Between Body Mass Index Range Research Articles

The Relationship between Body Mass Index (BMI) and Gleason Score of Indonesian Prostate Cancer Men in Hasan Sadikin General Hospital

The risk of high grade PCa in Asia in relation to BMI had positive or negative effect. The objective of this study is to know the relationship between BMI and Gleason score in Indonesian PCa patients. A cross sectional study was conducted in Hasan Sadikin General Hospital. The data were secondary data taken from medical records of prostate adenocarcinoma patients in Hasan Sadikin General Hospital. Ordinal data were analyzed using Chi square and correlation using Spearman. All calculation was done using SPSS 24. There were 95 Indonesian PCa patients. 78 patients is in normal BMI range. Of those 41 patients (52.6%) is in high level of Gleason score. 17 patients is in high BMI range. High Gleason score was found in 11 patients (P = 0.362; rs = 0.094). Conclusion, there is no relation between BMI in Indonesian PCa and Gleason score. Keywords : Prostate adenocarcinoma (PCa); BMI; Gleason score.

Dose–response relationship between body mass index and risks of all-cause mortality and disability among the elderly: A systematic review and meta-analysis

To establish the relationship between body mass index (BMI) and risks of mortality and disability among the Elderly. A systematic review and dose-response meta-analysis was performed. PubMed, Embase, Cochrane library, and Google Scholar were searched systematically until December 2017 for relative studies reporting the hazard ratio (HR) and corresponding 95% confidence intervals (CIs) of all-cause mortality or disability across different BMI categories. 44 studies (37 studies on all-cause mortality and 9 studies on disability) were included in the meta-analysis. The restricted cubic spline model presents a U-shape trend, which suggests a relationship between BMI and all-cause mortality. As BMI increased, the all-cause mortality decreased from 1.49 (95% CI: 1.31, 1.71) to 0.96 (95% CI: 0.93, 0.98) in the 14.0-27.9 range and increased from 0.96 (95% CI: 0.94, 0.99) to 1.95 (95% CI: 1.37, 2.77) in the 28.0-47.9 range. In comparison with the reference BMI (23.0-23.9), the 24.0-29.0 BMI presented a significant protective effect, whereas <23.0 BMI and >33.0 BMI presented a significant risk effect on all-cause mortality. For disability, the restricted cubic spline model shows a nonlinear relationship. Individuals with >28.0 BMI and 33.0 BMI were 19% (95% CI: 1.01, 1.40) and 43% (95% CI: 1.13, 1.82) more prone to disability risks compared with those in the reference group, respectively. The lower-end recommended BMI range, underweight, and obesity among the elderly is associated with significantly increased risks of mortality and disability. The 23.0-28.0 BMI range may be the healthy weight range for the elderly group.

Association Between Body Mass Index and the Risk of Hip Fracture by Sex and Age: A Prospective Cohort Study.

The association between body mass index (BMI) and hip fracture may differ by ethnic group. We examined the association between BMI and hip fracture according to sex and age and to identify BMI ranges associated with the lowest risk in Korean men and women. We followed up 288,068 Korean adults (aged 50 to 80 years), who underwent health examinations in 2002-03 to 2013; we examined national hospital discharge records. Hazard ratios (HRs) were calculated using Cox proportional hazard models after adjusting for confounders. During a mean follow-up period of 10.5 years, 1502 men and 2432 women suffered a hip fracture. Nonlinear associations were observed between BMI and hip fracture: a U-curve for women and a reverse J-curve for men. Men with BMIs of 27.5 to 29.9 kg/m2 and women with BMIs of 25 to 27.4 kg/m2 showed the lowest incidence of hip fracture. The multivariate-adjusted HRs for hip fracture per 5 kg/m2 decrease in BMI were 2.09 (95% confidence interval [CI] 1.83-2.38) and 1.34 (95% CI 1.19-1.51) in men and women with BMI <25 kg/m2 . The HRs were generally highest in the age group of 50 to 59 years (HR = 3.42 in men and 2.27 in women) and thereafter decreased with age. Among participants with BMI ≥25 kg/m2 , the HRs for hip fracture per 5 kg/m2 increase in BMI were 1.26 (95% CI 1.08-1.47) in women and 0.91 (95% CI 0.62-1.33) in men. In conclusion, the overweight range of BMI was associated with the lowest risk of hip fracture. Lower BMI was a risk factor for hip fracture, whereas obesity was associated with an increased risk of hip fracture, particularly in women. Overweight may be protective against hip fracture in Asian adults but not obesity. © 2018 American Society for Bone and Mineral Research.

