Alliance for a Healthy Border: factors related to weight reduction and glycemic success

We examined the factors related to success in achieving weight reduction and glycemic control in Alliance for a Healthy Border (AHB), a chronic disease prevention program implemented from 2006 to 2009 through 12 federally qualified community health centers serving primarily Hispanics in communities located along the US-Mexico border region. We analyzed data from Phase I of AHB using logistic regression to examine the determinants of success in achieving weight reduction and glycemic control among the participants in AHB programs. Factors affecting weight reduction success were sex, age, employment status, income, insurance, diabetes, baseline body mass index (BMI), smoking status, family history of diabetes, session type, program duration, and physical activity changes. Factors affecting achievement of glycemic success included sex, age, employment status, diabetes, baseline BMI, family history of diabetes, program duration, and physical activity changes. We found that the AHB interventions were more successful in reducing participants' HbA1c level than BMI. In addition to sociodemographic factors, participants with better baseline health conditions (ie, participants without diabetes or family history of diabetes, normal BMI, former smokers) were more likely to achieve success after the interventions. Of the 4 key features defining each of the 12 interventions, session type and program duration were associated with success. Within a relatively short time period, physical activity improvements had a stronger effect on weight reduction and glycemic success than improvements in dietary habits. The effectiveness of diabetes and cardiovascular disease prevention programs can be improved substantially by considering these factors during program design and structure.     

Cardiovascular disease risk factors are related to adult adiposity but not birth weight in young guatemalan adults

Fetal undernutrition has been hypothesized to program inappropriate metabolic responses to nutritional abundance in later life. Most studies have been conducted in industrialized countries. We studied the relationship between birth weight and risk factors for cardiovascular disease (CVD) among 187 men and 198 women age 20-29 y (mean age 24 y) who had participated in a longitudinal study conducted in Guatemala between 1969 and 1977. In women, birth weight was positively associated with adult body mass index (BMI; P < 0.01), systolic (P < 0.001) and diastolic blood pressure (P < 0.05), but not with glucose or any lipid measure. In men, birth weight was not associated with adult BMI, blood pressure or glucose, and was weakly and inversely related to total cholesterol and LDL cholesterol (test for trend: P = 0.06 and P = 0.09, respectively). Adult BMI was associated with increased prevalence of CVD risk factors in both men and women. Our data offer no support for the fetal programming of cardiovascular disease risk hypothesis in young adult women, and weak support in young adult men. Overweight in adults is a strong determinant of variance in CVD risk factor prevalence.     

Longitudinal study on factors related to the course of vibration-induced white finger

 Follow-up surveys were conducted in 1982 and 1988 to investigate factors affecting the course of vibration-induced white finger (VWF). Subjects were 353 patients, aged 40 to 70 at the start of the 1982 survey, who were receiving treatment for hand-arm vibration syndrome. Between 1982 and 1988, the attacks of VWF decreased, while numbness and pain in the hand changed slightly. Finger skin temperature showed a tendency to increase, but recovery time in nail compression tests was unchanged. Vibration perception threshold and grasping power tended to become worse. Of the 177 patients with VWF in 1982, 55 (31%) had no VWF in 1988. The improvement in VWF depended on its severity assessed by the frequency of attacks, the extent of the affected finger phalanges and the Stockholm vascular (V) stage at the start of the 1982 survey. The improvement was observed in 46% of the 1V (mild) stage cases, against only 17% of the 3V (severe) stage cases. Patients in the 2V (moderate) and 3V stages had lower finger skin temperature than those without VWF (the 0V stage). Patients with milder VWF seemed more likely to improve. Continued use of vibratory tools was found to be an unfavourable factor for improvement of VWF. Age, smoking and drinking habits, and medical complications showed no significant effects on the course of VWF. Received: 26 February 1996/Accepted: 2 May 1996     

Dietary intakes and socioeconomic factors are associated with the hemoglobin concentration of Bangladeshi women

