Difference In Mean Body Mass Index Research Articles

Body Mass Index Changes Among Adolescents and Young Adults Using the Etonogestrel Contraceptive Implant.

To evaluate body mass index (BMI) over 36 months among adolescents and young adults using the etonogestrel implant compared with those using depot medroxyprogesterone acetate (DMPA) and a control group. We conducted a retrospective longitudinal cohort study of postmenarchal adolescents and young adults assigned female at birth. The etonogestrel implant and DMPA groups initiated etonogestrel or DMPA between January 1, 2010, and December 31, 2017. Adolescents and young adults in the control group were prescribed a weight-neutral contraceptive or no contraceptive during the same timeframe. The primary outcome of BMI over time was estimated and compared between study groups with inverse probability of treatment weighting linear mixed-effects modeling. Changes in BMI weight category (underweight or normal weight, overweight, obesity) at 12, 24, and 36 months were also explored. Among the 20,409 eligible patients, 860 initiated etonogestrel, 1,817 initiated DMPA, and 17,732 made up the control group. Compared with individuals in the control group, those in the etonogestrel group had a significantly higher mean BMI difference at 9 months (+0.5, P<.01); at 36 months, the mean BMI difference was +1.0 (P<.01). Compared with individuals in the control group, those in the DMPA group had higher mean BMI at 6 months (+0.3, P<.01); at 36 months, the mean BMI difference was +1.3 (P<.01). Regardless of weight changes, increases in BMI weight categories were rare in all groups. Adolescent and young adult patients who initiated the etonogestrel implant demonstrated BMI changes like those on DMPA and higher than control patients; however, these differences may not be clinically concerning. This study provides important information that can help in counseling adolescent and young adult patients about expectations when starting and using etonogestrel.

Impact of body mass index on fracture severity, clinical, radiological and functional outcome in distal radius fractures: a retrospective observational study after surgical treatment

IntroductionDistal radius fracture (DRF) is one of the three most common fractures of the human body with increasing incidences in all groups of age. Known causes of increasing incidence, such as ageing of the population or increased obesity, have been described and discussed. So far, literature reports ambivalent effects of body mass index (BMI) on bone physiology. It is worthwhile to examine the influence of BMI on the outcome of fractures more detailed. This study aims to investigate the influence of an abnormal BMI on fracture severity and treatment, as well as clinical, radiological, and functional outcome to improve clinical decision making.Materials and methodsA retrospective observational study was conducted on data obtained from patients, who underwent open reduction and internal fixation (ORIF) of a DRF at a local Level 1 Trauma Center between May 2018 and October 2021. Follow-up examinations were performed approximately 1 year after surgical fracture treatment, during which various questionnaires and functional measurements (CMS, DASH, NRS, ROM) were applied. In addition, postoperative complications were recorded and radiological examinations of the affected hand were performed. After excluding incomplete data sets and applying set exclusion criteria, the complete data of 105 patients were analyzed.Results74 patients were female and 31 male with significant difference in mean BMI [p = 0.002; female: 23.8 (SD ± 3.3), men: 26.2 (SD ± 3.9)]. Patients with higher BMI had significantly more severe fractures (p = 0.042). However, there was no significant difference in surgery time for fracture management. At follow-up, patients with lower BMI showed a smaller difference in hand strength between the fractured and the other hand (p = 0.017). The BMI had no significant effect on the clinical and radiological outcome.ConclusionDespite the ambivalent effects of BMI on the skeletal system, our findings indicate that a higher BMI is associated with more severe DRF. Thereby BMI does not correlate with surgery time for fracture treatment. Furthermore, no evidence of an influence on the clinical and radiological outcome could be detected.

10-year level, trends and socio-demographic disparities of obesity among Ghanaian adults-A systematic review and meta-analysis of observational studies.

The double burden of malnutrition has assumed severer forms in Low and Middle Income Countries (LMICs) arising from sharper increases in prevalence rates of overweight and obesity in these countries compared to higher income countries. Considering that LMICs already have fragile health systems, the rising obesity levels may just be a ticking time bomb requiring expeditious implementation of priority actions by all global and national actors to prevent an explosion of cardiovascular disease related deaths. The aim of this systematic review and meta-analysis was to provide a current estimate of obesity and overweight prevalence among Ghanaian adults and assess socio-demographic disparities following the PRISMA guidelines. We searched Pubmed with Medline, Embase, Science direct and African Journals Online (AJOL) for studies on overweight and obesity published between 2013 and January 2023. Applying a quality effects model, pooled mean Body Mass Index (BMI) and prevalence of overweight and obesity were obtained from 42 studies conducted across all three geographical locations of Ghana with a combined sample size of 29137. From the analysis, the mean BMI of adults in Ghana was 24.7 kgm-2 while overweight and obesity prevalence was estimated as 23.1% and 13.3% respectively. Temporal analysis showed sharper increases in overweight and obesity prevalence from 2017/2018. Mean BMI (Females: 25.3kgm-2 vrs Males: 23.1 kgm-2), overweight (Females: 25.9% vrs Males: 16.5%) and obesity (Females: 17.4% vrs Males: 5.5%) prevalence were higher among females than males. Gender differences in mean BMI and obesity prevalence were both significant at p<0.001. Urban dwellers had higher mean BMI than their rural counterparts (24.9kgm-2 vrs 24.4kgm-2). Overweight (27.6% vrs 18.2%) and obesity (17.3% vrs 11.0%) prevalence were also higher in urban areas than in rural areas. Body weight indicators for the various geographical areas of Ghana were; southern sector: 25.4kgm-2, 28.9% and 15.4%, middle sector: 24.8kgm-2, 26.4% and 16.2% and northern sector: 24.2kgm-2, 15.4% and 8.5% for mean BMI, overweight and obesity prevalence respectively. The southern part of Ghana was similar to the middle part in terms of mean BMI, overweight and obesity but higher than the northern part. We conclude that overweight and obesity prevalence in Ghana has risen to high levels in recent years with women and urban dwellers disproportionately more affected. There is a possible implication for increased cardiovascular diseases and a generally poor quality of life for the people. Evidence-based public health interventions are needed to reverse the current situation.

