Different Categories Of Body Mass Index Research Articles

The Effect of Obesity on Severity of Asthma: An Observational Prospective Study from Pakistan.

The current research study aimed to access the relationship between obesity and asthma exacerbations and severity among adult patients at the outpatient section of a federal hospital (PIMS) in Islamabad, Pakistan. A cross-sectional research study was carried out on 207 asthma adult patients belonging to different areas and ethnic groups from the country. The study setting was the PIMS hospital, which attracts patients from all over the country due to its facilities and cost-effective treatments. The body mass index (BMI) of asthma patients was calculated using the heights and weights of the study subjects. However, the pulmonary functions were calculated using a computerized spirometer i-e Spirolab III S/N 303681 in line with Winspiro PRO 7.1.version software. It presents the patient's forced vital capacity that expires in the first second of expiration to full (FEV1) in comparison to forced vital capacity (FVC) ratio, that is, Tiffeneau-Pinelli index was also recorded to determine the asthma severity. According to recent surveys, the overall prevalence of patients with overweight and obesity was 29.0% and 23.7%, respectively. A Chi-square test was used, and a statistically significant relationship was observed between BMI and asthma severity (P < 0.001). The adult obese female patients presented poor pulmonary functions. The average FEV1/FVC ratio presented significant variance among four different categories of BMI with P < 0.05. This difference was due to the normal BMI category as the Tiffeneau-Pinelli index, that is, FEV1/FVC in the normal BMI group was significantly lower as compared to that in underweight and obese patients. The study subjects presented raised asthma severity in accordance with the raised BMI. Obese patients presented comparatively raised asthma exacerbations. Moreover, a statistically significant association of gender difference was observed between obesity and asthma severity. It was concluded that adult asthmatic women with obesity presented raised asthma severity as compared to adult asthmatic males.

Variation in Medial Foot Arch and Its Association with Different Categories of Body Mass Index- A Review

Background: Foot posture plays an important role in an individual’s life. The Body Mass Index (BMI) is believed to be one of the prominent factors in changing the function of foot arch. Methods: The keywords that were used were: osteoarthritis, OA knee, foot arch, medial arch, and foot posture. After finalizing keywords, internet search was conducted on Pub Med and Google Scholar; the University library and research center were also approached for e-copy and possible hand search of articles. The criteria for inclusion of articles were all research designs like Systematic review, Meta-analysis, Randomized Control trials, Cross sectional studies, Narrative Reviews and editor’s notes published in the English language, and full articles providing data on foot arches or foot posture in subjects with osteoarthritis of the knee. Results: In this review, total 12 articles were included from the various platforms and search engines. All the articles were appraised and scrutinized; their methodology, results and conclusion were read and filtered out. Conclusion: It was concluded that variation in foot arch has association with the different categories of BMI.

The Effect of Body Mass Index on Bleeding After on Pump Coronary Artery Bypass Grafting

Objective: To study the relationship of body mass index (BMI) and postoperative bleeding in patients undergoing isolated coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB).&#x0D; Study Design: Analytical cross sectional study&#x0D; Place and Duration of Study: Cardiothoracic services, Almana General Hospital, Al Khobar, Saudi Arabia, from Oct 2019 to Oct 2021.&#x0D; Methodology: Two hundred and twenty (220) consecutive patients who underwent CABG using cardiopulmonary bypass were included in the study. Patients who had additional procedures, those who were operated in emergency and those with significant comorbidities like hepatic and liver dysfunction were excluded from the final analysis. Patients were divided into three groups according to their BMI, healthy weight (BMI 18.5 to &lt;25), overweight (BMI 25 to &lt;30) and obese (BMI &gt;30). The world health organization (WHO) definition was used to define different categories of BMI. Various perioperative variables were recorded for all the patients. Only the immediate postoperative follow up period was included in the study. Data was analyzed using IBM SPSS-statistics 23.0 (IBM, SPSS Inc., Chicago, IL).&#x0D; Results: Of the 220 patients included in the study, 184(83%) were male patients and 36(16%) female patients. There was no significant difference in the mean age of the patients in the three groups (p=0.481). There were significantly more hypertensive patients 46(45%) in the overweight group compared to other two groups (p=0.025). Baseline diabetic status was not significantly different among the three categories (p=0.978). Total mediastinal drainage in the first 24 hours was significantly less in the obese group (3.7±4.45 ml) compared to overweight (4.4±2.7 ml) and healthy weight (7.35±8.5 ml) patients (p=0.001). There was no mortality in the studied cohort.&#x0D; Conclusion: Bleeding after isolated coronary artery bypass grafting is inversely related to BMI. Patients with healthy and overweight BMI are at higher risk of bleeding compared to obese patients.

