Between Body Mass Index Groups Research Articles

Prognostic value of body mass index for first-line chemoimmunotherapy combinations in advanced non-small cell lung cancer in Chinese population.

BackgroundFew studies have examined the correlation between body mass index (BMI) and effectiveness of first-line chemoimmunotherapy in patients with advanced non-small cell lung cancer (NSCLC); moreover, the conclusion remains elusive and no such studies have been conducted in the Chinese population. Our study aimed to validate the predictive significance of BMI in Chinese patients with advanced NSCLC receiving first-line chemoimmunotherapy combinations. MethodsData of patients with advanced NSCLC treated with first-line chemoimmunotherapy between June 2018 and February 2022 at three centers were retrieved retrospectively. The association between baseline BMI with progression-free survival (PFS) and overall survival (OS) was evaluated using the Kaplan–Meier method and Cox regression models. BMI was categorized according to the World Health Organization criteria. ResultsOf the included 805 patients, 5.3% were underweight, 63.4% had normal weight, 27.8% were overweight, and 3.5% were obese. Survival analysis showed that patients in the high BMI group had significantly better PFS (p=0.012) and OS (p=0.014) than those in the low BMI group. Further, patients in the overweight subgroup had better PFS (p=0.036) and OS (p=0.043) compared to the normal weight population. The results of Cox regression analysis confirmed the correlations between BMI and prognosis of advanced NSCLC patients receiving first-line chemoimmunotherapy combinations. ConclusionsBaseline BMI affected the clinical outcomes of first-line chemoimmunotherapy combinations in patients with advanced NSCLC, and was especially favorable for the overweight subgroup.

#1498 Higher body mass index in patients with diabetes mellitus and hemodialysis associated with a better survival in contrast to peritoneal dialysis

Abstract Background and Aims The association between Body Mass Index (BMI) and the risk of mortality in patients with end stage renal diseases and dialysis treatment is debated. The aim of this study was to assess the association between BMI and the risk of all-cause mortality in patients with diabetes mellitus (DM) on maintenance hemo- (HD) versus peritoneal dialysis (PD). Method We used the data from Swedish Renal Registry (SRR) which included 3235 patients with diabetes mellitus on dialysis treatment (2452 on HD and 783 on PD). The follow-up period was 3.9 ± 3.5 years and patients who switched from PD to HD, or vice versa, during the study period were excluded. The patients were divided in six groups by mean value of BMI according to classification of BMI by WHO. The relationships between mean value of BMI and mortality were examined by time-dependent Cox models to estimate hazard ratios (HR) and 95% confidence intervals (CI) in univariate and multivariate analyses, with adjustment for demographics, laboratory findings and comorbidities. The group with BMI 18.5<BMI≤25.0 kg/m2 was used as a reference group. Results During the follow-up period 1688 (53%) deaths occurred (1275 on HD, 413 on PD). The mean value of BMI was 27 ± 6 kg/m2 in HD and 26 ± 5 kg/m2 in PD. In the multivariate analyses, patients on HD with a low BMI≤18.5 kg/m2 had a higher risk for all-cause mortality (HR1.94, CI 1.47-2.54; p < 0.01) compared to the reference group. However, HD-patients with a higher BMI 25.1-30.0 kg/m2 (HR 0.84, CI 0.73-0.96; p < 0.01), 30.1-35 kg/m2 (HR 0.66, CI 0.55-0.78; p < 0.01), and 35.1-40.0 kg/m2 (HR 0.65, CI 0.49-0.85; p < 0.01) had a significantly decreased risk of all-cause mortality compared to the reference group. In multivariate analyses, patients on PD, BMI groups of 25.1-30 kg/m2 (HR 0.86, CI 0.67-1.09), 30.1-35 kg/m2 (HR0.94, CI 0.67-1.31), and 35.1-40 kg/m2 (HR 0.93, CI 0.48-1.77) were not-significantly associated with a risk of mortality. Conclusion In patients with diabetes mellitus on maintenance hemodialysis underweight (BMI≤18.5 kg/m2) was associated with an increased risk of all-cause mortality; however overweight (BMI 25.1-30.0 kg/m2), class 1 obesity (BMI 30.1-35.0 kg/m2) and class 2 obesity (BMI 35.1-40.0 kg/m2) were associated with better survival. In contrast, in patients with diabetes mellitus on maintenance peritoneal dialysis no association between BMI and risk of all-cause mortality was found.