Does inadequate sleep predispose to weight gain? A cross-sectional analysis among medical undergraduates

Background: Adequate sleep is essential for optimal health. Sleep deprivation has been shown to be associated with adverse health outcomes, including weight gain and obesity. Medical students represent one of the at-risk populations for sleep deprivation. Aims and Objectives: This study was aimed at exploring the relationship between inadequate sleep and weight gain in the medical student population. Materials and Methods: The present analytical and cross-sectional study was conducted in a sample of 126 undergraduate medical students (95 males and 31 females) within the age range 18–25 years at an institute in Southern Haryana, India. Sociodemographic and usual sleep-wake habits during the preceding month information about the participants were gathered through self-administration of a structured pro forma compiled as Google Forms. Height and weight of each subject were measured reliably using standard instruments and body mass index (BMI) was calculated. Data were expressed using suitable statistical measures and analyzed using appropriate statistical tests. Results: Our study revealed a significant association between subjective sleep quality and weight gain with those perceiving their sleep as poor being much more likely to be overweight (Crude Odd’s ratio; 95% confidence interval: 3.45; 1.33–8.95). Students reporting usually getting inadequate sleep and difficulty in falling asleep were also found to have a higher frequency of being overweight (76.9% vs. 23.1%, 61.5% vs. 38.5%, respectively). A small, though statistically insignificant, difference in mean BMI was also seen; students who reported getting insufficient sleep (&lt;7 h), taking ≥30 min to fall asleep, and rated their sleep quality as poor outweighed their counterparts. Conclusion: The findings of our study suggest that inadequate sleep might predispose to weight gain and obesity, though the same needs to be explored through a longitudinal approach controlling for potential confounders to arrive at a definitive conclusion.

Üreterorenoskopi sonrası double J stentin kadın cinsel fonksiyonlarına etkisi

OBJECTIVE: This study aims to evaluate the impact of double J stenting on female sexual functions following ureterorenoscopy (URS). MATERIAL and METHODS: Between April 2023 and September 2023, data from a total of 60 patients who underwent ureteroscopy (URS) treatment for ureteral stones in our clinic and a control group consisting of 30 individuals were retrospectively analyzed. Demographic and clinical characteristics of the patients, including age, body mass index (BMI), stone size, whether a double J stent was placed or not, length of hospital stay, duration of the double J stent in the patient, patients’ educational status, and Female Sexual Function Index (FSFI) scores at preoperative, postoperative 1 st, and 3rd months, were recorded. To assess psychological status, Beck Depression Scale scores were recorded at preoperative, postoperative 1 st, and 3rd months. The obtained parameters were compared between the groups. RESULTS: There were no statistically significant difference in mean age and BMI among the three groups (p=0.877 and p=0.932, respectively). The preoperative FSFI scores for Group 1, Group 2, and Group 3 were 13.83±1.76, 13.51±1.45, and 15.72±1.36, respectively. A statistically significant difference was observed among the groups (p&lt;0.001). The FSFI scores at postoperative 1st month were 14.2±1.39 for Group 1 and 12.82±1.5 for Group 2, with a statistically significant difference between the groups (p&lt;0.001). The FSFI scores at postoperative 3rd month were 14.54±1.7 for Group 1 and 14.4±1.54 for Group 2 (p=0.740). There was no statistically significant difference in Beck Depression scores during the preoperative period among the three groups (p=0.966). CONCLUSION: Based on our study, we believe that the placement of a double J stent after ureteroscopy (URS) may lead to a temporary impairment in female sexual functions. We recommend that patients be informed about this aspect during the preoperative period, suggest the removal of the double J stent at the earliest possible time when deemed necessary. Keywords: double J stent, female sexual function, ureteroscopy

Prevalence of Elevated Blood Pressure and Its Relationship With Anthropometric Risk Factors in Students of a Pre-university Girls' College in Bangalore: A Cross-Sectional Study.

