body mass index (bmi)

身体质量指数 (BMI)
  • 文章类型: Journal Article
    在促性腺激素释放激素拮抗剂(GnRH-ant)周期中,研究体重指数(BMI)对触发日孕酮(P)水平的影响。
    本研究为回顾性队列研究。选取2017年10月至2022年4月在我院生殖中心接受GnRH-ant方案控制性超促排卵(COH)的412例体外受精(IVF)/卵胞浆内单精子注射(ICSI)患者为研究对象。根据BMI水平分为3组:正常体重组(n=230):18.5kg/m2≤BMI<24kg/m2;超重组(n=122):24kg/m2≤BMI<28kg/m2;肥胖组(n=60):BMI≥28kg/m2。单变量分析中p<.10的变量(BMI,基础FSH,基底P,FSH天,Gn起始剂量和触发日的E2水平)以及可能影响触发日P水平的变量(不育因素,基础LH,总FSH,将HMG天数和总HMG)纳入多因素logistic回归模型,以分析BMI对GnRH-ant方案触发日P水平的影响。
    调整混杂因素后,与正常体重患者相比,超重和肥胖患者在触发日血清P升高的风险显著降低(OR分别为0.434和0.199,p<.05)。
    随着BMI的增加,GnRH-ant周期中触发日P升高的风险降低,BMI可作为GnRH-ant周期触发日P水平的预测因子之一。
    UNASSIGNED: To investigate the effect of body mass index (BMI) on progesterone (P) level on trigger day in gonadotropin-releasing hormone antagonist (GnRH-ant) cycles.
    UNASSIGNED: This study was a retrospective cohort study. From October 2017 to April 2022, 412 in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) patients who were treated with GnRH-ant protocol for controlled ovarian hyperstimulation (COH) in the reproductive center of our hospital were selected as the research objects. Patients were divided into three groups according to BMI level: normal weight group (n = 230):18.5 kg/m2≤BMI < 24 kg/m2; overweight group (n = 122): 24 kg/m2≤BMI < 28 kg/m2; Obesity group (n = 60): BMI ≥ 28 kg/m2. Variables with p < .10 in univariate analysis (BMI, basal FSH, basal P, FSH days, Gn starting dose and E2 level on trigger day) and variables that may affect P level on trigger day (infertility factors, basal LH, total FSH, HMG days and total HMG) were included in the multivariate logistic regression model to analyze the effect of BMI on P level on trigger day of GnRH-ant protocol.
    UNASSIGNED: After adjustment for confounding factors, compared with that in normal weight patients, the risk of serum P elevation on trigger day was significantly lower in overweight and obese patients (OR = 0.434 and 0.199, respectively, p < .05).
    UNASSIGNED: The risk of P elevation on trigger day in GnRH-ant cycles decreased with the increase of BMI, and BMI could be used as one of the predictors of P level on trigger day in GnRH-ant cycles.
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  • 文章类型: Journal Article
    背景和目标:结直肠癌是全球主要的健康问题,与转移阶段相关的发病率和死亡率显着增加。这项研究调查了转移性CRC患者各种临床和实验室参数的预后意义。材料和方法:2016年1月至2023年3月,回顾性队列分析了来自TimisoaraOncoHelp协会的188例CRC肝转移患者。人口统计数据,临床特征,和生物标志物,如淋巴细胞计数,以及各种炎症指标,进行了检查。统计分析包括单变量和多变量逻辑回归,Kaplan-Meier生存分析,和ROC曲线评估。结果:我们的发现表明生存结果与几种生物标志物之间存在显著关联。较高的BMI和淋巴细胞计数与较高的生存率有关,而中性粒细胞-血红蛋白-淋巴细胞(NHL)评分较高,中性粒细胞-淋巴细胞比率(NLR),血小板-淋巴细胞比率(PLR),和全身免疫炎症指数(SII)是预后较差的预测因子。值得注意的是,诊断时肝转移的存在是一个关键因素,显著降低总生存率。结论:该研究扩大了目前对CRC预后因素的认识,倡导多维度的预后评估方法。这种方法不仅要考虑传统的指标,如肿瘤分期和组织学分级,而且要考虑更广泛的生物标志物。未来的研究应旨在验证这些发现,并探索将这些生物标志物整合到常规临床实践中。提高预后评估的准确性,并最终指导更个性化的CRC患者治疗策略。
    Background and objectives: Colorectal cancer is a major global health concern, with a significant increase in morbidity and mortality rates associated with metastatic stages. This study investigates the prognostic significance of various clinical and laboratory parameters in patients with metastatic CRC. Materials and Methods: A retrospective cohort of 188 CRC patients with hepatic metastasis from the OncoHelp Association in Timisoara was analyzed from January 2016 to March 2023. Data on demographics, clinical characteristics, and biomarkers, such as lymphocyte counts, as well as various