BACKGROUND & AIMS: BACKGROUND:Trends in obesity have been reported to level off in several Western countries. The aim of this study was to investigate trends in body mass index (BMI) and prevalence of obesity between 2002 and 2010 in Stockholm County, Sweden. METHODS:Three cross-sectional questionnaires from the Stockholm Health Surveys were used for this study. A total of 31 182, 34 707 and 30 767 men and women aged between 18 and 64 years completed the questionnaire regarding sociodemographic factors, health parameters, physical activity, smoking habits and anthropometry in 2002, 2006 and 2010, respectively (response rate: 62.5, 61.3 and 55.6%, respectively). Linear regression was used to investigate changes in mean BMI. Relative risk regression models were used to investigate changes in prevalence of obesity, defined as BMI ≥ 30 kg/m(2). All analyses were stratified on age and further adjusted for smoking, education and socioeconomic position. RESULTS:Between 2002 and 2006, a stabilization was found in BMI and prevalence of obesity in both men and women. But from 2006 to 2010, BMI and prevalence of obesity had increased, also among the young. In 2010, the prevalence of obesity was 12.2% among men and 10.3% among women. CONCLUSION:After a period of stabilization in 2002-06, BMI and prevalence of obesity are increasing in Stockholm County, Sweden.

背景与目标： 背景：据报道，在一些西方国家，肥胖趋势趋于平稳。这项研究的目的是调查瑞典斯德哥尔摩县2002年至2010年之间的体重指数（BMI）和肥胖发生率的趋势。
方法：本研究使用了斯德哥尔摩健康调查的三份横断面问卷。分别于2002年，2006年和2010年完成了有关社会人口统计学因素，健康参数，身体活动，吸烟习惯和人体测量学的问卷调查，年龄分别在18至64岁之间的男性分别为31182、34707和30767，调查问卷（答复率为：62.5） ，分别为61.3和55.6％）。线性回归用于研究平均BMI的变化。相对风险回归模型用于调查肥胖发生率的变化，定义为BMI≥30 kg / m（2）。所有分析均按年龄分层，并针对吸烟，教育和社会经济地位作了进一步调整。
结果：在2002年至2006年之间，男性和女性的BMI和肥胖症患病率均趋于稳定。但是从2006年到2010年，BMI和肥胖症的患病率也在上升，其中年轻人也是如此。 2010年，肥胖症的患病率在男性中为12.2％，在女性中为10.3％。
结论：在2002-06年一段时​​间稳定之后，瑞典斯德哥尔摩县的BMI和肥胖症患病率呈上升趋势。

BACKGROUND & AIMS: INTRODUCTION:The polycomb group (PcG) proteins form chromatin-modifying complexes that are commonly deregulated in cancer. The PcG protein BMI-I is overexpressed by various tumours and thus may contribute to malignant transformation. The current study investigated the expression of BMI-I in human specimens of breast, ovarian, endometrial and cervical cancer. MATERIALS AND METHODS:Expression of BMI-I was evaluated in human ovarian cancer samples by Western blot analysis and immunohistochemistry (IHC) and compared to healthy ovarian tissue. BMI-I expression in human specimens of breast, endometrial and cervical cancer was evaluated by IHC and then compared with the respective benign tissues. RESULTS:BMI-I was significantly (p<0.05) overexpressed in human breast, ovarian, endometrial and cervical cancer specimens as compared to benign controls. BMI-I expression was also more pronounced in the ovarian cancer samples as demonstrated by Western blot analysis. In human breast cancer samples, BMI-I expression was most pronounced in the invasion front of the tumour. CONCLUSION:The current study showed for the first time that the BMI-I protein is significantly overexpressed in ovarian, endometrial and cervical cancer and may thus be a potential target for novel antitumor therapies.

背景与目标： 简介：多梳子基团（PcG）蛋白形成了染色质修饰复合物，通常在癌症中被解除调节。 PcG蛋白BMI-1被各种肿瘤过度表达，因此可能有助于恶性转化。当前的研究调查了BMI-I在乳腺癌，卵巢癌，子宫内膜癌和宫颈癌的人类标本中的表达。
材料与方法：通过蛋白质印迹分析和免疫组织化学（IHC）评估人卵巢癌样品中BMI-1的表达，并与健康卵巢组织进行比较。通过IHC评估了乳腺癌，子宫内膜癌和宫颈癌的人类标本中的BMI-1表达，然后将其与各自的良性组织进行了比较。
结果：与良性对照相比，BMI-1在人乳腺癌，卵巢癌，子宫内膜癌和宫颈癌标本中显着（p <0.05）过表达。如蛋白质印迹分析所证实，在卵巢癌样品中BMI-1表达也更明显。在人乳腺癌样品中，BMI-1表达在肿瘤的侵袭前沿最为明显。
结论：目前的研究首次表明，BMI-1蛋白在卵巢癌，子宫内膜癌和宫颈癌中显着过表达，因此可能成为新型抗肿瘤治疗的潜在靶标。

