Calculate Body Mass Index Research Articles

Self-Reported Height and Weight for BMI Calculation Compared With Measured Height, Weight, and BMI in Patients Undergoing Liposuction of the Upper and Lower Abdomen: A Single-Center Retrospective Review

Self-reported height and weight is commonly used in medical practice for the determination of body mass index (BMI). Self-reported height and weight can be underestimated or overestimated resulting in inaccurate BMI calculations. In our practice the self-reported height and weight are obtained at the time of cosmetic surgery consultation. The purpose of this study is to determine the accuracy of preoperative height, weight, and BMI calculations in patients undergoing liposuction of the abdomen in comparison to measurements obtained by nursing staff the day of surgery. Clinically, these data may affect perioperative risk stratification and preoperative planning with respect to deep venous thrombosis prophylaxis. Using Nextech electronic medical records (EMR) system, charts were reviewed from July 2019 to July 2022. Patients identified as having underwent liposuction of the upper and lower abdomen were reviewed. All patients had been consented for the prescribed procedure. Data extracted included the self-reported height/weight and calculated BMIs obtained at the time of consultation as well as measured height/weight and BMIs from the day of surgery. The study sample included 50 patients (31 women and 19 men), with an average age of 44 ± 11 years (range, 20-71 years). Time from consult to surgery ranged from 2 to 270 days with an average of 58 days. Time of consult (TOC) height average was 169.1 cm (range, 152.4-190.5 cm) versus day of surgery (DOS) height average of 169.5 cm (range, 149-190 cm). Time of consult weight average was 82.4 kg/181.66 lbs (range, 54.5-115.9 kg/120.15-264.89 lbs) versus DOS average of 84 kg/185.19 lbs (range, 53.8-116 kg/118.61-255.74 lbs). Time of consult BMI average was 28.5 kg/m2 (range, 21.1-43.9 kg/m2) with a DOS average of 29 kg/m2 (range, 20.9-47 kg/m2). Height was on average underestimated by 0.03 cm. Weight was on average underestimated by 1.6 kg at the TOC compared with DOS. BMI difference between TOC and DOS had an average underestimate of 0.5 kg/m2. A total of 8 patients upstaged to a higher obesity classification based on DOS BMI calculation. Subgroup analysis of male and female height and weight estimations versus measured data are also reviewed. When averaged the time of consultation height, weight, and BMI correlated with height, weight, and BMIs measured and calculated the day of surgery in patients undergoing liposuction of the abdomen. Sixteen percent of our study population were reclassified to a higher obesity class based on DOS height and weight. For the purposes of accurate perioperative risk management and deep venous thrombosis prophylaxis planning, height and weight should be obtained accurately at the time of consultation or at a preoperative visit within 1 month of surgery.

Patients with gastrointestinal cancer are more susceptible to unintentional weight loss after chemotherapy treatment

There is growing evidence showing that some chemotherapeutic agents employed for oncology treatments contribute to the induction of anorexia, leading to weight loss and the reduction of muscle mass due to the effects of treatment and the tumor, which may trigger the cachexia syndrome. Owing to the complexity of the diagnosis and body evaluation in these patients, the objective of this study was to evaluate the nutritional status of oncology patients submitted to chemotherapy treatment showing a weight loss greater than 5%. We screened 220 oncology patients and shortlisted 10 patients diagnosed with different types of tumors assisted by the Instituto Ribeirãopretano de Combate ao Câncer under chemotherapy treatment and who presented weight loss greater than 5%. Anthropometric data such as weight, height and arm circumference (AC) was used for the calculation of Body Mass Index (BMI). We also used the Arm Muscle Circumference (AMC) and Arm Muscle Area (AMB) and the application of the Oncology Patient Global Nutrition Questionnaire. The results point out that cancer patients presented different anthropometric classification pre-diagnosis and after the beginning of anticancer treatment resulting from the side effects of chemotherapeutic agents and the reduction in the volume of food ingested. Gastrointestinal tract cancer patients presented greater short-term weight loss when compared to other types of tumors. We suggest that the observed weight loss may be related to the MFLOX and FOLFOX treatment protocols, in addition to the reduction in food intake (while maintaining good nutritional quality). These factors together may lead to the reduction of life quality and life expectancy and worsened patients’ prognosis.

Study of preferences of patients with diabetes regard to pharmaceutical services

Pharmacies are a component of the healthcare. Pharmaceutical care and pharmaceutical services improve disease control, quality of patients life and reduce of the burden on healthcare. The implementation of pharmaceutical care and pharmaceutical services for patients with diabetes according to the standards of the GPP is relevant for the domestic pharmacy. Therefore, it is advisable to determine the preferences of patients with diabetes because they have their own needs for treatment and control.
 The purpose of the study was to study the views of patients with diabetes regarding to function of pharmacies, pharmaceutical services and determine their preferences.
 The survey of patients with diabetes by the questionnaire method was carried out. Relevant questionnaires of 510 patients with type 1 and type 2 diabetes were included in the study.
 The results of the survey showed that the majority of patients with diabetes would like to be served in a specialized pharmacy that specializes in drugs and medical products for diabetes. On the basis of the study, the preferences of patients with diabetes regarding to the activities of pharmacies were determined: availability of a wide rang of product; loyalty program for special products related to diabetes, additional services and pharmaceutical consultations. The majority of those interviewed noted that they need a pharmacist's consultation on taking medications. This type of service requires training of pharmacists in diabetes in order to provide pharmaceutical care at an appropriate level. Pharmaceutical services which patients with diabetes need were identificated. There are: testing of blood glucose, cholesterol, blood pressure, weight check, calculation of body mass index and interpretation of results. The creation of a «diabetes self-management school» based on pharmacies will improve the availability of education for patients with diabetes. It is necessary to study the demand directly in the area of the pharmacy before introduction this type of service. It is important to implement systematic special events in pharmacies for the World Diabetes Day. Thes is appropriated for the general population, but also for patients with diabetes. From the point of view of patients with diabetes during this event, they are interested in: consultation of an endocrinologist and nutritionist; blood glucose test; test of diabetes risk; information materials about diabetes.
 The results of the survey can be prospectively used to improve the service of patients with diabetes and provide for their needs.

Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.

Associations of Change in Body Size With All-Cause and Cause-Specific Mortality Among Healthy Older Adults

The association between weight change and subsequent cause-specific mortality among older adults is not well described. The significance of changes in waist circumference (WC) has also not been compared with weight change for this purpose. To examine the associations of changes in body weight and WC with all-cause and cause-specific mortality. This cohort study is a post hoc analysis of data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial, which recruited participants between March 1, 2010, and December 31, 2014. The study included community-based older adults (16 703 Australian participants aged ≥70 years and 2411 US participants aged ≥65 years) without evident cardiovascular disease (CVD), dementia, physical disability, or life-limiting chronic illness. Data analysis was performed from April to September 2022. Body weight and WC were measured at baseline and at annual visit 2. Analysis models were adjusted for baseline body mass index because height and weight were measured at baseline, allowing for calculation of body mass index and other variables. Both body weight and WC changes were categorized as change within 5% (stable), decrease by 5% to 10%, decrease by more than 10%, increase by 5% to 10%, and increase by more than 10%. All-cause, cancer-specific, CVD-specific, and noncancer non-CVD-specific mortality. Mortality events were adjudicated by an expert review panel. Cox proportional hazards regression and competing risk analyses were used to calculate hazard ratios (HRs) and 95% CIs. Among 16 523 participants (mean [SD] age, 75.0 [4.3] years; 9193 women [55.6%]), 1256 deaths were observed over a mean (SD) of 4.4 (1.7) years. Compared with men with stable weight, those with a 5% to 10% weight loss had a 33% higher (HR, 1.33; 95% CI, 1.07-1.66) risk of all-cause mortality, and those with more than a 10% decrease in body weight had a 289% higher (HR, 3.89; 95% CI, 2.93-5.18) risk. Compared with women with stable weight, those with a 5% to 10% weight loss had a 26% higher (HR, 1.26; 95% CI, 1.00-1.60) risk of all-cause mortality, and those with more than a 10% decrease in body weight had a 114% higher (HR, 2.14; 95% CI, 1.58-2.91) risk. Weight loss was associated with a higher cancer-specific mortality (>10% decrease among men: HR, 3.49; 95% CI, 2.26-5.40; 5%-10% decrease among women: HR, 1.44; 95% CI, 1.46-2.04; >10% decrease among women: HR, 2.78; 95% CI, 1.82-4.26), CVD-specific mortality (>10% decrease among men: HR, 3.14; 95% CI, 1.63-6.04; >10% decrease among women: HR, 1.92; 95% CI, 1.05-3.51), and noncancer non-CVD-specific mortality (>10% decrease among men: HR, 4.98; 95% CI, 3.14-7.91). A decrease in WC was also associated with mortality. This cohort study of healthy older adults suggests that weight loss was associated with an increase in all-cause and cause-specific mortality, including an increased risk of cancer, CVD, and other life-limiting conditions. Physicians should be aware of the significance of weight loss, especially among older men.

Association between obesity and cervical intraepithelial neoplasia: results from a case control study in south western Uganda

BackgroundThough obesity has been said to be associated with a number of malignancies including cervical cancer, its association with cervical intraepithelial neoplasia (CIN) is still a contentious issue. This study was designed to determining the prevalence and association between obesity and CIN.MethodsThis was an unmatched case control study, involving women with cervical intraepithelial neoplasia (cases) and those negative for intraepithelial lesions or malignancy (controls) at the cervical cancer clinic of Mbarara Regional Referral Hospital, in south-western Uganda, between April and November 2022. Cases and controls provided written informed consent and were recruited in a ratio of 1:1. Cases were identified by visual inspection with acetic acid (VIA) and subsequent confirmation with cytology and/or histology. Demographic information was collected using an enrolment form and height, weight and waist circumference were recorded. We calculated body mass index (BMI) and identified obese women as those with body mass index of ≥ 30 kg/m2 from both case and control groups. Central obesity was defined as waist: height ration of ≥ 0.5. Data was analysed using STATA version 17. Categorical variables were analysed using proportions, chi-square and logistic regression analysis to determine association between obesity and CIN. Our level of statistical significance was set at ≤ 0.05.ResultsThe prevalence of general and central obesity among cases was 25.5% (24/94) and 0% (0/94) respectively while the prevalence of general and central obesity among controls was 33.3% (37/111) and 0% (0/111) respectively. There was an increased prevalence of general obesity among women with low grade squamous intraepithelial lesions (LSIL). However, there was no statistically significant association between general obesity and CIN. Factors associated with general obesity included residing in Mbarara city (AOR 2.156, 95%CI 1.085–4.282, P-value 0.028), age group of 31–45 years (AOR 2.421, 95%CI 1.577–9.705, P-value 0.003) and ≥ 46 years (AOR 1.971, 95%CI 1.022–11.157, P-value 0.046).ConclusionWe observed an increased prevalence of general obesity among women with LSIL. However, there was no association between obesity and CIN. Factors associated with general obesity included residing in Mbarara city, and being in the age groups of 31–40 and ≥ 46 years. This highlights the need to rethink management of CIN to control other non-communicable diseases that could arise due to general obesity.

