Background: The introduction of immune checkpoint inhibitor (ICI) treatment has significantly improved the treatment of several cancer diagnoses, such as non-small cell lung cancer, renal and urothelial carcinoma, melanoma. However, there is a lack of real-world data on ICI treatment and outcomes from the Swedish healthcare setting. The cost of treatment is also significant, and securing equal access to emerging drugs for all patients is challenging in an era of rapidly evolving treatment recommendations. Methods: We conducted a population-based observational study of incident cases among ICI-treated patients, using a novel electronic healthcare record source for systemic cancer drugs linked to regional and national register data. Overall survival (OS) was calculated from start of the first ICI-treatment, using the Kaplan-Meier method. The aim was to examine treatment with ICI drugs during 2015–2023 in 10 Swedish regions (total population 4.3 million). Results: Median real-world OS was 2.0 years (95% confidence interval: 1.8–2.2 years) from start of ICI-treatment for patients with known palliative treatment intent (n = 1,941, lung 2.2 years, melanoma 5.0 years, renal 2.3 years, urothelial 1.1 years, head/neck 1.4 years). In 2023, 6.7% of all patients receiving systemic antineoplastic treatment for cancer were treated with ICI (74 per 100,000 inhabitants). The timing of the adoption of treatment with ICI drugs and the current patterns of use differed between Swedish regions. Conclusion: This study provides the first Swedish real-world OS estimates after ICI-treatment across major diagnoses, documents the rapidly increasing ICI use, and describes regional variation in treatment patterns.
Background:Gestational diabetes mellitus (GDM) is characterized by maternal insulin resistance and hyperglycemia and has been associated with placental mitochondrial alterations. Small humanin-like peptides (SHLP1-6), encoded within the mitochondrial 16S rRNA region, have been described as mitochondria-derived peptides (MDPs) with reported cytoprotective and metabolic effects in experimental settings. However, their expression in placental tissues from GDM pregnancies has not been previously investigated. Methods:Placental tissues were obtained from women with GDM and normoglycemic controls following cesarean delivery. Maternal fasting glucose, fasting insulin, glycated hemoglobin A1c (HbA1c), and the homeostatic model assessment for insulin resistance (HOMA-IR) were recorded. Total RNA was isolated from placental samples, and the mRNA expression levels of SHLP1-6 were quantified using quantitative real-time polymerase chain reaction (PCR). In addition, Humanin and SHLP2 peptide levels were assessed at the protein level. Group comparisons and correlation analyses were performed to evaluate associations between placental SHLP expression and maternal metabolic parameters within each group. Results:Placental expression levels of all six SHLP transcripts were significantly reduced in the GDM group compared with controls. Lower placental SHLP expression was significantly associated with higher HOMA-IR and HbA1c values. In addition, reduced SHLP transcript levels were associated with increased neonatal birth weight. Consistently, Humanin and SHLP2 levels were significantly reduced in both serum and placental samples in the GDM group. Conclusions:This study demonstrates that placental mRNA levels of SHLPs are reduced in pregnancies complicated by GDM and are associated with maternal metabolic status. The integration of transcriptional findings with targeted peptide measurements supports the notion that altered placental SHLP expression is linked to metabolic disturbances in GDM and warrants further investigation into the role of MDPs in placental adaptation during diabetic pregnancy.
