Genetic Influences on Change in BMI from Middle to Old Age: A 29-Year Follow-up Study of Twin Sisters

Weight gain through middle age is a common phenomenon that increases the risk for different types of metabolic diseases and functional limitations later in life. This study examined genetic and environmental influences on the evolution of body mass index (BMI) in women from middle to old age. BMI was evaluated in 102 monozygotic and 114 dizygotic pairs of twin sisters from the year 1975, when they were 42.6 ± 3.4 years-old, and thereafter in 1981, 1990, 2001 and 2004, in a total 29-year follow-up period. We examined genetic and environmental influences explaining BMI overall level and its rate of change using a latent growth modeling approach. The results showed that mean (±SD) BMI increased from 24.1 ± 3.1 to 28.2 ± 5.1 kg/m² during the 29-year period. The heritability of BMI showed a consistent increment across occasions, from 54% in 1975, to 72% in 2004. Genetic influences accounted for both overall BMI level (60%) and BMI rate of change (64%). Genetic and environmental correlations between BMI level and rate of change were: r_g = 0.40 and r_e = −0.24, respectively. We conclude that in relatively healthy women, genes affecting level of BMI may differ from those affecting change in BMI with age. These results provide a basis for identifying genetic variants for change in BMI. Edited by Danielle Posthuma.     

A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors

In this study of Japanese men and women, we determine reference values for sarcopenia and test the hypothesis that sarcopenia is associated with risk factors for cardiovascular disease, independent of waist circumference. A total of 1,488 Japanese men and women aged 18–85 years participated in this study. Appendicular muscle mass (AMM) was measured by dual-energy X-ray absorptiometry. Reference values for classes 1 and 2 sarcopenia (skeletal muscle index: AMM/height², kg m⁻²) in each sex were defined as values one and two standard deviations below the sex-specific means of reference values obtained in this study from young adults aged 18–40 years. The reference values for class 1 and class 2 sarcopenia were 7.77 and 6.87 kg m⁻² in men and 6.12 and 5.46 kg m⁻² in women. In subjects both with class 1 and class 2 sarcopenia, body mass index and % body fat were significantly lower than in normal subjects. Despite whole-blood glycohaemoglobin A1c in men with class 1 sarcopenia was significantly higher than in normal subjects, and brachial-ankle pulse wave velocity in women both with class 1 and class 2 sarcopenia were significantly higher than in normal subjects, using one-way ANCOVA with adjustment for the covariate of waist circumference. Although sarcopenia is associated with thin body mass, it is associated with more glycation of serum proteins in men and with greater arterial stiffness in women, independent of waist circumference.     

Heritability and Longitudinal Stability of Schizotypal Traits During Adolescence

The study investigated the genetic and environmental etiology of schizotypal personality traits in a non-selected sample of adolescent twins, measured on two occasions between the ages of 11 and 16 years old. The 22-item Schizotypal Personality Questionnaire- Child version (SPQ-C) was found to be factorially similar to the adult version of this instrument, with three underlying factors (Cognitive-Perceptual, Interpersonal-Affective, and Disorganization). Each factor was heritable at age 11–13 years (h ² = 42–53%) and 14–16 years old (h ² = 38–57%). Additive genetic and unique environmental influences for these three dimensions of schizotypal personality acted in part through a single common latent factor, with additional genetic effects specific to both Interpersonal-Affective and Disorganization subscales at each occasion. The longitudinal correlation between the latent schizotypy factor was r = 0.58, and genetic influences explained most of the stability in this latent factor over time (81%). These longitudinal data demonstrate significant genetic variance in schizotypal traits, with moderate stability between early to middle adolescence. In addition to common influences between the two assessments, there were new genetic and non-shared environmental effects that played a role at the later assessment, indicating significant change in schizotypal traits and their etiologies throughout adolescence.     