Abstract PO4-05-11: Effects of body mass index on the treatment outcome of patients with metastatic breast cancer in the real world

Abstract Purpose: Metastatic/recurrent breast cancer has a relatively long survival compared to other cancers and depending on the biologic subtype, the treatment outcome is different. In general, obesity or overweight is associated with poor prognosis of breast cancer, but the relationship between body mass index (BMI) and prognosis in metastatic cases is not clear. The aim of this study is investigating the effect of BMI on survival outcome through long-term follow-up in single institution, retrospectively. Method: This study included the patients with metastatic/recurrent breast cancer who has been diagnosed from January 2000 to December 2022 in an institution. BMI was calculated based on weight at diagnosis of metastatic disease, divided into 4 groups according to Asian-Pacific classification, and clinical characteristics including biologic subtype and overall survival (OS) were retrospectively reviewed. The statistical analysis was performed using Kaplan-Meier survival analysis and Cox proportional hazard model. Result: A total of 679 patients were enrolled. Median age was 51 years-old (25~89), 672 patients (99.0%) were female and 425 patients (62.6%) showed pre-menopausal status. The frequencies of HR+, HER2, and TNBC subtype were 335 (50.7%), 191 (28.9%), and 135 (20.4%), respectively and the BMI classification was 33 (5.5%), 251 (41.6%), 124 (20.5%), 196 (32.4%) for underweight, normal, overweight, and obesity, respectively. During a median follow-up of 33.8 months, the median OS in each of the HR+, HER2+, and TNBC subgroups was 54.9 (95% CI 38.7-71.1), 62.8 (95% CI 47.8-77.8), and 20.8 months (95% CI 12.0-29.7). In univariate analysis, there was no statistically significant difference in OS according to BMI in whole patients, however, in the HER2-positive group, the underweight BMI group showed poor OS (p=0.045). In multivariate analysis, the factors affecting OS were age (HR 0.59, 95% CI 0.41-0.87, p=0.008), poor ECOG PS (HR 8.35, 95% CI 2.54-27.49, p< 0.001), TNBC subtype (HR 2.14, 95% CI 1.56-2.94, p< 0.001), visceral metastasis (HR 2.13, 95% CI 1.63-2.79, p< 0.001), 5% or more weight loss during treatment (HR 1.46, 95% CI 1.09-1.97, p=0.012) and obesity BMI group (HR 0.69, 95% CI 0.51-0.94, p=0.019). Conclusion: In the case of patients with metastatic/recurrent breast cancer, there is concern about an increase in body weight, a known risk factor for breast cancer, while receiving palliative aim treatment. For the past 20 years, the mainstay of treatment for metastatic/recurrent breast cancer has been cytotoxic chemotherapy or anti-HER2 agents, and in this case, the higher BMI group patients showed better treatment outcomes compared with normal BMI patients. Citation Format: Kyoung Eun Lee, Ahrong Ham, Sewon Lee, Jungmin Jo, Soo Ji Hong, Ji Eun Lee, Haena Lee, Sungchan Gwark, Jeongshin An, Hyun-Goo Kim, Jun Woo Lee, Joohyun Woo, Woosung Lim, Byung-In Moon, Sei Hyun Ahn, Hye Ah Lee. Effects of body mass index on the treatment outcome of patients with metastatic breast cancer in the real world [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-05-11.

Association between dietary supplement use and mortality in cancer survivors with different body mass index and frailty status: a cohort study.

The association between Body Mass Index (BMI), frailty index (FI), and dietary supplement in cancer survivors has been a subject of growing interest. This study investigates the relationship of BMI and FI with mortality in American cancer survivors and explores the impact of dietary supplement usage on different BMI and FI groups. Three thousand nine hundred and thirty-two cancer patients from the National Health and Nutrition Examination Survey (NHANES) database were included in the analyses. BMI, FI, and supplement usage were obtained through the NHANES structured survey and the 49-item FI tool. Weighted logistic and Cox proportional hazards models, Kaplan-Meier survival analyses, and propensity score matching (PSM) were used to elucidate the relationships between BMI, FI, dietary supplement, and mortality outcomes. The study found significant associations between higher BMI and increased frailty (Odds ratio [OR] = 1.04, 95% confidence interval [95% CI], 1.02-1.06). BMI < 25 kg/m2 and FI > 0.2 are associated with an increased mortality rate. Dietary supplement use can reduce all-cause and cancer mortality in cancer patients with BMI < 25 kg/m2 (Hazard ratio [HR] = 0.63, 95% CI, 0.47-0.84; HR = 0.48, 95% CI, 0.29-0.80) or FI ≤ 0.2 (HR = 0.77, 95% CI, 0.60-0.99; HR = 0.59, 95% CI, 0.39-0.89). In cancer patients with BMI < 25 kg/m2 and FI ≤ 0.2, dietary supplement users had lower all-cause and cancer mortality (HR = 0.49, 95% CI, 0.30-0.79; HR = 0.25, 95% CI, 0.10-0.60). The study revealed a negative correlation between BMI and the FI among the cancer patient cohort as well as their complex impact on mortality and highlighted the role of dietary supplement in cancer prognosis, indicating benefits for non-frail patients with BMI < 25 kg/m2.

Body mass index and meniscal tears: Evidence from meta-analysis of observational studies and Mendelian randomization.

