bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher Peptide YY Levels Are Associated With Lower Bone Mineral Density in Low Weight Adolescent Girls With Avoidant/Restrictive Food Intake Disorder
Authors: Sella Aluma Chovel , Becker Kendra Rosamond , Slattery Meghan , Hauser Kristine , Kahn Danielle L , Kuhnle Magen , Thomas Jennifer J , Eddy Kamryn T , Misra Madhusmita , Lawson Elizabeth Austen 
Published: May 2021

Abstract
Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is a condition characterized by lack of interest in eating or food, sensory sensitivity, and/or fear of aversive consequences of eating; as opposed to the body image disturbance and fear of weight gain that characterize anorexia nervosa (AN). While appetite regulating hormones and their associations with bone mineral density (BMD) have been well studied in AN, little is known regarding BMD and its association with appetite regulating hormones in ARFID. Peptide YY (PYY), a gut derived anorexigenic hormone, acts via the Y2 receptor to inhibit osteoblastic activity in mammals. In AN, levels of PYY are higher than in healthy controls (HC) and are negatively associated with BMD. We hypothesized that similar to AN, low-weight female adolescents with ARFID would have lower BMD and higher PYY levels than in HC and that PYY levels would be inversely associated with BMD.
Methods: We studied 24 adolescent females (10 low weight with ARFID and 14 HC). BMD variables were measured by Dual-Energy X-ray Absorptiometry. We performed cross sectional analysis to compare BMD and fasting PYY levels between low weight ARFID and HC and to determine the relationship between BMD and PYY levels.
Results: ARFID and HC were 15.1±2.9 (mean ± SEM) and 17.1±3.8 years old, respectively (p=0.178), with mean BMI Z-scores of -1.74±0.88 kg/m2 and 0.24±0.51 kg/m2, respectively (p&lt;0.0001). Total body BMD Z-scores were significantly lower in ARFID (-1.59±1.19, n=10) compared to HC (-0.41±1.11, n=14) (p=0.022), and lumbar BMD Z-scores were numerically lower in ARFID (-1.13±1.40, n=9) vs. HC (-0.44±0.86, n=14) (p=0.212). Mean PYY levels trended higher in ARFID (104.6±39.9 pg/ml, n=8) vs. HC (71.4±24.5 pg/ml, n=9) (p=0.054). In a combined analysis of participants with ARFID and HC, PYY levels were negatively correlated with lumbar BMD and BMD Z-scores (r=-0.52, p=0.038 and r=-0.54 p=0.031, n=16). In multivariable regression analysis, PYY remained a primary determinant of lumbar BMD after adjusting for age and height (p=0.035, β= -0.36) and a borderline significant predictor of lumbar BMD Z-scores after adjusting for height (p=0.064, β=-0.5). Similar associations were noted within the ARFID group alone, with PYY being a significant predictor of lumbar BMD (p=0.031, β=-0.97) after adjusting for age and height.
Conclusion: Female adolescents with low-weight ARFID have lower BMD and a trend toward higher levels of PYY compared with HC. Increased PYY levels may contribute to the lower BMD observed in ARFID. These findings are an initial step in understanding the neuroendocrine dysregulation in low weight adolescents with ARFID, which may predict bone outcomes in this condition.
