Body Mass Index Categories Research Articles

Vitamin D Among Type 2 Diabetic Patients Attending Aden Diabetic Center During May-July 2023: A Descriptive Study

Introduction: Vitamin D plays a crucial role in the pathogenesis and management of type 2 diabetes mellitus (T2DM). However, limited data are available regarding the status of vitamin D among T2DM patients attending healthcare centers, particularly in the Aden Diabetic Center, Yemen. The study aimed to assess the prevalence of vitamin D deficiency among T2DM patients and explore its association with potential factors such as demographics, diabetes characteristics body mass index (BMI). Methods: A descriptive cross-sectional study was conducted on 138 T2DM patients attending Aden Diabetic Center (ADC) between May and July 2023. Data on age, sex, diabetes characteristics (diabetes duration, family history of diabetes, and medication use), RBS, BMI, and serum vitamin D level were measured. Vitamin D status was categorized as deficient, insufficient, or sufficient based on established cutoffs. Descriptive statistics and chi-square tests were used for data analysis. Results: Majority of patients had vitamin D deficiencyy (73.2%) and the remaining had insufficient (17.4%), and sufficient (9.4%) status. Males comprised 53.6% and females 46.4%. Mean age was 53.70±12.93 years, with the highest proportion (60.9%) were in the age group 40-60 years. Majority of the patients (62.3%) had T2DM duration ≥ 5 years, and 89.1% were receiving diabetes medications, and 68.8% had a family history of DM. The mean RBS level was 220.13±86.90 mg/dl, with more than half (55.6%) having RBS levels ≥ 140 mg/dl. Also, the mean BMI was 27.00±5.90 kg/m², and more than half of the patients had overweight and obesity. The study found no significant association between serum vitamin D levels with age, diabetes characteristics, or BMI categories, while a significant association to sex was observed (P = 0.006). Conclusion: The study highlights the high prevalence of vitamin D deficiency among T2DM patients attending the ADC in Aden. The majority of patients were found to have deficient levels of vitamin D, with limited differences based on age, diabetes characteristics, and BMI. The significant association between vitamin D levels and sex, indicating that sex may contribute to the risk of deficiency in T2DM patients. These findings emphasize the importance of assessing and addressing vitamin D status in T2DM patients to optimize their overall health and diabetes management.

Changes in body mass index and its association with socio-demographic characteristics between 2010 and 2016 in Singapore.

Epidemiological studies have observed an increase in the prevalence of obesity in both western and Asian countries. This study aims to compare the distribution of body mass index (BMI) in the general population of Singapore between 2010 and 2016, and to explore the socio-demographic risk factors associated with it. Data for this study were extracted from two national-wise studies in 2010 and 2016, two population-based, cross-sectional epidemiological studies. BMI cut-off scores were used as an indicator to assess obesity in this study, and the data included in the analysis was self-reported by the respondents. Overall, the study observed decreasing prevalence in underweight and normal weight categories; and an increasing prevalence in overweight and obesity categories in the Singapore adult population between 2010 and 2016. Age, gender, ethnicity, marital status, and educational level were found to be significantly associated with BMI categories. The observed increase in the population's BMI between 2010 and 2016 may lead to an increase in the incidence of chronic diseases in Singapore. Our study findings add to the existing local literature and provides data for evidence-based policymaking on health-related interventions and program planning.

The Effects of Gluten-free Diet on Body Mass Indexes in Adults with Celiac Disease: A Systematic Review and Meta-analysis of Observational Studies.

Gluten-free diet (GFD) includes a higher intake of sugars and fats. Previous studies have investigated its effect on body mass index (BMI) in celiac disease (CD) patients but had contradictive conclusions. Thus, we conducted a systematic review and meta-analysis examining the effect of GFD on BMI in CD patients. Systematically, we conducted literature research using Medline, Scopus, and Embase, and we identified 1565 potential studies/abstracts. Only studies of patients with CD under a GFD with recorded BMI before and after dietary intervention were included. Subgroup analyses based on study design and BMI categories were performed. We calculated the pooled odds ratios (ORs) and 95% confidence intervals (Cls) for the number of patients in each BMI group according to the World Health Organization (WHO) definitions after GFD using fixed and random effect meta-analysis. The analysis included 10 studies and 38 sub-studies/data sets, which encompassed 2450 patients from 5 countries. We found nonsignificant odds for changing the BMI group (pooled OR 0.972, 95% CI: 0.858-1.101, P=0.65) after GFD. However, looking specifically at BMI subgroups, we found higher odds for BMI category change after GFD in underweight patients (OR 0.588, 95% CI: 0.479-0.723, P <0.001), and overweight patients,25<BMI<30, (OR 1.332, 95% CI: 1.167-1.521, P<0.001). No publication bias was demonstrated, and the amount of heterogeneity between studies was moderate (I2=54.13). Although crucial in patients with CD, GFD is associated with increased BMI in some CD patient populations. Accordingly, special considerations and follow-up should be maintained in overweight patients with CD after GFD.