Genetic and Environmental Transmission of Body Mass Index Fluctuation

This study sought to determine the relationship between body mass index (BMI) fluctuation and cardiovascular disease phenotypes, diabetes, and depression and the role of genetic and environmental factors in individual differences in BMI fluctuation using the extended twin-family model (ETFM). This study included 14,763 twins and their relatives. Health and Lifestyle Questionnaires were obtained from 28,492 individuals from the Virginia 30,000 dataset including twins, parents, siblings, spouses, and children of twins. Self-report cardiovascular disease, diabetes, and depression data were available. From self-reported height and weight, BMI fluctuation was calculated as the difference between highest and lowest BMI after age 18, for individuals 18–80 years. Logistic regression analyses were used to determine the relationship between BMI fluctuation and disease status. The ETFM was used to estimate the significance and contribution of genetic and environmental factors, cultural transmission, and assortative mating components to BMI fluctuation, while controlling for age. We tested sex differences in additive and dominant genetic effects, parental, non-parental, twin, and unique environmental effects. BMI fluctuation was highly associated with disease status, independent of BMI. Genetic effects accounted for ~34 % of variance in BMI fluctuation in males and ~43 % of variance in females. The majority of the variance was accounted for by environmental factors, about a third of which were shared among twins. Assortative mating, and cultural transmission accounted for only a small proportion of variance in this phenotype. Since there are substantial health risks associated with BMI fluctuation and environmental components of BMI fluctuation account for over 60 % of variance in males and over 50 % of variance in females, environmental risk factors may be appropriate targets to reduce BMI fluctuation.     

Accuracy of self-reported body weight,height and waist circumference in a Dutch overweight working population

Background  

In population studies, body mass index (BMI) is generally calculated from self-reported body weight and height. The self-report of these anthropometrics is known to be biased, resulting in a misclassification of BMI status. The aim of our study is to evaluate the accuracy of self-reported weight, height and waist circumference among a Dutch overweight (Body Mass Index [BMI] ≥ 25 kg/m²) working population, and to determine to what extent the accuracy was moderated by sex, age, BMI, socio-economic status (SES) and health-related factors.     

Prediction of <Emphasis Type="Italic">V</Emphasis>O<Subscript>2max</Subscript> with daily step counts for Japanese adult women

The purpose of the study was to develop a new non-exercise VO_2max prediction model using a physical activity (PA) variable determined by pedometer-determined step counts (SC, steps day⁻¹) in Japanese women aged 20–69 years old. Eighty-seven and 102 subjects were used to develop the prediction model, and to validate the new model, respectively. VO_2max was measured using a maximal incremental test on a bicycle ergometer. SC was significantly related to VO_2max (partial correlation coefficient r = 0.40, P < 0.001) after adjusting for BMI (kg m⁻²) and age (years). When the new prediction equation developed by multiple regression to estimate VO_2max from age, BMI, and SC (R = 0.71, SEE = 5.3 ml kg⁻¹ min⁻¹, P < 0.001) was applied to the Validation group, predicted VO_2max correlated well with measured VO_2max (r = 0.81, P < 0.001), suggesting that SC is a useful PA variable for non-exercise prediction of VO_2max in Japanese women.     

C-Reactive Protein is Linked to Lower Cognitive Performance in Overweight and Obese Women

Our objective was to ascertain the nature of the associations between C-reactive protein (CRP) and cognition, and to examine how they are affected by gender and obesity. We evaluated 62 females and 63 males between 42 and 82 years of age. There were 20 lean females with a body mass index (BMI) of <25 kg/m² and 42 overweight or obese females, with BMIs ≥25 kg/m². There were 14 lean males and 49 with BMIs ≥25 kg/m². CRP was associated with lower scores on cognitive tests of frontal lobe function among females and these associations were driven by the overweight/obese female group. In these data no associations between CRP and cognition were found among males. Obesity-associated inflammation is much more prominent in females and it appears to be associated with cognitive dysfunction, particularly of frontal lobe tasks.     