Interest in the misfolding and aggregation of human proteins into amyloid fibrils has increased dramatically in recent years. The systemic amyloidoses constitute a group of serious disorders that often affect the heart. Each systemic amyloid type is derived from one of several plasma proteins, most commonly immunoglobulin light chains or transthyretin. Rapid progress has been made in developing effective treatments for several systemic forms.There is also growing evidence that localized amyloids – such as those found in the brain or in the islets of Langerhans – or their smaller prefibrillar aggregates can exert toxic effects on nearby cells. However, other localized amyloids remain insufficiently understood. Isolated atrial amyloid (IAA) is derived from the polypeptide hormone atrial natriuretic peptide (ANP), which is expressed by atrial cardiomyocytes. IAA is a common age-related amyloidosis, affecting the left atrium more frequently than the right, with highly variable prevalence reported across studies.The pathogenesis of IAA is unknown, although increased local concentrations of the precursor polypeptide are typically important in other hormone-derived amyloid disorders. IAA is suspected to contribute to the development of atrial fibrillation, but its potential mechanisms remain unclear and have been difficult to investigate due to the lack of methods for visualizing deposits in vivo. This paper, which provides an overview of the current research on IAA, highlights key gaps in knowledge and proposes approaches for studying IAA in vivo.
Background: Alveolar type II (AT2) cell injury plays an important role in the pathogenesis of acute lung injury (ALI), but the corresponding treatment options are limited in clinical practice. Endocan has been proved to exert a protective effect in ALI, however, the underlying mechanism remains unclear. The phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT )/mechanistic target of rapamycin (mTOR) signaling pathway was found to exhibit beneficial effects in lipopolysaccharide-induced ALI. This study aimed to investigate protective effects of endocan on AT2 cells and the signal pathway in LPS-induced ALI. Methods: Pulmonary function testing and hematoxylin-eosin staining were employed to evaluate the effects of endocan on the LPS-induced ALI in mice. Transmission electron microscopy (TEM) analysis, immunofluorescence and Western blot were used to assess the AT2 protection of endocan. Mouse lung epithelial cell line 12 (MLE-12) cells were facilitated to observe the activation of PI3K/AKT/mTOR pathway. Results: Endocan administration effectively ameliorated respiratory parameters in LPS-challenged ALI mice. TEM revealed that endocan treatment preserved AT2 cell integrity and maintained lamellar body ultrastructure compared to the mice injected LPS only. Western blot analysis showed a higher surfactant protein C expression in endocan-treated mice than that of model group. Moreover, the phosph-PI3K,-AKT,-mTOR levels detected by Western blot were significantly observed upregulated after endocan treatment. However, rapamycin, an mTOR inhibitor, abolished the protective effects of endocan against ALI, indicating this pathway may be critical for its action on AT2 cells. In LPS-treated MLE-12 cells, the Western blot analysis further confirmed that rapamycin suppressed endocan-induced activation of the PI3K/AKT/mTOR pathway, thereby attenuating the protective effects of endocan on MLE-12 cells. Conclusion: Endocan protects AT2 cells against ALI through activating PI3K/AKT/mTOR pathway, suggesting its therapeutic potential for AT2 in patients with ALI.
Background: Low-intensity pulsed ultrasound (LIPUS) is a non-invasive therapeutic modality with growing potential in the treatment of neurodegenerative diseases. However, its mechanistic role in regulating mitochondrial homeostasis in astrocytes under inflammatory stress remains poorly understood. This study aimed to investigate the effects of LIPUS on mitochondrial dynamics, morphology, oxidative stress, mitochondrial membrane potential, and mitochondrial stress response in an in vitro model of neuroinflammation. Methods: Normal Human Astrocytes (NHA) were stimulated with lipopolysaccharide (LPS; 0.5 µg/mL, 24 h) and subsequently treated with LIPUS (1 MHz, 50% duty cycle, 100 Hz, 15 min) at intensities of 100, 300, or 500 mW/cm2. The expression of mitochondrial fusion (MFN1, MFN2, OPA1) and fission (DRP1, FIS1) markers was analyzed using qPCR. Mitochondrial morphology was evaluated by confocal microscopy, while reactive oxygen species (ROS) levels and mitochondrial membrane potential (ΔΨm) were measured using specific fluorescent probes. Expression of mitochondrial stress-related genes (PGC1α, CLPP, HSP60, LONP1) was also assessed. Results: LIPUS treatment, particularly at 300 mW/cm2, significantly enhanced the expression of mitochondrial fusion markers while suppressing fission markers in a dose- and time-dependent manner, with peak effects observed 4 h post-treatment. Confocal imaging revealed that LIPUS mitigated LPS-induced mitochondrial fragmentation. Additionally, LIPUS reduced ROS accumulation, preserved ΔΨm, and attenuated the LPS-induced upregulation of mitochondrial stress-related genes, suggesting modulation of both stress response and biogenesis. Conclusion: LIPUS ameliorates mitochondrial dysfunction in inflamed astrocytes by restoring mitochondrial dynamics and reducing stress signaling, supporting its potential as a therapeutic strategy for neuroinflammation-associated neurodegenerative disorders.
