Trends In Body Mass Index Research Articles

Inequalities in early childhood body-mass index Z scores in Victoria, Australia: a 15-year observational study

Early childhood overweight and obesity increased substantially in high-income countries throughout the 1980s and 1990s. The flattening or reversal of this trend since the early 2000s might conceal widening inequalities. This study aimed to identify trends in body-mass index Z score (BMIz) among children aged 1-3·5 years in Victoria (Australia), by socioeconomic status and geographical location. This repeated, cross-sectional study used deidentified records of height, weight, and demographic information from electronic databases in the Victorian Maternal and Child Health system. Data from the consultations for children aged 1, 2, and 3·5 years were included in this analysis. We removed duplicate records; records with missing data for sex, age, weight, height, or postcode; and records with postcodes that were outside of Victoria. The coprimary outcomes were trends in mean BMIz (continuous linear models) and prevalence of high BMIz (>+1; generalised linear models), estimated for six independent age-sex groups. Secondary analysis was done for the prevalence of BMIz greater than 2. Effect modification by socioeconomic status and remoteness was evaluated. Electronic data were available for 48 local government areas collected between Jan 1, 2003, and Dec 31, 2017, representing approximately 63% of the Victorian population. Overall, 1 329 520 measurements from 675 991 children were included in the analysis. There were small, significantly decreasing trends in mean BMIz across all six age-sex groups, overall and in major cities. Similar patterns were observed for some subgroups in prevalence of high BMIz. These decreasing trends appear to be partly explained by migration. Conversely, in regional areas the trends in BMIz were consistently increasing in all age-sex groups and across socioeconomic strata, although not all groups were statistically significant. Inequalities in BMIz according to socioeconomic status persisted throughout the study period, such that the children from more advantaged areas had lower mean BMIz. This study showed that at a state level, mean BMIz and prevalence of high BMIz decreased in children aged 1, 2, and 3·5 years in Victoria between 2003 and 2017. We found metropolitan-regional differences to be key source of inequality in early childhood BMIz trends, alongside area-level socioeconomic status. These findings highlight the risk that analysis of overall trends in childhood BMIz might obscure important inequalities according to, for example, remoteness, socioeconomic status, and ethnicity. Future research requires monitoring data with large population samples to adequately examine differences in prevalence and trends between population subgroups. None.

Social inequalities and trends in pre-pregnancy body mass index in Swedish women

Obesity rates in adolescence and young adulthood have increased in Sweden, reflecting global trends. To which extent this occurs across different socioeconomic strata has not been clarified. The aim of the present study was to investigate trends in social inequalities in body mass index (BMI) in young/mid-adulthood Swedish women. We obtained weight and height for all women aged 20–45 years, at their first registered pregnancy (< 12 weeks of gestation) in the Swedish Medical Birth Register 1982–2013 (1,022,330, mean age = 28.8 years), documenting education and county of residence. Trends in mean BMI and in the prevalence of BMI categories between 1982 and 2013 were estimated across education levels and geographical location. Overall, mean BMI increased from 22.7 kg/m2 (SD 3.2) to 24.3 kg/m2 (SD 4.4) between 1982 and 2013. Simultaneously, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) increased from 18.1 to 33.4% while that of moderate obesity (BMI ≥ 30 to < 35 kg/m2) and severe obesity (BMI ≥ 35 kg/m2) increased markedly from 3.4 and 0.4% to 7.4 and 3.1%, respectively. The prevalence of moderate and severe obesity more than doubled during the study period across all educational levels. In conclusion, BMI and moderate and severe obesity increased markedly among young/mid-adulthood Swedish women regardless of education with a widening gap between those with lower and higher education. These growing social inequalities in BMI are likely to cause a rising divide in serious health problems following early and long-lasting obesity.

Trends in HbA1c and Body Mass Index Among Individuals with Type 2 Diabetes: Evidence from a US Database 2012-2019.

