by coefficient of variance (CV) in the liver slice. Results: (1) The CV significantly increased with increasing weight and BMI (r = 0.647, 0.483, all P < 0.01), and significantly decreased with increasing injected dose per kilogram (r = 0 695, P < 0.01). (2) The CV differed significantly among 4 BMI-based groups, except for normal-weight group versus overweight group and overweight group versus obese group (P < 0.01), and the ratio of overweight group and obese group to normal weight group was approximately 1.1 and 1.2, respectively. Meanwhile, the CV had a significant statistical difference among 3 injected dose per kilogram groups (P < 0.01), and the ratio of that for low dose group and high dose group to moderate dose group was approximately 1.2 and 0.8. Conclusion: The findings showed a feasibility of obtaining consistently high-quality PET image at low injected dose and shorter acquisition time. Estimation of optimal acquisition time and injected dose using CV is valid in improving PET image quality, which can provide reference for the establishment and promotion of 68Ga-DOTA-NOC imaging protocols in China.

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The Influence of BMI Levels on Phases of the Menstrual Cycle and Presumed Ovulation

The Linacre Quarterly ◽

10.1179/002436312804827082 ◽

2012 ◽

Vol 79 (4) ◽

pp. 451-459

Author(s):

Mary Grace Lasquety ◽

Dana Rodriguez ◽

Richard J. Fehring

Keyword(s):

Body Mass Index ◽

Menstrual Cycle ◽

Odds Ratio ◽

Luteal Phase ◽

High Body Mass Index ◽

Normal Weight ◽

Menstrual Cycles ◽

Significant Difference ◽

Overweight Group ◽

One Way Anova

Obesity and high body mass index (BMI) are known to be risks for anovulation and infertility. Little is known about how BMI levels affect parameters of the menstrual cycle. The purpose of this study was to determine the influence of BMI on parameters of the menstrual cycle and the likelihood for ovulation. The participants in this study were 244 women between the ages of twenty and fifty-four (mean thirty years) who charted from one to thirty-six menstrual cycles (mean seven cycles) for a total of 2,035 cycles. Urinary luteinizing hormone (LH) threshold tests were used to estimate the day of ovulation and the lengths of the follicular and luteal phases. The 244 participants were classified as normal weight with a BMI of 18.5–24.9 kg/m2 (N = 141), overweight with a BMI of 25–29.9 kg/m2 (N = 67), and obese with a BMI of 30 kg/m2 or greater (N = 36). One-way ANOVA indicated that there was a significant difference between groups in length of the luteal phase (F = 4.62, p < 0.01) and length of menses (F = 3.03, p < 0.05). Odds ratio indicated that the combined obese and overweight group was 34 percent less likely to have a positive detected urinary LH surge. We concluded that obesity might contribute to infertility by shortening the luteal phase and decreasing the probability of ovulatory menstrual cycles.

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Obesity and Overweight Are Independently Associated with Greater Survival in Critically Ill Diabetic Patients: A Retrospective Cohort Study

Journal of Diabetes Research ◽

10.1155/2021/6681645 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Wentao Huang ◽

Yongsong Chen ◽

Guoshu Yin ◽

Nasui Wang ◽

Chiju Wei ◽

...

Keyword(s):

