scholarly journals Frequency of Self-Weighing and Weight Change: Cohort Study With 10,000 Smart Scale Users (Preprint)

2020 ◽  
Author(s):  
Anna-Leena Vuorinen ◽  
Elina Helander ◽  
Julia Pietilä ◽  
Ilkka Korhonen
Keyword(s):  
Weight Loss ◽  
Cohort Study ◽  
Weight Change ◽  
Linear Models ◽  
Measurement Data ◽  
Normal Weight ◽  
Free Living ◽  
The Mean ◽  
Weight Loss Interventions

BACKGROUND Frequent self-weighing is associated with successful weight loss and weight maintenance during and after weight loss interventions. Less is known about self-weighing behaviors and associated weight change in free-living settings. OBJECTIVE This study aimed to investigate the association between the frequency of self-weighing and changes in body weight in a large international cohort of smart scale users. METHODS This was an observational cohort study with 10,000 randomly selected smart scale users who had used the scale for at least 1 year. Longitudinal weight measurement data were analyzed. The association between the frequency of self-weighing and weight change over the follow-up was investigated among normal weight, overweight, and obese users using Pearson’s correlation coefficient and linear models. The association between the frequency of self-weighing and temporal weight change was analyzed using linear mixed effects models. RESULTS The eligible sample consisted of 9768 participants (6515/9768, 66.7% men; mean age 41.5 years; mean BMI 26.8 kg/m2). Of the participants, 4003 (4003/9768, 41.0%), 3748 (3748/9768, 38.4%), and 2017 (2017/9768, 20.6%) were normal weight, overweight, and obese, respectively. During the mean follow-up time of 1085 days, the mean weight change was –0.59 kg, and the mean percentage of days with a self-weigh was 39.98%, which equals 2.8 self-weighs per week. The percentage of self-weighing days correlated inversely with weight change, <i>r</i>=–0.111 (<i>P</i>&lt;.001). Among normal weight, overweight, and obese individuals, the correlations were <i>r</i>=–0.100 (<i>P</i>&lt;.001), <i>r</i>=–0.125 (<i>P</i>&lt;.001), and <i>r</i>=–0.148 (<i>P</i>&lt;.001), respectively. Of all participants, 72.5% (7085/9768) had at least one period of ≥30 days without weight measurements. During the break, weight increased, and weight gains were more pronounced among overweight and obese individuals: 0.58 kg in the normal weight group, 0.93 kg in the overweight group, and 1.37 kg in the obese group (<i>P</i>&lt;.001). CONCLUSIONS Frequent self-weighing was associated with favorable weight loss outcomes also in an uncontrolled, free-living setting, regardless of specific weight loss interventions. The beneficial associations of regular self-weighing were more pronounced for overweight or obese individuals.

scholarly journals Weight loss, adherence, and dietary intakes of free-living adults consuming calorie-restricted diets varying in macronutrient composition: the POUNDS LOST Study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Catherine Champagne ◽  
Derek Miketinas ◽  
Frank Sacks ◽  
George Bray
Keyword(s):  
Weight Loss ◽  
Energy Density ◽  
Weight Change ◽  
Healthy Eating Index ◽  
Dietary Adherence ◽  
Fiber Intake ◽  
Macronutrient Composition ◽  
Free Living ◽  
Diet Type