Longitudinal Weight Gain and Lifestyle Factors in Women With and Without Polycystic Ovary Syndrome
Authors: Awoke Mamaru Ayenew , Earnest Arul , Joham Anju Elizabeth , Hodge Allison M , Brown Wendy J , Teede Helena Jane , Moran Lisa J 
Published: May 2021

Abstract
Background: While women with polycystic ovary syndrome (PCOS) have a higher prevalence of overweight/obesity and increased weight gain than women without PCOS, the association of lifestyle behaviours with weight change is not known. Methods: We used data from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health for longitudinal analysis over 19 years (N=14127 at survey 1). Linear mixed-effects models were used to examine weight change and its association with diet, physical activity and sitting time, adjusted for sociodemographic, psychological factors and health care utilisation. Results: Women with PCOS gained more weight annually (0.27 kg/year, 95% CI 0.14, 0.40; P&lt;0.001) and over 19 years (15.3 kg 95% CI 10.9, 19.7 Vs. 10.8 kg 95% CI 5.5, 16.2) than women without PCOS. There was a three-way interaction between energy intake (0.31 kg, 95% CI 0.004, 0.61; P=0.047), glycaemic index (0.44 kg, 95% CI 0.13, 0.74; P=0.005), sitting time (0.55 kg 95% CI 0.002, 1.10; P=0.049), physical activity (-0.37 kg, 95% CI -0.69, -0.05; P=0.022) and PCOS and time. While women with PCOS had higher weight gain than those without PCOS overall, this difference was greater for women with PCOS with higher energy intake, glycaemic index and longer sitting time and those not meeting PA guidelines. Conclusions: Women with PCOS had a higher rate of weight gain than those without PCOS with those with unhealthy lifestyle behaviours having the greatest weight gain. Women with PCOS may be biologically predisposed to weight gain when experiencing adverse lifestyle factors. This reinforces the contribution of lifestyle factors to weight change and the importance of early lifestyle intervention in PCOS.
Misperception of Weight Is Greater in Healthy Asian Indian Urban Men Than Women
Authors: Lathia Tejal , Chakravarti Sujata 
Published: May 2021

Abstract
Background: Recognizing being overweight is one step towards implementing weight-management behaviors and appropriate interventions Objective: This observational study was designed to study whether the self-perceived body mass index (BMI) status matched the calculated BMI status. Weight loss measures undertaken by overweight or obese participants in real life were also investigated Methods: Healthy men (M) and women (W) (18–65 years old) attending a health check-up at Fortis Hiranandani Hospital, Navi Mumbai, India from 1 August 2019 to 30 November 2019 were systematically included. Information on participants’ perception about their weight, intention of weight management and actual weight-management behavior were collected through simple structured questionnaire. Anthropometric measurements were obtained from all participants to compute their current BMI. Results: Overall, 148 (68%) of 218 (M=158; W=60; median [range] age: 36 [21–44] years) participants were overweight/obese (BMI&gt;25 kg/m2). Majority of the participants were graduate and above (93%). A significant association was seen between increasing age and overweight/obesity (p=0.006). Although similar number of M and W were overweight/obese (70% vs 63%), fewer M perceived themselves to be overweight/obese than W (58% vs 77%, p=0.049). Both M and W attributed their overweight/obese status to lack of exercise (44% vs 46%) and poor dietary habits (38% vs 28%). Additionally, W also attributed their overweight/obese status to hormonal imbalance (hypothyroidism, polycystic ovarian syndrome, post pregnancy, menopause; 28%). Most common (&gt;20% incidence) reasons stated to lose weight were to be healthier and disease-free (82 [55%], M=51; W=31) and look better (36 [24%], M=13; W=23). Majority of the participants attempted to lose weight by exercise (60 [73%], M=43; W=25) and dietary interventions (55 [67%], M=29, W=26). The most common (&gt;40%) exercise regimen used to lose weight was cardio/aerobic activity (31 [52%], M=19; W=12) followed by morning walks (29 [48%], M=20; W=9). Most common dietary intervention practiced was healthy eating based on general knowledge (34 [62%], M=17, W=17) and guidance from family and friends (10 [18%], M=6; W=4); only 1 woman consulted professional dietician. Conclusion: Discrepancy exists between self-perceived and actual calculated BMI status, especially so in men. Though women better perceived weight, they were less likely to participate in scientifically proven methods or professional guidance to lose weight.
