BMI Categories Research Articles

The Predictors of Osteoarthritis Among U.S. Adults: National Health and Nutrition Examination Survey, 2005 to 2018.

Background Osteoarthritis (OA) is a leading cause of disability in the United States (U.S.) population, and its prevalence continues to rise. Traditionally, extreme joint loading was described as the leading cause of OA; however, recent studies suggest OA may arise from more complex mechanisms. This study aimed to identify the association between OA and various health predictors among U.S. adults. Methods National Health and Nutrition Examination Survey (NHANES) data of adult participants from 2005 to 2018 was reviewed. OA diagnosis was patient-reported, and other health variables were assessed based on patient-reported, laboratory, and examination data. A multivariable survey logistic regression model was used to estimate adjusted odds ratios and confidence intervals (95% CIs).Stratified analysis based on BMI category was additionally performed to assess the modifying effect of obesity on the association between OA and health predictors. Results A total of 42,143 participants were included in this study. OA prevalence was highest in patients ages [Formula: see text]65 years, females, non-obese individuals, non-Hispanic Whites, and those with at least college education. After controlling for multiple confounding demographic variables and comorbidities, the odds of OA increased with aging, female sex, obesity, high cholesterol, hypertension, diabetes, depression, and thyroid disease. Non-Hispanic White patients and those with less than a high school education also had higher odds of OA. After stratified analysis, aging, female sex, and severe depression demonstrated similar associations with OA across each BMI strata. Having at least a college-level education additionally conferred a similar association with OA across each BMI strata. Conclusion The odds of OA increased with aging, female sex, obesity, less than high school education, high cholesterol, hypertension, diabetes, depression, and thyroid disease. Further studies are needed to characterize the mechanisms of these associations. Given the myriad of factors that influence OA development and progression, the utilization of multidisciplinary and holistic care of OA patients is recommended to limit the influence of other health predictors and reduce ensuing pain, disability, and other complications that result from OA.

Investigating predictors of protein intake in an adult population utilising the National Health and Nutrition Examination (NHANES) Survey in the United States

It is widely accepted that meeting recommended protein intake is protective of muscle mass(1). Insufficient intake is related to accelerated sarcopenia and impaired physical function, contributing to increased mortality and morbidity. The recommended target set by the American dietary guidelines is 0.8 g of protein per kg of body weight, based on data collated by the National Academies published in 2005(2). Currently approximately 50% of women and 30% of men do not meet these targets(3). It is of public interest to analyse current patterns of intake to allow for improved strategy through awareness of factors that impact protein intake.To investigate the factors which determine an individual’s protein intake and how they can be used to predict daily intake.A secondary data analysis of longitudinal data collected in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2020 has been carried out(4). Data was accessed from the public domain on the Centers for Disease Control and Prevention (CDC) website. The study protocol received approval from the research ethics review board of the National Center for Health Statistics (NCHS) of the CDC. Average protein intake has been calculated and participant demographics reported. STATA software has been used to carry out a bivariate regression of factors associated with protein intake, an adjusted multivariate regression analysis and a parsimonious model.19601 participants (52.4% women) aged 20 and over had valid protein data. Adjusted regression analysis generated three model fits, with the parsimonious model excluding BMI categories and household income had a statistically insignificant impact on protein intake. Men consumed 23.99g more protein per day compared to women (p<0.001: 95% CI 23.09 to 24.89). Individuals over 65 consumed 13.92g less protein per day compared to those aged 20-35 years old (p<0.001: 95% CI − 15.25 to −12.59). Mexican American individuals consumed 7.47g more protein than Non-Hispanic White individuals (p<0.001: 95% CI 5.89 to 9.04) and Non-Hispanic White individuals consumed 2.95g more protein compared to non-Hispanic Black individuals (p<0.001: 95% CI 4.13 to 1.77). Those with the lowest educational attainment consumed 10.77g less protein compared to individuals with a college degree (p<0.001: 95% CI −12.79 to −8.74). From 2011 to 2020, there was a gradual decline in protein intake which is statistically significant when comparing 2011/12 with 2015/16 and 2017/2020.Protein intake can be predicted by an individual’s gender, age, ethnicity, level of education attainment and time period. This study informs policymakers that individuals aged 65 and above are at risk of insufficient protein intake and there has been a general decrease in protein consumption over time. This provides evidence to support initiatives focused on this age category to maximise change and reduce rates of sarcopenia.

Sosialisasi Pencegahan dan Pengendalian Penyakit Tidak Menular

<em>Background: The increase in the prevalence of non-communicable diseases has become a serious threat, especially in the development of public health. Non-Communicable Diseases (NCD) in Indonesia are predicted to experience a significant increase in 2030. Its chronic nature and attacking productive age, causes NCDs to not only be a health problem, but also affect the resilience of the national economy if not controlled properly, correctly and continuously. The purpose of this community service is to increase public knowledge and awareness in preventing and controlling non-communicable diseases such as hypertension, stroke, heart disease and diabetes mellitus. Method: This activity is in the form of providing counseling in the Rawa Buntu Village Hall regarding non-communicable diseases & their prevention, PTM Nutrition, BMI counting (body mass index) exercises, and blood pressure checks to determine hypertension status and early detection of participants. Results: The results of blood pressure measurements showed that 25% had hypertension. While the BMI category is 41% with obesity BMI status and 22% with overweight BMI status. The mean posttest and pretest scores showed an increase in students' understanding of the prevention and control of non-communicable diseases after being given counseling or material explanations. Conclusion: One of the effective and efficient PTM controls is empowering and increasing community participation. Therefore, one way to reduce the prevalence of NCDs is to make individuals and families aware of reducing the prevalence rate, there is a need for further education at least at the family level regarding non-communicable diseases.</em>