AbstractVarious diets have been examined as potential weight-loss treatment for individuals with overweight and obesity. POUNDS LOST was a 2-year randomized clinical trial examining effects of four calorie-restricted diets of varying macronutrient composition on weight loss in free-living adults with obesity. The main results demonstrated that reducing calories, regardless of macronutrient content, can reduce body weight. Participants were randomized to receive one of four diets: 1) 20% fat, 15% protein; 2)20% fat, 25% protein; 3) 40% fat, 15% protein; and 4) 40% fat, 25% protein. Eight hundred eleven (811) subjects participated in the trial and weight loss, as expected, varied considerably. Three hundred forty-five participants (54.8% female; 86.5% Caucasian, 12.4% African American, and 1.1% other) provided baseline and 6-month follow-up dietary data. Dietary adherence was defined as consuming within + 5% of the target macronutrient composition for fat and protein. Stepwise regression and cross-validation techniques were used to model weight loss as a function of the following predictors: age, dietary adherence, energy density change, and fiber intake. Additionally, we explored whether all four diet types were healthy using the Healthy Eating Index 2015 (USDA). At 6 months, participants assigned to each diet had lost an average of 6 kg. Mean weight loss among adherers however was -8.4 + 5.0 kg and also did not vary across diet-type. Change in energy density was positively associated with weight change while age, dietary adherence, and fiber intake were inversely associated with weight change. Fiber intake was the strongest predictor of weight change; on average, a 10 g increase in fiber intake was associated with 2.2 kg decrease in body weight after 6 months of the dietary intervention. Only 46 (13.3%) of the 345 participants who provided follow-up data (61% male, 93% Caucasian) met the criteria for adherence to both energy (± 10% of target) and macronutrient targets. A decrease in energy density was positively associated with weight change for each diet-type; however, this effect was most profound in the high-fat, average-protein diet. Healthy Eating Index 2015 scores for the diets consumed by the subjects were: LF/AP, 74.8 ± 9.7; LF/HP, 73.8 ± 12.4; HF/AP, 73.4 ± 13.0; and HF/HP, 74.2 ± 9.8, which exceeds the scores of most Americans. These results suggest that dietary factors may positively influence weight loss in addition to energy intake and macronutrient composition. Furthermore, modified macronutrient, calorie-reduced diets can indeed be healthy compared to current dietary habits of US adults.

scholarly journals Regression to the mean contributes to the apparent improvement in glycemia 3.8 years after screening – the ELSA-Brasil Study

2020 ◽  
Author(s):  
Maria Inês Schmidt ◽  
Paula Bracco ◽  
Scheine Canhada ◽  
Joanna MN Guimarães ◽  
Sandhi Maria Barreto ◽  
...  
Keyword(s):  
Weight Loss ◽  
Real World ◽  
Complete Regression ◽  
Regression To The Mean ◽  
Free Living ◽  
Before And After ◽  
Baseline Values ◽  
The Mean ◽  
Design And Methods

<b>Objective </b> <p>Glycemic regression is common in real world settings, but the contribution of regression to the mean (RTM) has been little investigated. We aimed to estimate glycemic regression before and after adjusting for RTM in a free-living cohort of adults with newly ascertained diabetes and intermediate hyperglycemia (IH). </p> <p><b>Research Design and Methods</b></p> <p>ELSA-Brasil is a cohort study of 15,105 adults screened between 2008-2010 with standardized OGTT and HbA1c, repeated after 3.84 (0.42) years. After excluding those receiving medical treatment for diabetes, we calculated partial or complete regression before and after adjusting baseline values for RTM. </p> <p><b>Results</b></p> <p>Regarding newly ascertained diabetes, partial or complete regression was seen in 49.4% (95%CI 45.2 – 53.7); after adjustment for RTM, in 20.2% (95%CI 12.1 – 28.3). Regarding IH, regression to normal levels was seen in 39.5% (95%CI 37.9 – 41.3) or in 23.7% (95%CI 22.6% – 24.3%) depending on the WHO or the ADA definition, respectively; after adjustment, corresponding frequencies were 26.1% (95%CI 22.4 – 28.1) and 19.4% (95%CI 18.4 – 20.5). Adjustment for RTM reduced the number of cases detected at screening: 526 to 94 cases of diabetes; 3118 to 1986 cases of WHO-defined IH; and 6182 to 5711 cases of AD-defined IH. Weight loss ≥2.6% was associated with greater regression from diabetes (RR=1.52 95%CI 1.26-1.84) and IH (RR=1.30 95%CI 1.17-1.45). </p> <p><b>Conclusions</b></p> <p>In this quasi-real-world setting, regression from diabetes at ~4 years was common, less so for IH. Regression was frequently explained by RTM, but, in part, also related to improved weight loss and homeostasis over the follow-up. </p>

scholarly journals Regression to the mean contributes to the apparent improvement in glycemia 3.8 years after screening – the ELSA-Brasil Study

