High Body Mass Index Group Research Articles

Association between high BMI and high homocysteine levels in Chinese patients with bipolar disorder

BackgroundBipolar disorder (BD) has been associated with an increased prevalence of weight gain and abnormally elevated plasma homocysteine (Hcy) levels. However, the relationship between BMI and Hcy in BD patients has not been investigated. This study aimed to explore this relationship in Chinese patients with BD. MethodsPlasma Hcy levels, socio-demographic parameters, clinical and anthropometric data were collected from 195 BD inpatients and 84 healthy controls. The level of plasma Hcy was determined by high-performance liquid chromatography. Body mass index (BMI) was calculated by body weight divided by the square of the height. The participants were divided into a high BMI group and a low BMI group using 24 kg/m2 as a threshold. ResultsThe prevalence of high BMI was slightly elevated in BD patients in comparison to healthy controls. Patients with elevated BMI had significantly higher Hcy levels than patients with low BMI. Hcy level was an independent contributor of the occurrence of high BMI in BD patients. The level of Hcy was positively correlated with BMI in BD patients. In addition, depressive episodes of BD were positively correlated with the prevalence of high BMI and married BD patients were more likely to have high BMI levels. ConclusionsThere is a close relationship between BMI and plasma Hcy levels in patients with BD, suggesting that Hcy may be an important indicator for BD-induced weight gain. This finding provides a new avenue for weight management of BD patients and to help avoid the potential risk of cardiovascular diseases.

Pulmonary function of healthy Korean children from three independent birth cohorts: Validation of the Global Lung Function Initiative 2012 equation

Global Lung Function Initiative (GLI) 2012 equations were developed to resolve the age-related disparity in interpreting spirometry results. Local validation of the equation is needed, especially in Northeast Asian children. This study evaluated the GLI equation in Korean children. Spirometry indices (FEV1, FVC, FEV1/FVC, and FEF25%-75%) and clinical information were gathered from three population-based birth cohorts. Predicted GLI reference values and z scores of spirometry results were calculated for 1239 healthy children. The mean, standard deviation of z scores were compared with the expected 0 and 1. Probabilities of falling below the lower limit of normal (LLN) (z score: -1.64) were compared with the expected value 5%. GLI z scores were assessed according to low (<-2), normal (≥-2 and ≤2), and high (>2) BMI z score groups. Mean z scores significantly differed from 0 for FEV1/FVC in males (mean [95% confidence interval]: 0.18 [0.08, 0.27]) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in females (-0.23 [-0.31, -0.15] and -0.26 [-0.36, -0.16], respectively). The standard deviation was larger than 1 for all variables in males and FVC and FEV1/FVC in females. The probability of falling below the LLN was significantly larger than 5% for FEV1 (12.13% [9.64, 14.77]), FVC (15.86% [13.06, 18.81]), and forced expiratory flow at 25%-75% of forced vital capacity (FEF25%-75%) (7.31% [5.29, 9.49]) in males and FVC (11.91% [9.40, 14.60]) in females. FEV1 and FVC z scores increased across low to high body mass index (BMI) groups, and FEV1/FVC decreased from low to high BMI groups. GLI equations marginally differ from real-world values, which should be considered by pulmonologists in practice or research.

Morbid obesity increases the failure rate of sentinel lymph node mapping for endometrial carcinoma

<h3>Objectives:</h3> Sentinel Lymph Node (SLN) mapping is recommended for patients with endometrial carcinoma to reduce the rate of full lymphadenectomy and its associated morbidity such as lymphedema. Obesity is a risk factor for endometrial carcinoma, and many patients are morbidly obese at the time of diagnosis. The goal of this study is to examine the impact of body mass index (BMI) on the success rate of SLN mapping using indocyanine green (ICG) and near-infrared imaging. <h3>Methods:</h3> A retrospective cohort study was performed of women with endometrial carcinoma undergoing robotic hysterectomy and SLN mapping with ICG between March 2016 and August 2019. Robotic surgery cases were identified from the hospital financial system that were coded with a primary diagnosis of Endometrial Cancer, a procedure of hysterectomy, and a cost code for indocyanine green. A total of 369 cases were identified. A total of 28 cases were excluded because no dye was used or SLN mapping was not attempted due to extent of disease. Preoperative patient characteristics and surgical outcomes including SLN mapping success rate were compared across World Health Organization BMI groups. <h3>Results:</h3> BMI was categorized as normal weight (BMI 18.5 - 24.9, 41 patients), pre-obesity (BMI 25.0 - 29.9, 48 patients), obesity class I (BMI 30.0 - 34.9, 71 patients), obesity class II (BMI 35.0 - 39.9, 70 patients), and obesity class III (BMI ≥40, 111 patients). Across BMI groups, patient age and ASA category were significantly different, with younger ages and higher ASA scores in the higher BMI groups. BMI groups did not differ in the number of prior abdominal surgeries or FIGO Grade. Uterine weight, diameter and procedure time were all significantly different across BMI groups, with higher weights, diameters and procedure times in the higher BMI groups. Estimated blood loss and depth of myometrial invasion were not significantly different. In the cohort, 85% had FIGO Stage 1 disease. For procedures with successful unilateral or bilateral SLN detection, the mean number of lymph nodes removed per side was not significantly different across BMI groups. The overall bilateral SLN mapping success rate for the cohort was 68.9%. However, the bilateral SLN mapping success rate was significantly lower in patients with obesity class III (54.1%) compared with patients who were less obese (76.1%, p<0.01). There was no difference in success rate between lower BMI categories. <h3>Conclusions:</h3> Patients with class III obesity (BMI > 40) have a significantly lower success rate for SLN mapping when compared with all other BMI categories (54.1% vs 76.1%, respectively, p<0.01).