Does an obesogenic family environment moderate the association between sports participation and body composition in children? The ENERGY project.

Previous research on the association between sports participation and body composition has shown mixed findings. The family home is considered one of the most influential environments on childhood obesity. Thus, the association between sports participation and body composition in children may be influenced by an obesogenic home environment. To investigate if an obesogenic family environment moderates the association between sports participation and body composition in children. A total of 3999 children (54% girls; 11.6 ± 0.7 years) and their parent(s) were included from the ENERGY project. A composite obesogenic family environment risk score was created from 10 questionnaire items. Height, weight (to calculate body mass index), and waist circumference were obtained by trained researchers and used as indicators of body composition. The composite risk score significantly moderated the association between sports participation and both waist circumference and body mass index. In children from families with moderate and high obesogenic risk, organized sports participation was significantly associated with smaller waist circumference (moderate risk: -0.29, 95% CI -0.45 to -0.14; high risk: -0.46, 95% CI -0.66 to -0.25) and lower body mass index (moderate risk: -0.10, 95% CI -0.16 to -0.04; high risk: -0.14, 95% CI -0.22 to -0.06), but not in children with a low obesogenic family risk score. Enrolling children in sports activities from an early age can be important for healthy weight maintenance, especially among children from obesogenic family environments.

Unhealthy weight control practice and related factors among female public college students in Harari Regional State, Ethiopia, 2019

The aim of this study was to determine the magnitude of unhealthy weight control practice and related factors among female college adolescents in Harari region. A school based cross-sectional study was conducted among 290 female college adolescents who were randomly selected from two government colleges. A pre- tested self-administered questionnaire was used. Measurement was taken to calculate Body Mass Index. Data was entered, cleaned and analyzed using SPSS version 20. Anthropometric. In this study, the odds of getting engaged in unhealthy weight control practice was 7.21 times higher among those within perceived overweight group than adolescents in perceived normal weight group, [AOR =7.2; 95% CI =1.2-27.9]. Furthermore, female adolescents within dissatisfied group for middle torso had 1.43 times higher odds of getting engaged in unhealthy weight control practice than those within satisfied group, [AOR=1.4; 95% CI=1.1-1.9]. The findings of this study gave insight on the prevalence of unhealthy weight control practice among female college adolescents in Harari regional state. The study also have got significant association between perceived overweight, middle torso dissatisfaction and engagement in unhealthy weight control practice within the last 30 days among female college adolescents in Harari regional state.

Daily profile of arterial and central aortic pressure in patients with arterial hypertension and non-alcoholic fatty liver disease

Оbjective : to evaluate the features of daily monitoring of arterial and central aortic pressure in patients with arterial hypertension and non-alcoholic fatty liver disease. Materials and methods: a comparative cross-sectional study was conducted, which involved 120 patients (continuous sample, unorganized population), aged 45 to 65 years (mean age 56.2±8.8 years), including men (34 (28.3%) with AH stage I–II, 1–2 degree. The main group included 60 patients with hypertension and NAFLD, the control group included 60 patients with isolated hypertension. When examining patients, a clinical examination was carried out: taking an anamnesis, measuring "office" blood pressure, anthropometric parameters, calculating body mass index (BMI), WC. 24-hour monitoring of arterial (ABPM) and central aortic pressure (CAP) was assessed using the BPLab complex and Vasotens 24 software (LLC Petr Telegin, Russia). The SCORE scale was used to calculate total cardiovascular risk and 10-year fatal risk. Results : all patients of the study groups underwent ABPM. It was proved that in the patients of the main group, the IV SBP and IV DBP during the day and night significantly exceeded the similar parameters of patients in the comparison group (IV SBP: p=0.0019, p=0.007; IV DBP: p=0.009, p=0.009, respectively). One of the important criteria for assessing blood pressure was the determination of the degree of nighttime decrease in SBP and DBP — the daily index (SI), characterizing the balance in the work of the sympathetic and parasympathetic parts of the autonomic nervous system. In the main group, compared with the control group, there were more patients with SI DBP in the range from 0.0% to 10.0% (non-dipper) (p=0.034), with an increase in SBP at night (night-picker) (p=0.031). When assessing the parameters of CAP, in patients with AH and NAFLD, statistically significantly higher values of mean daily systolic (SADAo) and diastolic (DADo) aortic pressure were observed (p=0.016, p=0.039, respectively), SBP in the daytime (p=0.027), SADao and DADAO at night (p=0.002, p=0.003, respectively), compared with patients with isolated hypertension. Calculation of the risk of cardiovascular complications, in patients with hypertension and NAFLD, a significant increase in the 10-year risk of cardiovascular events was determined, compared with patients with isolated hypertension (3.7 (1.6; 6.0) vs 2.0 (0.6 ;4.3) %, p=0.013). Conclusion : according to the results of 24-hour BP monitoring, in patients with AH and NAFLD, compared with patients with isolated AH, a more significant increase in mean SBP and DBP, an increase in the rate of morning rise and BP variability, and the hypertension time index were revealed. In the main group, patients with a nocturnal increase in SBP were detected significantly more often, which indicates a greater risk of cardiovascular complications in patients with hypertension and NAFLD. In addition, compared with patients with isolated AH, patients with AH and NAFLD showed more significant increases in average daily and nighttime SBPao and DADAO.