IntroductionGiven the high rates of obesity and poor glycemic control among individuals with type 2 diabetes (T2D), this study examines current trends in HbA1c and body mass index (BMI) as well as the association between HbA1c and BMI among adults with T2D.MethodsData from the IBM® MarketScan® Explorys® Claims-EMR Data were used to construct eight annual cohorts for the years 2012–2019. Each annual cohort included adults identified with T2D who had at least one recorded HbA1c laboratory result and BMI value in the year of interest. Given these cohorts, trends in HbA1c and BMI were described over time using generalized estimating equation (GEE) tests.ResultsResults indicate that, over the study period from 2012–2019, average BMI increased significantly and there was a decrease in the percentage of adults with T2D who achieved glycemic control. In addition, for all years, higher BMI classification was associated with higher HbA1c values. When examining results for patients in different age groups, the findings were generally consistent with the overall population. In each age group, but most notably the age 18–44 group, the mean BMI increased over time and higher BMI was associated with higher HbA1c.ConclusionGiven the increase in BMI and decreasing percentage of individuals achieving glycemic control among adults with T2D found over the study period, therapies which decrease BMI as well as HbA1c can potentially have a significant impact on the management of T2D. The growing proportion of the younger age group with higher mean BMI may remain a key subgroup of interest.

Secular Change in Body Size and Somatotype of Indonesian Children aged 7–15 Years (1999–2019)

BACKGROUND: Secular changes assessment can help identifying the quality of health, wealth, and nutrition among populations and provide suggestions for policymakers. AIM: To examine the secular changes in weight, height, body mass index, and somatotype in Indonesian children between 1999 and 2019. METHODS: This cross-sectional study was conducted in 1999 and 2019 on 2021 children aged 7–15 years in Yogyakarta, Indonesia. Anthropometric measurements including height, weight, humerus and femur breadths, circumferences of upper arm and calf; skinfold thickness of triceps, subscapular, suprailiac, and calf were measured. Body mass index (BMI) was calculated as kg/m2. Somatotype components were defined by the Carter-Heath method. Statistical analyses used were three-ways ANOVA and least significant difference post hoc tests. RESULTS: Significant differences for boys and girls were found for height, weight, BMI, and three components of somatotype across the 2-time points. The boys in period 2019 were the tallest and girls were the heaviest, and for BMI, the highest value was observed in 2019 (girls). The children in the 1999 period had somatotype values 3.3 - 3.3 - 3.7 (boys) and 3.9 - 3.0 - 3.5 (girls), while in the 2019 period the somatotype values for boys were 3.5 - 4.5 - 3.0 and 4.3 - 4.1 - 2.4 for girls. CONCLUSION: In general, based on the order of age, there is a similar pattern between children in the two periods. Among Indonesian children from 1999 to 2019, there were positive trends in weight, BMI, endomorph, and mesomorph components, whereas a negative trend for the ectomorph component.

Combined hormonal contraceptives are associated with minor changes in composition and diversity in gut microbiota of healthy women

Recent human and animal studies have found associations between gut microbiota composition and serum levels of sex hormones, indicating that they could be an important factor in shaping the microbiota. However, little is known about the effect of regular hormonal fluctuations over the menstrual cycle or CHC-related changes of hormone levels on gut microbiota structure, diversity and dynamics. The aim of this study was to investigate the effect of CHCs on human gut microbiota composition. The effect of CHC pill intake on gut microbiota composition was studied in a group of 7 healthy pre-menopausal women using the CHC pill, compared to the control group of 9 age-matched healthy women that have not used hormonal contraceptives in the six months prior the start of the study. By analyzing the gut microbiota composition in both groups during one menstrual cycle, we found that CHC usage is associated with a minor decrease in gut microbiota diversity and differences in the abundance of several bacterial taxa. These results call for further investigation of the mechanisms underlying hormonal and hormonal contraceptive-related changes of the gut microbiota and the potential implications of these changes for women's health. This article is protected by copyright. All rights reserved.