Association Between Prepregnancy Body Mass Index and Newborn Breastfeeding Initiation.

Background: The benefits of breastfeeding a newborn are well documented. Identification of mothers who do not initiate breastfeeding is essential for developing initiatives to improve breastfeeding initiation. Methods: The study used data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) birth certificate data (2014-2021) to identifying 15,599,930 in-hospital deliveries. We used multivariable logistic regression to assess the association between seven body mass index (BMI) categories and initiation of breastfeeding before hospital discharge. Prepregnancy BMI (weight in kilograms/height in meters2) included underweight (<18.5), healthy weight (18.5-24.9), overweight (25.0-29.9), Obesity Class I (30-34.9), Obesity Class II (35-39.9), and Obesity Class III (40-49.9) classes, in addition to a class newly identified in the literature as super obese (≥50), hereafter "Obesity Class IV." "This project was deemed non-human subjects research." Results: Approximately, 83% of mothers initiated breastfeeding before hospital discharge. Compared to mothers with a healthy prepregnancy BMI, the likelihood of breastfeeding initiation before hospital discharge decreased with increasing prepregnancy BMI. Specifically, we found reduced likelihood of initiation for mothers who were overweight (adjusted odds ratio [aOR]: 0.952, 95% confidence interval [CI]: [0.948-0.955]), Obesity Class I (aOR: 0.884, 95% CI: [0.880-0.888]), Obesity Class II (aOR: 0.816, 95% CI: [0.811-0.820]), Obesity Class III (aOR: 0.750, 95% CI: [0.745-0.755]), and Obesity Class IV (aOR 0.672: 95% CI: [0.662-0.683]). Conclusions: Mothers with prepregnancy BMI above the healthy range had reduced likelihood of initiating breastfeeding prior hospital discharge. This information should be used to develop and initiate interventions for mothers who wish to breastfeed but may need additional lactation assistance support.

The Effects of an Eight-Week Swimming Program on Body Composition and Assessment of Dietary Intake in Post-COVID-19 Patients.

COVID-19 infection and its consequences (long-term COVID-19 syndrome) have implications for weight loss, body composition, and diet quality. In the context of the "PostCovSwim" project, which is part of a broader international study, the impact of an eight-week swimming program on post-COVID-19 patients' nutritional status (i.e., body composition and dietary intake) was evaluated. Body composition and dietary intake were assessed by medically approved and calibrated bioelectrical impedance (Tanita 780 S MA) and food frequency questionnaires. At the baseline, most participants were classified as overweight based on their body mass index (BMI). However, their body fat percentage (BF%) classification indicated normal weight, although females were near obesity thresholds. Furthermore, at the baseline, according to the BMI classification, 62% of females and 61% of males were female, whereas according to the BF% for obesity classification, 44% of females and 43% of males were considered overweight or obese. Surprisingly, despite the eight-week program, there were no significant changes in body composition. Additionally, the assessment of dietary intake, which remained consistent throughout the study, revealed dietary imbalances characterized by an unhealthy low-carbohydrate, high-fat dietary pattern. This dietary pattern entailed excessive consumption of ultraprocessed foods; reduced carbohydrate intake (39% E vs. 37% E); increased total fat intake (46% E vs. 47% E); increased saturated fatty acids (14% E vs. 13% E); increased cholesterol (412 mg/d vs. 425 mg/d); increased free sugars (7% E vs. 7% E); and inadequate intake of fibre (24 g/d vs. 20 g/d), polyunsaturated fatty acids (6.6% E vs. 7.7% E), vitamin B12 (in females: 3.1 µg/d), vitamin C (86 mg/d vs. 66 mg/d), vitamin D (2 µg/d vs. 3.2 µg/d), folate (in males: 258 µg/d), calcium (777 mg/d vs. 743 mg/d), and selenium (in males: 66 µg/d). After an eight-week swimming program following COVID-19, no significant changes were observed in the subjects' body composition. Their dietary intake was found to not align with the dietary recommendations. These findings underscore the urgency of implementing comprehensive dietary and lifestyle interventions for post-COVID-19 patients to optimize their recovery and overall well-being. Physical activity, like a swimming program, may positively affect various aspects of human well-being.

