Body Mass Index Measurements Research Articles

The Link between Abdominal Obesity Indices and the Progression of Liver Fibrosis: Insights from a Population-Based Study

There is currently no available information on the correlation between abdominal obesity indices and the risk of liver fibrosis progression. We aimed to investigate the relationship between the body mass index (BMI), waist circumference (WC), and the visceral adiposity index (VAI) with the progression of liver fibrosis. The study also evaluated the association between these indices and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. A total of 1403 subjects participated in the cross-sectional and longitudinal population-based study. Liver stiffness was assessed via transient elastography, at baseline and follow-up (median: 4.2 years). The subgroup with dysglycemia was also analyzed. In the cross-sectional study, the highest quartile of VAI, BMI ≥ 30 kg/m2, and abdominal obesity showed significant associations with the prevalence of MASLD and liver fibrosis, as well as with fibrosis progression. However, VAI showed no association with MASLD incidence. Among the dysglycemic subjects, there was no observed association between VAI and the incidence of MASLD or the progression of fibrosis. In conclusion, the BMI, WC, and the VAI are associated with an increased risk of progression to moderate-to-advanced liver fibrosis in the general population. However, the VAI does not perform better than the BMI and WC measurement.

Body Mass Index and Thoracic Expansion in Post-COVID Dyspnea: A Secondary Analysis.

Dyspnea secondary to lung impairment can persist following the acute phase of COVID-19. Thoracic expansion measurements have been used as a diagnostic tool to evaluate chest wall mobility, respiratory function, and the effects of respiratory muscle strength training. Changes in chest wall mobility may occur because of altered chest biomechanics in individuals with respiratory diseases and an elevated body mass index (BMI). The purpose of this secondary analysis was to evaluate whether BMI influences thoracic expansion or forced expiratory volume over 1 second (FEV1) in individuals with persistent dyspnea following COVID-19. This study assessed the relationship between BMI and thoracic expansion, pulmonary symptoms, and exercise capacity following a home-based pulmonary rehabilitation intervention. A secondary data analysis was conducted with a sample of 19 adults with persistent dyspnea following COVID-19 infection who participated in a 12-week, home-based pulmonary rehabilitation study. Participants received expiratory muscle strength training devices and were instructed to perform pulmonary rehabilitation exercises three times per week over the study period. Pulmonary function, pulmonary symptoms, exercise capacity, and BMI measurements were collected. For analysis, study participants were divided into obese (BMI > 30 kg/m2) or nonobese (BMI < 30 kg/m2) categories. Correlations using the change scores from baseline to 12 weeks between thoracic expansion, FEV1, pulmonary symptoms, and exercise capacity were assessed. In addition, the minimal detectable change (MDC) in thoracic expansion was explored. Thoracic expansion was significantly improved after 12 weeks of training (p = .012) in the nonobese group. There was a significant correlation between the change in walking distance and pulmonary symptoms (r = -.738, p < .001) and in thoracic expansion (r = .544, p = .020), and walking distance, when controlling for BMI, but no change in FEV1. Average MDC was 1.28 for inspiration and 0.91 for expiration. Measurements of thoracic expansion were significantly lower in post-COVID individuals with an increased BMI. Individuals with persistent dyspnea and a higher BMI may require additional measures to increase chest mobility or to detect pulmonary changes following COVID-19.

Decreased Left Ventricular Mass is Associated with Sarcopenia and its Severity in Elderly Inpatients.

Skeletal muscle mass and cardiac structure change with age. It is unclear whether the loss of skeletal muscle mass (SMM) is accompanied by a decrease in heart mass loss. The aim of this study is to investigate the relationship of left ventricular mass (LVM) with sarcopenia and its severity in elderly inpatients. Seventy-one sarcopenia subjects and 103 non-sarcopenia controls were enrolled in this study. Bioelectrical impedance analysis, handgrip strength, and 5-time chair stand test were used to evaluate SMM, muscle strength, and physical performance, respectively. Myocardial structure and function were assessed by echocardiography. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia criteria 2019. Sarcopenic patients had smaller left ventricular sizes and LVM than non-sarcopenic controls. Severe sarcopenic patients had smaller left ventricular sizes and LVM than non-severe sarcopenic patients. In univariate regression analysis, body mass index (BMI), cardiac size, and LVM were positively correlated with SMM or SMI. In multivariate regression analysis, BMI and LVM were independently correlated with SMM and SMI. The combined measurement of LVM and BMI predicts sarcopenia with 66.0% sensitivity and 88.7% specificity (AUC: 0.825; 95% CI: (0.761, 0.889); p < 0.001). In hospitalized elderly patients, decreased left ventricular mass is associated with sarcopenia and its severity, and the combined measurement of LVM and BMI has a predictive value for sarcopenia.