Age Differences in Genetic and Environmental Variations in Stress-Coping During Adulthood: A Study of Female Twins

The way people cope with stressors of day to day living has an important influence on health. The aim of the present study was to explore whether genetic and environmental variations in stress-coping differ over time during adulthood. The brief COPE was mailed to a large sample of the UK female twins (N = 4,736) having a wide range of age (20–87 years). Factor analyses of the items of the brief COPE yielded three coping scales: ‘Problem-Solving’, ‘Support Seeking’, and ‘Avoidance’. Monozygotic and dizygotic twin correlations tended to become lower with age for all three scales, suggesting that unique environmental factors may become more important with age during adulthood. Model-fitting results showed that relative influences of unique environmental factors increased from 60 % at age 20 years to 74% at age 87 years for ‘Problem-Solving’ and 56 % at age 20 years to 76% at age 87 years for ‘Avoidance’. During the same age period, genetic factors decreased from 40 to 26 % for ‘Problem-Solving’ and from 44 to 24 % for ‘Avoidance’. For ‘Seeking Support’, the magnitude of genetic and unique environmental factors was not significantly different across the adulthood. For all three scales, shared environmental effects were negligible. Overall, our findings implicate that the effects of environment that stem from idiosyncratic experience of stressful life events accumulate and become increasingly important in adulthood.     

Allometric scaling of isometric biceps strength in adult females and the effect of body mass index

The purposes of this study were to (1) derive and test allometric scaling models of biceps isometric strength using body mass (BM) and muscle cross-sectional area (CSA) as the scaling variables, (2) assess the influence of body mass index (BMI) by separating the cohort by BMI (normal <25 kg/m² vs. overweight/obese ≥25 kg/m²) and repeating step 1, and (3) assess the effect of BMI on isometric strength allometrically adjusted for differences in CSA by comparing scaled strength between normal weight versus overweight/obese women. The participants were 183 women (18–39 years old) who reported no strength training in the prior year. Isometric strength and CSA of the biceps were assessed on the non-dominant arm. The CSA allometric model met all statistical criteria and produced a scaling exponent of 0.44. The BM model did not meet these criteria until the entire cohort was separated by BMI. The scaling exponents for normal weight and overweight/obese women were 1.48 and 0.35, respectively. These data suggest that BMI exerted an influence on the relationship between BM and allometrically scaled isometric strength and may be explained by previous studies demonstrating greater contribution of fat mass (FM) versus fat-free mass (FFM) to BMI in overweight/obese women. As such, allometric scaling models of isometric strength, especially in populations that are heterogeneous with regard to body composition, must be carefully tested and examined across the range of BMI. Isometric strength relative to CSA was not significantly different between groups. However, allometrically scaled strength, using CSA as the criterion variable, was significantly greater in overweight/obese women compared to those of normal weight. These data suggest that isometric strength in women is not completely determined by CSA and other factors such as intramuscular fat and muscle fiber type may be confounding or contributing factors.     

The impact of obesity on cardiac troponin levels after prolonged exercise in humans

Elevated cardiac troponin I (cTnI), a marker for cardiac damage, has been reported after high-intensity exercise in healthy subjects. Currently, little is known about the impact of prolonged moderate-intensity exercise on cTnI release, but also the impact of obesity on this response. 97 volunteers (55 men and 42 women), stratified for BMI, performed a single bout of walking exercise (30–50 km). We examined cTnI-levels before and immediately after the exercise bout in lean (BMI < 25 kg/m², n = 30, 57 ± 19 years), overweight (25 ≤ BMI < 30 kg/m², n = 29, 56 ± 11 years), and obese subjects (BMI ≥ 30 kg/m², n = 28, 53 ± 9 years). Walking was performed at a self-selected pace. cTnI was assessed using a high-sensitive cTnI-assay (Centaur; clinical cut-off value ≥0.04 μg/L). We recorded subject characteristics (body weight, blood pressure, presence of cardiovascular risk) and examined exercise intensity by recording heart rate. Mean cTnI-levels increased significantly from 0.010 ± 0.006 to 0.024 ± 0.046 μg/L (P < 0.001). The exercise-induced increase in cTnI was not different between lean, overweight and obese subjects (two-way ANOVA interaction; P = 0.27). In 11 participants, cTnI was elevated above the clinical cut-off value for myocardial infarction. Logistic regression analysis identified exercise intensity (P < 0.001), but not BMI, body fat percentage or waist circumference to significantly relate to positive troponin tests. In conclusion, prolonged, moderate-intensity exercise results in a comparable increase in cTnI-levels in lean, overweight and obese subjects. Therefore, measures of obesity unlikely relate to the magnitude of the post-exercise elevation in cTnI.     