Mechanical Ventilation ◽

Critically Ill ◽

Cox Regression ◽

Normal Weight ◽

Diabetic Patients ◽

Weight Group ◽

Normal Weight Group ◽

Obesity And Overweight ◽

Overweight Group ◽

The Relationship

Background. The relationship between obesity and the outcomes of critically ill diabetic patients is not completely clear. We aimed to assess the effects of obesity and overweight on the outcomes among diabetic patients in the intensive care unit (ICU). Methods. Critically ill diabetic patients in the ICU were classified into three groups according to their body mass index. The primary outcomes were 30-day and 90-day mortality. ICU and hospital length of stay (LOS) and incidence and duration of mechanical ventilation were also assessed. Cox regression models were developed to evaluate the relationship between obesity and overweight and mortality. Results. A total of 6108 eligible patients were included. The 30-day and 90-day mortality in the normal weight group were approximately 1.8 times and 1.5 times higher than in the obesity group and overweight group, respectively ( P < 0.001 , respectively). Meanwhile, the ICU (median (IQ): 2.9 (1.7, 5.3) vs. 2.7 (1.6, 4.8) vs. 2.8 (1.8, 5.0)) and hospital (median (IQ): 8.3 (5.4, 14.0) vs. 7.9 (5.1, 13.0) vs. 8.3 (5.3, 13.6)) LOS in the obesity group and overweight group were not longer than in the normal weight group. Compared with normal weight patients, obese patients had significantly higher incidence of mechanical ventilation (58.8% vs. 64.7%, P < 0.001 ) but no longer ventilation duration (median (IQ): 19.3 (7.0, 73.1) vs. 19.0 (6.0, 93.7), P = 1 ). Multivariate Cox regression showed that obese and overweight patients had lower 30-day (HR (95% CI): 0.62 (0.51, 0.75); 0.76 (0.62, 0.92), respectively) and 90-day (HR (95% CI): 0.60 (0.51, 0.70); 0.79 (0.67, 0.93), respectively) mortality risks than normal weight patients. Conclusions. Obesity and overweight were independently associated with greater survival in critically ill diabetic patients, without increasing the ICU and hospital LOS. Large multicenter prospective studies are needed to confirm our findings and the underlying mechanisms warrant further investigation.

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Effect of Body Mass Index on the Prognosis of Liver Cirrhosis

Frontiers in Nutrition ◽

10.3389/fnut.2021.700132 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yue Yin ◽

Yiling Li ◽

Lichun Shao ◽

Shanshan Yuan ◽

Bang Liu ◽

...

Keyword(s):

Liver Cirrhosis ◽

Survival Rate ◽

Normal Weight ◽

Cumulative Survival Rate ◽

Weight Group ◽

Cumulative Survival ◽

Normal Weight Group ◽

Kaplan Meier ◽

Significant Difference

Objective: At present, the association of body mass index (BMI) with the prognosis of liver cirrhosis is controversial. Our retrospective study aimed to evaluate the impact of BMI on the outcome of liver cirrhosis.Methods: In the first part, long-term death was evaluated in 436 patients with cirrhosis and without malignancy from our prospectively established single-center database. In the second part, in-hospital death was evaluated in 379 patients with cirrhosis and with acute gastrointestinal bleeding (AGIB) from our retrospective multicenter study. BMI was calculated and categorized as underweight (BMI <18.5 kg/m2), normal weight (18.5 ≤ BMI < 23.0 kg/m2), and overweight/obese (BMI ≥ 23.0 kg/m2).Results: In the first part, Kaplan–Meier curve analyses demonstrated a significantly higher cumulative survival rate in the overweight/obese group than the normal weight group (p = 0.047). Cox regression analyses demonstrated that overweight/obesity was significantly associated with decreased long-term mortality compared with the normal weight group [hazard ratio (HR) = 0.635; 95% CI: 0.405–0.998; p = 0.049] but not an independent predictor after adjusting for age, gender, and Child–Pugh score (HR = 0.758; 95%CI: 0.479–1.199; p = 0.236). In the second part, Kaplan–Meier curve analyses demonstrated no significant difference in the cumulative survival rate between the overweight/obese and the normal weight groups (p = 0.094). Cox regression analyses also demonstrated that overweight/obesity was not significantly associated with in-hospital mortality compared with normal weight group (HR = 0.349; 95%CI: 0.096-1.269; p = 0.110). In both of the two parts, the Kaplan–Meier curve analyses demonstrated no significant difference in the cumulative survival rate between underweight and normal weight groups.Conclusion: Overweight/obesity is modestly associated with long-term survival in patients with cirrhosis but not an independent prognostic predictor. There is little effect of overweight/obesity on the short-term survival of patients with cirrhosis and with AGIB.