The obesity paradox: effect of body mass index on 2-years clinical outcome after primary percutaneous coronary intervention in Indonesia.

Several studies demonstrated that a high body mass index (BMI) might actually benefit patients with cardiovascular disease, including coronary heart disease. However, other studies were unable to confirm this paradoxical phenomenon in all populations. Therefore, this study aims to determine the association between BMI and long-term clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). This was a retrospective cohort study of 400 STEMI patients undergoing PCI. Clinical outcome evaluation was done by face-to-face or phone interview and collecting objective data. Statistical analysis was performed to compare the outcomes between underweight-normal group with overweight-obese group. The incidence of major adverse cardiovascular events (MACE) was lower in patients with higher BMI group in 2-years evaluation (24.1% vs. 39.9%; p < 0.001). Multivariate analysis showed that BMI was an independent predictor of MACE and the incidence of recurrent infarction (OR 2.322 [CI 95% 1.505-3.584; p < 0.001]). The risk of MACE reduces as the weight increases, with a nadir of risk reduction for MACE at 28 to 29.0 kg/m2, in which the curve rises after, but remained below the risk associated with BMI of 23 kg/m2. In our population, patients with high BMI have a lower incidence of long-term MACE, especially recurrent myocardial infarction, in patients with STEMI undergoing PCI.

Fatty Acid-Binding Protein 4 (FABP4) Is Associated with Cartilage Thickness in End-Stage Knee Osteoarthritis.

There is no single blood biomarker for the staging of knee osteoarthritis (KOA). The purpose of this study was to assess the relationship of obesity, serum biomarkers, the hip-knee-ankle angle (HKAA) with sonographic cartilage thickness. We conducted a cross-sectional study of n = 33 patients undergoing knee arthroplasty. Body mass index (BMI) was recorded, and patients were grouped based on BMI. Serum blood samples were collected, and the following biomarkers were measured using the ELISA technique (subgroup of n = 23): oxidized low-density lipoprotein (oxLDL), soluble receptor for advanced glycation end-products (sRAGE), fatty acid-binding protein 4 (FABP4), membrane-bound phospholipase A2 (PLA2G2A). The HKAA was analyzed on full-length limb standing x-ray images. Cartilage thickness was assessed on ultrasound images. Multivariable regression analysis was performed to account for confounding. After adjusting for age, gender, and HKAA, obese patients had thicker medial femoral cartilage (β = 0.165, P = 0.041). Furthermore, lateral cartilage thickness was negatively correlated with FABP4 level after adjusting for of age, gender, BMI, and HKAA (β = -0.006, P = 0.001). Confirming previous studies, after adjustment, FABP4 level was associated with a higher BMI group (β = 42.99, P < 0.001). None of the other markers (oxLDL, PLA2G2A, and sRAGE) was associated with BMI or cartilage thickness. Our results indicate that BMI has a weak, positive association with cartilage thickness in end-stage KOA patients. FABP4 levels were negatively associated with cartilage thickness. While our study is limited by a small sample size, these results further highlight the role of FABP4 as promising biomarkers of burden of disease in KOA.

