Increased Body Mass Index Values Research Articles

Does body mass index impact the early outcome of surgical revascularization? A comparison between off-pump and on-pump coronary artery bypass grafting

To investigate the effects of body mass index (BMI) on early outcomes after revascularization using either on-pump or off-pump surgery. Data for 3714 of 4314 patients who underwent surgical revascularization at our institution between 1999 and 2008 were analysed. Patients were divided into two groups [off-pump coronary artery bypass (OPCAB); n = 1958 and on-pump coronary artery bypass (ONCAB); n = 1756] and further assigned into five classes according to their BMI (underweight <20 kg/m(2), normal 20-24.99 kg/m(2), overweight 25-29.99 kg/m(2), obese 30-34.99 kg/m(2) and morbidly obese ≥35 kg/m(2)). Thirty-day mortality, occurrence of major adverse cardiac events (MACEs), occurrence of major non-cardiac adverse events (MNCAEs) and length of in-hospital stay were analysed in relation to BMI only (whole cohort analysis), to BMI and chosen surgical method (ONCAB versus OPCAB) as well as confounding factors. In the whole cohort analysis (n = 3714), no significant differences between BMI classes could be identified with regard to 30-day mortality (P = 0.78), MACEs (P = 0.72), MNCAEs (P = 0.45) or length of in-hospital stay (P = 0.94). With increasing BMI values, 30-day mortality tended to steadily increase (1.8% in BMI class 'underweight' vs 2.6% in BMI class 'morbidly obese'; P = 0.78), whereas MNCAEs tended to decrease with an increasing BMI (17.5% in BMI class 'underweight' vs 12.2% in BMI class 'morbidly obese'; P = 0.45). Compared with ONCAB, in patients with higher BMI values, OPCAB appeared to reduce slightly the frequency of 30-day mortality, MACEs and MNCAEs, while slightly increasing the length of in-hospital stay. Adjustment for other risk factors by covariate analysis in multiple regression models did not change the inferences drawn. Our study did not detect significant differences between BMI classes with regard to mortality and morbidity. However, a slight trend towards a steadily increasing short-term mortality was detectable for patients with higher BMI values. When comparing ONCAB versus OPCAB, patients with higher BMI values appeared to have a weak tendency towards a reduced short-term morbidity and mortality in favour of OPCAB.

Association between Vitamin D levels and BMI values in an Iranian Population [Clin. Lab. 2014;60:383-389. DOI: 10.7754/Clin.Lab.2013.121033

This study aimed to determine the relationship between vitamin D levels and body mass index (BMI) values in a group of Iranian people. In this cross-sectional study, the anthropometric values and serum vitamin D levels were measured in more than 3500 healthy adults, representing a random sample of the Iranian population in the urban areas of five large cities of Iran. The data used in this study were from the database of the Iranian Multi-centric Osteoporosis Studies (IMOS), previously conducted to assess bone health in the country. The association between BMI values and serum level of 25(OH)D was thereafter calculated. About 46% of the studied 3669 subjects had moderate to severe vitamin D deficiency regardless of their gender. About 43.2% of the overweight individuals and 45.2% of the obese had moderate-to-severe vitamin D deficiency. A linear but weak increasing trend was reported in the serum levels of 25(OH)D based on increasing BMI values. The significance of the value, however, disappeared after the data was adjusted for the possible confounders. A statistically positive association found between serum levels of 25(OH)D and BMI values raised concerns over the available data, suggesting that more studies should be performed in this regard.

Are the adverse effects of weight on reproductive potential an embryo or endometrial factor?