2020 ◽  
Author(s):  
Maria Inês Schmidt ◽  
Paula Bracco ◽  
Scheine Canhada ◽  
Joanna MN Guimarães ◽  
Sandhi Maria Barreto ◽  
...  
Keyword(s):  
Weight Loss ◽  
Real World ◽  
Complete Regression ◽  
Regression To The Mean ◽  
Free Living ◽  
Before And After ◽  
Baseline Values ◽  
The Mean ◽  
Design And Methods

<b>Objective </b> <p>Glycemic regression is common in real world settings, but the contribution of regression to the mean (RTM) has been little investigated. We aimed to estimate glycemic regression before and after adjusting for RTM in a free-living cohort of adults with newly ascertained diabetes and intermediate hyperglycemia (IH). </p> <p><b>Research Design and Methods</b></p> <p>ELSA-Brasil is a cohort study of 15,105 adults screened between 2008-2010 with standardized OGTT and HbA1c, repeated after 3.84 (0.42) years. After excluding those receiving medical treatment for diabetes, we calculated partial or complete regression before and after adjusting baseline values for RTM. </p> <p><b>Results</b></p> <p>Regarding newly ascertained diabetes, partial or complete regression was seen in 49.4% (95%CI 45.2 – 53.7); after adjustment for RTM, in 20.2% (95%CI 12.1 – 28.3). Regarding IH, regression to normal levels was seen in 39.5% (95%CI 37.9 – 41.3) or in 23.7% (95%CI 22.6% – 24.3%) depending on the WHO or the ADA definition, respectively; after adjustment, corresponding frequencies were 26.1% (95%CI 22.4 – 28.1) and 19.4% (95%CI 18.4 – 20.5). Adjustment for RTM reduced the number of cases detected at screening: 526 to 94 cases of diabetes; 3118 to 1986 cases of WHO-defined IH; and 6182 to 5711 cases of AD-defined IH. Weight loss ≥2.6% was associated with greater regression from diabetes (RR=1.52 95%CI 1.26-1.84) and IH (RR=1.30 95%CI 1.17-1.45). </p> <p><b>Conclusions</b></p> <p>In this quasi-real-world setting, regression from diabetes at ~4 years was common, less so for IH. Regression was frequently explained by RTM, but, in part, also related to improved weight loss and homeostasis over the follow-up. </p>

scholarly journals Maternal weight change from prepregnancy to 18 months postpartum and subsequent risk of hypertension and cardiovascular disease in Danish women: A cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. e1003486
Author(s):  
Helene Kirkegaard ◽  
Mette Bliddal ◽  
Henrik Støvring ◽  
Kathleen M. Rasmussen ◽  
Erica P. Gunderson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Weight Loss ◽  
Cohort Study ◽  
Weight Gain ◽  
Weight Change ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Prepregnancy Bmi ◽  
Postpartum Weight