Evaluation of the effects of ethylmethylhydroxypyridine succinate on cognitive function and clinical-functional status of patients with chronic obstructive pulmonary disease and ischemic heart disease

Objective — to assess the effects of ethylmethylhydroxypyridine succinate on cognitive function and clinical and functional status of patients with chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD). Materials and methods. The study was conducted among outpatients at the clinic of the GI «L.T.Mala National Therapy Institute of NAMS of Ukraine». Examinations involved 67 patients with mean age 61.64±9.17 years. Among them, 27 were patients with COPD and IHD combination, 22 patients with isolated COPD, and 18 patients with isolated IHD. According to the study design, during telephone contact 6 months after the start of observation, all patients were administered the drug ethylmethylhydroxypyridine succinate 500 mg per day for 3 months. The evaluation of its effects on cognitive function in patients with COPD and IHD was carried at visit‑2 (after 12 months from the start of observation). All patients underwent general clinical examination, anthropometric measurements, calculation of body mass index, and spirometry before taking ethylmethylhydroxypyridine succinate (at visit‑1) and after three months of taking the drug (visit‑2). To verify the degree of dyspnea intensity, the following scales were used: five‑point scale Mediсal Research Council Dyspnea Scale in Fletcher’s modification (mMRC) and modified 10‑point Borg scale (Borg, 1982). Questionnaire САТ (COPD Assessment Test) was used to assess COPD effects on the well‑being and everyday life of the patient. Physical load tolerance was evaluated based on the 6‑minute walk test. To assess the cognitive status of patients, the Hospital Anxiety and Depression Scale scale (HADS), Generalized Anxiety Disorder test (GAD‑7), and Montreal Cognitive Assessment were used. Results. In patients with COPD, both with concomitant IHD and without it, the manifestations of shortness of breath decreased and the tolerability of physical exertion improved against the background of administration ethylmethylhydroxypyridine succinate 500 mg per day for three months. Patients with isolated IHD demonstrated improved cognitive function and reduced depressive symptoms. The anxiety decrease was observed in patients with IHD with or without concomitant COPD. Conclusions. Ethylmethylhydroxypyridine succinate can be recommended to improve cognitive function in patients with COPD and IHD.

IMPACT ASSESSMENT MONO- AND COMBINATION ANTIHYPERTENSIVE THERAPY LERCANIDIN AND DILTIAZEM ON CENTRAL BLOOD PRESSURE AND ARTERIAL STIFFNESS IN PATIENTS WITH MILD TO MODERATE ARTERIAL HYPERTENSION

Nowadays widely debated search of new methods to reduce cardiovascular risk in thepopulation. Many randomized studies have proven the value of the arterial wall stiffnessin the forecast deterioration of cardiac patients. Therefore, based on these considerationstherapy that improves the elasticity of the arteries may have greater efficacy in preventingmajor cardiovascular events.Purpose – to compare the effectiveness of combination lerсanidipin and diltiazem indifferent dose in patients with mild and moderate arterial hypertension on effects oncentral blood pressure and arterial stiffness.Materials and methods. The study included 123 patients with mild to moderate arterialhypertension, the average office systolic (SBP) / diastolic (DBP) blood pressure – 149,12/ 91,92 ± 1,42 / 0,93 mm Hg. Average age of patients was 51,83 ± 0,86 years. All patientswere divided into group therapy. The first group (n = 20) – diltiazem administered topatients at a dose of 240 mg per day in two divided doses. The second group (n = 20) –patients lerkanidipin 20 mg administered once daily. The third group (n = 22) – patientsintended unfixed combination lerkanidipin 20 mg and 240 mg diltiazem day. The fourthgroup (n = 20) – patients intended unfixed combination lerkanidipin 10 mg and 240 mgdiltiazem day. The fifth group (n = 21) –patients intended unfixed combination lerkanidipin10 mg and 120 mg diltiazem day. The sixth group (n = 20) – patients intended unfixedcombination lerkanidipin 20 mg and 120 mg diltiazem day.All patients at the beginning and end of treatment conducted the following studies:measurement of body weight and height, calculation of body mass index. Measurementoffice SBP, DBP and HR, ambulatory blood pressure monitoring (DMAT), determinationof pulse wave velocity in elastic arteries (PWVe) and muscle (PWVm) types, the definitionof central BP, biochemical blood which included determination of total cholesterol(cholesterol), triglycerides (TG), high density lipoprotein cholesterol (HDL cholesterol),low density lipoprotein cholesterol (LDL-C). Duration of treatment was 1 month.Results. After analyzing all the data, it was found that the сentral blood pressure in alltreatment groups decreased effectively and equally. In the group of 240 mg diltiazemcentral BP significantly decreased by 10.95 mmHg; in group lercanidipin 20 mg 12.18mmHg; in the combination group lercanidipin 20 mg / diltiazem 240 mg 14.13 mm Hg. Inthe combination group lercanidipin 10 mg / diltiazem 240 mg central BP decreased on11.93 mmHg; in the combination group lercanidipin 10 mg / diltiazem 120 mg centralblood pressure decreased on 13.11 mmHg; in the combination group lercanidipin 20 mg /diltiazem 120 mg central blood pressure decreased on 14.82 mmHg. That is, all selectedtreatment regimens were equally effective in reducing central blood pressure. There wasno negative impact on the treatment of all levels of blood lipid spectrum. All treatmentregimen did not significantly affect the average values of indicators characterizing theelastic properties of the arteries (due to short-term observation).Conclusion. Therapy based on both mono and combination lercanidipin and diltiazemwas effective in reducing central blood pressure and did not significantly affect theaverage values of indicators characterizing the elastic properties of the arteries.