Donor Liver Attenuation Index and Liver Biopsy Correlation in Living Donor Liver Transplantation

Objective: Using non-invasive methods, such as BMI and CT LAIto suggest a prediction model for hepatic steatosis, examine the CT liver attenuation index and body mass index (BMI)association for pathological steatosis in living liver donors. Histological analysis remains the standard reference. Study Design: Retrospective study Place and Duration of Study: Liver Transplantation Department, Bahria International Hospital Orchard, Lahore from 1st June 2017 to 31st December 2018. Methodology: Fifty-nine donors were included with a median age of 23.00 years, as well as the potential donors for LDLT who experienced evaluation as a potential liver donor. Donors who underwent CT scan and histological liver evaluation were part of this study. Results: Of the donors, forty-eight (81.35%) had a CT LAI ≥1. The median BMI was 22.1 (range: 17.00–33.4). Twenty eight (47.5%) of the patients had undergone liver biopsy for screening in the pre-transplant period whereas 31 (52.5%) of the total evaluated donors underwent biopsy during the transplant. Thirty four (57.62%) out of 59 evaluated living liver donors underwent hepatectomy. Non-significant association (P=0.719) between different categories of BMI as the steatosis increases histologically, whereas significant association (P&lt;.05) for CT LAI as the steatosis increases histologically. Conclusion: Body mass index alone is not a reliable factor for liver fat estimation non-enhanced CT liver-spleen attenuation index of ≤0 correspond to severe hepatic steatosis reserving histopathological liver evaluation via biopsy for selected cases and decreasing the need of liver biopsy while making sure both donor and recipient are safe. Keywords:Living donor liver transplantation, CT LAI, BMI, Liver biopsy

Association between Different Categories of BMI and Severity of Acne- A Cross Sectional Hospital Based Prospective Study

Introduction: Acne vulgaris is a common skin disorder that affects 79% to 95% of the young population. In United States, 40% to 45% of men and women older than 25 years of age have some degrees of facial acne that continues to the middle age in 12% of women and 3% of men. Acne vulgaris (acne) is one of the most common chronic dermatological diseases among adolescents, affecting about 80% of young people between 12 and 18 years of age. Obesity is one of the biggest problems in western life style but nowadays, the problem is increasing even in low and middle-income countries. Body Mass Index (BMI) is used to accurately measure obesity. Objective: To find out the association between different categories of BMI and severity of acne. Materials and Methods: This was a cross sectional prospective study conducted in the outpatient Department of Dermatology, Shaheed M. Monsur Ali Medical College Hospital, Sirajganj, Bangladesh from January to March 2022. All the newly diagnosed patients with acne were included in the study. Height and weight of the patients was recorded and BMI was calculated. BMI was categorized as underweight, normal weight, overweight and obese. Type of lesions were noted and severity of acne was graded from 1 to 4. Statistical analysis was performed using SPSS version 21 for windows. One-way Analysis of Variance between groups (ANOVA) test was applied. P value of less than 0.05 was considered significant. Results: A total of 125 patients with acne were included in the study. Age of the patients ranged from 10 to 50 years with mean age of 20.82 ±5.9 years. Most of the patients were in the age group of 11-20 years. There was slightly a female preponderance with female: male ratio of 1:1.4. According to BMI, 65.5% were normal, 12% were overweight, 20.5% were underweight and 2% of patients were obese. Majority of the patients had Grade 2 acne (52.8%). There was no significant association between the BMI and severity of acne (p=0.129). Maximum number of obese patients had grade 4 acne, maximum number of overweight patients had grade 2 acne and maximum number of underweight patients had grade 1 acne. But there was no significant association between the BMI categories and grades of acne (p=0.129). Similarly, there was no significant association between the age and grades of acne (p=0.61). Conclusion: The prevalence of acne with severity more than moderate was much lower in patients who were underweight (BMI less than 18.5). However, this study showed no statistically significant difference in BMI among people with different severities of acne. Population-based studies, as well as age restriction of the participants, can lead to more accurate and reliable results in this regard. There was no significant association between BMI and severity of acne. However, a larger population-based study is indicated to validate our finding.