Background One-fourth of women experience substantially higher weight years after childbirth. We examined weight change from prepregnancy to 18 months postpartum according to subsequent maternal risk of hypertension and cardiovascular disease (CVD). Methods and findings We conducted a cohort study of 47,966 women with a live-born singleton within the Danish National Birth Cohort (DNBC; 1997–2002). Interviews during pregnancy and 6 and 18 months postpartum provided information on height, gestational weight gain (GWG), postpartum weights, and maternal characteristics. Information on pregnancy complications, incident hypertension, and CVD was obtained from the National Patient Register. Using Cox regression, we estimated adjusted hazard ratios (HRs; 95% confidence interval [CI]) for hypertension and CVD through 16 years of follow-up. During this period, 2,011 women were diagnosed at the hospital with hypertension and 1,321 with CVD. The women were on average 32.3 years old (range 18.0–49.2) at start of follow-up, 73% had a prepregnancy BMI <25, and 27% a prepregnancy BMI ≥25. Compared with a stable weight (±1 BMI unit), weight gains from prepregnancy to 18 months postpartum of >1–2 and >2 BMI units were associated with 25% (10%–42%), P = 0.001 and 31% (14%–52%), P < 0.001 higher risks of hypertension, respectively. These risks were similar whether weight gain presented postpartum weight retention or a new gain from 6 months to 18 months postpartum and whether GWG was below, within, or above the recommendations. For CVD, findings differed according to prepregnancy BMI. In women with normal-/underweight, weight gain >2 BMI units and weight loss >1 BMI unit were associated with 48% (17%–87%), P = 0.001 and 28% (6%–55%), P = 0.01 higher risks of CVD, respectively. Further, weight loss >1 BMI unit combined with a GWG below recommended was associated with a 70% (24%–135%), P = 0.001 higher risk of CVD. No such increased risks were observed among women with overweight/obesity (interaction by prepregnancy BMI, P = 0.01, 0.03, and 0.03, respectively). The limitations of this observational study include potential confounding by prepregnancy metabolic health and self-reported maternal weights, which may lead to some misclassification. Conclusions Postpartum weight retention/new gain in all mothers and postpartum weight loss in mothers with normal-/underweight may be associated with later adverse cardiovascular health.

scholarly journals Serum 25-hydroxyvitamin D level in relation to weight change and the risk of weight gain in adults of normal weight at baseline: the Norwegian HUNT cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039192
Author(s):  
Adaline Heitz ◽  
Xiao-Mei Mai ◽  
Yue Chen ◽  
Yi-Qian Sun
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Weight Change ◽  
Relative Weight ◽  
Normal Weight ◽  
Secondary Outcome ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Reduced Risk

ObjectiveWe sought to investigate the relationship of serum 25-hydroxyvitamin D (25(OH)D) level with weight change and the risk of weight gain in an adult population who had normal weight at baseline and were followed up for 11 years.DesignA population-based prospective cohort study.SettingNord-Trøndelag, Norway.ParticipantsThe study included 1501 adults who participated in the second and third surveys of the Nord-Trøndelag Health Study (HUNT2 (1995–1997) and HUNT3 (2006–2008)) and had a normal body mass index ≥18.5 and <25.0 kg/m2 at baseline.Primary and secondary outcome measuresRelative weight change (%) was calculated as ((HUNT3 weight−HUNT2 weight)/HUNT2 weight×100). Relative annual weight change (%) was calculated as (relative weight change/follow-up years×100). Clinical weight gain was defined as relative weight change ≥5% over the 11 years, while annual weight gain was defined as relative annual weight change >1.25%.MethodsMultiple regression models were used to estimate adjusted coefficients for the relative annual weight change and risk ratios (RRs) for the risk of clinical weight gain and of annual weight gain.ResultsEach 25 nmol/L increase in season-standardised serum 25(OH)D level at baseline was associated with a reduction of 0.05% (95% CI −0.11 to 0.01) for relative annual weight change, a 10% (RR 0.90, 95% CI 0.82 to 0.97) reduced risk of clinical weight gain, and a 19% (RR 0.81, 95% CI 0.65 to 1.00) reduced risk of annual weight gain. A statistically significant trend was evident for the risk of clinical weight gain when 25(OH)D levels were treated as a categorical variable (p=0.006).ConclusionsThe findings suggested an inverse association of serum 25(OH)D level with the risk of clinical weight gain in adults who had normal weight at baseline over 11 years’ follow-up.