BACKGROUND & AIMS: OBJECTIVE:To examine whether age-related increase in concentrations of circulating inflammatory mediators is due to concurrent increases in cardiovascular risk factors or is independent of these. METHODS AND RESULTS:Cytokines (IL-6, IL-18), chemokines (6Ckine, MCP-1, IP-10), soluble adhesion molecules (sICAM-1, sVCAM-1, sE-selectin) and adipokines (adiponectin) were measured in the plasma of healthy male subjects aged 18-84 years (n=162). These were related to known cardiovascular risk factors (age, BMI, systolic and diastolic blood pressure, plasma total cholesterol, LDL cholesterol, HDL cholesterol and triacylglycerol concentrations) in order to identify significant associations. Plasma concentrations of sVCAM-1, sE-selectin, IL-6, IL-18, MCP-1, 6Ckine, IP-10 and adiponectin, but not sICAM-1, were significantly positively correlated with age, as well as with several other cardiovascular risk factors. The correlations with other risk factors disappeared when age was controlled for. In contrast, the correlations with age remained significant for sVCAM-1, IL-6, MCP-1, 6Ckine and IP-10 when other cardiovascular risk factors were controlled for. CONCLUSIONS:Plasma concentrations of some inflammatory markers (sVCAM-1, IL-6, MCP-1, 6Ckine, IP-10) are positively correlated with age, independent of other cardiovascular risk factors. This suggests that age-related inflammation may not be driven by recognised risk factors.

背景与目标： 目的：研究年龄相关的循环炎症介质浓度增加是由于心血管危险因素的同时发生还是与之无关。
方法和结果：细胞因子（IL-6，IL-18），趋化因子（6Ckine，MCP-1，IP-10），可溶性粘附分子（sICAM-1，sVCAM-1，sE-selectin）和脂联素（adiponectin）是在18-84岁的健康男性受试者的血浆中测量（n = 162）。这些与已知的心血管危险因素（年龄，BMI，收缩压和舒张压，血浆总胆固醇，LDL胆固醇，HDL胆固醇和三酰甘油浓度）相关，以便确定显着的相关性。 sVCAM-1，sE-选择素，IL-6，IL-18，MCP-1、6Ckine，IP-10和脂联素的血浆浓度与年龄以及其他几个因素呈显着正相关心血管危险因素。当控制年龄时，与其他危险因素的相关性就消失了。相反，在控制其他心血管危险因素的情况下，sVCAM-1，IL-6，MCP-1、6Ckine和IP-10与年龄的相关性仍然很显着。
结论：某些炎症标记物（sVCAM-1，IL-6，MCP-1、6Ckine，IP-10）的血浆浓度与年龄呈正相关，而与其他心血管危险因素无关。这表明与年龄有关的炎症可能不是由公认的危险因素驱动的。

BACKGROUND & AIMS: :Muller et al. [1] have provided a strong critique of the Genome-Wide Association Studies (GWAS) of body-mass index (BMI), arguing that the GWAS approach for the study of BMI is flawed, and has provided us with few biological insights. They suggest that what is needed instead is a new start, involving GWAS for more complex energy balance related traits. In this invited counter-point, we highlight the substantial advances that have occurred in the obesity field, directly stimulated by the GWAS of BMI. We agree that GWAS for BMI is not perfect, but consider that the best route forward for additional discoveries will likely be to expand the search for common and rare variants linked to BMI and other easily obtained measures of obesity, rather than attempting to perform new, much smaller GWAS for energy balance traits that are complex and expensive to measure. For GWAS in general, we emphasise that the power from increasing the sample size of a crude but easily measured phenotype outweighs the benefits of better phenotyping.

背景与目标： ：Muller等。 [1]对人体质量指数（BMI）的全基因组关联研究（GWAS）提出了强烈的批评，认为GWAS研究BMI的方法是有缺陷的，并且为我们提供了很少的生物学见解。他们建议，需要的是一个新的起点，涉及GWAS，以实现更复杂的与能量平衡相关的特征。在这个受邀的对策中，我们重点介绍了由BMI的GWAS直接刺激的肥胖领域取得的实质性进展。我们同意GWAS对于BMI并不完美，但认为进一步发现的最佳途径可能是扩大对与BMI和其他容易获得的肥胖测量指标相关的常见和罕见变体的搜索，而不是尝试进行新的发现，用于能量平衡特征的小得多的GWAS，这很复杂且测量成本很高。一般而言，对于GWAS，我们强调增加原油样本量但易于测量的表型的能力胜过更好的表型化带来的好处。

BACKGROUND & AIMS: :Recent genome-wide association studies have identified multiple loci associated with BMI or the waist:hip ratio (WHR). However, evidence on gene-lifestyle interactions is still scarce, and investigation of the effects of well-documented dietary and other lifestyle data is warranted to assess whether genetic risk can be modified by lifestyle. We assessed whether previously established BMI and WHR genetic variants associate with obesity and weight change in the Finnish Diabetes Prevention Study, and whether the associations are modified by dietary factors or physical activity. Individuals (n 459) completed a 3 d food record and were genotyped for twenty-six BMI- and fourteen WHR-related variants. The effects of the variants individually and in combination were investigated in relation to obesity and to 1- and 3-year weight change by calculating genetic risk scores (GRS). The GRS were separately calculated for BMI and the WHR by summing the increasing alleles weighted by their published effect sizes. At baseline, the GRS were not associated with total intakes of energy, macronutrients or fibre. The mean 1- and 3-year weight changes were not affected by the BMI or WHR GRS. During the 3-year follow-up, a trend for higher BMI by the GRS was detected especially in those who reported a diet low in fibre (P for interaction=0·065). Based on the present findings, it appears unlikely that obesity-predisposing variants substantially modify the effect of lifestyle modification on the success of weight reduction in the long term. In addition, these findings suggest that the association between the BMI-related genetic variants and obesity could be modulated by the diet.