Body Mass Index and Vascular Disease in Men Aged 65Years and Over: HIMS (Health In Men Study).

BackgroundUnderstanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.Methods and ResultsIn this prospective cohort study, 12 203 men (aged ≥65) were recruited in 1996–1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow‐up. During a further 8 (SD3) years of follow‐up, there were 1136 first‐ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at ≈ 22.5 to 25 kg/m2. In the higher BMI range (≥25 kg/m2), 5 kg/m2 higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18–1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06–1.46]); 34% higher risk of stroke (1.34 [1.11–1.63]); and 78% higher risk of other vascular death (1.78 [1.32–2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m2 higher BMI, 0.82 [95% confidence interval, 0.61–1.12]).ConclusionsIn this population of older men, risk of major vascular events was lowest at ≈ 22.5 to 25 kg/m2. Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m2 higher BMI associated with ≈30% higher risk.

Relationship Between Myocardial Function, Body Mass Index, and Outcome After ST-Segment-Elevation Myocardial Infarction.

Better survival for overweight and obese patients after ST-segment-elevation myocardial infarction (STEMI) has been demonstrated. The association between body mass index (BMI), outcome, and left ventricular (LV) structure and function after STEMI, including LV longitudinal strain (global longitudinal strain), was evaluated. First patients with STEMI undergoing primary percutaneous coronary intervention (n=1604; mean age, 61±12 years; 75% men) had BMI measured on admission, and 2-dimensional transthoracic echocardiography performed within 48 hours. Patients were categorized based on standard criteria (normal/underweight, BMI<25 kg/m2 [n=486]; overweight, 25≤BMI<30 kg/m2 [n=820]; obese, BMI≥30 kg/m2 [n=298]). LV global longitudinal strain was measured using speckle-tracking analysis. Primary outcome measure was all-cause mortality. Compared with normal/underweight patients, obese patients were younger and more likely to have diabetes mellitus, hypertension, and hyperlipidemia and have higher discharge blood pressures. Despite no significant differences in infarct size, obese patients had significantly more impaired LV global longitudinal strain (-13.7±3.8 versus -15.0±4.2% and -15.0±4.1%; P<0.001) compared with normal/underweight and overweight patients, respectively. Although normal/underweight patients had the worst overall survival (log-rank P=0.04) after STEMI during a median follow-up of 5.2 (3.6, 6.9) years on Kaplan-Meier analysis, a significant nonlinear association between BMI and all-cause mortality across the range of BMI was seen, persisting after adjustment for age and sex. Obese patients demonstrate greater adverse LV remodeling and more impaired LV deformation after STEMI compared with those with normal BMI, amid similar infarct characteristics. Normal weight patients continue to demonstrate the worst survival, suggesting that the potential nonadverse effect of higher BMI in this population is independent of LV function.

BMI and BMI Changes to All-cause Mortality among the Elderly in Beijing: a 20-year Cohort Study

ObjectiveTo explore the association between body mass index (BMI) and all-cause mortality among the elderly in Beijing. MethodsThis analysis was based on the Beijing multidimensional longitudinal study of aging (BLSA), which included 2,090 subjects over 55 years old and was followed-up from 1992 to 2012. BMI-mortality curves were drawn to find the optimal BMI range with the lowest mortality. Cox proportional hazard models were used to obtain the hazard ratios (HRs) for BMI and BMI changes in the overall population and in specific stratified populations. ResultsDuring follow-up, 1,164 deaths were recorded; BMI-mortality curve was U-shaped, with the lowest mortality at a BMI of approximately 25 kg/m2. After adjusting for gender, age, smoking, drinking and some pre-existing diseases, HRs for underweight, overweight and obesity compared with normal weight were 1.372 (95% CI: 1.154-1.631), 0.767 (95% CI: 0.666-0.884) and 0.871 (95% CI: 0.830-1.246), respectively. HR for BMI drop was 3.245 (95% CI: 0.824-12.772) in the underweight group and 1.892 (95% CI: 0.830-1.246) in the normal weight group, HR for BMI rise was 1.795 (95% CI: 1.243-2.591) in normal weight group and 1.962 (95% CI: 1.202-3.203) in the overweight group. ConclusionKeeping BMI in an overweight status and stable is related to a reduced mortality.