Correlation of body mass index with dynamic balance using Y-Balance Test in adults with the Flexible Flat Foot: An Analytical Correlation Research Protocol

Background: Balance is one of the primary requirements for both static and dynamic activities. Body MassIndex (BMI) is measurement for estimating excess body fat. The Lower Quarter Y-Balance Test (YBTLQ) is a screening instrument that measures single-leg balance in different directions. Flexible flatfoot isthe postural aspect with depressed medial longitudinal arch, pronated subtalar joint and valgus position ofcalcaneus, evident only in weight-bearing position.Methods: An analytical correlation study with 255 participants (Purposive sampling) will be taken as perinclusion and exclusion criteria with study duration of 3 years. The BMI, sit to stand Navicular Drop Test(SSNDT), limb length and medial longitudinal arch angle (MLAA) will be measured and compared. Themean score of the Y Balance Test in different categories of BMI will be compared by performing one wayANOVA test. The mean score of the Y Balance Test between two groups in each category of BMI will becompared by Bonferroni t-test.Conclusion: The study aims the correlation of BMI with the dynamic balance on Y-balanced test in adultswith flexible flat foot. The expected outcome of study will concentrate on the significant correlation of YBalance Test in different categories of BMI.

A proposal for reference values of hand grip strength in women with different body mass indexes

ObjectiveHand grip strength (HGS) is frequently used in clinical practice, resulting in a potential marker of nutritional status. This study aimed to develop reference values of HGS in Italian women with different categories of body mass index (BMI). Additionally, the main predictors of HGS were identified. MethodsA cross-sectional study was conducted in Italian women between ages 16 and 55 y with different categories of BMI at the Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples Italy. The whole sample was divided into tertiles according to BMI: 15 to 17.29 kg/m2 (T1), 17.3 to 19.9 kg/m2 (T2), and 20 to 25 kg/m2 (T3). Anthropometry, bioimpedance analysis, and muscle strength by an HGS test were evaluated. The cut-off values for HGS were developed for all participants and stratified by age group. Finally, a multivariate linear regression analysis was performed to assess the main predictors of HGS. ResultsA total of 529 women with a mean age of 23.2 ± 7.0 y and an average BMI of 18.9 ± 2.5 kg/m2 were analyzed. HGS was higher for the dominant hand than for the non-dominant hand in all BMI tertiles. On both sides, according to age groups, HGS increased with increasing age in T1 and T3, whereas it increased in the women between ages 20 and 30 y in T2 only. Multivariate linear regression analysis showed that predictors of HGS varied according to tertiles. Specifically, we found that body weight (R2 = 0.252) was the main predictor in T1, whereas phase angle (PhA) was the main determinant in both T2 (R2 = 0.240) and T3 (R2 = 0.216). ConclusionThis study defined the normal reference values of HGS in Italian women with different BMI ranges, stratifying the sample group by age. Additionally, the main predictors of HGS were assessed for each BMI tertile. In primary malnutrition (T1), the main predictor of HGS was body weight, whereas in the other two tertiles (T2, T3), the PhA was the main predictor of HGS.

The comparison of morbid obesity quality of life and body image between surgery and other treatments: A case-control study.

BACKGROUND:Morbid obesity is rising around the world. Surgery is a selective treatment intervention for it. Since most of the surgeons use weight loss for evaluating of the morbid obesity surgical outcomes and paying attention to the the quality of life (QOL) and body image evaluation are rare, this study aimed to assess the QOL and body image in pre- and postsurgery with other interventions.MATERIALS AND METHODS:This case–control study was done on 200 morbidly obese patients (n = 100 in each group) who referred to the obesity clinic in Shiraz. The data were collected by Body Image Concern Inventory and 12-item Short Form Survey. The data were analyzed by t-test, Pearson correlation coefficient test, analysis of variance, and regression analysis. P = 0.05 was considered as significant.RESULTS:The paired t-test showed a significant difference in mean scores of body image (P < 0.001) and all dimensions of the QOL (P < 0.001) in the case and control groups. In the case group, there was a significant difference between the mean scores of the QOL and the different categories of body mass index (BMI) in postsurgery (P < 0.05) and the different mean scores of body image and the different categories of BMI in pre- and postsurgery wasn’t significant (P > 0.05). Age was a predictor variable for the QOL of morbidly obese persons after surgery (P < 0.001). After surgery, men showed better QOL than women (P < 0.001).CONCLUSION:Final results indicated that body image and QOL defects caused by obesity could be more improvement after surgery. This study can promote health-care team's knowledge about holistic supporting of all dimensions’ QOL of obese individuals. It is suggested that supporting interventions should be done as effective methods of maintenance for effects of weight loss methods such as surgery.