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Correlation between obesity and clinicopathological characteristics in patients with papillary thyroid cancer: a study of 1579 cases: a retrospective study

PeerJ ◽

10.7717/peerj.9675 ◽

2020 ◽

Vol 8 ◽

pp. e9675

Author(s):

Huijuan Wang ◽

Pingping Wang ◽

Yu Wu ◽

Xiukun Hou ◽

Zechun Peng ◽

...

Keyword(s):

Clinicopathological Characteristics ◽

Normal Weight ◽

Obese Group ◽

Papillary Thyroid ◽

Weight Group ◽

Normal Weight Group ◽

Advanced Tumor ◽

Tumor Node Metastasis Stage ◽

Overweight Group ◽

The Relationship

Objective To explore the relationship between body mass index (BMI) and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC). Methods The clinical data of 1,579 patients with PTC, admitted to our hospital from May 2016 to March 2017, were retrospectively analyzed. According to the different BMI of patients, it can be divided into underweight recombination (BMI < 18.5 kg/m), normal body recombination (18.5 ≤ BMI < 24.0 kg/m2), overweight recombination (24.0 ≤ BMI < 28.0 kg/m2) and obesity group (BMI ≥ 28.0 kg/m2). The clinicopathological characteristics of PTC in patients with different BMIs group were compared. Results In our study, the risk for extrathyroidal extension (ETE), advanced T stage (T III/IV), and advanced tumor-node-metastasis stage (TNM III/IV) in the overweight group were higher, with OR (odds ratio) = 1.99(1.41–2.81), OR = 2.01(1.43–2.84), OR = 2.94(1.42–6.07), respectively, relative to the normal weight group. The risk for ETE and T III/IV stage in the obese group were higher, with OR = 1.82(1.23–2.71) and OR = 1.82(1.23–2.70), respectively, relative to the normal weight group. Conclusion BMI is associated with the invasiveness of PTC. There is a higher risk for ETE and TNM III/IV stage among patients with PTC in the overweight group and for ETE among patients with PTC in the obese group.

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Obesity phenotypes and their relationships with atrial fibrillation

PeerJ ◽

10.7717/peerj.12342 ◽

2021 ◽

Vol 9 ◽

pp. e12342

Author(s):

Szu-Ying Tsai ◽

Hsin-Hao Chen ◽

Hsin-Yin Hsu ◽

Ming-Chieh Tsai ◽

Le-Yin Hsu ◽

...

Keyword(s):

Atrial Fibrillation ◽

Confidence Interval ◽

Normal Weight ◽

Metabolic Health ◽

Point Estimate ◽

Weight Group ◽

Wide Confidence Interval ◽

Metabolically Healthy ◽

Weight Groups

Background This study assessed the associations of metabolic obesity phenotypes with the risk of atrial fibrillation (Afib). Methods This prospective cohort study categorized Taiwanese adults according to their body mass index (BMI) and metabolic health status at baseline. We assigned the participants to the underweight (BMI < 18.5 kg/m2), normal weight (BMI = 18.5–23.9 kg/m2), and overweight/obesity groups (BMI ≥ 24 kg/m2). Metabolically healthy was defined as absence of hypertension, diabetes, and hyperlipidemia and the presence of healthy metabolic profiles. Results In total, 5,742 adults were included. During a median follow-up of 13.7 years, 148 patients developed Afib. Compared to the metabolically healthy normal weight group, the risk of Afib was significantly higher than those in the metabolically unhealthy overweight/obesity (hazard ratio = 2.20, 95% confidence interval [1.12–4.33]) and metabolically unhealthy normal weight groups (HR = 2.64, 95% CI [1.34–5.17]). Additionally, the point estimate suggested a 1.97-fold greater risk among the metabolically healthy overweight/obesity group, although this difference was not significant given the wide confidence interval (HR = 1.97, 95% CI [0.80–4.86]). Conclusion Our results demonstrated the relationships of metabolic health and weight regarding the risk of Afib in Taiwanese adults. The Afib risk among metabolic and obesity phenotypes is associated with a metabolically unhealthy status. A trend toward a higher Afib risk with obesity among metabolically healthy subjects was observed. However, the result was not robust and it still suggested further study.

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