Background There is a growing concern regarding elevated blood pressure in adolescence. Children and adolescents with high blood pressure are at risk for adult hypertension. Being overweight and obese are important risk factors for hypertension. This study aimed to determinethe prevalence of elevated blood pressure and its association with anthropometric risk factors among students of a pre-university girls' college. Methodology A cross-sectional study was conducted among 337 students at a pre-university girls' college aged 15-19 years in urban Bangalore. A self-administered, semi-structured, pretested questionnaire collected the sociodemographic details, family history, and lifestyle. Height, weight, waist circumference (WC), and hip circumference were measured. Standard cut-off levels were used for body mass index (BMI), WC, waist-hip ratio (WHR), and waist-height ratio (WHtR). Resting blood pressure was determined using a digital blood pressure monitor. It was classified into normotensive, pre-hypertension (>90th to <95th percentile), and hypertension (>95th percentile). Data were analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). Pre-hypertension and hypertension were considered as having elevated blood pressure. Results The prevalence of pre-hypertension and hypertension was 21.4% (n = 72, 95% confidence interval (CI) = 17.0-25.7) and 9.8% (n = 33, 95% CI = 6.6-13.0), respectively. The prevalence of overweight was 20.2% (n = 68, 95% CI = 15.9-24.5) and obesity was 12.2% (n = 41, 95% CI = 8.7-15.7). WC, WHR, and WHtR were abnormal in 34.7% (n = 117, 95% CI = 29.6-39.8), 47.5% (n = 160, 95% CI = 42.1-52.8), and 45.7% (n = 154, 95% CI = 50.4-51.0), respectively. There was a statistically significant correlation betweensystolic blood pressure and BMI (p < 0.001), WC (p < 0.001), and WHtR (p < 0.001), as well asdiastolic blood pressure and BMI (p < 0.001), WC (p = 0.008), and WHtR (p = 0.011). Statistically significant differences in mean BMI (p = 0.004), WC (p < 0.001), WHR (p = 0.007), and WHtR (p = 0.001) between normal, pre-hypertensive, and hypertensive students were also noted. Conclusions Pre-hypertension and hypertension are fundamental problems in pre-university girl students. With a similarly increased prevalence of obesity and other anthropometric risk factors, students must be aware of hypertension and its risk factors.

Abstract B065: Percent mammographic density and breast cancer risk among U.S. Black women

Abstract Background: High mammographic density is a well-established risk factor for breast cancer. A few studies have suggested a difference in mammographic density by race wherein Black women – who have a high risk of aggressive breast cancer subtypes – are more likely to have dense breasts compared to women of other racial/ethnic groups. It is unknown whether mammographic density may contribute to differences in breast cancer risk by tumor hormone subtype across race and ethnicity. Methods: We used a case-cohort study design to examine the association between percent mammographic density (PMD) and breast cancer risk among Black women in the United States using data from the Black Women’s Health Study (BWHS). Our study consisted of 5,904 women with digital screening (i.e., pre-diagnostic) mammograms of which 363 (6.15%) were women with breast cancer (cases) and 5,541 (93.85%) were women without breast cancer (non-cases). We used Cumulus to assess PMD. Quartiles for PMD were determined based on the distribution in the non-cases. We used logistic regression, adjusted for age and body mass index (BMI) at mammography, to estimate relative risks (RRs) and 95% confidence intervals (CIs) for the association of PMD with breast cancer overall and by estrogen receptor (ER) status. Fully adjusted models additionally included other established breast cancer risk factors. We also stratified analyses by age at mammography (&amp;lt;55 vs. ≥ 55 years). Results: The mean age at mammography was 56 years for both cases and non-cases and approximately 70% of participants were postmenopausal. Cases had a lower mean BMI at age 18 years (20.9 kg/m2) compared to non-cases (21.4 kg/m2), while there was no difference in mean BMI at mammography between cases and non-cases. As expected, cases were more likely than non-cases to have a family history of breast cancer (25% vs. 19%). Additionally, cases had a higher mean PMD than did non-cases (26.3% vs. 24.5%). Overall, women in the highest quartile of PMD had a 58% higher risk of breast cancer compared to those in the lowest quartile (RRQ4vsQ1 1.58; 95% CI: 1.14, 2.18). Corresponding RRs were 1.46 (95% CI: 0.99, 2.14) for ER+ cancer and 1.57 (95% CI: 0.79, 3.14) for ER– cancer. Among women under 55 years of age, the RR for the highest quartile of PMD relative to the lowest quartile was 1.35, 95% CI: 0.83, 2.19). Among the older women, the comparable RR was 1.75, 95% CI: 1.13, 2.69). Associations were largely unchanged in multivariable models. Conclusion: In the largest study of mammographic density in U.S. Black women to date, we confirmed that higher PMD is associated with both ER+ and ER– breast cancer risk in this population. Associations were statistically significant among women ≥55 years of age. Findings from this study reinforce the importance of breast density as a risk factor for breast cancer across racial/ethnic groups. Citation Format: Etienne X. Holder, Zahna Bigham, Kerrie P. Nelson, Julie R. Palmer, Kimberly A. Bertrand. Percent mammographic density and breast cancer risk among U.S. Black women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B065.

Trends in the ability of socioeconomic position to predict individual body mass index: an analysis of repeated cross-sectional data, 1991-2019.

