Body Mass Index Cut-off Values Research Articles

Predictive values of body mass index, prognostic nutritional index and C-reactive protein to prealbumin ratio for prognosis of patients receiving radical gastrectomy.

we aimed to analyze the predictive values of body mass index (BMI), prognostic nutritional index (PNI) and C-reactive protein to prealbumin ratio (CRP/PA) for the prognosis of patients receiving radical gastrectomy. one hundred patients subjected to radical gastrectomy from August 2015 to January 2018 were enrolled. The cut-off values of BMI, PNI and CRP/PA on the receiver operating characteristic (ROC) curves were obtained and applied to establish a low BMI group (n = 46) and a high BMI group (n = 54), a low PNI group (n = 48) and a high PNI group (n = 52), as well as a low CRP/PA group (n = 57) and a high CRP/PA group (n = 43). through comparing the low BMI group with the high BMI group, there were differences in the tumor diameter, invasion depth, clinical stage, and lymph node metastasis status (p < 0.05). Differences were found in the invasion depth, tumor diameter, lymph node metastasis status, clinical stage, and postoperative adjuvant therapy in the low CRP/PA group compared with the high CRP/PA group (p < 0.05). The survival rate of all patients was 45.00 % (45/100) during the 5 years of follow-up. According to the Kaplan-Meier survival analysis, the low BMI group, low PNI group and high CRP/PA group had significantly reduced overall survival rates in comparison to those of the high BMI group, high PNI group and low CRP/PA group, respectively (p < 0.05). BMI, PNI and CRP/PA have important predictive values for the prognosis of patients undergoing radical gastrectomy.

Anthropometric Measurements in Predicting Haemorrhagic Stroke Among Bangladeshi Population: The MAGPIE Study.

Anthropometric measurements used to predict cardiovascular disease vary worldwide but are mostly derived from those of Caucasian ancestry. We sought to undertake such measurements in the little studied Bangladeshi population. The MAGPIE (Multidimensional Approach of Genotype and Phenotype in Stroke Etiology) study is a Bangladeshi stroke case-control study that recruited nationwide between January 2022 and June 2024. The univariate analysis was utilised to curtail the risk of independent variables, and a receiver operating characteristic (ROC) curve was employed to identify the cut-off values of Body Mass Index (BMI), Waist Circumference (WC), and Hip Circumference (HC). Furthermore, a multivariate logistic regression (LR) model demonstrated the risk of independent predictors of haemorrhagic stroke (HS) among sexes. Of a total of 1491 age- and sex-matched study population, 918 were haemorrhagic stroke (61.5%) with female predominance (n=489; 53.3%) and significantly older than men (P=0.003). The BMI (22.9 ±3.0 vs 21.3 ±3.0; P<0.001), WC (84.0 ±7.3 vs 80.8 ±7.3; P<0.001) and HC (90.6 ±7.1 vs 85.5 ±7.7; P<0.001) was significantly higher among women compared to men. A ROC curve demonstrated that the cut-off values of BMI, WC, and HC are 20.6kg/m2, 78.8cm, and 84.6cm, respectively, in men and 21.1 kg/m2, 81.5cm, and 88.1cm, respectively, in women haemorrhagic stroke population. Furthermore, an age-adjusted multivariate LR model identified a HC of ≥84.6 cm in men (OR 2.8, 95% CI 1.61-4.97; P <0.001) and a WC of ≥81.5cm in women (OR 1.6, 95% CI 1.01-2.37; P=0.001) as potential independent predictors of haemorrhagic stroke. Bangladeshi men with a hip circumference of ≥84.6cm have about threefold, and women with a waist circumference of ≥81.1cm have about twofold heightened risk of haemorrhagic stroke.

Predicting complete concentric collapse at the palatal level during drug-induced sleep endoscopy: an analysis of 1761 cases.

Drug-induced sleep endoscopy (DISE) helps select patients with obstructive sleep apnea (OSA) for surgery by identifying upper airway collapse patterns. This study aimed to predict the probability of complete concentric collapse at the palatal level (CCCp) during DISE based on patient characteristics, specifically body mass index (BMI). We retrospectively reviewed records of OSA patients who underwent DISE from January 2018 to July 2023. Logistic regression with receiver operating characteristic (ROC) analysis and classification and regression tree (CART) analysis were used to assess the diagnostic efficiency of BMI and other predictors for CCCp. A consecutive series of 1761 eligible patients was included for analysis. CCCp was observed in 22.3% of cases. The CCCp group had significantly higher BMI, neck circumference, apnea-hypopnea index (AHI) and height as well as increase in partial and complete collapse at oropharyngeal level. The ROC analysis for predicting CCCp for a BMI cut-off was similar for males and females 29.4kg/m² and 29.5kg/m², with an area under the curve (AUC) of 0.65 and 0.73, respectively. Adding predictors like tonsils, AHI, height and neck circumference improved the model's performance. Although confirming an association between increasing BMI and presence of CCCp, we were unable to define an accurate BMI cut-off value for predicting CCCp. The multifactorial nature of this collapse pattern challenges BMI's efficacy as a sole predictor. Our findings underscore the continued importance of DISE in evaluating CCCp and other collapse patterns for clinical decision-making in patients considered for hypoglossal nerve stimulation therapy.