The validity of two Omron pedometers during treadmill walking is speed dependent

The purpose of this study was to examine the effects of walking speed on the accuracy of measurement of steps, distance, and energy expenditure of two commercially available Omron pedometers [HJ-720IT-E2 (HJ-720) and HJ-113-E (HJ-113)]. Twenty-four untrained males (age, 22.7 ± 2.8 years; BMI, 24.38 ± 2.19 kg m⁻²; body fat (%), 16 ± 2.2; VO_2max, 40.2 ± 6.5 ml kg⁻¹ min⁻¹) and 18 females (age, 22.4 ± 2.9 years; BMI, 21.68 ± 2.43 kg m⁻²; body fat (%), 23% ± 1.8; VO_2max, 35.9 ± 2.8 ml kg⁻¹ min⁻¹) walked at five different velocities (54, 67, 80, 94 and 107 m min⁻¹) on a treadmill in 5-min stages while wearing three types of pedometers: (a) HJ-720, (b) HJ-113, and (c) Yamax Digi-Walker SW-200 (YAM). Step-count for each pedometer was recorded at the end of each stage and compared with the value of a hand counter. Additionally, Omron pedometers were evaluated on their distance and energy expenditure (against VO₂ measurement with a gas-exchange analyzer) accuracy during each stage. HJ-720 and HJ-113 demonstrated high accuracy (r = 0.80–0.99) at all speeds. YAM underestimated step-count only at 54 m min⁻¹ (r = 0.46). HJ-720 and HJ-113 overestimated distance at slower speeds and underestimated distance at faster speeds, providing mean distance values that where to within 1.5–4% at 80 m min⁻¹. HJ-720 and HJ-113 underestimated energy expenditure (gross kilocalories) by 28%, when compared to indirect calorimetry. These results suggest that although the Omron HJ-720 and HJ-113 pedometers are accurate in the measurement of step-count, they demonstrate limited accuracy in the assessment of traveled distance and energy expenditure in a speed-dependent manner.     

Genetic and Environmental Influences on the Stability of Withdrawn Behavior in Children: A Longitudinal,Multi-informant Twin Study

We examined the contribution of genetic and environmental influences on the stability of withdrawn behavior (WB) in childhood using a longitudinal multiple rater twin design. Maternal and paternal ratings on the withdrawn subscale of the Child Behavior Checklist (CBCL) were obtained from 14,889 families when the twins were 3, 7, 10 and 12 years old. A longitudinal psychometric model was fitted to the data and the fit of transmission and common factor models were evaluated for each variance component. WB showed considerable stability throughout childhood, with correlation coefficients ranging from about .30 for the 9-year time interval to .65 for shorter time intervals. Individual differences in WB as observed by the mother and the father were found to be largely influenced by genetic effects at all four time points, in both boys (50–66%) and girls (38–64%). Shared environmental influences explained a small to modest proportion (0–24%) of the variance at all ages and were slightly more pronounced in girls. Non-shared environmental influences were of moderate importance to the variance and slightly increased with age, from 22–28% at age 3 to 35–41% at age 12 years. The stability of WB was largely explained by genetic effects, accounting for 74% of stability in boys and 65% in girls. Shared environmental effects explained 7% (boys) and 17% (girls) of the behavioral stability. Most shared environmental effects were common to both raters, suggesting little influence of rater bias in the assessment of WB. The shared environmental effects common to both raters were best described by a common factor model, indicating that these effects are stable and persistent throughout childhood. Non-shared environmental effects accounted for the remaining covariance over time. Edited by Hermine Maes.     

