BMI Cut-off Values Research Articles

The accuracy of STOP-Bang questionnaire in the screening of patients with obstructive sleep apnea

Objective: To evaluate the accuracy of STOP-Bang (SBQ) questionnaire in the screening of patients with obstructive sleep apnea (OSA). Methods: The data were collected from September, 2011 to May, 2012 at the Sleep Medicine Center of West China Hospital, Sichuan University. A total of 350 consecutive patients (302 males and 48 females, 19-68 years old, average (42.9±11.0) years old) with suspected OSA who underwent an overnight polysomnography (PSG) were recruited into this study. SBQ questionnaire was completed. Based on the severity of OSA which were determined by apnea-hypopnea index (AHI), the patients were classified into four groups of primary snoring (<5 events/h), mild (5-14 events/h), moderate (15-29 events/h) and severe OSA (≥30 events/h). To evaluate the accuracy of SBQ, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics curve of SBQ questionnaire were calculated. Results: Of the subjects, 322 (92.0%) were classified as high risk based on the questionnaire. With mild+moderate+severe OSA (AHI≥5 events/h), moderate+severe OSA (AHI≥15 events/h), and severe OSA as cutoffs, the sensitivity of SBQ questionnaire were 94.0%, 94.1%, and 95.3%; the specificity were 25.7%, 15.2%, and 13.2%; the positive predictive values were 91.9%, 79.2%, and 63.4%; the negative predictive values were 32.1%, 42.9%, and 64.3%, respectively. When variable BMI and age cutoffs (BMI≥24 kg/m(2) and age>42 years old), the questionnaire had the highest sensitivity (98.4%, 98.2%, and 99.5%, respectively) and the lowest specificity (8.6%, 3.8%, and 5.2%, respectively). Conclusions: When BMI and/or age cutoff values gradually decline, the sensitivity of SBQ questionnaire are increased, but the specificity and positive predictive values are declined. Lowering BMI and/or age cutoffs possibly does not improve questionnaire accuracy.

Increased prevalence of overweight and obesity in children with X-linked hypophosphatemia.

Background/aimX-linked hypophosphatemia (XLH) is a rare disease characterized by low phosphate levels. Scientific evidence points to a link between hypophosphatemia and obesity in general population. The aim of our longitudinal observational study was to investigate the prevalence of obesity and associated factors in a large cohort of children with XLH.Patients/methodsWe studied 172 XLH-children 5–20 years of age (113 girls/59 boys). Anthropometric parameters (weight, height, and BMI) were collected at birth and during follow-up at mean ages of 5.3, 8.2, 11.3, and 15.9 years (groups 1, 2, 3, and 4, respectively). In each group, subjects were classified based on International Obesity Taskforce (IOTF) cut off values of BMI for age and sex as overweight or obese (IOTF 25–30 or ≥30 kg/m2, respectively).ResultsIn each age-group, almost 1/3 of XLH-patients were classified as overweight or obese (29.4, 28.7, 27.5, and 36.7% in groups 1, 2, 3, and 4, respectively). Children without a XLH-family history had higher BMI-IOTF at every point of follow-up, compared to those with positive XLH-family history. Similarly, higher BMI-IOTF was significantly associated with treatment duration (23.3 ± 4.4 vs 23.8 ± 3.8 vs 25.2 ± 4.5 kg/m2, for subjects with treatment duration of <5, 5–10 and >10 years, respectively, P for trend = 0.025). Multiple regression analysis confirmed an association of treatment duration and lack of XLH-family history with higher BMI-IOTF.ConclusionOne out of three of XLH-children have phenotypically unfavourable metabolic profile expressed as increased prevalence of overweight or obesity in comparison to general population. Both the lack of XLH family history and the duration of treatment increase the risk of higher BMI-IOTF. BMI should be carefully monitored in children, and later in adults, with XLH.