Obesity Is in the Eye of the Beholder: BMI and Socioeconomic Outcomes across Cohorts

The biological and social costs of body mass cannot be conceptualized in the same way. Using semiparametric methods, we show that the association between body mass index (BMI) and socioeconomic outcomes such as wages, being married, and family income is distinctly shaped by gender, race, and cohort rather than being above a specific threshold of BMI. For white men, the correlation between BMI and outcomes is positive across the 'normal' range of BMI and turns negative near the cusp of the overweight range, a pattern that persists across cohorts. For white women, thinner is nearly always better, a pattern that also persists across cohorts. For black men in the 1979 cohort, the association between BMI and wages is positive across the normal and overweight ranges for wages and family income and inverted U–shaped for marriage. For black women in the 1979 cohort, thinner is better for wages and marriage. By the 1997 cohort, however, the negative association between body mass and outcomes dissipates for black Americans but not for white Americans. In the social world, 'too fat' is a subjective, contingent, and fluid judgment that differs depending on who is being judged, who does the judging, and the social domain.

The obese brain as a heritable phenotype: a combined morphometry and twin study.

BackgroundBody weight and adiposity are heritable traits. To date it remains unknown whether obesity-associated brain structural alterations are under a similar level of genetic control.MethodsFor this study we utilized magnetic resonance imaging (MRI) data from the Human Connectome Project. Voxel based morphometry (VBM) was used to investigate associations between body mass index (BMI) and regional gray matter volume (GMV) in a sample of 875 young adults with a wide BMI range (386m/489f; age 28.8 ± 3.7y; BMI 26.6 ± 5.3 kg*m-2), that included 86 pairs of monozygotic twins and 82 pairs of dizygotic twins. Twin data were analyzed by applying the additive genetic, common environmental and residual effects (ACE) model to determine heritability of brain regions that were associated with BMI.ResultsWe observed positive associations between BMI and GMV in the ventromedial prefrontal cortex and the right cerebellum and widespread negative associations within the prefrontal cortex, cerebellum, temporal lobes and distinct subcortical structures. Varying degrees of heritability were found for BMI-associated brain regions, with highest heritability estimates for cerebellar GMV and subcortical structures.ConclusionsThese data indicate that brain regions associated with obesity are subject to differing levels of genetic control and environmental influences. Specific brain regions with high heritability might represent an inherent vulnerability factor for obesity.

A Clinical Study of Relationship of Body Mass Index with Allergic Rhinitis

ABSTRACT Objectives Although the association between obesity and bronchial asthma (BA) has been gaining more attention, few studies have been conducted concerning the relationship between body mass index (BMI) and other allergic diseases. The purpose of this study is to determine the relationship between allergic rhinitis (AR) and BMI. Materials and methods This was a retrospective study. Two hundred and ten patients of AR (138 males and 72 females) and 424 healthy controls were included in the study. The BMI of patients and controls were calculated and correlated. Results The percentage of AR patients with a low BMI was 9.5%, whereas 57.6% had a normal BMI; 21% were preobese and 9.5% were obese. In the control group, 48.6% subjects had normal BMI range followed by preobese 21.2%, underweight 20.3%, and obese 9.9%. Among the overweight (preobese+ obese) category, the maximum number of subjects belonged to cases, i.e., 32.8% with an odds ratio (OR) of 0.95 (95% confidence interval (CI) 0.91-1.07). Thus, AR was not associated with high BMI. Among the underweight, the maximum number of subjects belonged to the control group, i.e., 20.3% with an OR of 2.13 (95% CI 1.24-3.68). Thus, AR had no relationship with lower BMI also. It was also observed that more of the female patients (18, 29.1, and 12.5% were underweight, preobese, and obese respectively) had deranged BMI than male patients (5.3, 20.2, and 7.9% were underweight, preobese, and obese respectively). A relative risk of 1.124 (95% CI 1.01-1.23) and 1.04 (95% CI 0.95-1.13) was present in female patients with low and high BMI respectively, which is statistically significant (p = 0.0008). Conclusion It was concluded that BMI was not associated with increased prevalence of AR. Among the underweight and overweight, AR was more common in females than in males. Thus, BMI had a significant association with AR among female patients. Overall, BMI had no significant association with AR. How to cite this article Kala H, Bhagat S, Varshney S, Bist SS. A Clinical Study of Relationship of Body Mass Index with Allergic Rhinitis. Clin Rhinol An Int J 2016;9(1):33-36.