Simple clinical predictors for making directive decisions in osteoporosis screening for women: a cross-sectional study

BackgroundOsteoporosis screening strategies vary according to a country’s policies. Simple and highly accurate diagnostic predictors should be developed and utilized. This cross-sectional study aimed to determine the diagnostic performances of weight, body mass index (BMI), and age for osteoporosis. Moreover, this study proposes and validates new cutoff values for these indicators.MethodsWomen aged 50 years or older who underwent Dual-energy x-ray absorptiometry (DXA) and did not receive any treatment for osteoporosis were enrolled. Age, weight, and BMI were used to analyze the diagnostic models. New cutoff values were proposed using the maximum Youden index value.ResultsA total of 1598 women were classified into normal bone mineral density, osteopenia, and osteoporosis groups. The mean age, weight, and BMI were 73.2 years, 53.6 kg, and 23.2 kg/m2, respectively, in the osteoporosis group, which significantly differed from those of the other groups. The new cutoff values for diagnosing osteoporosis at any site were 57.4 kg for weight, 23.8 kg/m2 for BMI, and 72 years for age. The area under the receiver operating characteristic curve (AUC) for weight < 57.4 kg, BMI < 23.8 kg/m2, and age ≥ 72 years cutoff values were 0.664, 0.633, and 0.558, respectively. The weight cutoff value yielded a significantly higher AUC than the BMI and age cutoff values (P = 0.002 and P < 0.001, respectively).ConclusionsThis study proposes new cutoff values for simple clinical predictors to facilitate directive decision-making in osteoporosis screening in women. Weight, which are easily obtained in clinical practice, are the most effective predictors of osteoporosis screening.

Relationships between human serum albumin levels and septic shock, in-hospital, and out-of-hospital mortality in elderly patients with pneumonia in different BMI ranges

ObjectiveThis retrospective cohort identified the association of human serum albumin (HSA) with adverse outcomes (septic shock, in-hospital and out-of-hospital mortality) in elderly hospitalized patients who have community-acquired pneumonia (CAP) and specific body mass index (BMI).Materials and methodsThis research included hospitalized CAP individuals (≥ 60 years) and was conducted at a teaching hospital in western China. All the patients were categorized into three populations based on two BMI cutoff values (18.5 kg/m2 and 24 kg/m2). The data was acquired from medical records, local government mortality databases, and telephone interviews. Binomial logistic regression analysis was used to explore the associations between low HSA and septic shock and in-hospital mortality, and Cox regression analysis was used to explore the association between low HSA and out-of-hospital mortality.ResultsA total of 627 patients were included in the analysis of in-hospital death and septic shock, and 431 patients were included in the analysis of out-of-hospital death. The study showed that 120 elderly patients with CAP (19.14%) died in the hospital, while 141 patients (32.71%) died out of the hospital, and 93 patients (14.83%) developed septic shock. No differences in in-hospital and out-of-hospital mortality were observed for BMI values < 18.5 kg/m2 or BMI ≥ 24 kg/m2, regardless of whether HSA was ≥ 40 g/l or < 40 g/l. When 18.5 kg/m2 ≤ BMI < 24 kg/m2, patients with HSA < 40 g/l had both higher in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: 26.13% vs. 11.46%, p < 0.001; out-of-hospital death: 46.15% vs. 19.17%, p < 0.001). No significant differences were observed in the incidence of septic shock between patients with HSA < 40 g/l and those with HSA ≥ 40 g/l either in the overall population or when the BMI values were divided according to the cutoff values of 18.5 kg/m2 and 24 kg/m2. After further logistic regression analysis and adjustment for potential confounders, the results showed that when 18.5 kg/m2 ≤ BMI < 24 kg/m2, elderly CAP patients with HSA < 40 g/l had a higher risk of in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: HR = 1.964, 95%CI = 1.08–3.573; out-of-hospital death: HR = 2.841, 95%CI = 1.745–4.627).ConclusionsHSA levels can predict the risk of in-hospital and out-of-hospital mortality in elderly patients with CAP and normal BMI values. However, HSA cannot predict the risk of septic shock in elderly patients hospitalized with CAP, irrespective of their BMI classification.