Obesity is a potential risk factor for meniscal tear (MT). We utilized meta-analysis of observational studies and Mendelian randomization (MR) analyses to elucidate the association between body mass index (BMI) and MT. In meta-analysis, a search was performed on June 27, 2022, using PubMed and Embase databases. Odds ratios and 95% confidence intervals were extracted from included studies. In MR analyses, the research utilized summary-level data on BMI and MT obtained from Genetic Investigation of Anthropometric Traits and the FinnGen Consortium, respectively. In meta-analysis, four studies comprising 826,383 participants were included. The pooled odds ratio of MT in the high BMI group was 1.32 (95% confidence interval, 0.83-2.09), compared with the nonhigh BMI group. The pooled odds ratio in the under 30 group was 1.76 (95% confidence interval, 0.61-5.03). In MR analyses, one standard deviation increase in genetically predicted BMI was associated with meniscus derangement as a chronic subtype of MT (odds ratio, 1.36; 95% confidential interval, 1.17-1.59). We found that a high BMI was not associated with an increased likelihood of MT based on meta-analysis of observational studies; however, by complementing MR analyses, we elucidated the causality of BMI increase on meniscus derangement as a chronic subtype of MT.

The association between body mass index and osteoporosis in a Taiwanese population: a cross-sectional and longitudinal study

This study investigates the correlation between body mass index (BMI) and osteoporosis utilizing data from the Taiwan Biobank. Initially, a comprehensive analysis of 119,009 participants enrolled from 2008 to 2019 was conducted to assess the association between BMI and osteoporosis prevalence. Subsequently, a longitudinal cohort of 24,507 participants, initially free from osteoporosis, underwent regular follow-ups every 2–4 years to analyze the risk of osteoporosis development, which was a subset of the main cohort. Participants were categorized into four BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese groups (BMI ≥ 27 kg/m2). A T-score ≤ − 2.5 standard deviations below that of a young adult was defined as osteoporosis. Overall, 556 (14.1%), 5332 (9.1%), 2600 (8.1%) and 1620 (6.7%) of the participants in the underweight, normal weight, overweight and obese groups, respectively, had osteoporosis. A higher prevalence of osteoporosis was noted in the underweight group compared with the normal weight group (odds ratio [OR], 2.20; 95% confidence interval [95% CI], 1.99 to 2.43; p value < 0.001) in multivariable binary logistic regression analysis. Furthermore, in the longitudinal cohort during a mean follow-up of 47 months, incident osteoporosis was found in 61 (9%), 881 (7.2%), 401 (5.8%) and 213 (4.6%) participants in the underweight, normal weight, overweight and obese groups, respectively. Multivariable Cox proportional hazards analysis revealed that the risk of incident osteoporosis was higher in the underweight group than in the normal weight group (hazard ratio [HR], 1.63; 95% CI 1.26 to 2.12; p value < 0.001). Our results suggest that BMI is associated with both the prevalence and the incidence of osteoporosis. In addition, underweight is an independent risk factor for developing osteoporosis. These findings highlight the importance of maintaining normal weight for optimal bone health.

Evaluating the potential mediating role of ADAMTS13 activity in the relationship between obesity and the severity of COVID-19: A retrospective cohort study.

Obesity and low enzyme A disintegrin and metalloproteinase with thrombospondin type-1 motif-13 (ADAMTS13) activity have been linked to poor coronavirus disease 2019 (COVID-19). Given that obesity may influence ADAMTS13 activity, it is feasible; however, it remains unclear whether ADAMTS13 activity acts as a mediator between obesity and COVID-19 outcomes. We investigated the link between body mass index (BMI) and COVID-19 outcomes, using ADAMTS13 activity as a mediator. ADAMTS13 activity was measured in 86 hospitalized COVID-19 patients. BMI, ADAMTS13 activity, and COVID-19 outcomes were assessed. Obese patients had a high odds ratio for low ADAMTS13 levels. When different levels of ADAMTS13 activity were considered, the severity of COVID-19 in obese patients was 4.5 times that in the normal BMI group. Furthermore, increased coagulopathy indicators correlated with low ADAMTS13 activity. Patients with elevated ALT and AST levels showed a 3 to 4-fold increase in the chances of low ADAMTS13 activity (OR:3.19, 95% CI:1.22-8.90, P = .021; OR:2.17, 95% CI:0.91-5.27, P = .082, respectively). When ADAMTS13 activity was considered, obese patients had greater COVID-19 severity and slower viral clearance than those with normal BMI. Low ADAMTS13 activity and impaired liver function are associated with poor COVID-19 outcomes. These findings encourage researchers to use molecular component identification to study the effects of obesity on the von Willebrand factor (VWF)/ADAMTS13 axis, COVID-19 pathogenesis, and outcomes.