Association between Low Calorie Sweetener Consumption Pattern, Anthropometric Indices, and Nutritional Status among Adults’ Males and Females in Calabar Municipality, Nigeria

Aim: This study aimed to investigate the association between low-calorie sweetener (LCS) consumption patterns, anthropometric indices, and nutritional status among adults and women in Calabar Municipality, Nigeria. Study Design; A cross-sectional Analytical design was conducted among 335 participants, selected by multistage sampling technique. Methodology: Dietary assessment using 24hrs recall, anthropometrics measures and socio-demographic characteristics data were collected using pretested questionnaire. The collected data were entered in to Microsoft Excel and exported to SPSS for further statistical analysis. Chi-square test at 95% confidence interval (CI) was used to quantify independent variables of nutritional indices. Using WHO-reference-2010, height, weight and BMI were measured Results: Over 40 products containing LCS were classified into five groups. Carbonated beverages were most consumed, while energy drinks were least consumed. Aspartame was the most commonly used LCS. Young single adults aged 20-35, mostly students, consumed LCS-containing products more frequently than other adults. The overall prevalence of LCS consumption was 58.1%, (moderate), with participants consuming an LCS containing beverage, at least three times a week at an estimated quantity of 1 liter. There was statistical significance (P=.05) differences in weight, waist circumference and hip circumference between men and women. The BMI for men and women were of 22.6 ± 0.9 and 21.0 ± 1.0 kg/m2, respectively. The BMI categories of the study participants were as follows; underweight (3.9%), normal weight (65.7) overweight (28.1) and obese (2.3%). The prevalence of abnormal waist-to-hip ratio was reported, with a significant (P=.05) association between LCS consumption and BMI. Bivariate analysis of LCS consumption and socio-demographic variables found significant association between variables such as gender, age, monthly income and educational level at P=.05. Multivariate logistic regression analysis identified age, income, and BMI as predictors of LCS intake. Conclusion: The study showed that the consumption pattern exists among the adults in terms of age category and gender. Consumption of LCS beverages was mostly moderate, on average around thrice per week and was influenced by demographic factors such as gender, age, and socioeconomic status.

Temporal change in prevalence of BMI categories in India: patterns across States and Union territories of India, 1999–2021

BackgroundThe problem of overweight/obesity often coexists with the burden of undernutrition in most low- and middle-income countries. BMI change in India incorporating the most recent trends has been under-researched.MethodsThis repeated cross-sectional study of 1,477,885 adults in India analyzed the prevalence of different categories of BMI among adults (age 20–54) in 4 rounds of National Family Health Surveys (1998–1999, 2005–2006, 2015–2016, and 2019–2021) for 36 states/UTs. State differences across time were harmonized for accurate analysis. The categories were Severely/Moderately Thin (BMI < 17.0), Mildly Thin (17.0-18.4), Normal (18.5–24.9), Overweight (25.0-29.9), and Obese (≥ 30.0). We also estimated change in Standardized Absolute Change (SAC), ranking of states, and headcount burden to quantify the trend of BMI distribution across time periods for all-India, urban/rural residence, and by states/UTs.ResultsThe prevalence of thinness declined from 31.7% in 1999 to 14.2% in 2021 for women, and from 23.4% in 2006 to 10.0% in 2021 for men. Obesity prevalence increased from 2.9% (1999) to 6.3% (2021) for women, and from 2.0% (2006) to 4.2% (2021) for men. In 2021, the states with the highest obesity prevalence were Puducherry, Chandigarh, and Delhi. These states also had a high prevalence of overweight. Dadra and Nagar Haveli and Diu, Gujarat, Jharkhand, and Bihar had the highest prevalence of severe/moderately thin. Prevalence of extreme categories (severely/moderately thin and obese) was larger in the case of women than men. While States/UTs with a higher prevalence of thin populations tend to have a larger absolute burden of severe or moderate thinness, the relationship between headcount burden and prevalence for overweight and obese is unclear.ConclusionsWe found persistent interstate inequalities of undernutrition. Tailored efforts at state levels are required to further strengthen existing policies and develop new interventions to target both forms of malnutrition.

Non-linear associations of serum spermidine with type 2 diabetes mellitus and fasting plasma glucose: a cross-sectional study.