Serum Calcium Levels in Chronic Kidney Disease Patient Stratified By Body Mass Index

Background : Most of the chronic kidney disease (CKD) patients have low blood calcium levels, yet hypercalcemia has a worse outcome in CKD patients. Interestingly, CKD patients with higher body mass index (BMI) have better outcomes. This study aimed to elucidate the difference in blood calcium levels stratified by BMI categories in patients with CKD. Methods : The study was conducted using a comparative analytical cross-sectional study design. Patients with CKD (n100), aged over 18 years old were included, Patients with the following were excluded: the history of hemodialysis, history of antioxidants, calcium and vitamin D supplement consumption, history of infection and malignancy. BMI of patients was categorized into underweight (<18.5 kg/m2), normal (8.5-22.9 kg/m2), and overweight or obese (≥23 kg/m2). Data were analyzed to compare blood calcium in different categories of BMI (Kruskal-Wallis test). Results: The age of patients with CKD included in this study had median age of 61 years old, predominantly was men (57%). The blood calcium level of CKD patients was on the lower border of the normal range. Median BMI was 23.48 kg/m2, of which 53% was categorized as overweight or obese. There was a trend that overweight/obese patients had higher blood calcium levels than underweight and normal-weight patients, however, no statistically significant difference between the BMI category (p=0.982). Conclusions : The blood calcium level in chronic kidney disease varies across the BMI category, however, no correlation with the BMI.

TCT-419 Effects of Body Mass Index on the Comparative Effectiveness of PCI Versus CABG for Left Main Coronary Artery Disease: Insights From the EXCEL Trial

The optimal revascularization strategy for pts with left main coronary artery disease (LMCAD) across different levels of body mass index (BMI) remains unclear. We sought to investigate the comparative effectiveness of PCI vs CABG in pts with LMCAD according to different categories of BMI. We

Association between Acne and Body Mass Index: A Hospital Based Cross Sectional Study

Introduction: Acne vulgaris is a common and chronic inflammatory skin disease of pilosebaceous unit. Obesity is one of the biggest problems in western life style but nowadays, the problem is increasing even in low and middle-income countries. Body Mass Index (BMI) is used to accurately measure obesity.Objective: To find out the association between different categories of BMI and severity of acne.Materials and methods: This was a cross sectional prospective study conducted in the outpatient department of Gandaki Medical College from January to July, 2017. All the newly diagnosed patients with acne were included in the study. Height and weight of the patients was recorded and BMI was calculated. BMI was categorized as underweight, normal weight, overweight and obese. Type of lesions were noted and severity of acne was graded from 1 to 4.Statistical analysis was performed using SPSS version 17.0 for windows. One-way Analysis of Variance between groups (ANOVA) test was applied. P value of less than 0.05 was considered significant.Results: There were altogether 249 patients with acne. Age of the patients ranged from 10 to 44 years with mean age of 20.82 ±5.9 years. Most of the patients were in the age group of 11-20 years. Female: male ratio was 1:1.4. Majority of patients (65.5%) had normal BMI. Most of the patients had Grade 2 acne (52.6%). There was no significant association between the BMI and severity of acne (p=0.129).Conclusion: There was no significant association between BMI and severity of acne.

The influence of body mass index (BMI) in the stair climbing function in patients with knee osteoarthritis (OA) and healthy people

