OBJECTIVES

Adiposity rebound (AR), the childhood period at which body mass index (BMI) rises from its lowest point, is linked to increased risk of later obesity. The study aims to determine the average age at AR, describe baseline characteristics and analyze the correlation between these characteristics and timing of AR in a population of Filipino pediatric outpatients.

DESIGN

Seven subjects born between 2016 and 2019 from a University Hospital Outpatient Department participated in this cross-sectional analytic study. Childhood anthropometrics were retrospectively collected to determine the age at AR by plot visual inspection. Sex, birth weight and gestational age were obtained from hospital records; breastfeeding duration, maternal BMI, parental obesity, maternal age, maternal smoking, education, parity and family income were gathered through a questionnaire completed by mothers or guardians. Associations were assessed using bootstrap univariate linear regression.

RESULTS

The mean age at AR was 3.2 years (SD = 1.2). Vaginal delivery was significantly associated with later age at AR compared to cesarean section (p = 0.035). Socioeconomic status at ages 2 to 5 showed positive association with delayed AR. Higher monthly family income (≥₱19,000) at ages 2 to 5 years was significantly associated with delayed age at AR. Other baseline childhood and parental factors showed no significant correlation with age at AR.

CONCLUSION

These results highlight the complex and context-dependent nature of AR, emphasizing the need for further studies to better understand and mitigate early obesity risk in Filipino children.

Human ; Young Adult: 19-24 Yrs Old ; Universities ; Regression (psychology) ; Hospital Records ; Gestational Age ; Body Mass Index ; Obesity, Maternal

OBJECTIVES

In Asia, younger individuals (below age 45) are diagnosed to have type 2 diabetes with increased rates of obesity defined by lower BMI yet with greater visceral adiposity (waist circumference and waisthip ratios). The prevalence data on type 1 diabetes is not well established, considered to be low, but is seen to be increasing as well. This changing phenotype therefore, presents a clinical dilemma in terms of correctly classifying diabetes and deciding on the consequent appropriate treatment. Distinguishing type 1 from type 2 diabetes has become more difficult with type 2 diabetes dramatically increasing in young adults and children. This study aims to define the characteristics of diabetes among young adults in the Philippines to provide a basis for appropriate management amidst changes in diabetes phenotypes seen globally.

METHODS

In this cross-sectional analytic study, we characterized the demographic, metabolic, and autoimmune features of diabetes among young adult Filipinos aged 18 to 45 years old consulting at a tertiary referral center in Manila, Philippines. Baseline serum A1c, FBS, 75-g oral glucose tolerance test, insulin, serum C-peptide, insulin autoantibodies, leptin, adiponectin, lipid profile, and thyroid function tests were obtained from the participants and analyzed. The homeostasis model assessment (HOMA) was used to estimate the insulin sensitivity.

RESULTS

A total of 348 patients with diabetes were included, with females comprising two-thirds of the participants. The mean age at diagnosis of diabetes was 35.9±7.22 years. The mean BMI was 28.12 kg/m2, with median waist to hip ratio (WHR) of 0·93. Metabolic syndrome was found in 60% of participants and 67.82% were obese by body mass index. The mean A1c was 9.07±2.52%. Good glucose control (A1c less than 7.0%) was seen in 23% of participants  while nearly half (48%) had HbA1c which was >9.0%. The median levels of fasting insulin and C-peptide were 12.62 (range 1.33–90.42) mIU/L and 0.78 ng/mL (range 0–16.2), respectively. 

Included participants were diagnosed with diabetes within a year and as such, majority did not have any micro- or macrovascular complications. The most common diabetes complication was sensory neuropathy detected by monofilament testing, which was found in 28% of participants, followed by non-proliferative diabetic retinopathy in 13%. A history of previous diabetic ketoacidosis was found in 10 patients (2.87%). Glutamic acid decarboxylase (GAD) and insulin auto-antibodies were found in 3.2% and 19.3% of participants, respectively. Approximately half (51.73%) of the participants were insulin resistant by HOMA-IR.

CONCLUSION

In contrast with Caucasians and other Asians, diabetes among young Filipino adults is associated with lower BMI but with a similarly high visceral adiposity as shown by an elevated WHR. Metabolic syndrome with insulin resistance as defined by a variety of indices is predominant. Type 1 diabetes with autoantibodies occur in only a small fraction of this population. Data derived from this work can provide a framework for cluster analysis towards personalized management specific to this population.