Levels and Trends of BMI, Obesity, and Overweight at National and Sub-national Levels in Iran from 1990 to 2016; A Comprehensive Pooled Analysis of Half a Million Individuals.

In developing countries like Iran, the burden of obesity increases through comorbid diseases. We estimated the mean body mass index (BMI) and prevalence of overweight/obesity by components of sex, age, province, and year in Iran from 1990 to 2016. Through a comprehensive systematic review, all relevant data sources pooled results with individual level national and sub-national population-based studies. Two stages of age-spatio-temporal modeling and Gaussian process regression were used to estimate mean BMI, followed by estimation of obesity and overweight prevalence through the crosswalk modeling. In 2016, the age-standardized mean BMI was 27.9 (27.2-28.7) kg/m² in women and 25.9 (25.2-26.5) kg/m² in men. At the same time, the prevalence rates of overweight and obesity were 71.7% (67.9-75.8), and 36.8% (34.1-39.7) in females, and 57.1% (53.7-60.6), and 18.4% (16.9-20) in men. This shows a considerable increase from 1990 when the figures were respectively 24.4 (23.3-25.5) , 36.6% (32.2-41.5), and 8.2% (95% UI: 6.9-9.7) in women, and 23.5 (22.5-24.5), 30% (26.4-34), and 4.7% (4.0-5.5) in men, with 66% attributed to population growth. Considering the increasing trends of BMI, Sustainable Development Goals (SDGs) seem far out of reach. We need to call for action, aiming for both weight loss strategies and controlling the comorbidities that mediate high BMI risk.

Extension of Mendelian Randomization to Identify Earliest Manifestations of Alzheimer Disease: Association of Genetic Risk Score for Alzheimer Disease With Lower Body Mass Index by Age 50 Years.

Weight loss or lower body mass index (BMI) could be an early symptom of Alzheimer disease (AD), but when this begins to emerge is difficult to estimate with traditional observational data. In an extension of Mendelian randomization, we leveraged variation in genetic risk for late-onset AD risk to estimate the causal effect of AD on BMI and the earliest ages at which AD-related weight loss (or lower BMI as a proxy) occurs. We studied UK Biobank participants enrolled in 2006-2010, who were without dementia, aged 39-73, with European genetic ancestry. BMI was calculated with measured height/weight (weight (kg)/height (m)2). An AD genetic risk score (AD-GRS) was calculated based on 23 genetic variants. Using linear regressions, we tested the association of AD-GRS with BMI, stratified by decade, and calculated the age of divergence in BMI trends between low and high AD-GRS. AD-GRS was not associated with BMI in 39- to 49-year-olds (β = 0.00, 95% confidence interval (CI): -0.03, 0.03). AD-GRS was associated with lower BMI in 50- to 59-year-olds (β = -0.03, 95% CI: -0.06, -0.01) and 60- to 73-year-olds (β = -0.09, 95% CI:-0.12, -0.07). Model-based BMI age curves for high versus low AD-GRS began to diverge after age 47 years. Sensitivity analyses found no evidence for pleiotropy or survival bias. Longitudinal replication is needed; however, our findings suggest that AD genes might begin to reduce BMI decades prior to dementia diagnosis.

Prevalence of Obesity and Trends of Body Mass Index in Azad Jammu and Kashmir

In the present study an attempt has been made to figure out the remarkable factors that were responsible for higher body mass index (BMI) and obesity as well as to observe the existing trends of BMI in Azad Jammu and Kashmir. The factors were age, sex, diabetes, blood pressure, total cholesterol, triglycerides, blood glucose and random glucose. The statistical analysis with both classical and Bayesian methodologies was carried out for the investigation of significant risk factors. The results showed that with the increase in age the BMI also increases i.e., respondents of age group &gt; 60 have the highest percentage of 82.76% for BMI. Moreover, it was found that except sex and blood pressure all other factors had significant association with BMI. Additionally, four factors namely, age, diabetes, total cholesterol and triglycerides were selected for the development of the parsimonious model of BMI based on generalized linear model, step wise regression and Bayesian model averaging.