Similarities in Drinking Behavior of Twin’s Friends: Moderation of Heritability of Alcohol Use

Previous research has indicated that friends’ drinking may influence alcohol use in adolescents and young adults. We explored whether similarities in the drinking behavior of friends of twins influence the genetic architecture of alcohol use in adolescence and young adulthood. Survey data from The Netherlands Twin Register were available for 1,526 twin pairs aged 16–25 years. We categorized the twin pairs as concordant (both report similar alcohol use in their friends) or discordant for the alcohol use of their friends. Genetic moderator models were tested by carrying out multi-group analyzes in Mplus. Findings showed a significant moderation effect. Genetic factors were more and common environment less important in the explanation of variation in alcohol use in twins discordant for alcohol use of friends than in twins concordant for alcohol use of friends. Edited by Michael Lyons.     

Risk factors and long-term health consequences of macrosomia: a prospective study in Jiangsu Province,China

We sought to determine risk factors associated with fetal macrosomia and to explore the long-term consequence of infant macrosomia at the age of 7 years.A prospective population based cohort study was designed to examine the associations between maternal and perinatal characteristics and the risk of macrosomia.A nested case-control study was conducted to explore the long-term health consequence of infant macrosomia.The mean maternal age of the macrosomia group was 24.74±3.32 years,which is slightly older than that in the control group(24.35±3.14 years,P = 0.000).The mean maternal body mass index(BMI) at early pregnancy was 22.75±2.81 kg/m 2,which was also higher than that in the control group(21.76±2.59 kg/m 2,P = 0.000).About 64.6% of macrosomic neonates were males,compared with 51.0% in the control group(P = 0.000).Compared with women with normal weight(BMI:18.5-23.9 kg/m 2),women who were overweight(BMI:24-27.9 kg/m 2) or obese(BMI ≥ 28 kg/m 2),respectively,had a 1.69-fold(P = 0.000) and a 1.49-fold(P = 0.000) increased risks of having a neonate with macrosomia,while light weight(BMI18.5 kg/m 2) women had an approximately 50% reduction of the risk.Furthermore,macrosomia infant had a 1.52-fold and 1.50-fold risk,respectively,of developing overweight or obesity at the age of 7 years(P = 0.001 and P = 0.000).Older maternal age,higher maternal BMI at early pregnancy and male gender were independent risk factors of macrosomia.Macrosomic infant was associated with an increased predisposition to develop overweight or obesity at the beginning of their childhood.     

Time to resolution of respiratory and systemic coronavirus disease 2019 symptoms in community setting

ObjectivesTo assess the time to resolution of respiratory and systemic symptoms and their associated factors in outpatients during the coronavirus disease 2019 (COVID-19) pandemic.MethodsCohort study including adult outpatients, managed with Covidom, a telesurveillance solution, with RT-PCR-confirmed diagnosis, from 9 March 2020 until 23 February 2021. Follow up was 30 days after symptom onset.ResultsAmong the 9667 patients included, mean age was 43.2 ± 14.0 years, and 67.5% were female (n = 6522). Median body mass index (BMI) was 25.0 kg/m² (interquartile range 22.1–28.8 kg/m²). Main co-morbidities were: hypertension (12.9%; n = 1247), asthma (11.0%; n = 1063) and diabetes mellitus (5.5%; n = 527). The most frequent symptom during follow up was dyspnoea (65.1%; n = 6296), followed by tachypnoea (49.9%; n = 4821), shivers (45.6%; n = 4410) and fever (36.7%; n = 3550). Median times to resolution of systemic and respiratory symptoms were 3 days (95% CI 2−4 days) and 7 days (95% CI 6−8 days), respectively. Ultimately, 17.2% (95% CI 15.7%−18.8%) still presented respiratory symptoms at day 30. Longer time to respiratory symptom resolution was associated with older age, increased BMI, chronic obstructive pulmonary disease, coronary artery disease, asthma and heart failure. Regarding systemic symptoms, coronary artery disease, asthma, age above 40 years and elevated BMI were associated with longer time to resolution.ConclusionsTime to symptom resolution among outpatients with COVID-19 seemed shorter for systemic than respiratory symptoms. Prolonged respiratory symptoms were common at day 30. Risk factors associated with later resolution included age, and cardiovascular and pulmonary diseases.     