Factors Affecting Arterial Stiffness and Brachial-Ankle Pulse Wave Velocity in Patients With Type 2 Diabetes.

Background We defined the progression of atherosclerosis in patients by brachial-ankle pulse wave velocity (ba-PWV) and determined the relationship between ba-PWV and body composition factors, muscle strength, and patient characteristics. Methodology The arterial stiffness index, body composition, anthropometric parameters, blood test data, and background factors were evaluated in 109 patients with type 2 diabetes mellitus (T2DM). Statistical analysis was conducted using logistic regression analysisand analysis of covariance (p < 0.05). Results The mean age of the participants was 62.87 ± 12.11 years, body mass index (BMI) was 25.72 ± 4.35 kg/m²,ba-PWV was 1653.08 ± 366.55 cm/s, systolic blood pressure was 138.87 ± 16.74 mmHg, the number of years of disease was 11.17 ± 9.51 years, and hemoglobin A1c value was 6.90 ± 0.74%. Binomial logistic regression analysis of ba-PWV divided into two groups by arterial stiffness index, ≥ (or <) 1,400 cm/s, showed systolic blood pressure (odds ratio = 1.11, 95% confidence interval = 1.05-1.18, p < 0.001), BMI, and number of years of disease were significant independent variables. The cut-off value for BMI was 26.28 kg/m². BMI was a significant explanatory factor for ba-PWV in the analysis of covariance (p < 0.001). Conclusion BMI was associated with the incidence of atherosclerosis in patients with T2DM. We proposed a cut-off value for BMIbelow which the atherosclerosis index increased, a result that may reflect the influence of the metabolic paradox.

AWGC2023 cachexia consensus as a valuable tool for predicting prognosis and burden in Chinese patients with cancer.

The Asian Working Group for Cachexia (AWGC) proposed the first consensus report on diagnostic criteria for cachexia in Asians in 2023. However, the current consensus lacks cohort evidence to validate its effectiveness and practicality. We aimed to explore the value of the AWGC2023 criteria for predicting the prognosis and medical burden of patients with cancer through a retrospective post hoc cross-sectional analysis of the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers (INSCOC) project in China. Cox regression analyses were performed to assess the independent association between cachexia and long-term survival. We utilized C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), inflammatory burden index (IBI), albumin (ALB) and Glasgow prognostic score (GPS) as diagnostic markers for cachexia, designating them as CRP-based cachexia, NLR-based cachexia, IBI-based cachexia, ALB-based cachexia and GPS-based cachexia, respectively. Additionally, we diagnosed cachexia using body mass index (BMI) cutoff values of 18.5, 20, 21 and 22kg/m2, respectively, and subsequently compared their prognostic predictive value through Harrell's concordance index (C-index). Logistic regression models were used to assess the association between cachexia and medical burden. A total of 5426 patients with cancer were enrolled in this study. Cox regression analysis confirmed that cachexia based on the AWGC2023 criteria was an independent predictor of long-term survival in patients with cancer. Patients with cachexia had significantly poorer long-term survival than patients without cachexia (66.4% vs. 49.7%, P<0.001). Inflammatory biomarker-based cachexia was as an independent predictor of prognosis in patients with cancer, with inflammatory burden index (IBI)-based cachexia demonstrating the optimal prognostic discriminatory ability. The C-index indicated that cachexia based on BMI cutoff values of 18.5, 20, and 22kg/m2 did not perform as well as a BMI cutoff value of 21kg/m2. Logistic regression models revealed that using the AWGC2023 criteria, patients with cachexia had a 16.6% higher risk of prolonged hospitalization and a 16.0% higher risk of high medical expenses than patients without cachexia. The AWGC2023 criteria represent a valuable tool for predicting survival and medical burden among Chinese patients with cancer. Encouragement for further validation in other Asian populations is warranted for the AWGC2023 criteria.

