Body Mass Index Categories Research Articles

Data mining identifies meaningful severity specifiers for anorexia nervosa.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders defines anorexia nervosa (AN) severity based on body mass index (BMI). However, BMI categories do not reliably differentiate the intensity of AN and comorbid symptoms. Shape/weight overvaluation has been proposed as an alternative severity specifier. The present study used structural equation model (SEM) Trees to empirically determine specific levels of BMI and/or shape/weight overvaluation that differentiate AN severity. We also compared whether the SEM Tree-derived severity groups outperformed existing AN severity definitions. Participants were 1,666 adolescents and adults with AN who were receiving eating disorder treatment at one of the three levels of care (outpatient, partial hospital program, or residential). Participants completed self-reported questionnaires assessing eating pathology and comorbid symptoms. SEM Tree analyses first specified an outcome model of AN severity, and then recursively partitioned the outcome model into subgroups based on all values of BMI and shape/weight overvaluation. One-way analyses of variance and t tests determined which severity definition explained the most variance in clinical characteristics. SEM Tree analyses yielded five severity groups, all of which were defined based on increasing intensities of shape/weight overvaluation: < 2.25, 2.25-3.24, 3.25-4.24, 4.25-5.24, and ≥ 5.25. No groups were defined based on BMI. SEM Tree-derived groupings explained more variance in clinical characteristics than existing severity definitions. Taken together, shape/weight overvaluation appears to be a more accurate marker of AN severity than BMI. The empirically determined AN severity scheme accounted for the most variance in clinical characteristics. Future research should assess the predictive value of these empirically defined AN severity indicators. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of body mass index on rehabilitation outcomes after lower limb amputation.

To determine the effect of obesity on physical function and clinical outcome measures in patients who received inpatient rehabilitation services for lower extremity amputation. A retrospective review was performed on patients with lower extremity amputation (n = 951). Patients were stratified into five categories adjusted for limb loss mass across different levels of healthy body mass index (BMI), overweight, and obesity. Outcomes included the Inpatient Rehabilitation Facility Patient Assessment Instrument functional scores (GG section), discharge home, length of stay (LOS), therapy time, discharge location, medical complications and acute care readmissions. Deep learning neural networks (DLNNs) were developed to learn the relationships between adjusted BMI and discharge home. The severely obese group (BMI > 40 kg/m2) demonstrated 7%-13% lower toileting hygiene functional scores at discharge compared to the remaining groups (p < .001). The severely obese group also demonstrated 8%-9% lower sit-to-lying and lying-to-sitting bed mobility scores than the other groups (both p < .001). Sit-to-stand scores were 16%-21% worse and toilet transfer scores were 12%-20% worse in the BMI > 40 kg/m2 group than the other groups (all p < .001). Walking 50 ft with two turns was most difficult for the BMI > 40 kg/m2 group, with mean scores 7%-27% lower than the other BMI groups (p = .011). Wheelchair mobility scores for propelling 150 ft were worst for the severely obese group (4.9 points vs. 5.1-5.5 points for all other groups; p = .021). The LOS was longest in the BMI > 40 group and shortest in the BMI < 25 group (15.0 days vs. 13.3 days; p = .032). Logistic regression analysis indicated that BMI > 40 kg/m2 was associated with lower odds risk (OR) of discharge-to-home (OR = 0.504 [0.281-0.904]; p < .022). DLNNs found that adjusted BMI and BMI category were ranked 11th and 12th out of 90 model variables in predicting discharge home. Patients with severe obesity (>40 kg/m2) achieved lower functional independence for several tasks and are less likely to be discharged home despite higher therapy volume than other groups. If a patient is going home, obesity will pose unique demands on the caregivers and resources can be put in place to help reintegrate the patient into life.

Association Between Obesity and Intra-Abdominal Solid Organ Damage in Patients with Blunt Abdominal Trauma: A Cross-Sectional Study.