Increased Risk of Cardiometabolic Disease in Ideal Weight Adults With History of Overweight/Obesity in China: A Prospective Cohort Study.

Overweight and obesity represent critical modifiable determinants in the prevention of cardiometabolic disease (CMD). However, the long-term impact of prior overweight/obesity on the risk of CMD in later life remains unclear. We aimed to investigate the association between longitudinal transition of body mass index (BMI) status and incident CMD. This prospective cohort study included 57 493 CMD-free Chinese adults from the Kailuan Study. BMI change patterns were categorized according to the BMI measurements obtained during the 2006 and 2012 surveys. The primary end point was a composite of myocardial infarction, stroke, and type 2 diabetes. Cox regression models were used to evaluate the associations of transitions in BMI with overall CMD events and subtypes, with covariates selected on the basis of the directed acyclic graph. During a median follow-up of 7.62 years, 8412 participants developed CMD. After considering potential confounders, weight gain pattern (hazard ratio [HR], 1.34 [95% CI, 1.23-1.46]), stable overweight/obesity (HR, 2.12 [95% CI, 2.00-2.24]), and past overweight/obesity (HR, 1.73 [95% CI, 1.59-1.89]) were associated with the incidence of CMD. Similar results were observed in cardiometabolic multimorbidity, cardiovascular disease, and type 2 diabetes. Additionally, triglyceride and systolic blood pressure explained 8.05% (95% CI, 5.87-10.22) and 12.10% (95% CI, 9.19-15.02) of the association between past overweight/obesity and incident CMD, respectively. A history of overweight/obesity was associated with an increased risk of CMD, even in the absence of current BMI abnormalities. These findings emphasize the necessity for future public health guidelines to include preventive interventions for CMD in individuals with past overweight/obesity.

Relationship Between Prepatellar Fat Thickness and Bone Mineral Density.

To evaluate the relationship between bone mineral density (BMD) by measuring the prepatellar fat thickness with knee radiography and to gain a measurement method that has not been done before in the literature. Cross-sectional descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation, Training and Research Hospital, Sanliurfa, Turkiye, between January and June 2020. Patients' age, body mass index (BMI) data, prepatellar fat thickness (mm), L1-L4 total, bone mineral density femoral neck, femur trochanter major, and femur total T scores were recorded. The relationships between these three groups (normal, osteopenia, osteoporosis) and between prepatellar fat tissue measurement were evaluated. One-way analysis of variance (ANOVA) and Post Hoc Tukey tests were used in the analysis. A statistically significant difference was found in terms of trochanter major T score measurements (X2 = 20.435; p <0.001) and BMI (X2 = 66.535; p <0.001) measurements of prepatellar fat thickness measurement. A statistically significant difference was found between the three groups in terms of prepatellar fat thickness measurement, L1-4 T-score, femoral neck, and femur total values (p <0.001). Prepatellar fat thickness in postmenopausal Turkish women was positively correlated with BMD; BMD increases as the prepatellar fat thickness increases. This explains that perapatellar fat thickness creates a mechanical load on the bones and causes an increase in BMD. Osteoporosis, Fat thickness, Bone mineral density.

High Variability of Body Mass Index Is Independently Associated With Incident Heart Failure.

Heart failure (HF) is a serious condition with increasing prevalence, high morbidity, and increased mortality. Obesity is an established risk factor for HF. Fluctuation in body mass index (BMI) has shown a higher risk of cardiovascular outcomes. We investigated the association between BMI variability and incident HF. In the UK Biobank, we established a prospective cohort after excluding participants with prevalent HF or cancer at enrollment. A total of 99 368 White participants with ≥3 BMI measures during >2 years preceding enrollment were included, with a median follow-up of 12.5 years. The within-participant variability of BMI was evaluated using standardized SD and coefficient of variation. The association of BMI variability with incident HF was assessed using Fine and Gray's competing risk model, adjusting for confounding factors and participant-specific rate of BMI change. Higher BMI variability measured in both SD and coefficient of variation was significantly associated with higher risk in HF incidence (SD: hazard ratio [HR], 1.05 [95% CI, 1.03-1.08], P<0.0001; coefficient of variation: HR, 1.07 [95% CI, 1.04-1.10], P<0.0001). Longitudinal health records capture BMI fluctuation, which independently predicts HF incidence.