Personality traits and BMI trends over three years in Japanese university students.

In Europe and America, associations between personality traits and body-mass index (BMI) have been reported. However, in Japan, the association between personality traits and BMI (i.e., thinness and obesity) has not been well studied. In this study, we investigated the relationship between Temperament and Character Inventory (TCI) personality traits and changes in BMI status among Japanese students during their university attendance. We measured the height and weight of 5,340 students in a Japanese university during annual medical checkups and calculated their BMI. The students’ personality traits were measured using the short Japanese version of the TCI at university admission. The participants were divided into seven groups based on how BMI changed from the first year to the fourth year at university. In men, compared to the group that maintained normal BMI status (N = 2,189) over time (i.e., the control group), the group that maintained thinness status (N = 226) were lower in Reward Dependence, and the group whose status improved from thinness to normal (N = 117) were higher in Harm Avoidance. In women, compared with the control group (N = 1,510), the group that maintained thinness status (N = 302) was lower in Novelty Seeking, and the group whose status worsened from normal to thinness (N = 127) was higher in Harm Avoidance. Weak associations were found between thinness and TCI personality traits among Japanese university students. Further elaboration of the relationship between obesity or thinness and personality traits may help to provide effective preventive interventions in these areas.

Gaucher disease type 1 patients from the ICGG Gaucher Registry sustain initial clinical improvements during twenty years of imiglucerase treatment

BackgroundAlglucerase enzyme replacement therapy was approved for Gaucher disease (GD) in the United States in 1991; imiglucerase in 1994. We report hematologic, visceral, bone pain, bone crisis, height, weight, and Body Mass Index (BMI) outcomes in patients treated for 20 (±3) years with subset analyses based on pre-treatment severity, genotype, and age at treatment initiation. MethodsGD type 1 (GD1) patients in the ICGG Gaucher Registry with complete sets of baseline, 10-year, and 20-year data are included (N = 475). Ten-year and 20-year data are compared to pre-treatment baseline, stratified by splenectomy status. ResultsNon-splenectomized patients: Improvements observed at 10 years were maintained at 20 years for most outcomes. Mean changes from baseline at 10 and 20 years, respectively, were: spleen volume: 18.2 multiples of normal (MN) to 5.1 MN and 4.2 MN; liver volume: 1.8 MN to 1.0 MN and 1.0 MN; hemoglobin: 11.4 g/dL to 13.7 g/dL and 13.8 g/dL; platelet count: 91.6 × 109/L to 168.0 × 109/L and 169.1 × 109/L; without bone crisis: 85.0% to 98.2% and 96.5%; without bone pain: 52.5% to 72.0% at 10 years, no significant change at 20 years (58.5%). Splenectomized patients: significant changes were observed in liver volume: 2.3 MN to 1.1 MN and 1.0 MN; hemoglobin: 11.7 g/dL to 13.3 g/dL and 13.4 g/dL; platelet count: 229.1 × 109/L to 288.1 × 109/L and 257.0 × 109/L; without bone crisis: 52.2% to 91.3% and 100%; without bone pain: 16.3% to 30.6% (not significant) and 46.9%. Similar results were found in each of the subset analyses. Patients who start treatment during childhood have normal weight and height in young adulthood. Many treated adult patients are overweight or obese; however, this is consistent with BMI trends observed in the general population. After 1–2 years, the average biweekly imiglucerase dose is ~40 units/kg body weight. ConclusionImiglucerase is an effective, long-term treatment for GD1. In a long-term observational setting, improvements seen during early treatment years are sustained by continuing treatment for 20 years, except for bone pain in non-splenectomized patients. These results are consistent when analyzed by different patient subsets, including by disease severity.