Previous animal experiments have demonstrated the potential of spermidine to mitigate glucose intolerance, insulin resistance, and hyperinsulinemia. However, there remains a scarcity of epidemiological evidence supporting these findings. Therefore, we aimed to elucidate the associations of serum spermidine with T2DM and FPG. The cross-sectional study was conducted from June to August 2019 in the rural areas of Fuxin County, Liaoning Province, China. A total of 4,437 participants were included in the study. The serum spermidine was detected using high-performance liquid chromatography with a fluorescence detector. FPG was measured using the hexokinase method. T2DM was defined as participants with a FPG level of 7.0 mmol/L or greater, or self-reported diagnosis of diabetes by a doctor. Restricted cubic spline model and piecewise linear regression model were used to explore the associations of serum spermidine with T2DM and FPG, respectively. The mean (SD) age of the participants was 59.3 (10.0) years, with 622 out of 4,437 participants being defined as T2DM. The serum spermidine in participants stratified by age and BMI categories was significantly different, with p values of 0.006 and 0.001, respectively. Among all the participants, the association of serum spermidine with T2DM was J-shaped. The log (spermidine) was negatively associated with T2DM (OR = 0.68, 95% CI: 0.52 to 0.92, p = 0.01) below the inflection point, while log (spermidine) was not significantly associated with T2DM (OR = 1.97, 95% CI: 0.93 to 4.15, p = 0.07) above the inflection point. Among the participants without T2DM, the association of serum spermidine with FPG was inverted J-shaped. The log (spermidine) was positively associated with FPG (β = 0.13, 95% CI: 0.05 to 0.21, p = 0.001) below the inflection point, while log (spermidine) was negatively associated with FPG (β = -0.29, 95% CI: -0.42 to -0.16, p < 0.001) above the inflection point. In conclusion, non-linear associations of serum spermidine with T2DM and FPG were found in the cross-sectional study in Chinese rural adults. This provided insights into the use of spermidine for the prevention of T2DM, highlighting the potential role in public health prevention strategies of spermidine.

INFLUENCE OF OBESITY ON FUNCTIONAL OUTCOMES AND REVISION RATES FOLLOWING REVISION TOTAL KNEE ARTHROPLASTY

BackgroundObesity has been linked with increased rates of knee osteoarthritis. Limited information is available on the survival and functional outcome results of rTKR in the obese patients. This registry-based study aimed to identify whether BMI is an independent risk factor for poorer functional outcomes and /or implant survival in rTKA.MethodsNew Zealand Joint Registry (NZJR) data of patients who underwent rTKA from 1st January 2010 to January 2023 was performed. Demographics, American Society of Anesthesiologists (ASA), BMI, Operative time, indications for revision and components revised of the patients undergoing rTKA was collected. Oxford knee score (OKS) at 6 months and rates of second revision (re- revision) were stratified based on standardised BMI categories.ResultsOf the 2687 revisions, functional outcome scores were available for 1261 patients. Oxford knee scores following rTKA are significantly inferior in higher BMI patients (36.5 vs 31.5 p&lt;0.001). This held true when adjusted for age (35.7 vs 30.9 p&lt;0.001).Tibial component loosening was a more common indication for revision in patients with BMI &gt;40 (31.1% vs 21% for BMI &lt;25), whereas periprosthetic femoral fracture was significantly more commonly seen in patients with BMI &lt;25.Re-revision rates displayed no significant differences between any pairs of BMI groups (2.18/100 component years) and adjusting for age and sex did not alter this (p= 0.462). Indications for re-revision were also not different between BMI categories.Over 50% of the rTKA patients were obese. Significantly more obese patients were ASA grade 3,4 and more were &lt;75 years. Operative time was longer in the obese patients (p&lt;0.001).ConclusionsAlthough overall re-revision rates are similar between all BMI categories, the functional outcomes favour those with lower BMI. Patients with higher BMI are younger, more comorbid and carry potentially higher perioperative risks. The registry data provides valuable information when providing counsel to patients undergoing rTKA and lends further support to optimising patients prior to pTKA.

SIMULATED WEIGHT REDUCTION WITH AN ANTI-GRAVITY TREADMILL: A PILOT STUDY TO ASSESS PAIN REDUCTION IN FOOT AND ANKLE ARTHRITIS

IntroductionOsteoarthritis in the foot and ankle affects approximately 30,000 patients annually in the UK. Evidence has shown that excess weight exacerbates foot pain, with significant increases in joint forces. However, despite the current trend for Clinical Commissioning Groups to ration surgery for obese patients, studies have not yet determined the effect of weight loss in obese patients with foot and ankle arthritis.AimPilot study to investigate the effect of simulated weight loss on pain scores in obese patients with symptomatic foot and ankle arthritis.MethodsFollowing ethical approval, a prospective study of 17 obese patients (mean BMI 39.2, range 31.2 – 50.3) with foot and ankle arthritis was undertaken (BOFAS funded). Under physiotherapist supervision, patients walked for one minute on an anti-gravity treadmill, which allowed simulated weight reduction. Following baseline assessment, reduced BMI was simulated, starting at 20, rising in increments of 5, until each patient's usual BMI was reached. Pain was assessed using a Visual Analogue Scale (VAS). Repeated measures ANOVA was used to assess for significant changes in pain, comparing baseline with each simulated BMI category (significance set at p&lt; 0.05).ResultsSimulated weight loss caused a significant reduction in pain (p=0.005, power 0.91). Mean VAS pain scores improved by 24% (p=0.003) and 17% (p=0.040) for BMI categories 20 and 25, compared with baseline. Pain scores were not significantly different comparing BMI categories of 25 and 20.ConclusionSimulated weight loss to normal BMI significantly decreased pain in obese patients with foot and ankle arthritis. The use of the anti-gravity treadmill to demonstrate the feeling of normal BMI has also provided motivation to several patients to lose weight. The current study could be used to power future studies to investigate the effects of weight loss in foot and ankle patients.