The cut-off points of body mass index and waist circumference for predicting metabolic risk factors in Chinese adults

Objective: To assess the association of BMI and waist circumference (WC) with metabolic risk factors, and confirm the appropriate cut-off points of BMI and WC among Chinese adults. Methods: After excluding participants with missing or extreme measurement values, as well as individuals with self-reported histories of cancer, a total of 501 201 adults in baseline and 19 201 adults in the second re-survey from the China Kadoorie Biobank were included. The associations of BMI and WC with metabolic risk factors were estimated. Receiver operating characteristic (ROC) analyses were conducted to assess the appropriate cut-off values of BMI and WC to predict the risk of hypertension, diabetes, dyslipidemia and clustering of risk factors. Results: The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all presented ascending trends with the increasing levels of BMI or WC. Defined as the points on the ROC curve where Youden's index reached the highest, the appropriate overweight cut-off points of BMI were around 24.0 kg/m(2) both in men and women, and the points of WC were around 85 cm in men and 80 to 85 cm in women. With specificity 90% for identification of risk factors, the appropriate obese cut-off points of BMI were around 28.0 kg/m(2) both in men and women, with the range of 27.0 to 28.9 kg/m(2). Conclusions: The cut-off points for overweight and obesity recommended by Coorperative Meta-analysis Group of China Obesity Task Force was verified in the large sample survey conducted more recently. The cut-off points of BMI were 24.0 and 28.0 kg/m(2) for overweight and obesity, and the cut-off point of WC was 85 cm in men and 80 to 85 cm in women for central obesity.

Risk factors for refracture after plate removal for midshaft clavicle fracture after bone union

BackgroundOpen reduction and internal fixation (ORIF) with plates and screws is one of the treatment options for clavicle fractures. However, an additional operation for implant removal after union of the fracture is commonly performed due to a high incidence of hardware irritation. Despite union of the fracture, a subsequent refracture might occur after removal of the implant which requires additional surgeries for fixation. This study aims to determine the risk factors associated with refracture of the clavicle after hardware removal.MethodsWe retrospectively reviewed the medical records of 278 patients that were diagnosed with a midshaft clavicle fracture (male 190; female 88) that had (1) undergone ORIF of the clavicle with plates and (2) received a second operation for removal of hardware after solid union of the fracture between 2010 and 2017. Their mean age was 40.1 ± 15.1 years, and mean interval from fixation to plate removal was 12.5 ± 7.5 months. The patients were then divided into two groups based on the presence of refracture (n = 20) or without refracture (n = 258). We analyzed patient demographics, interval between fixation and implant removal, fracture classification (AO/OTA, Robinson), fixation device, whether wires or interfragmentary screws were used, clavicular length, and bone diameter at the fracture site.ResultsThe overall refracture rate was 7.2%, and the mean interval between plate removal and refracture was 23.9 days. A multivariate analysis showed that female (adjusted odds ratio [aOR] 4.74; 95% CI 1.6–14.1) and body mass index [BMI] (for every 1-unit decrease, aOR 1.25; 95% CI 1.06–1.48) were risk factors for refracture. In women, BMI was the only risk factor. The optimal BMI cutoff value was 22.73. In a female patient with a lower BMI, the refracture rate was 29.8%.ConclusionsThere are no significant radiographic parameters associated with refracture. Routine plate removal in a female patient with a low BMI after bony union of a midshaft clavicle fracture is not recommended because of a high refracture rate.

Treatment outcome of oral appliance in patients with REM-related obstructive sleep apnea

PurposeOral appliances (OA) are used to treat patients with obstructive sleep apnea (OSA). The purpose of this study is to evaluate the efficacy of OA treatment in patients with rapid eye movement (REM)–related OSA.MethodsForty-six patients with REM-related OSA and 107 with non-stage-specific OSA were prescribed OA treatment after diagnosis by polysomnography (PSG) and a follow-up sleep test by PSG was conducted. Efficacy and treatment outcome predictors were evaluated according to the following criteria for treatment success: #1, reduction of the apnea-hypopnea index (AHI) to less than 5 and > 50% compared with baseline; #2, AHI reduction to less than 10 and > 50% compared with baseline; and #3, > 50% AHI reduction compared with baseline.ResultsSuccess rates according to criteria #1, #2, and #3 were 45.7%, 50.0%, and 50.0% in REM-related OSA and 36.4%, 52.3%, and 63.6% in non-stage-specific OSA, respectively. No significant differences in success rate were found between the two groups. In multivariate logistic regression analysis with each criterion as the response variable, only BMI was extracted as a significant predictor. The BMI cutoff values defined based on the maximum Youden index according to the three criteria were 26.2 kg/m2, 25.6 kg/m2, and 26.2 kg/m2, respectively.ConclusionsNo significant differences in success rate of OA treatment were found between REM-related OSA and non-stage-specific OSA. BMI has greater impact on treatment outcome of OA in patients with REM-related OSA.