Purpose: Evidences show that obesity is a great risk factor in the development of knee osteoarthritis (OA). In addition, they also demonstrate that individuals with higher body mass index (BMI) have greater pain and more severe OA. However, the association between the different categories of BMI and functional activities, such as ascending and descending stairs, remains unclear. Therefore, the aim of this study was to evaluate and to compare the results obtained in the Stair Climbing Test, as well as the items corresponding to this functional activity in WOMAC questionnaire in individuals with knee OA (OAG) and healthy (CG), categorized by BMI (normal, overweight and obese). Methods: Patients with knee OA were selected based on the American College of Rheumatology criteria (ACR) and classified by the Kellgren and Lawrence scale. One hundred and sixteen participants (82 with knee OA and 34 healthy), with a mean age of 53.44 ± 8.151 years (OAG); 55.90 ± 7.135 (CG) years, were classified by body mass index (BMI) among normal: 18.5–24.9; overweight: 25.0–29.9 and obese ≥30 kg/m2. All participants answered the WOMAC (Western Ontario and McMaster Universities), a self-applied questionnaire. For the present study, it was considered the final score of the activities “ascending stairs” and “descending stairs” from the “physical function” of WOMAC domain; thus, the amounts were considered worse as higher the score achieved. In addition, the participants performed the Stair Climbing Test. The test should be performed as quickly as possible by the patients, and the total test time was timed in seconds; whereas, longer times indicated physical function more compromised. Initially, data were checked for normality by the Kolmogorov–Srmirnov test. To compare the categories of BMI (normal x overweight x obese) was applied one-way ANOVA test and post-hoc Bonferroni to identify statistical differences. For comparison between groups (control x OA) was used independent t test. For all analyzes we adopted a significance level of 5% (p ≤ 0.05). Results: The results of this study are shown in Table 1, as mean ± SD. For the Stair Climbing test, when it was compared the BMI categories, participants of CG categorized as obese had statistically higher values than those categorized as overweight and normal (p = 0,0073). In the comparison among groups, the OAG had statistically higher values compared to the CG only in the normal category (p < 0.0034). For the item “ascending stairs” in the WOMAC questionnaire, the category “obese” had statistically higher values compared to “overweight” and “normal” in CG (p < 0.0001), and compared to overweight in OAG (p = 0,0051). Comparing the groups, there were statistically higher values in OAG compared to CG in the categories “normal” (p = 0.0004) and “overweight” (p < 0.0001). For the item “descending stairs” in the WOMAC, the category “obese” also showed statistically higher values compared to “overweight” and “normal” in CG (p < 0.0001), and compared to “overweight” in OAG (p = 0.0030). Comparing the groups, it was discovered that the OAG had statistically higher values compared to CG in the categories “normal” (p = 0.0006) and “overweight” (p = 0.0007). Conclusions: It can be concluded that besides the functional impairment caused by OA, high BMI can also have a functional affect in some activities, such as ascending and descending stairs, observed in patients with OA, but mainly in healthy people.Tabled 1Table 1. Mean and standard deviation values of Stair Climbing Test, WOMAC “Ascending Stairs” and WOMAC “Descending Stairs” for CG and OAG in BMI categories (normal, overweight and obese)Stair Climbing TestNormalOverweightObesep valueCG (n = 34)10.301 ± 1.086 (n=14)10.368 ± 1.686 (n=10)12.193 ± 1.343∗Statistically significant difference compared with normal,#Statistically significant difference compared to overweight (n=10)0.0073OAG (n = 82)12.065 ± 1.962£statistically significant difference compared to GC (n = 18)12.272 ± 4.772 (n = 30)14.563 ± 4.814 (n = 34)0.0605p value0.00340.25100.1788WOMAC “Ascending Stairs”NormalOverweightObesep valueCG (n = 34)0.000 ± 0.000 (n = 14)0.222 ± 0.4410 (n = 10)1.800 ± 1.033∗Statistically significant difference compared with normal,#Statistically significant difference compared to overweight (n = 10)<0.0001OAG (n = 82)1.765 ± 1.147£statistically significant difference compared to GC (n = 18)1.533 ± 0.8193£statistically significant difference compared to GC (n = 30)2.324 ± 0.9761#Statistically significant difference compared to overweight (n = 34)0.0051p value0.0004<0.00010.2392WOMAC “Descending Stairs”NormalOverweightObesep valueCG (n = 34)0.200 ± 0.4140 (n = 14)0.222 ± 0.4410 (n = 10)1.800 ± 1.033∗Statistically significant difference compared with normal,#Statistically significant difference compared to overweight (n = 10)<0.0001OAG (n = 82)1.882 ± 1.269£statistically significant difference compared to GC (n = 18)1.400 ± 0.932£statistically significant difference compared to GC (n = 30)2.324 ± 1.007#Statistically significant difference compared to overweight (n = 34)0.0030p value0.00060.00070.2416∗ Statistically significant difference compared with normal# Statistically significant difference compared to overweight£ statistically significant difference compared to GC Open table in a new tab

Comparison of chronology of teeth eruption with body mass index among school children at Mangalore: A cross-sectional study

