Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific...Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial(NIT)cohort.Methods:Body weight of 21,028 healthy residents of Linxian,Henan province,aged 40-69 years was measured two times from 1986 to 1991.Outcome events were prospectively collected up to 2016.Weight maintenance group(weight change<2 kg)or stable normal weight group was treated as the reference.Cox proportional hazard model was performed to calculate hazard ratios(HRs)and 95%confidence intervals(95%CIs)to estimate the risk of mortality.Results:A total of 21,028 subjects were included in the final analysis.Compared with the weight maintenance group,subjects with weight loss≥2 kg had an increased risk of death from all-cause(HR_(All-cause)=1.14,95%CI:1.09-1.19,P<0.001),cancer(HR_(Cancer)=1.12,95%CI:1.03-1.21,P=0.009),and heart disease(HR_(Heart diseases)=1.21,95%CI:1.11-1.31,P<0.001),whereas subjects with weight gain≥5 kg had 11%(HR_(Cancer)=0.89,95%CI:0.79-0.99,P=0.033)lower risk of cancer mortality and 23%higher risk of stroke mortality(HR_(Stroke)=1.23,95%CI:1.12-1.34,P<0.001).For the change of weight status,both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death(HR_(Overweight to normal)=1.18,95%CI:1.09-1.27;HR_(Becoming underweight)=1.35,95%CI:1.25-1.46)and cancer death(HR_(Overweight to normal)=1.20,95%CI:1.04-1.39;HR_(Becoming underweight)=1.44,95%CI:1.24-1.67),while stable overweight could increase the risk of total death(HR_(Stable overweight)=1.11,95%CI:1.05-1.17)and death from stroke(HR_(Stable overweight)=1.44,95%CI:1.33-1.56).Interaction effects were observed between age and weight change on cancer mortality,as well as between baseline BMI and weight change on all-cause,heart disease,and stroke mortality(all P_(interaction)<0.01).Conclusions:Weight loss w展开更多
目的探讨成年患者在重症监护室(intensive care unit,ICU)住院期间体质量变化对死亡率的影响。方法采用多中心回顾性队列研究,利用eICU-CRD数据库,纳入首次入院单次入住ICU且ICU住院时长>24 h的成年患者。采用单因素和多因素Logisti...目的探讨成年患者在重症监护室(intensive care unit,ICU)住院期间体质量变化对死亡率的影响。方法采用多中心回顾性队列研究,利用eICU-CRD数据库,纳入首次入院单次入住ICU且ICU住院时长>24 h的成年患者。采用单因素和多因素Logistic回归分析,并控制相关混杂因素,研究ICU住院期间体质量变化与死亡率之间的关系。在不同年龄组、急性生理和慢性健康评估Ⅳ评分(Acute Physiology and Chronic Health EvaluationⅣscore,APACHEⅣ)评分、ICU住院时长和入院时BMI基线水平中进行亚组分析。结果本研究共纳入ICU患者34311例,其中男性占比55.1%,白种人占比82.4%,≥65岁以上人群占比51.3%;与体质量降低组患者比较,体质量升高的患者出现肾衰竭(1938例,11.1%)、肝衰竭(106例,0.6%)和败血症(2442例,14.0%)的比例更高,并且体质量增加组的患者在ICU住院时长、医院住院时长和APACHEⅣ评分也较高。多因素Logistic回归模型结果显示体质量增加组患者的住院死亡率是体质量降低组的1.25倍(95%CI:1.16~1.36,P<0.001),ICU死亡率是体质量降低组的1.36倍(95%CI:1.22~1.50,P<0.001),而且在疾病严重程度较高、ICU住院时间较长的患者中更明显,并且研究结果不受年龄及BMI基线水平的影响。结论在成年患者中,体质量变化是其发生ICU死亡和医院死亡的独立危险因素。展开更多
BACKGROUND The impact of body mass index(BMI)on survival in patients with esophageal squamous cell carcinoma(ESCC)undergoing surgery remains unclear.Therefore,a definition of clinically significant BMI in patients wit...BACKGROUND The impact of body mass index(BMI)on survival in patients with esophageal squamous cell carcinoma(ESCC)undergoing surgery remains unclear.Therefore,a definition of clinically significant BMI in patients with ESCC is needed.AIM To explore the impact of preoperative weight loss(PWL)-adjusted BMI on overall survival(OS)in patients undergoing surgery for ESCC.METHODS This retrospective study consisted of 1545 patients who underwent curative resection for ESCC at West China Hospital of Sichuan University between August 2005 and December 2011.The relationship between PWL-adjusted BMI and OS was examined,and a multivariate analysis was performed and adjusted for age,sex,TNM stage and adjuvant therapy.RESULTS Trends of poor survival were observed for patients with increasing PWL and decreasing BMI.Patients with BMI≥20.0 kg/m2 and PWL<8.8%were classified into Group 1 with the longest median OS(45.3 mo).Patients with BMI<20.0 kg/m2 and PWL<8.8%were classified into Group 2 with a median OS of 29.5 mo.Patients with BMI≥20.0 kg/m2 and PWL≥8.8%(HR=1.9,95%CI:1.5-2.5),were combined into Group 3 with a median OS of 20.1 mo.Patients in the three groups were associated with significantly different OS(P<0.05).In multivariate analysis,PWL-adjusted BMI,TNM stage and adjuvant therapy were identified as independent prognostic factors.CONCLUSION PWL-adjusted BMI has an independent prognostic impact on OS in patients with ESCC undergoing surgery.BMI might be an indicator for patients with PWL<8.8%rather than≥8.8%.展开更多
Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quas...Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.展开更多
To investigate motivators and strategies of adult weight loss or management, 1805 adults aged 18 - 65 were asked by computer assisted telephone interviews about their weight management behavior during the previous fou...To investigate motivators and strategies of adult weight loss or management, 1805 adults aged 18 - 65 were asked by computer assisted telephone interviews about their weight management behavior during the previous four weeks. High levels of importance to reduce risks associated with chronic diseases such as cancer, heart disease and diabetes were observed, although were indistinguishable between people attempting or not attempting to lose or maintain weight. Results showed that BMI was the strongest predictor of attempting to manage weight irrespective of age and, compared with males, females were more likely to attempt weight management at a lower BMI. Among the weight management group, the most popular weight management strategy was to choose healthier food options (77% and 70% for females and males respectively). With the weight management group also more likely to be monitoring the amount of food they consume, limiting portions sizes and tracking their physical activity participation compared with people not managing their weight. The current study showed that the likelihood of weight management within four weeks prior to the survey peaked for both sexes when BMI reached obese levels, (BMI = 30 - 39.9), suggesting that among people categorised as obese most were attempting to manage their weight. The results also suggest that at least some adults were not attempting to maintain their weight in the four weeks prior to the survey, irrespective of their BMI status. The implications of these findings suggest more effective approaches to weight loss and maintenance could focus on strategies that directly address the benefits and motivations of weight loss and weight maintenance, rather than focusing on conveying the risks of being overweight and the importance of avoiding chronic disease.展开更多
基金National Cancer Institute contract(No.75N91022C00059)
文摘Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial(NIT)cohort.Methods:Body weight of 21,028 healthy residents of Linxian,Henan province,aged 40-69 years was measured two times from 1986 to 1991.Outcome events were prospectively collected up to 2016.Weight maintenance group(weight change<2 kg)or stable normal weight group was treated as the reference.Cox proportional hazard model was performed to calculate hazard ratios(HRs)and 95%confidence intervals(95%CIs)to estimate the risk of mortality.Results:A total of 21,028 subjects were included in the final analysis.Compared with the weight maintenance group,subjects with weight loss≥2 kg had an increased risk of death from all-cause(HR_(All-cause)=1.14,95%CI:1.09-1.19,P<0.001),cancer(HR_(Cancer)=1.12,95%CI:1.03-1.21,P=0.009),and heart disease(HR_(Heart diseases)=1.21,95%CI:1.11-1.31,P<0.001),whereas subjects with weight gain≥5 kg had 11%(HR_(Cancer)=0.89,95%CI:0.79-0.99,P=0.033)lower risk of cancer mortality and 23%higher risk of stroke mortality(HR_(Stroke)=1.23,95%CI:1.12-1.34,P<0.001).For the change of weight status,both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death(HR_(Overweight to normal)=1.18,95%CI:1.09-1.27;HR_(Becoming underweight)=1.35,95%CI:1.25-1.46)and cancer death(HR_(Overweight to normal)=1.20,95%CI:1.04-1.39;HR_(Becoming underweight)=1.44,95%CI:1.24-1.67),while stable overweight could increase the risk of total death(HR_(Stable overweight)=1.11,95%CI:1.05-1.17)and death from stroke(HR_(Stable overweight)=1.44,95%CI:1.33-1.56).Interaction effects were observed between age and weight change on cancer mortality,as well as between baseline BMI and weight change on all-cause,heart disease,and stroke mortality(all P_(interaction)<0.01).Conclusions:Weight loss w
