1825 OBESOGENIC PROFILE OF CONTEMPORARY NORTH AMERICAN RENAL STONE PATIENTS
Bibliographic record
Abstract
You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111825 OBESOGENIC PROFILE OF CONTEMPORARY NORTH AMERICAN RENAL STONE PATIENTS Anatoly Shuster, Christopher B. Allard, Ayman Raees, Michael Patlas, Edward D. Matsumoto, Jehonathan H. Pinthus, and J. Paul Whelan Anatoly ShusterAnatoly Shuster Hamilton, Canada More articles by this author , Christopher B. AllardChristopher B. Allard Hamilton, Canada More articles by this author , Ayman RaeesAyman Raees Hamilton, Canada More articles by this author , Michael PatlasMichael Patlas Hamilton, Canada More articles by this author , Edward D. MatsumotoEdward D. Matsumoto Hamilton, Canada More articles by this author , Jehonathan H. PinthusJehonathan H. Pinthus Hamilton, Canada More articles by this author , and J. Paul WhelanJ. Paul Whelan Hamilton, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1844AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obesity is linked to increased rates of renal stone (RS) formation and treatment failures, and is usually defined according to body mass index (BMI). BMI has inherent limitations as a measure of obesity and fails to account for fat distribution, a more accurate predictor of morbidity. Patterns of fat distribution may affect the success of extracorporeal shockwave lithotripsy (ESWL), since peripheral adipose tissue increases the skin-to-stone distance more than does visceral adipose tissue (VAT). The objective of this study was to characterize the fat distribution and metabolic hormonal milieu in a cohort of RS patients. METHODS 113 patients (73 male; 40 female; mean age 54 years) undergoing treatment for RS between November 2009 and June 2010 at one center were prospectively enrolled; 81 met inclusion for BMI analysis and 63 for %VAT. CT scans were analyzed for visceral and subcutaneous adipose tissue volumes from axial slices at 3 fixed levels (L2 vertebral body, umbilicus and anterior superior iliac spine) using commercial software (Clear Image Demo). Adipose tissue was defined as -250 to -30 Hounsfield Units. The ratio of visceral to total adipose tissue (%VAT) was calculated and BMI data collected. Adiponectin and leptin levels of fasting serum samples were measured by ELISA. RESULTS 28% of patients had BMI within the normal range (<25kg/m2), while 32% were overweight (25 35kg/m2). Mean BMI was 30kg/m2. 54% of females and 32% of males were obese or morbidly obese (BMI>30kg/m2). Mean %VAT was 47.7 and 29.7 for males and females respectively (p<0.001), indicating relatively higher visceral adiposity in males, and peripheral adiposity in females. Mean levels of adiponectin and leptin were 7.67 and 17.50 respectively (normal values are 10ìg/ml and 10 ng/ml respectively). CONCLUSIONS In this cohort of RS patients, males had a higher proportion of visceral adiposity than females (%VAT 47.7 vs. 29.7), while more females were obese or morbidly obese according to BMI. The gender differences in fat distribution may affect ESWL success; obese females have more peripheral adiposity, increasing the skin-to-stone distance and, consequently, the probability of ESWL failure. Mean serum levels of adiponectin and leptin indicate that these RS patients are at risk of obesity-related metabolic disorders and higher perioperative complication rates. These associations should be further investigated in a larger multi-center cohort. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185 Issue 4S April 2011 Page: e732 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Anatoly Shuster Hamilton, Canada More articles by this author Christopher B. Allard Hamilton, Canada More articles by this author Ayman Raees Hamilton, Canada More articles by this author Michael Patlas Hamilton, Canada More articles by this author Edward D. Matsumoto Hamilton, Canada More articles by this author Jehonathan H. Pinthus Hamilton, Canada More articles by this author J. Paul Whelan Hamilton, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".