Body Mass Index Between 15 and 30 Does Not Influence Patient-Reported Outcomes After Anterior Cruciate Ligament Surgery Using a 10-mm-Diameter Bone-Tendon-Bone Graft

PurposeThe purpose of this study was to investigate the relationship between body mass index (BMI) and outcomes after anterior cruciate ligament reconstruction (ACLR) using 10mm diameter bone- patellar tendon- bone (BTB) grafts. MethodsThe retrospective study used the Surgical Outcome System to measure patient-reported outcomes before and after ACL (anterior cruciate ligament) reconstruction between 2015 and 2019. Inclusion criteria involved patients undergoing primary ACLR by the senior surgeon, with recorded ages >15 years and BMI 15.0>30. Exclusion criteria involved revisions, concomitant procedures, age <15 years, or unknown BMI. Patients were divided into cohorts to evaluate MARS, Tegner, IKDC, and Lysholm scores at various timepoints from injury to 2-years post operatively. results137 patients (100 male, 37 female) with an average age of 33 [30.6, 35.4] years and average BMI of 23.58 [23.1, 24.0] were divided into Group A (n= 69; BMI: 15>23.4) and Group B (n=68; BMI: 23.5>30). A significant difference was demonstrated in MARS scores between BMI groups at pre-treatment with means of 11.55 (group A) and 9.41 (Group B) (p= 0.011), and at 2-years, Tegner scores indicated significance with scores of 6.45 and 5.41 for groups A and B respectively (p=0.009). Daily function scores were all insignificant. Females exhibited no significant differences across any PROMS or timepoints. Contrarily, males expressed a significant difference in pre-treatment MARS scores (Group A: 14.30; Group B: 9.96; p=0.011). Additionally, scores at 2-years depicted Tegner values of 7.40 (Group A) and 5.30 (Group B) and IKDC values of 96.92 (Group A) and 90.47 (Group B) (Tegner p=0.012; IKDC p=0.048). All results for females and males under 30 years old indicated no significance. ConclusionRegardless of patient age or sex, BMI is not significantly associated with patient reported outcomes after ACL reconstruction utilizing 10mm diameter BTB grafts. Level IIIRetrospective Cohort Study

P399 Impact of Body Mass Index on Clinical Outcomes in Intestinal Behçet’s disease

Abstract Background The impact of underweight and obesity on clinical outcomes for intestinal Behçet’s disease (BD) is unknown. We aimed to identify the association between body mass index (BMI) and clinical outcomes in patients with intestinal BD. Methods We categorized 760 patients with intestinal BD according to the BMI at diagnosis into four groups (underweight, normal, overweight, obese) at Severance Hospital, Seoul, Korea between 1997 and 2021.We performed a Cox proportional hazard analysis to investigate the predictive capability of BMI for clinical outcomes such as biologics use, surgery, hospitalization and emergency room visit. Results Of the 760 patients, 130 patients were classified into underweight group (BMI&amp;lt;18.5), 384 patients into normal group (BMI 18.5~22.9), 152 patients into overweight group (BMI 23~24.9), and 94 patients into obese group (BMI≥25). Patients with a higher BMI group showed significantly lower cumulative rates of biologics use (p trend = 0.001), surgery (p trend = 0.008), hospitalization (p trend = 0.002), and emergency room visits (p trend = 0.003) than those with a lower BMI group. In a multivariate analysis, normal BMI group (HR: 0.667, 95% CI 0.483-0.992, p =0.014), overweight group (HR: 0.589, 95% CI 0.394-0.879,p=0.010), and obese group (HR: 0.515, 95% CI 0.321-0.828, p=0.006) were negatively associated with future hospitalization compared to underweight group. Overweight group (HR: 0.490, 95% CI 0.241-0.996, p =0.049) and obese group (HR: 0.312, 95% CI 0.116-0.840,p =0.021) were negatively associated with future biologics use compared to the underweight group. Normal BMI group (HR: 0.706, 95% CI 0.484- 1.029, p=0.070) and obese group (HR : 0.556, 95% CI 0.303-1.020,p=0.058) were negatively associated with future surgery compared to the underweight group. Normal BMI group (HR: 0.711, 95% CI 0.513-0.985, p=0.041) and obese group (HR: 0.602, 95% CI 0.376-0.963, p=0.034) were negatively associated with future emergency room visit compared to the underweight group. Conclusion Underweight could affect poor outcomes in intestinal Behçet’s disease. Physicians should pay attention to the patients with underweight and make an effort to improve nutritional status.

P390 Adiposity is negatively associated with a stenosing Crohn’s disease behaviour: a UK wide study in 8797 patients within the IBD Bioresource