Functional movement screen score to predict injury risk of sports students: a review of foot shape and body mass index

Background and Study Aim. Excessive physical activity poses a risk of injury, particularly when coupled with high exercise intensity. Factors such as Body Mass Index (BMI) and foot morphology may contribute to this risk. This study seeks to evaluate the relationship between BMI, foot shape, and the likelihood of injury among sports students. Material and Methods. A total of 119 sports students, comprising 33 females and 86 males, participated in this study. Purposive sampling was employed to select participants. BMI was determined using height and weight measurements, while foot shape was assessed through footprint measurements. The Functional Movement Screening (FMS) instrument, encompassing 7 movements: Deep Squats, Hurdle Steps, Inline Lunges, Shoulder Mobility, Active Straight Leg Raises, Trunk Stability Push-ups, and Rotary Stability, was utilized to assess injury risk. Data analysis was conducted using Microsoft Excel and IBM SPSS v.25.0, employing descriptive statistics. Results. Based on data analysis, the FMS value in females shows a mean of 18.7 and a standard deviation of 1.21. At the same time, the FMS value in males shows 18.5 and a standard deviation of 1.41. BMI values in females showed a mean of 21.6 and a standard deviation of 3.03. At the same time, BMI values in males showed a mean of 22.9 and a standard deviation of 4.62. The results were that all FMS scores were ≥14. While of BMI measurements, some samples obtained ˂18 kg/m² and ˃30kg/m². BMI measurements according to gender were mainly in the normal weight category. However, those who fall into the obesity category are primarily males. With the results of measuring the foot's shape, the percentage of flat feet is only 0.84% in females and 7.59 in males, while the rest of the sample has a normal foot shape. Conclusions. Individuals with a BMI in the overweight to obese category are more susceptible to high-category injuries, likely due to limited motion range. However, the study did not find evidence linking flat foot shape to high-category injury risk. This inability to establish a correlation may be attributed to the predominantly normal foot shape observed in the sample, resulting in a prediction of low-category injury risk.

Unveiling the mediating role of self-esteem in the relationship between physical activity and BMI: A structural equation modeling study in adolescents

The purpose of this study was to examine the mediating effect of self-esteem on the relationship between physical activity and Body Mass Index (BMI) in adolescents. Two hundred and sixty-nine adolescents completed the Self-Esteem Scale, the International Physical Activity Questionnaire (IPAQ), and BMI measurements. The Zhengzhou Education Authority facilitated data collection. We used Partial Least Squares (PLS) software for data analysis to evaluate the mediating effect of self-esteem. The results found that physical activity significantly improved self-esteem (β = 0.520, t = 12.881, p &lt;.05) and negatively affected BMI (β = -0.404, t = 7.658, p &lt;.05). The analyses of the Structural Equation Model (SEM) showed that self-esteem demonstrated a significant negative effect on BMI (β=-0.181, t=2.965, p&lt;.05) and mediated the relationship between physical activity and BMI, accounting for 20.6% of the total effect. Thus, elevating adolescents' self-esteem may lead to a direct and indirect reduction in BMI by promoting a heightened inclination towards physical activities. This research indicates that strategies to enhance adolescent health should broaden their focus beyond merely increasing physical activity and include efforts to boost self-esteem. It provides fresh perspectives on the intricacies of adolescent physical health, emphasizing the intricate relationships among physical activity, self-esteem, and BMI.

Dialysis Duration, Time Interaction, and Visceral Fat Accumulation: A 6-Year Posttransplantation Study.

Kidney transplantation (KT) leads to body composition change, particularly increasing the fat mass. However, limited researches have focused on the long-term follow-up of these changes and factors influencing body composition after KT. This study evaluated body composition in 31 adult KT recipients, measuring body mass index (BMI), the psoas muscle mass index (PMI) representing muscle mass, visceral and subcutaneous adipose tissue (VAT and SAT) representing fat mass, and skeletal muscle radiodensity (SMR) representing muscle quality before KT and at 2, 4, and 6years posttransplantation using computed tomography. Linear mixed models (LMM) analyzed temporal changes and contributing factors, while growth curve models assessed influence of these factors on body composition changes posttransplantation. Following KT, BMI, and PMI remained stable, while SAT increased significantly, revealing a 1.30-fold increase from baseline 2years after transplantation. Similarly, a substantial increase in VAT was observed, with a 1.47-fold increase from baseline 2years after transplantation with a further 1.75-fold increase 6years after transplantation. In contrast, SMR decreased with a 0.86-fold decrease from baseline after 2years. VAT increase was significantly influenced by the interaction between posttransplantation and dialysis duration. Growth curve models confirmed this interaction effect persistently influenced VAT increase posttransplantation. The study revealed that KT promoted significant alterations in body composition characterized by increase in the VAT and SAT and a decline in SMR. Notably, dialysis duration and its interaction with posttransplantation duration emerged as significant factors influencing VAT increase.