Hyperinsulinemia/diabetes, hearing, and aging in the University of Wisconsin calorie restriction monkeys

The purpose of this study was to determine the effects of hyperinsulinemia/Type 2 diabetes mellitus (HI-T2DM) on hearing impairment using rhesus monkeys to obtain control over diet and lifestyle factors that confound human studies. The study is a retrospective evaluation of rhesus monkeys from the Wisconsin National Primate Research Center (WNPRC) study on caloric restriction and aging. The research questions were the following: 1. Is HI-T2DM related to hearing impairment? 2. If so, what is the site of lesion in the auditory system? and 3. What physiological factors affect the risk of hearing loss in HI-T2DM? Three groups of eight monkeys each were matched by sex and age; the caloric restricted (CR) monkeys had a reduced risk of diabetes, the normal control (NL) group had a normal risk, and the hyperinsulinemia/diabetes (HI-D) group had already developed HI-T2DM. Auditory testing included distortion product otoacoustic emissions (DPOAEs) with f2 frequencies from 2211 to 8837 Hz and auditory brainstem responses (ABRs) obtained with clicks and tone bursts (8, 16, and 32 kHz). DPOAEs had signal-to-noise ratios 8–17 dB larger in the NL group than in the HI-D and CR groups, signifying that cochlear function was best in the NL group. ABR thresholds were 5–8 dB better in the NL group than in the HI-D group, although no significant differences across the groups were evident for the thresholds, latencies, interwave intervals, or amplitudes. Correlations were significant for quadratic relations between body mass index (BMI) and DPOAE, with largest DPOAEs for animals in the middle of the BMI range. ABR thresholds elicited with 16 and 32 kHz signals were significantly correlated, positively with BMI and HbA1c, and negatively with KG (glucose tolerance), SI (insulin sensitivity index) and DI (disposition index). These findings suggest that the hearing loss associated with HI-T2DM is predominantly cochlear, and auditory structures underlying the higher frequencies are at risk with HI-T2DM. Loss of auditory function begins in the hyperinsulinemia, pre-diabetic state.

Body mass index and mortality among Korean elderly in rural communities: Kangwha Cohort Study.

BackgroundThe relationship between body mass index (BMI) and mortality may differ by ethnicity, but its exact nature remains unclear among Koreans. The study aim was to prospectively examine the association between BMI and mortality in Korean.Methods6166 residents (2636 men; 3530 women) of rural communities (Kangwha County, Republic of Korea) aged 55 and above were followed up for deaths from 1985–2008. The multivariable-adjusted hazard ratios were calculated using the Cox proportional hazards model.ResultsDuring the 23.8 years of follow-up (an average of 12.5 years in men and 15.7 years in women), 2174 men and 2372 women died. Men with BMI of 21.0–27.4 and women with BMI of 20.0–27.4 had a minimal risk for all-cause mortality. A lower BMI as well as a higher BMI increased the hazard ratio of death. For example, multivariable-adjusted hazard ratios associated with BMI below 16, and with BMI of 27.5 and above, were 2.4 (95% CI = 1.6–3.5) and 1.5 (95% CI = 1.1–1.9) respectively, in men, compared to those with BMI of 23.0–24.9. This reverse J-curve association was maintained among never smokers, and among people with no known chronic diseases. Higher BMI increased vascular mortality, while lower BMI increased deaths from vascular diseases, cancers, and, especially, respiratory diseases. Except for cancers, these associations were generally weaker in women than in men.ConclusionsA reverse J-curve association between BMI and all-cause mortality may exist. BMI of 21–27.4 (rather than the range suggested by WHO of 18.5–23 for Asians) may be considered a normal range with acceptable risk in Koreans aged 55 and above, and may be used as cut points for interventions. More concern should be given to people with BMI above and below a BMI range with acceptable risk. Further studies are needed to determine ethnicity-specific associations.

