Association Of Body Mass Index Categories Research Articles

Body Mass Index (BMI) correlate with blood glucose level in the state of Qatar

Objectives: Development of type 2 diabetes mellites (T2DM) is highly corelated to obesity. This is a cross-sectional study conducted in the state of Qatar to investigate the association between blood sugar level and body mass index (BMI). Methods: Two-hundred and nineteen adult subjects, undiagnosed with T2DM (defined by ICD-9-CM diagnosis codes and not on anti-diabetic medications) participated in the study. Age ranged from 18-65 with a mean of 42.0 ± 9.8 years (34.0 + 8.6 among females and 44.2 ± 9.6 among males). Blood sugar, weight, height, and BMI were measured during the survey. Individuals with BMI < 18.5 kg/m2 were excluded, (Mean BMI =27.4 ±4.71). Blood sugar level of overweight: BMI 25–29.9 kg/m2 or Obese: BMI ≥30 kg/m2 compared with normal BMI (18.5–24.9 kg/m2) to assess the impact of BMI on blood sugar. Results: 219 participants included in this study, a positive association between BMI with blood sugar level and the risk of a T2DM diagnosis was noticed. Conclusions: Blood sugar level and the risk of being diagnosed with T2DM is highly dependent and corelated with BMI. The incremental association of BMI category on the risk of T2DM is stronger for people with a higher BMI relative to people with a lower BMI.

Association of body mass index (BMI) with clinical efficacy of immune checkpoint inhibitors (ICI) in advanced cancer patients: A retrospective analysis.

e15066 Background: Obesity is linked to an increased risk of cancer development. The excess of body fatness seems to be associated with alterations in hormonal, metabolic and inflammatory pathways, that may lead to activation of the carcinogenesis process. Previous studies suggested this obesity pro-inflammatory state could improve ICI clinical efficacy. Methods: Baseline characteristics and clinical outcomes were retrospectively collected from advanced cancer patients of any primary site, and treated with ICI in our institution. The BMI was determined for all pts and categorized into 2 groups: obese (BMI≥30) and non-obese (BMI < 30). Primary outcomes were the association of BMI category with overall survival (OS) and progression free survival (PFS) assessed by log-rank statistic, and both were stratified by sex, age, treatment agent and primary tumor site using the Cox-regression. Secondary outcome was the association of BMI with objective response rate (ORR). Results: We collected data from 448 advanced cancer pts - 192 (43%) as normal weight, 159 (36%) as overweight, 78 (17%) as obese and 19 (4%) as underweight. A total of 370 pts (83%) were included in the non-obese group (BMI < 30) and 78 (17%) patients in the obese group (BMI≥30). The majority of pts (387 - 84%) received anti-PD-1/anti-PD-L1; 128 pts (28%) were treated at 1st line and 200 pts (44%) at 2nd line. The obese group experienced longer mOS than the non-obese group - 21.8 months (95% CI NR - NR) vs. 14.9 months (95% CI 8.3 -21.5); HR = 0.82, (95% CI 0.57-1.18, P = 0.28). However, this was not statistically significant and even after stratification. The obese group had an inferior mPFS than the non-obese group - 4.7 months (95% CI 3.8- 5.7) vs. 5.3 months (95% CI 3.45-7.15); - HR = 0.99, (95% CI 0.76 -1.30), P = 0.95. There was no significative difference in mPFS and ORR according to BMI. Conclusions: Although study did not report an improved OS among high BMI pts treated with ICI, our results suggested a trend in survival benefit. The BMI should be explored as a stratification variable in the design of prospective trials with advanced cancer pts and ICI treatment.