Excess weight, weight gain, and prostate cancer risk and prognosis: the PROCA-life study.

Studies of excess weight and weight changes throughout adult life for prostate cancer (PCa) risk and prognosis have shown inconsistent results. In a population-based cohort, the Prostate Cancer Study throughout life (PROCA-life), 16,960 healthy men from the prospective cohort Tromsø Study (1994-2016) were included. Body mass index (BMI) and weight were measured at all four attendings, and weight change was calculated as the difference between the first and last of either Tromsø4, Tromsø5 or Tromsø6. Overall, 904 men developed PCa during 16 years of follow-up, and Poisson regression with fractional polynomials was used to investigate trends in incidence. Cox proportional hazard and logistic regression models were used to study associations between measurements of BMI and weight change and PCa risk, severity, and mortality. At study entry, 46% of the participants (median age 44 years) were overweight, and 14% were obese (BMI > 30 kg/m2). We observed a 127% increase in overall age adjusted PCa incidence in the cohort during 1995 through 2019. No overall associations between BMI or weight change and PCa risk were observed. However, in sub-group analysis, weight gain among obese men was associated with a three-fold higher PCa risk (HR 3.03, 95% CI 1.39-6.58) compared with obese men with stable weight. Overweight was associated with lower risk of metastatic cancer (OR 0.48, 95% CI 0.30-0.75) at diagnosis. Men with obesity had higher risk of PCa-specific death (HR 1.72, 95% CI 1.03-2.88), while nonsmoking obese PCa cases had two times higher PCa-specific mortality compared with normal weighted PCa cases (HR 2.10, 95% CI 1.11-3.70). In our cohort, weight gain among obese men was associated with higher risk of PCa, and obesity was associated with higher PCa-specific mortality, especially among nonsmokers. The relationship between weight and risk for PCa remains complicated, and future studies are needed to determine clinical implications.

The Effects of High-Intensity Interval Training and Moderate-Intensity Continuous Training on Body Mass Index and Cardiopulmonary Function in Obese College Students

Objective: To observe the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body mass index (BMI) and cardiopulmonary function in obese college students.Methods: Fifty obese students from the first to third year of our university were randomly selected to participate in this study and were randomly divided into two groups, with 25 students in each group participating in different training programs. The groups were divided into HIIT and MICT groups, respectively, and they participated in high-intensity interval training and moderate-intensity continuous training for 3 months. Before and after the different interventions, the average BMI, vital capacity, and resting heart rate were measured.Results: There was no significant difference in BMI measurements between the two groups of obese college students before the intervention (P&gt;0.05). Before and after the intervention, both groups showed a significant decrease in average BMI compared to before the intervention (P&lt;0.05). After the intervention, the average BMI of the MICT group was significantly lower than that of the HIIT group (P&lt;0.05). There was no significant difference in vital capacity and resting heart rate measurements between the two groups of obese college students before the intervention (P&gt;0.05). After different interventions, both groups showed a significant increase in average vital capacity and a significant decrease in average resting heart rate compared to before the intervention (P&lt;0.05). After the intervention, the average resting heart rate of the MICT group was significantly lower than that of the HIIT group (P&lt;0.05).Conclusion: Both high-intensity interval training and moderate-intensity continuous training can significantly improve BMI and cardiopulmonary function in obese college students, with moderate-intensity continuous training having certain advantages in improving BMI and resting heart rate.

Assessment of transabdominal fat volumes as a predictor of prognosis in patients undergoing transcatheter aortic valve replacement.