Prevalence of Obesity and Hypertension Among the Zou Mothers of Manipur, Northeast India

The present study was conducted to find out the prevalence of overweight/obesity and hypertension among the Zou mothers, a tribal population of Manipur state. A cross-sectional study was conducted among 533 mothers who are within their reproductive stages of age 17–49 years following house-to-house visits. The subjects were divided into different age groups to examine the influence of age on their health condition. The finding shows that the mean systolic and diastolic blood pressure increases along with advancing age group. The cut-off value of BMI for both categories of Asian population and WHO international shows that there is a positive association between different BMI categories and blood pressure (BP). Minimum BP was found among underweight and maximum among obese category. BP was found the lowest among the younger age group and the highest among the menopausal mothers. Although the magnitude of correlation differed, there was a significant positive correlation among BMI, systolic, diastolic, and age. The effect of changing socioeconomic environment and sedentary lifestyle in addition to inactive physical activities could be the main reasons for prevalence of overweight and obesity in study population.

SAT-259 Natural History of Anthropometric Parametres of Obesity in Children Affected by X-Linked Hypophosphatemia: Longitudinal Obserbational Study

Growing body of scientific evidence points to link between fibroblast growth factor-23 (FGF-23) and unfavourable metabolic profile (obesity, insulin resistance, hyperglycemia) and all-cause mortality in general population with normal kidney function. On the other hand, there is little information about metabolic profile in situations characterized by pathophysiologically high FGF-23 such as chronic kidney disease and X-linked hypophosphatemia (XLH). The aim of the present longitudinal observational study was to investigate anthropometric parameters of obesity and metabolic profile on large cohort of children with XLH. Methods: Among 263 XLH-patients registered in our centre we selected 168 children of 5-20 years (108 girls/60 boys). Total period of FU was divided in five sub-periods according age (group 0: birth, N=168; group 1: 5-7 years, N=122; group 2: 7-10 years, N=86; group 3: 10-15 years, N=89; group 4: 15-20 years, N=49). Anthropometric parameters (weight, height, BMI) were collected from birth (group 0) and for every point of FU (group 1-4). In each group, subjects were classified based on International Obesity Taskforce (IOTF) cut off values of BMI for age and sex as overweight or obese (IOTF 25-30 or ≥30 kg/m2, respectively). Metabolic parameters (total cholesterol, triglycerides, HDL, LDL, fasting glycemia and insulinemia, HOMA-IR) were measured at one point of FU in some patients (N=40). Results: In each group of FU (1,2,3,4) almost 1/3 of patients were classified as overweight or obese (29.5% vs 29.4% vs 28.1% vs 36.7%, respectively). Even without reaching statistical significance (p=0.75), there was a tendency of higher number of overweight or obese patients in group 4 (15-20 years) (36.7%) compared to group 1,2,3, which was explained by gender differences (higher number of overweight or obese girls compared to boys (42.4% vs 25%, respectively, p=0.35). There were no differences in BMI z-score (SDS) and BMI-IOTF between groups 1,2,3,4 during FU (BMI-SDS: 0.9±1.1 vs 0.7±1.0 vs 0.6±1.1 vs 0.6±0.9, respectively, p=0.45; BMI-IOTF: 23.5±4.4 vs 23.5±4.1 vs 23.7±4.2 vs 24.3±3.6, respectively, p=0.72). As regard other metabolic parameters, only 1 patient was diagnosed with diabetes mellitus at age 10. No other alterations were found. In each group of FU, no correlation was found between FGF-23 and BMI, total cholesterol, triglycerides, HDL, LDL, fasting glycemia, insulinemia, HOMA-IR. In conclusion, 1/3 of XLH children have phenotypically unfavourable metabolic profile expressed as overweight or obesity which is higher compared to general paediatric population. This phenomenon has increasing tendency after puberty, especially in girls, and requires strict follow-up of BMI in XLH patients. In order to understand the further development of metabolic parameters, the studies on adult XLH population are needed.