The widening of group-level socioeconomic differences in body mass index (BMI) has received considerable research attention. However, the predictive power of socioeconomic position (SEP) indicators at the individual level remains uncertain, as does the potential temporal variation in their predictive value. Examining this is important given the increasing incorporation of SEP indicators into predictive algorithms and calls to reduce social inequality to tackle the obesity epidemic. We thus investigated SEP differences in BMI over three decades of the obesity epidemic in England, comparing population-wide (SEP group differences in mean BMI) and individual-level (out-of-sample prediction of individuals' BMI) approaches to understanding social inequalities. We used repeated cross-sectional data from the Health Survey for England, 1991-2019. BMI (kg/m2) was measured objectively, and SEP was measured via educational attainment, occupational class, and neighbourhood index of deprivation. We ran random forest models for each survey year and measure of SEP adjusting for age and sex. The mean and variance of BMI increased within each SEP group over the study period. Mean differences in BMI by SEP group also increased: differences between lowest and highest education groups were 1.0kg/m2 (0.4, 1.6) in 1991 and 1.3kg/m2 (0.7, 1.8) in 2019. At the individual level, the predictive capacity of SEP was low, though increased in later years: including education in models improved predictive accuracy (mean absolute error) by 0.14% (- 0.9, 1.08) in 1991 and 1.05% (0.18, 1.82) in 2019. Similar patterns were obtained for occupational class and neighbourhood deprivation and when analysing obesity as an outcome. SEP has become increasingly important at the population (group difference) and individual (prediction) levels. However, predictive ability remains low, suggesting limited utility of including SEP in prediction algorithms. Assuming links are causal, abolishing SEP differences in BMI could have a large effect on population health but would neither reverse the obesity epidemic nor reduce much of the variation in BMI.

Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam.

One of the most prevalent oral diseases affecting preschoolers, early childhood caries (ECC), can significantly lower a child's quality of life. The pain and discomfort that ECC causes will alter the child's eating habits, which will have an impact on both their physical and mental health, as shown by the deviation from the body mass index (BMI). Dental caries and deviation from the normal BMI are both significantly influenced by children's eating habits and socioeconomic status (SES). To determine the association of ECC with BMI, dietary habits, and SES among 3-6-year-old preschool children. A cross-sectional study was conducted among 375 preschool children of 3-6 years of age. The decayed, missing, or filled teeth (deft) index was used to determine the caries status. Measurement of height (m) and weight (kg) was done using a stadiometer and electronic weighing machine. For each child, the BMI (kg/m2) was calculated, and the child's body weight status was assessed using Centers for Disease Control and Prevention (CDC)-based classification. Questionnaires were collected with demographic details, 3 days diet diary, and the SES of parents. The dietary habit and SES were obtained from the healthy eating index-2005 (HEI-2005) score and Modified Kuppuswamy's Scale 2018. All the data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) software V 20.0. The prevalence of ECC was 44.8%. On comparison of mean height, weight, and BMI scores, there was a significant difference in mean weight (p = 0.006) and BMI (p = 0.001) among the two study groups. Children with ECC had a lower HEI-2005 score and belonged to a lower social class compared to caries-free children (p = 0.001). Children with ECC are significantly associated with BMI being overweight, or risk of being overweight; lower grades of SES and lower total score of HEI-2005 with poor diet and diet that needs improvement. Suresh A, Srinivasan D, AR SE, et al. Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam. Int J Clin Pediatr Dent 2023;16(4):565-571.

Twelve-month effectiveness of telephone and SMS support to mothers with children aged 2 years in reducing children’s BMI: a randomized controlled trial

Background/objectivesFew quality intervention studies have assessed whether a combined telephone and short message service (SMS) intervention to mothers is effective in reducing BMI and obesity risk behaviors of children at 3 years of age. This study aimed to assess effectiveness of telephone and SMS support in reducing children’s body mass index (BMI) and obesity risk behaviors.Subjects/MethodsA randomized controlled trial (RCT) with 662 women of 2-year-old children (with the proportion of overweight and obesity being similar to the general population) was conducted in Sydney, Australia, March 2019–October 2020. The mothers in the intervention group received three telephone support sessions plus SMS messages and mailed-intervention-booklets over a 12 months period i.e., 24–26, 28–30, and 32–34 months of the child’s age. Mothers in the control group received usual care and two mailed booklets on information not related to the intervention. The primary outcome was child’s BMI at 3 years of age. Secondary outcomes were children’s dietary and activity behaviors. All outcome measures were based on mothers’ self-report using standardized tools due to COVID-19 pandemic restrictions.Results537 (81%) mothers completed the post-intervention assessment at 3 years with only 470 (71%) children having weight and height measures. Multiple imputation analysis showed no statistically significant difference in mean BMI between the groups. Children in the intervention group were more likely not to eat in front of the TV [AOR 1.79 (95% CI 1.17–2.73), P = 0.008], more likely to meet the dietary recommendations [AOR 1.73 (95% CI 0.99–3.02), P = 0.054] and meet the activity recommendations [AOR 1.72 (95% CI 1.11–2.67), P = 0.015] than those in the control group respectively. Among those with an annual household income (<AUD$80,000), the intervention was significantly associated with a lower mean BMI [16.26 (SD 2.22) kg.m−2] in the intervention group than [16.84 (SD 2.37)] in the control, a difference of −0.59 kg/m2 (95% CI: −1.15 to −0.03, P = 0.040).ConclusionsA staged telephone and SMS support intervention to mothers with children aged 2 years was associated with improved dietary and activity behaviors. The intervention was also associated with reduced children’s BMI at age 3 years only for those from lower income households.Trial registrationThe trial is registered with the Australian Clinical Trial Registry (ACTRN12618001571268)

International standard growth charts overestimate stunting prevalence in Nabire and Jakarta, Indonesia, compared to the Indonesian national growth chart.