A 51-year-old woman with rheumatoid arthritis treated with rituximab and leflunomide presented with a 5-month history of malodorous vaginal discharge. Initial examination revealed vulvovaginitis and cervicitis, and she was treated with metronidazole and topical corticosteroids. Pelvic ultrasound showed free fluid in the pouch of Douglas, raising suspicion of ovarian malignancy. Shortly thereafter, she was hospitalized with fever, abdominal pain, and elevated C-reactive protein. Despite broad-spectrum intravenous antibiotics and multiple surgical drainages for recurrent intra-abdominal abscesses, the infection persisted, and repeated cultures were negative. Corticosteroids led to transient improvement, but new abscesses developed despite immunosuppressive therapy, and an aseptic abscess syndrome was suspected. Given her immunosuppressed status, further testing was undertaken, and polymerase chain reaction (PCR) analyses from urine, vaginal secretions, synovial fluid, and paraspinal abscess aspirate were positive for Ureaplasma parvum, for which her partner also tested positive.Treatment with oral doxycycline led to rapid clinical and laboratory test improvement, and moxifloxacin was added for bactericidal coverage. Because of mild hypogammaglobulinemia, monthly intravenous immunoglobulin therapy was initiated.This case illustrates the diagnostic challenges of Ureaplasma infections in immunocompromised patients, particularly those receiving B-cell-depleting therapy such as rituximab. Standard cultures fail to detect the organism, often delaying diagnosis. Ureaplasma parvum should therefore be considered in patients presenting with sterile abscesses, systemic inflammation, and urogenital symptoms. Early recognition through molecular testing and targeted antimicrobial treatment can prevent prolonged morbidity and unnecessary surgical interventions.
Purpose: To compare best corrected visual acuity (BCVA) measurements obtained using a digital visual acuity chart with those from the gold-standard Early Treatment Diabetic Retinopathy Study (ETDRS) chart and to assess differences in measurement variability and examination time. Methods: Altogether 42 subjects (≥ 55 years) were examined using both charts on two separate occasions. BCVA was recorded in logMAR. Examination time was recorded. Subjects were stratified into four visual acuity classes. A nested analysis of variance (ANOVA) was used to analyze systematic differences and variance components. Results: A statistically significant difference in BCVA between the charts was found, but the 95% confidence interval (CI) for the mean difference (Digital − ETDRS: −0.03 ± 0.04 logMAR) was below the 0.1 logMAR resolution threshold. No significant interaction was observed between chart type and acuity class. The digital chart significantly reduced examination time by an average of 50 sec (95% CI: ±21). Variance was highest between testing occasions compared with that between-subject and for interaction between chart type and subjects. Conclusions: The digital chart provides clinically equivalent BCVA estimates compared to the ETDRS chart, with shorter examination time. Its use in routine clinical settings is supported.