Customized BMI and waist circumference cut-off values are needed to identify metabolic syndrome among South Koreans according to their Sasang constitutional type

Customized BMI and waist circumference cut-off values are needed to identify metabolic syndrome among South Koreans according to their Sasang constitutional type

Effect of BMI and Its Optimal Cut-Off Value in Identifying Hypertension in Uyghur and Han Chinese: A Biethnic Study from the China National Health Survey (CNHS).

Objective The effect of adiposity on hypertension among Uyghur Chinese is not clear. This study aimed to compare the effect of BMI and its optimal cut-off value in identifying hypertension in Uyghur and Han adults in China. Methods By using a multistage stratified sampling method, 3072 Uyghur and 3195 Han adults underwent questionnaire interview, physical examination, and biochemical tests. Age- and sex-standardized prevalence of hypertension was calculated. Adjusted odds ratios for adiposity associated with hypertension were estimated. ROC analyses were used for assessing the ethnic and sex specific optimal BMI cut-off values in identifying hypertension. Results Both in Uyghur and Han, increased BMI was consistent with the elevated systolic and diastolic blood pressure. Although more Uyghur were overweight/obese, their standardized prevalence of hypertension (17.87%) was lower than that of Han (20.28%). Han adults had 1.42 times odds than Uyghur of hypertension. The adjusted ORs of overweight and obesity were 2.67 and 6.04 in Uyghur and 2.74 and 7.58 in Han. In male, the optimal cut-off values of BMI identifying hypertension in Uyghur and Han were 24.6 kg/m2 and 24.9 kg/m2 , respectively, but the correspond values in Uyghur and Han females were 27.2 kg/m2 and 25.0 kg/m2. Conclusions Adiposity had strong effect on hypertension, but this effect was less strong in Uyghur female than in Han female.

Robotic Adrenalectomy: Are We Expanding the Indications of Minimally Invasive Surgery?

Laparoscopic adrenalectomy (LA) is accepted as the gold standard treatment for most adrenal pathologies. Open surgery is still considered the standard of care for large tumors and malignancies. In the past decade, robotic adrenalectomy (RA) has become an alternative to the laparoscopic and open approaches. The aim of this study was to analyze perioperative and postoperative outcomes in a series of consecutive nonselected patients undergoing a RA, to determine whether factors that negatively affect outcomes in LA (body mass index [BMI], size, and side of the tumor) have the same impact in RA. This is a single-center single-surgeon retrospective study with 43 patients who underwent a RA. Patients were divided into different groups according to tumor size (cutoff values of 5 or 8 cm), tumor side (left/right), and BMI (cutoff value of kg/m2). Perioperative and postoperative outcomes included operative time, length of hospital stay, blood loss, readmissions, complications, and conversions to open. There were no significant differences between the groups with tumors <5 cm versus ≥5 cm regarding gender, age, race, BMI, American Society of Anesthesiologists (ASA) score, history of previous abdominal surgery, tumor side, and histopathological diagnosis (all P values ≥.06). There were no significant differences in any of the outcomes analyzed with respect to the tumor size (all P values ≥.14) except for a higher occurrence of complications in patients with tumors ≥8 cm versus <8 cm (P = .03). There were no significant differences in any outcomes related to side (left versus right) of the tumor nor BMI (<30 versus ≥30 kg/m2). The overall readmission and conversion rates were both 2.3% and no mortalities were registered. Patient's BMI, tumor side, and size did not demonstrate a negative impact on perioperative and postoperative outcomes of RA. This approach could potentially expand the indications of minimally invasive surgery.