Abstract Background Obesity has been implicated in the pathogenesis of fibrosis. With the rising incidence of Crohn`s Disease (CD) alongside an obesity pandemic, we hypothesise that adiposity may be associated with stenosing CD. Methods Using NIHR IBD Bioresource data, we retrospectively assessed the relationship between body mass index (BMI) and stenosing CD by logistic regression. BMI was the primary variable of interest; CD behaviour the dependent variable; stenosing CD the primary outcome. Confounders were adjusted for in a multivariate model. Statistical analyses were performed using SPSS 28.0.1.1. Results 8,797 patients diagnosed between 1942 and 2020 were included. Mean overall BMI was 26.3kg/m2 (SD = 5.5). 52.7% had a BMI &amp;gt;25kg/m2 (mean 30.2kg/m2, SD 4.5). Majority had inflammatory CD (62.9%) followed by stenosing (25.1%) and penetrating CD (12%). Stenosing and penetrating CD were more common in the &amp;lt;25kg/m2 BMI group (50.7%, 50.3% respectively) p&amp;lt;0.001. On univariate analysis, stenosing disease was positively associated with ileal disease location, disease duration, a surgical history, use of advanced therapies (infliximab, ustekinumab, vedolizumab, adalimumab) and azathioprine but negatively associated with BMI even after adjusting for confounders (OR 0.98, 95% CI [0.967-0.988]). On multivariate analyses, disease duration (OR 1.135, 95% CI [1.135-1.105-1.170]), ileal disease location (OR 3.69, 95% CI [3.22-4.24]), adalimumab (OR 1.47, 95% CI [1.30-1.66]) and ustekinumab (OR 1.512, 95% CI [1.14-2.01]) and azathioprine (OR 1.34, CI [1.189-1.529]) usage remained positively associated with stenosing CD (Table 1). Conclusion We observed a negative relationship between BMI and stenosing disease. This might reflect a change in eating behaviour due to persistent abdominal pain related to stenosing disease. Large longitudinal studies are needed to investigate this relationship further.

Relationship Between Obesity and Global Longitudinal Strain in the Pediatric Single Ventricle Fontan Population Across Ventricular Morphologies.

Obesity is associated with diminished myocardial function as measured by strain echocardiography in children and young adults with normal cardiac anatomy. Data are lacking about the effect of obesity on myocardial strain in patients with a single ventricle. In this study, the relationship between body mass index (BMI) and single ventricle myocardial strain in the Fontan population was assessed. Thirty-eight abnormal BMI Fontan cases (21 overweight and 17 obese) and 30 normal BMI Fontan controls matched based on single ventricular morphology, age, and sex were included in the study. Ventricular morphology was categorized as single right ventricle, single left ventricle, or biventricular. Single ventricle global longitudinal peak systolic strain (GLS) and other echocardiographic measurements were performed and compared between groups, with a P≤0.05 defined as significant. The abnormal BMI group demonstrated diminished GLS (-15.7±3.6% versus -17.2±3.2%, [P=0.03]) and elevated systolic blood pressure (P=0.04) compared with the normal BMI group. On subgroup analysis of those with single right ventricle morphology, the abnormal BMI group demonstrated diminished GLS compared with controls. There was no significant difference in GLS between the abnormal BMI and control groups in the single left ventricle and biventricular subgroups. Analyzed by ventricular morphology, no other variables were statistically different in the abnormal BMI group including systolic blood pressure. Inter-reader reproducibility for GLS and strain rate were excellent for both measures. Obesity has an adverse relationship with myocardial strain in the young Fontan population, with the most maladaptive response seen in the single right ventricle.

Correlation Between Body Mass Index and Compliance With Iron Tablet Consumption with The Incidence of Anemia in Adolescent Girls

Background: The substance-based on research data from Health Basic (Riskesdas) 2018, the prevalence of anemia in teenage women in Indonesia by 32%. This means 3-4 out of 10 teenagers Princess suffering from anemia. The factor that exacerbates anemia in teenage princesses is the lack of intake of the substance iron, where the substance iron in teenage princesses is really needed by the body for accelerated growth and development. Besides that, teenage princesses experience menstruation every month, so they need it. Meanwhile, the amount of food consumed is not fulfilled, because the factor wants to slim. The aims study was to determine the relationship between body mass index (BMI) and the behavior of consuming iron supplement tablets with the incidence of anemia in adolescent girls at the Private Vocational High School Keluarga Bunda Jambi.&#x0D; Method: The method is an analytic study with a cross-sectional approach. The research sample was all students in grades X and XI at the Private Vocational High School Keluarga Bunda Jambi, totaling 52 people, (total sampling). Data collection was carried out in May 2021 using a questionnaire and the hemoglobin value was obtained through examination of the hematology analyzer at the Medical Laboratory Technology of Health Polytechnic of Jambi, data analysis using Chi-square.&#x0D; Result: The results of the study showed that the incidence of anemia in young women was 25%. Based on BMI, the most common anemia occurred in the normal BMI group (46.1%), followed by a thin BMI of 30.7%. The highest incidence of anemia (92.3%) was in the group of adolescent girls who did not take iron tablets regularly&#x0D; Conclusion: There is a relationship between adherence to taking Iron Blood tablets and the incidence of anemia with a P-value of 0.000, but there is no significant relationship to BMI.