Temporal trend of early pregnancy high body mass index in Australian women: risk factors and outcomes

Background There is a shift toward the increasing weight gain among women of reproductive age. Aim To assess changes in the prevalence of high body mass index (BMI) (including both overweight and obese) in early pregnancy in Australian women, and its risk factors and association with selected birth outcomes from 2011–2017. Methods Records of pregnant women who received antenatal care and gave birth at an Australian tertiary hospital during 2011–2017 were evaluated and trends of high BMI were investigated. Results The risk of high BMI at early pregnancy increased by 3% annually and rose from 37% in 2011 to 44% in 2017. The risk of high BMI was greater in women who were more than 35 years old, multiparous, were smoking during pregnancy, and who had neurological disorders. High maternal BMI was associated with greater risks of having assisted conception, caesarean section and larger neonate. Conclusion The rate of high BMI in early pregnancy increased between 2011–2017.

When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity

• Children with obesity face increased biopsychosocial risks during COVID-19. • Stress exacerbates inflammation and immune response in obesity and COVID-19. • The COVID-19 pandemic has significantly interrupted children's daily routines. • The health effects of the obesogenic environment are exacerbated by COVID-19. • Access to timely, comprehensive healthcare is critical during COVID-19.

Sex differences in impact of long-term burden and trends of body mass index and blood pressure from childhood to adulthood on arterial stiffness in adults: A 30-year cohort study

Background and aimsObesity and hypertension play important roles in the development of arterial stiffness. We aimed to examine the sex differences in the impact of the cumulative long-term burden and trends of body mass index (BMI) and blood pressure (BP) since childhood on adult arterial stiffness (AS). MethodsThis longitudinal study consisted of 1553 individuals aged 6–15 years, who were examined 4 or more times for BMI and BP since childhood, with a follow-up period of 30 years. The area under the curve (AUC) was calculated as a measure of the long-term burden (total AUC) and trends (incremental AUC) of BMI and BP from childhood to adulthood. Brachial–ankle pulse wave velocity (baPWV) was recorded by a non-invasive automatic waveform analyser in adulthood. ResultsThe total AUC and incremental AUC of systolic BP and diastolic BP were significantly associated with higher baPWV in adults, both male and female, after adjustment for other covariates. There was no association between the total AUC of BMI and arterial stiffness regardless of sex. However, there were sex differences in the association between the incremental AUC of BMI and arterial stiffness (p = 0.019 for interaction). The incremental AUC of BMI indicated an increased risk of arterial stiffening during adulthood in males, but this association was not found in females. ConclusionsThese results emphasize the importance of developing prevention and intervention strategies for hypertension and obese men (especially those who are gradually gaining weight) to reduce the risk of arterial stiffening and cardiovascular disease in adulthood.

BMI Trends In Patients With Ventricular Assist Devices After Bariatric Surgery

Background There is paucity of knowledge about the efficacy of bariatric surgery (BS) to achieve sustained weight loss in ventricular assist device (VAD) patients. Furthermore, the wide range of body mass index (BMI) and length of follow-up have made it impossible for small cohort studies to predict BMI trends after BS in VAD patients, in whom evidence from the general bariatric population may not be accurate. Methods We conducted a systematic search in ClinicalTrials.gov, Cochrane, Embase and PubMed. We also screened for references in Google Scholar, meeting proceedings, journal sites, and among citations in included studies. We extracted individual participant data of obese patients with VADs who underwent BS. We used Spearman's correlation test to analyze trends in BMI data. P Results For the 29 patients included, the mean age was 41.9 (± 12.2) years. All patients underwent either laparoscopic sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass. The baseline BMI at the time of BS was 45.2 (± 6.7) kg/m2. Every patient had lower BMI during follow-up than at the time of BS (Figure 1). Seven patients experienced some degree of weight gain ≥ 12 months after BS. There were statistically significant correlations (all P Conclusions Obese patients with VADs experience significant decreases in BMI, especially in excess BMI, over time after undergoing BS, although some patients re-gained some weight after one year. These results are promising, but further research, ideally with large registries combining bariatric, VAD, and transplantation outcomes, could provide more valuable insight to help identify predictive factors and guide patient selection for BS with VADs.