Children's height in Indonesia is increasing slowly and unevenly across the country, with urban areas growing faster than rural areas. Thus, international growth charts may be ineffective for monitoring the development of Indonesian children. We conducted an analytical cross-sectional study on 1,829 children aged 6 to 12 in Nabire and 1,283 children in Jakarta. Anthropometric measurements were obtained and plotted on the Centers for Disease Control and Prevention (CDC) growth charts and Indonesian National Growth Charts to determine which chart is more suitable for monitoring children's growth in Indonesia. Nabire children were shorter and had lower body mass index (BMI) than Jakarta children, with a mean height difference of 7.03 cm in boys and 6.89 cm in girls (p = 0.001) and a mean BMI difference of 1.66 in boys and 1.39 in girls (p = 0.001). Despite their short stature, more Nabire children had a normal BMI, indicating a healthy nutritional status. Using the Indonesian National Growth Charts, fewer children were classified as stunted or wasted. Most of the short stature observed in Nabire children was not due to stunting; the children showed no signs of malnutrition. The Indonesian National Growth Charts represent the growth of Indonesian children more accurately than the CDC growth charts.

Associations of Neighborhood Opportunity and Social Vulnerability With Trajectories of Childhood Body Mass Index and Obesity Among US Children

Physical and social neighborhood attributes may have implications for children's growth and development patterns. The extent to which these attributes are associated with body mass index (BMI) trajectories and obesity risk from childhood to adolescence remains understudied. To examine associations of neighborhood-level measures of opportunity and social vulnerability with trajectories of BMI and obesity risk from birth to adolescence. This cohort study used data from 54 cohorts (20 677 children) participating in the Environmental Influences on Child Health Outcomes (ECHO) program from January 1, 1995, to January 1, 2022. Participant inclusion required at least 1 geocoded residential address and anthropometric measure (taken at the same time or after the address date) from birth through adolescence. Data were analyzed from February 1 to June 30, 2022. Census tract-level Child Opportunity Index (COI) and Social Vulnerability Index (SVI) linked to geocoded residential addresses at birth and in infancy (age range, 0.5-1.5 years), early childhood (age range, 2.0-4.8 years), and mid-childhood (age range, 5.0-9.8 years). BMI (calculated as weight in kilograms divided by length [if aged <2 years] or height in meters squared) and obesity (age- and sex-specific BMI ≥95th percentile). Based on nationwide distributions of the COI and SVI, Census tract rankings were grouped into 5 categories: very low (<20th percentile), low (20th percentile to <40th percentile), moderate (40th percentile to <60th percentile), high (60th percentile to <80th percentile), or very high (≥80th percentile) opportunity (COI) or vulnerability (SVI). Among 20 677 children, 10 747 (52.0%) were male; 12 463 of 20 105 (62.0%) were White, and 16 036 of 20 333 (78.9%) were non-Hispanic. (Some data for race and ethnicity were missing.) Overall, 29.9% of children in the ECHO program resided in areas with the most advantageous characteristics. For example, at birth, 26.7% of children lived in areas with very high COI, and 25.3% lived in areas with very low SVI; in mid-childhood, 30.6% lived in areas with very high COI and 28.4% lived in areas with very low SVI. Linear mixed-effects models revealed that at every life stage, children who resided in areas with higher COI (vs very low COI) had lower mean BMI trajectories and lower risk of obesity from childhood to adolescence, independent of family sociodemographic and prenatal characteristics. For example, among children with obesity at age 10 years, the risk ratio was 0.21 (95% CI, 0.12-0.34) for very high COI at birth, 0.31 (95% CI, 0.20-0.51) for high COI at birth, 0.46 (95% CI, 0.28-0.74) for moderate COI at birth, and 0.53 (95% CI, 0.32-0.86) for low COI at birth. Similar patterns of findings were observed for children who resided in areas with lower SVI (vs very high SVI). For example, among children with obesity at age 10 years, the risk ratio was 0.17 (95% CI, 0.10-0.30) for very low SVI at birth, 0.20 (95% CI, 0.11-0.35) for low SVI at birth, 0.42 (95% CI, 0.24-0.75) for moderate SVI at birth, and 0.43 (95% CI, 0.24-0.76) for high SVI at birth. For both indices, effect estimates for mean BMI difference and obesity risk were larger at an older age of outcome measurement. In addition, exposure to COI or SVI at birth was associated with the most substantial difference in subsequent mean BMI and risk of obesity compared with exposure at later life stages. In this cohort study, residing in higher-opportunity and lower-vulnerability neighborhoods in early life, especially at birth, was associated with a lower mean BMI trajectory and a lower risk of obesity from childhood to adolescence. Future research should clarify whether initiatives or policies that alter specific components of neighborhood environment would be beneficial in preventing excess weight in children.