High body mass index and triglyceride levels at health checkups increase the risk of new-onset chronic kidney disease and worsening renal function: the TAMA MED Project-CKD

BackgroundHealth checkups are important in patients with chronic kidney disease (CKD), which is not easily accompanied by subjective symptoms. CKD can be caused or aggravated by factors that have not yet been identified.MethodsThis retrospective cohort study included 7 483 patients who underwent specific annual health checkups at a medical institution in Tama City, did not have CKD in 2012, and continued to undergo checkups (aged 40–74 years). We examined the risk factors for new-onset CKD and 1.5-fold increase in serum creatinine levels among laboratory values from 2012 to 2020.ResultsAge, body mass index (BMI), triglyceride levels, atrial fibrillation, and medication for hypertension (HT) and diabetes mellitus were independent risk factors for proteinuria, whereas current smoking, BMI, systolic blood pressure (SBP), and medication for HT were independent risk factors for estimated glomerular filtration rate < 60 mL/min/1.73 m2. SBP, triglyceride levels and medication for HT were risk factors for a 1.5-fold increase in serum creatinine levels during course of the study. The cut-off values of BMI for eGFR < 60 mL/min/1.73 m2 were 22.2 (men 24.7, women 22.1) kg/m2 and fasting triglyceride levels for a 1.5-fold increase in serum creatinine level were 171 (men 247, women 170) mg/dL, respectively.ConclusionsHealth checkups provide information to prevent new-onset CKD and worsening of renal function. It is necessary to increase the rate of health checkups and visits to medical institutions after health checkups as well as to use these results for health guidance.

Abstract P139: Association Between Anthropometric Measurements and Diabetes and Their Abilities to Predict Diabetes: Based on the UK Whitehall II Study

Introduction: It is recognized that people with a high body mass index (BMI) will have a high risk of developing diabetes. However, some studies showed that other indices may provide a more accurate insight into the risk of developing diabetes. Our study aimed to compare the predictive abilities of 5 anthropometric measurements [BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-by-height0.5 (WHT.5R), and a body shape index (ABSI)] for diabetes. Hypothesis: WHtR may be most strongly associated with diabetes. High WHtR but normal BMI persons may have higher risk for developing diabetes than persons with high BMI but normal WHtR. Methods: From the UK Whitehall II cohort, we included participants with full records of weight, height, and WC in Phase 3 (1991-1994) for baseline survey, and carried out follow-up survey in Phase 9 (2007-2009) for the non-diabetics of the baseline survey. Our study indices, BMI, WC, WHtR, WHT.5R, and ABSI, were calculated from measured weight, height, or WC. Based on the recognized cut-off value of BMI, WC, and WHtR, we classified the persons into normal group (BMI: &lt;25 kg/m 2 ; WC: &lt;90 cm for men and &lt;80 cm for women; WHtR: &lt;0.5) and abnormal group (≥ corresponding cut-off value). For the indices (WHT.5R and ABSI) without an accepted cut-off value, we selected the 75th cohort-wide centile as the cut point to divide the participants into normal group (WHT.5R &lt;75th cohort-wide centile; ABSI &lt;75th cohort-wide centile) and abnormal group (≥ corresponding cut-off value). Subgroup analyses were based on combination of BMI and WHtR (normal BMI + normal WHtR; high BMI + normal WHtR; normal BMI + high WHtR; high BMI + high WHtR). The outcome is diabetes. We studied predictive value of the indices to diabetes by receiver operator characteristic (ROC) curve analysis at baseline survey, and evaluated the association between the indices and diabetes by Cox regression analysis at follow-up survey. Results: A total of 7979 participants were included at baseline survey [mean age: 50.1 ± 6.0 years; 2468 (30.9%) females], and there were 7488 non-diabetics available for the follow-up survey. At baseline survey, ABSI [areas under the curve (AUC): 0.711, sensitivity: 77.0%, specificity: 55.5%] and WHtR (AUC: 0.709, sensitivity: 67.2%, specificity: 65.6%) had top 2 predictive value of diabetes. At follow-up survey, the abnormal group divided by cut-off value of WHtR had the highest hazard ratio (HR) (2.46; 95% CI: 2.06-2.93), while the abnormal group classified by ABSI cut-off value had the lowest HR (1.77; 95% CI: 1.45-2.15). In subgroup analyses, “normal BMI + high WHtR” group (HR: 2.28; 95% CI: 1.59-3.27) appears to have higher risk for developing diabetes than “high BMI + normal WHtR” group (HR: 1.63; 95% CI: 1.22-2.17). Conclusion: WHtR seems to be an effective indicator for predicting diabetes. Besides BMI, controlling WHtR to the normal range is important for the prevention of diabetes.