Objective: This research aims to identify the main influencing factors for dysplasia in ulcerative colitis (UC) patients and explored the correlation between dysplasia and the recurrence frequency of UC. Methods: This study retrospectively included 348 UC patients from the outpatient clinic of the Second Hospital of Hebei Medical University between December 2021 and December 2023 as the research subjects. The UC patients were divided into the dysplasia group and the non-dysplasia group based on pathological results. The general data and clinical data of the two groups were compared, and the typical computed tomography enterography (CTE) imaging features of the patients in the dysplasia group were explored. The main influencing factors for the occurrence of dysplasia in patients were screened using the univariate logistic regression analysis method and the ridge regression analysis method. All the follow-up data of the research subjects were complete, the recurrence situations of UC in the two groups were compared. The correlation between dysplasia and the recurrence frequency of UC was analysed using the Spearman rank correlation coefficient. Results: This study found that there were statistically significant differences in indicators such as disease classification, disease severity, lesion extent, disease activity degree, and faecal calprotectin (FC) level between the two groups of patients. Patients with dysplasia presented usually with CTE imaging features of mesenteric lymphadenopathy, mucosal abnormal enhancement, and bowel wall thickening. Univariate logistic regression revealed that the above indicators were influencing factors for dysplasia in UC patients (P < 0.05). Collinearity test and ridge regression analysis showed that chronic continuous type/acute fulminant type disease classification, severe disease severity, E3 lesion range, moderately active stage/severely active stage of disease activity degree, and high FC level would increase the possibility of dysplasia (P < 0.05). The recurrence rate of UC diseases in the dysplasia group was higher than that in the non-dysplasia group, and recurrence types were also different (P < 0.05). Spearman rank correlation analysis indicated that the grade of dysplasia, disease severity, lesion range, and degree of disease activity were positively correlated with recurrence frequency of UC (P < 0.05). Conclusion: Disease classification, disease severity, lesion extent, disease activity degree, and FC were independently correlated with occurrence of dysplasia in UC patients. Moreover, dysplasia increased the probability of patient recurrence. The grade of dysplasia and related influencing factors showed a positive correlation with the recurrence frequency of UC.
Correction for ”Cost-effectiveness analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at low risk of surgical mortality in Sweden” Ups J Med Sci. 2024;129: e10741. doi: 10.48101/ujms.v129.10741
Aims:The main aim of the present study was to identify factors influencing health-related quality of life (HRQoL), as measured by EQ-5D-5L, in individuals 1 year after the acute phase of COVID-19. Methods:This cross-sectional study included 75 participants (51% females), 1 year after confirmed SARS-CoV-2 infection (76% hospitalised). Associations between HRQoL, measured by patient-reported outcome measures (PROMs): EQ-5D-5L, and factors of interest, including persistent symptoms, comorbidities, work ability index (WAI), lung function, six-minute walking test (6MWT), and dyspnoea-12 (D-12) questionnaire, were assessed by an analysis of variance (ANCOVA) model (adjusted by various factors of interest) with post hoc pairwise comparison. Results:In the ANCOVA, lower HRQoL was significantly associated with not having a university education (mean difference [MD] with 95% confidence interval [CI]: 0.115 [0.013-0.217]), a higher number of persistent symptoms (for 10 vs. 1-3 symptoms: -0.153 [-0.291, -0.015]), lower work ability (for poor vs. excellent: -0.283 [-0.445, -0.120]), any comorbidity (0.077 [0.015-0.138]), and affective distress in the D-12 (0.257 [0.096-0.417]). No significant sex differences in HRQoL and the level of care at the acute infection were shown. In descriptive analysis, lower HRQoL was significantly associated with age under 55, sick leave, more dyspnoea in D-12, and poorer work ability. Conclusions:Work ability, comorbidities, persistent symptoms, and affective distress were associated with lower HRQoL at 1-year follow-up after COVID-19. No significant differences in HRQoL were observed between sexes. Our study highlights the need to address HRQoL in post-COVID-19 rehabilitation and broader public health planning.