1393. Body Mass Index Change In People Living With HIV During The COVID-19 Pandemic In New York

Abstract Background People living with HIV (PLHIV) suffer from adverse outcomes of metabolic syndrome. We hypothesized the COVID-19 pandemic, particularly with the stay-at-home status in 2020, resulted in physical inactivity and dietary changes leading to increases in weight and body mass index (BMI). Methods This retrospective observational chart review evaluated PLHIV at an infectious diseases clinic with a documented BMI from 2017 to 2020. Data on patients’ demographics, comorbidities, and antiretroviral therapy (ART) as of 2020 and the yearly values of BMI, A1c, and LDL from 2017 to 2020 were collected. Results Among 256 HIV-infected persons, mean age±SD was 48.5±13.1 (median=51; Q1-Q3: 39.5-57.5; range: 20-78) and 95 (37%) were female. Mean BMI were 28.19±6.32, 28.44±5.95, 28.57±5.91, and 29.00±6.09 for 2017, 2018, 2019, and 2020 respectively. Unadjusted and adjusted analysis showed a significant difference in BMI across time, where the mean BMI in 2020 was significantly higher than in 2017 (p&amp;lt; 0.0001), 2018 (p&amp;lt; 0.0001), and 2019 (p&amp;lt; 0.0001). Furthermore, for each consecutive year prior to 2019, there was no significant difference in mean BMI (2017 vs. 2018, p&amp;lt; 0.3464; 2018 vs. 2019, p&amp;lt; 0.4671; 2017 vs. 2019, p&amp;lt; 0.0861). There was a significant difference in A1c when adjusting for age, sex, race, and ART (Geometric Mean: 5.64, 5.68, 5.68, 5.78 for 2017 through 2020), with the visit year 2020 being significantly higher than 2017 (p&amp;lt; 0.003) and 2019 (p&amp;lt; 0.023) but not 2018 (p&amp;lt; 0.092). There were no significant differences in annual LDL using the same variables for adjustment. Body mass index (BMI) increased over time from 2017 to 2020 Mean BMI were 28.2±6.3, 28.4±5.9, 28.6±5.9, and 29.0±6.1 for 2017, 2018, 2019, and 2020 respectively. Pairwise comparison of BMI from 2017 to 2020 Unadjusted and adjusted analysis showed a significant difference in BMI across time, where the mean BMI in 2020 was significantly higher than in 2017 (p&amp;lt;0.0001), 2018 (p&amp;lt;0.0001), and 2019 (p&amp;lt;0.0001). Furthermore, for each consecutive year prior to 2019, there was no significant difference in mean BMI (2017 vs. 2018, p&amp;lt;0.3464; 2018 vs. 2019, p&amp;lt;0.4671; 2017 vs. 2019, p&amp;lt;0.0861). Conclusion Among PLHIV at our clinic, there was a substantial BMI increase in 2020, possibly due to the stay-at-home status in early 2020. A previous study utilized questionnaires to estimate the weight change in this patient population but this is the first report of documented BMI in the clinic setting. It is important to note that the magnitude of these differences was small and should be interpreted with caution. On the other hand, depending on a person’s initial height and weight, a one-unit change in BMI may translate to a substantial weight gain, which can be meaningful. Disclosures All Authors: No reported disclosures.

P117. An evaluation of preoperative patient weight and body mass index during single-position minimally invasive spine surgery

<h3>BACKGROUND CONTEXT</h3> The single position minimally invasive (MIS) approach allows access to the anterior and posterior columns with the ability to mitigate complications associated with open procedures while achieving circumferential fusion. The purpose of this study was to identify if patient weight or body mass index (BMI) leads to differences in intraoperative event rates. <h3>PURPOSE</h3> To determine if patient weight and BMI will correlate with the occurrence of intraoperative events during MIS spine surgery. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort. <h3>PATIENT SAMPLE</h3> A total of 524 MIS patients. <h3>OUTCOME MEASURES</h3> Weight (kg), BMI (kg/m2), Aborted procedures, estimated blood loss (EBL), operative time (OpTime). <h3>METHODS</h3> Of 524 patients eligible, 226 (43.1%) had available data. Of these, 88 met inclusion criteria (52 Lat and 36 PL). The majority were male (49, 55.7%), mean age of 49.2 yrs and 2.0 levels fused and 18 (20.5%) undergoing an osteotomy. Lat patients with a weight > 130 kg had significantly longer OpTime (p=0.003) and more EBL (p=0.019). There was a significant difference in mean weight for lat patients with (121.8 kg) and without (97.7 kg) an aborted procedure, p=0.021. There was also a significant difference in mean BMI for lat patients with (35.3 kg/m2) and without (29.6 kg/m2) an aborted procedure, p=0.015. Multivariable analysis showed that weight (OR 1.03 [CI 1.01-1.06], p=.020) and BMI (OR 1.15 [CI 1.02-1.30], p=.026) were independent predictors for aborted procedures in lat patients. In an analysis of PL patients, there was one aborted case (weight > 120 kg), but no significant findings for EBL or OpTime. <h3>RESULTS</h3> Of 524 patients eligible, 226 (43.1%) had available data. Of these, 88 met inclusion criteria (52 Lat and 36 PL). The majority were male (49, 55.7%), mean age of 49.2 yrs and 2.0 levels fused and 18 (20.5%) undergoing an osteotomy. Lat patients with a weight > 130 kg had significantly longer OpTime (p=0.003) and more EBL (p=0.019). There was a significant difference in mean weight for lat patients with (121.8 kg) and without (97.7 kg) an aborted procedure, p=0.021. There was also a significant difference in mean BMI for lat patients with (35.3 kg/m2) and without (29.6 kg/m2) an aborted procedure, p=0.015. Multivariable analysis showed that weight (OR 1.03 [CI 1.01-1.06], p=.020) and BMI (OR 1.15 [CI 1.02-1.30], p=.026) were independent predictors for aborted procedures in lat patients. In an analysis of PL patients, there was one aborted case (weight > 120 kg), but no significant findings for EBL or OpTime. <h3>CONCLUSIONS</h3> Weight and BMI appear to be independently associated with aborted procedures for patients in the lateral decubitus position during minimally invasive spine surgery. Patients in the lateral decubitus position who weighed 130 kg or more had on average longer operative times and more estimated blood lost. This study has the potential to help with risk stratification in the future when determining patients undergoing a single position procedure. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