Cross sectional study on the association among hypertension with obesity indicators and dietary patterns of fishing community at coastal regions in India

Background and aimOne of the main factors of sickness and disability around the world is hypertension and obesity is the main predictor of hypertensive condition. A few population-based studies on fishermen in West Bengal, India, evaluated the association between anthropometric parameters, nutritional intake, and obesity indicators with blood pressure (BP). The present investigation aims to explore the association between obesity indicators and nutrient consumption with blood pressure. MethodsIn the present study, a number of 1202 male fishermen (ages 25–60 years) from West Bengal's coastal areas, took their anthropometric measurements, BP values, and nutritional intake using standard techniques. The cut-off values of body mass index (BMI) and percentage of body fat (BF%) correlated with hypertension were determined by using receiver operating characteristic analysis. The statistical analyses were performed using SPSS (Version 20) and MedCalc statistical software (version 20.115). ResultsThe study showed that most of the anthropometric parameters were higher in the control group than the fishermen, and most of the fishermen remain in normotensive conditions. Obesity indicators were significantly high in hypertensive individuals. Increasing of the obesity indicators were associated with hypertensive condition. In the case of nutrient intake, only fat and oil intake had a significant positive correlation with an increase in BP. This finding also suggests that the BMI and BF% cut off values were associated with hypertension. ConclusionThis study suggests that the increasing value of BMI and the cut-off value of BMI and BF% of this study are all potential risk factors for hypertension.

Association of BMI and incidence of type 2 diabetes in Saudi population.

The study aims to identify the optimal body mass index (BMI) cut-off for obesity based on the risk of developing type 2 diabetes among the general population visiting primary health care in Saudi Arabia. A cross-sectional study was conducted in Al-Ahsa City, Saudi Arabia, from January to June 2022. The study included Saudi citizens aged 35 and older who had not previously or currently been diagnosed with type 2 diabetes. Data were collected through electronic health records from 48 primary healthcare centers. The variables derived from medical records were age, gender, HbA1c, weight, and height. The BMI mean among nondiabetic, prediabetic, and diabetic groups were 29.6 ± 6.2, 31.2 ± 6.6, and 31.7 ± 6.9 kg/m2, respectively. The BMI of the prediabetic and diabetic males were 30.1 ± 6.3 and 30.5 ± 6.5 kg/m2, respectively, and the BMI of the pre-diabetic and diabetic females were 31.9 ± 6.6 and 32.8 ± 7 kg/m2, respectively. The current study correlated the result of HbA1c levels with BMI cut-off values as a modifiable risk factor for developing type 2 diabetes among the Al-Ahsa population in Saudi Arabia. The BMI mean among nondiabetic, prediabetic, and diabetic groups were 29.6 ± 6.2, 31.2 ± 6.6, and 31.7 ± 6.9 kg/m2, respectively. This study provided a list of BMI values as cut-off points with their sensitivity and specificity measures so the policymaker could utilize them. The best cut-off point could be decided based on cost-effective analysis. Further studies in the future might help evaluate the efficacy of screening programs and the association between BMI and other types of diabetes.

The prevalence of obesity and relationship between obesity indicators and chronic diseases in Northern Shaanxi, China.

Obesity not only affects human health but also is an important risk factor for a variety of chronic diseases. Therefore, it is particularly important to analyse the epidemic trend of obesity and actively carry out the prevention and control of obesity in the population. A total of 4565 adults were selected by multi-stage stratified random sampling in Shenmu, Shaanxi Province, China. Univariate analysis was used to explore the epidemic characteristics of obesity in this region. Multivariate logistic regression was used to analyse the relationship between obesity and chronic diseases. Finally, the prediction efficiency of different obesity indexes was analysed by drawing receiver operator characteristic curves (ROC). All statistical analysis was completed by SPSS 26.0 software. The prevalence rates of overweight, obesity, and central obesity were 39.9%, 18.2%, and 48.0%, respectively. After adjusting for other confounding factors, multivariate logistic regression analysis showed that overweight and obesity were risk factors for hypertension, dyslipidaemia, and hyperuricaemia. Central obesity is a risk factor for dyslipidaemia and hyperuricaemia. High level of waist-to-height ratio (WHtR) was a risk factor for dyslipidaemia and hyperuricaemia (p < 0.05). Obesity-related indicators: body mass index (BMI), waist circumference (WC), and WHtR, are strongly correlated with the increased risk of chronic diseases in northern Shaanxi, China. The optimal BMI cut-off values for predicting hypertension, dyslipidaemia, and hyperuricaemia were 24.27, 24.04, and 25.54, respectively. The optimal WC cut-off values for predicting dyslipidaemia and hyperuricaemia were 84.5 and 90.5, and WHtR cut-off values were 0.52 and 0.54, respectively. The problem of overweight, obesity, and central obesity in adults is serious in northern Shaanxi, China. Obesity of all types will increase the risk of chronic diseases. Therefore, a variety of preventive and therapeutic measures should be adopted to curb obesity and reduce the incidence of related chronic diseases.

Nutrition and Health in Arab Adolescents (NaHAR): Study protocol for the determination of ethnic-specific body fat and anthropometric cut-offs to identify metabolic syndrome.