Objectives: This study aimed to determine the effects of von Hippel–Lindau protein (VHL) expression on hypoxia-inducible factor (HIF) and E-cadherin proteins. Furthermore, to evaluate the influence of the VHL–HIF–E-cadherin pathway in clear cell renal cell carcinoma (ccRCC). Materials and Methods: This study used tissue samples collected from 150 patients with ccRCC and 24 adjacent kidney cortex samples. Immunoblotting was performed to measure the expression levels of VHL and E-cadherin. Additionally, nuclear expression of HIF-α was evaluated by immunohistochemistry (IHC) using a tissue microarray (TMA). Results: pVHL levels were lower in ccRCC than in the adjacent kidney cortex; however, pVHL levels showed no correlation with clinicopathological parameters. Nuclear HIF-1α levels were higher in stage IV tumors, whereas HIF-2α levels increased with tumor size. No correlation was observed between HIF-3α levels and clinicopathological parameters. E-cadherin protein expression was reduced in ccRCC tissues and in higher-stage and larger tumors. In pVHL-high ccRCC, E-cadherin levels were lower in advanced-stage and larger tumors. Higher levels of HIF-1α and HIF-3α were observed in pVHL-low tumors. E-cadherin expression negatively correlated with nuclear HIF-1α expression. In pVHL-high ccRCCs, E-cadherin was negatively correlated with HIF-1α, while in pVHL-low ccRCCs, E-cadherin was negatively correlated with HIF-2α. E-cadherin was not associated with cancer-specific survival in patients with pVHL-low tumors, whereas E-cadherin expression was linked to improved survival in patients with pVHL-high tumors. Conclusion: VHL inactivation causes HIF-α activation and suppresses E-cadherin expression, thereby promoting ccRCC progression. This study provides insights into the potential biomarkers and therapeutic targets for ccRCC treatment.
High stroma content, as measured by tumor-stroma ratio (TSR), is generally a negative prognostic parameter for epithelial cancers, including sporadic colorectal cancer (sCRC). Inflammatory bowel disease patients have higher risk for colorectal cancer than the background population. Evidence suggests that this colitis-associated colorectal cancer (CAC) is more aggressive and occurs at younger age than sCRC. CAC also differs from sCRC in oncogenesis and prognosis. This study tests the hypothesis that TSR in CAC tumors correlates with survival. Age at CAC diagnosis relative to TSR was also explored. TSR was quantified in 36 CAC cases. In routine hematoxylin–eosin staining, the amount of stroma was estimated in categorical steps of 10% increments per image field. The area with highest amount of stroma and tumor tissue at all quadrants of the visual field boundary was scored for TSR. For statistical analysis, tumors were divided into stroma-high (> 50%) or stroma-low (≤ 50%). Of all cases, 22 were stroma-high and 14 were stroma-low. Five-year survival in the stroma-high group was 32% (n = 22), compared to 71% (n = 14) in the stroma-low group (p = 0.049). High stroma content was more frequent if cancer diagnosis was before 60 years of age (17/23) compared to after 60 years of age (5/13). Despite differences in oncogenesis and tumor biology in CAC compared to sCRC, high stroma content also predicts worse outcome in CAC and is particularly common in younger patients.
Patients with systemic lupus erythematosus (SLE) display an increased expression of type I interferon (IFN)-regulated genes, a so-called IFN signature. This discovery was preceded by the observation in Uppsala that patients with malignant diseases treated with type I IFN occasionally developed autoimmune diseases, including SLE. The adverse event of IFN treatment was the start of an intensive search for the role of the type I IFN system in patients with spontaneously occurring SLE. A key finding by our group was the detection in patients with SLE of endogenous IFN-inducers that could activate plasmacytoid dendritic cells (pDC) to IFN production. Further studies revealed the mechanisms by which these cells are triggered to a continuous IFN synthesis. We could also identify a large number of risk genes for SLE and several molecules connected to type I IFN production and response. My group early on suggested the possibility that some of these molecules are suitable therapeutic targets in SLE, but also other IFN-driven diseases. Antibodies against the type I IFN receptor (anifrolumab) have recently shown efficacy in clinical trials for SLE, and anifrolumab is now approved as a treatment for this disease. Several other drugs targeting critical molecules in the IFN signaling pathways – including BCDA-2 (Blood Dendritic Cell Antigen 2), TLR7/8 (Toll-like receptor 7/8), and TYK2 (Tyrosine Kinase 2) – are currently in early clinical phases, potentially expanding therapeutic options for SLE. In this review, several important observations regarding the role of the type I IFN system in SLE and therapeutic implications are discussed.