Long-term burden of higher body mass index from childhood on adult cardiometabolic biomarkers: A 30-year cohort study

Background and aimsData are limited regarding the association between long-term burden of higher body mass index (BMI) from childhood and cardiometabolic biomarkers. Methods and resultsA total of 1553 individuals aged 6–15 years, who were examined 4 or more times for BMI since childhood and followed for 30 years were included in our analysis. Total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trends of BMI. Cardiometabolic biomarkers including serum uric acid (SUA), fasting blood-glucose (FBG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) were obtained from venous blood samples. The results showed a positive association of BMI AUCt and AUCi with cardiometabolic biomarkers. After adjusting for demographic variables, the AUCt and AUCi of BMI were significantly associated with a higher level of SUA (β = 3.71; 2.87), FBG (β = 0.09; 0.09), and TG/HDL-C (β = 0.14; 0.11). We performed further studies after dividing subjects into four groups according to AUCt and AUCi of BMI by quartiles. Compared with the lowest quartile group, the highest quartile group had significantly increased risk ratios of hyperuricemia (RR = 2.01; 1.74), type 2 diabetes mellitus (RR = 8.18; 3.96), and high-risk TG/HDL-C (RR = 4.05; 3.26). ConclusionOur study identifies all subjects’ BMI growth curve from childhood and indicates that the long-term burden of higher BMI significantly increases the cardiometabolic risk, and the impact of excessive body weight on cardiometabolic health originates in early life. We emphasize the importance of weight control from childhood for cardiometabolic health.

Impact of body mass index on surgical coronary revascularization for ischaemic heart failure: insights from STICHES.

AimsPatients with obesity and ischaemic heart failure may counter‐intuitively have better outcomes compared with patients with normal body weight due to an ‘obesity paradox’. This study sought to determine if body mass index (BMI) impacts the treatment effects or safety outcomes of the treatment of ischaemic heart failure with coronary artery bypass grafting (CABG).Methods and resultsWe obtained and reviewed the Surgical Treatment of Ischaemic Heart Failure (STICHES) data for 1212 patients. We categorized obesity by the World Health Organization (WHO) classes to define baseline characteristics and test for treatment interactions for the primary and secondary STICHES outcomes by treatment groups. While CABG decreased the risk of death, there was no evidence of treatment interaction by BMI per 5 kg/m2 (P = 0.83) or WHO obesity class. For the overall cohort, there was no interaction by WHO obesity class for the cumulative incidence of death in either the medical therapy or CABG plus medical therapy (P‐interaction = 0.90). There was a non‐significant trend for higher BMI and a lower risk of death [hazard ratio 0.92, 95% confidence interval (CI) 0.85–1.00, P = 0.051]. Increasing body size (per 5 kg/m2) was associated with return to the operating room (odds ratio 2.48, 95% CI 1.45–4.26, P < 0.001) and infectious mediastinitis (odds ratio 2.09, 95% CI 1.10–3.97, P = 0.024) at 30 days but not other 30 day safety outcomes.ConclusionsThe benefit of CABG vs. medical therapy for ischaemic heart failure was consistent regardless of BMI or WHO obesity class for death or secondary clinical outcomes. However, higher BMI was associated with some short‐term post‐CABG complications.