Background/Objectives: The global prevalence of obesity continues to rise. However, whether obesity affects the degree of intra-abdominal solid organ damage following blunt trauma remains unclear. This study aimed to investigate the correlation between obesity and intra-abdominal solid organ damage. Methods: This cross-sectional study was conducted at a regional trauma center in the Republic of Korea from January 2018 to December 2022 and included 582 patients aged 18-98 years with blunt abdominal trauma. Patients were categorized into four groups-underweight, normal weight, overweight, and obesity-based on their body mass index (BMI). Odds ratios (ORs), beta coefficients, and 95% confidence intervals (CIs) for intra-abdominal organ damage were calculated across BMI categories using multiple logistic regression analysis after adjusting for the confounding variables. Results: The obesity group exhibited a significant decrease in the prevalence of liver injury (OR: 0.553, CI: 0.316 to 0.966) and a reduction in liver injury severity (β: -0.214, CI: -0.391 to -0.037) compared with the normal-weight group after adjusting for the confounding factors. However, no significant association was observed between the BMI and injuries to other solid organs, such as the spleen, pancreas, and kidneys. Additionally, the younger obesity group (participants aged < 45 years) exhibited a significant negative association with both liver injury and injury grade. However, the older obesity group (participants aged > 65 years) exhibited a statistically significant association only with the liver injury grade compared with the normal-weight group. Conclusions: Obesity can serve as a predictive factor for the presence and severity of liver damage caused by blunt abdominal trauma.

Tofacitinib Efficacy/Safety in Patients with Ankylosing Spondylitis by Baseline Body Mass Index: A Post Hoc Analysis of Phase 2/3 Trials.

We assessed tofacitinib efficacy and safety in ankylosing spondylitis (AS) by body mass index (BMI) category. Data were pooled from phase 2/3 trials; analyses included patients with active AS randomized (1:1) to tofacitinib 5 mg twice daily or placebo, who were stratified by baseline BMI into < 25, ≥ 25 to < 30, and ≥ 30 kg/m2 categories. Efficacy was assessed at week 12 and safety to week 16. Of 370 patients, 153, 131, and 86 had a baseline BMI of < 25, ≥ 25 to < 30, and ≥ 30kg/m2, respectively. Atbaseline, patients with BMI < 25 kg/m2 were younger and more likely to be current smokers/Asian, and patients with BMI ≥ 30 kg/m2 had higher mean waist circumference/swollen joint count (SJC) and were more likely to have enthesitis, high-sensitivity C-reactive protein (hsCRP) > 5 mg/L, an inadequate response to tumor necrosis factor inhibitors (TNFi), and prior biologic disease-modifying anti-rheumatic drug (bDMARD) use versus other categories. Across categories, tofacitinib responses/improvements were greater than with placebo, except for ≥ 40% Assessment of SpondyloArthritis international Society improvement (ASAS40), ASAS partial remission, 50% improvement from baseline in the Bath Ankylosing Spondylitis Disease Activity Index score (BASDAI50), and Ankylosing Spondylitis Disease Activity Score using C-reactive protein (ASDAS-CRP) inactive disease rates, which were similar for tofacitinib and placebo in the BMI ≥ 30 kg/m2 category. Treatment effects were similar across categories, except for BASDAI50, which was smaller in the BMI ≥ 30category versus the < 25 kg/m2 category. More adverse events (AEs) and serious adverse events (SAEs) with tofacitinib were reported in the BMI < 25 kg/m2 category, which had a higher proportion of current smokers versus other categories. Regardless of baseline BMI category, efficacy was greater with tofacitinib versus placebo in patients with AS, and no treatment effect differences between categories were observed, with exceptions for BMI ≥ 30 kg/m2 (more active/treatment-refractory disease and a smaller sample size). Overall, tofacitinib safety was generally comparable across categories; however, AE/SAE rates with tofacitinib were higher in the BMI < 25kg/m2 category (which had more current smokers). This post hoc analysis demonstrates that tofacitinib can be considered as a treatment option for AS, regardless of baseline BMI category; however, interpretation was limited by small sample sizes and differences in sample sizes and baseline characteristics across categories. ClinicalTrials.gov identifiers, NCT01786668 and NCT03502616.

Lack of correlation between asprosin serum levels and hyperphagic behavior in subjects with prader-Willi Syndrome.