Adult Weight Gain and Risk of Developing Non-Hodgkin Lymphoma (NHL): Results from a Large Prospective Cohort Study of Older Women.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2389-2389
Author(s):  
Aditya Bardia ◽  
Thomas M. Habermann ◽  
Robert A. Vierkant ◽  
Alice H. Wang ◽  
James R. Cerhan
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Older Women ◽  
Hodgkin Lymphoma ◽  
Weight Change ◽  
Adult Weight ◽  
Non Hodgkin Lymphoma ◽  
The Mean ◽  
Percent Weight Gain

Abstract Background: Obesity has been associated with risk of non-Hodgkin lymphoma (NHL) in several recent studies. However, the effect of weight gain during adulthood, a potentially modifiable risk factor, on the incidence of NHL is not clear. We therefore examined the association of weight gain since age 18 years with the risk of NHL among older women. Methods: We examined this association in the Iowa Women’s Health Study, a prospective study of 37,762 Iowa women aged 55 to 69 years at enrollment in 1986. Lifestyle and other risk factors, including weight at age 18 and at enrollment, were self-reported on a mailed questionnaire. We defined stable weight as no increase in weight or up to a 10% weight loss from age 18 to enrollment, while percent weight gain was divided into tertiles based on the distribution observed in the cohort. NHL incidence through 18 years of follow-up was ascertained by linkage with the Iowa SEER Cancer Registry. Cox proportional hazards models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) of percent weight gain with NHL incidence, adjusting for age (Age-adjusted model) and age, marital status, farm residence, transfusion history, diabetes, use of hormone replacement therapy, alcohol use, smoking, and intake of red meat and fruits (Multivariate model). Results: The mean age of the women in the cohort in 1986 was 62.1 years. During 593,474 person-years of follow-up, 379 incident cases of NHL were observed. The mean age at diagnosis was 72.6 years (range 58–87 years). The main results are reported in the table. Similar results were found for absolute weight gain. Stratification of these results on body mass index at age 18 (using a cutpoint of 21 kg/m2) showed similar results, with the exception of >10% weight loss for women with a BMI of <21 at age 18 where we could not estimate a RR (no cases observed). Conclusions: Weight gain or large weight loss (>10% of body weight) during adulthood were both associated with increased risk of NHL, although the RRs for percent weight gain were not statistically significant and there was no dose-response. This study suggests another potential benefit of avoiding adult weight gain, although further studies are needed to confirm these novel findings. Association of percent weight change during adulthood (age 18 to age 55–69 years) and risk of NHL % Weight Change NHL Cases Person-years Age-Adjusted RR(95% CI) Multivariate RR (95% CI) >10% weight loss 15 17053 2.06 (1.05–4.02) 2.02 (1.03–3.95) Stable 20 45973 1 (reference) 1 (reference) 0–18.2% gain 115 175883 1.50 (0.94–2.42) 1.50 (0.93–2.41) 18.3–34.8% gain 119 176258 1.54 (0.96–2.47) 1.53 (0.95–2.47) >34.8% gain 110 178308 1.40 (0.87–2.25) 1.32 (0.82–2.14).

scholarly journals Underweight as a risk factor for respiratory death in the Whitehall cohort study: exploring reverse causality using a 45-year follow-up

Thorax ◽  
2015 ◽  
Vol 71 (1) ◽  
pp. 84-85 ◽  
Author(s):  
Mika Kivimäki ◽  
Martin J Shipley ◽  
Joshua A Bell ◽  
Eric J Brunner ◽  
G David Batty ◽  
...  
Keyword(s):  
Weight Loss ◽  
Risk Factor ◽  
Cohort Study ◽  
Normal Weight ◽  
Reverse Causality ◽  
Respiratory Mortality ◽  
Adjusted Risk ◽  
Stepwise Manner ◽  
Respiratory Death