Effects of moderate-intensity combination exercise on increase adiponectin levels, muscle mass, and decrease fat mass in obese women

Obesity is reported to be strongly associated with low levels of adiponectin, which may be involved in metabolic syndrome, insulin resistance, cardiovascular disease, hypertension, and cancer cell proliferation. Meanwhile, physical exercise has been reported to increase adiponectin levels and decrease insulin resistance in obese individuals. Therefore, this study aimed to prove the effects of four weeks of moderate-intensity combination exercise (aerobic and resistance) on increasing adiponectin levels, skeletal muscle mass (SMM), and decreasing fat mass (FM) in obese women. A total of 14 obese adolescent women aged 20-24 years with a body mass index (BMI) of 27.5-36.5 kg/m2 (based on Asia-Pacific BMI classification) were selected as research subjects and divided into two intervention groups: control (CON) and moderate-intensity combination exercise (MCE) groups. The ELISA kit method was used to analyze pre- and post-exercise adiponectin levels, while the mBCA 554 seca was used to measure BMI, FM, and SMM. Statistical analysis was performed using an independent samples t-test with a 5% significance level. The data showed ∆-BMI between CON and MCE (0.54±0.99 vs -1.31±0.19 kg/m2; p = 0.001), ∆-FM (1.56±3.89 vs -3.60±1.16 kg; p = 0.006), ∆-SMM (-0.85±1.91 vs 3.61±0.74 kg; p = 0.001), ∆-Adiponectin (0.55±2.39 vs 15.45±6.21 ng/mL; p = 0.001). The results demonstrate that a 4-week moderate-intensity combination exercise intervention effectively increases adiponectin levels and skeletal muscle mass and reduces body mass index and fat mass in obese women. Keywords: Obesity, combination exercise, adiponectin levels, body composition.

Body Mass Index and Mortality in Cardiogenic Shock.

We explored the association of body mass index (BMI) with mortality in cardiogenic shock (CS). Using the Cardiogenic Shock Working Group registry, we assessed the impact of BMI on mortality using restricted cubic splines in a multivariable logistic regression model adjusting for age, gender, and race. We also assessed mortality, device use, and complications in BMI categories, defined as underweight (<18.5 kg/m 2 ), normal (18.5-24.9 kg/m 2 ), overweight (25-29.9 kg/m 2 ), obese (30-39.9 kg/m 2 ), and severely obese (>40 kg/m 2 ) using univariable logistic regression models. Our cohort had 3,492 patients with CS (mean age = 62.1 ± 14 years, 69% male), 58.0% HF-related CS (HF-CS), and 27.8% acute myocardial infarction (AMI) related CS. Body mass index was a significant predictor of mortality in multivariable regression using restricted cubic splines ( p < 0.0001, p = 0.194 for nonlinearity). When stratified by categories, patients with healthy weight had lower mortality (29.0%) than obese (35.1%, p = 0.003) or severely obese (36.7%, p = 0.01). In HF-CS cohort, the healthy weight patients had the lowest mortality (21.7%), whereas it was higher in the underweight (37.5%, p = 0.012), obese (29.2%, p = 0.003), and severely obese (29.9%, p = 0.019). There was no difference in mortality among BMI categories in AMI-CS.

Analysis of the Effects of Maternal Body Mass Index and Gestational Weight Gain on Maternal and Neonatal Outcomes in Twin Pregnancy

Objective: To investigate the effects of maternal body mass index (BMI) and gestational weight gain on maternal and neonatal outcomes in twin pregnancies. Methods: Five hundred cases of twin pregnancies were divided into a low body weight group (68 cases), a normal weight group (355 cases), an overweight group (65 cases), and an obesity group (12 cases) according to the World Health Organization (WHO) Body Mass Index (BMI) classification guidelines Results: Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight. The higher the BMI before pregnancy, the higher the incidence of excessive weight gain during pregnancy. The incidences of gestational diabetes mellitus (GDM) and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain (P &lt; 0.05). The incidences of gestational hypertension, preeclampsia, and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain (P &lt; 0.05). The incidence of neonatal birth weight, fetal distress, and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups (P &lt; 0.05). The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers (P &lt; 0.05). Conclusion: Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy. Therefore, for women with twin pregnancies, weight management is crucial to ensure maternal and infant health.

