Abstract
There is increasing incidence of abnormal weight changes in Sub-Saharan Africa, including Nigeria. Factors which influence body mass index (BMI) in developing countries have not been completely identified. Weight changes may be observed even in general out patients, unrelated to the major complaints for which the patients are presenting in clinics. This study was set out to evaluate BMI and potential risk factors of underweight and obesity in subjects attending the general out-patient clinic in Federal Medical Centre, Owerri, Nigeria. This was a cross-sectional study conducted on general out patients. Body mass index was determined. Relevant investigations were performed. Association of weight changes with their potential risk factors and the strength of variables to predict BMI, underweight and obesity were determined. The mean BMI of the subjects was 25.5± 6.5kg/m<sup>2</sup>. Underweight was present in 14(10.3%), normal weight in 57(41.9%), overweight in 24(17.6%) and obesity in 41(30.1%) of the subjects. There was significant association between BMI and hemoglobin (Hb), 24-hour urine osmolality (24HUOsm), serum cholesterol, serum low density lipoprotein cholesterol (LDL), serum high density lipoprotein cholesterol (HDL), as well as serum triglyceride. There was significant but poor correlation between BMI and spot urine protein (SUP), spot urine creatinine (SUCr), spot urine osmolality (SUOsm), serum cholesterol, serum triglyceride, serum HDL, serum LDL, as well as Hb. Spot urine protein, SUOsm, and Hb predicted BMI. Furthermore, SUOsm, serum cholesterol, serum HDL and serum LDL predicted obesity. The prevalence of underweight (10.3%) and obesity (30.1%) were high in the general out patients. Abnormalities of serum lipids, proteinuric renal disease with dilute urine were common in these subjects. There is a need for clinicians to routinely assess BMI and further search for anemia, dyslipidemia and renal damage in subjects with underweight and obesity attending the general out-patient clinics.
Highlights
Studies have shown a trend in the epidemiology of obesity: the low and middle income groups have high incidence of obesity in the developed nations while in the developing countries the incidence is rising among people of high economic status, urban dwellers and even rural dwellers. [7, 8, 9] Under-nutrition is high among rural dwellers in developing countries. [10]
This will help in identifying factors that may influence underweight and obesity with a view to instituting early interventions that will whittle down adverse outcomes in patients with underweight and obesity attending the general out-patient clinics
This study found a significant association between body mass index (BMI) and serum low density lipoprotein cholesterol (LDL), and further demonstrated that the prevalence of LDL hypercholesterolemia declined with underweight but increased with obesity
Summary
Studies have shown a trend in the epidemiology of obesity: the low and middle income groups have high incidence of obesity in the developed nations while in the developing countries the incidence is rising among people of high economic status, urban dwellers and even rural dwellers. There is a paucity of studies on the associated factors of underweight, overweight and obesity in the general out patients in Nigeria. This has prompted us to evaluate BMI and the factors which might be associated with underweight and obesity in this group of people. This will help in identifying factors that may influence underweight and obesity with a view to instituting early interventions that will whittle down adverse outcomes in patients with underweight and obesity attending the general out-patient clinics
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