Sex-specific effect of BMI on insulin sensitivity and TNF-α expression.

Obesity is a major predisposing risk factor for the development of insulin resistance. Recently, a sexual dimorphism in the relationship between body mass index (BMI) and insulin resistance has been reported, with the deleterious effect of increasing BMI being more evident in men than in women [1]. To the best of our knowledge, the biology underlying this sex-specific association has never been addressed. By inhibiting insulin signaling, TNF-a overexpression is the main mechanism responsible for the deleterious effect of obesity on insulin resistance [2]. It is, therefore, reasonable to address the role of TNF-a as a mediator of the sex-specific response of insulin sensitivity to the insult of increasing BMI. Accordingly, we measured both the HOMA-IR insulin resistance index and TNF-a mRNA levels (in peripheral whole blood cells; PWBC) from healthy subjects with a wide range of BMI and then looked for BMI-by-sex interaction in modulating these two variables.

Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study

Data on the association between body mass index (BMI) and risk of knee osteoarthritis (KOA) are sparse for Asian populations who are leaner than Western populations. We evaluated the association between BMI and risk of total knee replacement (TKR) due to severe KOA among Chinese in Singapore. We used data from the Singapore Chinese Health Study (SCHS), a population-based prospective cohort of 63,257 Chinese men and women, aged 45-74 years at enrollment from 1993 to 1998. Information on height, weight, diet and lifestyle factors were obtained via in-person interviews. TKR cases for severe KOA were identified via linkage with the nationwide hospital discharge database through 2011. Cox regression and weighted least squares regression were used in the analysis. The mean BMI among cohort participants was 23.1kg/m(2), and more than two-thirds had BMI below 25kg/m(2). A total of 1649 had TKR attributable to severe KOA. Risk of TKR increased in a strong dose-dependent manner with increasing BMI throughout the 15-32kg/m(2) range and became less clear at BMI >32kg/m(2). In the BMI range 16-27kg/m(2), there was a 27% increase in TKR risk for each unit increase in BMI (P for trend<0.001). Compared to BMI 19-20kg/m(2), the risk estimates of TKR were all statistically significant with increasing unit of BMI ≥21kg/m(2). Results were similar for men and women. Our results provided evidence for a constant mechanical mechanism underlying BMI and KOA initiation and/or progression.

BMI and all-cause mortality in older adults: a meta-analysis

Whether the association between body mass index (BMI) and all-cause mortality for older adults is the same as for younger adults is unclear. The objective was to determine the association between BMI and all-cause mortality risk in adults ≥65 y of age. A 2-stage random-effects meta-analysis was performed of studies published from 1990 to 2013 that reported the RRs of all-cause mortality for community-based adults aged ≥65 y. Thirty-two studies met the inclusion criteria; these studies included 197,940 individuals with an average follow-up of 12 y. With the use of a BMI (in kg/m2) of 23.0-23.9 as the reference, there was a 12% greater risk of mortality for a BMI range of 21.0-21.9 and a 19% greater risk for a range of 20.0-20.9 [BMI of 21.0-21.9; HR (95% CI): 1.12 (1.10, 1.13); BMI of 20.0-20.9; HR (95% CI): 1.19 (1.17, 1.22)]. Mortality risk began to increase for BMI >33.0 [BMI of 33.0-33.9; HR (95% CI): 1.08 (1.00, 1.15)]. Self-reported anthropometric measurements, adjustment for intermediary factors, and exclusion of early deaths or preexisting disease did not markedly alter the associations, although there was a slight attenuation of the association in never-smokers. For older populations, being overweight was not found to be associated with an increased risk of mortality; however, there was an increased risk for those at the lower end of the recommended BMI range for adults. Because the risk of mortality increased in older people with a BMI <23.0, it would seem appropriate to monitor weight status in this group to address any modifiable causes of weight loss promptly with due consideration of individual comorbidities.