Human ; Acids ; Adiponectin ; Adiposity ; Adult ; Aged ; Antibodies ; Asia ; Asian ; Asian Continental Ancestry Group ; Autoantibodies ; Body Mass Index ; C-peptide ; Carboxy-lyases ; Child ; Cluster Analysis ; Demography ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis ; Diabetic Retinopathy ; Diagnosis ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Glutamate Decarboxylase ; Glutamic Acid ; Insulin ; Insulin Resistance ; Ketosis ; Leptin ; Lipids ; Metabolic Syndrome ; Obesity ; Patients ; Peptides ; Phenotype ; Philippines ; Population ; Prevalence ; Serum ; Therapeutics ; Thyroid Gland ; Thyroid Function Tests ; Young Adult

Abstract Background: This study aims to determine the effectiveness of programmed exercise with telerehabilitation at home in patients with obesity and knee osteoarthritis on visual analogue scale scores, body mass index, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Methods: This research is a pre–post study in patients with obesity and knee osteoarthritis. Research subjects performed a series of exercise programs at home for 28 days. Before the program, there was an initial assessment from a psychologist and a nutritionist. During the program, there was tele-education, telemonitoring, and teleconsultation from doctors. Twenty-six female subjects participated. Results: Visual analogue scale scores decreased statistically significantly every week, until the end of the fourth week, compared with before the intervention (p<0.001). Body mass index and WOMAC scores decreased statistically significantly at the end of the fourth week compared with before the intervention (both p<0.001). Further analysis of all WOMAC components in the intervention group, including pain, stiffness, and physical function, also showed a statistically significant decrease (p<0.001). Conclusion: Programmed exercise as part of telerehabilitation at home has been statistically proven to reduce visual analogue scale scores, body mass index, and WOMAC in patients with obesity and knee osteoarthritis.
Telerehabilitation ; Knee Osteoarthritis ; Obesity ; Body Mass Index ; Visual Analogue Scale ; WOMAC

Introduction: Obesity is a chronic disease characterized by complex alterations in body composition and metabolic health. Traditional reliance on body weight may overlook important physiological adaptations during lifestyle intervention. Methodology: A cohort of 99 participants at programme entry underwent body composition assessment using bioelectrical impedance analysis. Parameters included percent body fat (PBF), visceral fat area (VFA), skeletal muscle index (SMI), and phase angle (PhA). Correlation analyses were performed to explore relationships between adiposity, muscle mass, and cellular health. Results: Participants demonstrated elevated adiposity (PBF 38.9 ± 8.9%; VFA 142.9 ± 56.1 cm²). PhA was inversely associated with VFA (r ≈ −0.23, p <0.05) and positively associated with SMI (r ≈ 0.49, p <0.001). Notably, a subset of overweight individuals exhibited relatively preserved PhA, indicating heterogeneity in metabolic health despite similar adiposity levels. Conclusion Body composition and PhA provide complementary insights into metabolic health beyond body weight. These findings support the role of bioimpedance-derived parameters in identifying metabolic heterogeneity and guiding personalized obesity management.
Body Composition ; Body Weight ; Workplace ; Obesity

Introduction: Precocious puberty is increasingly recognized in children. Effect of gonadotropin-releasing hormone agonist (GnRHa) on height velocity (HV) and body mass index (BMI) during treatment of Central Precocious Puberty (CPP) is not welldocumented. Methodology: Records of all patients treated with GnRH for CPP who attended the paediatric endocrine clinic over a 5-year period (2021–2025) [N1.1] were reviewed retrospectively for HV and BMI changes for 3 consecutive years. Basal luteinizing hormone levels ≥0.3 IU/L or stimulated levels ≥5 IU/L are considered diagnostic of CPP. Results: Twenty patients were reviewed and median age at the start of study was 7.8 years (4.3–10.3). Majority were female (n = 18, 90%) with median Tanner Stage 3 and of Malay origin (n = 18, 90%[N2.1]). Median chronological age was 7.8 years (4.3–10.3) with bone age 10.3 years (5.8–13.4). Causes of CPP were idiopathic (n = 16, 80%), CNS lesion (n = 2, 10%) and poorly controlled congenital adrenal hyperplasia (n = 2, 10%). Nine (82%) of the 11 patients who had MRI brain done had normal findings. After 1 year of treatment, the median HV SDS was −0.83 (range −2.45 to 2.42), and BMI SDS was 0.45 (−1.94 to 2.15). After 2 years (n = 12), HV SDS declined to −1.3 (−3.44 to 0.69), with BMI SDS of 0.13 (−1.16 to 1.79). After 3 years (n = 9), HV SDS declined further to −1.51 (−3.52 to 3.13), and BMI SDS was 0.16 (−0.12 to 1.25). After 1 year of treatment, 20% (n = 4) of patients were overweight and 10% (n = 2) were obese. By 3 years, 22% (n = 2) remained overweight, and none were obese. Conclusion Premature growth plate senescence induced by prior estrogen exposure may lead to HV decline. Although obesity is a risk factor for the onset of CPP, whether GnRHa treatment directly increases BMI remains controversial as our cohort’s BMI change reveals otherwise.
Child ; Body Mass Index ; Puberty, Precocious ; Hormones