inflammation indices, were examined. Statistical analyses included univariate and multivariate logistic regression, Kaplan-Meier survival analysis, and ROC curve assessments. Results: Our findings indicate significant associations between survival outcomes and several biomarkers. Higher BMI and lymphocyte counts were linked with better survival rates, while higher values of Neutrophil-Hemoglobin-Lymphocyte (NHL) score, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) were predictors of poorer outcomes. Notably, the presence of hepatic metastasis at diagnosis was a critical factor, significantly reducing overall survival. Conclusions: The study has expanded the current understanding of prognostic factors in CRC, advocating for a multi-dimensional approach to prognostic evaluations. This approach should consider not only the traditional metrics such as tumor stage and histological grading but also incorporate a broader spectrum of biomarkers. Future studies should aim to validate these findings and explore the integration of these biomarkers into routine clinical practice, enhancing the precision of prognostic assessments and ultimately guiding more personalized treatment strategies for CRC patients.
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  • 文章类型: Journal Article
    肥胖是一个严重的健康问题,这逐渐影响到患有心脏病合并症的个体的生活,中风,和糖尿病。由于其患病率尤其在五岁以下儿童中增加,应确定其遗传和环境原因,以预防和控制该疾病。这项研究旨在检测纯母乳喂养的肥胖婴儿家庭中潜在的遗传风险因素。
    招募了一个三代家庭进行肥胖评估。对可用的家庭成员进行了详细的检查以及体重指数计算。使用Illumina-NextSeq550对7个月大的肥胖婴儿进行全外显子组测序。在GenomizeSEQ平台上进行生物信息学分析,对于所有正常群体,在次要等位基因频率(MAF)<1%下进行变体过滤。Sanger测序用于变体确认和家族分离。
    神经运动发育特征正常,遗传综合征被排除在指标之外。早发性重度肥胖(4.25SDS身高体重)在指标病例中明显,他的父亲和祖母也肥胖(BMI:分别为38.1kg/m2和31.3kg/m2)。WES分析显示SH2B1、PDE11A、ADCY3和CAPN10基因先前与肥胖相关。除PDE11A和家族分离确认的父系遗传外,所有变体均被评估为肥胖的新候选者。
    这项研究证实了所有潜在有害肥胖相关变异的父系遗传。单个变体的累积效应可能解释该家族中的肥胖表型。由于以后儿童肥胖的风险增加,建议婴儿进行定期随访。
    UNASSIGNED: Obesity is a serious health problem, that progressively affects individuals\' lives with comorbidities involving heart disease, stroke, and diabetes mellitus. Since its prevalence increases particularly in children under age-of-five years, its genetic and environmental causes should be determined for prevention and control of the disease. This study aimed to detect underlying genetic risk factors in a family with an exclusively breastfed obese infant.
    UNASSIGNED: A three-generation family was recruited to be evaluated for obesity. Detailed examinations along with body mass indexcalculations were performed on available family members. Whole exome sequencing was performed on 7-month-oldobese infant utilizing Illumina-NextSeq550. Bioinformatic analyses were performed on the Genomize SEQ platform with variant filtering at minor allele frequencies (MAF)<1% for all normal populations. Sanger sequencing was applied in variant confirmation and family segregation.
    UNASSIGNED: Neuro-motor developmental features were normal and genetic syndromes were excluded from the index. Early-onset severe obesity (4.25SDS weight-for-height) was obvious in index case, where his father and grandmother were also obese (BMIs: 38.1kg/m2 and 31.3kg/m2, respectively). WES analysis revealed deleterious variants in SH2B1, PDE11A, ADCY3, and CAPN10 genes previously associated with obesity. All variants were evaluated as novel candidates for obesity except PDE11A and family segregation confirmed paternal inheritance.