Underweight adults have higher rates of respiratory death than the normal weight but it is unclear whether this association is causal or reflects illness-induced weight loss (reverse causality). Evidence from a 45-year follow-up of underweight participants for respiratory mortality in the Whitehall study (N=18 823; 2139 respiratory deaths) suggests that excess risk among the underweight is attributable to reverse causality. The age-adjusted and smoking-adjusted risk was 1.55-fold (95% CI 1.32 to 1.83) higher among underweight compared with normal weight participants, but attenuated in a stepwise manner to 1.14 (95% CI 0.76 to 1.71) after serial exclusions of deaths during the first 5–35 years of follow-up (Ptrend<0.001).

scholarly journals Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson
Keyword(s):  
Urinary Incontinence ◽  
Cohort Study ◽  
Real World ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Healthcare Services ◽  
International Consultation ◽  
The Mean

ObjectivesThe efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.DesignProspective cohort study.ParticipantsDuring a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.InterventionThree months’ use of the app Tät, containing information, a pelvic floor muscle training programme and lifestyle advice.Main outcome measuresChange in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).ResultsOf the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.ConclusionsThe app Tät was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.

scholarly journals Association of weight change with cerebrospinal fluid biomarkers and amyloid positron emission tomography in preclinical Alzheimer’s disease

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Oriol Grau-Rivera ◽  
◽  
Irene Navalpotro-Gomez ◽  
Gonzalo Sánchez-Benavides ◽  
Marc Suárez-Calvet ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Weight Loss ◽  
Cerebrospinal Fluid ◽  
Weight Change ◽  
Emission Tomography ◽  
Link Type ◽  
Preclinical Ad ◽  
Positron Emission ◽  
T Tau

Abstract Background Recognizing clinical manifestations heralding the development of Alzheimer’s disease (AD)-related cognitive impairment could improve the identification of individuals at higher risk of AD who may benefit from potential prevention strategies targeting preclinical population. We aim to characterize the association of body weight change with cognitive changes and AD biomarkers in cognitively unimpaired middle-aged adults. Methods This prospective cohort study included data from cognitively unimpaired adults from the ALFA study (n = 2743), a research platform focused on preclinical AD. Cognitive and anthropometric data were collected at baseline between April 2013 and November 2014. Between October 2016 and February 2020, 450 participants were visited in the context of the nested ALFA+ study and underwent cerebrospinal fluid (CSF) extraction and acquisition of positron emission tomography images with [18F]flutemetamol (FTM-PET). From these, 408 (90.1%) were included in the present study. We used data from two visits (average interval 4.1 years) to compute rates of change in weight and cognitive performance. We tested associations between these variables and between weight change and categorical and continuous measures of CSF and neuroimaging AD biomarkers obtained at follow-up. We classified participants with CSF data according to the AT (amyloid, tau) system and assessed between-group differences in weight change. Results Weight loss predicted a higher likelihood of positive FTM-PET visual read (OR 1.27, 95% CI 1.00–1.61, p = 0.049), abnormal CSF p-tau levels (OR 1.50, 95% CI 1.19–1.89, p = 0.001), and an A+T+ profile (OR 1.64, 95% CI 1.25–2.20, p = 0.001) and was greater among participants with an A+T+ profile (p < 0.01) at follow-up. Weight change was positively associated with CSF Aβ42/40 ratio (β = 0.099, p = 0.032) and negatively associated with CSF p-tau (β = − 0.141, p = 0.005), t-tau (β = − 0.147 p = 0.004) and neurogranin levels (β = − 0.158, p = 0.002). In stratified analyses, weight loss was significantly associated with higher t-tau, p-tau, neurofilament light, and neurogranin, as well as faster cognitive decline in A+ participants only. Conclusions Weight loss predicts AD CSF and PET biomarker results and may occur downstream to amyloid-β accumulation in preclinical AD, paralleling cognitive decline. Accordingly, it should be considered as an indicator of increased risk of AD-related cognitive impairment. Trial registration NCT01835717, NCT02485730, NCT02685969.