Transcatheter aortic valve replacement (TAVR) has emerged as a well-established treatment option for eligible patients with severe aortic stenosis. This study aimed to investigate the correlation between abdominal fat tissue volumes, measured using computed tomography (CT), and all-cause mortality in patients undergoing TAVR. The study included 258 consecutive patients who underwent TAVR at a single center between September 2017 and November 2020. During the preoperative preparation, CT scans were used to perform a semi-quantitative measurement of abdominal fat components. Body mass index (BMI) for each participant was calculated. The relationship between fat parameters and overall survival was determined using multivariable Cox proportional hazards models. Participants had a mean age of 76.8 ± 7.8years, of whom 32.9% were male. The median follow-up period was 12months, during which 38 patients (14.7%) died. Both the survivor and non-survivor groups showed comparable risk factors. Regarding transabdominal fat volume parameters, deceased individuals exhibited significantly lower values. However, no significant differences were observed in BMI and transabdominal area measurements. Among transabdominal fat parameters, only subcutaneous fat volume [adjusted Hazard Ratio (aHR) = 0.83, p = 0.045] and total fat volume (TFV) [aHR = 0.82, p = 0.007] were identified as significant predictors of reduced all-cause mortality. Furthermore, TFV demonstrated the highest discriminative performance with a threshold of ≤ 9.1 L (AUC = 0.751, p < 0.001, sensitivity 71.1%, specificity 70.9%). Preoperative CT-based abdominal fat volume parameters, particularly TFV, can serve as potential predictors of survival in patients undergoing TAVR.

Rapid Increase of Female but not Male Obesity: Analysis of the 2023 Vanuatu Health Transition Project Survey on Aneityum

Rapid Increase of Female but not Male Obesity: Analysis of the 2023 Vanuatu Health Transition Project Survey on Aneityum

New role of fat-free mass in cancer risk linked with genetic predisposition

Cancer risk is associated with the widely debated measure body mass index (BMI). Fat mass and fat-free mass measurements from bioelectrical impedance may further clarify this association. The UK Biobank is a rare resource in which bioelectrical impedance and BMI data was collected on ~ 500,000 individuals. Using this dataset, a comprehensive analysis using regression, principal component and genome-wide genetic association, provided multiple levels of evidence that increasing whole body fat (WBFM) and fat-free mass (WBFFM) are both associated with increased post-menopausal breast cancer risk, and colorectal cancer risk in men. WBFM was inversely associated with prostate cancer. We also identified rs615029[T] and rs1485995[G] as associated in independent analyses with both PMBC (p = 1.56E–17 and 1.78E–11) and WBFFM (p = 2.88E–08 and 8.24E–12), highlighting splice variants of the intriguing long non-coding RNA CUPID1 (LINC01488) as a potential link between PMBC risk and fat-free mass.

Abstract 3429: Using metabolomics to identify biomarkers mediating the associations of adiposity in childhood and early adulthood with mammographic breast density in premenopausal women

Abstract Introduction: Mammographic breast density (MBD), a strong predictor of breast cancer risk, is highly influenced by body mass index (BMI) in childhood and early adulthood, but the mechanisms elucidating this relationship are undetermined. To our knowledge, no study has explored the mediating role of biomarkers on the relationship between early-life adiposity and MBD. The goal of this study is to discover metabolites that mediate the relationship between BMI at ages 10 and 18 with MBD in premenopausal women. Methods: This study includes premenopausal women who had their screening mammogram at Washington University in St. Louis, MO, and provided a fasting blood sample. Metabolon performed untargeted metabolomic profiling, detecting 1,074 metabolites. Metabolites missing &amp;gt;300 observations were excluded, leaving 828 metabolites; the other missing values were imputed using the nearest neighbor method. To mitigate batch effect, we normalized the metabolite peak area data using ComBat. Volumetric percent density (VPD) was calculated in 700 women using Volpara software. BMI at age 10 was estimated using the Stunkard pictogram, and BMI at age 18 was calculated from self-reported weight at 18 and height at study initiation. To assess the mediating role of the 828 metabolites, we performed high dimensional mediation analysis using the hima R package adjusting for potential confounders. Missing values in the covariates and BMI measures included in the mediation analysis were imputed using multivariate imputation by chain equations. Associations were considered significant if FDR p-value &amp;lt;0.1. Results: Four metabolites (glutamate, beta-cryptoxanthin, phytanate, and cortolone glucuronide (1)) mediated the relationship between BMI at age 10 and VPD; and 2 metabolites (glutamate, beta-cryptoxanthin) mediated the relationship between BMI at age 18 and VPD. Glutamate and beta-cryptoxanthin significantly mediated the relationship between both BMI measures and VPD, but glutamate was the strongest mediator across both time points. Glutamate mediated 6.7% (FDR p-value=0.06) and 9.3% (FDR p-value=0.008) of the total effect between BMI at age 10 and 18, respectively, on VPD. Beta-cryptoxanthin mediated 4.1% (FDR p-value=0.06) and 6.3% (FDR p-value=0.04), of the total effect between BMI at age 10 and 18, respectively, on VPD. Additionally, phytanate mediated 2.6% (FDR p-value=0.06) and cortolone glucuronide (1) mediated 2.0% (FDR p-value=0.07) of the total effect between BMI at age 10 and VPD. Conclusion: Amino acid, lipid, cofactor/vitamin, and xenobiotic metabolites mediated the associations of BMI in early-life and VPD in premenopausal women. This innovative study offers insight into the biological mechanisms underlying the link between early-life adiposity and MBD, which can support future research into breast cancer prevention. Citation Format: Kayla R. Getz, Myung Sik Jeon, Lili Liu, Lei Liu, Chongliang Luo, Jingqin Luo, Adetunji T. Toriola. Using metabolomics to identify biomarkers mediating the associations of adiposity in childhood and early adulthood with mammographic breast density in premenopausal women [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 3429.