背景与目标： ：最近的全基因组关联研究确定了与BMI或腰围：臀围比率（WHR）相关的多个基因座。然而，关于基因与生活方式相互作用的证据仍然很稀少，因此有必要对文献记录丰富的饮食和其他生活方式数据的影响进行研究，以评估生活方式是否可以改变遗传风险。在芬兰糖尿病预防研究中，我们评估了先前建立的BMI和WHR遗传变异是否与肥胖和体重变化有关，以及是否通过饮食因素或体育锻炼来改变这种关联。个体（n 459）完成了3 d的食物记录，并对26种BMI和14种WHR相关变种进行了基因分型。通过计算遗传风险评分（GRS），研究了与肥胖以及1年和3年体重变化有关的个体和组合变体的影响。通过将增加的等位基因加权并按其公布的效应大小加权，分别计算出BMI和WHR的GRS。在基线时，GRS与能量，大量营养素或纤维的总摄入量无关。平均1年和3年体重变化不受BMI或WHR GRS的影响。在3年的随访中，特别是在那些饮食中纤维含量较低（相互作用P = 0·065）的人群中，GRS发现了BMI升高的趋势。基于目前的发现，从长远来看，肥胖倾向的变异似乎不太可能实质性地改变生活方式对减肥成功的影响。此外，这些发现表明，饮食可以调节BMI相关遗传变异与肥胖之间的关联。

BACKGROUND & AIMS: OBJECTIVES:To compare the management, maternal and perinatal outcomes of women with a body mass index (BMI) ≥60 kg/m2 with women with a BMI >50-59.9 kg/m2. DESIGN:International collaborative cohort study. SETTING:Binational study in the UK and Australia. PARTICIPANTS:UK: all pregnant women, and Australia: women who gave birth (birth weight ≥400 g or gestation ≥20 weeks) METHODS: Data from the Australasian Maternity Outcomes Surveillance System and UK Obstetric Surveillance System. Management, maternal and infant outcomes were compared between women with a BMI ≥60 kg/m2 and women with a BMI >50-59.9 kg/m2, using unconditional logistic regression. RESULTS:The sociodemographic characteristics and previous medical histories were similar between the 111 women with a BMI ≥60 kg/m2 and the 821 women with a BMI >50-59.9 kg/m2. Women with a BMI ≥60 kg/m2 had higher odds of thromboprophylaxis usage in both the antenatal (24% vs. 12%; OR 2.25, 95% CI 1.39 to 3.64) and postpartum periods (78% vs. 66%; OR 1.68, 95% CI 1.04 to 2.70). Women with BMI ≥60 kg/m2 had nearly double the odds of pre-eclampsia/eclampsia (adjusted OR 1.83 (95% CI 1.01 to 3.30)). No other maternal or perinatal outcomes were statistically significantly different. Severe adverse outcomes such as perinatal death were uncommon in both groups thus limiting the power of these comparisons. The rate of perinatal deaths was 18 per 1000 births for those with BMI ≥60 kg/m2; 12 per 1000 births for those with BMI >50-59.9 kg/m2; those with BMI ≥60 kg/m2 had a non-significant increased odds of perinatal death (unadjusted OR 1.46, 95% CI 0.31 to 6.74). CONCLUSIONS:Women are managed differently on the basis of BMI even at this extreme as shown by thromboprophylaxis. The pre-eclampsia result suggests that future research should examine whether weight reduction of any amount prior to pregnancy could reduce poor outcomes even if women remain extremely obese.

背景与目标： 目的：比较体重指数（BMI）≥60kg / m2的女性和体重指数> 50-59.9 kg / m2的女性的管理，母体和围产期结局。
设计：国际协作队列研究。
地点：在英国和澳大利亚进行的国立研究。
参加者：英国：所有孕妇，澳大利亚：分娩的妇女（出生体重≥400μg或妊娠≥20周）方法：来自澳大利亚产妇结果监测系统和英国产科监测系统的数据。使用无条件逻辑回归比较BMI≥60kg / m2的女性和BMI> 50-59.9 kg / m2的女性的管理，母婴结局。
结果：BMI≥60kg / m2的111名妇女和BMI> 50-59.9 kg / m2的821名妇女的社会人口统计学特征和既往病史相似。 BMI≥60kg / m2的妇女在产前（24％比12％；或2.25，95％CI 1.39至3.64）和产后时期（78％比66％； OR 1.68）上有更高的预防血栓使用几率，95％CI 1.04至2.70）。 BMI≥60kg / m2的妇女发生先兆子痫/子痫的几率几乎翻倍（调整后的OR为1.83（95％CI 1.01至3.30））。其他母亲或围产期结局在统计学上均无显着差异。在两组中，严重的不良后果（如围产期死亡）并不常见，因此限制了这些比较的效力。 BMI≥60kg / m2的围产儿死亡率为每1000例中有18例。 BMI> 50-59.9 kg / m2的人每1000胎中有12胎; BMI≥60kg / m2的婴儿围产期死亡几率无明显增加（未调整OR 1.46，95％CI 0.31至6.74）。
结论：即使在这种极端情况下，血栓预防措施也可以根据BMI对妇女进行不同的管理。先兆子痫的结果表明，未来的研究应检查即使孕妇仍然非常肥胖，怀孕前减轻体重是否可以减轻不良后果。