PS01.165: HIGH BMI HAS NO IMPACT ON THE SURVIVAL OF CHINESE PATIENTS WITH ESOPHAGEAL ADENOCARCINOMA TREATED WITH CURATIVE ESOPHAGECTOMY: A PROPENSITY SCORE-MATCHED STUDY

Abstract Background Controversy still exists as to whether high BMI has any impact on the long-term survival of esophageal cancer patients treated with curative esophagectomy. Due to the rarity of esophageal adenocarcinoma in Chinese patients, its characteristics were rarely reported and the prognostic value of high BMI in Chinese esopaheagl adenocarcinoma patients has not been investigated yet. Therefore, we conducted this propensity score-matched study to explore the prognostic value of high BMI in Chinese patients with esophageal adenocarcinoma for the first time. Methods We retrospectively collected data of patients with lower thoracic esophageal adenocarcinoma who underwent curative esophagectomy in our department from January 2009 to December 2016. Patients were grouped into high BMI group (≥ 23 kg/m2) and normal BMI group (18.5–22.9 kg/m2) according to the Asian specific BMI cutoff value. Both Cox regression survival analysis and propensity score-matched analysis were applied. Results A total of 132 patients were included for analysis. Fifty-three patients were in the high BMI group while 79 patients were in the normal BMI group. There were no significant differences regarding age, gender, comorbidity, tumor differentiation, tumor site, lymphovascular invasion, or surgical approaches between the two groups. However, patients in the high BMI group had more stage III diseases but less rate of adjuvant therapy than patients in the normal group. For survival, there was no significant survival difference between patients with high BMI and those with normal BMI (5-year overall survival rate: 40.8%VS 48.1%; P = 0.398). In the multivariate analysis, high BMI was not found to be an independent prognostic factor of Chinese patients with esophageal adenocarcinoma (HR = 1.028, 95%CI: 0.621–1.667, P = 0.945). A total of 92 patients were included after propensity-score matched analysis, and all those baseline data were comparable between the two groups. However, there was still no significant difference of survival between patients with high BMI and those with normal BMI (5-year overall survival rate: 41.4%VS 43.3%; P = 0.760). Conclusion High BMI have no impact on survival of Chinese patients with lower thoracic esophageal adenocarcinoma treated with curative esophagectomy. Therefore, esophageal adenocarcinoma patients with high BMI should not be denied for curative esophagectomy. Disclosure All authors have declared no conflicts of interest.

Anthropometric Measurements as a Screening for OSA Among Employees of Philippine Heart Center

SESSION TITLE: Sleep 2 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Obesity is a key risk factor for the development of OSA and if undiagnosed and untreated, may lead to serious complications. This study aims to determine the association of anthropometric measurements with risk for OSA, through utilization Berlin Questionnaire, among employees of Philippine Heart Center. METHODS: This is a cross sectional study conducted at the Philippine Heart Center. Anthropometric measurements of 260 employees were obtained and assessed for high risk for OSA through Berlin questionnaire. RESULTS: Subjects who were high risk for OSA based on the Berlin Questionnaire were significantly more likely than those at low risk to have an increased weight 73.9 kg ± 15.1 vs low risk 64.3 kg ± 13.2 (p value <0.001), increased BMI 28.5 ± 4.09 vs low risk 24.5 ± 4.1 (p value <0.001); larger neck circumference 36.9 cm ± 3.7 vs low risk 34.9 cm ± 3.8 (p value 0.0003), larger waist circumference 91.8 cm ± 10.5 vs low risk 82.4 cm ± 12.7 (p value <0.001), greater hip circumference 102.9 cm ± 8.4 vs low risk 95.8 cm ± 10.7 (p value<0.001) and thigh circumference 56.8 cm ± 6.3 vs low risk 53.5 cm ± 8.5 (p value 0.0053). Logistic regression analysis was used after obtaining cut off values for BMI, neck circumference, waist circumference and waist-to-hip ratio. The results showed that increased BMI, waist circumference and waist to hip ratio were statistically significant risk factor for OSA. It is 4.6 times likely to occur if BMI is 28.72 kg/m2 (p value <0.001). Likewise, there was a threefold increase in the probability of OSA if the subject’s waist circumference was >97 cm (p value 0.002) and a twofold more likely of OSA if the subject waist-to-hip ratio >1 in men and >0.85 in women (p value 0.004). Though, neck circumference was close to being statistically significant (p value 0.051). CONCLUSIONS: The result of our study showed that anthropometric indices like BMI, waist circumference, and waist to hip ratio, are significant risk for OSA. On the other hand, our results suggest that neck circumference is not a good predictor of OSA. Thigh circumference was also associated with high risk for OSA which is not included in other studies. CLINICAL IMPLICATIONS: It is important that these anthropometric measurements should be taken on all patients especially if they present with snoring, daytime somnolence, fatigue and hypertension, as they provide cost-effective test in screening OSA prior to polysomnography. DISCLOSURE: The following authors have nothing to disclose: Mander Cambonga, Ma. Encarnita Limpin, Aileen Banzon No Product/Research Disclosure Information