Introduction: The development and eruption of the teeth, chronologies of human dentitions, dental age, and tooth formation standards are important aspects applied to dental practice. Body mass index (BMI) gives an indication about the nutritional status of the child. It is relevant to know whether BMI has influenced chronology of tooth eruption pattern. Aim: To determine the eruption age of the different permanent teeth and compare eruption age with BMI in a group of children from selected schools in Mangalore. Materials and Methods: A cross-sectional study was designed in which 2928 children ranging in age from 5.5 to 15 years were included in the study. The children were divided into 20 chronological age groups with half year intervals. All the children were examined by a single examiner with the help of a trained assistant. The teeth were examined under natural light with mouth mirror. The comparison was made between mean eruption ages in males and females using the independent t -test. Results: There were 1526 males constituting 52.1% and 1402 females constituting 47.9% of the total sample of 2928 children. The mean age of eruption of maxillary central incisor, maxillary lateral incisor, maxillary and mandibular canines, maxillary and mandibular premolars, maxillary and mandibular second molars were found to have statistical significant with BMI. The mean age of eruption of the teeth in females was found to be earlier than in males, with the exception of the maxillary first molar which is earlier in males. Conclusion: Different categories of BMI were underweight, normal weight, risk of overweight and overweight, wherein overweight children had early eruption of teeth. Girls had early eruption time compared to boys.

Insulin resistance and beat-to-beat cardiovascular dynamics: a constant relationship across different body mass index and blood pressure categories.

Epidemiological studies have shown a progressive increase in insulin resistance (IR) accompanying body weight gain and blood pressure (BP) increase. This has led to the consideration that hemodynamic effects of IR might depend on its relationship with body mass index (BMI) and BP. The aim of our study was to determine whether IR is associated with changes in hemodynamic indices of cardiovascular function across different categories of BMI (normal weight, overweight, and obese), and BP levels (normal, high normal, and hypertension). This was a cross-sectional study conducted in a population sample of nondiabetic individuals (n = 731). Insulin resistance was evaluated with the homeostasis model assessment of insulin resistance (HOMA) and subjects were classified into quartiles according to HOMA index values. Synchronized beat-to-beat recordings of stroke volume (impedance cardiography) and R-R interval, along with repeated auscultatory BP measurements were performed. Derived hemodynamic parameters were computed and averaged. Analysis of covariance adjusting for confounders showed significant differences for most hemodynamic parameters among different quartiles of HOMA index both in the general population and within each BMI and BP category. Overall, increasing values of HOMA index were associated with significantly higher BP; and reduced R-R interval, stroke index, cardiac index, pre-ejection period and left ventricular ejection time (P < .01) across different categories of BMI and BP. These findings suggest that even small increases in HOMA index (not necessarily in the range to define IR) may induce significant changes on indices of cardiovascular function even in normal-weight and normotensive subjects, emphasizing the importance of IR at an early stage of the cardiovascular risk continuum.

Impact of body mass index for patients undergoing pancreaticoduodenectomy

To evaluate the impact of body mass index (BMI) on short and long term results after pancreaticoduodenectomies (PD). A consecutive series of PDs performed at the Karolinska University Hospital from 2004 till 2010 were retrieved from our prospective database. The patients were divided by BMI into overweight/obese (O; BMI ≥ 25 kg/m(2)) and controls (C; BMI < 25 kg/m(2)). Demographics, peri-operative data, morbidity, mortality, pancreatic fistula (PF) rate, length of stay (LOS), hospital costs, histology, and survival were analyzed. An additional sub analysis of survival was performed in patients with a diagnosis of pancreatic ductal adenocarcinoma (PDAC) and divided in underweight, normal-weight, overweight and obese. A total of 367 PDs were included (O = 141/C = 226). No differences were found between O and C regarding demographics, peri-operative data, costs, morbidity or mortality. O was associated with higher intra-operative blood loss (1392 ± 115 mL vs 1121 ± 83 mL; P = 0.01), rate of PF (20% vs 9.5%; P = 0.006) and marginally longer LOS (18 ± 0.9 d vs 15 ± 1.1 d; P = 0.05). An increasing risk for PF was observed with increasing BMI. The 1, 3 and 5 years survival rate was similar in O and C in PDAC (68.7%, 26.4% and 8.8% vs 66.1%, 30.9% and 17.9% respectively; P = 0.9). When the survival was analyzed using 4 different categories of BMI (underweight, normal, overweight and obese), a trend was seen toward a difference in survival, with a worse prognosis for the underweight and obese patients compared to normal weight and overweight patients. Overweight increases the risk for intra-operative bleeding and PF, but do not otherwise alter short or long term outcome after PD for pancreatic cancer.