BACKGROUND & AIMS: :The aggregation of Electronic Health Records (EHR) and personalized genetics leads to powerful discoveries relevant to population health. Here we perform genome-wide association studies (GWAS) and accompanying phenome-wide association studies (PheWAS) to validate phenotype-genotype associations of BMI, and to a greater extent, severe Class 2 obesity, using comprehensive diagnostic and clinical data from the EHR database of our cohort. Three GWASs of 500,000 variants on the Illumina platform of 6,645 Healthy Nevada participants identified several published and novel variants that affect BMI and obesity. Each GWAS was followed with two independent PheWASs to examine associations between extensive phenotypes (incidence of diagnoses, condition, or disease), significant SNPs, BMI, and incidence of extreme obesity. The first GWAS examines associations with BMI in a cohort with no type 2 diabetics, focusing exclusively on BMI. The second GWAS examines associations with BMI in a cohort that includes type 2 diabetics. In the second GWAS, type 2 diabetes is a comorbidity, and thus becomes a covariate in the statistical model. The intersection of significant variants of these two studies is surprising. The third GWAS is a case vs. control study, with cases defined as extremely obese (Class 2 or 3 obesity), and controls defined as participants with BMI between 18.5 and 25. This last GWAS identifies strong associations with extreme obesity, including established variants in the FTO and NEGR1 genes, as well as loci not yet linked to obesity. The PheWASs validate published associations between BMI and extreme obesity and incidence of specific diagnoses and conditions, yet also highlight novel links. This study emphasizes the importance of our extensive longitudinal EHR database to validate known associations and identify putative novel links with BMI and obesity.

背景与目标： 电子病历（EHR）和个性化遗传学的集合导致与人口健康相关的有力发现。在这里，我们使用来自EHR的综合诊断和临床数据，进行基因组范围的关联研究（GWAS）和伴随的表型范围的关联研究（PheWAS），以验证BMI的表型-基因型关联，并在更大程度上验证严重的2型肥胖。我们队列的数据库。在内华达州6,645名健康参与者的Illumina平台上，有500,000个变体的三个GWAS，确定了一些影响BMI和肥胖症的已发表和新颖的变体。每个GWAS后面都有两个独立的PheWAS，以检查广泛的表型（诊断，病状或疾病的发生率），重要的SNP，BMI和极端肥胖的发生率之间的关联。第一个GWAS在一个没有2型糖尿病的队列中研究了与BMI的关联，仅侧重于BMI。第二个GWAS在一个包括2型糖尿病的队列研究中检查了与BMI的关联。在第二个GWAS中，2型糖尿病是合并症，因此在统计模型中成为协变量。这两项研究的重要变体的交集令人惊讶。第三个GWAS是病例与对照研究，病例定义为极度肥胖（2或3级肥胖），对照定义为BMI在18.5至25之间的参与者。这最后一个GWAS确定了与极端肥胖的强烈关联，包括确定的变体FTO和NEGR1基因中的基因，以及尚未与肥胖相关的基因座。 PheWAS验证了BMI与极端肥胖以及特定诊断和病状的发生之间已发表的关联，但也突出了新颖的联系。这项研究强调了我们广泛的纵向EHR数据库对于验证已知关联并识别与BMI和肥胖症之间可能存在的新颖联系的重要性。

BACKGROUND & AIMS: BACKGROUND:Stunted growth in early infancy is a public health problem in low-and-middle income countries. Evidence suggests heavy agricultural work during pregnancy is inversely associated with maternal body mass index (BMI) and infant birth weight in low- and middle-income countries; but pathways linking agricultural work to length-for-age Z-scores (LAZ) in early infancy have not been examined. This study aimed to investigate the relationship between agricultural work during pregnancy, post-natal maternal BMI and LAZ among young infants in rural Pakistan; and explored whether maternal BMI mediated the relationship between agricultural work and infant LAZ. METHODS:A cross-sectional survey was conducted from December 2015 to January 2016 in rural Sindh, Pakistan. Mother-infant dyads were recruited via systematic random cluster sampling at 2-12 weeks' post-partum (n = 1161). Anthropometric measurements (maternal and infant height/length and weight) and questionnaire data were collected. Multivariable linear regression and structural-equation based mediation analyses were used to examine associations of agricultural work during pregnancy with maternal BMI and infant LAZ. RESULTS:During pregnancy, women reported engaging in livestock-related work (57.0%), crop-related work (42.7%), and cotton harvesting (28.4%). All three forms of agricultural work were negatively associated with maternal BMI (β = - 0.67 [- 1.06; - 0.28], β = - 0.97 [- 1.51; - 0.48]; and β = - 0.87 [- 1.33; - 0.45], respectively). Maternal engagement in cotton harvesting alone was negatively associated with infant LAZ after controlling for confounding factors. The total negative effect of cotton harvesting on infant LAZ was - 0.35 [- 0.53; - 0.16]. The indirect effect of maternal BMI on infant LAZ was - 0.06 [- 0.08; - 0.03], revealing that 16% (- 0.06/- 0.35) of the relationship between cotton harvesting and infant LAZ, after adjustment, was mediated via maternal BMI. CONCLUSION:These results underscore a need to reduce labour-intensive agricultural workload demands during pregnancy, especially in cotton harvesting, to reduce risks of negative maternal energy balance and poor growth outcomes in early infancy.

