Daily ReCAP May 1, 2017


The latest news on chronic, acute, and preventive care across the health care landscape.

Chronic: Obesity and Type 2 Diabetes Combined Increases Risk of Brain Abnormalities

Patients with type 2 diabetes (T2D) who are obese or overweight have an increased risk of brain abnormalities compared with individuals of normal weight. In a study published inDiabetologia, investigators sought to examine the effects of high body mass index (BMI) on the brain and cognitive functions of individuals with early stage T2D. For the study, investigators recruited 150 Koreans aged 30 to 60 years of whom 50 were overweight or obese individuals with T2D, 50 were normal-weight individuals with T2D, and 50 were normal-weight individuals without diabetes and served as the controls. The participants underwent an MRI and cognitive assessments consisting of tests regarding memory, psychomotor speed, and executive function. The results of the study showed that patients with diabetes had grey matter that was significantly thinner in clusters in the temporal, prefrontoparietal, and motor and occipital cortices of the brains, compared with the control group. They also observed further thinning of the temporal and motor cortices in the overweight or obese diabetic arm compared with normal-weight diabetes. In addition, the investigators found region-specific changes that suggest the temporal lobe is vulnerable to the combined effects of T2D and being obese or overweight. “These findings suggest that weight status may play additive roles in T2D-related brain and cognitive alterations,” the authors said. “Our findings also highlight the need for early intervention aimed to reduce risk factors for overweight or obesity in type 2 diabetic individuals to preserve their brain structure and cognitive function.”

Acute: Daily Platelet Counts Predict Risk of Dengue Shock Syndrome

Daily blood counts can predict the risk of dengue shock syndrome (DSS) in children with early stage dengue virus infection. In a study published inPLOS Neglected Tropical Diseases, investigators followed 2301 children aged 5 to 15 years who were admitted to the Hospital for Tropical Diseases in Ho Chi Minh City for suspected dengue between 2001 and 2009. Daily blood counts, vital signs, symptoms, and physical exam information were available for each child at presentation, all of whom were enrolled in the first 4 days of onset. Of the 2301 children, 143 progressed to DDS. The researchers analyzed which factors were associated with a greater risk of developing DDS and found that a history of vomiting, higher temperature, palpable liver, and lower platelet count were all risk factors present at enrollment that increased the child’s risk. Furthermore, daily platelet counts and changes in platelet counts over time helped distinguish which patients would go on to develop DSS. Although the findings show promise, the investigators noted that the model has only moderate predictive value in identifying all patients who go on to develop DSS. More research needs to be done to determine additional factors that could be integrated into a more clinically useful prediction model.

Preventive: Staying Active Reduces Weight Gain From Gene Variant that Causes Obesity

Individuals who engage in physical activity can reduce the weight-gaining effects of the obesity-causing gene variant. In a study published inPLOS Genetics, investigators sought to examine how physical activity and genetic variants related to obesity can be reduced through physical activity. They conducted a genome-wide interaction meta-analyses that included more than 200,000 individuals. The study participants were categorized as active or inactive, and they were then screened for approximately 2.5 million genetic variants. The data were then correlated with physical indicators of obesity, including waist circumference, BMI, and waist-to-hip ratio. The results of the study showed that physical activity could reduce the weight-gaining effects of the FTO gene by approximately 30%. FTO is the strongest known genetic risk factor for obesity. In addition, the investigators were able to identify 11 novel genetic variants linked to obesity by accounting for physical activity. The finding suggests that physical activity and other relevant environmental factors should be taken into consideration when searching for novel genes.

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