Individuals with Prader-Willi syndrome (PWS) exhibit hyperphagic behavior, the severity of which varies throughout life. The mechanisms underlying this behavior are still unknown. Asprosin is a new discovered adipokine involved in the regulation of food intake, glucose homeostasis and energy balance. In this study we assessed asprosin serum levels in a cohort of children, adolescents and adults with PWS with the aim to correlate them with hyperphagic behavior, body mass index (BMI) and metabolic parameters, and to evaluate age-related changes. This cross-sectional study included 87 children and adolescents and 31 adults with PWS. Auxological data, fasting levels of glucose, insulin, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG) and asprosin were collected, and the homeostasis model assessment for insulin resistance (HOMA-IR) was determined. The 11-item Italian version of the Hyperphagia Questionnaire (HQ) was administered to the parents/caregivers of the patients to assess hyperphagia. Patients were analysed according to age (children < 10 years, adolescents between 10 and 17.9 years, adults ≥ 18 years) or BMI categories [normal weight (NW), overweight (OW), and obesity (OB)]. No significant correlations were found between asprosin levels and cardiometabolic risk factors in the whole cohort. Higher values of asprosin were found in adults compared with adolescents, as well as in the OB group compared to the NW group (p = 0.014). Hyperphagia total score and hyperphagic subdimensions were significantly lower in children compared to adults (p < 0.05). Similarly, hyperphagia total score and hyperphagic subdimensions were significantly lower in the NW group compared to the OB group. Asprosin levels were significantly higher in patients with deletion versus patients with uniparental disomy (p = 0.037). By logistic regression analysis, HQ total score and hyperphagic subdimensions were significantly associated with BMI-SDS independently of age, sex, and asprosin levels. In conclusion, our data demonstrated higher asprosin levels in PWS individuals with OB compared to NW, while differences by age and sex were inconsistent. The lower levels of hyperphagia, BMI-SDS, and metabolic variables in children with PWS compared to adults underline that prevention of obesity should start very early in life and should be maintained over time.

Obesity is associated with a higher prevalence of gingival inflammation

BackgroundStudies have identified a possible link between obesity, overweight, and gingival inflammation. The objective of this study was to investigate whether overweight and obesity are associated with a higher prevalence of gingival bleeding among university students. MethodsData were collected from 2,089 students in 2016 through a self-administered questionnaire. Gingival inflammation was assessed with the question, “Does your gum bleed when you brush your teeth?” Responses were classified as “yes” or “no”. Body mass index (BMI) was assessed based on self-reported weight and height, following WHO standards: Normal (<25), Overweight (25-30), and Obesity (>30). A Poisson regression model was applied to analyze the association between BMI categories and gingival bleeding prevalence. ResultsThe prevalence of gingival inflammation was 50.8% and the prevalence of obesity and overweight was 8% and 23%, respectively. Obese individuals demonstrated a 32% higher prevalence of gingival bleeding compared to those with a normal BMI (PR=1.32, 95%CI[1.17–1.49]). Overweight students showed no significant association with gingival bleeding (PR 1.01, 95%CI[0.91–1.13]). ConclusionObesity was associated with a higher prevalence of gingival bleeding, while overweight status showed no significant association. These results suggest that obesity, rather than overweight, is associated with increased gingival inflammation.

Association of triglyceride glucose index combined with obesity indicators with cognitive impairment

BackgroundThe association of a combination of the TyG index and obesity markers, specifically waist circumference (WC), with cognitive function is unknown. This research investigated the relationship between TyG-WC measurements and cognitive impairment in a low-income population in China; moreover, this study evaluated the role of diabetes mellitus and body mass index (BMI) in modulating this relationship.Methods1125 eligible individuals aged ≥ 60 years participated in this study. The TyG index and obesity indicators (BMI, WC, and waist-to-height ratio) were calculated for individual participants and categorized into quartiles. Multivariate logistic regression analysis was used to evaluate the correlation between TyG-WC values and cognitive impairment; the possibility of a nonlinear relationship was explored using constrained cubic spline analysis. The participants were divided into different groups according to their diabetes status and BMI category for subgroup analyses. Linear regression was used to investigate the correlation between TyG-WC values and MMSE scores.ResultsThe prevalence of cognitive impairment in the study participants was 47.3%, with a significant negative association between TyG-WC values and cognitive impairment, (odds ratio [OR] = 0.999; 95% confidence interval [CI], 0.997–1.00, P = 0.009). A U-shaped correlation was observed between the TyG-WC values and cognitive impairment (P = 0.008). Subgroup analyses showed that the inverse association between TyG-WC values and cognitive impairment was stronger in non-diabetic individuals (OR = 0.998; 95% CI, 0.997–0.999; P = 0.002) and in those with a lower BMI (< 24 kg/m2; OR = 0.996; 95% CI, 0.994–0.998; P = 0.001). A positive correlation was found between TyG-WC values and MMSE scores, particularly in men and non-diabetic individuals (β = 0.003; 95% CI, 0.0002–0.005; P = 0.031).ConclusionThis study demonstrates a nonlinear U-shaped relationship between TyG-WC values and cognitive function. The stronger inverse association between TyG-WC values and cognitive decline in the non-diabetic and low-BMI subgroups suggests that these populations may benefit the most from targeted interventions. These findings are important for clinical practice and formulating disease-prevention policies, emphasizing the need for metabolic health management to prevent cognitive decline, particularly in low-income populations.