背景与目标： 背景：婴儿期发育迟缓是中低收入国家的公共卫生问题。有证据表明，在低收入和中等收入国家，怀孕期间从事繁重的农业工作与孕产妇体重指数（BMI）和婴儿出生体重成反比。但是尚未研究将农业工作与婴儿早期的Z评分相关的途径。这项研究的目的是调查巴基斯坦农村地区的婴儿在怀孕期间从事农业工作，产后母亲BMI和LAZ之间的关系。并探讨了母亲的BMI是否介导了农业工作与婴儿LAZ之间的关系。
方法：2015年12月至2016年1月在巴基斯坦信德省农村进行了横断面调查。通过在产后2-12周内进行系统随机整群抽样（n = 1161）来招募母婴二联体。收集人体测量值（母亲和婴儿的身高/长度和体重）和问卷数据。基于多元线性回归和基于结构方程的中介分析用于检验孕期农业工作与孕产妇BMI和婴儿LAZ的关系。
结果：在怀孕期间，妇女报告从事与牲畜有关的工作（57.0％），与作物有关的工作（42.7％）和棉花收获（28.4％）。三种形式的农业工作均与孕产妇的BMI呈负相关（β==-0.67 [-1.06;-0.28]，β=-0.97 [-1.51;-0.48];β=-0.87 [-1.33;-0.45]，分别）。在控制了混杂因素之后，母亲单独从事棉花收获与婴儿LAZ呈负相关。棉花收获对婴儿LAZ的总负面影响为-0.35 [-0.53； -0.16]。母体BMI对婴儿LAZ的间接作用为-0.06 [-0.08; -0.03]，表明调整后的棉花收获与婴儿LAZ之间的关系中有16％（-0.06 /-0.35）是通过母体BMI介导的。
结论：这些结果强调需要减少怀孕期间劳动密集型农业工作量的需求，尤其是在棉花收获期间，以减少母体能量平衡不良和婴儿早期生长不良的风险。

BACKGROUND & AIMS: :We have examined the relationships between percentage of body fat (PBF) and risk factors for cardiovascular disease and insulin resistance and how good body mass index (BMI) and other anthropometric measures are as indices of obesity. High PBF levels were associated with increased risk of cardiovascular disease and insulin resistance. The World Health Organization BMI of 30 kg/m(2) for obesity has low sensitivity, 6.7% and 13.4% for men and women, respectively. For every obese man and woman identified, 6.7 and 1.76 times nonobese men and women, respectively, will be misclassified as obese. With the locally established BMI cutoff point for obesity of 27 kg/m(2) for men and 25 kg/m(2) for women, the sensitivity was improved to 46.7% and 60.8%, respectively. For every obese man and woman identified, 3.76 and 1.64 times nonobese men and women, respectively, will be misclassified as obese. None of the other anthropometric indices was better than the locally established BMIs. We showed that the BMIs for obesity for our local men and women are different. These BMIs were most precise among all indices studied. However, they still lead to high false-positive rates. For more effective management of the problem of obesity, we need to develop more precise, simple, and cost-effective methods for the measurement of PBF.

背景与目标： ：我们已经检查了体脂百分比（PBF）与心血管疾病和胰岛素抵抗的危险因素之间的关系，以及良好的体重指数（BMI）和其他人体测量学如何将其作为肥胖指数。高PBF水平与心血管疾病和胰岛素抵抗的风险增加有关。世界卫生组织的肥胖症BMI为30 kg / m（2），其敏感性较低，男性和女性分别为6.7％和13.4％。对于确定的每个肥胖男人和女人，非肥胖男人和女人的肥胖率分别为6.7和1.76倍。男性在当地建立的BMI肥胖临界点为27 kg / m（2），女性为25 kg / m（2），敏感性分别提高到46.7％和60.8％。对于确定的每个肥胖男人和女人，非肥胖男人和女人的肥胖率分别为3.76和1.64倍。其他人体测量指标没有一个比本地建立的BMI更好。我们表明，当地男性和女性的肥胖BMI有所不同。这些BMI在所有研究指标中最为精确。但是，它们仍然导致较高的假阳性率。为了更有效地解决肥胖问题，我们需要开发更精确，简单且经济高效的方法来测量PBF。

BACKGROUND & AIMS: :The aims of this paper were to compare (1) the proportion of participants diagnosed with threshold or subthreshold Bulimia Nervosa (BN) and Binge Eating Disorder (BED) (clinical utility), and (2) the severity of participants' clinical features and mental Health-Related Quality of Life (HRQoL) (convergent validity), when diagnosed according to either the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) or the proposed International Classification of Diseases 11th edition (ICD-11) schemes. One hundred and seven adult men and women, with a high Body Mass Index (BMI) were evaluated by interview to confirm their eating disorder diagnoses. All participants completed self-report assessments of current symptoms and mental HRQoL. The majority of participants in either diagnostic scheme were included in the main categories of BN or BED (102/107, 95% in the ICD-11 and 85/107, 79% in the DSM-5). Fewer individuals received a subthreshold other or unspecified diagnosis with the ICD-11 compared to the DSM-5 scheme (5% vs. 21%). No significant differences in demographic, clinical features or mental HRQoL of participants with complete or partial BN or BED were found between diagnostic categories. Compared to the DSM-5, the proposed ICD-11 was not over inclusive, i.e., it did not appear to include people with less severe and potentially less clinically relevant symptoms. These results support the greater clinical utility of the ICD-11 whilst both schemes showed convergent validity.