Comparison of Pentraxin-3 in Migraine Patients without Aura and Healthy Controls

Background and Objectives: Migraine is a common cerebrovascular condition marked by one-sided, pulsating headache, which may or may not be accompanied with an aura. Migraine is mostly found in females who are of childbearing age. One of the speculated mechanisms for the pathophysiology of migraine is endothelial dysfunction. A new biomarker of inflammatory disorders, pentraxin-3 is often produced by endothelium injury. In earlier investigations, it was shown that migraine sufferers had elevated levels of pentraxin-3. Our study's objectives were to analyze the serum pentraxin-3 levels in migraine sufferers without aura and healthy controls.Methods: It was a cross-sectional comparative study. This was done at the IMBB Department, University of Lahore, Lahore Pakistan, from March 2020 to April 2022. We took 40 diagnosed migraine cases and 40 healthy controls. Detailed examination was done and proformas were filled by both cases and controls. Serum was collected by each of them and pentraxin-3 values were determined by using specific Elisa kits. SPSS version 22 was used for statistical analysis. For normality of data Shapiro wilk test was used. Mann whiteny U test was used for the comparision of means of pentraxin-3 in migrainers and healthy controls.Results: The data were non-normally distributed after the Shapiro-Wilk Test. The average age of the controls was 25±6.06 years, while that of individuals with migraines was 26±7.78 years. Patients with migraine were mostly women. The majority of the patients had BMI category 18 to 24.5. Patients with migraine had mean pentraxin-3 levels of 145.75 ±157.7 pg/l, compared to 43.65 ±33.01 pg/l in the control group. Median was100.5 in cases and 31.15 in controls. P-value was 0.0001.Conclusion: When compared to the control group, migraine patients had considerably higher blood levels of PTX-3, and no correlations between age, BMI, marital status, smoking history, and usage of preventative medications were found.Key words: migraine, pentraxin-3, endothelial dysfunction, C-reactive protein (CRP),

Abstract PO5-11-03: Associations among BMI and patient-reported body image dissatisfaction after breast reconstruction

Abstract INTRODUCTION Breast reconstruction surgery helps women restore their physical appearance and contributes to overall well-being. We assessed body image concerns in the context of breast reconstruction using patient-reported outcome measures: Body Image Scale (BIS), Brief Symptom Inventory (BSI), Appearance Schemas Inventory (ASI-R), and BREAST-Q. Since obesity is known to be associated with body image dissatisfaction1, body size may influence a patient’s adjustment to bodily changes arising from breast cancer and its treatment. Thus, we investigated the associations among BMI and patient-reported body image dissatisfaction after immediate autologous breast reconstruction. MATERIAL AND METHODS Patients undergoing breast reconstruction surgery were enrolled in an IRB approved study from 2011 to 2014 at The University of Texas MD Anderson Cancer Center. Participants (N=44) included patients who underwent immediate autologous (DIEP/TRAM) reconstruction and completed the BIS, BSI, ASI-R, and BREAST-Q, both preoperatively and postoperatively at 12+ months. Descriptive statistics including means, standard deviations, and medians were used to summarize continuous variables, while frequencies and percentages were used to summarize the categorical clinical and demographic characteristics. Univariate analyses were conducted to identify potential factors among preoperative variables for subsequent multivariable regression analysis: age, race, ethnicity, BMI, laterality, BIS, BSI, ASI-R, BREAST-Q psychosocial wellbeing score (PWBS), and BREAST-Q satisfaction with breast score (SWBS). Factors with a t test p-value≤0.2 were considered potential predictive variables for the postoperative dependent variables BIS, BREAST-Q PWBS, and BREAST-Q SWBS. Multivariable linear regression models were used to assess the relationship between the dependent and the selected predictive variables. A multivariable linear regression model was fitted using stepwise selection procedure, and the model with the highest adjusted R-squared value and the lowest Akaike information criterion (AIC) was chosen. All tests were two-sided with p-value&amp;lt; 0.05 considered statistically significant, and for each significant predictor, we report the unstandardized coefficient β. Analyses were performed using SPSS 29.0.0 and SAS 9.4. RESULTS Results from the selected models are summarized in Table 1. Age and BMI were significant predictors for postoperative BIS score. Older patients and those with BMI categorized as overweight and obese tend to feel less dissatisfied with their body image after immediate autologous breast reconstruction compared to patients with healthy BMI. Preoperative BSI anxiety was identified as significant predictor for postoperative BREAST-Q PWBS, i.e., patients with higher preoperative anxiety scores tend to have lower postoperative BREAST-Q PWBS. Preoperative BSI anxiety and laterality were significant predictors for postoperative BREAST-Q SWBS. Patients with higher preoperative anxiety scores tend to be less satisfied with their breasts after immediate autologous reconstruction and patients who underwent unilateral reconstruction tend to be less satisfied with their breasts postoperatively compared to patients with bilateral reconstruction. CONCLUSION Women with higher BMI may experience improved body image after undergoing immediate autologous breast reconstruction, as compared to women with healthy BMI. The use of BIS may provide more insight to plastic surgeons compared to relying solely on the body image correlates provided by the BREAST-Q. Moreover, body image counseling can be beneficial for individuals across all BMI categories, including those with healthy BMI. REFERENCES 1. Weinberger, N.A., et al., Body Dissatisfaction in Individuals with Obesity Compared to Normal-Weight Individuals: A Systematic Review and Meta-Analysis. Obes Facts, 2016. 9(6): p. 424-441. Table 1: Table for reporting selected multivariable linear regression models; (a) Postoperative BIS with explanatory variables age and BMI category, (b) Postoperative BREAST-Q PWBS with explanatory variable Preoperative BSI anxiety score, (c) Postoperative BREAST-Q SWBS with explanatory variables Preoperative BSI anxiety score and laterality. Citation Format: Sara Bouhali, Nassima Noufail, Tzuan Chen, Mary Catherine Bordes, Greg Reece, Mia Markey, Fatima Merchant, Deepti Chopra. Associations among BMI and patient-reported body image dissatisfaction after breast reconstruction [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-11-03.