1433-P: Comparative Weight Loss with GLP-1 Receptor Agonists vs. Bariatric Surgery in Obesity: A Systematic Review and Pair-Wise Meta-analysis

Background: One in three adults suffers from obesity.1 Glucagon-like peptide-1 (GLP-1) receptor agonists have been associated with 15-20% weight loss, a range previously only achieved with bariatric surgery.2,3,4 This systematic review and meta-analysis compares weight loss between GLP-1 receptor agonists and bariatric surgery. Methods: MEDLINE, Medline-in-Process, Medline EPUBS Ahead of Print, EMBASE Classic + EMBASE (OvidSP) ; and Cochrane (Wiley) databases were searched from inception to April 21, 2021. We included randomized controlled trials (RCTs) and observational studies. Two independent reviewers extracted data, reported risk of bias, and graded certainty of evidence. Risk of bias was reported using Risk of Bias 2 (RoB 2) tool for RCTs and Risk of Bias in Non-randomized Studies- of Interventions (ROBINS-I) tool for observational studies. Data were pooled separately for RCTs and observational studies using random effects models. Change in weight, body mass index (BMI) , and glycated hemoglobin (HbA1C) were summarized. Results: Seven included studies encompassed 11patients. Among RCTs, mean difference in weight between bariatric surgery and GLP-1 receptor agonist was −22.68 (95% CI: −31.41, −13.96) , mean difference in BMI was −8.18 (95% CI: −11.59, −4.77) , and mean difference in HbA1C was −1.28 (95% CI: −1.94, −0.61) . Among observational studies, mean difference in weight was −16.56 (95% CI: −36.53, 3.42) and mean change in BMI was −10.60 (95% CI:−17.22, −3.98) . These effects all favoured bariatric surgery. Conclusion: In adults with obesity, bariatric surgery still confers highest reductions in weight and BMI compared to GLP-1 receptor agonists, but similar effects in glycemic control. Word count: 248 Disclosure P. Palcu: None. Funding Clinician Investigator Program, University of Toronto

Cemented Versus Cementless Total Knee Arthroplasty in Obese Patients With Body Mass Index ≥35 kg/m2: A Contemporary Analysis of 812 Patients.

Cemented total knee arthroplasty (TKA) has been shown to have higher failure rates in obese patients, and cementless TKA may provide more durable fixation. This study compared outcomes and survivorship of obese patients undergoing cemented and cementless TKA of the same modern design. We identified a consecutive series of 406 primary cementless TKA performed in obese patients with body mass index (BMI) ≥35 kg/m2 in 2013-2018. Each case was matched 1:1 with 406 cemented TKA based on age, sex, BMI, bearing surface, and year of surgery. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and Short Form-12 were collected preoperatively, at 6 months and 2 years. Implant survivorship was recorded at mean 4.0 years (range 2.0-7.8). There was no difference in mean BMI between the cemented (38.6 ± 3.4 kg/m2; range, 35-60) and cementless cohorts (38.7 ± 3.3 kg/m2; range, 35-54; P= .706). Both groups had similar final postoperative scores and improvement in scores at 2 years. Furthermore, a similar percentage met the minimal clinically important difference (Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, 70.0% vs 71.2%, P= .700; Short Form-12 Physical, 74.1% vs 70.4%, P= .240). Both groups demonstrated high 7-year survivorship free from aseptic revision (99.0% vs 99.5%, P= .665). Obese patients with BMI ≥35 kg/m2 undergoing cementless and cemented TKA of the same modern design had similar outcomes and survivorship at early to mid-term follow-up. Continued surveillance of this high-risk population is necessary.

Body mass index increase and weight gain among people living with HIV-1 initiated on single-tablet darunavir/cobicistat/emtricitabine/tenofovir alafenamide or bictegravir/emtricitabine/tenofovir alafenamide in the United States