    UNASSIGNED: This study confirmed the paternal inheritance of all potentially deleterious obesity-related variants. The cumulative effect of individual variants might explain the obesity phenotype in this family. The infant is recommended to be under periodic follow-up due to increased risk for later childhood obesity.
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  • 文章类型: Journal Article
    鉴于波多黎各和更广泛的美国普遍存在的肥胖和糖尿病问题,迫切需要调查BMI之间复杂的相互作用,孕前,和妊娠期糖尿病,以及它们对新生儿发育过程中先天性心脏病(CHD)发生的潜在影响。
    使用波多黎各先天性缺陷的全面警戒和监测系统,我们对2016-2020年诊断为冠心病的新生儿进行了重点分析.我们的评估包括一系列变量,包括产妇年龄,胎龄,BMI,孕前糖尿病,妊娠期糖尿病,高血压,流产史,和先兆子痫的存在。
    我们的研究包括673名患者。产妇平均年龄26岁,在22到32年的范围内。平均胎龄测量为39周,中位跨度为38至39周。在673名患者中,274名(41%)母亲生下了被诊断为冠心病的新生儿。在这个群体中,22例与孕前糖尿病有关,而202则没有;20例与妊娠糖尿病有关,与200例没有;148例表现出超重或肥胖的BMI,而126显示正常的BMI。
    我们确定了孕前糖尿病与CHD发生之间的统计学显着相关性。然而,我们的分析未显示孕妇BMI与CHD可能性之间存在统计学显著关联.这些结果可能有助于制定有效的策略来预防和管理新生儿CHD。
    UNASSIGNED: Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States, there is a compelling need to investigate the intricate interplay among BMI, pregestational, and gestational maternal diabetes, and their potential impact on the occurrence of congenital heart defects (CHD) during neonatal development.
    UNASSIGNED: Using the comprehensive System of Vigilance and Surveillance of Congenital Defects in Puerto Rico, we conducted a focused analysis on neonates diagnosed with CHD between 2016 and 2020. Our assessment encompassed a range of variables, including maternal age, gestational age, BMI, pregestational diabetes, gestational diabetes, hypertension, history of abortion, and presence of preeclampsia.
    UNASSIGNED: A cohort of 673 patients was included in our study. The average maternal age was 26 years, within a range of 22 to 32 years. The mean gestational age measured 39 weeks, with a median span of 38 to 39 weeks. Of the 673 patients, 274 (41%) mothers gave birth to neonates diagnosed with CHD. Within this group, 22 cases were linked to pre-gestational diabetes, while 202 were not; 20 instances were associated with gestational diabetes, compared to 200 without; and 148 cases exhibited an overweight or obese BMI, whereas 126 displayed a normal BMI.
    UNASSIGNED: We identified a statistically significant correlation between pre-gestational diabetes mellitus and the occurrence of CHD. However, our analysis did not show a statistically significant association between maternal BMI and the likelihood of CHD. These results may aid in developing effective strategies to prevent and manage CHD in neonates.
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  • 文章类型: Journal Article
    这项横断面研究旨在探讨复合膳食抗氧化剂指数(CDAI)和体重指数(BMI)对美国成年人中风风险的相互作用影响,利用2001年至2018年进行的国家健康和营养检查调查(NHANES)的数据。
    分析涉及42,042名来自非制度化美国平民代表性样本的参与者,通过分层选择,多级概率抽样方法。使用自动多次通过方法在两个24小时内收集饮食摄入量数据。该研究计算了一个改良的CDAI来评估膳食抗氧化剂的摄入量,不包括补品和水源。统计方法包括多变量逻辑回归和广义加法模型(GAM),以评估CDAI评分和BMI与卒中风险之间的相互作用。适应广泛的人口统计学,生活方式,和健康协变量。
    研究发现,在卒中风险评估中,CDAI评分和BMI类别之间存在显著的相互作用。虽然在整个人群中观察到CDAI评分与卒中风险之间呈负相关(OR0.97,95%CI0.96-0.99),这种关系在不同BMI组之间差异显著.在BMI≥25的参与者中,持续存在统计学上显著的负相关关系,显示非线性图案。该研究还揭示了CDAI评分的一个拐点,表明膳食抗氧化剂与中风风险之间的关系发生了变化。
    这项研究强调了在确定美国成年人中风风险时,膳食抗氧化剂摄入量与BMI之间的复杂相互作用。研究结果表明,BMI较高的人可能会从饮食抗氧化剂中预防中风中获得更明显的益处。这些见解可以提供有针对性的饮食建议和旨在降低中风风险的公共卫生策略。特别是在BMI较高的人群中。需要进一步的研究来充分了解这些相互作用及其对中风预防指南的影响。
    UNASSIGNED: This cross-sectional study aims to explore the interactive effects of the Composite Dietary Antioxidant Index (CDAI) and Body Mass Index (BMI) on stroke risk among U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018.