Response to: Association of Intraoperative Red Blood Cell Transfusions With Venous Thromboembolism and Adverse Outcomes After Cardiac Surgery.

We are grateful for the interest and comments of Butt et al1 with regard to our recently published study.2 First, Butt et al1 noted that the overall exposure rate to intraoperative packed red blood cells (PRBCs) was 17.8% in our study compared to the reported rate of 12.8% to 60.3% in previous studies in similar patients. They then speculated that the relatively lower rate of intraoperative PRBC transfusion observed in our study was due to our decision to label missing information on intraoperative PRBC transfusion as “no transfusion.” In support of their argument, they cited a retrospective study of 8141 patients from 10 centers who had cardiac surgery between 2011 and 2014; these patients underwent either isolated coronary artery bypass grafting (CABG) surgery or aortic valve replacement, and Butt et al1 did not cite the risk-adjusted rate for intraoperative PRBC transfusion, which was found to be 4% to 59%.3 Thus, our reported rate of 17.8% is likely reflective of the more contemporary and average national rate of intraoperative PRBC transfusion for isolated CABG surgery. Furthermore, Butt et al1 highlighted that labeling missing data for intraoperative PRBC transfusions as “no transfusion” as justified in the methodology section of our manuscript, and omission of any postoperative transfusion before any hospital-acquired venous thromboembolic (HA-VTE) complications might have biased the association between intraoperative PRBC transfusion and HA-VTE complications. To address this, we performed a sensitivity analysis which indicated that after removing patients with missing data for intraoperative PRBC transfusion the association between intraoperative PRBC transfusion and HA-VTE remained (odds ratios [ORs] for 1, 2, 3, and ≥4 units of PRBC versus none: 1.16 [1.09 to 1.23], 1.19 [1.12 to 1.26], 1.59 [1.49 to 1.68], 1.49 [1.40 to 1.58]). Postoperative transfusion before any HA-VTE complications was not collected by the Society of Thoracic Surgeons Adult Cardiac Surgery Database and was not available for analysis. Second, Butt et al1 also indicated that a causality relationship between intraoperative PRBC transfusion and HA-VTE complications was not supported by the lower odds of HA-VTE complications in women. To address this comment, we reiterate the following: i) given the retrospective nature of our study it was not meant to definitively ascertain a causality, but rather reinforce a previously described association between intraoperative PRBC transfusion and HA-VTE complications in a large-scale national registry; ii) our propensity score-weighted, and covariate-adjusted analysis including adjusting for sex indicated that intraoperative PRBC transfusion was independently associated with HA-VTE complications after isolated CABG surgery; iii) only a small proportion of patients had missing data for height (0.03%) and weight (0.02%), and thus, the calculated body mass index (BMI) was observed in nearly all patients (missing, 0.03%). Therefore, our conditional imputation for 0.03% of the missing BMI is highly unlikely that it may have impacted the association of BMI and intraoperative PRBC transfusion in the development of the propensity score. We agree with Butt et al1 that it would have been potentially valuable to study the impact of geographic location on our selected patient- and procedure-related characteristics, but this information was not available through the participant user file research mechanism via which our study was approved. Third, we agree with the comment that delayed thromboprophylaxis during a prolonged hospital length of stay may also exacerbate HA-VTE complications independently or in combination with intraoperative and postoperative PRBC transfusions. As indicated by Butt and colleagues1 the Society of Thoracic Surgeons Adult Cardiac Surgery Database does not capture data on delayed thromboprophylaxis during a prolonged hospital length of stay, and thus we were not able to study its respective association with prolonged length of stay. Butt et al1 speculate that our approach of implementing a propensity score-weighted method using matching inverse probability of treatment weighting to account for potential confounding of the association between intraoperative PRBC transfusion and our outcomes may have been impacted by handling of extreme weights.4 To address the possibility of residual confounding, we considered the evidence for causality (E value),5 which is considered as an alternative approach to sensitivity analyses for potential unmeasured confounding, and were able to demonstrate that there was a low potential for unmeasured confounding significantly influencing the association between intraoperative PRBC transfusion and our primary outcome of HA-VTE. Finally, we agree with Butt et al1 that there is a need to better predict HA-VTE. We also strongly believe that there is a potentially unmet need for current and future “studies to explore interventions aimed at improving perioperative anemia and blood management while maintaining appropriate postoperative thromboprophylaxis, thereby significantly decreasing the need for PRBC transfusions in this setting and potentially decreasing the incidence of postoperative venous thromboembolism after cardiac surgery.”2

Abstract P5-03-02: Adiposity and immune-related gene expression in the breast tumor microenvironment