Towards Using Photo-Plethysmogram Amplitude to Measure Blood Pressure During Sleep

There is considerable interest in non-intrusive and reliable continuous ambulatory blood pressure measurement systems. Pulse amplitude is the peak to trough amplitude of the photo-plethysmogram signal. We compared pulse amplitude with a currently popular parameter, the pulse arrival time (PAT), for estimating continuous systolic blood pressure (SBP). Overnight sleep data from 18 young, healthy subjects (14 M 4 F, age 24 ± 5 years, BMI 23.8 ± 4.0 kg/m²) was analyzed. We found that pulse amplitude was more effective than PAT for estimating SBP during sleep. Mean coherence between pulse amplitude and SBP was significantly stronger than that for PAT [p < 0.001, 95% CI: 0.21–0.25 (finger), 0.11–0.14 (wrist)]. Correlation between pulse amplitude and SBP was significantly stronger than that for PAT [p < 0.001, 95% CI: 0.46–0.53 (finger), 0.13–0.20 (wrist)]. SBP estimation errors were significantly lower using pulse amplitude [p < 0.001, 95% CI: −1.55 to −1.29 mmHg (finger), −0.53 to −0.36 mmHg (wrist)]. We also found that while pulse amplitude was closely related to SBP, the relationship weakened during and around REM sleep (ANOVA of REM, transitional Wake-REM and transitional REM-Sleep versus other sleep states: F = 24.7, p < 0.001). These results suggest that pulse amplitude is potentially a more suitable measure than pulse arrival time for estimating continuous blood pressure.     

DeFries–Fulker Analysis of Longitudinal Reading Performance Data from Twin Pairs Ascertained for Reading Difficulties and from Their Nontwin Siblings

Reading difficulties are both heritable and stable; however, little is known about the etiology of this stability. Results from a preliminary analysis of data from 56 twin pairs who participated in the Colorado Longitudinal Twin Study of Reading Disability (Astrom et al., Twin Res Hum Genet 10:434–439, 2007) suggested that about two-thirds of the proband deficit at follow-up was due to genetic factors that also influenced deficits at their initial assessment. Although our proband sample is now nearly twice as large, it is still relatively small; thus, to increase power, we subjected data from probands, co-twins and their nontwin siblings to a novel extension of DeFries–Fulker analysis (DeFries and Fulker, Behav Genet 15:467–473, 1985; DeFries and Fulker, Acta Genet Med Gemellol, 37, 205–216, 1988). In addition to providing estimates of univariate and bivariate heritability, this analysis facilitates a test of the difference between shared environmental influences for twins versus siblings. Longitudinal composite reading performance scores at 10.6 and 15.5 years of age, on average, were analyzed from 33 MZ and 64 DZ twin pairs in which at least one member of each pair had reading difficulties, and from 44 siblings of the probands. Scores were highly stable (.86 ± .03, across probands, co-twins and siblings) and heritability of the group deficit at initial assessment was .67 ± .22. Longitudinal bivariate heritability was .59 ± .21, suggesting that nearly 60% of the proband reading deficit at follow-up is due to genetic factors that influenced reading difficulties at the initial assessment. However, tests for special twin environmental influences were nonsignificant.     

The effect of endurance training on resting heart rate variability in sedentary adult males