The association of weight loss with one-year mortality in hospital patients, stratified by BMI and FFMI subgroups

The European Society for Clinical Nutrition and Metabolism (ESPEN) has recently published consensus-based criteria for the diagnosis of malnutrition; in subjects identified at nutritional risk the diagnosis is confirmed by either BMI <18.5kg/m2 or weight loss in combination with low BMI or low FFMI. Concerns have been raised whether this definition correctly classifies malnutrition in patients with normal weight or overweight and concomitant weight loss. Therefore, the aim of this research is to assess the association between weight loss and one-year mortality in hospitalized patients, stratified by BMI and FFMI subgroups. This prospective study included 769 patients admitted to the VU University Medical Center. Critical weight loss (CWL) was defined as >5% weight loss in the previous month or >10% weight loss in the previous six months. The association between CWL and one-year mortality was analyzed with a priori stratification by BMI cut-off values (</≥20.0kg/m2 for patients <70 years and </≥22.0kg/m2 for patients ≥70 years) and FFMI cut-off values (derived from BIA measurements, </≥15kg/m2 for females and </≥17kg/m2 for males). Mortality risks were calculated (HR, 95% CI). CWL occurred in 35% of patients and was associated with an increased one-year mortality rate vs. no-CWL (25% vs. 15%, p=0.001), HR for mortality risk 1.76 (1.26-2.45)). CWL+low FFMI was associated with higher mortality risk (HR 1.95 (1.20-3.17), whereas CWL+normal FFMI was not (HR 1.37 (0.85-2.21)). Among patients with normal/high BMI, those with CWL had a significantly higher mortality risk compared to those without critical weight loss, however additionally adding FFMI to that model showed that a low FFMI was crucial in the observed association with mortality (CWL+normal BMI+low FFMI, HR 2.69 (1.29-5.65); CWL+normal BMI+normal FFMI, HR 1.38 (0.84-2.27)). - Patients with critical weight loss have a higher one-year mortality compared to patients with no critical weight loss. FFMI seems to play a crucial role in this association, as normal weight patients with normal FFMI had lower mortality rates than their counterparts with low FFMI.

Is Underweight Associated with more Positive Body Image? Results of a Cross-Sectional Study in Adolescent Girls and Boys.

The aim of the study was to investigate the relationship between body image and prevalence of underweight, normal weight, and overweight in adolescents. The study included 1702 girls and 1547 boys, aged 14-16 years, who completed questionnaire assessing body satisfaction. The participants' BMI status: underweight, normal weight or overweight was determined on the basis of BMI cut-off values. Results revealed that more girls (p < .001) showed low body satisfaction (44.8%) and fewer girls (p < .001) had high body satisfaction (17.6%) compared to boys (28.5% and 29.0%, respectively). A two-way ANOVA revealed a significant interaction between BMI status and gender on body satisfaction F(2, 3243) = 4.10, p = .017, η2 = .003. In boys, body satisfaction was higher in normal weight and underweight in comparison to overweight individuals (p < .001). Underweight girls presented higher body satisfaction than those who were normal weight and overweight (p < .001). Our findings indicated that, in relation to gender, BMI status can be associated with different body satisfaction in adolescents. This should be taken into consideration when designing programs aimed at obesity and disordered eating prevention and body image improvement. Due to the fact that underweight girls and boys have high body satisfaction, this can lead to behaviors that maintain low body weight in adolescents and in turn this may have negative health consequences.