    UNASSIGNED: The analysis involved 42,042 participants from a representative sample of non-institutionalized U.S. civilians, selected through a stratified, multistage probability sampling method. Dietary intake data were collected over two 24-h periods using the Automated Multiple-Pass Method. The study calculated a modified CDAI to assess dietary antioxidant intake, excluding supplements and water sources. Statistical methods included multivariable logistic regression and Generalized Additive Models (GAM) to evaluate the interaction between CDAI scores and BMI in relation to stroke risk, adjusting for a wide range of demographic, lifestyle, and health covariates.
    UNASSIGNED: The research identified a significant interaction between CDAI scores and BMI categories in stroke risk assessment. While a negative correlation was observed between CDAI scores and stroke risk across the total population (OR 0.97, 95% CI 0.96-0.99), this relationship varied notably across different BMI groups. In participants with a BMI ≥25, a statistically significant negative association persisted, displaying a non-linear pattern. The study also revealed an inflection point in the CDAI score, indicating a shift in the relationship between dietary antioxidants and stroke risk.
    UNASSIGNED: This study underscores the complex interaction between dietary antioxidant intake and BMI in determining stroke risk among U.S. adults. The findings suggest that individuals with higher BMI may experience more pronounced benefits from dietary antioxidants in stroke prevention. These insights could inform targeted dietary recommendations and public health strategies aimed at reducing stroke risk, particularly in populations with higher BMI. Further research is needed to fully understand these interactions and their implications for stroke prevention guidelines.
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  • 文章类型: Journal Article
    目前没有关于腹部肥胖指数与肝纤维化进展风险之间的相关性的可用信息。我们的目的是调查身体质量指数(BMI),腰围(WC),内脏脂肪指数(VAI)与肝纤维化的进展有关。该研究还评估了这些指标与代谢功能障碍相关的脂肪变性肝病(MASLD)和肝纤维化的患病率之间的关联。共有1403名受试者参与了基于人群的横断面和纵向研究。通过瞬时弹性成像评估肝脏硬度,在基线和随访(中位数:4.2年)。还分析了血糖异常的亚组。在横断面研究中,VAI的最高四分位数,BMI≥30kg/m2,腹部肥胖与MASLD和肝纤维化的患病率显着相关,以及纤维化进展。然而,VAI与MASLD发生率无相关性。在血糖异常的受试者中,未观察到VAI与MASLD发生率或纤维化进展之间的关联.总之,BMI,WC,在一般人群中,VAI与进展为中度至晚期肝纤维化的风险增加相关.然而,VAI的表现并不优于BMI和WC的测量。
    There is currently no available information on the correlation between abdominal obesity indices and the risk of liver fibrosis progression. We aimed to investigate the relationship between the body mass index (BMI), waist circumference (WC), and the visceral adiposity index (VAI) with the progression of liver fibrosis. The study also evaluated the association between these indices and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. A total of 1403 subjects participated in the cross-sectional and longitudinal population-based study. Liver stiffness was assessed via transient elastography, at baseline and follow-up (median: 4.2 years). The subgroup with dysglycemia was also analyzed. In the cross-sectional study, the highest quartile of VAI, BMI ≥ 30 kg/m2, and abdominal obesity showed significant associations with the prevalence of MASLD and liver fibrosis, as well as with fibrosis progression. However, VAI showed no association with MASLD incidence. Among the dysglycemic subjects, there was no observed association between VAI and the incidence of MASLD or the progression of fibrosis. In conclusion, the BMI, WC, and the VAI are associated with an increased risk of progression to moderate-to-advanced liver fibrosis in the general population. However, the VAI does not perform better than the BMI and WC measurement.