Iron deficiency anemia affects a large number of women in developing countries, especially during child-bearing years. The hemoglobin concentration is useful for identifying iron deficiency anemia. The main objectives of this study were, first, to extend algorithms for calculating bioavailable iron from mixed diets, taking into account the enhancers and inhibitors of iron absorption under alternative assumptions on body iron stores. Second, a comprehensive longitudinal model was developed for the proximate determinants of hemoglobin concentration that included the subjects' dietary intakes, nutritional status, morbidity and socioeconomic factors and the unobserved between-subject differences. The model for hemoglobin concentration was estimated using three repeated observations on 514 free living women in Bangladesh. Socioeconomic factors affecting the iron intake from meat, fish and poultry and from all animal sources were also modeled. The main results were that bioavailable iron, women's height and mid upper arm circumference and intake of iron tablets were significant predictors of hemoglobin concentration. Increases in household incomes were associated with higher intake of iron from meat, fish and poultry and from all animal sources. The algorithms for estimating bioavailable iron showed the importance of assumptions regarding body iron stores and underscored the need to develop suitable algorithms for subjects in developing countries.     

Fruit and vegetable intakes are an independent predictor of bone size in early pubertal children

BACKGROUND: Adequate intakes of fruit and vegetables are recommended for optimum health in children. OBJECTIVE: The objective of this study was to determine whether consuming fruit and vegetables >3 times per day is beneficial to bone mass in children. DESIGN: Fifty-six white females (Tanner stage 2) recorded dietary intake on 3 independent days. The numbers of servings of fruit and vegetables were recorded for each day and tallied, and the subjects were divided into 2 consumption groups for analysis (low consumption: <3 servings/d, n = 22; high consumption: > or = 3 servings/d, n = 34). Bone area and the bone mineral content of the whole body and radius were assessed by using dual-energy X-ray absorptiometry. Radioimmunoassays measured serum parathyroid hormone and 25-hydroxyvitamin D. Twenty-four-hour urine samples were assessed for calcium, sodium, and creatinine. RESULTS: After adjustment for age, body mass index, and physical activity, those children who reported consuming > or = 3 servings fruit and vegetables/d had more bone area of the whole body (6.0%; P = 0.03) and radius (8.3%; P = 0.03), lower urinary calcium excretion (2.6 +/- 0.2 compared with 1.8 +/- 0.3 mg/kg; P = 0.04), and lower parathyroid hormone (19.6 +/- 1.9 compared with 25.0 +/- 1.6 pg/mL; P = 0.01) than did those children who reported consuming <3 servings fruit and vegetables/d. CONCLUSIONS: High fruit and vegetable intakes have beneficial effects on the bone area of the radius and whole body in early pubertal girls. The lower urinary calcium output associated with higher fruit and vegetable intakes may be a modulating factor.     

体外受精-胚胎移植后早期妊娠丢失的相关因素分析

目的 探讨体外受精-胚胎移植后早期妊娠丢失的相关因素。方法 回顾性分析体外受精获得妊娠1 720个周期的临床资料,按妊娠结局研究对象分为三组：A组（生化妊娠组）、B组（早期自然流产组）、C组（对照组）。C组为正常分娩或继续妊娠超过3个月者。分析3组患者基本情况、促排卵及体外受精过程对妊娠结局的影响。结果 B组年龄、基础促卵泡激素（basic follicle stimulating hormone,bFSH）水平、≥2次自然流产史高于A组和C组,差异有统计学意义（均有P<0.001）;C组人绒毛膜促性腺激素（human chorionic gonadotropin,HCG）注射后雌激素（estrogenic hormone,E2）水平下降率、卵泡晚期添加人绝经期促性腺激素（human menopausal gonadotropin,HMG）剂量及辅助孵化比例低于A组、B组,差异有统计学意义（均有P<0.05）。短方案组早期流产率高于长方案组,差异有统计学意义（P<0.05）;子宫内膜异位症患者的早期流产率高于输卵管性不孕因素,差异有统计学意义（P<0.05）。多因素Logistic回归分析,年龄及≥2次自然流产史是早期自然流产的独立风险因素。结论 高龄及≥2次自然流产史是体外受精早期自然流产的独立风险因素。     

Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women

BACKGROUND: Although increased consumption of dietary fiber and grain products is widely recommended to maintain healthy body weight, little is known about the relation of whole grains to body weight and long-term weight changes. OBJECTIVE: We examined the associations between the intakes of dietary fiber and whole- or refined-grain products and weight gain over time. DESIGN: In a prospective cohort study, 74,091 US female nurses, aged 38-63 y in 1984 and free of known cardiovascular disease, cancer, and diabetes at baseline, were followed from 1984 to 1996; their dietary habits were assessed in 1984, 1986, 1990, and 1994 with validated food-frequency questionnaires. Using multiple models to adjust for covariates, we calculated average weight, body mass index (BMI; in kg/m(2)), long-term weight changes, and the odds ratio of developing obesity (BMI > or = 30) according to change in dietary intake. RESULTS: Women who consumed more whole grains consistently weighed less than did women who consumed less whole grains (P for trend < 0.0001). Over 12 y, those with the greatest increase in intake of dietary fiber gained an average of 1.52 kg less than did those with the smallest increase in intake of dietary fiber (P for trend < 0.0001) independent of body weight at baseline, age, and changes in covariate status. Women in the highest quintile of dietary fiber intake had a 49% lower risk of major weight gain than did women in the highest quintile (OR = 0.51; 95% CI: 0.39, 0.67; P < 0.0001 for trend). CONCLUSION: Weight gain was inversely associated with the intake of high-fiber, whole-grain foods but positively related to the intake of refined-grain foods, which indicated the importance of distinguishing whole-grain products from refined-grain products to aid in weight control.     

Impulsivity in the supermarket. Responses to calorie taxes and subsidies in healthy weight undergraduates

The present study investigated the effect of taxing high-energy dense products and subsidizing low-energy dense products on changes in calorie consumption. More specifically, we hypothesized that ‘more impulsive’ individuals were less influenced by such pricing strategies compared to ‘less impulsive’ individuals. Contrary to our hypothesis, results showed that ‘more impulsive’ individuals adjusted their calorie consumption with regard to price changes whereas ‘less impulsive’ participants were less influenced by price changes. Furthermore, taxing high-energy dense products was more successful in reducing calorie consumption than subsidizing low-energy dense products.     

Fiber intakes and anthropometric measures are predictors of circulating hormone, triglyceride, and cholesterol concentrations in the women's health trial

The unhealthy eating patterns and obesity among women in the U.S. are indicated by changes in biomarkers, such as insulin, lipoproteins, and estradiol, that are risk factors for breast cancer and cardiovascular diseases. This article models the inter-relations among diet, serum insulin, estradiol, and sex hormone binding globulin (SHBG) concentrations, plasma LDL and HDL cholesterol, and net triglyceride concentrations, using the data at baseline and 12 mo on 379 and 615 postmenopausal women in the Control and Intervention groups, respectively, of the Women's Health Trial: Feasibility Study in Minority Populations. Subjects in the Intervention group received detailed advice over a period of 1 y for reducing fat intakes and increasing the consumption of whole grains and fruits and vegetables. The main findings were that there were significant differences between the Control and Intervention groups in the changes from baseline to 12 mo in LDL and HDL cholesterol and SHBG concentrations. Second, using a comprehensive random effects modeling framework, the ratio of fiber to energy intake was significantly associated (P < 0.05) with lower insulin and triglyceride levels, and with a higher HDL cholesterol concentration in the Intervention group. Third, the subjects' waist-to-hip ratio and BMI were significantly associated with insulin, SHBG, LDL and HDL cholesterol, and triglyceride concentrations. Fourth, insulin levels were significantly negatively associated with SHBG and HDL cholesterol, and positively associated with LDL cholesterol, triglyceride, and estradiol concentrations. Overall, weight loss, especially around the waist, and increased fiber intakes are likely to be beneficial for lipid, cholesterol, and hormone profiles of U.S. women.     