The Body Mass Index BMI Should be Abandoned in Favour of the Body-Shape Index BSI for Controlling Body Weight in Adults

Objective: This paper aims at optimal metrology for defining healthy weights in humans using weight-height ratios. Study Design: Normal appearing Caucasian males and females of any age and height were stochastically selected individually and grouped into cohorts of gender, different heights and ages, in order to apply rigorous statistical analyses, using the least squares method of Gauss. Methods: 246 Caucasian males and 258 Caucasian females of “normal” appearance represent an unbiased stochastically selected cohort sufficiently large to analyse statistically individual and cohort values for Body-MassIndex, kg/m2 , and Body-Shape-Index, kg/m3 , relating to gender, height, and age. Results: For Caucasians taller than ~1.2m the BMI is largely inferior to the BSI. In adults, the single average normal weight BSI value is 12.54 for males and 12.36 for females, with standard deviations of 1.67 and 1.95, respectively. For children smaller than ~1.2m the BMI is superior showing at normal weight an average value of ~16.0 for males and ~15.2 for females, with standard deviations of 1.70 for males and 1.66 for females. The difference between BMI and BSI applicability lies in the proportionality of body shapes changing with growth from childhood to adults. Conclusions: The BMI is the choice for weight control only of children of &lt;1.2m. In individuals taller than 1.7m, a single BMI value introduces serious errors and should not be used. The BSI provides a stable value with height &gt;1.2m and should replace the BMI. - BSI and BMI cut-off values are given for severe underweight, overweight and obesity for males and females for clinical guidance and use in public health.

"Body Mass Status among Primary School Going Children"

Background: School going children is important part of our society. Their growth, development and body weight is of utmost significance and presents general health status of a community and nation as a whole. For the assessment of nutritional status WHO Asian cuts-off BMI for age recommended BMI less than 18.5 kg/m considered underweight, 18.5-24.9 normal weight, more than 25 overweight. The objective of this study is to access body mass status among primary school going children of Hyderabad.Methods: The study design was cross sectional study in which different school of Hyderabad were selected to collect data (semi government and private sector).This study has assessed the body mass index between 7-14 years old age group of both genders of primary school going children of Hyderabad. BMI has calculated with the help of weight and height of the body.Result: In this study out of 100 children 10%were 7-8 year old 20% were 9-10 year old, 20% were 11-12year old and 30% were 13-14 year old. The analysis shows 80% were underweight (below 18.5), 18% were normal weight (18.5-24.9) and only 2% overweight (above 25) according to the Asian cut-off value of BMI for Asian children. When it was analyzed by gender 62% of the boys and 18% of the girls were underweight, 6% of boys and 12% out of girls were normal weight, 2% of the boys were overweight no girl found overweight in the study. In the above study 80% found underweight, 18% normal weight, 2% overweight.Conclusion: Under nutrition among the school going children is currently a health problem faced by Hyderabad school going children. There is need to be taken address these problems in order to prevent nation from nutritional deficiency among school going children and buildup a strong and healthy nation in future.

Fatty liver index is a risk determinant of incident type 2 diabetes in a metabolically healthy population with obesity.