The prevalence of adolescent obesity in the Middle-East is considered among the highest in the world. Obesity in adolescents is associated with several cardiometabolic abnormalities, the constellation of which is referred to as the metabolic syndrome (MetS). This multi-country cross-sectional study aims to determine the optimal cut-off values for body fat (BF); body mass index (BMI) z-score; waist circumference (WC) percentile, and mid-upper arm circumference (MUAC) for the prediction of MetS among adolescents from Kingdom of Saudi-Arabia (KSA), Kuwait, Jordan, Lebanon and Syria. A secondary objective is to examine the validity of Bioelectrical Impendence Vector Analysis (BIVA) in estimating BF against the deuterium dilution technique (DDL). In each country, a sample of 210 adolescents will be recruited. Data collection will include demographics, socioeconomic, lifestyle and dietary data using a multi-component questionnaire; anthropometric measurements will be obtained and body composition will be assessed using the DDL and BIVA; blood pressure and biochemical assessment will be performed for the identification of the MetS. Receiver operating characteristic analyses will be undertaken to determine optimal cut-off values of BMI, WC, MUAC and BF in identifying those with MetS. Odds ratios (OR) and their respective 95% confidence interval (CI) for the association of the anthropometric measurements with MetS will be computed based on multiple logistic regression analysis models. The Bland and Altman approach will be adopted to compare BIVA against the reference DDL method for the determination of body composition parameters. This study responds to the need for ethnic-specific anthropometric cut-offs for the identification of excess adiposity and associated cardiometabolic risks in the adolescent population. The adoption of the generated cut-offs may assist policy makers, public health professionals and clinical practitioners in providing ethnic-specific preventive and curative strategies tailored to adolescents in the region.

Prevalence of Malnutrition using Anthropometric Index among the Sabar Tribal Preschool Children of Purulia District of West Bengal, India

Background It is well-established that tribal preschool children are still suffering from different types of malnutrition. Although data on the prevalence of malnutrition in the form of thinness (low body mass index (BMI) for age) among preschool children, particularly tribal preschool children in India, is limited. Objective The purpose of this study was to look at the anthropometric characteristics as well as the prevalence of malnutrition in the form of thinness using recent age and sex-specific BMI cut-off values. Methods The present cross-sectional study was carried out at seven different villages in the three Sabar concentrated blocks of the Purulia district. A total of 104 (49 boys and 55 girls) Sabar preschool children (aged 2-5-years) were investigated. Preschool children from seven Sabar-dominated villages were investigated. The prevalence of malnutrition in the form of thinness was assessed using an age- and sex-specific international BMI cut-off. Results There were significant age variations in mean weight and height observed in both sexes (p&lt;0.001). The overall prevalence of malnutrition among Sabar preschool children was 80.77%. Boys (85.71%) were more malnourished (low BMI-for-age) than girls (76.4%). Overall, about 37.5% of preschool children were severely malnourished. Conclusion The results revealed that their nutritional status was not satisfactory. Therefore, an appropriate nutritional intervention programme should be taken to reduce the burden of malnutrition among the Sabar preschool children of Purulia district, West Bengal, India.

Obesity may be a risk factor for transbronchial lung cryobiopsy-related adverse events in Japanese patients with interstitial lung disease

BackgroundTransbronchial lung cryobiopsy (TBLC) is known to be associated with a high incidence of adverse events. However, few studies have investigated the correlation between obesity and the risk of TBLC-related adverse events, especially in Asians, who are known to have characteristic differences in height and weight as compared to individuals of other ethnicities. MethodsWe retrospectively assessed 102 Japanese patients who underwent TBLC for the diagnosis of interstitial lung disease to evaluate the correlation between patient characteristics and the occurrence of TBLC-related adverse events (hemorrhage, pneumothorax, and acute exacerbation of interstitial lung disease). ResultsTBLC-related adverse events occurred in 19 patients (18.6 %), with hemorrhage being the most common adverse event (in 14 patients, 13.7 %). There was no correlation between age, sex, or pulmonary function test results and the occurrence of adverse events. The body mass index (BMI) cut-off predicting the occurrence of all adverse events was 26.6 kg/m2 (sensitivity of 0.389 and specificity of 0.852), and that predicting the occurrence of adverse events of hemorrhage was 26.8 kg/m2 (sensitivity of 0.462 and specificity of 0.907). Among patients with a BMI >26.8 kg/m2, adverse events of hemorrhage occurred in 37.5 % of cases, which was higher than among those with a BMI <26.8 kg/m2. ConclusionsObesity is a risk factor for the incidence of TBLC-related adverse events, particularly adverse events of hemorrhage, in Japanese patients. The BMI cut-off values that predicted an increased frequency of TBLC-related adverse events and hemorrhage specifically were 26.6 and 26.8 kg/m2, respectively.