背景与目标： ：本文的目的是比较（1）被诊断为阈值或亚阈值的神经性贪食症（BN）和暴食症（BED）（临床效用）的参与者的比例，以及（2）参与者的临床特征和严重程度根据《精神疾病诊断和统计手册》第5版（DSM-5）或拟议的《国际疾病分类》第11版（ICD-11）诊断出的与精神健康相关的生活质量（HRQoL）（收敛效度）计划。通过访谈评估了一百零七名体重指数（BMI）高的成年男性和女性，以确认他们的饮食失调诊断。所有参与者均完成了对当前症状和心理HRQoL的自我报告评估。两种诊断方案中的大多数参与者都包括在BN或BED的主要类别中（102/107，在ICD-11中为95％，在85/107，在DSM-5中为79％）。与DSM-5计划相比，使用ICD-11进行亚阈值其他或未明确诊断的个体更少（5％对21％）。在诊断类别之间，未发现完全或部分BN或BED的参与者的人口统计学，临床特征或心理HRQoL没有显着差异。与DSM-5相比，拟议的ICD-11并未囊括所有内容，也就是说，它似乎并未包括那些症状较轻且临床相关症状可能较轻的人。这些结果支持了ICD-11的更大的临床实用性，而两种方案均显示出收敛的有效性。

BACKGROUND & AIMS: :It is recommended that prenatal care include nutrition counseling; however, <70% of women report receipt of nutrition counseling during pregnancy. In this study, we aimed to characterize prenatal nutrition counseling (PNC) among large-for-gestational age deliveries at a low-income and minority-serving hospital by performing a retrospective chart review of infants with a birth weight > 4000 g. Of the 2380 deliveries, 165 met the inclusion criteria. Demographics, PNC receipt, and pregnancy outcomes were compared among normal-weight (NW; BMI: 18.5-24.9 kg/m2, 19%, n = 31), overweight (OW; BMI: 25-29.9 kg/m2, 29%, n = 48), and obese (OB; BMI > 30 kg/m2, 52%, n = 86) women. The majority (78%, n = 129) of women were Hispanic White with a mean age of 30.4 ± 5.7 yrs and gestational weight gain of 12.1 ± 5.8 kgs. A total of 62% (n = 103) of women received PNC. A total of 57% gained above the Institute of Medicine (IOM) recommendations (n = 94). OB women were 2.6 and 2.1 times more likely to receive PNC than OW (95% CI: 1.1-2.0) and NW (95% CI: 0.9-1.9) women, respectively. Women who gained within the IOM recommendations for their pre-pregnancy body mass index (BMI) were 50% less likely to receive PNC than women who gained above the IOM recommendations for their pre-pregnancy weight (χ = 4.45, p = 0.035; OR = 0.48, CI: 0.24 to 0.95). Infant birthweight was significantly higher among women who received PNC (4314 ± 285 vs. 4197 ± 175 g, p = 0.004). These data suggest that PNC was directed toward women who enter pregnancy in the obese weight category and/or gain excessively across gestation. Future studies should provide PNC to all women to evaluate whether it reduces the risk of delivering large-for-gestational age deliveries across all maternal weight categories. Additionally, more work is needed to identify the types of PNC that are most effective for this high-risk population.

背景与目标： ：建议产前检查包括营养咨询；但是，<70％的妇女报告在怀孕期间接受了营养咨询。在这项研究中，我们旨在通过对出生体重> 4000 g的婴儿进行回顾性图表审查，以在低收入和少数族裔服务医院为大孕龄分娩中表征产前营养咨询（PNC）。在2380架飞机中，有165架符合入选标准。比较了正常体重（NW; BMI：18.5-24.9 kg / m2，19％，n = 31），超重（OW; BMI：25-29.9 kg / m2，29％， n = 48）和肥胖（OB; BMI> 30 kg / m2，52％，n = 86）妇女。大部分女性（78％，n = 129）为西班牙裔白人，平均年龄为30.4±5.7岁，孕期体重增加为12.1±5.8 kgs。共有62％（n = 103）的女性接受了PNC。总共比医学研究所（IOM）的建议（n = 94）高出57％。 OB女性接受PNC的可能性分别比OW女性（95％CI：1.1-2.0）和NW女性（95％CI：0.9-1.9）高2.6倍和2.1倍。在怀孕前体重指数（BMI）达到IOM建议范围内的女性比怀孕前体重超过IOM建议范围以上的女性接受PNC的可能性低50％（χ= 4.45，p = 0.035；或= 0.48，CI：0.24至0.95）。接受PNC的妇女的婴儿出生体重明显更高（4314±285 vs. 4197±175 g，p = 0.004）。这些数据表明，PNC是针对肥胖体重类别中进入妊娠和/或在整个妊娠过程中过度增长的女性的。未来的研究应向所有妇女提供PNC，以评估其是否降低了所有孕产妇体重类别的大胎龄分娩风险。此外，还需要做更多的工作来确定对于这种高风险人群最有效的PNC类型。