P0804TRENDS IN BODY MASS INDEX IN PATIENTS WITH INCIDENT CHRONIC AND END STAGE KIDNEY DISEASE FROM 2004 - 2019

Abstract Background and Aims Obesity is increasingly prevalent in the general population. Body mass index (BMI) has a U-shaped relationship with mortality in chronic kidney disease (CKD), but also has implications for service delivery. We analysed the BMI trends in incident patients referred to CKD clinic (CKD), starting haemodialysis (HD), peritoneal dialysis (PD) and receiving a kidney transplant (Tx). Our aim was to establish the trend in BMI across these specified patient groups over the last 15 years. Method A single centre retrospective analysis was carried out including adults referred to secondary care nephrology services between 2004 and 2019. Patients were categorised into CKD, HD, PD, or Tx. Those reaching ESKD were grouped according to first method of renal replacement therapy (RRT). Patients with acute kidney injury and with missing BMI data were excluded. As per the World Health Organisation’s definition, BMI was categorised into classes I, II and III (&amp;gt;30, 35, and 40kg/m2 respectively). Results Of 10,057 patients, 6,936 patients were included. Of these, 59.96% (n=4,249) were CKD, 7.39% (n=524) were Tx, 4.85% (n=344) were PD, and 27.43% (n=1,944) were HD. BMI was 27.3±7.2kg/m2 in 2004 and 27.8±7.72kg/m2 in 2019 with no significant change in BMI as a whole throughout that time period (p=0.07). In subgroup analysis, there was no change in BMI in the CKD (p=0.52) or PD (0.76) groups. However, there was a significant increase in BMI seen in both the HD (p&amp;lt;0.001) and Tx (p=0.006) groups. An increase in the proportion of patients with class III obesity was also observed in the HD group (p=0.009) but not the CKD, Tx or PD groups. Conclusion In contrast to the general population, the prevalence of obesity has not changed in incident patients with kidney disease over the last 15 years. In subgroup analysis however, there is a trend towards rising BMI in the incident haemodialysis patient group. Limitations of the study include retrospective design, lack of ethnicity data, and inclusion of only a single measure of adiposity. Although the relationship between BMI and mortality in patients receiving maintenance haemodialysis is non-linear, the increase in the very obese in this patient group will have significant implications for healthcare providers.

1556-P: Trend and Prevalence of Underweight, Overweight, Obesity in Chinese Patients with Type 2 Diabetes, Aged 20-89 Years

Background: Both underweight and obesity are associated with highly elevated risks of adverse health outcomes. Gender, and age differences of overweight and obesity prevalence had been identified in overall population. However, less data was specialized evaluate the body mass index (BMI) characteristics, gender and age differences in patients with type 2 diabetes (T2D). Methods: We analyzed six hospital-based studies that had recorded height and weight in adults with T2D aged between 20 and 89 years. We calculated the trends of mean BMI and the prevalence of BMI categories defined by World Health Organization (WHO) and Working Group on Obesity in China (WGOC) criteria stratified by sex, age and provinces. Results: According to WGOC standard, the crude prevalence of general obesity (BMI ≥28 kg/m2) and overweight (24 kg/m2 ≤ BMI &amp;lt; 28 kg/m2) ranged from 10.3% to 16.4%, and 42.0% to 45.2%, respectively. According to WHO standard, the prevalence of general obesity (BMI ≥ 30 kg/m2) and overweight (25 kg/m2 ≤ BMI &amp;lt;30 kg/m2) ranged from 3.9% to 7.0%, and 34.3% to 37.8%, respectively. The crude prevalence of underweight (BMI &amp;lt;18.5 kg/m2) ranged from 1.7% to 2.4%. Age-stratified analysis revealed BMI and prevalence of obesity peaked in men aged 20 to 29 years, thereafter gradually declined. However, in women, BMI and trends of obesity were not consistent. The prevalence of underweight was higher in younger and older patients in both men and women. Geographic heterogeneity of obesity, overweight and underweight were observed across different provinces in mainland China. Conclusion: Gender, age and regional differences of BMI and prevalence of underweight, overweight, obesity were observed in Chinese patients with T2D, aged 20-89 years. Further studies are warranted to investigate the better BMI cutoff value in T2DM of different gender and age to plan health services and promote scientific decision-making in T2D. Disclosure F. Lv: None. X. Cai: None. L. Ji: None. Funding National Natural Science Foundation of China (81970698, 81900805), National Key Research and Development Program of China (2016YFC1304901)