ObjectiveThere is a greater incidence of reproductive-related disorders among underweight as well as obese females resulting in trouble getting pregnant naturally and with ART. Extremes in Body Mass Index (BMI) have been negatively associated with clinical outcomes (Fedorcsak et, al), but a causal relationship remains unclear. Hormonal disturbances, elevated LDL and steroid precursors related to the additional adipose tissue in overweight and obese patients may affect endometrial, oocyte, and embryo quality. To determine if IVF patients with an altered BMI have similar blastocyst development rates, implantation, FHB and SAB as patients with a normal BMI.DesignRetrospective analyses of patients (n=594).Materials and Methods1245 cycles, 594 were candidates. Good blastocyst development defined as an ICM and trophectoderm grades of better than 3 (Grade of 1 = distinct ICM, cohesive trophectoderm, 2 = present ICM, good trophectoderm, 3 = small ICM, trophectoderm with mooning or too few cells). Fisher's exact test (two tailed P value) was used for statistical analysis.ResultsTable 1BMI% BLASTPRFHBIRSAB<19.972/219 33%*19/38 50%15/65 23%*19/65 29%*4/38 11%*20-24.24.9527/1703 31%*141/260 54%131/430 30%*141/430 33%*10/260 4%25-29.9447/1197 37%*90/172 52%89/290 31%90/290 31%1/172 0.5%*>30329/789 42%*62/124 50%53/119 45%*62/119 52%*10/126 8%** = statistically significant.Increasing rates of miscarriage were associated with increasing BMI values. Open table in a new tab ConclusionMaternal obesity effects clinical outcome. Endometrial receptivity as evidenced by implantation and miscarriage rates is more adversely affected by BMI changes than embryo quality. Women with extremes of BMI either too thin or too heavy have significantly higher pregnancy loss rates than those with ideal body weights implying an altered endometrial environment in these women. ObjectiveThere is a greater incidence of reproductive-related disorders among underweight as well as obese females resulting in trouble getting pregnant naturally and with ART. Extremes in Body Mass Index (BMI) have been negatively associated with clinical outcomes (Fedorcsak et, al), but a causal relationship remains unclear. Hormonal disturbances, elevated LDL and steroid precursors related to the additional adipose tissue in overweight and obese patients may affect endometrial, oocyte, and embryo quality. To determine if IVF patients with an altered BMI have similar blastocyst development rates, implantation, FHB and SAB as patients with a normal BMI. There is a greater incidence of reproductive-related disorders among underweight as well as obese females resulting in trouble getting pregnant naturally and with ART. Extremes in Body Mass Index (BMI) have been negatively associated with clinical outcomes (Fedorcsak et, al), but a causal relationship remains unclear. Hormonal disturbances, elevated LDL and steroid precursors related to the additional adipose tissue in overweight and obese patients may affect endometrial, oocyte, and embryo quality. To determine if IVF patients with an altered BMI have similar blastocyst development rates, implantation, FHB and SAB as patients with a normal BMI. DesignRetrospective analyses of patients (n=594). Retrospective analyses of patients (n=594). Materials and Methods1245 cycles, 594 were candidates. Good blastocyst development defined as an ICM and trophectoderm grades of better than 3 (Grade of 1 = distinct ICM, cohesive trophectoderm, 2 = present ICM, good trophectoderm, 3 = small ICM, trophectoderm with mooning or too few cells). Fisher's exact test (two tailed P value) was used for statistical analysis. 1245 cycles, 594 were candidates. Good blastocyst development defined as an ICM and trophectoderm grades of better than 3 (Grade of 1 = distinct ICM, cohesive trophectoderm, 2 = present ICM, good trophectoderm, 3 = small ICM, trophectoderm with mooning or too few cells). Fisher's exact test (two tailed P value) was used for statistical analysis. ResultsTable 1BMI% BLASTPRFHBIRSAB<19.972/219 33%*19/38 50%15/65 23%*19/65 29%*4/38 11%*20-24.24.9527/1703 31%*141/260 54%131/430 30%*141/430 33%*10/260 4%25-29.9447/1197 37%*90/172 52%89/290 31%90/290 31%1/172 0.5%*>30329/789 42%*62/124 50%53/119 45%*62/119 52%*10/126 8%** = statistically significant.Increasing rates of miscarriage were associated with increasing BMI values. Open table in a new tab * = statistically significant. Increasing rates of miscarriage were associated with increasing BMI values. ConclusionMaternal obesity effects clinical outcome. Endometrial receptivity as evidenced by implantation and miscarriage rates is more adversely affected by BMI changes than embryo quality. Women with extremes of BMI either too thin or too heavy have significantly higher pregnancy loss rates than those with ideal body weights implying an altered endometrial environment in these women. Maternal obesity effects clinical outcome. Endometrial receptivity as evidenced by implantation and miscarriage rates is more adversely affected by BMI changes than embryo quality. Women with extremes of BMI either too thin or too heavy have significantly higher pregnancy loss rates than those with ideal body weights implying an altered endometrial environment in these women.

Assessment of sleep quality and correlates in a large cohort of Colombian women around menopause

The aim of this study was to determine the relationship between self-reported sleep quality, menopausal symptom intensity, and correlates (including ethnicity) among middle-aged women. The present cross-sectional study involved 1,078 Colombian women aged 40 to 59 years who completed the Pittsburgh Sleep Quality Index (PSQI), the Menopause Rating Scale (MRS), and a general questionnaire exploring sociodemographic data. The median [interquartile range] age of the whole sample was 49.0 [9.0] years. Among the participants, 45.4% were postmenopausal, 57.2% had increased body mass index values, 13.9% were black, 20.7% had hypertension, 74.1% had a stable partner, and 3.8% used hormone therapy. The prevalence of poor sleep quality was 57.1% (PSQI global score ≥5). Significant correlations between PSQI global scores and MRS total and subscale scores were found. Multiple linear regression analysis found that higher PSQI scores (poorer quality of sleep) correlated with higher MRS psychological and somatic subscale scores (more severe symptoms), smoking habit, and hypertension. Menopause status and black ethnicity were excluded from the final regression model. Despite study limitations, poor sleep quality is highly prevalent in this large middle-aged Colombian female sample and is related to menopausal symptom severity, tobacco use, and presence of hypertension.