Association between BMI trajectories in late-middle age and subsequent dementia risk in older age: a 26-year population-based cohort study

BackgroundThe association between body mass index (BMI) and dementia risk differs depending on follow-up time and age at BMI measurement. The relationship between BMI trajectories in late-middle age (50–65 years old) and the risk of dementia in older age (> 65 years old) has not been revealed.MethodsIn the present study, participants from the Health and Retirement Study were included. BMI trajectories were constructed by combining BMI trend and variation information. The association between BMI trajectories at the age of 50–65 years and dementia risk after the age of 65 years was investigated. Participants with European ancestry and information on polygenic scores for cognitive performance were pooled to examine whether genetic predisposition could modify the association.ResultsA total of 10,847 participants were included in the main analyses. A declining BMI trend and high variation in late-middle age were associated with the highest subsequent dementia risk in older age compared with an ascending BMI trend and low variation (RR = 1.76, 95% CI = 1.45–2.13). Specifically, in stratified analyses on BMI trajectories and dementia risk based on each individual's mean BMI, the strongest association between a declining BMI trend with high variation and elevated dementia risk was observed in normal BMI group (RR = 2.66, 95% CI = 1.72–4.1). Similar associations were found when participants were stratified by their genetic performance for cognition function without interaction.ConclusionsA declining BMI trend and high variation in late-middle age were associated with a higher risk of dementia. Early monitoring of these individuals is needed to prevent dementia in older individuals.

Examining the Relationship Between BMI, Sex, and Fundamental Movement Skill Performance in Low-Income Rural Children

This study examined the relationship between body mass index (BMI), Sex, and Fundamental Movement Skills (FMS) performance among low-income rural children aged 5 to 7 years. 39 children (20 boys and 19 girls) participated in the study. FMS proficiency was evaluated using the Furtado-Gallagher Child Observational Movement Pattern Assessment System (FG-COMPASS). The children’s height and weight were measured to calculate BMI, which was then classified into ‘normal weight’ and 'overweight'. A two-way factorial ANOVA assessed the effects of sex and BMI group on manipulative fundamental motor skills (MFMS), locomotor fundamental motor skills (LFMS), and total fundamental motor skills (TFMS). We hypothesized that normal weight children would outperform their overweight counterparts in locomotor (LFMS), manipulative (MFMS), and total (TFMS) fundamental motor skills and that boys would outperform girls on MFMS and TFMS but not on LFMS. Our findings showed a significant main effect of sex on MFMS, with boys performing significantly better than girls. However, no significant main effects were found for LFMS or TFMS based on sex or BMI group. Furthermore, Pearson correlation analysis revealed weak, negative, non-significant correlations between BMI percentiles and all three motor skill scores. The study’s results highlight the importance of considering sex differences when assessing FMS in children and indicate that overweight status may not necessarily relate to poorer motor skill performance in a rural, low-income context. Further research should ensure a balanced representation across BMI categories and explore the potential influence of demographic factors on motor skill development.

Association between body mass index and clinical outcomes in patients with out-of-hospital cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation: A multicenter observational study

BackgroundWe examined the association between body mass index (BMI) and outcomes in patients with out-of-hospital cardiac arrest (OHCA) undergoing extracorporeal cardiopulmonary resuscitation (ECPR). MethodsWe retrospectively analyzed the database of an observational multicenter cohort in Japan. Adult patients with OHCA of cardiac etiology who received ECPR between 2013 and 2018 were categorized as follows: underweight, BMI < 18.5; normal weight, BMI = 18.5–24.9; overweight, BMI = 25–29.9; and obese, BMI ≥ 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were unfavorable neurological outcomes at discharge (cerebral performance category ≥ 3) and ECPR-related complications. BMI’s association with outcomes was assessed using a logistic regression model adjusted for age, sex, comorbidities, witness/bystander CPR, initial rhythm, prehospital return of spontaneous circulation, and low-flow time. ResultsIn total, 1,044 patients were analyzed. Their median age was 61 (IQR, 49–69) years; the median BMI was 24.2 (21.5–26.9) kg/m2. The overall rates of in-hospital mortality, unfavorable neurological outcome, and ECPR-related complications were 62.2%, 79.9%, and 31.7%, respectively. In multivariate analysis, the overweight and obese groups had higher in-hospital mortality odds than the normal BMI group (odds ratio [95%CI], 1.37 [1.02–1.85], p = 0.035; and 2.09 [1.31–3.39], p < 0.001, respectively). The odds ratio for unfavorable neurological outcomes increased more in the obese than in the normal BMI group (3.17 [1.69–6.49], p < 0.001). ECPR-related complications were not significantly different among groups. ConclusionsIn OHCA patients undergoing ECPR, a BMI ≥ 25 kg/m2 was associated with increased in-hospital mortality, and a BMI ≥ 30 kg/m2 was also associated with a worse neurological outcome.