Changes in body mass index among people living with HIV who are new on highly active antiretroviral therapy: a systematic review and meta-analysis

ABSTRACT In the era of highly active antiretroviral therapy (HAART), obesity is increasingly being reported among people living with HIV (PLHIV). In this study, we reviewed published literature on body mass index (BMI) changes among treatment-naïve adult PLHIV who started HAART and remained on treatment for at least six months. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, four databases were searched, and results of included studies were synthesized to describe the BMI trend among PLHIV on treatment. The search generated 4948 studies, of which 30 were included in the qualitative synthesis and 18 were eligible for the meta-analysis. All the studies showed an increase in group BMI. HAART was associated with increase in BMI (pooled effect size [ES] = 1.58 kg/m2; 95% CI: 1.36, 1.81). The heterogeneity among the 18 studies was high (I 2 = 85%; p < .01). Subgroup analyses showed pooled ES of 1.54 kg/m2 (95% CI: 1.21, 1.87) and 1.63 kg/m2 (95% CI: 1.34, 1.91) for studies with follow-up ≤1 year and >1 year, respectively. We conclude that the greatest gain in BMI is in the initial 6–12 months on treatment, with minor gains in the second and subsequent years of treatment.

Longitudinal association between body mass index and physical activity among adolescents with different parental risk: a parallel latent growth curve modeling approach

BackgroundData available on the association between physical activity (PA) and body mass index (BMI) in different periods of life is controversial. Using a parallel latent growth curve modeling (LGCM) approach, the current study aimed to investigate the influence of daily PA on adolescents’ BMI over a 12 year follow-up, taking into account their parental risk.MethodParticipants comprised 1323 adolescents (53.5% girls), aged 12–18 years who had participated in the baseline phase of Tehran Lipid and Glucose Study (TLGS) (2001–2003), and were followed for an average period of 12 years. Physical activity, including leisure time and occupational activities, was assessed using the reliable and validated Iranian version of the Modifiable Activity Questionnaire (MAQ). Weight and height were objectively measured in order to calculateBMI.Atwo-step cluster analysis was conducted to classify parents into two high- and low-risk clusters. Parallel LGCM was fitted to estimate cross-sectional, prospective and parallel associations, which assessed the longitudinal association between simultaneous changes in PA and BMI during the study period. Analyses were stratified by gender and parental clusters.ResultsA rising trend of BMI per 3 years was observed in boys 1.39 kg.m2(95% CI; 1.32, 1.48) and girls 0.9 kg.m2(95% CI; 0.82, 0.98), as well as in the low risk 1.11 kg.m2(95% CI; 1.03, 1.18) and high-risk 1.12 kg.m2(95% CI; 1.03, 1.22) clusters. Moreover, a positive prospective association between PA at baseline and BMI change over the 12 year follow-up, was observed in adolescents in the low-risk parental cluster 0.27(95% CI; 0.14, 0.41) indicating that higher levels of PA at baseline may lead to greater BMI in adolescents over time. However, examining longitudinal parallel association between simultaneous changes of PA and BMI per 3 years revealed adverse associations for adolescents in the low-risk parental cluster − 0.07 (95% CI; − 0.13, − 0.01) and in boys − 0.06 (95% CI; − 0.11, − 0.01).ConclusionDespite a positive prospective association between BMI and PA at baseline, there was a weak inverse parallel association between these variables over time, particularly in boys and adolescents with low parental risk. These findings imply the potential role of other influential factors indetermining adolescents’ weight status which need to be considered in the future plannings.