Neurobiology of Avoidant/Restrictive Food Intake Disorder in Youth With Overweight/Obesity Versus Healthy Weight
Authors: Liya Kerem , Van De Water Avery L , Kuhnle Megan C , Harshman Stephanie , Hauser Kristine , Eddy Kamryn T , Becker Kendra R , Misra Madhusmita , Micali Nadia , Thomas Jennifer J , Holsen Laura , Lawson Elizabeth A 
Published: May 2021

Abstract
Objective: Avoidant/restrictive food intake disorder (ARFID) occurs across the weight spectrum, however research addressing the coexistence of ARFID with overweight/obesity (OV/OB) is lacking. We aimed to establish co-occurrence of OV/OB and ARFID and to characterize divergent neurobiological features of ARFID by weight.
Method: Youth with full/subthreshold ARFID (11 with healthy weight [HW], 12 with OV/OB) underwent fasting brain fMRI scan while viewing food/non-food images (M age = 16.92 years, 65% female, 87% white). We compared groups on BOLD response to high-calorie foods (HCF) (vs. objects) in food cue processing regions of interest. Following fMRI scanning, we evaluated subjective hunger pre- vs. post-meal. We used a mediation model to explore the association between BMI, brain activation and hunger.
Results: Participants with ARFID and OV/OB demonstrated significant hyperactivation in response to HCF (vs. objects) in the orbitofrontal cortex (OFC) and anterior insula compared with HW subjects with ARFID. Mediation analysis yielded a significant indirect effect of group (HW vs. OV/OB) on hunger via OFC activation (effect=18.39, SE=11.27, 95% CI [-45.09, -3.00]), suggesting that OFC activation mediates differences in hunger between ARFID participants with HW and OV/OB.
Conclusions: Compared to youth with ARFID and HW, those with OV/OB demonstrate hyperactivation of brain areas critical for reward value of food cues. Postprandial changes in subjective hunger depend on BMI and are mediated by OFC activation to food cues. Whether these neurobiological differences contribute to selective hyperphagia in ARFID presenting with OV/OB and represent potential treatment targets is an important area for future investigation.
No Differences in Metabolic Parameters Between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy, Regardless of Achieved Weight Loss
Authors: Holanda Narriane Chaves Pereira , Lacerda Mariana Braga , de Holanda Limeira Caio Chaves , Borges Heloisa Calegari , Sales Marilia Moreira , de Oliveira Viana Gabrielly , Cavalcante Arthur Gomes , Nobrega Medeiros Igor Rosembergh , Carvalho Nara Nóbrega Crispim , Bandeira Francisco Farias 
Published: May 2021

Abstract
Background: Roux-en-y (RYGB) is considered a procedure with more malabsorptive impact than sleeve Gastrectomy (SG), so the risk of chronic complications seems greater. Aim: To describe the metabolic profile and weight regain of patients who underwent bariatric surgery, according to each procedure. Method: A retrospective cohort with patients who underwent bariatric surgery (2003–2018). The sample was divided into SG group and RYGB group. Comparisons were made to analyze the relationship between the procedure itself and metabolic improvements, weight loss and weight regain. Results: We included 117 eligible participants (91.5 % female, 51.2% RYGB surgery), mean follow-up was 4.4± 3.3 years. Mean age was 41.8±6.8 years, without significant difference between the groups. Before the surgery, the groups were similar according metabolic profile (fasting glucose, Hba1c, total cholesterol, LDLc, triglycerides and HOMA IR), except by non-HDLc (RYGB 108.8±26.3 vs SG 127.2±33.2 mg/dl, p=0,002) and 25OHD (RYGB 28.9±4,7 vs SG 34.3±9,5 ng/ml, p=0.044). The RYGB group had greater weight than the SG group (mean 114.1±13.5 kg vs 122.7±20.5 Kg, p&lt;0.0001) and almost 23.3% of the participants had T2DM and 36.2% of them had systemic arterial hypertension, without significant difference between the groups. The RYGB group had a greater postoperative time than the SG group (mean 5.0±4.0 vs 3.6± 2.9 years, respectively). After the surgery, although weight loss was greater in the RYGB group than the SG group (mean 39%±10.2 vs 34.1%±9.8, p&lt;0.0001, respectively), both groups were similar regarding BMI, body fat percentage (BFP) and abdominal circumference. Also, there were no differences in the metabolic profile (fasting glucose, Hba1c, HOMA IR, leptin, triglycerides and HDLc), according to the type of surgery, except in the total cholesterol and LDLc levels (RYGB 167.9±28.2 vs SG 187.9±35.1 and RYGB 92.6±25.6 vs SG 109.5±30.8). Nearly the whole sample (95%) has reached &gt; 20% weight loss. Despite that, 37.6% of the patients have regained &gt; 20% of weight loss, with no relation regarding the type of surgery. Only 7% of the patients remained with some degree of glucose intolerance, with no difference between the groups. Conclusion: We found similar benefits among metabolic markers and weight regain after SG, compared to RYGB.