Abstract 4976: The impact of obesity on survival in epithelial gynecological tumors

Abstract Background: The impact of obesity on the survival of patients with epithelial gynecological tumors is not yet clear. We aim to elucidate the impact of body mass index (BMI) on epithelial gynecological tumors in a large tertiary center at Saudi Arabia. Methods: We retrospectively reviewed the medical files of all patients with pathologically confirmed epithelial gynecological tumors at our center. Then, we assessed the difference in overall survival (OS) according to primary tumor location, BMI, stage at presentation, and performance status (PS) at presentation using log-rank tests. Results: 400 patients were included in the analysis. The mean age at diagnosis was 56.1±13 years. 242 (60.5%) patients were diagnosed with uterine carcinomas, 137 (34.3%) with ovarian carcinomas, and 21 (5.3%) with cervical carcinomas. 278 (69.5%) patients were obese at presentation, 74 (18.5%) were overweight, 43 (10.8%) were within normal range, and 7 (1.8%) were underweight. The PS at presentation was 0, 1, 2, 3, and 4 in 351 (87.8%), 17 (4.3%), 10 (2.5%), 16 (4%), and 6 (1.5%) patients, respectively. Cervical cancer was associated with long OS, while ovarian cancers demonstrated poor prognosis (p=0.0159). There was no difference in OS between different BMI groups (p=0.072). Patients with stage 4 cancers had significantly shorter OS (p&amp;lt;0.0001). Patients with PS 4 at presentation was associated with the worst prognosis (p&amp;lt;0.0001). Interpretation: Shorter OS was associated with ovarian carcinomas, advanced staging, and poor PS at presentation. BMI classification had no impact on OS. Further studies are needed to confirm our findings. Citation Format: Ahmed Badran, Mahmoud Elshenawy, Waleed Fallatah, Abdullaah K. Hinkston, Saad S. Ali, Mohammed Ali Omar, Abdulaziz M. Alaklabi, Hytham M. Abdalla, Tarek Z. Arabi, Belal N. Sabbah, Hamed Alhusaini. The impact of obesity on survival in epithelial gynecological tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4976.

Abstract 3406: Transcriptomic analysis reveals differentially expressed pathways in colon tumors of cancer patients with vs without obesity: Results from the ColoCare Study

Abstract Despite the rise of global obesity rates and obesity’s implication in increased colon cancer risk, the understanding of mechanisms underlying these associations and opportunities for interception are limited. This work leveraged transcriptomic data from colon tumors to identify pathways and biologically relevant functions that characterize the tumors among obese vs nonobese individuals. Fresh-frozen colon tumor samples were collected from 155 patients who underwent surgery without neoadjuvant treatment as part of the ColoCare Study at Huntsman Cancer Institute, Utah, and Heidelberg University Hospital, Germany. RNA was sequenced using the NovaSeq X. The DESeq2 R package identified differentially expressed genes stratified by body mass index (BMI) at diagnosis (&amp;gt;30 kg/m2 vs &amp;lt;30 kg/m2) adjusting for age, sex, study site, and tumor stage. Genes with padj &amp;lt; 0.2 were entered into Ingenuity Pathway Analysis (IPA) software for pathway and expression analyses. Significant pathways were identified using Fischer’s Exact Test as the probability of molecules’ association with canonical pathways due to chance. The analysis was also repeated testing a median BMI categorization of &amp;gt;27.7 kg/m2 vs &amp;lt;27.7 kg/m2 using padj &amp;lt; 0.1 for IPA entry. Patients were 49% female, 63±14 years old, 47% stage III with a mean baseline BMI of 28.8±6.0 kg/m2. In colon tumors of those with &amp;gt;BMI 30 kg/m2, 213 genes were differentially expressed compared to BMI &amp;lt;30 kg/m2. IPA identified five upregulated pathways (neurovascular coupling signaling, adrenergic receptor signaling, activation of N-methyl-D-aspartate receptors and postsynaptic events, response to elevated platelet cytosolic Ca2+, docosahexaenoic acid signaling) and one downregulated pathway (WNT/B-catenin signaling) in patients with vs without obesity (p &amp;lt;0.05). The top predicted functional pathways, based on activation z-scores, identified in expression analysis included significant activation in chromosomal instability and aberration, size of body, phosphorylation of L-tyrosine, protein kinase cascade, and cell death and survival categories among colon tumors in obese patients. Using a median BMI categorization, 458 genes and 35 pathways were differentially expressed in those with BMI &amp;gt; 27.7 kg/m2 vs &amp;lt; 27.7 kg/m2. Both BMI models had good agreement with 5 pathways consistently significantly (z-score &amp;gt; |2|) up- or down-regulated, including predicted downregulation of organismal death and increased body size and phosphorylation of L-tyrosine in the higher BMI group. Colon tumors from patients with a higher BMI had pathways associated with more aggressive tumors, such as increased chromosomal instability and decreased cell death. Our ongoing work investigates the role of the adipose-tissue tumor microenvironment among patients, and the potential for interception using parallel mouse models. Citation Format: Victoria M. Bandera, Tengda Lin, Caroline Himbert, Elaine M. Glenny, Aik Choon Tan, Jennifer Ose, Christy Warby, Olena Aksonova, Alessandro Carpanese, Chris Stubben, David Nix, Kenneth Boucher, Peter Schirmacher, Ildiko Strehli, Jolanta Jedrzkiewicz, Lyen C. Huang, Jessica N. Cohan, Alexander Brobeil, Martin A. Schneider, Christoph Kahlert, Erin M. Siegel, Adetunji T. Toriola, David Shibata, Christopher I. Li, Jane C. Figueiredo, Biljana Gigic, Jatin Roper, Stephen Hursting, Cornelia M. Ulrich. Transcriptomic analysis reveals differentially expressed pathways in colon tumors of cancer patients with vs without obesity: Results from the ColoCare Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3406.