Anthropometric Measures of Adiposity and Their Associations with Blood Pressure among Malay Adolescents Aged 18 to 19 Years Old in Terengganu

This study aims to explore association of anthropometric adiposity measures with blood pressure among Malays aged 18 to 19 years. Participants comprised 309 university students of Malay ethnicity residing in Kuala Nerus, Terengganu. This cross-sectional research study was done in April 2021 to August 2023. A total of 40.7% of participants were overweight/obese, 42.1% normal weight, and 17.5% underweight based on World Health Organisation (WHO)-Asian Body Mass Index (BMI) classification. Among this population, 15.5% of the students was considered as Hypertension (HPT) and 21.4% had Elevated Blood Pressure (EBP). Proportions of male students with HPT (35.7%) and EBP (29.8%) were significantly higher compared to female students (18% and 18.2%, respectively). Linear regression analysis indicated that BMI was a significant factor that influenced Systolic Blood Pressure (SBP), especially among female participants. Obese adolescents had 7.0 times higher odds of developing EBP/HPT compared to those in other BMI categories (aOR=6.97; 95% CI: 2.92, 16.6; p&lt;0.05). The high prevalence of HPT and EBP raises concern, as the study also confirmed an association between obesity and blood pressure. In conclusion, anthropometric measures of adiposity were associated with increased odds of HPT. Thus, early identification of individuals with high-risk anthropometric adiposity is crucial to facilitate timely intervention and mitigate associated risks.

Factors influencing postoperative urinary retention after radical hysterectomy for cervical cancer: development and validation of a predictive model in a prospective cohort study in Southwest China

ObjectivesTo explore influencing factors for postoperative urinary retention (POUR) in cervical cancer patients and construct and validate a POUR prediction model.DesignA prospective cohort study.SettingA large tertiary hospital specialised in child...

The Association Between Body Mass Index and 28-day Mortality in Patients With Sepsis: A Retrospective Cohort Study.

Sepsis is a severe clinical syndrome with high morbidity and mortality in intensive care units (ICUs). Body Mass Index (BMI) shows a rising trend of obese patients being admitted to ICUs. The relationship between BMI and the clinical outcome of sepsis remains highly debated. The data used in this study were sourced from the Intensive Care Information Center IV (MIMIC-IV) database. Baseline information extracted within 24 hours of ICU admission was categorized according to World Health Organization (WHO)'s BMI classifications. A multivariate Cox regression model and curve fitting assessed the independent correlation between BMI and the primary outcome. A total of 7836 patients were included in the study and categorized into five groups based on BMI. The overall 28-day mortality rate was 21.94% (1719/7836). Class I obesity (17.14%) and class II/III obesity (13.49%) individuals tended to be younger and male. Compared to patients with normal BMI (32.55%), those with low BMI (5.79%) had a 47% increased risk of 28-day mortality (HR 1.47, 95% CI 1.16-1.85, P = 0.0013), while class II/III obesity patients had a 17% lower 28-day mortality rate (HR 0.83, 95% CI 0.71-0.97, P = 0.0218). Curve fitting revealed a nonlinear relationship between BMI and 28-day mortality. The Kaplan-Meier survival analysis highlighted variations in survival rates across the five groups (P = 0.0123), with underweight patients exhibiting poorer survival outcomes. In sepsis patients, a low BMI is related to higher 28-day mortality compared to those with a normal BMI. Conversely, patients with a BMI≥35kg/m2 have significantly reduced mortality risks.