Association of maternal nutritional status and small for gestational age neonates in peri-urban communities of Karachi, Pakistan: findings from the PRISMA study

BackgroundEarly pregnancy nutritional status can be associated with adverse birth outcomes such as small-for-gestational age (SGA) and low birth weight (LBW). BMI (Body Mass Index) and MUAC (Mid-upper arm circumference) are easy to use assessments and are indicative of the pre-pregnancy nutritional status if obtained in the first trimester. This study primarily assesses the association of maternal nutritional status using BMI and MUAC with SGA in a community-based cohort of Pakistani women. It also aims to determine the predictive ability of MUAC and BMI in predicting SGA. Secondarily, we assessed the association between maternal nutrition and large for gestational age (LGA) and LBW.MethodsThis study is a secondary analysis of an ongoing pregnancy cohort “Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA)“in Ibrahim Hyderi and Rehri Goth, Karachi. PRISMA participants who were enrolled between January 2021 to August 2022 were included given they had a gestational age < 14 weeks confirmed via ultrasound, MUAC and BMI measurements were available and birth weight was captured within 72 hours. Multivariable logistic regression was used to determine an association between maternal nutritional status and SGA. The PRISMA study was approved by the Aga Khan University Ethics Review Committee (2021–5920-15,518).ResultsOf 926 women included in the analysis, 26.6% (n = 247) had a low MUAC (< 23 cm) while 18.4% (n = 171) were underweight (BMI < 18.5 kg/m2). Nearly one third of low MUAC and underweight women delivered SGA infants (34.4 and 35.1% respectively). Underweight women and women with low MUAC had a statistically significant association with SGA (Underweight: OR 1.49, 95% CI 1.1,2.4; Low MUAC-OR 1.64, 95% CI 1.2,2.3) as well as LBW (Underweight: OR-1.63, 95% CI 1.1,2.4; Low MUAC-OR-1.63, 95% CI 1.2,2.3). ROC curves showed that MUAC and BMI had modest predictability for SGA (AUC < 0.7).ConclusionMaternal nutritional status as indicated by BMI and MUAC are strongly associated with adverse pregnancy outcomes including SGA, LGA and LBW. Although MUAC and BMI are widely used to determine maternal nutritional status, they have poor predictive ability for newborn size. Further research is needed to identify other tools or a combination of tools to better predict adverse birth outcomes in resource-limited settings and plan interventions.

Abstract 3425: Genetic predisposition to obesity and survival in women with breast cancer