Obesity, Body Fat Distribution, and Circulating Glutamate Concentrations, A BI-Directional Mendelian Randomization Study
Authors: Maltais-Payette Ina , Bourgault Jérôme , Arsenault Benoît , Tchernof Andre 
Published: May 2021

Abstract
Background: Various observational studies have reported that circulating levels of the amino acid glutamate was significantly associated with central fat accumulation in men and women. This is the case in the Framingham Heart Study Generation 3 for waist circumference, in the TwinsUK cohort for trunk fat and in a cohort of 1449 Japanese for visceral adipose tissue area measured by computed tomography. However, whether the association between abdominal adiposity and circulating glutamate is causal, as well as the direction of this association, is unknown. Here, we aimed to determine whether obesity and abdominal obesity were causally associated with circulating glutamate levels. Methods: We used a two-sample bi-directional inverse-variance weighted Mendelian randomization study design (IVW-MR). We derived summary statistics for our exposures and outcomes from published genome-wide association studies from the GIANT consortium (n = 681 275) and blood metabolites (n = 7 804). We identified independent genetic variants (r2 &lt; 0.1) associated with body mass index (BMI) and waist-to-hip ratio adjusted for BMI (WHRadjBMI, p &lt; 5x10-8) as well as circulating glutamate (p &lt; 5x10-5). Results: We found no causal association between circulating glutamate levels and BMI (beta = 0.082, SE = 0.0413, p = 0.0471) or WHRadjBMI (beta = -0.00106, SE = 0.0401, p = 0.979). However, there was a positive effect of BMI (beta = 0.0608, SE = 0.0150, p = 5.19x10-5) and WHRadjBMI (beta = 0.0701, SE = 0.0198, p = 3.98x10-4) on circulating glutamate level. Conclusion: This Mendelian randomization analysis suggests that obesity and abdominal obesity are causally related to elevated circulating glutamate levels. Glutamate levels are not causally related to adiposity. Whether the downregulation of branched-chain amino acid catabolism in adipose tissue reported in obesity underlies this association should be explored.