Abstract PO5-16-09: Associations of age, body mass index, diabetes and hypertension with relative dose intensity among women receiving anthracycline- and/or taxane-based chemotherapy for invasive breast cancer

Abstract Research suggests that medical comorbidity is associated with reduced relative dose intensity (RDI) in patients receiving chemotherapy for treatment of breast cancer. We aimed to determine factors associated with RDI of specific chemotherapy drugs in anthracycline- and/or taxane-based regimens. Women with a diagnosis of lymph node positive, invasive breast cancer who received neoadjuvant or adjuvant chemotherapy with either doxorubicin (DOX) + paclitaxel (PAC) or docetaxel (DOCE)-containing regimens at a single centerfrom2012 to2019 were included in this retrospective study. Age, race, comorbidities, height, weight, and chemotherapy regimen and dose were abstracted from the electronic health record. BMI was calculated using height and weight measured in clinic at the time initial chemotherapy orders were written and categorized according to US national guidelines (18.5 to &amp;lt; 25, 25 to &amp;lt; 30, and &amp;gt;30kg/m2). Presence of diabetes (DM) and hypertension (HTN) at time of diagnosis were determined by chart review. The oncologists’ initial chemotherapy orders (dose and duration) were used as the basis for RDI calculations. Cumulative actual dose received and duration of treatment were compared to planned dose and duration for individual chemotherapy drug and by regimen (DOX+PAC vs. DOCE). Associations between patient characteristics and RDI were evaluated in bivariate and multivariable analyses. A total of 230 women met the inclusion criteria, with 125 receiving a DOX+PAC regimen and 105 receiving a DOCE-based regimen. A higher percentage of women on DOX+PAC received &amp;gt;85% RDI compared to women receiving DOCE (80.8% vs 67.6%). Women aged 65+ years had lower median RDI [IQR] for DOCE than younger women (0.83 [0.67 - 0.98] vs 0.94 [0.84 - 1.00], p = 0.04), and a lower percentage in the older group received &amp;gt;85% RDI (35.3% vs 73.9%, p&amp;lt; 0.01). Median RDIs of PAC and DOX+PAC were lower for Black women than for White and Asian women (PAC: 0.91 [0.75 - 1.00] vs 1.00 [0.89 - 1.00], p = 0.02, DOX+PAC: 0.92[0.87-0.99] vs. 0.97 [0.91-1.00], p = 0.03), and the percent of Black women receiving &amp;gt;85% RDI of PAC was also lower (55.3% vs 77.6%, p = 0.01). BMI category was associated with median RDI for PAC (p= 0.03) and DOX+PAC (p = 0.01), with women in the &amp;gt;30kg/m2 category having the lowest median RDIs and PAC RDI &amp;gt;85% (p &amp;lt; 0.01). Median RDI of DOX+PAC was lower for women with DM (0.89 [0.84-0.92] vs. 0.96 [0.88-1:00], p = 0.03), and a lower percentage of women with DM received DOX RDI &amp;gt;85% compared to women without DM (66.7% vs 91.6%, p &amp;lt; 0.01). Median RDI was lower among women with HTN compared to women without for PAC (0.85 [0.73 - 1.00] vs 0.98 [0.83 - 1.00], p = 0.01) and DOX+PAC (0.91 [0.84 - 0.97] vs 0.97 [0.90 - 1.00], p = 0.01), and a lower percentage of women with HTN received &amp;gt;85% RDI for PAC (50.0% vs 73.3%, p = 0.01). Multiple logistic regression models adjusted for age (continuous), race, BMI (continuous), DM, and HTN had modestly improved predictive value compared to null models (McFadden’s R2 = 0.10 to 0.19); each year of increased age was associated with lower odds of RDI &amp;gt; 85% for DOX (OR [95% confidence interval] 0.91 [0.84-0.97], p = &amp;lt; 0.01), DOX+PAC (0.95 [0.90-0.99], p = 0.02), and DOCE (0.93 [0.88-0.97], p &amp;lt; 0.01), and DM with lower odds for DOX (0.26 [0.07-0.95], p = 0.04). Our findings of associations between increasing age, Black race, BMI, DM, and HTN and reduced RDI are consistent with prior research and present new data regarding associations between medical comorbidities and individual components of chemotherapy regimens. Citation Format: Heather Wopat, Annette Aldous, Adam Ciarleglio, Kendall Anderson, Kim Robien. Associations of age, body mass index, diabetes and hypertension with relative dose intensity among women receiving anthracycline- and/or taxane-based chemotherapy for invasive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-16-09.