Abstract Background. Higher body mass index (BMI) is associated with poor survival after breast cancer diagnosis. BMI is a heritable trait. A polygenic risk score (PRS) for BMI has been associated with cardiometabolic traits and found to modify weight loss interventions. Whether BMI genetic scores affect survival in women with breast cancer is unknown. Methods. This analysis was conducted in the Cancer Prevention Study II Nutrition cohort. Women diagnosed with non-metastatic breast cancer between 1992 and 2017 were included in the analysis if they had genotype data. Analyses were restricted to unrelated, postmenopausal women at the time of diagnosis who were of European ancestry (N=3,566). Deaths through 2020 were identified through linkage with the National Death Index. Primary cause of death was based on the International Classification of Disease codes. Pre-diagnosis BMI was self-reported (median 1.3 years from BMI measurement to diagnosis, interquartile range (IQR): 0.6, 1.9). We constructed a PRS using findings from a published meta-analysis of BMI genome wide association studies (GWAS) that included ~700,000 individuals and the PRSice tool.Hazard ratios (HR) and 95% confidence intervals (CI) between the PRS and all-cause mortality were estimated using Cox proportional hazards regression and Fine and Gray models for cause-specific mortality to account for competing risks. Models were adjusted for age and GWAS-specific statistically significant (P&amp;lt;0.05) principal components for population stratification. Mediation was estimated using the mediation R package. Results. The median age at diagnosis was 71.5 years (IQR: 66.3, 76.8). Most women were overweight (33.5%) or obese (18.4%) and were diagnosed with localized stage (63%) and estrogen receptor positive (65%) breast cancer. During a median follow-up of 14.5 years (IQR: 9.7-19.8), there were 1,825 (51.2%) deaths, including 301 breast cancer and 337 cardiovascular disease (CVD) specific deaths. In multivariable models, a 5 Kg/m2 increase in BMI was associated with increased risks of all-cause mortality (HR=1.09, 95% CI: 1.04, 1.15), breast cancer-specific mortality (HR=1.27, 95% CI: 1.13, 1.42), and CVD-specific mortality (HR=1.25, 95% CI: 1.11, 1.41). The PRS was highly predictive of pre-diagnostic BMI (P&amp;lt;0.001). A 1-standard deviation increase in the PRS was associated with statistically increased risk of all-cause mortality (HR=1.06, 95% CI: 1.02, 1.11). Risks of breast cancer (HR=1.07, 95% CI: 0.96, 1.19) or CVD (HR=1.01, 95% CI: 0.90, 1.12) specific mortality did not reach statistical significance. We estimated that 27% of the PRS and all-cause mortality association was mediated by BMI (95% CI: 12%, 91%; P=0.004). Conclusions. Women with breast cancer predisposed to higher BMI were at increased risk of all-cause mortality. A BMI-related PRS may be a useful tool to identify women with breast cancer in need of additional interventions and/or surveillance. Citation Format: Clara Bodelon, Adriana Lori, Mariah Landry, James Hodge, Parichoy Pal Choudhury, Ying Wang, Lauren E. McCullough, Alpa V. Patel, Lauren R. Teras. Genetic predisposition to obesity and survival in women with breast cancer [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 3425.

Abstract 2197: Weight history and colorectal cancer risk in the Cancer Prevention Study-3 cohort

Abstract While the link between obesity and colorectal carcinogenesis is established, limited evidence suggests that early-life overweight/obesity may be an important consideration, particularly in the development of early-onset colorectal cancer (CRC). Using data from the American Cancer Society’s Cancer Prevention Study-3 (CPS-3), we investigated the association of body weight across the life course and risk of CRC. From 2006-13, over 300,000 participants (ages 30-65) enrolled in the CPS-3 cohort and provided a baseline waist circumference (WC) measure, self-reported baseline weight and height, weight at age 18, and weight at each decade of adulthood (20s to current age). Body shape phenotype (apple, pear, other) was self-reported in 2015. Excess body mass index (BMI)-years was calculated by subtracting a reference BMI of 25 from the reported BMI for each decade of life and aggregating excess BMI for the reported years of life. Through 2018, 424 incident cases of colorectal cancer were reported, of which 94 were younger than 50 years. Associations of BMI measures and WC with incident CRC were estimated using multivariable-adjusted Cox proportional hazards regression and stratified by sex and body shape. After exclusions (n=248,804), 78% of participants were women, 85% were non-Hispanic white, 69% were never smokers, and 8% had a family history of CRC. The mean baseline age was 47.8 (women) and 48.5 (men) years. The mean baseline BMI, WC, and age 18 BMI were 27.6 kg/m2, 91.9 cm, and 21.7 kg/m2, respectively, among women and 28.3 kg/m2, 103.8 cm, and 23.1 kg/m2, respectively, among men. Baseline BMI was associated with 8% higher CRC risk (95% confidence interval (CI) 0.99-1.18) per 5 kg/m2 increase. However, apple body shape was associated with higher CRC risk (hazard ratio (HR) per 5 kg/m2 BMI = 1.18, 95% CI 1.02-1.38). WC was associated with higher CRC risk (HR 1.08, 95% CI 1.01-1.15) per 10 cm increase, and the association was higher for apple body shape (HR 1.14, 95% CI 1.01-1.28). BMI at age 18 was associated with 17% higher CRC risk (95% CI 1.03-1.32) per 5 kg/m2 increase, and the association was higher for apple body shape (HR 1.36, 95% CI 1.12-1.65). Associations for non-apple body shapes were not statistically significant across all exposures. For early-onset CRC, associations with baseline BMI, WC, and age 18 BMI were suggestive of higher risk but not statistically significant. Participants in the highest category of excess BMI-years (women ≥35, men ≥81) relative to those in the lowest had 56% higher risk of overall CRC (95% CI 1.19-2.05), but the association with early-onset CRC was not statistically significant (HR 1.92, 95% CI 0.90-4.07). These findings suggest that while obesity is associated with higher CRC risk, excess weight gain around the waist and at younger ages may be of importance. Studies are needed to confirm these findings and further investigate the potential role of early-life obesity in the development of early-onset CRC. Citation Format: Caroline Y. Um, Christina C. Newton, Aparna Parikh, Marjorie L. McCullough, Alpa V. Patel. Weight history and colorectal cancer risk in the Cancer Prevention Study-3 cohort [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 2197.