BMI and its association with death and the initiation of renal replacement therapy (RRT) in a cohort of patients with chronic kidney disease (CKD)

BackgroundA survival advantage associated with obesity has often been described in dialysis patients. The association of higher body mass index (BMI) with mortality and renal replacement therapy (RRT) in preterminal chronic kidney disease (CKD) patients has not been established.MethodsSubjects were patients with pre-terminal CKD who were recruited to the CKD.QLD registry. BMI at time of consent was grouped as normal (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), mild obesity (BMI 30–34.9 kg/m2) and moderate obesity+ (BMI ≥ 35 kg/m2) as defined by WHO criteria. The associations of BMI categories with mortality and starting RRT were analysed.ResultsThe cohort consisted of 3344 CKD patients, of whom 1777 were males (53.1%). The percentages who had normal BMI, or were overweight, mildly obese and moderately obese+ were 18.9, 29.9, 25.1 and 26.1%, respectively. Using people with normal BMI as the reference group, and after adjusting for age, socio-economic status, CKD stage, primary renal diagnoses, comorbidities including cancer, diabetes, peripheral vascular disease (PVD), chronic lung disease, coronary artery disease (CAD), and all other cardiovascular disease (CVD), the hazard ratios (HRs, 95% CI) of males for death without RRT were 0.65 (0.45–0.92, p = 0.016), 0.60 (0.40–0.90, p = 0.013), and 0.77 (0.50–1.19, p = 0.239) for the overweight, mildly obese and moderately obese+. With the same adjustments the hazard ratios for death without RRT in females were 0.96 (0.62–1.50, p = 0.864), 0.94 (0.59–1.49, p = 0.792) and 0.96 (0.60–1.53, p = 0.865) respectively.In males, with normal BMI as the reference group, the adjusted HRs of starting RRT were 1.15 (0.71–1.86, p = 0.579), 0.99 (0.59–1.66, p = 0.970), and 0.95 (0.56–1.61, p = 0.858) for the overweight, mildly obese and moderately obese+ groups, respectively, and in females they were 0.88 (0.44–1.76, p = 0.727), 0.94 (0.47–1.88, p = 0.862) and 0.65 (0.33–1.29, p = 0.219) respectively.ConclusionsMore than 80% of these CKD patients were overweight or obese. Higher BMI seemed to be a significant “protective” factor against death without RRT in males but there was not a significant relationship in females. Higher BMI was not a risk factor for predicting RRT in either male or female patients with CKD.

Stillbirth, Inflammatory Markers, and Obesity: Results from the Stillbirth Collaborative Research Network.

Obesity is associated with increased risk of stillbirth, although the mechanisms are unknown. Obesity is also associated with inflammation. Serum ferritin, C-reactive protein, white blood cell count, and histologic chorioamnionitis are all markers of inflammation. This article determines if inflammatory markers are associated with stillbirth and body mass index (BMI). Additionally, we determined whether inflammatory markers help to explain the known relationship between obesity and stillbirth. White blood cell count was assessed at admission to labor and delivery, maternal serum for assessment of various biomarkers was collected after study enrollment, and histologic chorioamnionitis was based on placental histology. These markers were compared for stillbirths and live births overall and within categories of BMI using analysis of variance on logarithmic-transformed markers and logistic regression for dichotomous variables. The impact of inflammatory markers on the association of BMI categories with stillbirth status was assessed using crude and adjusted odds ratios (COR and AOR, respectively) from logistic regression models. The interaction of inflammatory markers and BMI categories on stillbirth status was also assessed through logistic regression. Additional logistic regression models were used to determine if the association of maternal serum ferritin with stillbirth is different for preterm versus term births. Analyses were weighted for the overall population from which this sample was derived. A total of 497 women with singleton stillbirths and 1,414 women with live births were studied with prepregnancy BMI (kg/m2) categorized as normal (18.5-24.9), overweight (25.0-29.9), or obese (30.0 + ). Overweight (COR, 1.48; 95% confidence interval [CI]: 1.14-1.94) and obese women (COR, 1.60; 95% CI: 1.23-2.08) were more likely than normal weight women to experience stillbirth. Serum ferritin levels were higher (geometric mean: 37.4 ng/mL vs. 23.3, p < 0.0001) and C-reactive protein levels lower (geometric mean: 2.9 mg/dL vs. 3.3, p = 0.0279), among women with stillbirth compared with live birth. Elevated white blood cell count (15.0 uL × 103 or greater) was associated with stillbirth (21.2% SB vs. 10.0% live birth, p < 0.0001). Histologic chorioamnionitis was more common (33.2% vs. 15.7%, p < 0.0001) among women with stillbirth compared with those with live birth. Serum ferritin, C-reactive protein, and chorioamnionitis had little impact on the ORs associating stillbirth with overweight or obesity. Adjustment for elevated white blood cell count did not meaningfully change the OR for stillbirth in overweight versus normal weight women. However, the stillbirth OR for obese versus normal BMI changed by more than 10% when adjusting for histologic chorioamnionitis (AOR, 1.38; 95% CI: 1.02-1.88), indicating confounding. BMI by inflammatory marker interaction terms were not significant. The association of serum ferritin levels with stillbirth was stronger among preterm births (p = 0.0066). Maternal serum ferritin levels, elevated white blood cell count, and histologic chorioamnionitis were positively and C-reactive protein levels negatively associated with stillbirth. Elevated BMIs, both overweight and obese, were associated with stillbirth when compared with women with normal BMI. None of the inflammatory markers fully accounted for the relationship between obesity and stillbirth. The association of maternal serum ferritin with stillbirth was stronger in preterm than term stillbirths.