Objective:Although polymorphisms in the Toll-like receptor 2 (TLR2) gene have been proposed as host genetic factors influencing susceptibility to Helicobacter pylori infection, existing data remain inconclusive. This meta-analysis aimed to clarify whether two common variants - rs3804099 and del -196 to -174 - contribute to infection risk across diverse populations. Materials and methods:A systematic search of PubMed, Scopus, and Web of Science (up to January 2025) identified eligible case-control studies examining the association between TLR2 polymorphisms and H. pylori infection. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity, publication bias, and sensitivity were assessed according to PRISMA 2020 guidelines. Results:Ten studies comprising 4,521 subjects were included. Pooled analyses under allelic, dominant, recessive, homozygous, and heterozygous models revealed no significant association between either rs3804099 or del -196 to -174 polymorphisms and infection risk. Substantial inter-study heterogeneity was observed, particularly for rs3804099, but sensitivity analyses confirmed the stability of pooled results. Conclusion:This meta-analysis refutes a consistent genetic association between TLR2 rs3804099 or del -196 to -174 polymorphisms and H. pylori infection. The findings suggest that host innate immunity variability alone does not explain differences in infection susceptibility among populations. Future studies integrating bacterial virulence genotypes and host immunogenetic profiles are warranted to delineate population-specific risk mechanisms.
Background: Two out of three randomised controlled trials (RCTs) fail to meet their recruitment goals. Recruitment to Efficacy oF Fluoxetine – a randomisEd Controlled Trial in Stroke (EFFECTS), fluoxetine for stroke recovery was slower than anticipated. We aimed to evaluate an intervention to improve recruitment to EFFECTS. Methods: This stepped wedge, cluster randomised study investigated whether a teleconference with the study personnel and the head of department could enhance recruitment in the ongoing EFFECTS. We included 20 low- and medium recruiting active centres. We excluded high recruiting centres. All centres started as controls and were followed by 60 days of observation. We used block randomisation. The primary outcome was a 20% increase of recruitment within 60 days post intervention compared within 60 days pre intervention. Secondary outcomes were comparing recruitment between different types of centres, that is small versus large or experienced versus non-experienced centres, and university versus non-university hospitals. In exploratory analyses, recruitment within 30 days post versus 30 days pre intervention was compared. Results: The recruitment increased by 10% at 60 days. We noticed a short-lived increase of 23% the first month. The increased recruitment was most pronounced in low-recruiting, small and non-university hospitals. The recruitment of patients increased after the first contact with the centres where we announced that there would be a conference. Conclusion: A teleconference with the study personnel and the head of department increased the recruitment by 23% within 30 days and by 10%, 60 days post intervention in this embedded RCT. This implies that this structured intervention aimed at increased recruitment was short-lived and would need frequent repetitions in order to be effective.