scholarly journals POS1383 THE ASSOCIATION BETWEEN BARIATRIC SURGERY AND DUPUYTREN DISEASE: A COHORT STUDY FROM SWEDISH NATIONWIDE HEALTHCARE REGISTRIES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 974.3-975
Author(s):  
T. Burkard ◽  
J. Lane ◽  
D. Holmberg ◽  
A. M. Burden ◽  
D. Furniss
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Weight Loss ◽  
Cohort Study ◽  
Secondary Care ◽  
High Body Mass Index ◽  
Null Result ◽  
Increased Risk ◽  
Dupuytren Disease

Background:Dupuytren disease (DD) is multifactorial, with several genetic and environmental risk factors contributing to disease susceptibility. High body mass index, however, was suggested to be protective of DD.1 The impact of weight loss among obese patients on DD has not been assessed to date.Objectives:To assess the association between bariatric surgery and DD in a secondary care setting.Methods:We performed a propensity score (PS)-matched cohort study using data from Swedish nationwide healthcare registries (patient registry [secondary care], causes of death registry, prescribed drug registry). Patients aged 30-79 years who underwent bariatric surgery between 2006 and 2019 were matched to up to 2 obese bariatric surgery-free patients (called unexposed patients) based on their PS. PS-matching was carried out in risk set sampling to reduce selection bias, within 4 sequential cohort entry blocks to account for time trend biases. The outcome DD was defined as a diagnosis of DD in secondary care or partial or total fasciotomy of wrist or hand. After a 1-year run-in period, patients were followed in an “as-treated” approach. We applied Cox proportional hazard regression to calculate hazard ratios (HR) with 95% confidence intervals (CIs) of incident DD among bariatric surgery patients when compared to obese unexposed patients overall, and in subgroups of age, sex, bariatric surgery type, and by duration of follow-up.Results:A total of 34 959 bariatric surgery patients were PS-matched to 54 769 obese unexposed patients. A total of 71.6% of bariatric surgery patients were women. Bariatric surgery patients had a mean age of 45.5 years and a mean follow-up of 6.9 years. All patient characteristics in obese unexposed patients were highly similar. We observed 126 and 136 severe DD cases among bariatric surgery and obese unexposed patients, respectively. The risk of DD was significantly increased in bariatric surgery patients compared to obese unexposed patients (HR = 1.30, 95% CI 1.02-1.65). The risk of DD was higher in women (HR = 1.36, 95% CI 1.00-1.84) than in men (HR = 1.05, 95% CI 0.70-1.58). Age did not modify the risk of DD among bariatric surgery patients compared to obese unexposed patients. Malabsorptive bariatric surgery yielded an increased risk of DD when compared to obese unexposed patients (HR = 1.33, 95% CI 1.04-1.71), while restrictive bariatric surgery yielded a null result. The risk of DD increased with duration of follow-up (>5 years of follow-up: HR = 1.63, 95% CI 1.14-2.34, null result in earlier follow-up).Conclusion:Our results suggest that substantial weight loss is associated with a latent increased risk of severe DD in an obese population. This observation further strengthens current evidence that high body mass index is protective against DD. The latency of risk increase of DD after bariatric surgery may suggest that slowly adapting metabolic changes may be part of the mechanism of DD emergence.References:[1]Hacquebord JH, Chiu VY, Harness NG. The Risk of Dupuytren Surgery in Obese Individuals. J Hand Surg Am. 2017, 42: 149–55.Acknowledgements:We thank Prof. Dr. Jesper Lagergren (Karolinksa Institutet, Stockholm, Sweden) for hosting Dr. Theresa Burkard for a research stay at the Upper Gastrointestinal Surgery Group and making the data available for use. Furthermore, we thank Dr. Giola Santoni (Karolinksa Institutet, Stockholm, Sweden) for her technical support.Disclosure of Interests:None declared

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