Association of BMI with total mortality and recurrent stroke among stroke patients: A meta-analysis of cohort studies

Background and aimsStudies of the association between obesity and total mortality and recurrent stroke events have shown contradictory results. Therefore, we aimed to conduct a meta-analysis to examine the association of body mass index (BMI) with total mortality and recurrent stroke events among patients after stroke onset. MethodsWe performed an electronic search of PubMed, EMBASE and the Cochrane Library Database, as well as a bibliography review to identify relevant cohort studies published prior to 15th December 2015. Estimates of relative risks (RRs) and corresponding 95% confidence intervals (CIs) comparing underweight, overweight and obese groups with normal weight were pooled using random effects models. ResultsIn total, 15 studies with 122,472 stroke patients were eligible for inclusion in the meta-analysis. Compared with the normal weight group, obese stroke patients had a significant decreased risk for total mortality (RR = 0.83, 95% CI, 0.73–0.93, p = 0.002), while underweight patients had a significant increased risk for total mortality (RR = 1.54, 95% CI, 1.31–1.82, p = 3.66 × 10−7). A similar, but not significant, association of BMI categories with recurrent stroke events was also observed. Furthermore, the dose-response meta-analysis identified a nonlinear trend for total mortality and a linear trend for recurrent stroke events, associated with BMI. ConclusionsOur results suggested that obesity may have a protective effect on total mortality and recurrent stroke events among patients with established stroke.

The benefits of weight loss, even if regained, in reducing cardiovascular disease: welcoming evidence!

The relation between obesity and risk of cardiovascular disease (CVD) is complex and – despite extensive research – still not fully understood. Whereas research has conclusively demonstrated that several obesity-related factors such as insulin resistance/diabetes, dyslipidaemia and hypertension are strong and independent risk factors for CVD, less is known about whether obesity increases the CVD risk independent of these risk factors. Some (1,2), but not all (3,4), of the recent observational studies have suggested that obesity is only associated with increased atherosclerotic CVD risk through metabolic disturbances, which has casted doubts as to whether being overweight or obese is always bad. A particular challenge when interpreting the results of such studies is that time of follow-up often is limited and that there is no sensitive and specific method for distinguishing between those who will and will not develop metabolic disturbances. Also, it takes time to develop overt CVD, especially in the absence of a larger burden of risk factors. Thus, from a CVD point of view, it is obviously not valid to state that metabolic healthy overweight or obese individuals do not need to lose weight. The opposite postulation, i.e. that weight loss among overweight or obese individuals will translate into a reduction in future CVD events is, however, also not supported by an overwhelming amount of evidence (5,6). In selected cohorts, those who are overweight may even have better prognosis than normal or underweight individuals (7). The amount of studies showing such an obesity paradox is so overwhelming that we sometimes have doubted whether weight loss is beneficial and may, perhaps, even be detrimental for selected people. The recent study by Charakida et al., published in Lancet Diabetes and Endocrinology, contributed important insights on the long-term relation of body mass index (BMI) and CVD risk (8). The authors studied participants of a cohort derived from a nationally representative sample of singleton births occurring in 1946 in England, Scotland and Wales who attended a clinical assessment at age 60–64 year. The participants had previously been examined at ages 2, 4, 6, 7, 11, 36, 43 and 53 years. Authors looked at the cross-sectional association of BMI category (divided into normal weight, overweight and obese) and carotid intima media thickness (cIMT); a measure of subclinical atherosclerosis that relates to the future risk of overt CVD (9). They observed a direct association of higher cIMT with higher BMI groups after adjustment for several confounding variables including systolic blood pressure and lowdensity lipoprotein cholesterol levels. Authors also showed that those who had been overweight or obese at any of the prior examinations, but had moved ‘downward’ to a lower BMI category had cIMT levels nearly comparable with those who had never been overweight or obese. This clinical obesity doi: 10.1111/cob.12073