Prevalence of High Body Mass Index in Children with Sickle Cell Disease and Its Correlation of Disease Severity

▪BackgroundChildren with sickle cell disease (SCD), particularly those with the homozygous form designated HbSS, have frequently been reported to suffer from impaired growth, delayed onset of puberty and poor nutritional status (1). However, improvement in healthcare of children with SCD in more economically developed countries, along with increased use of SCD-directed therapies such as hydroxyurea and chronic transfusions along with the recent rise in childhood obesity rates may have influenced growth of children with SCD. Two recent reports in the US found that 19-22% of children with SCD were overweight or obese (2, 3) . It is not known whether high body mass index (BMI) in children with SCD results in a worse clinical phenotype. Known association of childhood obesity with obstructive sleep apnoea (OSA) raises the potential of worsening clinical phenotype of SCD by increasing the incidence of nocturnal hypoxaemia which in turn may give rise to increased vaso-occlusive episodes (4). This study aimed to determine the prevalence of high body mass index (BMI) in an urban population of children in the UK with SCD and assess if there is correlation between BMI and disease severity.MethodsA retrospective chart review was performed on all patients aged 2-18 years with SCD who attended an outpatient clinic at Kings College Hospital, London between April 2015 and April 2017. Acute sickle cell-related emergency department (ED) attendances and hospital admissions in this period were recorded. BMI percentile, demographic information and laboratory markers of disease were recorded from the most recent clinic visit. Age and gender specific definitions of BMI percentiles were used, based on the British 1990 growth reference charts. Patients were assigned to 1 of 3 groups based on their BMI percentile: low, normal and high BMI. A high BMI was defined as >85th percentile for age and gender, whilst underweight was defined as <5th percentile.ResultsData was collected on 385 children with SCD in a single tertiary Paediatric Haemoglobinopathy centre in London. 16.6% children with SCD were overweight or obese and 5.2% were underweight. In contrast, government figures indicate that in the South London Borough of Southwark, up to 28% children aged 10-11 years were overweight or obese and 0.9% children were underweight in 2016-2017 (data.london.gov.uk). A high BMI among our SCD patients was associated with HbSC genotype (P= 0.006) and females (P=< 0.001). HbSS patients taking hydroxycarbamide had a significantly higher mean BMI compared to those not taking it (P=0.006). No association was found between BMI group and the number of acute sickle cell-related A&E attendances or hospital admissions for HbSS patients (P=0.450 and 0.780 respectively) or HbSC patients (P=0.838 and P=0.750 respectively). Patients with HbSS SCD in the high BMI group had a significantly higher haemoglobin (Hb) and fetal Hb (HbF) than those in the normal BMI group (P=<0.001 and P=0.010 respectively). HbSS patients in the high BMI group had a significantly lower absolute reticulocyte count (ARC) than those in the normal BMI group (P=0.022), see Table 1. These results suggest that HbSS patients with a high BMI may have a less severe disease than those with a normal BMI. These associations were not demonstrated in patients with HbSC disease.ConclusionsNearly one-sixth of children and adolescents with SCD in this urban population were overweight or obese. The association of hydroxycarbamide therapy and higher BMI in children with HbSS has been demonstrated in this study for the first time. There was no association between BMI group and the number of acute sickle cell-related A&E attendances or hospital admissions. In patients with HbSS disease, laboratory markers of disease severity, including Hb, HbF and ARC, suggest than patients with a high BMI may have a less severe disease than those with a normal BMI. Longitudinal studies monitoring BMI of children over time and markers of severity in SCD would produce greater evidence of the impact of a high BMI on disease severity. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Improved Survival in Overweight and Obese Patients with Non-Hodgkin's Lymphoma Treated with Rituximab Containing Chemotherapy for Curative Intent