Association between World Trade Center disaster exposures and body mass index in community members enrolled at World Trade Center Environmental Health Center

Studies suggest that environmental disasters have a big impact on population health conditions including metabolic risk factors, such as obesity and hypertension. The World Trade Center (WTC) destruction from the 9/11 terrorist attack resulted in environmental exposures to community members (Survivors) with potential for metabolic effects. We now examine the impact of WTC exposure on Body Mass Index (BMI) using the data from 7136 adult participants enrolled in the WTC Environmental Health Center (EHC) from August 1, 2005, to December 31, 2022. We characterized WTC-related exposures by multiple approaches including acute dust-cloud exposure, occupational or residential exposures, and latent exposure patterns identified by synthesizing multiplex exposure questions using latent class analysis. Employing multivariable linear and quantile regressions for continuous BMI and ordered logistic regression for BMI categories, we found significant associations of BMI with WTC exposure categories or latent exposure patterns. For example, using exposure categories, compared to the group of local residents, local workers exhibited an average BMI increase of 1.71 kg/m2 with 95% confidence intervals (CI) of (1.33, 2.09), the rescue/recovery group had an increase of 3.13 kg/m2 (95% CI: 2.18, 4.08), the clean-up worker group had an increase of 0.75 kg/m2 (95% CI: 0.09, 1.40), and the other mixer group had an increase of 1.01 kg/m2 (95% CI: 0.43, 1.58). Furthermore, quantile regression analysis demonstrated that WTC exposures adversely affected the entire distribution of BMI in the WTC EHC Survivors, not merely the average. Our analysis also extended to blood pressure and hypertension, demonstrating statistically significant associations with WTC exposures. These outcomes highlight the intricate connection between WTC exposures and metabolic risk factors including BMI and blood pressure in the WTC Survivor population.

Effect of Furocyst on Lipid Profile and Insulin Resistance Across Different Categories of Body Mass Index in Women With Polycystic Ovarian Syndrome (PCOS)

Effect of Furocyst on Lipid Profile and Insulin Resistance Across Different Categories of Body Mass Index in Women With Polycystic Ovarian Syndrome (PCOS)

Clinical Characteristics and Risk Factors of Surgical Site Infection in Patients with Open Abdomen with Fistula Undergoing the Abdominal Wall Reconstruction Utilizing Biological Mesh: A Single-Center Retrospective Study.

Objective: This study aimed to evaluate the clinical characteristics and identify risk factors for surgical site infection (SSI) following abdominal wall reconstruction using biological mesh. Methods: A retrospective analysis was conducted on patients with open abdomen (OA) with fistula who underwent abdominal wall reconstruction with biological mesh at Jinling Hospital between January 2010 and August 2023. Patients were divided into SSI and non-SSI groups, and their perioperative data were compared to identify potential risk factors. Results: The SSI rate following abdominal wall reconstruction was 23.71% (23/97) in patients with OA with fistula. Significant differences (p < 0.05) were found between the SSI and non-SSI groups in body mass index (BMI), BMI classification, nutritional risk index (NRI) classification, abdominal wall defect partition, pre-operative day one neutrophil count (NEUT), post-perative day one white blood cells (WBCs) and NEUT, post-operative day three WBCs and NEUT, post-operative day seven procalcitonin (PCT) and NEUT, length of hospitalization, and total hospitalization cost. Multifactorial analysis identified normal BMI (odds ratio [OR]: 0.151, 95% confidence interval [CI]: 0.041-0.551, p = 0.004) and high BMI (OR: 0.072, 95% CI: 0.010-0.546, p = 0.011) as protective factors against SSI and moderate NRI (OR: 4.054, 95% CI: 1.069-15.376, p = 0.004), severe NRI (OR: 18.233, 95% CI: 2.971-111.897, p = 0.002), and abdominal wall defect partition (OR: 4.032, 95% CI: 1.218-13.349, p = 0.022) as independent risk factors for SSI. Conclusions: Normal BMI and high BMI act as protective factors against SSI, whereas moderate NRI, severe NRI, and abdominal wall defect partition are independent risk factors for SSI. Nutritional management and surgical care should be emphasized to reduce SSI incidence in patients with OA with fistula undergoing abdominal wall reconstruction.

Individual and joint associations of obesity and metabolic health parameters on arterial stiffness: Evidence from the UK Biobank.

