Aim: Since traditional anthropometric measurements such as waist circumference (WC) and body mass index (BMI) can not adequately demonstrate muscle, fat mass, and body fat distribution, new indices have been developed taking into account the shape of the body. In this study, we aimed to investigate whether new anthropometric indices such as Rohrer Index (RI), Body Shape Index (BSI), and Body Roundness Index (BRI) can be used as  markers for the presence of metabolic syndrome or not. 

Materials and Methods: This study was performed on 1059 patients who met the inclusion criteria. Waist-to-height ratio (WHtR), BMI, BRI, BSI, RI were calculated using the appropriate anthropometric measurements taken from the files of the participants.  

Results: The prevalence of metabolic syndrome was 39.9% (n=423). There was a statistically significant relationship between BMI, WHtR, RI, BSI, BRI and gender, age, and metabolic syndrome (p<0.001). While there was a weak positive correlation between BSI and metabolic syndrome (r=0.182, p<0.001), there was a strong positive correlation between BRI and metabolic syndrome (r=0.610, p<0.001). The optimum cutting values for BMI, WHtR, and BRI were determined as 30.19 kg/m2, 0.59 cm and 5.24, respectively. 

Discussion: BRI and WHtR were found to have a higher capacity to predict metabolic syndrome than other indices (BSI, RI, BMI), however, it was seen that it was not superior to BMI. Other anthropometric indices can be used as well as BMI and waist circumference for the prevention, early diagnosis, and detection of the metabolic syndrome risks in the primary health care centers.


Aim: This study aims to compare smartphone addiction and food addiction in patients admitted for weight loss. 

Materials and Methods: The study was conducted with the participation of 113 volunteers who were admitted to the obesity outpatient clinic of our hospital between January 2017 and January 2018. The participants of the study were given a sociodemographic characteristics form, the Yale food addiction questionnaire, and the smartphone addiction scale. The physical examination and anthropometric measurements (age, gender, height, weight, waist circumference, hip circumference, blood pressure) of all patients were performed by the researcher. SPSS 22 package program was used for the statistical analysis of the data. A p-value of <0.05 was considered significant.

Results: The median age of the participants, 95 of whom were female and 18 were male, was 34,5 (45,0-31,0) years. Among the participants, 17.7% had smartphone addiction and 33.6% had food addiction. The rate of food addiction was 50.0% in the group with smartphone addiction, while it was 30.1% in the group without smartphone addiction (p> 0.05), and there was a positive correlation between the smartphone addiction score and the food addiction score (r; 0.207 p = 0.033). While the mean age of the group with smartphone addiction was lower (28.5 years vs. 34.0 years) (p = 0.013), the height, weight, BMI, waist circumference, hip circumference, systolic and diastolic blood pressure parameters were similar to those without smartphone addiction (p> 0.05) (Table 2). The age, height, weight, BMI, waist circumference, hip circumference, systolic and diastolic blood pressure parameters of the groups with and without food addiction were similar (p> 0.05). 

Discussion: Overweight and obese people with smartphone addiction exhibited negative eating behaviors. Effective nutrition education programs and a national support policy are required to correct the unhealthy eating behaviors of obese people caused by smartphone use. 

Aim: The aim of the present study was to compare the doses of sugammadex based on ideal body weight, corrected body weight or actual body weight in terms of reversal of neuromuscular blockade and recovery of cognitive function. 

Material and Methods: Sixty morbidly obese patients scheduled for laparoscopic sleeve gastrectomy (LSG) were studied. Patients were randomly divided into three groups and received sugammadex according to IBW, CBW or ABW. BIS and acceleromyography were used in addition to routine monitoring. All patients received total intravenous anesthesia during the operation. Neuromuscular reversal times and cortical recovery times were recorded after administration of sugammadex for recovery from anesthesia. 

Results: Eye opening times were not statistically different between groups. The time to TOFR to 0.9, time to extubation was shortest in Group ABW and these times were longest in Group IBW. Cognitive recovery markers differed significantly among groups. The time to reach a BIS level above 80 was 160 s in Group ABW, 231 s in Group CBW and 290 s in Group IBW (p=0.024). Time to first verbal answer to questions and time to orientation were significantly longest in Group IBW and shortest in Group ABW. Among the three groups, none of the patients had a delayed discharge from PACU secondary to respiratory complications. 

Discussion: The ideal dosing regimen for administration of sugammadex to obese patients is still unclear.  We suggest that TBW might be more appropriate for calculating sugammadex dose for safe and effective reversal of moderate rocuronium-induced neuromuscular block in morbidly obese patients. 