Abstract Background: Extreme adiposity has been associated with tumor progression and increased mortality after a breast cancer diagnosis, but the underlying mechanisms remain unclear. Pre-clinical and in vitro analyses suggest that higher levels of adiposity impair anti-tumor immunity, but studies in human breast cancer patients are lacking. Previously, we found that higher levels of subcutaneous adiposity had stronger associations with breast cancer outcomes than did higher levels of visceral adiposity or overall obesity measured by BMI, underscoring the importance of measuring adipose tissue distribution as well as overall body size to understand the adiposity-cancer link. Methods: We identified women with a first-primary, stage 2 or 3 invasive breast cancer diagnosed and treated at Kaiser Permanente Northern California between 2005 and 2015. Using diagnostic computed tomography scans collected as part of routine clinical care, we measured subcutaneous (SAT) and visceral adipose tissue (VAT) areas in cm2 at the third lumbar vertebra. We calculated body mass index (BMI) from clinically-collected height and weight. We isolated RNA from 251 FFPE breast tumors collected at biopsy or excision; these were a preliminary, random sample within each immunohistochemical subtype groups from an ongoing study that will analyze 1400 breast tumors. We verified RNA quality prior to performing NanoString BC 360™ assays to calculate the PAM50 molecular intrinsic subtype and measure the expression levels of genes related to immune cell abundance and anti-tumor immune activity. Using linear regression models, we examined the mean change in log2 gene expression (dependent variables) associated with each adiposity exposure (BMI, SAT and VAT as independent variables). Results: Mean (SD) age at diagnosis was 56 (13); a majority of women were either overweight (BMI 25- < 30-kg/m2: 30%) or obese (BMI>30-kg/m2: 35%), and most were diagnosed with stage 2 (61%) vs. stage 3 (39%) breast cancer with representation from each PAM50 subtype: n (%) Luminal A, 46 (18%) Luminal B, 56 (22%), HER2-overexpressing 26 (27%), and 82 (33%) basal-like. In unadjusted analyses, expression of genes related to macrophages, PD-1 and TIGIT increased with increasing subcutaneous adiposity, whereas expression of genes related to mast cells decreased (see Table 1). We found a similar (though non-significant) pattern for BMI. Associations with increasing visceral adiposity were closer to the null. After adjusting for PAM50 subtype, age and stage at diagnosis, only the association of increasing subcutaneous adiposity with increasing PD-1 expression remained statistically significant. Conclusion: Excess subcutaneous adiposity was associated with increased PD-1 expression, whereas excess visceral adiposity or obesity defined by BMI were not. These results from the first 251 samples of an ongoing study of 1400 tumors provide evidence from human breast cancer patients to demonstrate the importance of measuring body composition to assess adipose tissue distribution and support the hypothesis that excess adiposity impairs anti-tumor immunity. Association of Adiposity Measures with Immune-Related Gene Expression in the Breast Tumor Microenvironment (n=251 patients with stage 2-3 breast cancer at Kaiser Permanente Northern California) 195% Confidence Interval 2A 1-unit increase represents a doubling in the log expression level of the genes in the signature Citation Format: Deborah A. Dillon, Elizabeth M. Cespedes Feliciano, Alexa Zimbalist, En Cheng, Bette J. Caan, Wendy Y. Chen, Elizabeth A. Mittendorf, Roberto Bonfim Pimenta Peixoto, Tabata Alves Domingos, Krishan Taneja, Ashka Patel. Adiposity and immune-related gene expression in the breast tumor microenvironment [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-03-02.

Associations between socioeconomic status and risk of obesity and overweight among Chinese children and adolescents

BackgroundIn China, the threat of obesity and overweight in children and adolescents is developing quickly. It may be possible to lower the risk of obesity and overweight in children and adolescents by understanding the factors that drive these conditions. Therefore, this study aimed to investigate the association between SES and risk of obesity and overweight among children and adolesecnts in China’s provinces of Jiangsu, Anhui, Zhejiang, and Shanghai.MethodsChinese children and adolescents (n = 2,746; 46.3% boys) were recruited using multistage sampling. SES was measured using self-reported questionnaires, the specific indicators were parental education, perceived family wealth, and Family Affluence Scale II. Height and weight were measured and used to calculate body mass index (BMI, categorized into obesity or overweight). The definition of obesity or overweight was based on the Chinese standard "Screening for obesity and overweight among school-age children and adolescents". Descriptive statistics, independent sample t-tests, and a Chi-square test were used to report the sample characteristics and analyse BMI differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with BMI in children and adolescents.ResultsOverall, 22.5% of children and adolescents were obese or overweight. Participants with medium and high maternal education levels were 1.48 [95% CI 1.15–1.91] and 1.47 [95% CI 1.03–2.11] times more likely to be obese/overweight. Girls with medium maternal education levels were 1.70[95% CI 1.21–2.40] times more likely to be obese/overweight. For boys, no association was observed. Junior middle school students with medium maternal education levels were 1.51[95% CI 1.10–2.07] times more likely to be obese/overweight. Participants with medium or high FAS, perceived family wealth, or paternal education levels were not associated with obesity/overweight.ConclusionsThe findings of this study indicated a positive association between SES and risk of overweight/obesity in girls, suggesting that maternal education level may have a substantial impact on future prevention efforts for these conditions in girls. To increase the effectiveness of interventions, longitudinal studies are necessary to better understand the causal association between SES and obesity/overweight.