IntroductionConflicting results have been reported about the association between obesity and survival in diffuse large B-cell lymphoma (DLBCL). Some studies have shown improved survival with increased body mass index (BMI), whereas other studies have not supported this association, making the relationship between body weight and survival in DLBCL unclear. Moreover, many of the earlier studies were based on smaller datasets (sample sizes) and/or patient populations who were not treated with rituximab, making the interpretation of these results less clear in the current Rituximab era. Thus, the aim of this study was to investigate the relationship between BMI and survival in non-Hodgkin lymphoma (NHL) patients treated with rituximab containing chemotherapy in a large population-based database in Ontario, Canada.MethodsWe conducted a population-based retrospective cohort study using an administrative database in the Ontario Cancer Registry (OCR) in Ontario, Canada. Incident cases of aggressive histology lymphoma treated with a rituximab containing chemotherapy regimen for curative intent were captured between January 1st, 2008 and October 31st, 2016 using the database from the New Drug Funding Program in Cancer Care Ontario, which provides universal public funding of rituximab for this indication. Exclusion criteria included patients who were < 18 years of age, had diagnosis of HIV, or received rituximab > 6 months from time of diagnosis. Aggressive histology lymphoma was defined according to morphology codes in the OCR, and included DLBCL and Burkitt lymphoma. BMI at time of diagnosis was calculated by dividing weight in kilogram (Kg) by height in meter (m2). We first categorized subjects according to low BMI (≤25 Kg/m2) and high BMI (>25 Kg/m2), and then by the World Health Organization (WHO) criteria for BMI as underweight (<18.5 Kg/m2), normal weight (18.5-24.9 Kg/m2), overweight (25-29.9 Kg/m2) and obese (≥ 30 Kg/m2) for subsequent analyses. Subjects were followed from time of first treatment until death (all-cause). Cox proportional hazard models were used to estimate the impact of BMI on overall survival, after adjusting for explanatory variables, such as age, sex, rural/urban residence, income quintile, and comorbidities (Charlson Comorbidity Index). Survival was estimated using Kaplan-Meier analysis, and statistical comparisons were made using the log-rank statistic.ResultsA total of 7046 patients with aggressive histology NHL treated with a rituximab containing chemotherapy regimen were identified. After excluding 1,075 patients due to implausible or missing BMI data, 5,971 patients were included in the study cohort (Table 1).Kaplan-Meier analysis demonstrated decreased mortality in the overweight and obese groups, and increased mortality in the underweight group, as compared to normal weight group (Figure 1). Multi-variable analyses revealed that increased BMI had a protective effect on overall survival; the rate of all-cause mortality was lower in the high BMI group (HR 0.82; 95% CI 0.74-0.90) compared to the low BMI group. Furthermore, when BMI was categorized by WHO criteria the rate of all-cause mortality was lower in overweight (HR 0.87; 95% CI 0.78-0.97) and obese (HR 0.77; 95% CI 0.68-0.86) groups compared to the normal weight group (Table 2).When BMI was analyzed as a continuous variable, multivariable analyses revealed that an incremental increase in per unit of BMI was associated with an increased rate of overall survival with a HR of 0.98; 95% CI 0.97-0.99.ConclusionIn the largest cohort to-date and with all patients treated with rituximab containing chemotherapy, we show that increased BMI in patients with aggressive histology NHL is associated with improved survival. Hypotheses for improved survival at higher BMIs include higher cumulative anthracycline doses due to its lipophilic nature, and the ability of overweight and obese patients to tolerate more intense chemotherapy regimens with less dose reductions that is known to improve survival. These results have important implications for NHL patients in North America where two-thirds of the population is overweight or obese, and more research is needed to explore the possible mechanisms of improved survival with increased body weight in NHL. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Pre-pregnancy metabolic syndrome and insulin administration in gestational diabetes: A nationwide population-based cohort study

BackgroundThe present study aimed to evaluate whether mothers with obesity/central obesity and metabolic syndrome before gestation are at higher risk of insulin administration in gestational diabetes mellitus (GDM) to diminish the burden of insulin use during pregnancy. MethodsThis was a population-based retrospective cohort study conducted using data from the National Health Information Database of Korea. We identified all deliveries from January 1, 2011 to December 31, 2015 (N = 1,214,655). Among the deliveries, we identified mothers with pre-pregnancy health checkup records and without previous diabetes history (N = 325,208). Hazards of insulin use in GDM were calculated based on pre-pregnancy obesity/central obesity and metabolic syndrome. ResultsHazards of insulin use in GDM increased proportionately with an increase in the pre-pregnancy body mass index (BMI) and waist circumference (WC). After the adjustment for clinical factors, high BMI group (≥30 kg/m2) and high WC group (≥100 cm) were significantly associated with higher hazard ratios (HRs) (HR 4.161, 95% Confidence interval [CI] 3.381–5.121, P < 0.001 and HR 2.563, 95% CI 1.769–3.712, P < 0.001, respectively). The presence of pre-pregnancy metabolic syndrome significantly increased the hazard of insulin use in GDM (0.54% vs. 5.04%). In the presence of obesity (BMI ≥ 25 kg/m2) or central obesity (WC ≥ 85 cm), HRs of insulin use in GDM were 2.637 (95% CI 2.275–3.056) and 1.603 (95% CI 1.023–2.511), respectively, after adjustment for clinical factors. ConclusionsThe presence of pre-pregnancy obesity/central obesity and metabolic syndrome in Korean mothers is associated with increased risk of insulin use in GDM.