Aim: Obesity is an important risk factor of multiple sclerosis particularly in younger age. Many studies reported an association between elevated body mass index (BMI) and development of MS especially in teenagers and adolescents. As obesity is a major health problem in Saudi Arabia, an elevated risk of multiple sclerosis is expected. This study aimed to evaluate the association between elevated body mass index and multiple sclerosis. Material and Method: This casecontrol study included 231 participants aged ≥17 years old, of them 77 cases were multiple sclerosis and 154 controls. Patients previously diagnosed with MS or had no medical records were excluded. Controls had no MS or any related neurological symptoms and selected from outpatients’ clinics. Data were collected from hospital records regarding demographics and BMI. Results: The majority of the participants aged 21-40 years old. About 30% of them were 21-30 years old and 35% were 31-40 years old. Regarding BMI categorization of the respondents 51.5% had an elevated BMI, while 112 (48.5%) had a normal BMI. Findings of the binary logistic regression model showed an increased risk of multiple sclerosis by 2.3 times among participants with an elevated BMI than those with normal BMI (p value = 0.005, OR: 2.28, 95% CI=1.289 to 4.019). Discussion: As multiple sclerosis has been linked to genetic factors, an assessment of the presence of such association in different populations are meaningful. The cross-sectional approach is  defective in the assessment of association, thus a retrospective analytical approach with the case-control study was the most appropriate design. Conclusions: There was a significant association between BMI and the occurrence of multiple sclerosis, the risk is doubled among overweight or obese people in Saudi Arabia in comparison to normal or underweight people.

Aim: In addition to sleep study, the self-administered questionnaires have been used to identify high- risk groups among the general population as they are  more feasible than sleep studies. In the literature, the Berlin questionnaire was the most commonly used followed by Wisconsin sleep questionnaire, however,  STOP and STOP-BANG questionnaires were recommended due to ease of use and higher methodological quality. This study aimed to identify high-risk group  of OSA in the general population of Saudi Arabia and other important risk factors. Material and Method: This was a cross-sectional study conducted through  the self-administered questionnaires distributed electronically among the general population in the Jazan region where 745 adult participants those living  outside the Jazan region, or those with missing data were included. Data were collected anonymously through the STOP-BANG questionnaire and then coded.  The data were analyzed using frequency, percentages as descriptive statistics, while Chi-Square was used to identify significant differences. The logistic  regression was conducted to identify significant predictors for previously diagnosed OSA and any p-value less than 0.05 indicated significant differences.  Results: Out of 745 valid questionnaires were included in the study, 51.4% were females and 48.6% were males. The body mass index indicated that about  52% of the respondents had elevated BMI and 22% were smokers. Based on the STOP-BANG questionnaire, 16.5% of the respondents were at a high risk of  OSA. Among other reported risk factors, chronic sinusitis was the most common followed by tonsillitis with the prevalence of 23.4% and 16.9%, respectively.  Significant associations between reported OSA and snoring, daytime tiredness, observed stop breathing during sleep, hypertension, BMI> 35 kg m−2, and age  over than 50 years. The results of binary logistic regression demonstrated that the presence of hypertension and respiratory arrest observed by others during  sleep are significant predictors for reported OSA. Discussion: The identification of a high-risk group of sleeping apnea using the STOB-BANG questionnaire  was found valid and reliable. Arabic version of the STOB-BANG had a good internal consistency with 0.7 Cronbach’s alpha, 98% sensitivity and 86% positive  predictive value. We used 7-item questionnaire, after exclusion of neck circumferences question, since the vast majority of the respondents left this question  blank. . Similarly, Alharthi et al. found only 12% response rate for the question of neck diameter in Taif city. Conclusions: It was concluded that a considerable  percentage of the general population in Jazan region had a high risk of obstructive sleeping apnea based on the STOB-BANG questionnaire. Hypertension and  respiratory arrest observed by others during sleep were significant predictors for diagnosed OSA.

Aim: In this study, we aimed to explore the effect of a suggested physical therapy protocol on the anthropometric parameters and hormonal profile of obese adolescent girls with polycystic ovarian syndrome (PCOS). Material and Method: Twenty obese adolescent girls with PCOS participated in this study. Their ages ranged from 14 to 18 years and their body mass index (BMI) ranged from 30 to 35 kg/m2. They received a specific diet therapy connected with a program of aerobic exercise for 6 months. Anthropometric parameters and serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were measured before starting the study, after 3 months and after 6 months of the suggested physical therapy protocol. Results: There was a statistically highly significant reduction in the anthropometric parameters and LH/FSH ratio in the post 6 months of treatment compared with the pre-treatment and post 3 months of treatment (p<0.01). Also, there was a statistically highly significant reduction in the anthropometric parameters (p<0.01), while there was a statistically significant reduction in the LH/FSH ratio in the post 3 months of treatment compared with the pre-treatment (p<0.05). Discussion: The suggested physical therapy protocol for obese adolescent girls with PCOS is optimal for improving their anthropometric parameters and hormonal profile.