External validation test of body height estimation on outpatient radiotherapy clinic of Dr. Cipto Mangunkusumo General Hospital

Background : Stature is required to calculate body mass index and determine the energy needs of patients in nutritional medical therapy. Difficulty was found to obtain stature data in patients who are unable to stand. Therefore, there are some height estimation formula to predict the actual height using knee height. This study aimed to validate the Chumlea formula on outpatient clinic of Dr. Cipto Mangunkusumo General Hospital, Indonesia.
 Methods : This cross-sectional study used 90 respondents selected by consecutive sampling. Actual height, knee height, age and gender data were collected. Estimated height using the three of Chumlea formula. Pearson correlation was used to see the correlation between actual height and estimated height. Paired t-test were used to determine the difference significance.
 Results : The average age of the subjects was 45±10 years old with actual height 157±10 cm, and knee height 48.8±3.5 cm. A strong positive correlation was found between actual height with all estimated height on male (p=0.000; r > 0.8) and female subjects (p=0.000; r > 0.6). However, comparison between actual height and estimated height showed no significant differences only in Chumlea L1 formula (p=0.087) and Chumlea L3 formula (p=0.824) on the male subjects.
 Conclusions : Chumlea L1 and Chumlea L3 formula was a valid fomulation for calculating the estimated body height in adult male patients. There was no valid Chumlea’s formulation to estimate body height in female patients.

Sex-specific relationships between obesity, physical activity, and gray and white matter volume in cognitively unimpaired older adults.

Independently, obesity and physical activity (PA) influence cerebral structure in aging, yet their interaction has not been investigated. We examined sex differences in the relationships among PA, obesity, and cerebral structure in aging with 340 participants who completed magnetic resonance imaging (MRI) acquisition to quantify grey matter volume (GMV) and white matter volume (WMV). Height and weight were measured to calculate body mass index (BMI). A PA questionnaire was used to estimate weekly Metabolic Equivalents. The relationships between BMI, PA, and their interaction on GMV Regions of Interest (ROIs) and WMV ROIs were examined. Increased BMI was associated with higher GMV in females, an inverse U relationship was found between PA and GMV in females, and the interaction indicated that regardless of BMI greater PA was associated with enhanced GMV. Males demonstrated an inverse U shape between BMI and GMV, and in males with high PA and had normal weight demonstrated greater GMV than normal weight low PA revealed by the interaction. WMV ROIs had a linear relationship with moderate PA in females, whereas in males, increased BMI was associated with lower WMV as well as a positive relationship with moderate PA and WMV. Males and females have unique relationships among GMV, PA and BMI, suggesting sex-aggregated analyses may lead to biased or non-significant results. These results suggest higher BMI, and PA are associated with increased GMV in females, uniquely different from males, highlighting the importance of sex-disaggregated models. Future work should include other imaging parameters, such as perfusion, to identify if these differences co-occur in the same regions as GMV.

Prevalence of anemia and its predictors among patients with chronic kidney disease admitted to a teaching hospital in Ethiopia: A hospital-based cross-sectional study.

Anemia is a common complication of chronic kidney disease (CKD) and is associated with adverse patient outcomes. However, data on the prevalence of anemia in CKD patients is sparse, particularly in resource-limited settings. Therefore, this study aimed to assess the prevalence of anemia and its predictors among patients with CKD admitted to the Jimma medical center, southwest Ethiopia. A hospital-based prospective cross-sectional study was conducted from September 1 to November 30, 2020. All adult patients with CKD aged ≥18 years who fulfilled the inclusion criteria were consecutively recruited into the study. Data were entered into the Epi data manager version 4.4.1 and then exported to SPSS version 22 (IBM Corp., Armonk, NY) for analysis. The predictors of anemia were determined using multivariable logistic regression analysis. Statistical significance was set at P < .05. A total of 150 patients were included in this study. Of these, 64.67% were male, 56.67% had stage 5 CKD, 78% had a CKD duration of less than 1 year, and 74% had proteinuria. Hypertension (40.7%) and diabetes (14.7%) were the common causes of CKD. The prevalence of anemia was 85.33%. Of the patients, 28.67%, 40.67%, and 16% had mild, moderate, and severe anemia, respectively. On multivariate logistic regression, stage 4 CKD (adjusted odds ratio [AOR] 3.2, confidence interval [CI]: 1.78-12.91, P = .025), stage 5 CKD (AOR 4.03, CI: 1.17-13.73, P = .016), and CKD duration of less than 1 year (AOR 3, CI: 1.19-9.11, P = .007) were significantly associated with anemia. The prevalence of anemia among stage 3 to 5 CKD patients was very high. Anemia was significantly associated with the severity and duration of CKD. Therefore, serial follow-up of patients with a long duration and advanced stages of CKD may help prevent anemia and its adverse consequences.

Non-alcoholic fatty liver disease in diabetes mellitus patients on chronic hemodialysis - A case series addressing cardiovascular and mortality risks.