BACKGROUND & AIMS: OBJECTIVE:Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance which is diagnosed during pregnancy and poses considerable health risks for mother and child. Maternal body mass index (BMI) correlates with GDM diagnosis and the pathophysiology of this link may be explained through oxidative stress and mitochondrial dysfunction. In this study we investigate if mitochondrial dysfunction is evident in GDM by measuring cell free mitochondrial DNA concentration and determine if a potential relationship exists between maternal mitochondrial function and GDM diagnosis. STUDY DESIGN:Plasma samples were taken at 20 weeks' gestation from women who subsequently developed GDM (n = 44) and matched with women with uncomplicated pregnancies (n = 85) as controls. Control group 1 was matched by maternal age and BMI (n = 41) to GDM cases, while control group 2 was matched by maternal age alone (n = 44). Prediction potential was determined by binary regression analysis. Statistical analysis was performed on SPSS Statistics v25. RESULTS:Binary regression analysis showed a statistically significant association between mtDNA concentration and GDM diagnosis (p = 0.032) in GDM cases versus control group 2, indicating that GDM patients have higher circulating mtDNA concentrations relative to healthy control patients. The lack of statistical significance in control group 1 suggests that BMI may be linked to mitochondrial function in GDM patients. CONCLUSION:These results demonstrate a potential pathogenic role for mitochondrial dysfunction in GDM, with BMI presenting as a likely physiological mediator.

背景与目标： 目的：妊娠期糖尿病（GDM）的定义是在怀孕期间诊断出的任何程度的葡萄糖不耐症，对母婴构成相当大的健康风险。孕产妇体重指数（BMI）与GDM诊断相关，并且可以通过氧化应激和线粒体功能障碍来解释这一联系的病理生理学。在这项研究中，我们通过测量无细胞线粒体DNA的浓度来调查GDM中线粒体功能障碍是否明显，并确定母体线粒体功能与GDM诊断之间是否存在潜在的关系。
研究设计：在妊娠20周时从随后发展为GDM（n = 44）的妇女中抽取血浆样本，并与没有单纯妊娠（n = 85）的妇女相匹配。对照组1与孕产妇的年龄和BMI相匹配（n = 41），而对照组2与孕产妇的单独年龄（n = 44）相匹配。预测潜力通过二元回归分析确定。在SPSS Statistics v25上进行统计分析。
结果：二元回归分析显示，与对照组2相比，GDM病例中mtDNA浓度与GDM诊断之间存在统计学意义的关联（p = 0.032），表明GDM患者相对于健康对照患者具有更高的循环mtDNA浓度。对照组1中缺乏统计学意义表明BMI可能与GDM患者的线粒体功能有关。
结论：这些结果证明了GDM中线粒体功能障碍的潜在致病作用，其中BMI可能是生理介质。

BACKGROUND & AIMS: :In this study, we tested the hypothesis that diet composition reported by children before the beginning of an obesity treatment program could be a predicting factor of the clinical outcome. A sample of 138 obese 6-16-year-old children and adolescents were recruited. Anthropometry and dietary habits were recorded. Each patient participated in a multidimensional treatment program in an outpatient obesity public service clinic. Therapy was based on a 6-month educational program on nutrition, lifestyle and physical activity. Children with a lipid intake above 34.7% of total energy had a 2.5 times higher chance of reducing at least 1.5 units of BMI with treatment than children with lower lipid intake. These results suggest that the assessment of habitual diet, in particular diet composition before starting treatment, may help to identify obese children who are more sensitive to intervention and those who need more specific nutritional assistance.

背景与目标： ：在这项研究中，我们检验了以下假设：肥胖治疗计划开始之前儿童报告的饮食组成可能是临床结果的预测因素。招募了138名肥胖的6-16岁儿童和青少年。记录人体测量学和饮食习惯。每位患者都在门诊肥胖症公共服务诊所参加了多维治疗计划。治疗是基于为期6个月的营养，生活方式和体育锻炼的教育计划。脂质摄入量占总能量的34.7％以上的儿童，其接受BMI降低至少1.5个单位的机率是脂质摄入量较低的儿童的2.5倍。这些结果表明，习惯饮食的评估，特别是开始治疗前的饮食组成，可能有助于确定对干预更敏感的肥胖儿童和需要更具体营养援助的儿童。