Aim: Obesity is a risk factor for autoimmune disorders and worsens the disease process. The purpose of this study was to investigate the association between the body mass index (BMI), sex differences and fatigue in MS patients compared to healthy controls. Material and Method: Our study consisted of 59 MS patients (37 females, 22 males) and 45 healthy controls. Medical history of MS patients, including the duration of illness, BMI, Fatigue Severity Scale (FSS) number of annual episodes, demographic data (sex, age) and BMI and fatigue severity of healthy control group were recorded. Results: The female MS patients had a significantly higher mean BMI than the control group and a significant positive correlation between BMI and Extended Disability Scale Score (EDSS) and fatigue. There was no significant difference between the male MS patients’ BMI and that of controls. Obese MS patient group had a significantly higher mean fatigue level than the normoweight and overweight ones and significantly higher mean annual attack number than the normoweight MS group. In the female MS patients group, the mean BMI and EDSS of Fatigue Severity Scale (FSS) ≥4 group were significantly higher than of FSS <4 group but there was no significant correlation between the FSS ≥4 and FSS <4 groups in the male MS patients. Discussion: These findings suggest that being obese in MS patients may affect attacks via inflammatory pathway as well as disability, particularly so in women; they also show the necessity of approaches encouraging weight loss for MS treatment.

Aim: We think that vitamin B12 may affect serum lipid parameters because it is a cofactor of the enzyme that plays a role in fatty acid catabolism, and also because of its association with obesity and increased risk of myocardial infarction in its deficiency. In this study, we aimed to investigate whether vitamin B12 insufficiency, which is common and associated with many diseases, is related to serum lipid parameters. Material and Method: This is a cross-sectional retrospective study. In this retrospective study, data such as serum vitamin B12, glucose, lipid, thyroid function tests, ferritin, and demographic data such as age and gender, were obtained from records of the examinations of the patients who applied to the family medicine clinics, at the northern region in Turkey. The study included 228 patients who underwent concurrent lipid and vitamin B12 analysis and who met the inclusion criteria. Patients who met the exclusion criteria were not included in the study. Results: There was a statistically significant, low positive correlation (r = 0.278, p = 0.001, n = 228) between serum HDL and vitamin B12 levels. There was a statistically significant low negative correlation (r = 0.322, p = 0.001, n = 228) between serum triglycerides and vitamin B12 levels. Discussion: As a result, we can say that serum vitamin B12 levels affect lipid parameters. We may suggest that the risk of diabetes, obesity, and coronary artery disease may increase due to high triglyceride or low HDL levels in the absence of vitamin B12.

Aim: Alpha-1-antitrypsin (A1AT) loses its antiprotease activity as a result of oxidation of the methionine in its structure. Vitamin B12 plays an active role as a co-factor during methionine synthesis. Thus, we think that vitamin B12 deficiency may lead to decreased A1AT. Material and Method: The research was planned as an observational study. One hundred eighty patients were enrolled. The levels of serum A1AT and vitamin B12 were compared based on demographic characteristics of the patients. Twenty-seven patients’ -who have accomplished therapeutic protocol and who have come to control visits- A1AT levels were controlled after treatment and compared with the before treatment levels. Results: The levels of serum A1AT could not be found statistically significantly different according to the level of vitamin B12. However, in patients using any medication because of a chronic disease, the levels of serum A1AT were found higher in the group with high level of vitamin B12, than the group with the low level of vitamin B12. Serum A1AT levels were found significantly lower in obese than non-obese participants. Following treatment with vitamin B12, the levels of serum A1AT (pre-treatment 121.67±13.884, post-treatment 138.04±16.922, P=0.001) were found to be increased. Discussion: This study’s results suggest that the level of vitamin B12 may have a significant role in the synthesis of A1AT.

Aim: It is not known whether overweight or obese women with endometriosis have the same outcomes of in vitro fertilization (IVF) when compared with normal weight patients. In the present study, we aimed to evaluate the impact of obesity on assisted reproductive outcomes in patients with endometriosis. Material and Method: A total of 45 women with a history of endometrioma operation who underwent IVF or ICSI treatment from 2009 to 2014 in our center were included in this retrospective cohort study. The patients were divided into two groups according to their body mass index (BMI): Group 1 was composed of 15 patients with a BMI of ≥25 kg/m2; group 2 included 30 normal weight women (18.5-25 kg/m2). IVF/ICSI characteristics and outcomes were analyzed. Only fresh cycles were included. Women over the age of 38 were excluded. BMI was calculated by using height and weight information from the medical records. Results: There were no significant differences between the groups regarding mean age, basal FSH, and basal LH. The overweight and obese patients had similar numbers of oocytes retrieved (p=0.739), metaphase 2 oocytes (p=0.680), and peak estradiol levels on HCG administra¬tion day (p=0.751) compared with the normal weight patients. The clinical pregnancy rate was also similar in the two groups. Discussion: BMI does not seem to affect IVF/ICSI characteristics and outcomes in patients with a history of endometrioma operations.

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