Non-alcoholic fatty liver disease (NAFLD) has an important role in the pathogenesis of cardiovascular diseases in the population with diabetes and it is highly prevalent in end-stage renal disease (ESRD) patients. This case series describes NAFLD associated factors and survival in type 2 diabetes patients (T2DM) who have ESRD treated with hemodialysis. NAFLD prevalence in patients with T2DM and ESRD is 69.2%. A high number of patients (15 out of 18) have obesity evaluated by calculating body mass index (BMI) and bioimpedance measurements. Patients with NAFLD have higher cardiovascular mortality risk, 13 of 18 patients were already diagnosed with coronary heart disease, 6 of 18 had cerebrovascular disease, and 6 of 18 had peripheral artery disease. Fourteen patients were treated with insulin, two patients with sitagliptin (renal adjusted dose of 25mg/day) and two patients with medical nutrition therapy, with an HbA1c ranging from 4.4 to 9.0%. After one-year follow-up 7 of 18 patients died, the causes having roughly equal proportions: myocardial infarction, SARS-CoV2 infection, and pulmonary edema. In conclusion, our population of type 2 diabetic patients with ESRD in hemodialysis had a prevalence of ultrasound-diagnosed NAFLD of 69.2%. Also, this population had a high death rate at one-year follow-up, cardiovascular causes being among the most common.

The Link between NAFLD and Metabolic Syndrome.

Metabolic syndrome (MetS) is characterized by an association of cardiovascular and diabetes mellitus type 2 risk factors. Although the definition of MetS slightly differs depending on the society that described it, its central diagnostic criteria include impaired fasting glucose, low HDL-cholesterol, elevated triglycerides levels and high blood pressure. Insulin resistance (IR) is believed to be the main cause of MetS and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Most recent studies revealed that IR may also be present in non-obese patients, and considered visceral adiposity to be the main effector of MetS' pathology. Visceral adiposity is strongly linked with hepatic fatty infiltration also known as non-alcoholic fatty liver disease (NAFLD), therefore, the level of fatty acids in the hepatic parenchyma is indirectly linked with MetS, being both a cause and a consequence of this syndrome. Taking into consideration the present pandemic of obesity and its tendency to drift towards a progressively earlier onset due to the Western lifestyle, it leads to an increased NAFLD incidence. Novel therapeutic resources are lifestyle intervention with physical activity, Mediterranean diet, or therapeutic surgical respective metabolic and bariatric surgery or drugs such as SGLT-2i, GLP-1 Ra or vitamin E. NAFLD early diagnosis is important due to its easily available diagnostic tools such as non-invasive tools: clinical and laboratory variables (serum biomarkers): AST to platelet ratio index, fibrosis-4, NAFLD Fibrosis Score, BARD Score, fibro test, enhanced liver fibrosis; imaging-based biomarkers: Controlled attenuation parameter, magnetic resonance imaging proton-density fat fraction, transient elastography (TE) or vibration controlled TE, acoustic radiation force impulse imaging, shear wave elastography, magnetic resonance elastography; and the possibility to prevent its complications, respectively, fibrosis, hepato-cellular carcinoma or liver cirrhosis which can develop into end-stage liver disease.

P858 Prevalence of sarcopenia in patients with inflammatory bowel disease and factors associated with it

Abstract Background Sarcopenia is a progressive and generalized skeletal muscle disorder with significant reduction in skeletal muscle mass associated with low muscle strength and physical performance. Multiple factors contribute to sarcopenia in active as well as quiescent inflammatory bowel disease (IBD). It has been implicated in disease complications and surgical outcomes Methods Inclusion criteria: Consecutive consenting patients &amp;gt; 18 years old with IBD attending the division of Gastroenterology between June 2021 and June 2022 Exclusion criteria: Associated systemic diseases, patient with prior surgery for IBD, that could contribute to sarcopenia were excluded All patients had anthropometric measurements, calculation of body mass index (BMI), and measurement of mid-arm muscle circumference. The muscle strength was measured by hand-grip strength by hand-held dynamometer. The physical performance was measured by gait speed by 4-meters walk test. The muscle mass was calculated by measuring skeletal muscle index (SMI) with single slice of CT scan at the level 3rd Lumbar vertebra. Patients were categorized according to the European Working Group on Sarcopenia in Older People, 2018 definition, into probable sarcopenia (low muscle strength), sarcopenia (low muscle strength and low muscle mass), and severe sarcopenia (low muscle strength, low muscle mass, and low physical performance1. Factors evaluated for association with sarcopenia were age, gender, disease subtype (Crohn’s disease [CD], ulcerative colitis [UC] or IBD-U (unclassified), activity and nutrition. SMI value of &amp;lt;42 cm2/m2 for men and &amp;lt;38 cm2/m2 for women were taken as per a recent Indian study2. Results Of 117 patients, 73 had ulcerative colitis (UC), 42 Crohn’s disease (CD), and 2 IBD- unclassified (IBD-U). Forty (34.2%) patients had probable sarcopenia; 47 (40.2%) patients had sarcopenia (29 UC, 18 CD) including 10 with severe sarcopenia. Ten (21.3%) patients with sarcopenia were in disease remission. On univariate analysis BMI, disease activity, low hemoglobin, and biologic use were significantly associated with sarcopenia (Table1); on multivariate analysis, only BMI showed significant association with sarcopenia. (Table 2) Conclusion Sarcopenia was detected in over 40% of patients with IBD and a fifth had severe sarcopenia. One-fifth of them were in clinical remission. Low BMI significantly correlated with sarcopenia. Screening for sarcopenia should be considered in all patients with IBD. 1. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis.Age Ageing.2019;48:16-31 2. Sidhu S, Saggar K, Goyal O, Kishore H, Sidhu SS. Normative values of sarcopenia in the Indian population. Indian J Gastroenterol. 2018;37(suppl 1): A1–A137