恶性肿瘤患者外周中心静脉导管置管期感染相关因素及血清炎症因子变化的研究

目的了解恶性肿瘤患者外周中心静脉导管置管期的感染情况、导致患者感染的危险因素及感染对患者血清炎症因子的影响。方法选取医院肿瘤科、心胸外科2015年12月-2016年12月期间收治的外周中心静脉导管置管期恶性肿瘤患者286例为研究对象,对患者置管术后感染发生情况进行分析,对感染患者和非感染患者的相关临床资料进行调查和统计,并采用单因素及多因素回归分析外周中心静脉导管置管期的感染的危险因素,对感染的患者的致病菌进行检测,对感染患者和非感染患者的血清炎症因子水平进行观察。结果 286例患者中感染患者28例,感染率为9.79%;糖尿病、操作人员经验、本次穿刺次数和导管留置时间是外周中心静脉导管置管期感染的独立危险因素;28例感染患者共计检测病原菌55株,其中革兰阴性菌35株占63.64%、革兰阳性菌15株占27.27%、真菌5株占9.09%;感染患者的肿瘤坏死因子(TNF-α)、白细胞介素-12(IL-12)、IL-18、IL-6和IL-8分别为(24.31±7.61)ng/L、(134.51±43.43)ng/L、(253.31±50.32)ng/L、(99.31±38.43)ng/L和(96.31±40.33)ng/L均高于非感染患者的(16.14±6.81)ng/L、(96.31±35.41)ng/L、(185.21±48.31)ng/L、(66.21±32.31)ng/L和(67.21±43.21)ng/L,差异有统计学意义(P<0.05)。结论糖尿病、操作人员经验、本次穿刺次数和导管留置时间是外周中心静脉导管置管期感染的独立危险因素,革兰阴性菌是主要的临床致病菌,感染患者的血清炎症因子水平会显著升高。     

Obesity and changes in body weight related to 10-year diabetes incidence in women in Taiwan

This study aimed to investigate the relation of obesity and changes in body weight through adulthood with risks of type 2 diabetes. This study of 954 middle-aged women free of diabetes (mean age, 37.1 +/- 9.6 years) was conducted in a hospital. The baseline and biannual health check-ups were performed from 1993 to 2003. The cumulative incidence rate of type 2 diabetes was 3.64 per 1000 person-years during the mean follow-up period of 10 years. 73.3% of subjects who developed type 2 diabetes were overweight (16.6%) or obese (56.7%). Obese subjects (body mass index more than 25 kg/m2) had a relative risk of type 2 diabetes of 10.4 (95% confidence interval 2.95-36.9) compared with subjects with an optimal body mass index (18-22.9 kg/m2). Long-term weight gain was strongly related to the risk of type 2 diabetes. Each 1 kg of weight gain was associated with a 16% increase in risk of developing diabetes. This study indicated that obesity at young adult and weight gain appreciably increase risk for type 2 diabetes. Maintaining a lean weight throughout adulthood seems to be beneficial in the primary prevention of type 2 diabetes.     