Obesity as risk factor for lithiasic recurrence

ObjectivesObese patients may have special characteristics in the urinary stones formed, as the body mass index (BMI) may also be a predictive factor in lithiasic recurrence. We aim to evaluate and compare the lithiasic characteristics according to the different BMI categories, also considering the likelihood of lithiasic recurrence in presence of age and gender covariables. Material and methodsRetrospective, cross-sectional analysis on 346 lithiasic patients was done: 96 (27.7%) had low-normal weight, 151 (43.6%) were overweight, and 99 (28.6%) were obese. The Chi-square and ANOVA tests were used. Survival analysis for the calculation of likelihood of lithiasic recurrence (yes/no) was made based on time on 158 patients in whom complete resolution of the initial stone was achieved by the Kaplan Meier method. Comparisons between the different categories of BMI were made using the log-Rank, Breslow and Tarone–Ware tests. Multivariate analysis was also made with the Cox regression model, introducing the covariables of age and gender. ResultsA significant growing linear tendency has been demonstrated between multiplicity and BMI (p=0.03). The variables size and composition did not show significant differences between the groups. Median follow-up of 158 patients included in the survival analysis was 1866 days (95% CI 1602.5–2129.5). Eighteen (11.4%) of them recurred, without finding significant differences between groups: 4 low-normal weight (9.8%), 10 overweight (14.1%) and 4 obese (8.7%). The multivariate analysis did not show a significant influence of the BMI on lithiasic recurrence either (p=0.86, HR=1.06 95% CI 0.56–2.03). ConclusionA significant influence of BMI was shown on lithiasic multiplicity on diagnosis, although not on lithiasic recurrence based on time. It seems to be necessary to carry out studies in larger samples to calculate the true influence of BMI on lithiasic recurrence.

Abstract MP066: The Role of Environmental Factors in Modifying Heritability of Coronary Heart Disease

Introduction Coronary heart disease (CHD) is affected by both genetic and environmental factors. These classes of factors may act independently or interactively (gene-environment interactions). Recent large genome-wide association (GWA) studies have identified several genetic loci associated with CHD. However, few studies have considered the modifying effects of specific environmental factors on these associations, and the full extent of how those environmental factors affect the additive genetic component of CHD is not known. Hypothesis Our hypothesis was that modifiable environmental factors including smoking, alcohol intake, physical activity and body mass index (BMI) would affect CHD risk via interactions with genetic factors. Methods The environmental factors studied were smoking (ever regular smoker, never regular smoker); alcohol intake (never-drinking, drinking); physical activity (sedentary vs. non-sedentary); and highest BMI during life time (normal [less than 25 kg/m 2 ], overweight [25 to 30 kg/m 2 ], and obesity [more than 30 kg/m 2 ]). All same-sex twins born before 1958 in the Swedish Twin Registry were included in the current study. We identified 6,133 incident CHD events as the first CHD onset without any prior myocardial infarction, stroke or heart failure. We estimated heritability of CHD conditioned on the above-mentioned environmental factors in up to 26,901 twin pairs with environmental information available. Parameter estimation and model fitting was conducted with structural equation modeling as implemented in the software package Mx. Preliminary results The overall heritability of CHD in our sample was 36% (adjusted for age and sex). Smoking and overweight/obesity significantly modified the additive genetic component of CHD (P&lt;0.001 and P=0.038, respectively). Thus, heritability of CHD differed between smokers (29.0%) and non-smokers (42.5%). Further, heritability of CHD also differed among different categories of BMI: 29.9% among normal-weight, 27.1% among overweight and 23.6% among obese individuals. Neither alcohol consumption nor physical activity had any significant modifying effect on heritability of CHD (P=0.33 and 0.16, respectively) Conclusion In our nation-wide twin study of 26,901 twin pairs, purported measures of the environment affected heritability of CHD incidence. We demonstrated that smoking, as well as overweight and obesity modify heritability estimates, potentially indicating that genetic factors play a more prominent role for disease development in the absence of important environmental factors. Our results suggest that increased understanding of gene-environment interactions will be important for full understanding of the etiology of CHD.