A Comparative Study of the Influence of Body Mass Index on Clinical Outcomes of Total Laparoscopic Hysterectomy in Birat Medical College Teaching Hospital, Morang, Nepal

Introduction: Although laparoscopy is a safe route of hysterectomy as it provides battier view of abdominal anatomy, facilitates meticulous hemostasis and reduces surgical morbidity, laparoscopic hysterectomy in overweight and obese women may pose an increased risk of intraoperative and postoperative complications as omental fat and limited manipulation of instruments may render operation difficult.&#x0D; Objectives: The aim of the study is to evaluate the impact of Body Mass Index (BMI) on the clinical outcome of total laparoscopichysterectomy.&#x0D; Methodology: This is a comparative cross-sectional study conducted in 190 patients who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020.Ninety five patients were enrolled in high BMI group and normal BMI group each&#x0D; Result: Mean BMI was 28.90±2.27 ( Kg/M2)in high BMI group and 23.54 ± 1.14 (Kg/M2)in normal BMI group. Urinary tract injury occurred in 4 (4.21%) cases in high BMI group and 2 (2.1%) cases in normal BMI group. Intraoperative and immediate postoperative complication were similar in both groups.&#x0D; Conclusion: Intraoperative and postoperative complications were similar in both the groups. Patients with high BMI have no increased risk of complications during total laparoscopic hysterectomy.

The Effect of Body Mass Index on Peri-operative Parameters of Total Laparoscopic Hysterectomy: An Institutional Experience.

ObjectivesWorldwide, there is an increase in the obese population and laparoscopic surgery is now becoming one of the preferred modes of surgery. Therefore, it is important to examine its feasibility and safety in overweight and obese women. The study was aimed to evaluate the effects of body mass index (BMI) on intraoperative and postoperative parameters in patients undergoing total laparoscopic hysterectomy (TLH).Materials and methodsA retrospective data analysis was conducted over a period of two years among women who underwent TLH. Data were grouped as per their BMI into Normal, Overweight, and Obese groups. Baseline demographic and clinical characteristics, intraoperative outcomes including operative time, estimated blood loss, hemoglobin difference, the need for blood transfusion, conversion to laparotomy, uterine weight, intraoperative and postoperative complications, postoperative pain, duration of hospital stay, and readmission were noted.ResultsBaseline demographic characteristics were similar in all three groups. Operative time was comparable among the groups. However, a weak positive correlation was found between operative time and total BMI value, which was statistically significant (p = 0.039). For every 1 kg/m2 increase in BMI, operative time increased by 2.35 minutes. Other intraoperative parameters were comparable among all the groups except hemoglobin difference, which was significantly higher in obese women. Postoperative parameters were similar among all groups.ConclusionTotal laparoscopic hysterectomy is a safe, efficient, and feasible surgical approach in higher BMI groups. This approach provides advantages over open surgery of early recovery, short hospital stay, and less postoperative pain to obese women.

Associations between low body mass index and mortality in patients with sepsis: A retrospective analysis of a cohort study in Japan.

The distribution of body mass in populations of Western countries differs from that of populations of East Asian countries. In East Asian countries, fewer people have a high body mass index than those in Western countries. In Japan, the country with the highest number of older adults worldwide, many people have a low body mass index. Therefore, this study aimed to determine the association between a low body mass index and mortality in patients with sepsis in Japan. We conducted this retrospective analysis of 548 patients with severe sepsis from a multicenter prospective observational study. Multivariate logistic regression analyses determined the association between body mass index and 28-day mortality adjusted for age, sex, pre-existing conditions, the occurrence of septic shock, Acute Physiology and Chronic Health Evaluation II scores, and Sequential Organ Failure Assessment scores. Furthermore, the association between a low body mass index and 28-day mortality was analyzed. The low body mass index group represented 18.8% of the study population (103/548); the normal body mass index group, 57.3% (314/548); and the high body mass index group, 23.9% (131/548), with the 28-day mortality rates being 21.4% (22/103), 11.2% (35/314), and 14.5% (19/131), respectively. In the low body mass index group, the crude and adjusted odds ratios (95% confidence intervals) for 28-day mortality relative to the non-low body mass index (normal and high body mass index groups combined) group were 2.0 (1.1-3.4) and 2.3 (1.2-4.2), respectively. A low body mass index was found to be associated with a higher 28-day mortality than the non-low body mass index in patients with sepsis in Japan. Given that older adults often have a low body mass index, these patients should be monitored closely to reduce the occurrence of negative outcomes.