Impact of non-obese metabolic dysfunction-associated fatty liver disease on risk factors for the recurrence of esophageal squamous cell carcinoma treated with endoscopic submucosal dissection: A multicenter study.

Metabolic dysfunction is a risk factor for esophageal squamous cell carcinoma (ESCC). We investigated the impact of the recently proposed metabolic dysfunction-associated fatty liver disease (MAFLD) and its subtypes on ESCC recurrence after endoscopic treatment. This multicenter observational cohort study enrolled consecutive patients newly diagnosed with ESCC after endoscopic treatment. Patients were classified into MAFLD or non-MAFLD groups. The MAFLD group was further classified into non-obese and obese MAFLD groups with a body mass index cutoff value of 25kg/m2 . The impact of MAFLD on the recurrence of ESCC was evaluated using a decision tree algorithm and random forest analysis. A total of 147 patients (average age 69years; male:female, 127:20; observational period, 2.4years) were enrolled. The 1-, 3-, and 5-year recurrence rates were 2.0%, 21.1%, and 33.7%, respectively. Independent risk factors for the recurrence of ESCC were MAFLD (HR 2.2812; 95% confidence interval 1.0497-4.9571; p=0.0373), drinking status, and smoking status. Metabolic dysfunction-associated fatty liver disease was identified as the second most important classifier for recurrence, followed by drinking status. The cumulative incidence of ESCC recurrence was higher in the MAFLD group than in the non-MAFLD group. In a subanalysis, the cumulative incidence of recurrence was significantly higher in the non-obese than in the obese MAFLD group among abstainers/non-drinkers. Directed acyclic graphs revealed that MAFLD directly contributes to ESCC recurrence. MAFLD was independently and directly associated with ESCC recurrence after endoscopic treatment; a high recurrence rate was observed in patients with non-obese MAFLD. Metabolic dysfunction-associated fatty liver disease may identify patients at high risk for ESCC recurrence.

Optimal Cut-Off Values for Body Mass Index and Fat Mass Index Based on Age in Physically Active Males Using Receiver Operating Characteristic Curve.

This study aims to redefine obesity cut-off points for body mass index (BMI) and fat mass index (FMI) according to the different age groups of physically active males. Healthy physically active volunteers (N = 1442) aged 18-57 years (y), with a mean BMI = 22.7 ± 2.8 kg/m2, and mean FMI = 4.3 ± 1.7 kg/m2 were recruited from various fitness centers. BMI was calculated and individuals were categorized according to the Asia-Pacific BMI criterion of ≤22.9 kg/m2 and the previous WHO-guided BMI criterion of ≤24.9 kg/m2. FMI was also calculated for the study participants with a cut-off of 6.6 kg/m2. Redefining of BMI and FMI cut-off values was carried out based on different age groups categorized with a difference of 10 y and 5 y using the receiver operating characteristic (ROC) curve and Youden's index. For the entire study population, BMI redefined cut-off points for overweight and obesity were 23.7 kg/m2 and 24.5 kg/m2, respectively, while FMI redefined cut-off points for overweight and obesity were 4.6 kg/m2 and 5.7 kg/m2, respectively. With 10 y of age group difference, a constant BMI and FMI values were observed, while with 5 y of age group difference, a constant increase in the BMI cut-offs was observed as the age group increased, i.e., from 23.3 kg/m2 in 20-24 y to 26.6 kg/m2 in ≥45 y and a similar trend was seen in FMI cut-offs. To conclude, our study suggests that age-dependent BMI and FMI cut-off points may provide appropriate measurements for physically active males as the age group increases.

Prognostic Value of Nutritional Markers for Long-Term Mortality in Patients Undergoing Endovascular Aortic Repair

Objective: The relationship between nutritional status and morbidity and death in a number of diseases and disorders has garnered considerable attension. In patients having endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA), we assessed the prognostic value of nutritional markers of albumin (ALB), body mass index (BMI), and geriatric nutritional risk index (GNRI) for long-term mortality. Materials and Methods: Retrospective data analysis was done on patients who had undergone elective EVAR for AAA more than 5 years earlier. Results: A total of 176 patients underwent EVAR for AAA between March 2012 and April 2016. The optimal cutoff value of ALB, BMI, and GNRI for predicting long-term mortality was calculated as 3.75 g/dL (area under the curve [AUC] 0.64), 21.4 kg/m2 (AUC 0.65), and 101.4 (AUC 0.70), respectively. Low ALB, low BMI, and low GNRI as well as age ≥75 years, chronic obstructive pulmonary disease, chronic kidney disease, and active cancer were independent risk factors for long-term mortality. Conclusion: Malnutrition, which is measured by ALB, BMI, and GNRI, is an independent risk factor for long-term mortality in patients receiving EVAR for AAA. Of the nutritional markers, the GNRI can be the most reliable nutritional indicator to identify a potentially high-risk group of mortality after EVAR.