An Examination of the Relationship Between Dietary Behaviours and Physical Activity and Obesity in Adults with Type 2 Diabetes

ABSTRACT OBJECTIVES: The primary objective of the current study was to explore the relationship between 2 dietary behaviours — (i) fruit and vegetable intake and (ii) dietary fat intake — with body mass index (BMI) and physical activity. A secondary objective was to examine the reliability of these relationships at 6 and 18 months. METHODS: Demographic factors, including height and weight to calculate BMI, were self-reported by a sample of adults with type 2 diabetes (n=1614) recruited through the Canadian Diabetes Association registry and through random-digit dialling. Physical activity levels were assessed using the Godin Leisure Time Exercise Questionnaire, while fruit, vegetable and dietary fat intake were measured using the Summary of Diabetes Self-Care Activities Measure. These variables were assessed at 3 time points: baseline, 6 months and 18 months. Two-way between-group analysis of variance was conducted separately for fruit and vegetable consumption and fat intake in order to examine the association of BMI categories and activity level and their interactions with these dietary behaviours. RESULTS: At baseline, participants reported consuming 5 or more servings of fruits and vegetables 5.2 days per week and high-fat foods 1.6 days per week. The mean BMI was 29.3kg/m 2 , and 65% of participants were inactive (i.e. not meeting physical activity guidelines). There was a statistically significant main effect for both BMI (F=11.58, p CONCLUSION: Obese individuals reported significantly lower fruit consumption and higher fat consumption compared to their overweight and healthy-weight counterparts. Active individuals had a higher fruit and vegetable intake. These results will help guide the development of diabetes education programs that are tailored to better meet the needs of people with type 2 diabetes.

Abstract 2475: Excess Cardiovascular Mortality among Lean Hypertensive Nonsmoking Japanese

BACKGROUND: Although several reports demonstrated that underweight was associated with higher cardiovascular (CVD) mortality, smoking was considered to be a major confounding factor. In Japan, prevalence of underweight is higher. METHODS: We studied 13,089 subjects (mean age 55±13 years, men 18%) who had the annual health examination offered to adult citizens of Moriguchi city, Osaka, Japan in 1997 and were not current smoker at the examination. Underweight was defined as a body mass index (BMI) &lt;18.0 kg/m 2 . Proportional hazards regression analysis was used to assess the association of BMI categories with CVD mortality. RESULTS: During a mean follow-up of 9.4±2.4 years, there were 136 CVD deaths. Of those, 78 CVD deaths, including 32 stroke deaths and 22 coronary deaths occurred in the hypertensives (n=3,925). Incidence of CVD deaths according to BMI categories and hypertension status was presented in the figure. Age and sex-adjusted proportional hazards regression analysis in the hypertensives showed CVD mortality was significantly higher in the underweight group (HR=3.2, 95%CI=1.3 to 7.7; p=0.0105), compared with the normal weight group (BMI 18.0 –24.9 kg/m 2 ). After adjustment for age, sex, diabetes mellitus, hypercholesterolemia, and drinking habit in the hypertensives, the result was unchanged (HR=3.1, 95%CI=1.3 to 7.4; p=0.0130). In the analyses restricted to never smokers (n=3,506) of the hypertensives, the result remained unchanged (HR=2.9, 95%CI=1.1 to 7.8; p=0.0296) after adjustment for all clinical variables. CONCLUSIONS: In the general Japanese hypertensive population, underweight was associated with higher CVD mortality unrelated to smoking.