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  • 文章类型: Journal Article
    近年来,辣椒摄入对超重和肥胖的影响引起了人们的极大兴趣。本研究旨在探讨辣椒消费频率之间的相关性,体重指数(BMI),和肥胖在美国人口中的患病率。
    收集了2003-2006年国家健康和营养调查(NHANES)参与者的数据。在这项横断面研究中,我们招募了6,138名参与者,提供了有关辣椒摄入量和BMI的完整信息。采用多因素logistic回归分析和敏感性分析探讨辣椒摄入频率、BMI与肥胖的关系。采用亚组分析和相互作用测试来评估所观察到的相关性的稳定性。
    辣椒消费频率的增加与更高的BMI值和更高的肥胖患病率有关。与非消费群体相比,在完全校正模型中,最高频率组的BMI的多变量校正β为0.71(95%CI:0.05,1.38),肥胖的OR为1.55(95%CI:1.22,1.97).辣椒摄入频率与肥胖之间的正相关在女性和老年人(≥60岁)中更为明显。
    我们的研究结果表明,在美国成年人中,辣椒摄入频率与BMI和肥胖之间存在正相关。这表明控制辣椒的摄入频率可能有助于改善普通人群的体重管理.
    UNASSIGNED: The effects of chili intake on overweight and obesity have attracted significant interest in recent years. This study aimed to investigate the correlation between chili consumption frequency, body mass index (BMI), and obesity prevalence in the American population.
    UNASSIGNED: Data from participants in National Health and Nutrition Examination Survey (NHANES) 2003-2006 were collected. We enrolled 6,138 participants with complete information on chili intake and BMI in this cross-sectional study. Multivariate logistic regression and sensitivity analyses were conducted to explore the relationship between chili intake frequency and BMI and obesity. Subgroup analyses and interaction tests were employed to assess the stability of the observed correlation.
    UNASSIGNED: Increased chili consumption frequency was linked to higher BMI values and a greater prevalence of obesity. Compared to the non-consumption group, the highest frequency group had a multivariate-adjusted β of 0.71 (95% CI: 0.05, 1.38) for BMI and an OR of 1.55 (95% CI: 1.22, 1.97) for obesity in the fully adjusted model. This positive association between chili intake frequency and obesity was more pronounced in females and older adults (≥ 60 years old).
    UNASSIGNED: Our findings suggest a positive association between chili intake frequency and BMI and obesity in United States adults, suggesting that controlling chili intake frequency could potentially contribute to improved weight management in the general population.
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  • 文章类型: Journal Article
    已经对脂肪组织与恶性淋巴瘤风险之间的相关性进行了广泛的研究。尽管有许多观察性研究探索了这种联系,关于脂肪组织和恶性淋巴瘤之间的因果关系仍然存在不确定性.
    脂肪组织的增加或减少由BMI的高度表示。BMI和恶性淋巴瘤全基因组关联研究(GWAS)使用了OPENGWAS网站的摘要数据集。在BMIGWAS中满足P<5e-8和r2=0.001的LD标准的单核苷酸多态性(SNP)被选择为遗传工具变体(IVs)。鉴定了LD为r2>0.8的代理SNP,而回文和离群SNP被排除。孟德尔随机化(MR)分析使用五种方法,包括逆方差加权(IVW)模型,加权中位数(WM),MR-Egger,简单模式,和加权模式。敏感性评估包括CochranQ测试,MR-Egger截距测试,和遗漏分析。由国家卫生统计中心(NHANSE)随机选择的参与者和福建医科大学协和医院新诊断的HL患者进行外部验证。
    MR分析的结果强烈支持BMI与霍奇金淋巴瘤(HL)之间的因果关系。研究表明,BMI较低的人患HL的风险显着增加,风险高91.65%(ORIVW=0.0835,95%CI0.0147-0.4733,P=0.005)。在MR研究中未观察到水平或方向多效性的迹象。验证结果与MR分析结果一致(OR=0.871,95%CI0.826-0.918,P<0.001)。BMI与非霍奇金淋巴瘤(NHL)之间无因果关系。
    MR分析研究表明,较低的BMI与HL直接相关。这表明脂肪组织的减少增加了发展HL的风险。然而,进一步的研究对于全面把握这种因果关联的潜在机制至关重要。
    UNASSIGNED: Extensive research has been conducted on the correlation between adipose tissue and the risk of malignant lymphoma. Despite numerous observational studies exploring this connection, uncertainty remains regarding a causal relationship between adipose tissue and malignant lymphoma.