Profile of Intestinal Microbiota and Anxiety Level in Overweight Children and Adolescents
Authors: Bandeira Farias Maria Paula Costa , Carvalho Bruno , Neto Adauto 
Published: May 2021

Abstract
Justification: Obesity is considered a worldwide epidemic, with a significant increase in its prevalence in the last 30 years in both children and adolescents. Anxiety disorders can be considered both a cause and a consequence of obesity. The intestinal microbiota has been identified as a participant in the inflammatory process of both obesity and depression / anxiety disorders. Objective: Describe and compare the intestinal microbiota profile of overweight/obese children/teenagers with and without signs of anxiety. METHODOLOGICAL PROCEDURES: descriptive, observational, cross-sectional study with an analytical character (comparison of groups), carried out during the months of January to October of the year 2019. 30 overweight/obesity children/teenagers (BMI greater than P85 – WHO 2007), between seven and 17 years old, convenience sampling. None of the participants had taken antibiotics during the past eight weeks of participation on the study or had chronic or endocrine disease that was not being adequately treated. The participants were divided into two groups: the first group consists of children/adolescents with excess weight without signs of anxiety (n 16) and the second group consists of children/adolescents with excess weight with signs of anxiety (n 14), assessed by a Screen for Child Anxiety Related Emotional Disorders (SCARED) screening questionnaire. Results: The group with signs of anxiety showing higher HOMA IR compared to the group without signs of anxiety with values ​​of 5.05 ± 2.08 and 3.47 ± 1.6 (p = 0.041), respectively. There was a statistically significant difference for beta diversity of the intestinal microbiota profile using the CHAO method (p = 0.025) and the Jackknife method (p = 0.01) between the groups with signs of anxiety and without signs of anxiety. Conclusion: difference was found between the intestinal microbiota diversity of obese children / adolescents with signs of anxiety in relation to the intestinal microbiota diversity of obese children / adolescents without signs of anxiety. This finding suggests a possible involvement of the imbalance of the intestinal microbiota with anxiety disorders and depression in children/adolescents with weight excess.
Renal Outcomes One Year After Metabolic Bariatric Surgery: A Clinical Audit
Authors: Wee Zongwen , Tham Kwang Wei , Tan Hong Chang , Ganguly Sonali , Lim Chin Hong , Chan Weng Hoong , Hock Eng Alvin Kim , Hui Tan Jeremy Tian , Wee Lim Eugene Kee , Lin Ho Emily Tse , Kovalik Jean-Paul , Lee Phong Ching 
Published: May 2021

Abstract
Introduction: Obesity increases the risk of incident chronic kidney disease (CKD), being one of the strongest risk factors for new-onset CKD even in the metabolically normal obese. Weight loss has been shown to reduce renal hyperfiltration and proteinuria. Metabolic Bariatric Surgery (MBS) remains an effective treatment for obesity and its metabolic related complications. However, literature on its impact on long term renal function remains limited.
Methods: This was an observational retrospective study in a tertiary centre in Singapore. MBS cases performed at the centre between 2008 and 2019 were included. The primary outcome measure was estimated Glomerular Filtration Rate (eGFR), calculated using the CKD Epidemiology Collaboration equation, and albuminuria (defined as urine Albumin-Creatinine Ratio (uACR) &gt;3.5 mg/mmol) at baseline and at one-year post surgery.
Results: 557 patients were included. Baseline parameters are as follows: mean age 41.7 ±10.1 years; female 65.4%; ethnic composition: Chinese (35.2%), Malay (33.0%), Indian (26.9%); BMI 42.5 ±7.9 kg/m²; glycaemic status: Diabetes Mellitus (34.5%), Pre-diabetes (13.5%), Non-diabetic (52.1%); Hypertensive status: Hypertension (55.2%), Pre-Hypertension (1.9%), Normotensive (42.9%). Median eGFR was 110.9 (92.4 - 121.5) mL/min/1.73 m² and median uACR was 1.00 (0.40 - 3.55) mg/mmol. At one-year post surgery, patients achieved statistically significant reductions in mean BMI (-11.3 ±4.2 kg/m2), systolic BP (-3.24 ±19.3 mmHg), diastolic BP (-5.23 ±13.8 mmHg), fasting glucose (-1.95 ±2.89 mmol/L) and improvement in HDL (0.29 ±0.26 mmol/L). In addition, statistically significant reductions in the proportion of patients on anti-hypertensive (48.8% to 14.4%), anti-diabetic (34.1% to 12.7%) and lipid-lowering medications (37.8% to 20.4%) were seen. In particular, ACE-inhibitor and/or angiotensin receptor blocker (32.9% to 9.2%, p&lt; 0.001) usage was reduced. At one-year post surgery, median eGFR increased by 1.66 mL/min/1.73 m² (p&lt;0.001). Further stratification by glycemic status showed significant increases in GFR in patients without diabetes or pre-diabetes. There was a decrease in median uACR (0.30 mg/mmol, p=0.001) at one-year post surgery; this remained statistically significant in patients with diabetes and pre-diabetes. 12.9% of patients had improvements in CKD staging. The proportion of patients with albuminuria decreased from 24.8% at baseline to 1.89% one-year post surgery (p&lt;0.001).