Is overweight and class I obesity associated with increased health claims costs?

Evaluate the relationship between body mass index (BMI) and health claims costs over the last decade, assess the strength and nature of the relationship between BMI and costs, and identify comorbidities that may drive any increased costs. Using 2001-2011 claims data for employees participating in annual health appraisals, annual paid claims costs were calculated. One-part negative binomial models were fit to evaluate the relationship between BMI and costs, controlling for age, gender, race/ethnicity, and calendar year period. The relationship between increasing BMI and increasing health claims costs is gradual and starts already at a BMI of 19. The nature of the relationship did not change notably over time. The most important obesity-related comorbidities, expressed as percent increase in cost per BMI unit, was cardiovascular disease (males 10.53, 95% CI [6.46, 14.77], females 4.27, 95% CI [1.25, 7.38), while cardiovascular agents (7.23, 95% CI [6.08, 8.39]) were the most important driver of pharmacy costs. In contrast to recent evidence relating to effects on mortality, we observed a gradual increase in health claims costs starting at the low end of the recommended BMI range.

IJU this issue

In this issue of the journal, we have four Review Articles, six Original Articles, one Short Communication, one Case Report and two Letters to the Editor. I would like to pay close attention to the interesting papers that reported and discussed current topics of prostate cancer. Masuda et al. (Tokyo, Japan) explored the relationship between body mass index (BMI) and prostate cancer risk at biopsy in Japanese men, and compared the risk with that of Caucasian men. They retrospectively evaluated Japanese men with prostate-specific antigen (PSA) levels from 2.5 to 19.9 ng/mL undergoing an initial extended prostate biopsy. There was a significant positive relationship between BMI and prostate cancer risk at biopsy, with an increased risk observed in men whose BMI was ≥27.0, compared with the reference group. A significantly increased risk starting at BMI ≥25.0 was found in high-grade disease. In contrast to their results, there has been no reported increase in the risk of prostate cancer at biopsy in Caucasians within the overweight range (BMI of 25.0–29.9). The authors concluded that Japanese men within the overweight BMI range who have an elevated PSA also have a significant risk of harboring prostate cancer, especially high-grade disease, and that overweight Japanese might be at greater prostate cancer risk at biopsy than overweight Caucasians. The accuracy of the Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score, which was developed as a risk stratification instrument for patients undergoing primary androgen deprivation therapy, was externally validated for predicting cause-specific survival (CSS) among patients in the USA community-based Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry; however, there have been no investigations to validate the accuracy of the J-CAPRA score in predicting progression-free survival (PFS) along with analysis of clinical situation. Kitagawa et al. (Kanazawa, Japan) examined whether the clinical outcomes of patients treated by combined androgen blockade (CAB) with bicalutamide could be stratified using the J-CAPRA score. The factors used in the J-CAPRA points were significant predictors of PFS, and clinical T stage and M stage were also significant predictors of PFS. The probabilities of PFS and CSS were significantly different among the groups categorized according to the J-CAPRA risk strata. The authors concluded that the J-CAPRA score is a useful tool for predicting the clinical outcomes of patients with prostate cancer treated by CAB including bicalutamide. Several papers of laparoendoscopic single-site surgery in urology have been published, but just a few cases of radical prostatectomy have been reported. Nakane et al. (Anjo, Japan) showed the early outcomes of an original two-port laparoendoscopic approach for radical prostatectomy. A multichannel port with three 5-mm trocars, providing easier instrument handling, was inserted extraperitoneally through a 2.5-cm lower umbilical “U” incision. An additional 12-mm port was inserted into the left fossa to allow an adequate working angle. The operation was successfully completed in all 22 patients with early-stage prostate cancer; only one patient required an additional 5-mm port to control bleeding. There were no intraoperative complications. The authors concluded that this new procedure can be safely carried out if the surgeon is familiar with conventional five-port laparoscopic radical prostatectomy. Paraneoplastic limbic encephalitis (PLE) is a rare tumor-related syndrome, and the prognosis for neurological recovery and survival is poor. The neoplasms most frequently associated with PLE are small cell lung cancer and testicular cancer. Jakobsen et al. (Viborg, Denmark) reported a rare case of prostate cancer-related PLE. The authors showed that high-risk prostate cancer can trigger PLE, a rapidly progressive neurological syndrome with a bad prognosis. None declared.