Incident HIV-Associated Wasting/Low Weight Is Associated with Nearly Doubled Mortality Risk in the Modern ART Era.

HIV-associated wasting (HIVAW) is an underappreciated AIDS-defining illness, despite highly effective antiretroviral therapy (ART). We (a) assessed the association between incident HIVAW/low weight and all-cause mortality and (b) described virologic outcomes after people with HIV (PWH) experienced HIVAW/low weight while on ART. In the Observational Pharmaco-Epidemiology Research & Analysis (OPERA®) cohort, PWH without prior HIVAW/low weight who were active in care in 2016-2020 were followed through the first of the following censoring events: death, loss to follow-up, or study end (October 31, 2021). HIVAW/low weight was a diagnosis of wasting or low body mass index (BMI)/underweight or a BMI measurement <20 kg/m2. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-dependent HIVAW/low weight and mortality were estimated with extended Cox regression models. Over a median follow-up of 45 months (interquartile range: 27, 65), there were 4,755 (8%) cases of HIVAW/low weight and 1,354 (2%) deaths among 62,314 PWH. PWH who experienced HIVAW/low weight had a significantly higher risk of death than those who did not (HR: 1.96; 95% CI: 1.68, 2.27) after adjusting for age, race, ethnicity, and changes in viral load (VL) and Veterans Aging Cohort Study Mortality Index scores over follow-up. Among 4,572 PWH on ART at HIVAW/low weight, 68% were suppressed (VL of <200 copies/mL); subsequent virologic failure was uncommon (7%). Among viremic PWH, 70% and 60% achieved suppression and undetectability (VL of <50 copies/mL), respectively, over follow-up. HIVAW remains a challenge for some PWH. Particular attention needs to be paid to HIVAW/low weight and virologic control to restore health and potentially reduce the risk of death.

Abstract P438: Combined Association of Body Mass Index and Central Obesity on Mortality Risk in Diabetes Population: The China Health And Retirement Longitudinal Study (CHARLS)

Introduction: Abdominal fat is associated with an elevated mortality risk and higher healthcare costs. Body mass index (BMI), commonly used to measure body fatness, underestimates excess abdominal fat due to its limited accuracy in reflecting fat and muscle distribution. Waist circumference (WC) is a more precise indicator of central obesity, which is defined as excess abdominal fat accumulation. The joint associations of combined BMI and WC with mortality risk in the diabetes population are not fully understood. Methods: We included individuals with diabetes and at least one measure of BMI and WC, from 2011, 2013, and 2015 waves with follow-up to 2018 in CHARLS. All individuals were classified into four groups: normal weight without central obesity, normal weight with central obesity (WC, male ≥ 90 cm, female ≥ 85 cm), overweight (BMI ≥ 24 kg/m 2 ) without central obesity, and overweight with central obesity. Multivariable logistic regression was used to model the associations between four groups and the mortality risk among people with diabetes adjusted for demographic characteristics, smoking, drinking, multimorbidities, and diabetes treatment. Results: Among 940 participants (mean age 60.4 years, 58.3% women), there were 124 incident cases of death recorded. Compared to normal weight without central obesity group, the mortality risk was increased among normal weight with central obesity group (Adjusted odds ratio = 2.11, 95% CI: [1.07, 4.18]). Other groups exhibited no statistically significant association with mortality risk (Figure 1). In sensitivity analysis excluding individuals with BMI ≤ 18.5 kg/m 2 , results were largely consistent with the previous findings. Conclusions: A significant association between central obesity and increased mortality risk in diabetes population was revealed. While, overweight with central obesity showed no significant association to mortality risk. Our findings stress the importance of customized strategies for central obesity in the diabetes population to reduce medical expenses.