BACKGROUND & AIMS: OBJECTIVE:To study the demographic and clinical parameters of three different categories of obesity, with particular focus on a cohort of individuals with BMI > or = 50 kg/m2, the fastest growing category of obesity. DESIGN:Over 700 obese individuals were studied (186 with BMI = 30-39 kg/m2, 316 with BMI = 40-49 kg/m2 and 290 with BMI > or = 50 kg/m2). RESULTS:Median BMI was 51 kg/m2 for patients who reported onset of overweight before 15 years of age, 47 kg/m2 for patients who reported onset between 15 and 30 years, and 42 kg/m2 for patients who became overweight after 30 years of age. The BMI > or = 50 kg/m2 group was notably younger than the group with BMI = 30-39 kg/m2 (44 (SD 11) years v. 50 (SD 15) years; P < 0.0001). Eighteen per cent of obese patients studied were considered metabolically healthy according to standard cut-off points for blood pressure, fasting glucose and lipid profiles. However, the proportion of metabolically healthy individuals was significantly higher in the BMI = 30-39 kg/m2 group than in the BMI = 40-49 kg/m2 and BMI > or = 50 kg/m2 groups (31% v. 17% and 12% respectively; P < 0.05 and P < 0.005). When compared with people of similar age in the general population, individuals with BMI > or = 50 kg/m2 had lower rates of marriage (51% v. 72%) and a higher prevalence of unemployment (14% v. 5%). CONCLUSIONS:The current study suggests that the increasing prevalence of childhood obesity worldwide will lead to many more individuals achieving a higher BMI at a younger age. Furthermore, an earlier onset of overweight does not appear to prevent the adverse metabolic health outcomes associated with extreme obesity.

背景与目标： 目的：研究三种不同类别的肥胖症的人口统计学和临床​​参数，特别关注人群中BMI>或= 50 kg / m2（增长最快的肥胖症）的人群。
设计：研究了700多名肥胖个体（186例BMI = 30-39 kg / m2、316例BMI = 40-49 kg / m2和290例BMI> or = 50 kg / m2）。
结果：报告称在15岁之前开始超重的患者的BMI中位数为51 kg / m2，报告在15至30岁之间开始的患者的BMI中值为47 kg / m2，而在30岁之后开始超重的患者为42 kg / m2年龄。 BMI>或= 50 kg / m2组明显比BMI = 30-39 kg / m2（44（SD 11）岁vs 50（SD 15）岁； P <0.0001）组年轻。根据血压，空腹血糖和脂质分布的标准分界点，研究的肥胖患者中有18％被认为是代谢健康的。但是，BMI = 30-39 kg / m2组中代谢健康个体的比例显着高于BMI = 40-49 kg / m2和BMI> or = 50 kg / m2组（31％对17％）和分别为12％； P <0.05和P <0.005）。与一般人口中类似年龄的人相比，BMI>或= 50 kg / m2的人的婚姻率较低（51％对72％），失业率较高（14％对5％）。
结论：目前的研究表明，世界范围内儿童肥胖的患病率上升将导致更多的人在年轻时达到较高的BMI。此外，超重的较早发作似乎并未预防与极端肥胖有关的不良代谢健康结果。

BACKGROUND & AIMS: PURPOSE:Body mass index (BMI) and physical activity (PA) affect health-related quality of life (HRQL); however, the long-term impact of youth BMI and PA on adult HRQL is unknown. We investigated the relationship of youth BMI and PA to adult HRQL 22 years later. METHODS:Subjects included 310 participants aged 7 to 18 in the 1981 Canada Fitness Survey, followed up in 2002-2004. The associations of youth BMI and leisure time PA to adult HRQL were examined, comparing to age- and sex-adjusted Canadian SF-36 norms. RESULTS:Bivariate analyses revealed positive associations between youth overweight and mental aspects of adult HRQL, but little association with physical aspects. In logistic regression adjusting for adult BMI and other covariates, overweight youth were 7 times more likely than healthy weight youth to score at/above the norm on both mental health (MH) and bodily pain, and almost 18 times more likely on the mental component score (MCS). Youth BMI was also positively associated with general health (GH), social functioning, and role emotional. Removing adult BMI from the models led to attenuated associations with mental HRQL and no association with GH. Longitudinal BMI status change was explored, and findings supported the main regression results. Youth PA was not associated with adult HRQL. CONCLUSIONS:Youth overweight conveyed a long-term positive impact on several aspects of adult HRQL, and this impact may be both direct and indirect through BMI change and the effect on adult BMI. Youth PA had no long-term impact on adult HRQL.

背景与目标： 目的：身体质量指数（BMI）和体育锻炼（PA）影响与健康相关的生活质量（HRQL）；然而，尚不清楚青年BMI和PA对成人HRQL的长期影响。我们调查了22年后青年BMI和PA与成人HRQL的关系。
方法：受试者包括1981年加拿大健康调查中的310位7至18岁的参与者，并于2002-2004年进行了随访。与年龄和性别调整后的加拿大SF-36规范相比，研究了青年BMI和休闲时间PA与成人HRQL的关联。
结果：双变量分析显示，青少年超重与成人HRQL的心理方面呈正相关，而与身体方面的相关性很小。在针对成人BMI和其他协变量进行logistic回归调整后，超重青年在心理健康（MH）和身体疼痛方面得分均高于/高于正常体重青年的几率是健康体重青年的7倍，而在心理因素方面的可能性高出近18倍分数（MCS）。青年BMI与总体健康（GH），社会功能和角色情感也呈正相关。从模型中删除成人BMI导致与心理HRQL的关联减弱，而与GH无关。探索了纵向BMI状态变化，研究结果支持了主要的回归结果。青年PA与成人HRQL无关。
结论：青少年超重对成人HRQL的多个方面产生了长期的积极影响，这种影响可能是通过BMI变化以及对成人BMI的直接或间接影响。青年PA对成人HRQL没有长期影响。