OBJECTIVE: To analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China. METHODS: Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI. RESULTS: The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95% CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences. CONCLUSION The continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
Humans ; Osteoarthritis, Knee/epidemiology* ; China/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Aged ; Adult ; Prevalence ; Body Mass Index ; Disability-Adjusted Life Years ; Cost of Illness ; Aged, 80 and over ; Sex Factors ; Global Burden of Disease ; Age Factors ; Young Adult ; Quality-Adjusted Life Years

OBJECTIVE: To explore the epidemiological characteristics of knee osteoarthritis (KOA) among the elderly in the community, and its correlation with bone mass loss. METHODS: A cross-sectional study was conducted on elderly community population over 50 year old from 12 community health service centers in Zhejiang province. Their gender, age, body mass index (BMI), T value and KOA diagnosis were collected using face to face questionnaire survey. Univariate regression was used to analyze the influence of age, gender, BMI and bone loss on KOA. Logistic multivariate regression model was used to analyze the independent effect of bone mass loss on KOA. RESULTS: Among 4 173 subjects in this study, 1 710 of them were had a KOA. The prevalence rate was 40.9%. The mean age, the proportion of females and the mean BMI in KOA patients were (65.5±3.8) years old, 67.7%(1 158/1 710) and(24.59±1.28) kg·m^-2, respectively, which were significantly higher than (58.5±3.2) years old, 51.3%(1 263/2 463), and (23.48±1.25) kg·m^-2 in non-KOA subjects (P<0.001). In the population aged from 60 to 69 years old, the influence of osteopenia and osteoporosis on the prevalence of KOA was[OR=1.21, 95%CI(1.00, 1.46), P=0.053 2], [OR=1.42, 95%CI(1.14, 1.78), P=0.002 2]. The influence of male and female osteoporosis on the prevalence of KOA was [OR=1.52, 95%CI(1.16, 1.99), P=0.002 7] and [OR=1.87, 95%CI(1.51, 2.32), P<0.000 1], respectively. In the population of 24 kg·m^-2≤BMI<28 kg·m^-2, the influence of osteopenia and osteoporosis on the prevalence of KOA was [OR=1.47, 95%CI(1.21, 1.80), P=0.000 1], [OR=2.69, 95%CI(2.11, 3.42), P<0.000 1], respectively. After controlling the confounding factors of age, gender and BMI, compared with people with normal bone mass, the effect of osteopenia on the prevalence of KOA was [OR=1.34, 95%CI(1.08, 1.67), P=0.009 2], and the effect of osteoporosis on the prevalence of KOA was [OR=1.38, 95%CI(1.06, 1.79), P=0.017 9]. CONCLUSION Elderly overweight women are more likely to develop KOA. Bone mass loss is an independent risk factor for KOA, which will significantly increase the prevalence of KOA in people overweight or aged 60 to 69 years old.
Humans ; Female ; Male ; Aged ; Osteoarthritis, Knee/etiology* ; Middle Aged ; Cross-Sectional Studies ; Bone Density ; Aged, 80 and over ; Incidence ; Body Mass Index ; China/epidemiology* ; Osteoporosis/epidemiology*