T-002 DOES OBESE ELDERLY LIVE LONGER? A PROSPECTIVE STUDY WITH A PROPENSITY SCORE ANALYSIS IN TAIPEI CITY

Background It is a common presumption that older adults with higher body mass index (BMI) are at risk of shortened survival. Recent evidence, however, shows that obesity is paradoxically associated with a lower, not higher, mortality risk in the elderly. Methods In 2001, 20,558 TaipeiCityelderly citizens received free Physical Health Examination (PHE) at hospitals in Taipei. The PHE included medical history, physical examination and routine blood, urine and stool laboratory evaluation. BMI was calculated by dividing weight (kg) by height squared (m2). Cox regression model was used to select measures significant to all-cause mortality. Propensity score for each participant was derived from multivariate regression model. A matched sample was randomly selected based on the propensity score. We used hazard ratio (HR) from Cox model to demonstrate mortality risk for continuous BMI per unit and for different categories of BMI, while controlling for potential confounding factors. Results A total of 3573 deaths occurred in 7 years of follow-up. After controlling for potential confounding factors, higher BMI was significantly associated with a decreased risk of mortality (HR = 0.95 per unit: 95% CI: 0.93–0.97). Compared with elderly with normal weight, overweight and obese elderly had a significant lower hazard ratio (HR = 0.79, 95% CI:0.70–0.88and HR = 0.78, 95% CI: 0.68–0.90, respectively). However, underweight obese had a 31% higher risk of mortality (95% CI:1.07–1.61). Conclusion Elders with a higher BMI demonstrate a low mortality risk compared with those with a lower BMI, suggesting obesity paradox does exist in the elderly of TaipeiCity.

Obesidad como factor de riesgo para la recidiva litiásica

ObjectivesObese patients may have special characteristics in the urinary stones formed, as the body mass index (BMI) may also be a predictive factor in lithiasic recurrence. We aim to evaluate and compare the lithiasic characteristics according to the different BMI categories, also considering the likelihood of lithiasic recurrence in presence of age and gender covariables. Material and methodsRetrospective, cross-sectional analysis on 346 lithiasic patients, 96 (27.7%) had low-normal weight, 151 (43.6%) overweight, and 99 (28.6%) obesity. The Chi-square and ANOVA tests were used. Survival analysis for the calculation of likelihood of lithiasic recurrence (yes/no) was made based on time on 158 patients in whom complete resolution of the initial stone was achieved by the Kaplan Meier method. Comparisons between the different categories of BMI were made using the log-Rank, Breslow and Tarone-Ware tests. Multivariate analysis was also made with the Cox regression model, introducing the covariables of age and gender. ResultsA significant growing linear tendency has been demonstrated between multiplicity and BMI (p=0.03). The variables size and composition did not show significant differences between the groups. Median follow-up of 158 patients included in the survival analysis was 1866 days (95% CI 1602.5-2129.5). Eighteen (11.4%) of them recurred, without finding significant differences between groups: 4 low-normal weight (9.8%), 10 overweight (14.1%) and 4 obese (8.7%). The multivariate analysis also did not show a significant influence of the BMI on lithiasic recurrence (p=0.86; HR =1.06; 95% CI: 0.56-2.03). ConclusionA significant influence of BMI was shown on lithiasic multiplicity on diagnosis, although not on lithiasic recurrence based on time. It seems to be necessary to carry out studies in larger samples to calculate the true influence of BMI on lithiasic recurrence.

Risk of malnutrition and health-related quality of life in community-living elderly men and women: The Tromsø study

PurposeTo explore the association between risk of malnutrition as well as current body mass index (BMI) and health-related quality of life (HRQoL) in elderly men and women from the general population.MethodsIn a cross-sectional population survey including 1,632 men and 1,654 women aged 65 to 87 years from the municipality of Tromsø, Norway, we assessed HRQoL by using the EuroQol (EQ-5D) instrument in three risk groups of malnutrition and in different categories of BMI. The Malnutrition Universal Screening Tool (‘MUST’) was used to evaluate the risk of malnutrition.ResultsWe found a significant reduction in HRQoL with an increasing risk of malnutrition, and this was more pronounced in men than in women. The relationship between BMI and HRQoL was dome shaped, with the highest score values in the BMI category being 25–27.5 kg/m2.ConclusionsHRQoL was significantly reduced in elderly men and women at risk of malnutrition. The highest HRQoL was seen in moderately overweight individuals.