Cardiometabolic and Metabolic Profiles of Lean/Normal, Overweight and Obese Patients with Nonalcoholic Fatty Liver Disease.

Disagreements about the risk of non-obese, non-alcoholic fatty liver disease for cardiometabolic outcomes occurred widely. This study aims to characterize the cardiometabolic and metabolic profile of lean/normal, overweight and obese patients with nonalcoholic fatty liver disease on a big sample. Appeared healthy adults who participated in health examinations during the year of 2019-2022 were screened for fatty liver diagnosis. BMI classified fatty livers as lean, overweight and obese. Eleven cardiometabolic metrics (SBP: systolic blood pressure; DBP: diastolic blood pressure; TC: total cholesterol; TG: triglycerides; HDL: high-density lipoprotein cholesterol; LDL: low-density lipoprotein cholesterol) and metabolic metrics (GLU: blood glucose; GHB: glycated haemoglobin; UA: uric acid; AST: aspartate aminotransferase; ALT: alanine aminotransferase) were included, described and compared among BMI categories. There were 56,496 fatty livers diagnosed by ultrasound in this study. In total, the lean fatty liver had lowest mean SBP, DBP, GLU, TG, UA, AST, and ALT but highest TC and HDL among BMI categories (all p < 0.001). The number of abnormal metrics in total was 2.5, 2.9 and 3.4 in lean, overweight, and obesity, respectively (p < 0.001, p_trend < 0.001). Visualized data showed that lean fatty liver was similar but milder in all metabolic metrics than overweight and obesity at the young ages. However, lean fatty liver had higher coefficients of age and risk of metabolic abnormality regression (p <0.001 for SBP, DBP, GLU, GHB, TC). The lean type of fatty livers at a younger age has a relatively favourable cardiometabolic and metabolic profile compared to overweight and obese fatty livers. Due to the possible catch-up effect of metabolic dysfunctions in young lean fatty liver, lean fatty liver may have the same health outcomes as overweight/obesity fatty liver in long term. The evaluation and intervention may be critical for young lean fatty liver management to slowdown the rapid progress of metabolic dysfunction.

A Nonlinear Relation between Body Mass Index and Long-Term Poststroke Functional Outcome-The Importance of Insulin Resistance, Inflammation, and Insulin-like Growth Factor-Binding Protein-1.

Both high serum insulin-like growth factor-binding protein-1 (s-IGFBP-1) and insulin resistance (IR) are associated with poor functional outcome poststroke, whereas overweight body mass index (BMI; 25-30) is related to fewer deaths and favorable functional outcome in a phenomenon labeled "the obesity paradox". Furthermore, IGFBP-1 is inversely related to BMI, in contrast to the linear relation between IR and BMI. Here, we investigated s-IGFBP-1 and IR concerning BMI and 7-year poststroke functional outcome. We included 451 stroke patients from the Sahlgrenska Study on Ischemic Stroke (SAHLSIS) with baseline measurements of s-IGFBP1, homeostasis model assessment of IR (HOMA-IR), BMI (categories: normal-weight (8.5-25), overweight (25-30), and obesity (>30)), and high-sensitivity C-reactive protein (hs-CRP) as a measure of general inflammation. Associations with poor functional outcome (modified Rankin scale [mRS] score: 3-6) after 7 years were evaluated using multivariable binary logistic regression, with overweight as reference due to the nonlinear relationship. Both normal-weight (odds-ratio [OR] 2.32, 95% confidence interval [CI] 1.30-4.14) and obese (OR 2.25, 95% CI 1.08-4.71) patients had an increased risk of poor functional outcome, driven by deaths only in the normal-weight. In normal-weight, s-IGFBP-1 modestly attenuated (8.3%) this association. In the obese, the association was instead attenuated by HOMA-IR (22.4%) and hs-CRP (10.4%). Thus, a nonlinear relation between BMI and poor 7-year functional outcome was differently attenuated in the normal-weight and the obese.