Objective:The aim of this review is to describe the regulatory background of the COVID-19 vaccines, the national recommendations for use issued and vaccine uptake in Sweden. It includes an overview of licensing and relevant safety aspects identified by the European Medicines Agency (EMA) and the national vaccination plan issued by the Public Health Agency (PHA) of Sweden. Materials and methods:Information on dates of licensing and safety aspects of importance identified by EMA published on its website, was compiled and presented in a chronological order. National recommendations on COVID-19-vaccination and vaccinations-data on uptake and coverage using the national-vaccine-register are presented. Results:COVID-19 vaccines development, assessments using rolling review and licensing of the covid-19 vaccines was done in 2020 during less than a year. Large-scale production was implemented. Monthly safety reviews performed by the EMA identified risk for thrombosis with thrombocytopenia syndrome with adenoviral vaccines and myocarditis for mRNA vaccines which led to restrictions in national recommendations for specified groups.National vaccinations were launched in a phased manner during 2021. Persons of high age, risk groups and nursing home personnel were prioritised during primary vaccinations and for initial boosters. In the Swedish population, 85% recieved at least on vaccine dose from the age of 12. At least two doses were recieved by 81% from age 18 and 95% from age 80. Conclusion:Recommendations for national use adhered to relevant adverse drug reactions identified. The vaccine coverage was high. Timelines presented should be considered in follow-up studies of COVID-19-vaccines to manage possible selection bias and confounding.
Objective: The aim of this review is to describe the regulatory background of the COVID-19 vaccines, the national recommendations for use issued and vaccine uptake in Sweden. It includes an overview of licensing and relevant safety aspects identified by the European Medicines Agency (EMA) and the national vaccination plan issued by the Public Health Agency (PHA) of Sweden. Materials and methods: Information on dates of licensing and safety aspects of importance identified by EMA published on its website, was compiled and presented in a chronological order. National recommendations on COVID-19-vaccination and vaccinations-data on uptake and coverage using the national-vaccine-register are presented. Results: COVID-19 vaccines development, assessments using rolling review and licensing of the covid-19 vaccines was done in 2020 during less than a year. Large-scale production was implemented. Monthly safety reviews performed by the EMA identified risk for thrombosis with thrombocytopenia syndrome with adenoviral vaccines and myocarditis for mRNA vaccines which led to restrictions in national recommendations for specified groups.National vaccinations were launched in a phased manner during 2021. Persons of high age, risk groups and nursing home personnel were prioritised during primary vaccinations and for initial boosters. In the Swedish population, 85% recieved at least on vaccine dose from the age of 12. At least two doses were recieved by 81% from age 18 and 95% from age 80. Conclusion: Recommendations for national use adhered to relevant adverse drug reactions identified. The vaccine coverage was high. Timelines presented should be considered in follow-up studies of COVID-19-vaccines to manage possible selection bias and confounding.
Background:This study aimed to describe eating patterns among individuals with overweight and obesity and to investigate associations between eating patterns and anthropometric measures, including body mass index (BMI) and waist circumference, and blood pressure. Methods:This study enrolled a cohort of adults with overweight or obesity (n = 176) participating in a clinical trial focused on weight reduction. Self-reported eating patterns were assessed as part of the trial's baseline survey. Trained study nurses conducted measurements of anthropometric indicators and blood pressure. To examine associations, statistical analyses included the application of the Mann-Whitney U-test, Fisher's exact test, the chi-squared test, and linear regression models as appropriate. Results:The median age of the participants was 55 years (interquartile range [IQR] 12), 79% were female, and the median BMI was 33 kg/m2 (IQR 5). The predominant eating pattern identified was characterized by five meals per day, including breakfast, two prepared meals, and two snacks. Among older participants (≥ 55 years), 51% reported eating two prepared meals per day as compared to 75% among the younger (P <> 0.05). A higher percentage of older participants reported consuming more than one snack per day (82% vs. 68%, P = 0.04). Additionally, older participants were more likely to rate their eating habits as 'good' compared to their younger counterparts (64% vs. 52%, P = 0.03). Women reported a higher number of eating occasions than men (> 3/day: 93% vs. 78%, P = 0.01) and a higher frequency of snacks (> 1 snack/day: 79% vs. 61%, P = 0.03). No significant associations between the number of eating occasions or number of snacks and BMI, waist circumference, or blood pressure (systolic and/or diastolic) were found in regression models when age and sex were considered. Conclusions:Varying eating patterns were observed among adults with overweight and obesity according to age and sex. No association between eating patterns and anthropometric measures or blood pressure independent of age and sex was found.