Obesity and Primary Total Hip Arthroplasty: The Absolute versus Relative Risk of Periprosthetic Joint Infection at 15 Years

BackgroundTo make an informed decision about total hip arthroplasty (THA), surgeons and patients need to understand the absolute and relative risks of periprosthetic joint infection (PJI). We sought to evaluate the long-term risk of PJI following primary THA stratified by body mass index (BMI) and PJI-related risk factors. MethodsWe identified 21,550 primary THAs performed from 2000 to 2021 at a single institution. Patients were stratified as having 0, 1, or ≥ 2 PJI risk factors (diabetes, chronic kidney disease, nonprimary osteoarthritis, immunosuppression, or active smoking) and into BMI categories. The 15-year cumulative risk of PJI was evaluated by BMI and PJI risk factors. ResultsFor the entire cohort, the 15-year absolute risk of PJI was 2%. For patients who did not have PJI risk factors, the absolute risk of PJI at 15 years was 1% in normal weight, 2% in class III obesity, and 4% in class IV obesity. Patients who had class III and IV obesity had a 3-times and 9-times higher relative risk of PJI, respectively (P = .03, P < .001). Among patients who had ≥ 2 PJI risk factors, the absolute risk of PJI at 15 years was 2% in normal weight, 4% in class III obesity, and 18% in class IV obesity. ConclusionsHealthy patients who had class III and IV obesity had a 3-times and 9-times increased risk of PJI at 15 years relative to normal weight patients. However, the absolute risk of PJI at 15 years was 2 and 4%, respectively. Given emerging data questioning whether BMI modification decreases PJI risk, surgeons and patients must consider both a 3-times to 9-times increased relative risk of PJI and a 2 to 4% absolute risk of PJI at 15 years for healthy patients who had a BMI ≥ 40. Level of evidenceIV.

Enhanced Stature in the Elderly: The Immediate Impact of Acute Postural Exercises.

This study investigates the immediate effects of acute postural exercises on the stature of seniors, focusing on changes in both upright and supine stature measurements. A within-subject design with repeated measures was applied, involving seniors participating in continuous exercises aimed at enhancing core musculature strength and promoting muscle relaxation. Stature measurements were recorded pre- and post-exercise in both upright and supine positions, alongside assessments of body mass index (BMI) category classifications. The results revealed a post-exercise increase in stature ranging from 0.9 to 6.0 cm and from 0.2 to 7.2 cm in upright and supine positions, respectively, with an average increase of approximately 3.5 cm in both upright and supine positions. Statistically significant and clinically relevant changes were observed (p < 0.05), including a modification of BMI by approximately two units, reclassifying 55% of participants from overweight or obese to normal weight or overweight. Furthermore, the similarity between post-exercise upright stature and pre-exercise supine stature suggested that the supine position might provide a more accurate measure of stature in seniors. Conclusively, acute postural exercises have an immediate positive impact on the stature of seniors, suggesting their potential utility in clinical settings for accurate stature measurement. However, BMI results should be interpreted with caution because they are only related to the acute change in stature and therefore may lead to the misinterpretation of the study findings, so future studies focused on evaluating the chronic effect of postural exercises integration on the health outcomes of older adults are needed to demonstrate their potential utility in clinical settings to improve postural health and general well-being.

Abstract P148: Prevalence and Correlates of Overweight and Obesity Among Adults in an Urban HIV Clinic in Uganda