OBJECTIVE: To investigate the anthropometric parameters that can accurately predict the diameter of the hamstring tendon graft, and to examine the correlation between disease etiology, duration, and graft diameter. METHODS: A retrospective analysis was conducted on data from 166 patients who underwent anterior cruciate ligament reconstruction using hamstring tendon autografts (semitendinosus and gracilis tendon) between January 2013 and December 2023. The cohort conprised 135 males and 31 females;the age ranged from 14 to 62 years old with an average of (28.87±10.46) years old. Pearson correlation coefficients, partial correlation coefficients, and stepwise multiple linear regression analysis were utilized to elucidate the relationship between the outcome variable (diameter of hamstring tendon grafts) and predictive variables (e.g., height). RESULTS: Correlation analysis revealed significant associations between the diameter of hamstring tendon grafts and height (r=0.379, P<0.001), weight (r=0.225, P=0.002), male gender (r=0.302, P<0.001), age(r=-0.218, P=0.002), and sports injury etiology (r=0.167, P=0.016). No significant correlations were found with surgical side, body mass index (BMI), or injury duration (P>0.05). Stepwise multiple linear regression analysis using a backward elimination method indicated that height was the sole significant predictive variable (R²=0.144, P<0.001), with the optimal predictive equation being:Graft size =2.636+0.029×Height (cm). Partial correlation analysis, after controlling for height, showed no significant association between age, gender, weight, and injury etiology with graft diameter. CONCLUSION Height is an effective predictive factor for the diameter of autologous hamstring tendon grafts. Factors such as gender, age, surgical side, body weight, and BMI are not influential to the diameter of the hamstring tendon grafts. Under the condition of the same height, there is no significant difference in the influence of these factors on the graft diameter. Preoperative physical activity level and the duration of injury do not significantly affect the diameter of the hamstring tendon grafts obtained during surgery. It is recommended to use the formula 'Graft Diameter=2.636 + 0.029 × Height (cm)' for preoperative prediction.
Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; Adolescent ; Young Adult ; Transplantation, Autologous ; Anthropometry ; Anterior Cruciate Ligament Reconstruction ; Tendons/anatomy & histology* ; Autografts ; Hamstring Tendons/transplantation* ; Quadriceps Muscle/surgery*

Objective To investigate the regulatory effect of suppressor of cytokine signaling 1 (SOCS1) on the proliferation and apoptosis of myelodysplastic syndrome (MDS) cells SKM-1 and its potential mechanisms. Methods SOCS1 was overexpressed in SKM-1 cells by transfection with exogenous SOCS1-overexpressing plasmid. Cell viability, cell cycle and apoptosis were analyzed with CCK-8 and flow cytometry assays, respectively. Western blot was used to evaluate the expression of proteins related to the Janus kinase 2/signal transducer and activator of transcription (JAK2/STAT) signaling pathway. Additionally, a NOD/SCID mouse model of MDS was established to record mouse body weight and survival time, assessing the impact of the SOCS1 gene on the growth of SKM-1 cells in vivo. Results Transfection of the SOCS1-overexpressing plasmid significantly increased the mRNA and protein expression levels of SOCS1 in the MDS cell line SKM-1. Overexpression of SOCS1 remarkably reduced cell viability, inhibited cell proliferation, and promoted apoptosis of SKM-1 cells, which also decreased the expression of phosphorylated-JAK2 (p-JAK2), phosphorylated-STAT3 (p-STAT3), and p-STAT5 proteins. Furthermore, in vivo experiment results showed that the body weight and survival time of mice in the SOCS1 overexpression group were significantly better than those in the MDS model group, and the number of CD45⁺ SKM-1 cells in the peripheral blood was significantly lower than that in the MDS model group, indicating that SOCS1 overexpression could inhibit the activity of SKM-1 cells in mice. Western blot results verified the protein expression level of SOCS1 in the bone marrow of mice in the SOCS1 overexpression group was significantly higher than that in the MDS model group, while the protein expression levels of p-JAK2, p-STAT3, and p-STAT5 were significantly lower than those in the MDS model group. Conclusion SOCS1 inhibits the proliferation of MDS cell line SKM-1 and promotes its apoptosis by negatively regulating the JAK2/STAT signaling pathway, making it a potential therapeutic target for myelodysplastic syndromes.
Animals ; Humans ; Mice ; Apoptosis ; Body Weight ; Bone Marrow/metabolism* ; Janus Kinase 2/metabolism* ; Mice, Inbred NOD ; Mice, SCID ; Myelodysplastic Syndromes/metabolism* ; Phosphorylation ; STAT3 Transcription Factor/metabolism* ; STAT5 Transcription Factor/metabolism* ; Suppressor of Cytokine Signaling 1 Protein/metabolism* ; Cell Proliferation

To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l -1 vs 32.95 [18.56] IU l -1 , P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l -1 vs 25.59 [18.40] IU l -1 , P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01-1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71-0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.
Humans ; Male ; Azoospermia/surgery* ; Sperm Retrieval/statistics & numerical data* ; Adult ; Follicle Stimulating Hormone/blood* ; Retrospective Studies ; Testis/pathology* ; Microdissection ; Organ Size