A DESCRIPTIVE STUDY ON THE RELATIONSHIP BETWEEN BODY MASS INDEX AND BODY POSTURE IN CLINICIANS

BACKGROUND : Clinicians in the today's world are always under sustained levels of physical exertion. As they form backbone of healthcare setup, the health of clinicians themselves is a very signicant factor towards providing good health to all. AIMS &amp; OBJECTIVES - The objective of the study was to determine the relation of body mass index (BMI) on both static standing as well as dynamic sitting body posture in clinicians. This will establish a relation between obesity and postural stress of clinicians METHODS: The descriptive study was conducted in OPD clinics of our medical college and various private hospitals of Jalandhar. BMI was calculated as ratio of weight (kg) to the square of height (m). Standing posture was assessed with the help of plumb bob passing the line in lateral and posterior aspect of the body nding the correct (YES) or faulty (NO) posture taken for the calculation. Dynamic (work sitting) posture was checked with observation during the OPD work by using the RULA (Rapid Upper Limb Assessment) worksheet. All the values obtained were statistically analysed with Chi square test to determine association. RESULTS: In high BMI group, three-fourths of the clinicians were found to have faulty standing static posture and 79% had faulty dynamic work posture whereas normal BMI group had minimum faulty posture. Female clinicians showed more level of faulty posture than male clinicians. The results also show that with increase in BMI, faulty posture also takes a higher turn. CONCLUSION: BMI is positively related to postural stress in clinicians, especially in the higher age group. This information serves as an awareness and warning signal for the clinicians to safeguard their own health and correct their faulty posture

Evaluation of mothers’ opinions on appetite and body shape perception of their children

ObjectivesIn this study, we aimed to evaluate how mothers perceived the appetite and body shape of their children using gender- and age-specific development sketches. Study designThe study design used in the study is a single-centred descriptive study. MethodsWe included 153 children aged 2–14 years and their mothers who attended family medicine polyclinic outpatient services, for any reason, at the University of Health Sciences, Şişli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey, between February 2019 and April 2019. Weight and height measurements of both the children and their mothers were taken. In addition, the mothers completed the sociodemographic data form and were asked to select an image from the gender- and age-specific development sketches that best represented their child's body shape. Participants were divided into four groups by their body mass index (BMI) in accordance with criteria from the Centres for Disease Control and Prevention. Results were compared using appropriate statistical procedures. ResultsA significant weak positive correlation was observed between maternal BMI and child BMI (r = 0.166, P = 0.041). When the maternally perceived BMI (determined by the age-specific development sketches) was compared with the actual BMI values of children, mothers perceived their underweight children to be in higher BMI groups, whereas the overweight and obese children were perceived to be in lower BMI groups. The results were similar when the same comparison was made for the mother's expectation (i.e. the body shape the mother desired for their child). ConclusionsWhen mothers were asked to visually evaluate the body shape of their children, their responses were inaccurate compared with both the actual data and the researcher's evaluation. Obtaining verbal assessments from mothers about their children (e.g. an assessment of the child's bodily appearance) is important for physicians to make correct referrals and also for public health policies. It is valuable for mothers to correctly interpret the weight status of their children, thus enabling early diagnosis and treatment, and preventing future health consequences.

The reduction of body mass index and risk of incidence of cardiovascular events in the elderly population

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Obesity is known to be risk factor for incidence of cardiovascular (CV) events. However, the association between the reduction of body mass index (BMI) and incidence of cardiovascular event is not well established in elderly Asian population. Methods From the National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013, 13,038 participants over 75 years old without baseline comorbidities (mean age: 78.4 ± 3.2 years 5243 (40.2%) male) were included in this study. We measured the change of BMI from first to second visit for health check-up within mean 23.6 ± 5.8months of follow-up. We categorized the reduction of BMI as five group according to the amount of change in BMI in overall patients (group 1: BMI change &amp;lt;-10%, group 2: -10%≤BMI change&amp;lt;-3%, group 3: -3% ≤ BMI change &amp;lt; 3%, group 4: 3% ≤BMI change &amp;lt; 10%, group 5: 10% ≤BMI change). We investigated the influence of change in BMI on the incidence of new-onset AF, stroke, acute myocardial infarction (MI), and CV mortality Results In the overall patients, new-onset AF, stroke, acute MI, and CV death was occurred in the 494 patients (3.5%), 775 patients (5.9%), 16 patients (0.1%), and 458 patients (3.5%) respectively. The Kaplan-Meier curve showed significant cumulative incidence rate of CV death in group 1 (Log rank p &amp;lt; 0.001). The multivariate cox regression after adjusting for compound clinical covariates showed the risk of stroke (HR 1.43, 95% CI [1.09-1.89], p = 0.01) and CV death (HR 2.06, 95% CI [1.49-2.84] were significant higher in the group 1 as compared with group 3. In the high BMI (≥25) group, the risk of AF was significant higher in the group 5 as compared with group 3 (HR 2.38, 95% CI [1.02-5.54], p = 0.04). In contrast, the risk of stroke (HR 1.70, 95% CI [1.07-2.71], p = 0.02) and CV death (HR 3.27, 95% CI [1.66-6.41], p &amp;lt; 0.001) was significant higher in the group 1 than in group 3. Conclusions In the elderly Asian population over 75 years old, the reduction of body weight affected worse effect on the incidence of stroke and CV death in overall patient and high BMI (≥25) group. It needs careful consideration to reduce BMI in the elderly Asian population even with high BMI (≥25) for purpose of CV events.