Objective This study evaluated body mass index (BMI) and weight changes in people living with human immunodeficiency virus (HIV-1; PLWH) initiated on single-tablet darunavir/cobicistat/emtricitabine/tenofovir alafenamide (DRV/c/FTC/TAF) or bictegravir/FTC/TAF (BIC/FTC/TAF). Methods Electronic medical records (EMR) data for treatment-naïve or virologically suppressed adults with HIV-1 who initiated treatment with DRV/c/FTC/TAF or BIC/FTC/TAF (index date) were obtained from Decision Resources Group’s EMR (7/17/2017–3/1/2020). Inverse probability of treatment weighting was used to account for differences in baseline characteristics between the two cohorts. BMI and weight changes from pre-index to 3, 6, 9, and 12 months following the index date were compared using weighted mean differences (MDs). The time until an increase in BMI or weight ≥5% or ≥10% was compared using weighted hazard ratios (HRs). Results The weighted DRV/c/FTC/TAF and BIC/FTC/TAF cohorts comprised 1,116 and 1,134 PLWH, respectively (mean age=∼49 years, females: ∼28%). Larger increases in BMI and weight from pre-index to each post-index time points were observed in PLWH initiating BIC/FTC/TAF vs DRV/c/FTC/TAF (12 months: MD in BMI =1.23 kg/m2, p < 0.001; MD in weight =2.84 kg [6.26 lbs], p = 0.008). PLWH receiving BIC/FTC/TAF were significantly more likely to experience weight gain ≥5% (HR =1.76, p = 0.004) and ≥10% (HR =2.01, p = 0.020) and BMI increase ≥5% (HR =1.77, p = 0.004) and ≥10% (HR =1.76, p = 0.044) than those receiving DRV/c/FTC/TAF. Conclusions BIC/FTC/TAF was associated with greater BMI and weight increases compared to DRV/c/FTC/TAF. Weight gain and its sequelae may add to the clinical burden of PLWH and should be considered among other factors when selecting antiretroviral single-tablet regimens.

Effect of weight loss on erectile function in men with overweight or obesity: A meta-analysis of randomised controlled trials.

Obesity and overweight are independent risk factors of erectile dysfunction (ED). It is controversial whether weight loss can improve erectile function. We thereby performed this meta-analysis to clarify the therapeutic effect of weight loss on erectile function in overweight or obese men. Literature search was conducted on databases including Cochrane Library, Embase, Web of Science and PubMed to obtain all relevant English articles published before March 1, 2021. The primary outcome was final International Index of Erectile Function (IIEF) score or change in IIEF score. The secondary outcome was final body weight and body mass index (BMI) or change in body weight and BMI. After screening, 5 studies with 619 participants were enrolled in our meta-analysis. Our result showed that the mean difference in body weight between weight loss group and control group was -18.07kg with p<.01, and the mean difference in BMI was -9.6kg/m2 with p<.01. The mean difference of IIEF between weight loss group and control group was 1.99 with p<.01. This meta-analysis showed that weight loss could improve erectile function in overweight or obese men. Losing weight could serve as an adjuvant therapy for ED.

Income in relation to obesity measures in an East German adult population: findings from the LIFE-Adult-Study

BackgroundObesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fat indicators. We examined income as a possible cause of obesity in an East German general population, focusing on appropriate representation of study variables, as well as on confounding and modification of the income-obesity association.MethodsWe used data of 9599 participants in the baseline examination of the LIFE-Adult-Study, conducted in the city of Leipzig from 2011 to 2014. Body mass index (BMI) and waist circumference (WC) as obesity measures were based on standardised measurements, net equivalised income (NEI) on self-reports. We estimated adjusted means of BMI and WC within NEI categories representing the range from risk of poverty to affluence. We stratified the analyses by gender, age, and education.ResultsA substantial part of the age-adjusted associations of income with obesity measures was attributable to other SES indicators. Adjusted for these variables, NEI was comparably associated with BMI and WC. Among women, BMI and WC decreased across NEI categories. The inverse associations tended to be stronger at non-working age (≥ 65 years) than at working age (< 65 years). Conversely, among working-age men, BMI and WC increased with increasing NEI. Among older men, risk of poverty was related to higher values of the obesity measures. The aforementioned associations were predominantly stronger in highly educated participants compared to those with medium/low education. The differences in mean BMI and WC between persons at risk of poverty and higher income groups were rather small, ranging from 1 to 2 kg/m2 for BMI and 2 to 4 cm for WC.ConclusionsOur investigation indicates an association between income and body fatness in an East German adult population that depends on the sociodemographic context of the people. However, it does not suggest that income disparities are a major driver of body fat accumulation in this population. Differential selection of study participants, error in the measurement of long-term income, and possibly reverse causality may have affected our conclusions.

Role of Neutrophil to Lymphocyte Ratio in Predicting Severity of Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) has been linked to and is associated with increased cardiovascular and cerebrovascular morbidity. Ongoing inflammatory responses play an important role in this association. Systemic inflammation is important in pathophysiology of OSA and its comorbidity. In this study, we aimed to evaluate the role of neutrophil-to-lymphocyte ratio (NLR) in OSA patients and comparing with other well-known inflammatory marker, C-reactive protein (CRP) along with thyroid-stimulating hormone(TSH) and body-mass index(BMI). We conducted a retrospective analysis of 162 patients with OSA and divided them into 2 categories based on apnea-hypopnea index (AHI) (< 30 and > = 30), and recorded their leukocyte profiles, sex, age and body mass index. 80 matched healthy controls were taken. Patients were excluded if they had underlying cancer, chronic inflammatory disease, any systemic infection, uncontrolled hypertension and diabetes mellitus, a known acute coronary syndrome, valvular heart disease, renal or hepatic dysfunction. We found that N/L Ratio in severe OSA patients was significantly higher compared with mild and moderate OSA patients and healthy controls (p < 0.001). CRP levels were not different in all OSA stages (p = 0.595). We noted a significant difference in mean BMI of the two groups. In the wake of increase in prevalence of OSA in a developing country like India coupled with inadequate proportion of sleep labs, NLR is an inexpensive, easy to obtain, widely available marker of inflammation that might in combination with other markers assist in identifying patients with severe OSA.