This study investigated the effect of fatty liver disease (FLD) on the risk of incident type 2 diabetes in a population with metabolically healthy obesity (MHO). The study population comprised 34,258 Koreans without type 2 diabetes. Participants were stratified by BMI (cutoff value, 25.0 kg/m(2) ) and metabolic health state (using Wildman criteria). FLD was defined by the fatty liver index (FLI), a predictive algorithm to detect FLD. Subjects were classified into low and high FLI groups based on tertile. At baseline, there were significant differences in FLI between four study groups. During a median follow-up of 36.5 months, 1.7% individuals developed type 2 diabetes. The risk of incident type 2 diabetes varied for the MHO group according to the level of FLI. The risk of type 2 diabetes in the MHO with low FLI was not significantly elevated compared with the metabolically healthy individuals without obesity (MHNO) with low FLI (multivariate-adjusted HR, 1.19 [95% CI 0.66-2.14]). However, the MHO with high FLI had an elevated risk of incident type 2 diabetes (multivariate-adjusted HR, 1.99 [95% CI 1.36-2.92]). MHO subjects have a substantially higher risk of incident type 2 diabetes than MHNO subjects. The presence of FLD assessed by FLI partially explains this increased risk.

The prevalence of metabolic syndrome among low-income South Asian Americans.

The purpose of the present paper is to examine the prevalence of metabolic syndrome (MetS) and its components using the harmonized definition in an interviewed sub-sample of diverse, low-income, adult South Asians (SA) of both sexes residing in Maryland. We also wanted to derive a BMI cut-off value that was highly correlated with the recommended waist circumference (WC) that we could apply to a larger sample of SA Americans for whom only BMI values were available from clinic files. We also examined differences in MetS prevalence among various Asian ethnic groups (defined by country of origin) and the clustering pattern of their MetS components. Clinical data extraction on subjects (n 1002) and interviewees (n 401) were used in a cross-sectional study of SA Americans. Two community health centres in Montgomery and Baltimore County, MD, USA. SA adult males and females (n 1403) aged 20-68 years. The prevalence of MetS using harmonized WC cut-offs (90 cm in men and 80 cm in women) was 47% in men and 54% in women. Using a BMI of 23.0 kg/m2 gave a similar prevalence of MetS for males (48%) and females (47%). Of the five MetS components, the prevalence pattern differed among the ethnic groups, particularly for SA Indians. The prevalence of MetS in a diverse, low-income, SA American immigrant group using the harmonized definition was 51%. Derived lowered BMI cut-off of 23.0 kg/m2 should be used by clinicians in studies on SA when WC values are not available for detecting metabolic risk. SA Indians had a higher prevalence of abnormal TAG and blood glucose values compared with other SA, and therefore results for SA Indians should not be generalized to all SA ethnic groups.

Validity of Newly Developed BMI and Waist Cutoff Values for Sri Lankan Children

Background: Excess body fat leads to obesity-related morbidity and population/ethnicity-specific cut-off values of anthropometric measures are useful for better diagnosis. This study assesses the s...

Prevalence of nutritional risk in the non-demented hospitalised elderly: a cross-sectional study from Norway using stratified sampling

There is a lack of accurate prevalence data on undernutrition and the risk of undernutrition among the hospitalised elderly in Europe and Norway. We aimed at estimating the prevalence of nutritional risk by using stratified sampling along with adequate power calculations. A cross-sectional study was carried out in the period 2011 to 2013 at a university hospital in Norway. Second-year nursing students in acute care clinical studies in twenty hospital wards screened non-demented elderly patients for nutritional risk, by employing the Nutritional Risk Screening 2002 (NRS2002) form. In total, 508 patients (48·8 % women and 51·2 % men) with a mean age of 79·6 (sd 6·4) years were screened by the students. Mean BMI was 24·9 (sd 4·9) kg/m(2), and the patients had been hospitalised for on average 5·3 (sd 6·3) d. WHO's BMI cut-off values identified 6·5 % as underweight, 48·0 % of normal weight and 45·5 % as overweight. Patients nutritionally at risk had been in hospital longer and had lower average weight and BMI compared with those not at risk (all P < 0·001); no differences in mean age or sex were observed. The prevalence of nutritional risk was estimated to be 45·4 (95 % CI 41·7 %, 49·0) %, ranging between 20·0 and 65·0 % on different hospital wards. The present results show that the prevalence of nutritional risk among elderly patients without dementia is high, suggesting that a large proportion of the hospitalised elderly are in need of nutritional treatment.