Background: Obesity has become a major comorbidity faced by people living with HIV (PLH). This study aimed to estimate the prevalence and correlates of overweight and obesity among PLH in Uganda. Methods: From June 2016 and February 2020, we conducted a cross-sectional analysis among PLH receiving comprehensive HIV care in a large urban clinic in Kampala, Uganda. We collected data on socio-demographic and behavioral anthropometry, and included variables such as age, marital status, occupation (farmer/other), migration history (rural to urban, urban to rural, consistently rural, consistently urban), contraceptive use history (pills, injections, implants), previous pregnancies (categorized as 0-2, 3-5, ≥6), and socioeconomic status (SES) index variable developed for Ugandan settings. Standardized weight and height assessments were performed with BMI categorization into normal, overweight and obese categories. We performed sex-stratified analysis employing multinomial logistic regression (Stata 18.0) to estimate adjusted relative risk ratios (aRRR) and 95% confidence intervals (CIs) for overweight and obesity compared to under or normal weight., focusing on correlates of overweight in males due to the limited number of obese male participants (n=15). Results: Of 1939 participants aged 18-80 years, 60.2% were female and the median age (IQR) was 43 (35-50) years for females and 47.5 (40-54) years for males. Median body mass index (BMI) was 24.27(21.09-27.99) kg/m2 for females and 21.63 (19.69-24.11) kg/m2 for males. 27.1% and 17.2% were overweight and 16.7% and 2% were obese among females and males, respectively. In adjusted analysis among females, factors positively associated with being overweight were older age (36-50 years: aRRR=1.84; 95% CI:1.26-2.68, &gt;50 years: aRRR=2.16; 95% CI:1.34-2.46), being married (aRRR=2.00; 95% CI:1.46-2.73), middle SES (aRRR=1.47; 95% CI:1.01-2.13), upper SES (aRRR=2.05; 95% CI:1.44-2.90), and rural-to-urban migration (aRRR=1.52; 95% CI:1.05-2.22). Being a farmer was negatively associated with overweight (aRRR=0.42; 95% CI:0.22-0.77). Similar associations were observed with obesity, with ever use of contraception and having had &gt;2pregnancies also significantly associated with increased risk of obesity. For males, being older (36-50 years: aRRR=2.09; 95% CI:1.06-4.11, &gt;50 years: aRRR=2.04; 95% CI:1.01-4.08) and having high SES (aRRR=2.38; 95% CI:1.53-3.70) were positively associated with overweight, while being a farmer was inversely associated (aRRR=0.43; 95% CI:0.20-0.93). Conclusions: High prevalence of overweight and obesity were observed among PLH in Uganda, notably among females. Migration, SES, and reproductive factors were strongly associated with higher BMI. Identified sociodemographic risk factors can guide targeted interventions in this region.

Abstract P347: Variability in Predictive Error of Waist Circumference Models: A Stratified Analysis Based on Body Mass Index, Waist Circumference, and Their Ratio

Introduction: Waist circumference (WC) independently predicts cardiovascular risks, yet clinical measurements are sporadic. Some models have been developed for WC prediction, with body mass index (BMI) as a key predictor. While these models are generally efficient, variability in error across distinct subpopulations is possible. This study aimed to assess the prediction error (PE) variability of WC models across different strata of BMI, WC, and their ratio, and to evaluate the role of BMI for WC prediction. Hypothesis: 1) PE varies across BMI, WC, and their interrelated strata. 2) BMI is a key feature for WC prediction. Methods: Data from 30,298 individuals from the National Health and Nutrition Examination Survey (2007-2018) were analyzed. After outlier removal and kNN-imputation for missing values, machine learning predictive models for WC were developed. The base model included age, gender, ethnicity, height, weight, and BMI. A non-BMI model was also formulated, incorporating demographics and clinical variables selected via a feature-selection process. Root Mean Square Error (RMSE) across BMI, WC, and ratio of BMI-decile to WC-decile categories were assessed. Results: The base model's RMSE for the entire cohort was 5.70. Stratification by BMI revealed higher error rates for obesity classes II (5.88) and III (12.28), contrasting with lower RMSEs in participants with normal BMI (3.95), overweight (4.63), and obesity class I (5.41). Individuals with high WC had an increased RMSE (6.28) compared to those with low WC (5.04). Those with a BMI-decile/WC-decile below one had elevated error (6.98) compared to those with ratios equal to (4.60) or above one (5.52). Across all categories, the base model outperformed the non-BMI model (Figure 1). Conclusion: WC model PE demonstrated variability across BMI, WC, and their respective ratios, underscoring the predictive significance of BMI for WC. Considering population-specific variations in predictive WC modeling is important within clinical and research sets.

Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study

BackgroundThe effects of organochlorine pesticide (OCP) exposure on the development of human papillary thyroid cancer (PTC) are not well understood. A nested case-control study was conducted with data from the U.S. Department of Defense Serum Repository (DoDSR) cohort between 2000 and 2013 to assess associations of individual OCPs serum concentrations with PTC risk.MethodsThis study included 742 histologically confirmed PTC cases (341 females, 401 males) and 742 individually-matched controls with pre-diagnostic serum samples selected from the DoDSR. Associations between categories of lipid-corrected serum concentrations of seven OCPs and PTC risk were evaluated for classical PTC and follicular PTC using conditional logistic regression, adjusted for body mass index category and military branch to compute odds ratios (OR) and 95% confidence intervals (CIs). Effect modification by sex, birth cohort, and race was examined.ResultsThere was no evidence of associations between most of the OCPs and PTC, overall or stratified by histological subtype. Overall, there was no evidence of an association between hexachlorobenzene (HCB) and PTC, but stratified by histological subtype HCB was associated with significantly increased risk of classical PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 1.61, 95% CI, 1.09, 2.38; p for trend = 0.05) and significantly decreased risk of follicular variant PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 0.38, 95% CI, 0.16, 0.91; p for trend = 0.04). Further stratified by sex, risk of classical PTC was higher for females (third tertile above LOD vs. <LOD, OR = 2.23, 95% CI: 1.23, 4.06; p-trend = 0.02) than for males (OR = 1.22, 95%CI: 0.72–2.08; p-trend = 0.56), though the test for interaction by sex was not statistically significant (p-interaction = 0.30). Similarly, β-hexachlorocyclohexane (β-HCCH) was associated with a higher risk for classical PTC for women with concentrations ≥LOD versus <LOD (OR = 1.76, 95% CI: 1.07, 2.89), while the effects were null for men. There were no consistent trends when stratified by race or birth year. ConclusionsThe U.S. Environmental Protection Agency has classified HCB and other OCPs we studied here as probable human carcinogens. Our findings of increased risks for classical PTC associated with increased concentrations of HCB and β-HCCH, which were stronger among females, should be replicated in future studies of other populations.

The distribution of breast density in women aged 18years and older.

Age and body mass index (BMI) are critical considerations when assessing individual breast cancer risk, particularly for women with dense breasts. However, age- and BMI-standardized estimates of breast density are not available for screen-aged women, and little is known about the distribution of breast density in women aged < 40. This cross-sectional study uses three different modalities: optical breast spectroscopy (OBS), dual-energy X-ray absorptiometry (DXA), and mammography, to describe the distributions of breast density across categories of age and BMI. Breast density measures were estimated for 1,961 Australian women aged 18-97years using OBS (%water and %water + %collagen). Of these, 935 women had DXA measures (percent and absolute fibroglandular dense volume, %FGV and FGV, respectively) and 354 had conventional mammographic measures (percent and absolute dense area). The distributions for each breast density measure were described across categories of age and BMI. The mean age was 38years (standard deviation = 15). Median breast density measures decreased with age and BMI for all three modalities, except for DXA-FGV, which increased with BMI and decreased after age 30. The variation in breast density measures was largest for younger women and decreased with increasing age and BMI. This unique study describes the distribution of breast density measures for women aged 18-97 using alternative and conventional modalities of measurement. While this study is the largest of its kind, larger sample sizes are needed to provide clinically useful age-standardized measures to identify women with high breast density for their age or BMI.

O265: Laparoscopic Cholecystectomy in Class III (Morbid) Obesity

Abstract Background High body-mass index (BMI) has been associated with increased operative-time, conversion to open surgery, and poorer perioperative outcomes. Criteria for day-surgery often includes BMI, with centers excluding patients with BMI&amp;gt;40kg/m2. However, as cholecystectomies are routinely performed laparoscopically with low complication rates in patients with higher BMI, this cut-off is being questioned. Objectives To examine outcomes of Laparoscopic Cholecystectomy in patients with increased BMI, particularly when comparing patients with morbid-obesity (Class-III;BMI&amp;gt;40 kg/m2) to those with lower BMI. Methods Data was collected between 01/01/2022 and 31/07/2023 from hospitals throughout the Aneurin-Bevan University Health-Board, South-Wales, UK. Data on BMI, surgical indication, surgical duration, length of admission, and 30-day complications, amongst others was collected. Results This study included a total of 915 patients, 77.92%female 22.08%male. Patients were placed into 5 BMI categories: BMI&amp;lt;25(n=98),25-29(n=255),30-34(n=253),35-39(n=176), and&amp;gt;40(n=133). Median BMI was 31kg/m2, median surgical duration was 79-minutes, length of stay 0-days, the complication rate was 7.3%. There were two 30-day mortalities, one in each of BMI categories &amp;lt;25 and 25-29. Comparing patients with BMI&amp;gt;40 with others showed a significantly higher surgical duration (median 90.05mins vs83.5mins;p=0.045) but no difference in complications including bile-leak (2.3%vs1.8%;p=0.1823), significant bleed (0.7%vs0.4%;p=0.4779) or bile-duct injury (0%vs0.1%;p=0.4060). Due to existing day-surgery criteria, there was significantly increased length of admission in this group (median 1vs0 days;p=0.00). Conclusion This retrospective study finds Laparoscopic Cholecystectomy safe in patients with Class-III obesity with no increased association with intraoperative or post-operative complications. Criteria for day-surgery based solely on BMI&amp;gt;40 appears inappropriate.