Eleven previously sedentary adult males, serving as the experimental (EXP) group [mean (SE) age 36.6 (1.7) years, body mass 87.2 (4.3) kg, body mass index, BMI, 28.4 (1.5) kg·m^–2] participated in a 16-week supervised exercise program (3 days·week^–1, 30 min·day^–1, at ≅80% of heart rate reserve) to determine the temporal effects of a moderate-to-vigorous-intensity exercise program on heart rate variability (HRV). Five sedentary males [mean (SD) age 36.6 (4.2 )years, body mass 83.8 (6.6) kg, BMI 22.8 (1.7) kg·m^–2] served as non-exercising controls (CON). HRV was measured every 4 weeks from a resting electrocardiogram obtained while subjects paced their breathing at 10 breaths·min^–1 (0.167 Hz). The time-domain measures of HRV recorded were the proportion of adjacent intervals differing by more than 50 ms (pNN50), the root mean square of successive differences (rMSSD), and the standard deviation of the resting interbeat interval. The frequency-domain measures recorded were high (HF) and low (LF) frequency oscillations, as determined using the fast Fourier transform technique. Aerobic capacity (i.e., peak oxygen uptake) increased by 13.8% in EXP (P<0.001), but did not change in CON. Resting heart rate did not change in either EXP or CON. In EXP, pNN50 at week 12 (P<0.01), rMSSD at weeks 12 (P<0.01) and 16 (P=0.05), and HF power at weeks 12 (P<0.01) and 16 (P=0.05) were elevated above baseline. Time- and frequency-domain measures of HRV remained unchanged in CON. It is concluded that a moderate-to-vigorous-intensity exercise program produces increases in time- and frequency-domain measures of HRV within 12 weeks. Electronic Publication     

Laparoscopic detection of aberrant left hepatic artery: a prospective study in 300 consecutive patients

Laparoscopic gastric banding comprises the systematic section of the pars flaccida and condensa of the lesser omentum. Aberrant left hepatic arteries (ALHA) originating from the left gastric artery are located in the pars condensa of the lesser omentum. The aim of the present work was to study aberrant left hepatic artery rate in a prospective series of patients operated on for morbid obesity using laparoscopic gastric banding. Between October 2001 and December 2003, a monocentric prospective study of 300 consecutive patients operated on for morbid obesity was carried out. There were 245 women and 55 men with a mean age of 39±11 years. Preoperative weight was 123±18 kg, mean size was 166±9 cm and preoperative mean BMI was 44.5±5.6 kg m⁻² . Data were collected intraoperatively using a questionnaire submitted to the surgeon with patient and ALHA characteristics. The ALHA were detected in 102 patients (34%): one ALHA in 100 cases (98%) and two ALHA in two cases (2%). The ALHA diameter was estimated by comparison using laparoscopic instruments. The median ALHA diameter was 2 mm (0.5–13). A diameter ≥3 mm was observed in 47 patients (16%) and ≤1 mm in 23 patients (8%). The ALHA presence and/or size were not correlated with patient age, BMI or clinical characteristics. Using laparoscopic detection, ALHA rate (34%) was higher than in the main previously reported series. This higher ALHA rate was not related to the patient age, weight or BMI but seems to be due to the great sensitivity of this approach.     

Water turnover in children and young adults

Water homeostasis is essential for life and optimal function and considerable interest surrounds the issue of recommendations for water consumption in healthy individuals. Objective data on water turnover in free-living individuals are limited, however. The aim of the present work was to measure water turnover in children and young adults using isotopically labeled water to provide objective data on magnitude and variability in relation to body weight, fat-free mass and physical activity level. Water turnover was measured by deuterated water dilution in 91 healthy children (40 boys, 51 girls; age 5–14 years) and 109 healthy young adults (80 women, 29 men; age 18–27 years) with a wide range of body mass index (13.3–51.8 kg/m²) and percent body fat (6.1–59.3%). Total energy expenditure (TEE) and resting metabolic rate were measured by the doubly labeled water technique and indirect calorimetry, respectively. Water turnover was 1.77 ± 0.57 (SD), 1.79 ± 0.44, 2.85 ± 0.82, and 3.90 ± 0.81 L/day in girls, boys, women, and men, respectively. Water turnover indexed to body surface area did not differ significantly between girls and women but was higher in men than boys. Water turnover indexed to TEE was 0.8 mL/kcal in girls and boys and 1.0 mL/kcal in women and men. This study provides objective data on water turnover for children and young adults in a temperate climate and shows that anthropometric parameters can account for the variation between girls, boys and women but not between these groups and the more active men.