Conclusions: Metabolic bariatric surgery had a positive impact on renal function as shown by the improvement in eGFR in the non-diabetic group, and the reduction in albuminuria in the diabetes and pre-diabetes group at one-year post surgery. More adequately powered, longer-term data is required to investigate the durability of this impact.
Serum Levels of Lipocalin Are Lower in Adolescents With X-Linked Hypophosphatemia
Authors: Simpson Christine A , Santoro Anna Maria , Carpenter Thomas O , Insogna Karl Leonard 
Published: May 2021

Abstract
Individuals with X-linked hypophosphatemia (XLH) are at greater risk for being overweight or obese. It has generally been assumed that the primary reason for this is impaired mobility due to accelerated osteoarthritis, abnormal biomechanics of ambulation, pseudofractures and enthesopathy. These known complications limit the ability of patients with XLH to engage in regular aerobic exercise. Whether there are underlying metabolic abnormalities that also put patients with XLH at greater risk for excessive weight gain is largely unknown. A recent French study1 confirmed that patients with XLH, especially adolescents, have a predilection to obesity. Evidence suggests that elevated circulating levels of fibroblast growth factor 23 (FGF23) are associated with an increase in fat mass and dyslipidemia in elderly normal individuals. Whether the elevated levels of FGF23 in XLH play a direct pathogenic role in the risk for excessive weight gain in XLH is unclear. Lipocalin (LCN2) has recently received considerable attention as a factor regulating energy consumption and specifically is postulated to be anorexigenic and improve insulin sensitivity. We therefore measured circulating levels of LCN2, leptin and insulin in 32 patients with XLH, ages 2–60 y.o., all of whom were being treated with burosumab and 40 Cntrl subjects, matched for age, sex, and BMI or weight/height z-score for children and adolescents. Serum was obtained from excess sample from clinical 25-hydroxy vitamin D testing in our laboratory. All patients were de-identified for the study. In 7 adults with XLH 20–60 y.o. (mean age 35) and 11 Cntrls (mean age 41), mean values for BMI, LCN2, leptin and insulin levels in the two group were as follows, (XLH vs. Cntrl); BMI: 36 vs. 34 kg/m2, LCN2: 83 vs. 108 ng/mL, leptin: 26 vs. 39 ng/mL, insulin: 19 vs. 20 µIU/mL. The pediatric patients were separated into two groups: 2–10 and 11–18 y.o.. In the 2–10 y.o. group the mean values were (XLH vs. Cntrl); age: 5.5 y.o. vs. 5.8 y.o., weight/height Z-score: 0.8 vs. 1.1, LCN2: 47 vs. 60, leptin: 2.2. vs. 6.7, and insulin: 8.4 vs. 13. In the 11–18 group, mean values were (XLH vs. Cntrl); age: 14 y.o. vs. 14 y.o., weight/height Z-score: 1.0 vs. 1.2, LCN2: 65 vs. 105, leptin: 24 vs.19, and insulin: 17 vs. 48. In all age groups LCN2 was lower in the patients with XLH than Cntrls and this difference reached significance in the adolescents with XLH (p=0.04). No other parameters were significantly different among the groups. Since all patients with XLH were treated with burosumab it is unlikely that a direct effect of excess FGF23 production explains this finding. We conclude that reduced expression of lipocalin in adolescents with XLH may contribute to their risk for obesity.1Lecoq et.al. Obesity and Impaired Glucose Metabolism in Adult Patients with X-Linked Hypophosphatemia, J, Endo. Soc. 2020 https://doi.org/10.1210/jendso/bvaa046.1355