No Association Between Statin Use and the Prognosis of Endometrial Cancer in Women With Type 2 Diabetes

Preclinical studies have suggested statins have antiproliferative and anti-metastatic effects on endometrial cancer cells. Similarly, most previous epidemiological studies have reported a better prognosis of endometrial cancer in patients who used statins. In this study, we explored the role of statins in the prognosis of endometrial cancer in women with type 2 diabetes in a hospital-based cohort. This retrospective cohort consisted of 119 women with type 2 diabetes who were diagnosed and treated for endometrial cancer at Oulu University Hospital, Finland, between 2007 and 2014. The patients were classified as statin users (n = 58) and nonusers (n = 61) based on the type of medication they were using at the time of endometrial cancer diagnosis. Statin use showed no association with progression-free survival or overall survival in the whole cohort nor the subgroups with type I or type II histology, in lower or higher body mass index groups, or at an early or advanced stage. The results remained similar in the multivariate analysis after adjusting for the patient’s age, cancer stage, and histology. Furthermore, statin use seemed not to have any association with most of the prognostic factors at the time of endometrial cancer diagnosis.

121 Behavioral Attention Relationships Vary Between Demographic Groups Across Sleep Loss and Recovery

Abstract Introduction The Psychomotor Vigilance Test (PVT) is a behavioral attention measure widely used to describe sleep loss deficits. Although there are reported differences in PVT performance for various demographic groups, no study has examined the relationship between measures on the 10-minute PVT (PVT10) and the 3-minute PVT (PVT3) within sex, age, and body mass index (BMI) groups throughout a highly controlled sleep deprivation study. Methods Forty-one healthy adults (mean±SD ages, 33.9±8.9y) participated in a 13-night experiment [2 baseline nights (10h-12h time in bed, TIB) followed by 5 sleep restriction (SR1-5) nights (4h TIB), 4 recovery nights (R1-R4; 12h TIB), and 36h total sleep deprivation (TSD)]. A neurobehavioral test battery, including the PVT10 and PVT3 was completed every 2h during wakefulness. Repeated measures correlation (rmcorr) compared PVT10 and PVT3 lapses (reaction time [RT] &amp;gt;355ms [PVT3] and &amp;gt;500ms [PVT10]) and response speed (1/RT) by examining correlations by day (e.g., baseline day 2) and time point (e.g., 1000h-2000h) within sex groups (18 females), within age groups defined by a median split (median=32, range=21-49y), and within BMI groups defined by a median split (median=25, range=17-31). Results PVT10 and PVT3 1/RT was significantly correlated at all study days and time points excluding at baseline for the younger group and at R2 for the higher BMI group. PVT10 and PVT3 lapses showed overall lower correlations across the study relative to 1/RT. Lapses were not significantly correlated at baseline for any group, for males across recovery (R1-R4), for the high BMI group at R2-R4, for the older group at R2-R3, or for the younger group at SR5 or R3. Conclusion Differentiating participants based on age, sex, or BMI revealed important variation in the relationship between PVT10 and PVT3 measures across the study. Surprisingly, lapses were not significantly correlated at baseline for any demographic group or across recovery for males or the high BMI or older group. Thus, PVT10 and PVT3 lapses may be less comparable in certain populations when well-rested. These findings add to a growing literature suggesting demographic factors may be important factors to consider when evaluating the effects of sleep loss. Support (if any) ONR Award N00014-11-1-0361;NIH UL1TR000003;NASA NNX14AN49G and 80NSSC20K0243; NIHR01DK117488

Effect of Obesity on the Expression of Nutrient Receptors and Satiety Hormones in the Human Colon.