    UNASSIGNED: The increase or decrease in adipose tissue was represented by the height of BMI. The BMI and malignant lymphoma genome-wide association studies (GWAS) used a summary dataset from the OPEN GWAS website. Single-nucleotide polymorphisms (SNPs) that met the criteria of P <5e-8 and LD of r2 = 0.001 in the BMI GWAS were chosen as genetic instrumental variants (IVs). Proxy SNPs with LD of r2 > 0.8 were identified, while palindromic and outlier SNPs were excluded. Mendelian randomization (MR) analysis used five methods, including inverse-variance weighted (IVW) model, weighted median (WM), MR-Egger, simple mode, and weighted mode. Sensitivity assessments included Cochran\'s Q test, MR-Egger intercept test, and leave-one-out analysis. Participants randomly selected by the National Center for Health Statistics (NHANSE) and newly diagnosed HL patients at Fujian Medical University Union Hospital were used for external validation.
    UNASSIGNED: The results of the MR analysis strongly supported the causal link between BMI and Hodgkin\'s lymphoma (HL). The research demonstrated that individuals with lower BMI face a significantly increased risk of developing HL, with a 91.65% higher risk (ORIVW = 0.0835, 95% CI 0.0147 - 0.4733, P = 0.005). No signs of horizontal or directional pleiotropy were observed in the MR studies. The validation results aligned with the results from the MR analysis (OR = 0.871, 95% CI 0.826 - 0.918, P< 0.001). And there was no causal relationship between BMI and non-Hodgkin\'s lymphoma (NHL).
    UNASSIGNED: The MR analysis study demonstrated a direct correlation between lower BMI and HL. This suggested that a decrease in adipose tissue increases the risk of developing HL. Nevertheless, further research is essential to grasp the underlying mechanism of this causal association comprehensively.
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  • 文章类型: Journal Article
    尽管确定了许多与移植物血栓形成相关的有害风险因素,但在术后早期仍有约10-20%的胰腺同种异体移植物丢失。
    我们在2000年至2018年间进行了一项多中心研究,包括899名胰腺移植受者。完全血栓形成导致的早期胰腺衰竭,长期胰腺,分析肾脏和患者的存活率,并根据供体进行调整,使用多变量特定于原因的Cox模型对移植中心进行分层。
    有高血压史的捐献者的胰腺(6.7%),以及高体重指数(BMI),与术后前30天内胰腺衰竭风险增加独立相关(分别,HR=2.57,95%CI从1.35到4.89,HR=1.11,95%CI从1.04到1.19)。高血压与BMI的交互作用为阴性。供者高血压也影响长期胰腺存活(HR=1.88,95%CI从1.13到3.12)。然而,当在术后30天后计算胰腺存活率时,供体高血压不再是显著的危险因素(HR=1.22,95%CI为0.47~3.15).与其他患者相比,接受没有RAAS(肾素血管紧张素醛固酮系统)阻滞剂的高血压供体胰腺的患者的胰腺存活率较低(50%vs14%,p<0.001)。在RAAS阻滞剂下,非高血压供体和高血压供体的胰腺存活率相似。
    供者高血压是胰腺衰竭的重要且独立的危险因素。肾素-血管紧张素-醛固酮系统的众所周知的致病作用似乎与这种立即移植物衰竭的发生有关。
    UNASSIGNED: About 10-20% of pancreas allografts are still lost in the early postoperative period despite the identification of numerous detrimental risk factors that correlate with graft thrombosis.