The role of obesity on autologous bone marrow transplant and post-transplant outcomes

Background/Aim: Autologous hematopoietic cell transplantation (AutoHCT), administered at high doses, has improved survival rates among patients with refractory or recurrent lymphoma and multiple myeloma (MM). However, inconsistencies in defining obesity, varying body weight ranges, and heterogeneous patient populations have been examined. Some researchers have hypothesized that significantly overweight patients face a higher risk of transplant-related complications. This study investigates the association between body mass index (BMI), obesity, and autologous peripheral stem cell mobilization. Methods: A retrospective evaluation of data from 180 patients who underwent peripheral stem cell mobilization at our clinic between 2014 and 2020 was conducted. Excluding patients under 18 years of age, the primary objective was to assess how BMI influences autologous transplant outcomes and mortality. This retrospective cohort study aimed to determine whether obesity constitutes an independent risk factor for autologous bone marrow transplantation. Results: Among the patients, the most prevalent diagnosis (47.2%) was MM, with notable differences in incidence rates across BMI categories (P=0.039). Obesity and overweight were associated with a higher incidence of MM (47.2%), whereas normal and underweight individuals had predominantly been diagnosed with DLBCL (44.2%). Significant differences in CD34 cell counts were observed among BMI groups (P=0.033). Overweight and obese individuals exhibited lower CD34 cell counts than underweight/normal groups (P=0.033). The treatment group showed significantly higher CD34 cell counts than the G-CSF alone group (P=0.046). Female gender (P=0.022), PLT engraftment (P=0.024), post-chemo-mobilization hospital-stay duration (P=0.019), and G-CSF count were identified as mortality risk factors (P=0.017). Conclusions: This investigation found no adverse correlation between mortality and weight among patients with various hematological malignancies undergoing AutoHCT. Obesity alone should not be a contraindication for proceeding with AutoHCT in clinically warranted hematological malignancy treatment, as no significant survival differences were observed among overweight, obese, and normal-weight individuals.

The impact of sex, body mass index and chronic kidney disease on outcomes following percutaneous coronary intervention

ObjectiveThis study sought to evaluate 1) the relationship between body mass index (BMI), chronic kidney disease (CKD) and bleeding complications in patients undergoing percutaneous coronary intervention (PCI); and 2) whether CKD modified the effect of BMI on major bleeding and major adverse cardiac and cerebrovascular events (MACCE). BackgroundThe interaction of CKD, sex and BMI in patients undergoing PCI is unclear. MethodsBetween 2010 and 2018, a total of 31,116 patients underwent PCI at six New York metropolitan area hospitals. Bleeding complications were classified by the Bleeding Academic Research Consortium (BARC). Major bleeding was defined as BARC≥3. MACCE was the composite of in-hospital death; myocardial infarction; cerebrovascular events and major bleeding complications. Interaction on multiplicative scales was assessed adjusting for other factors. A three-way multiplicative interaction between BMI, CKD and sex were considered and evaluated for both endpoints of primary interest (BARC≥3 and MACCE). ResultsPatients with BARC≥3 bleeding were older (p < 0.0001) and more likely female (p < 0.0001). A 3-way interaction existed between sex, BMI, and CKD on BARC≥3 (p = 0.02). Specifically, the effect of CKD status on odds of BARC≥3 depended on BMI group among males, whereas BMI did modify the relationship between CKD and BARC≥3 among females; after stratification by sex, a significant interaction between BMI and CKD was present in females (p = 0.03) but not in males (p = 0.43). Among females without CKD, normal BMI patients had the greatest odds of BARC≥3 compared to obese or overweight females. Contrasted to females without CKD, among females with CKD there was no significant increased odds of BARC≥3 in normal BMI patients compared to obese or overweight females. However, overweight females with CKD had a significantly increased odds of BARC≥3 compared to obese females with CKD. Furthermore, obese females with CKD had significantly greater BARC≥3 odds compared to obese females without CKD. Similarly, overweight females with CKD had an increased odds of BARC≥3 compared to overweight females without CKD. No significant interactions were found for the odds of MACCE. ConclusionIn patients undergoing PCI, there was evidence of a significant and complex 3-way interaction between BMI, CKD and sex for major bleeding events. The predicted probability of major bleeding was greater for females than for male patients, and for both sexes, greater among those with CKD, but BMI group influences these probabilities. Obese females with kidney disease had the lowest incidence of bleeding complications when compared with overweight or normal weight female patients undergoing PCI. This interaction was not seen in the male group or for MACCE. Furthermore, age, cardiogenic shock, STEMI and use of IABP/Impella were each independently associated with odds of major bleeding (among both males and females) and MACCE.

Functional Recovery after Hip Fracture as a Function of Body Mass Index

Aims To evaluate the association between body mass index (BMI) and functional recovery among hip fracture patients discharged from rehabilitation. Methods We retrospectively analyzed data from patients in a orthogeriatric unit who were classified into four groups: underweight (BMI <18.5 kg/m2), normal weight (18.5 to <25), overweight (25 to 30), and obese (≥30). Functional recovery was assessed using the Agence Technique de l’Information et de l’Hospitalization (ATIH) motor autonomy instrument and the Groupe Iso Ressource (GIR) scale. Results Among 295 hip fracture patients, upon discharge, the ATIH and GIR scores improved. According to the ATIH score, 36% of the patients were very dependent on discharge (vs. 68% on admission). According to the GIR score, the corresponding values were 28% and 53%. There were no significant differences in functional recovery between BMI groups. Conclusions In hip fracture patients, functional scores improved during hospitalization but were not influenced by the BMI.