Elexacaftor/tezacaftor/ivacaftor influences body composition in adults with cystic fibrosis: a fully automated CT-based analysis

A poor nutritional status is associated with worse pulmonary function and survival in people with cystic fibrosis (pwCF). CF transmembrane conductance regulator modulators can improve pulmonary function and body weight, but more data is needed to evaluate its effects on body composition. In this retrospective study, a pre-trained deep-learning network was used to perform a fully automated body composition analysis on chest CTs from 66 adult pwCF before and after receiving elexacaftor/tezacaftor/ivacaftor (ETI) therapy. Muscle and adipose tissues were quantified and divided by bone volume to obtain body size-adjusted ratios. After receiving ETI therapy, marked increases were observed in all adipose tissue ratios among pwCF, including the total adipose tissue ratio (+ 46.21%, p < 0.001). In contrast, only small, but statistically significant increases of the muscle ratio were measured in the overall study population (+ 1.63%, p = 0.008). Study participants who were initially categorized as underweight experienced more pronounced effects on total adipose tissue ratio (p = 0.002), while gains in muscle ratio were equally distributed across BMI categories (p = 0.832). Our findings suggest that ETI therapy primarily affects adipose tissues, not muscle tissue, in adults with CF. These effects are primarily observed among pwCF who were initially underweight. Our findings may have implications for the future nutritional management of pwCF.

P090 Real-world data on immuno-modulation therapies and body mass index in children and young people with juvenile idiopathic arthritis

Abstract Background/Aims There is some evidence that children and young people (CYP) with Juvenile Idiopathic Arthritis (JIA) who are overweight/obese have less favourable disease control and treatment outcomes. The aim of this study was to investigate any association between BMI and total number of immune modulation therapies used in CYP with JIA. Methods This was a retrospective observational study at a tertiary paediatric rheumatology centre. Cross-sectional data was captured in April 2022 from CYP receiving immunomodulation therapies for JIA. Data on diagnosis, treatments and weight/height at last routine follow-up was included. BMI was calculated for each patient and centile assigned using Royal College of Paediatrics and Child Health electronic BMI charts as follows: BMI ≥85th to 94th centile - overweight, ≥95th centile - obese, as per population monitoring British 1990 growth reference (UK90). Results 187 CYP were identified and 180 included (seven were excluded due to missing BMI data). Baseline demographic, disease and treatment data are summarised in Table A. 67% were female. Median (interquartile range (IQR)) age in years at diagnosis and follow-up was 4.3 (2.7, 8) and 11.9 (8.5, 14.4) respectively. At follow-up, 41.1% of CYP were either obese or overweight. The median (IQR) number of total immunomodulation therapies per patient according to BMI categories were: under/normal weight 2 (1, 3); overweight 3 (2, 3) and obese 3 (2, 5). The median (IQR) years of follow-up in under/normal weight, overweight and obese groups were 4.77 (2, 8.74); 5.27 (1.86, 7) and 5.5 (3, 9.1) respectively. Conclusion CYP that were overweight/obese received more therapies compared to under/normal weight. The high proportion (41%) of CYP in this study who were either overweight or obese is similar to prevalence (44.2%) for children in year six at school in this region. Corticosteroid use and limited physical activity is associated with inadequate control of joint inflammation and increased BMI but this data was not collected and is an important limitation, in addition to cross-sectional and retrospective study design. The overweight/obese group had longer follow-up and may have accumulated more therapies. Future research to evaluate optimal dosing of immunomodulation in CYP with high BMI is warranted. Disclosure K. Hartley: Grants/research support; NIHR BRC Internship. S. Jandial: None. F. McErlane: None. E. Sen: None. S. Sampath: None.

Obstructive Sleep Apnea Among Obese Children in Tabuk City, Saudi Arabia.

Introduction Obstructive sleep apnea (OSA) is prevalent among children, impacting their well-being. Obesity and related morbidity may lead to serious health disorders. In obese children, OSA may be a risk factor for systemic diseases that negatively affect their quality of life. This study explored the correlation between obesity and OSA among children aged five to 14 years in Tabuk, Saudi Arabia. Methods This cross-sectional study employed an online questionnaire for the parents of 517 children, assessing sociodemographic variables, medical history, and OSA symptoms. The data analysis used Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY) software, employing descriptive and inferential statistics. Results The children were predominantly male (281, 54.4%) and from Tabuk (405, 78.3%), with 158 (30.6%) classified as obese. Symptoms such as snoring (191, 36.9%), daytime fatigue (195, 37.7%), and impact on daily activities (79, 15.3%) were prevalent. OSA scores significantly correlated with BMI categories (p < 0.001), family history of OSA (p < 0.001), and medical conditions including diabetes, hypertension, and high cholesterol (p < 0.05). Correlations showed weak positive associations of age (ρ = 0.159) and height (ρ = 0.229) with OSA score, whereas a strong correlation existed between weight (ρ = 0.531) and OSA score (p < 0.001). Conclusion Obesity demonstrated a strong association with OSA severity among children in Tabuk. Higher BMI categories, a family history of OSA, and certain medical conditions correlated significantly with increased OSA scores. Although age and height displayed weaker associations, weight emerged as a major contributing factor to OSA severity. These findings emphasize the importance of addressing obesity in managing pediatric OSA, advocating for early interventions to mitigate its impact on children's health and well-being.

Nutritional Habits of Hungarian Older Adults.