    UNASSIGNED: We conducted a multicenter study including 899 pancreas transplant recipients between 2000 and 2018. Early pancreas failure due to complete thrombosis, long-term pancreas, kidney and patient survivals were analyzed and adjusted to donor, recipient and perioperative variables using a multivariate cause-specific Cox model stratified to transplant centers.
    UNASSIGNED: Pancreas from donors with history of hypertension (6.7%), as well as with high body mass index (BMI), were independently associated with an increased risk of pancreas failure within the first 30 post-operative days (respectively, HR= 2.57, 95% CI from 1.35 to 4.89 and HR= 1.11, 95% CI from 1.04 to 1.19). Interaction term between hypertension and BMI was negative. Donor hypertension also impacted long-term pancreas survival (HR= 1.88, 95% CI from 1.13 to 3.12). However, when pancreas survival was calculated after the postoperative day 30, donor hypertension was no longer a significant risk factor (HR= 1.22, 95% CI from 0.47 to 3.15). A lower pancreas survival was observed in patients receiving a pancreas from a hypertensive donor without RAAS (Renin Angiotensin Aldosterone System) blockers compared to others (50% vs 14%, p < 0.001). Pancreas survival was similar among non-hypertensive donors and hypertensive ones under RAAS blockers.
    UNASSIGNED: Donor hypertension was a significant and independent risk factor of pancreas failure. The well-known pathogenic role of renin-angiotensin-aldosterone system seems to be involved in the genesis of this immediate graft failure.
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  • 文章类型: Journal Article
    目的:在过去的几十年中,育龄妇女和孕妇的肥胖患病率一直在上升。体重指数(BMI)与产科肛门括约肌损伤(OASIS)或会阴切开术之间的关系尚未得到彻底研究。这项研究的目的是阐明这个问题。
    方法:本回顾性队列研究使用大学附属三级医疗中心产科的电子数据库进行。包括2015年1月至2021年12月期间的所有自发性单胎阴道分娩。主要结果是OASIS(三度和四度会阴撕裂)和肥胖的发生率。在三个BMI类别中进行了比较:正常(BMI低于25kg/m2),超重(BMI25.0-29.9kg/m2),和肥胖(BMI为30kg/m2及以上)。
    结果:在确定的13,932例自然阴道分娩中,34.7%的人的BMI在正常范围内,43.1%的人超重,25.4%为肥胖。多变量分析显示肥胖(OR0.2,95CI0.04-0.9)和超重(OR0.3,95CI0.1-0.99)女性的OASIS发生率较低,与正常体重队列相比。此外,肥胖队列中会阴切开术的发生率较低(OR0.7,95CI0.6~0.8).
    结论:肥胖女性OASIS发病率下降,与较低的会阴切开术结合使用。这些发现表明,产科诊所可能会考虑对肥胖患者采取更保守的外阴切开术方法。
    OBJECTIVE: Prevalence of obesity in reproductive age and pregnant women has been on the rise during the past several decades. The relationship between body mass index (BMI) and obstetric anal sphincter injuries (OASIS) or episiotomy has not yet been thoroughly investigated. The objective of this study was to shed light on this issue.
    METHODS: This retrospective cohort study was performed using electronic database of an obstetrics department at a university-affiliated tertiary medical center. All spontaneous singleton vaginal deliveries at term between January 2015 and December 2021 were included. The primary outcome was the incidence of OASIS (third- and fourth-degree perineal tears) and obesity. These were compared across three BMI categories: normal (BMI below 25 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obesity (BMI of 30 kg/m2 and over).
    RESULTS: Of the overall 13,932 spontaneous vaginal deliveries identified, 34.7 % had BMI in the normal range, 43.1 % were overweight, and 25.4 % were obese. Multivariate analysis demonstrated lower rates of OASIS in obese (OR 0.2, 95 %CI 0.04-0.9) and in overweight (OR 0.3, 95 %CI 0.1-0.99) women, as compared to the normal-weight cohort. In addition, lower rates of episiotomy were noted in the obese cohort (OR 0.7, 95 %CI 0.6-0.8).
    CONCLUSIONS: Decreased incidence of OASIS was noted in women with obesity, in conjunction with lower use of episiotomy. These findings imply that obstetrics clinics might consider a more conservative approach to episiotomy in obese patients.
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