Body mass index underestimates adiposity in women with spinal cord injury

ObjectiveTo assess the relationship between body mass index (BMI) and adiposity as well as the influence of injury level on this relationship in 24 women with spinal cord injury (SCI) and 23 able-bodied (AB) women with similar age, race, and BMI.Design and methodsBody composition was measured by dual energy x-ray absorptiometry (DXA). Analysis of covariance was performed to compare total and regional soft tissue percent fat (PF) measures between groups.ResultsWomen with SCI had a higher soft tissue PF than AB women at any given BMI. The BMI-adjusted soft tissue PF (mean ± SE) was 44.4 ± 1.8%, 37.8 ± 1.3%, and 35.9 ±1.1% for tetraplegic, paraplegic, and AB women, respectively. The BMI explained about equal amounts of the variance in soft tissue PF among paraplegic and AB women (65%), but only 28% in tetraplegic women.ConclusionThis study confirms a limited use of BMI in measuring adiposity in women with SCI, particularly among those with tetraplegia. Our observation of lower BMI cutoff points for defining obesity (28 kg/m2 for paraplegia and 21 kg/m2 for tetraplegia) needs further confirmation. The underweight/malnutrition issue also deserves the consideration while proposing the ideal weight and BMI range for persons with SCI.

Anesthesia Literature Review

Anesthesia Literature Review

Association Between Body Mass Index and Health-Related Quality of Life Among an Australian Sample

Objective This study investigated the association between body mass index (BMI) and changes in BMI over time with health-related quality-of-life data among a general and representative sample of the Australian population. Methods The sample consisted of respondents between the ages of 18 and 79 who completed the Household, Income and Labour Dynamics in Australia (HILDA) Survey in 2007 and 2009. These respondents completed the SF-36 questionnaire and provided data on their height, weight, medical conditions, and sociodemographic characteristics. SF-36 questionnaire responses were converted into health state utility values using the SF-6D algorithm. Regression analysis was used to examine the relationship between BMI and utility, controlling for a range of obesity-related medical conditions and sociodemographic characteristics. Results Obese men (BMI value ≥30) had, on average, a lower utility score (–0.0190, P < 0.001) than men within an “acceptable” BMI range (BMI 18.5 to <25). Obese women (BMI value ≥30) also had, on average, a lower utility score (–0.0338, P < 0.001) than women within an acceptable BMI range (18.5 to <25). Although BMI was not associated longitudinally with utility, there was a statistically significant negative longitudinal relationship between arthritis (–0.0153, P < 0.01) and depression/anxiety disorders (–0.0358, P < 0.001) and utility. Conclusions Cross-sectional results suggest that BMI is negatively associated with utility and that further investigation of the longitudinal relationship between BMI and utility is warranted.

Attachment anxiety, disinhibited eating and body mass index in adulthood

Several studies report a relationship between body mass index (BMI) and disinhibited eating (a failure to restrict intake and to overeat). However, the aetiology of disinhibited eating has received scant attention. In this study, we consider a role for ‘attachment orientation’, a trait that reflects the quality of bonding in early life and remains stable throughout adulthood. Participants (N=200, females=135, BMI range from 17.4 to 41.1 kg m−2) completed measures of disinhibition and attachment orientation. ‘Attachment anxiety’ was a good predictor of disinhibited eating (P<0.001). Furthermore, mediation analysis confirmed that it is through this relationship that attachment anxiety also predicts BMI (P=0.02). These findings are consistent with other studies, showing an association between attachment orientation and other disinhibited behaviours, including alcohol and substance abuse. Our interpretation is that disinhibited eaters engage in external affect regulation. In doing so, they seek to mitigate the anxiety associated with poor interpersonal attachments.