Epidemiological features of acute medial meniscus posterior root tears.

Untreated or overlooked medial meniscus posterior root tears (MMPRTs) induce sequential knee joint degradation. We evaluated epidemiological features of acute MMPRT for its early detection and accurate diagnosis. Among 330 MMPRT patients from 2018 to 2020, those who underwent arthroscopic pullout repairs were enrolled. Patients who underwent non-operative treatment or knee arthroplasty, those with a cruciate ligament-deficient knee or advanced osteoarthritis of the knee, and those with insufficient data were excluded. Finally, we retrospectively evaluated data from 234 MMPRTs (female: 79.9%, complete tears: 92.7%, mean age: 65years). Welch's t-test and Chi-squared test were used for pairwise comparisons. Spearman's rank correlation analysis was performed between age at surgery and body mass index (BMI). Multivariable logistic regression analysis with stepwise backward elimination was applied to the values as risk factors for painful popping events. In both sexes, there were significant differences in height, weight, and BMI. In all patients, there was a significant negative correlation between BMI and age (ρ = - 0.36, p < 0.001). The BMI cutoff value of 27.7kg/m2 had a 79.2% sensitivity and a 76.9% specificity for detecting MMPRT patients aged < 50years. A painful popping event was confirmed in 187 knees (79.9%), and the frequency was significantly reduced in partial tears as compared to complete tears (odds ratio: 0.080, p < 0.001). Higher BMI was associated with a significantly younger age of MMPRT onset. Partial MMPRTs had a low frequency of painful popping events (43.8%).

The association between baseline patient characteristics and alpelisib-induced hyperglycaemia in patients with HR+, HER2-, PIK3CA-mutated metastatic breast cancer.

e13059 Background: Alpelisib (A) is a PI3Kα-selective inhibitor and degrader which, in combination with fulvestrant, has been approved for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2-), PIK3CA-mutated advanced breast cancer (ABC). Hyperglycemia is the most commonly observed adverse event of A. A pooled analysis of X2101 AND SOLAR-1 trials showed the association between five baseline patient characteristics (age, fasting plasma glucose (FPG), glycated haemoglobin, body mass index (BMI) and blood monocyte count (BMC)) and the development of A-induced hyperglycaemia (HG). We examined the association between baseline factors and the A-induced HG grade (G) ≥2 in a real-world setting. Methods: We performed the retrospective observational study and included patients (pts) with HR+, HER2-, PIK3CA-mutated metastatic breast cancer who received A + fulvestrant between Oct 18, 2019, and Oct 13, 2022, at the Institute of Oncology Ljubljana. Electronic records were reviewed. Baseline age, FPG, glycated haemoglobin, BMI and BMC before the start of A therapy and glucose levels during treatment with A were collected. Random plasma glucose values (RPG) were used for HG grading according to CTCAE V. The chi-square test was used to determine the association between the baseline characteristics and A-induced HG G ≥2. Results: Thirty-one female pts were included in the analysis. The median follow-up was 21 months, and the median duration of A treatment was 5.4 months. The baseline pts characteristics were as follows: median age 58 years (range 33–80), median FPG 5.6 mmol/L (range 3.10–8.6), median BMI 21.7 kg/m² (range 18.7–30.4), and median BMC was 10.3% (range 5.3–16.6). Baseline glycated haemoglobin values were only known for 58.1% of patients, so we did not further analyse them. The highest HG grades during treatment with A were as follows: G0 in 14 pts (45.2%), G1 in 5 pts (16.1%), G2 in 6 pts (19.4%), G3 in 6 pts (19.4 %). The calculated cut-off values associated with A-induced HG ≥2 were: age above 65 years, FPG above 5.9 mmol/L and BMC more than 11.5. None of the BMI cut-off values was associated with HG G≥2. Association between the baseline age, FPG and BMC and A-induced HG G≥2. Conclusions: Age over 65 years, FPG more than 5.9 mmol/L and BMC more than 11.5% have a statistically significant higher probability for A-induced HG G≥2. Therefore, these patients need more frequent blood glucose measurements, lifestyle adjustments and early treatment with metformin and/or other oral glucose-lowering agents. [Table: see text]