Background: Receptors located on enteroendocrine cells (EECs) of the colon can detect nutrients in the lumen. These receptors regulate appetite through a variety of mechanisms, including hormonal and neuronal signals. We assessed the effect of obesity on the expression of these G-protein coupled receptors (GPCRs) and hormones at both mRNA and protein level. Methods: qPCR and immunohistochemistry were used to examine colonic tissue from cohorts of patients from the Netherlands (proximal and sigmoid tissue) and the United Kingdom (tissue from across the colon) and patients were grouped by body mass index (BMI) value (BMI < 25 and BMI ≥ 25). Results: The mRNA expression of the hormones/signaling molecules serotonin, glucagon, peptide YY (PYY), CCK and somatostatin were not significantly different between BMI groups. GPR40 mRNA expression was significantly increased in sigmoid colon samples in the BMI ≥ 25 group, but not proximal colon. GPR41, GPR109a, GPR43, GPR120, GPRC6A, and CaSR mRNA expression were unaltered between low and high BMI. At the protein level, serotonin and PYY containing cell numbers were similar in high and low BMI groups. Enterochromaffin cells (EC) showed high degree of co-expression with amino acid sensing receptor, CaSR while co-expression with PYY containing L-cells was limited, regardless of BMI. Conclusions: While expression of medium/long chain fatty acid receptor GPR40 was increased in the sigmoid colon of the high BMI group, expression of other nutrient sensing GPCRs, and expression profiles of EECs involved in peripheral mechanisms of appetite regulation were unchanged. Collectively, these data suggest that in human colonic tissue, EEC and nutrient-sensing receptor expression profiles are not affected despite changes to BMI.

Anal and urinary incontinence in nulliparous women - Prevalence and associated risk factors.

To establish the prevalence and risk factors of urinary and anal incontinence in nulliparous women. Thirty-one catholic convents were sent a validated questionnaire to determine the prevalence and severity of urinary incontinence, and a similarly structured questionnaire to assess anal incontinence. Multivariable regression models were used to determine independent risk factors associated with the likelihood of urinary incontinence or anal incontinence. Urine/faecal/flatal incontinence and symptom severity. Of 202 nuns, 167 (83%) returned the questionnaire. Twenty-two women were excluded due to history of childbirth. Of 145 nulliparous women, 56.2% reported urinary incontinence and 53.8% reported anal incontinence. Women aged 66-76 years had significantly increased odds of experiencing urinary incontinence in comparison to women aged 40-65 years: OR: 2.35 (95% CI: 1.02-5.45) (p = 0.04). The risk of urinary incontinence was increased in women with a body mass index ≥ 30 in comparison to those with a body mass index < 19: OR: 6.25 (95% CI: 1.03-38.08) (p = 0.04). With regards to anal incontinence, although none of the differences with age and body mass index groups reached statistical significance, there was a trend towards women in higher body mass index groups having an increased prevalence of anal incontinence. Current/previous hormonal replacement therapy was also associated with significantly increased odds of experiencing urinary incontinence: OR: 2.53 (95% CI: 1.01-6.36), (p = 0.04). However, when adjusting for age and body mass index, there was no significant association with urinary incontinence. This study highlights that while childbirth is an important risk factor, urinary incontinence and anal incontinence also occur in over 50% of nulliparous women. Additional studies are required to identify other risk factors that may be associated with incontinence in this population.

Myocardial Injury After Noncardiac Surgery-Slightly Heavier May Be Better.

Myocardial Injury After Noncardiac Surgery-Slightly Heavier May Be Better.

Burden of increased blood glucose due to modifiable risk factors among men in India

Background and aimsWorldwide, many diabetes cases are occurring mainly due to lifestyle risk factors. Hence, to quantify and compare the attributable burden of key modifiable risk factors associated with increased Blood Glucose (BG) among Indian states and districts. MethodsThe study used the National Family Health Survey (2015–16) data to estimate Population Attributable Risk (PAR) for increased BG (>140 mg/dl) among men aged 15–54 years in 640 districts of 36 States/Union Territories (UTs), India. We have considered three key modifiable factors such as high Body Mass Index (BMI), use of tobacco and alcohol. Population Attributable Risk techniques were employed to address the attributable burden of increased blood glucose due to modifiable risk factors. ResultsSubstantial variations were found in the burden of increased BG due to high BMI, alcohol and tobacco use in India. The overall burden of increased BG due to high BMI, tobacco and alcohol in India was 28.5%, 2.1% and 6.4%, respectively. Regional variations in BG were found in high BMI, tobacco and alcohol consumption groups. The high burden of increased BG related to the above key modifiable risk factors mostly seen in North-Eastern’ districts due to alcohol, Southern and Northern’ districts was due to high BMI. However, the higher burden due to tobacco was reported in Central, Eastern and North-Eastern’ districts. ConclusionThree modifiable risk factors are contributing significantly to increased BG among men. Since there are regional differences in their contributions, state/district, specific targeted interventions may be necessary to control increased BG among men in India.