There is conflicting evidence regarding whether excess adiposity without metabolic abnormalities reflects a truly benign phenotype. This study evaluated the independent and joint associations of the presence of excess adiposity and metabolic abnormalities on arterial stiffness. Participants in UK Biobank with body mass index (BMI) and arterial stiffness index (ASI) recorded between 2006 and 2010, free from cardiovascular diseases and not underweight (BMI <18.5 kg/m2) were included. The primary outcome was severity of ASI analysed using multivariate-adjusted linear regression. Of 162 590 participants, 42.5% were overweight and 24.4% were obese. Within the normal BMI strata, 50.7% had ≥1 metabolic abnormality. Compared to individuals with normal BMI and no metabolic abnormality (reference group), increased BMI or metabolic abnormalities were similarly associated with higher ASI: normal BMI with metabolic abnormalities (adjusted β-coefficient and 95% CI, 0.35; 0.30-0.40); overweight without metabolic abnormalities (0.32; 0.26-0.37). Individuals with obesity and no metabolic abnormality had higher ASI (0.65; 0.57-0.74) but was lower than individuals with overweight and metabolic abnormalities (0.80; 0.75-0.84). Individuals with obesity and metabolic abnormalities had the highest ASI (1.07; 1.02-1.12) among all six metabolic combinations, p < 0.001 for each versus reference group. Sensitivity analysis suggested higher ASI with increasing number of metabolic abnormalities within BMI categories and higher ASI in the presence of abdominal obesity within metabolic categories. Excess adiposity and metabolic abnormalities are independently associated with increased arterial stiffness to a similar degree, suggesting that metabolically healthy individuals with overweight and obesity are not benign groups. This reinforces the need to prevent excess adiposity and consider primary prevention strategies even before metabolic abnormalities emerge.

Outcome of surgical site infection following inguinal hernia closure

Objective: This study's goal is to look into how inguinal hernia surgery patients respond to surgical site infections (SSIs). The purpose of the study is to examine the association between the prevalence of SSIs and demographic factors such as age, body mass index (BMI), habitation type (urban/rural), presence of diabetes mellitus and hypertension, degree of education, length of hospital stay, and length of surgery. Methods: Patients who underwent inguinal hernia closure surgeries were included in this retrospective analysis, which was carried out in a medical facility. A patient's demographics, BMI, type of habitation, diabetes and hypertension status, education level, length of hospital stay, length of operation, and presence or absence of surgical site infections were all collected from their medical records. To evaluate the patient population's characteristics and the prevalence of SSIs, data analytic techniques included frequency distribution and percentage calculation. In order to identify correlations between factors and the occurrence of SSI, statistical tests were run. Results: The study involved all of the patients. The age distribution displayed 35.1% in the 20–30 age, 21.1% in the 40–50 age, and 43.9 % in the 40–50 age. BMI categories were revealed with BMIs of 20–23, 23–25, and 25–28. Participants who lived in cities made up 22(29.7%) of the group, whereas participants who lived in rural areas made up 35.1 %. Diabetes mellitus was more common than hypertension 23 (20.2%) vs. 17(14.9%). The distribution of education levels was as follows: 17(14.9 %) with no education, 46 (40.4%) with SSC-level education and 51(44.7%) with HSSC or higher education. Hospital stays lasting 1-3 days in 55 (48.2%) of cases and 3-6 days in 59 (51.8%) of cases, respectively. There were two categories for operation length: 1-3 months 59(51.8%) and 3-6 months 55 (48.2%). 22 (19.3%) of cases had surgical site infections, while 92 (80.7%) of cases had no infections at all. Conclusion: The results of surgical site infections after inguinal hernia closure are clarified by this investigation. The frequency of SSIs highlights the significance of strict infection control procedures. Further investigation is required to determine the association between demographic factors and the prevalence of SSI. These findings have implications for post-operative care plans and surgical protocols that aim to reduce the risk of SSIs and improve patient outcomes. To fully comprehend the multifactorial nature of SSIs in inguinal hernia closure surgeries, additional study is required.

Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index

Postpartum depression (PPD) poses significant risks to maternal and child health. Understanding temporal trends is crucial for evaluating prevalence and identifying populations at risk. To evaluate recent trends in PPD and assess how these trends are associated with race, ethnicity, and prepregnancy body mass index (BMI). A serial, cross-sectional analysis using data from the Kaiser Permanente Southern California (KPSC) electronic health records (EHRs), with live and stillbirths at 20 or more weeks of gestation who were KPSC members at the time of delivery between 2010 and 2021. Data were analyzed from July 2022 to August 2023. Self-reported race, ethnicity, and recorded prepregnancy BMI. PPD cases were identified using validated diagnostic codes and prescription records within 12 months postpartum in the KPSC EHRs. Patients with an Edinburgh Postnatal Depression Scale score of 10 or more within 6 months postpartum were further evaluated by a mental health specialist for formal PPD diagnosis. In this study of 442 308 pregnancies, the median (IQR) maternal age at delivery was 31 (27-34) years. The cohort was racially and ethnically diverse, with 62 860 individuals (14.2%) identifying as Asian/Pacific Islander, 231 837 (52.4%) as Hispanic, 33 207 (7.5%) as non-Hispanic Black, 108 201 (24.5%) as non-Hispanic White, 5903 (1.3%) as multiple or other, and 300 (0.1%) unknown. PPD prevalence doubled over the study period, increasing from 9.4% in 2010 to 19.0% in 2021. The largest increases were observed among Asian and Pacific Islander participants (280% increase) and non-Hispanic Black participants (140% increase). PPD rates increased across all BMI categories, particularly among individuals with obesity (class I) and morbid obesity (class II/III). In this cross-sectional study, PPD diagnosis increased significantly across all racial and ethnic groups and BMI categories over the past decade. While rising PPD may reflect improved screening and diagnosis practices, the persistently high rates highlight the need to develop and implement interventions to prevent the condition while expanding efforts to mitigate the impact of PPD on maternal and child health.

Central obesity may account for most of the colorectal cancer risk linked to obesity: evidence from the UK Biobank prospective cohort.

General obesity commonly represented by body mass index (BMI) is an established risk factor for colorectal cancer (CRC). However, it is unclear to what extent this association is accounted for by central obesity. We aimed to evaluate the associations between BMI, waist-to-hip ratio (WHR), and waist circumference (WC) with CRC risk and to investigate if and to what extent these associations are independent from each other. Data from more than 500,000 male and female participants aged 40-69, recruited in the UK Biobank study between 2006 and 2010, were analyzed. Multivariable Cox proportional hazards models were fitted and hazard ratios (HR) and their 95% confidence intervals (CI) were calculated. During a median follow-up of 12.5 years, of 460,784 participants, 5,977 developed CRC. Multivariable adjusted HRs (95% CIs) per standard deviation increase of BMI, WHR, and WC were 1.10 (1.07-1.13), 1.18 (1.14-1.22), and 1.14 (1.11-1.18), respectively. After mutual adjustment, the association with CRC was substantially attenuated for BMI (1.04 (1.01-1.07)), and remained substantially stronger for WHR (1.15 (1.11-1.20)). Furthermore, WHR showed strong, statistically significant associations with CRC risk within all BMI categories, whereas associations of BMI with CRC risk were weak and not statistically significant within WHR categories. BMI was also not associated with CRC risk in women and with rectal cancer after mutual adjustment. Conversely, WHR was strongly associated with CRC risk in both sexes and with both colon and rectal cancer risk before and after adjustment for BMI. BMI and WC could not be mutually adjusted for due to their high correlation. Central obesity is a much stronger predictor of CRC and may account for most of the CRC risk linked to obesity. Our findings also emphasize the need for incorporating measures such as WHR alongside BMI in clinical practice to improve obesity prevention and management.

Prediction of intrapartum cesarean delivery among women with obesity: A retrospective cohort study

AbstractObjectiveTo determine risk factors and design a clinically based predictive model for the risk of intrapartum cesarean delivery (CD) in women with obesity.MethodsA retrospective cohort study was conducted in a single tertiary medical center between 2012 and 2022 and included all consecutive women with a pre‐gestational body mass index (BMI) ≥30 who planned a trial of labor. Uni‐ and multivariate analyses compared maternal and neonatal characteristics of women who delivered vaginally to those who underwent intrapartum CD. A specific risk prediction score was developed in accordance with the relative risk to predict the need for intrapartum CD.ResultsOf the 5663 women with obesity included in the study cohort, 424 (7.5%) underwent intrapartum CD and 5239 (92.5%) delivered vaginally. The independent risk factors for CD were maternal age &gt;35 years, pre‐gestational BMI category (BMI 35–40 and BMI &gt;40), nulliparity, epidural anesthesia, induction of labor, antibiotic administration during labor, multiple gestation, previous uterine scar, and pre‐eclampsia. The intrapartum CD prediction score model demonstrated predictive performance with 85% sensitivity and 70% specificity.ConclusionScore model for intrapartum CD can be used by caregivers to offer a more informed consultation to women with obesity facing the decision of mode of delivery.