#3841 ASSOCIATION BETWEEN BODY MASS INDEX, WAIST CIRCUMFERENCE AND CLINICAL OUTCOMES IN KOREAN ADVANCED CHRONIC KIDNEY DISEASE PATIENTS

Abstract Background and Aims This study analysed the association between body mass index (BMI) and waist circumference (WC) with all-cause death, 3-point major cardiovascular event (MACE), end-stage kidney disease (ESKD) and total composite events in nation-wide cohort of Korean advanced chronic kidney disease (CKD) patients. Method This nationwide cohort study, using the National Health Insurance Database, included adult health examinees who received two or more check-ups from 2009 to 2012. Among them, CKD patients (N = 325,657, stage G3a, G3b and 4) were identified. Patients were classified into three groups for BMI (&amp;lt;18.5, 18.5-25 [reference] and ≥25) and four groups for WC (female; &amp;lt;75 cm or male; &amp;lt;85 cm [WC1], female; 75 cm≤WC&amp;lt;85 cm or male; 85 cm≤WC&amp;lt;95 cm [reference], female; 85 cm≤WC&amp;lt;95 cm, male; 95 cm≤WC&amp;lt;105 cm [WC2] and female; ≥95 cm, male; ≥105 cm [WC3]). Risks were evaluated using Cox proportional hazard analysis. Results Patients (58.6±7.7 years) had mean eGFR of 54.32±5.83ml/min/1.73 m2. The underweight (BMI&amp;lt;18.5) group had increased risks of death [HR 1.757, 95% CI (1.573-1.964)] and total events [HR 1.244, (1.144-1.353)]. Overweight (BMI≥25) group showed lower risks of death [HR 0.888, (0.86-0.917)], ESKD [HR 0.855, (0.788-0.927)] and total events [HR 0.975, (0.956-0.995)]. However, the risk was increased for 3-point MACE [HR 1.056, (1.031-1.081)]. For the association between WC and clinical outcomes, the low WC group (WC1) had increased risk of death [HR 1.129, (1.089-1.17)] and reduced risk for 3-point MACE [HR 0.92, (0.894-0.947)]. In higher WC groups, increased risks were observed for death [WC2: HR 1.052, (1.008-1.098), WC3: HR 1.32, (1.213-1.437)], 3-point MACE [WC2: HR 1.071, (1.038-1.104), WC3: HR 1.104, (1.036-1.176)] and total events [WC2: HR 1.049, (1.022-1.077), WC3: HR 1.12, (1.062-1.181)]. Conclusion In CKD patients, both lower BMI and WC were risk factors for mortality and ESKD. However, compared to the reference group, higher BMI group exhibited better outcomes while higher WC groups exhibited poorer outcomes. As increased WC is more specifically related to central obesity, we need different approaches to interpreting clinical risks associated with different BMI and WC criteria.

Impact of body mass index on disease progression and outcomes in patients with nonalcoholic fatty liver disease.

The relationship between body mass index (BMI) and outcomes in patients with nonalcoholic fatty liver disease (NAFLD) is not well defined. This study aimed to assess the presentations, outcomes, and development of liver-related events (LREs) and non-LREs in patients with NAFLD stratified by BMI. Records of NAFLD patients from 2000-2022 were reviewed. Patients were categorized as lean (18.5-22.9kg/m2), overweight (23-24.9kg/m2), and obese (>25kg/m2) based on BMI. Stage of steatosis, fibrosis, and NAFLD activity score were noted in the patients undergoing liver biopsy in each group. Out of 1051 NAFLD patients, 127 (12.1%) had normal BMI, 177 (16.8%) and 747 (71.1%) were overweight and obese, respectively. Median [interquartile range] BMI was 21.9 [20.6-22.5], 24.2 [23.7-24.6], and 28.3 [26.6-30.6] kg/m2 in each group, respectively. Prevalence of metabolic syndrome and dyslipidemia were significantly higher in the obese. Obese patients had significantly higher median [interquartile range] liver stiffness (6.4 [4.9-9.4] kPa) than overweight and lean subjects. A higher proportion of obese patients had significant and advanced liver fibrosis. At follow-up, there were no significant differences in the progression of liver disease, new LREs, coronary artery disease, or hypertension across the BMI groups. Overweight and obese patients were more likely to develop new-onset diabetes by follow-up. The mortality rates in the three groups were comparable (0.47, 0.68, and 0.49 per 100 person-years, respectively), with similar causes of death (liver-related vs non-liver-related). Patients with lean NAFLD have similar disease severity and rates of progression as the obese. BMI is not a reliable determinant of outcomes in NAFLD patients.