种植牙早期感染危险因素及其炎症因子水平

目的 探究早期感染对种植牙周围骨丧失、磷脂酰肌醇(PI3K)/蛋白激酶B(AKT)信号通路及相关炎症因子水平影响。方法 选择2018年3月-2021年3月于海口市第三人民医院进行植牙手术患者为研究对象,植牙术后1周牙周感染患者54例为感染组,未出现牙周感染患者76例为非感染组,比较两组患者植牙术后1周种植牙周围骨丧失情况和PI3K/AKT信号通路及相关炎症因子水平变化。单因素及多因素回归分析种植牙术后早期感染的影响因素。结果 两组患者种植牙周围骨丧失发生率(7.41%vs 3.95%),比较差异无统计学意义(Z=0.218,P=0.640)。感染组患者PI3K mRNA、AKT mRNA、NF-kB mRNA、IL-6、TGF-β1水平均高于非感染组(P<0.05); NF-kB mRNA、IL-6及吸烟史是种植牙术后早期感染的危险因素(P<0.05)。结论 早期感染不会导致种植牙周围骨丧失发生率升高,但是会诱使PI3K/AKT信号通路激活,上调炎症因子水平,NF-kB mRNA、IL-6及吸烟史是种植牙术后早期感染的危险因素。     

Adjusted body weight, pro: evidence to support the use of adjusted body weight in calculating calorie requirements.

The optimal nutrition regimen for obese hospitalized patients remains controversial, and clinicians use a variety of different methods for estimating needs of obese patients who require nutrition support. Adjusted body weight has been proposed as one method to improve the accuracy of predictive equations when calculating calorie expenditure of obese patients. Although adjusted body weight has been criticized as a "nonscientific method," several studies have investigated the accuracy of adjusted body weight calculations and found it comparable or superior to several prediction equations. This article will summarize the results and discuss the limitations of data from studies regarding calculations for obese hospitalized patients. The use of adjusted body weight is discussed in the context of what is clinically significant in calculations of energy expenditure and in light of the limitations of current outcome data.     

Individual differences in reward sensitivity are related to food craving and relative body weight in healthy women

According to the theory of J.A. Gray, a strongly reactive approach system is highly sensitive to reward or to cues that signal reward. This implies that intake driven by the rewarding properties of food should be affected by individual differences in reactivity of the approach system. The present study examined whether reward sensitivity is associated with food craving and relative body weight in a sample of female college students. Participants completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire and the trait version of the Food Craving Questionnaire and also reported their weight and height in order to compute Body Mass Index (BMI). Sensitivity to reward was significantly related to food craving and BMI. Furthermore, the correlation between reward sensitivity and BMI was not attenuated when the influence of food craving was partialled out, indicating that the relation between sensitivity to reward and BMI was not mediated by food craving. This is the first study demonstrating a relation between the personality trait of sensitivity to reward and BMI. These findings are discussed in the context of the involvement of dopaminergic reward circuitry in overeating.     

Effects of changes in body weight on carbohydrate metabolism, catecholamine excretion, and thyroid function

BACKGROUND: Weight gain and loss increases and decreases energy expenditure, respectively, out of proportion to changes in metabolic mass. OBJECTIVE: We hypothesized that changes in energy expenditure associated with weight gain or loss were due in part to changes in catecholamine release, thyroid hormones, carbohydrate utilization, or a combination thereof. METHODS: Urinary catecholamine excretion, serum thyroid hormone concentrations, and results of 3-h oral-glucose-tolerance tests were examined in obese and never-obese subjects at their usual weights, during weight loss or gain, and at stable weights 10-20% below or 10% above usual. RESULTS: Urinary norepinephrine excretion decreased significantly during and after weight loss and increased during and after weight gain. Serum concentrations of reverse triiodothyronine increased significantly during and after weight loss, whereas serum concentrations of triiodothyronine increased significantly (by approximately 0%) during and after weight gain. Serum insulin and glucose concentrations during the oral-glucose-tolerance test increased significantly after weight gain in obese subjects. The percentage change in urinary norepinephrine excretion and in serum concentrations of triiodothyronine were significantly correlated with percentage changes in energy expenditure and with each other. CONCLUSIONS: Changes in body weight were associated with changes in catecholamine excretion and thyroid hormones, which might-by virtue of the effects on energy expenditure-have favored a return to usual body weight. Weight gain induced more apparent insulin resistance in the obese than the never-obese subjects, suggesting a threshold effect of total body fat on this phenomenon.