There are many nutritional changes that come with aging, mostly as consequences of health regression. Malnutrition and overweight often start with inadequate food consumption, followed by alterations in biochemical indices and body composition. In our study, we aimed to analyze the feeding habits and energy and nutrient intake of a Hungarian elderly population, focusing on macronutrient, water, fruit, and vegetable consumption while searching for possible nutritional factors leading to NCD and many other chronic diseases in this population. Two questionnaires were used. These were the Mini Nutritional Assessment (MNA) and one asking about nutritional habits, and a 3-day feeding diary was also filled. Subjects (n = 179, 111; females (F), 68 males (M), older than 50 years were recruited. Based on MNA results, 78 adults (43.57% of the studied population) were malnourished or at risk of malnutrition, although, according to BMI categories, 69% were overweight and 7.3% were obese among M, while 42.3% were overweight among F. The average daily meal number was diverse. The amount of people consuming fruit (11.7%) and vegetables (8.93%) several times a day was extremely low (15.3% of F and 4.4% of M). Daily fruit consumption in the whole sample was 79.3%. Overall, 36.3% consumed 1 L of liquid and 0.5 L of consumption was found in 15.1% of participants. A significant gender difference was found in water consumption, with F drinking more than M (p ≤ 0.01). In our sample, 27.93% of the respondents took dietary supplements. Further analysis and research are needed to explore the specific health implications of and reasons behind these findings.

Molnupiravir Real-World Utilization in COVID-19 Patients in the Czech Republic.

Background/Objectives: Molnupiravir (MOV), an oral antiviral COVID-19 treatment, was introduced in the Czech Republic in December 2021 for COVID-19 patients at a high risk of progression to severe disease requiring hospitalization. In this observational, retrospective study, we aimed to describe the characteristics and healthcare resource utilization in non-hospitalized, adult COVID-19 patients prescribed MOV in the Czech Republic between 1 January and 30 April 2022. Methods: A total of 621 patients were included and followed up with for 28 days. Results: The median age was 68.0 (20-99) years, 77.8% were overweight or obese, 14.1% smoked, and 85.7% were vaccinated. The overall cumulative incidence (95% CI) of all-cause hospitalization was 0.71 (0.37; 1.24) per 1000 person years or 1.9%, with similar rates across sexes, age groups, BMI category, multimorbidity category, polypharmacy category, and COVID-19 vaccination status. Among patients reported hospitalized, oxygen-based resources were not observed, and no deaths occurred. Conclusions: These data describe the characteristics and healthcare resource utilization in Czech MOV-treated patients whose clinical characteristics may put them at increased risk of severe disease.

Trial of Labor versus Repeat Cesarean Delivery in Individuals with Morbid Obesity after Previous Cesarean Delivery.

This study aimed to compare adverse neonatal outcomes associated with the trial of labor after cesarean (TOLAC) at term in pregnancies according to maternal prepregnancy body mass index (BMI; kg/m2) and the presence of previous vaginal delivery (VD). This was a repeated cross-sectional analysis of individuals with singleton, cephalic, and term deliveries with a history of one or two cesarean deliveries in the Linked Birth/Infant Death data from 2011 to 2020. Outcomes were examined according to the BMI category including BMI <30, 30 to 39.9, and 40 to 69.9 kg/m2. The primary outcome was a composite neonatal outcome, defined as any presence of neonatal death, neonatal intensive care unit admission, assisted ventilation, surfactant therapy, or seizures. Outcomes were compared between TOLAC and elective repeat cesarean delivery (eRCD) after stratifying by BMI category and previous VD. Log-binomial regression was performed to obtain adjusted relative risk (aRR) with 99% confidence intervals, controlling for covariates. Of 4,055,440 individuals, 2,627,131 had BMI <30 kg/m2, 1,108,278 had BMI 30 to 39.9 kg/m2, and 320,031 had BMI 40 to 69.9 kg/m2. In individuals with no previous VD, VD rates after TOLAC were 66.7, 57.2, and 48.1%, respectively. In individuals with previous VD, VD rates after TOLAC were 81.4, 74.7, and 67.3%, respectively. In individuals without previous VD, compared with those who had an eRCD, those who had TOLAC were more likely to experience composite neonatal outcomes in individuals with BMI < 30 kg/m2 (5.0 vs. 6.5%; aRR = 1.33 [1.30-1.36]), BMI 30 to 39.9 kg/m2 (6.1 vs. 7.8%; aRR = 1.29 [1.24-1.34]), and BMI 40 to 69.9 kg/m2 (8.2 vs. 9.0%; aRR = 1.15 [1.07-1.23]). In individuals with previous VD, there was no difference in the composite neonatal outcomes in BMI < 30 kg/m2 (6.2 vs. 5.8%; aRR = 0.98 [0.96-1.00]), BMI 30 to 39.9 kg/m2 (7.4 vs. 7.1%; aRR = 0.99 [0.95-1.02]), and BMI 40 to 69.9 kg/m2 (9.4 vs. 8.7%; aRR = 0.96 [0.91-1.02]). TOLAC among obese individuals could be offered in selected cases. · TOLAC among obese individuals could be offered selectively, despite their reduced likelihood of attempting or succeeding at it.. · Higher BMI individuals show decreased rates of both attempting and achieving successful TOLAC.. · Despite these trends, attempting TOLAC after a previous vaginal delivery does not heighten neonatal complications..

Erectile Dysfunction as an Obesity-Related Condition in Elderly Men with Coronary Artery Disease.

Background: This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods: Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results: The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg2, and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0-13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions: The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.