Is a higher body mass index associated with longer duration of survival with disability in frail than in non-frail older adults?

This study investigated the hitherto unclear association of body mass index (BMI) with age at overall, disability, and disability-free survival in older adults with and without frailty. This prospective cohort study enroled 10232 Japanese adults aged ≥65 years, who underwent follow-up for adverse events, from the Kyoto-Kameoka Study conducted from 2011-2016. BMI, calculated based on self-reported height and body weight, was classified into five categories: <18.5, 18.5-21.4, 21.5-24.9, 25.0-27.4, and ≥27.5 kg/m2. Frailty was assessed using the validated Kihon Checklist. The relationships between BMI and disability and mortality were analysed using multivariate Cox proportional hazards models and Laplace regression. During the 5.3-year median follow-up period (45472 person-years), 2348 (22.9%) incidences of disabilities occurred. After adjusting for confounders, including medical history and lifestyle, individuals in the lowest and highest BMI categories had a higher hazard ratio (HR) of disability [<18.5 kg/m2: HR: 1.31, confidence interval (CI): 1.16-1.49; ≥27.5 kg/m2: HR: 1.27, 95% CI: 1.08-1.49, p for non-linearity <0.001] compared with that of those with BMI = 21.5-24.9 kg/m2. In the 50th percentile differences in age at overall and disability-free survival, participants with BMI < 18.5 kg/m2 were more likely to die before disability incidence [survival with disability (overall survival - disability-free survival): -10.2 months]; those with BMI ≥ 27.5 kg/m2 had longer survival with disability (12.5 months). These relationships were more marked in the frailty-stratified model, where in the BMI ≥ 27.5 kg/m2 group, individuals with frailty survived longer with disability (27.2 months) than did individuals without frailty (6.2 months). Higher BMI is associated with a longer duration of survival with disability among older adults, especially in those with frailty. Therefore, reversing frailty should be prioritised because individuals with frailty have a shorter probability of disability-free survival than do individuals without frailty, regardless of BMI.

Frequency of physical activity during leisure time and variables related to pain and pain medication use in Spanish adults: A cross-sectional study.

Physical inactivity has been identified as a risk factor for pain. The main objective was to analyze the relationships between leisure time physical activity frequency (PAF) and pain prevalence, pain level, pain impairment, daily life pain impairment, and analgesic use in Spanish adults. In addition, risk factors such as sex, body mass index, marital status and social class were assessed for these pain variables in addition to PAF. Cross-sectional study based on data from the 2014 and 2020 European Health Surveys in Spain residents. The Chi-square test was used to analyze the relationship of dependence between the variables of interest. A correlation study calculating Spearman's rho and a multiple logistic regression were performed to assess risk factors for pain variables. 20,113 and 19,196 subjects with a median age of 49 and 52 years old in 2014 and 2020 European Health Surveys, respectively, were analyzed. Dependence relationships were found between PAF and pain variables (p<0.001). The prevalence of: pain, high levels of pain, pain impairment, high level of pain impairment and use analgesic were higher in the inactive population than in the rest of the PAF levels (36.7-53%) vs (18.6-44.3%), p<0.05. Weak correlations were found between PAF and pain variables (-0.177 ≤ Rho ≤ -0.107) (p<0.001). Logistics regression show that being active or very active reduces the odds of pain, the intensity of pain and being affected in daily activities due to pain by 0.524 to 0.776 times. Likewise, being active or very active reduces the odds of taking pain medication by 0.661 to 0.755 times. Also age, low social class, being a woman, and being obese increase of odds of pain, pain affectation and use of analgesics in both surveys by 1.008 to 2.202 times. Physical inactivity was related to a higher prevalence of: pain, higher levels of pain, higher pain involvement and higher analgesic use. In addition, lower social class, being female, older age, and obesity were factors for higher odds of pain, pain involvement, and analgesic use in both surveys.