文摘目的探讨成年患者在重症监护室(intensive care unit,ICU)住院期间体质量变化对死亡率的影响。方法采用多中心回顾性队列研究,利用eICU-CRD数据库,纳入首次入院单次入住ICU且ICU住院时长>24 h的成年患者。采用单因素和多因素Logistic回归分析,并控制相关混杂因素,研究ICU住院期间体质量变化与死亡率之间的关系。在不同年龄组、急性生理和慢性健康评估Ⅳ评分(Acute Physiology and Chronic Health EvaluationⅣscore,APACHEⅣ)评分、ICU住院时长和入院时BMI基线水平中进行亚组分析。结果本研究共纳入ICU患者34311例,其中男性占比55.1%,白种人占比82.4%,≥65岁以上人群占比51.3%;与体质量降低组患者比较,体质量升高的患者出现肾衰竭(1938例,11.1%)、肝衰竭(106例,0.6%)和败血症(2442例,14.0%)的比例更高,并且体质量增加组的患者在ICU住院时长、医院住院时长和APACHEⅣ评分也较高。多因素Logistic回归模型结果显示体质量增加组患者的住院死亡率是体质量降低组的1.25倍(95%CI:1.16~1.36,P<0.001),ICU死亡率是体质量降低组的1.36倍(95%CI:1.22~1.50,P<0.001),而且在疾病严重程度较高、ICU住院时间较长的患者中更明显,并且研究结果不受年龄及BMI基线水平的影响。结论在成年患者中,体质量变化是其发生ICU死亡和医院死亡的独立危险因素。
基金Supported by National Natural Science Foundation of China,No.81970481Sichuan Science and Technology Program,No.2018HH0150+1 种基金Chengdu Science and Technology BureauNo.2017GH00072
文摘BACKGROUND The impact of body mass index(BMI)on survival in patients with esophageal squamous cell carcinoma(ESCC)undergoing surgery remains unclear.Therefore,a definition of clinically significant BMI in patients with ESCC is needed.AIM To explore the impact of preoperative weight loss(PWL)-adjusted BMI on overall survival(OS)in patients undergoing surgery for ESCC.METHODS This retrospective study consisted of 1545 patients who underwent curative resection for ESCC at West China Hospital of Sichuan University between August 2005 and December 2011.The relationship between PWL-adjusted BMI and OS was examined,and a multivariate analysis was performed and adjusted for age,sex,TNM stage and adjuvant therapy.RESULTS Trends of poor survival were observed for patients with increasing PWL and decreasing BMI.Patients with BMI≥20.0 kg/m2 and PWL<8.8%were classified into Group 1 with the longest median OS(45.3 mo).Patients with BMI<20.0 kg/m2 and PWL<8.8%were classified into Group 2 with a median OS of 29.5 mo.Patients with BMI≥20.0 kg/m2 and PWL≥8.8%(HR=1.9,95%CI:1.5-2.5),were combined into Group 3 with a median OS of 20.1 mo.Patients in the three groups were associated with significantly different OS(P<0.05).In multivariate analysis,PWL-adjusted BMI,TNM stage and adjuvant therapy were identified as independent prognostic factors.CONCLUSION PWL-adjusted BMI has an independent prognostic impact on OS in patients with ESCC undergoing surgery.BMI might be an indicator for patients with PWL<8.8%rather than≥8.8%.
文摘Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.
文摘To investigate motivators and strategies of adult weight loss or management, 1805 adults aged 18 - 65 were asked by computer assisted telephone interviews about their weight management behavior during the previous four weeks. High levels of importance to reduce risks associated with chronic diseases such as cancer, heart disease and diabetes were observed, although were indistinguishable between people attempting or not attempting to lose or maintain weight. Results showed that BMI was the strongest predictor of attempting to manage weight irrespective of age and, compared with males, females were more likely to attempt weight management at a lower BMI. Among the weight management group, the most popular weight management strategy was to choose healthier food options (77% and 70% for females and males respectively). With the weight management group also more likely to be monitoring the amount of food they consume, limiting portions sizes and tracking their physical activity participation compared with people not managing their weight. The current study showed that the likelihood of weight management within four weeks prior to the survey peaked for both sexes when BMI reached obese levels, (BMI = 30 - 39.9), suggesting that among people categorised as obese most were attempting to manage their weight. The results also suggest that at least some adults were not attempting to maintain their weight in the four weeks prior to the survey, irrespective of their BMI status. The implications of these findings suggest more effective approaches to weight loss and maintenance could focus on strategies that directly address the benefits and motivations of weight loss and weight maintenance, rather than focusing on conveying the risks of being overweight and the importance of avoiding chronic disease.