Relationship between body mass index and cardiometabolic health in a multi-ethnic population: A project baseline health study

ObjectiveObesity is associated with a higher risk of cardiovascular disease. Understanding the associations between comprehensive health parameters and body mass index (BMI) may lead to targeted prevention efforts. MethodsProject Baseline Health Study (PBHS) participants were divided into six BMI categories: underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), class I obesity (30–34.9 kg/m2), class II obesity (35–39.9 kg/m2), and class III obesity (BMI ≥40 kg/m2). Demographic, cardiometabolic, mental health, and physical health parameters were compared across BMI categories, and multivariable logistic regression models were fit to evaluate associations. ResultsA total of 2,493 PBHS participants were evaluated. The mean age was 50±17.2 years; 55 % were female, 12 % Hispanic, 16 % Black, and 10 % Asian. The average BMI was 28.4 kg/m2±6.9. The distribution of BMI by age group was comparable to the 2017–2018 National Health and Nutrition Examination Survey (NHANES) dataset. The obesity categories had higher proportions of participants with CAC scores >0, hypertension, diabetes, lower HDL-C, lower vitamin D, higher triglycerides, higher hsCRP, lower mean step counts, higher mean PHQ-9 scores, and higher mean GAD-7 scores. ConclusionWe identified associations of cardiometabolic and mental health characteristics with BMI, thereby providing a deeper understanding of cardiovascular health across BMI.

Body Mass Index Does Not Drive the Risk for Early Postoperative Instability After Total Hip Arthroplasty: A Matched Cohort Analysis

BackgroundInstability remains the leading cause of revision following total hip arthroplasty (THA). The objective of the present investigation was to determine whether an elevated body mass index (BMI) is associated with an increased risk of instability after primary THA. MethodsAn administrative claims database was queried for patients undergoing elective, primary THA for osteoarthritis between 2010 and 2022. Patients who underwent THA for a femoral neck fracture were excluded. Patients who had an elevated BMI were grouped into the following cohorts: 25 to 29.9 (n = 2,313), 30 to 34.9 (n = 2,230), 35 to 39.9 (n = 1,852), 40 to 44.9 (n = 1,450), 45 to 49.9 (n = 752), and 50 to 59.9 (n = 334). Patients were matched 1:1 based on age, sex, and Elixhauser Comorbidity Index, as well as a history of spinal fusion, neurodegenerative disorders, and alcohol abuse, to controls with a normal BMI (20 to 24.9). A multivariate logistic regression controlling for age, sex, Elixhauser Comorbidity Index, and additional risk factors for dislocation was used to evaluate dislocation rates at 30 days, 90 days, 6 months, 1 year, and 2 years. Rates of revision for instability were similarly compared at 1 year and 2 years postoperatively. ResultsNo significant differences in dislocation rate were observed between control patients and each of the evaluated BMI classes at all evaluated postoperative intervals (all P values > .05). Similarly, the risk of revision for instability was comparable between the normal weight cohort and each evaluated BMI class at 1 year and 2 years postoperatively (all P values > .05). ConclusionsControlling for comorbidities and known risk factors for instability, the present analysis demonstrated no difference in rates of dislocation or revision for instability between normal-weight patients and those in higher BMI classes.

Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty.

Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA. 1736 patients within a prospective observational study were categorized into BMI classes. Pre- and postoperative Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR), satisfaction, and pain scores were compared by BMI class using one-way ANOVA. Healthy weight patients reported the highest preoperative HOOS JR (56.66 ± 13.35) compared to 45.51 ± 14.45 in Class III subjects. Healthy weight and Class III patients reported the lowest (5.65 ± 2.01) and highest (7.06 ± 1.98, p < 0.0001) preoperative pain, respectively. Changes in HOOS JR scores from baseline suggest larger improvements with increasing BMI class, where Class III patients reported an increase of 33.7 ± 15.6 points at 90days compared to 26.1 ± 17.1 in healthy weight individuals (p = 0.002). Fewer healthy weight patients achieved the minimal clinically important difference (87.4%) for HOOS JR compared to Class II (96.5%) and III (94.7%) obesity groups at 90days postoperatively. Changes in satisfaction and pain scores were largest in the Class III patients. Overall, no functional outcomes varied by BMI class postoperatively. Patients of higher BMI class reported greater improvements following THA. While risk/benefit shared decision-making remains a personalized requirement of THA, this study highlights that utilization of BMI cutoff may not be warranted based on pain and functional improvement.