Prevalence of insomnia and related factors in a large mid-aged female Colombian sample

ObjectiveTo assess the prevalence of insomnia and related factors in a large cohort of mid-aged Colombian women of different ethnical background. MethodsThis cross-sectional study involved 1325 women aged 40–59 of 3 ethnical groups: Mestizo (70.0%), Black (11.5%) and Zenú indigenous (18.5%), who completed the items of the Athens Insomnia Scale (AIS), the Menopause Rating Scale (MRS) and a general questionnaire containing personal socio-demographic data. ResultsMedian [interquartile range] age of the whole sample was 48.0 [10.0] years. A 43.4% were postmenopausal, 51.7% had increased body mass index values, 18.2% had hypertension and 5.1% used hormone therapy. A 27.5% displayed insomnia (AIS total score ≥6). Significant Spearman rho correlations were found between total AIS and MRS scores (total and subscales). Multiple linear regression analysis found that higher total AIS scores (more insomnia) correlated with tobacco consumption and higher MRS psychological and somatic subscale scores (more severe symptoms). Age, ethnicity and partner and menopausal status were excluded from the final regression model. ConclusionsIn this large mid-aged Colombian cohort insomnia was present in nearly one third of cases, related to smoking habit and the severity of somatic and psychological menopausal symptoms and independent of ethnics and menopausal status.

Association between bisphenol A exposure and body mass index in Chinese school children: a cross-sectional study

BackgroundThere is increasing evidence suggesting that Bisphenol A (BPA), one of the highest volume chemicals produced worldwide, can interfere with the body’s natural weight control mechanisms to promote obesity. However, epidemiological studies for this are limited, especially for children.MethodsA cross-sectional study was conducted to investigate the association between BPA exposure and body mass index (BMI) in school children. Three primary and three middle schools were randomly selected from 26 primary and 30 middle candidate schools in Changning District of Shanghai City in China. According to the BMI-based criteria by age and sex for screening of overweight or obese children, we randomly chose 20 obese, 10 overweight, and 30 normal weight children aged 8-15 years of age from each selected school. First morning urine was collected and total urine BPA concentrations were determined by ultra-performance liquid chromatography tandem mass spectrometry. Multiple linear regression analysis was conducted to examine the association of urine BPA concentrations and daily intake estimates with BMI.ResultsBPA was detected in 84.9% of urine samples with a geometric mean of 0.45 ng/mL. The daily intake estimates ranged from 0.03 μg/day to 1.96 μg/day with a geometric mean of 0.37 μg/day. The average urine BPA concentrations and daily intake estimates were similar for boys and girls, but significantly higher in older children than younger ones, and showed an increasing trend with BMI. Multiple linear regression analyses showed that urine BPA concentrations were significantly associated with increasing BMI values in all subjects after adjustment for age and sex and the results were similar before and after corrected by urine specific gravity. When stratified by age or sex, the associations remained significant in females and in those 8-11 years of age before corrected by specific gravity. Similar results were shown for the association between BMI and daily intake estimates.ConclusionsThere is a possibility that BPA exposure increases BMI in school children. Given the cross-sectional nature of this study, longitudinal studies are warranted to confirm BPA exposure as a contributor to increased BMI in children.

Perceived stress, insomnia and related factors in women around the menopause

BackgroundStudies assessing perceived stress and insomnia in mid-aged women are scarce. ObjectiveTo assess perceived stress, insomnia and related factors in mid-aged Spanish women. MethodThis was a cross sectional study in which 235 women aged 40–65 completed the Menopause Rating Scale (MRS), the Perceived Stress Scale (PSS), the Insomnia Severity Index (ISI), and a general socio-demographic questionnaire containing personal and partner data. Internal consistency of each tool was also computed. ResultsMedian [interquartile range] age of the sample was 52 [9.0] years. A 61.3% were postmenopausal, 49.4% had increased body mass index values, 43.8% were abdominally obese, 11.9% had hypertension, and 74.0% had a partner. In addition, 9.8% used hormone therapy and 12.3% psychotropic drugs. Multiple linear regression analysis found that higher PSS scores (more stress) inversely correlated with female age and positively with MRS psychological and urogenital scores (impaired quality of life in these domains), total higher ISI scores (more insomnia) and partner premature ejaculation. Higher ISI scores positively correlated with PSS and MRS somatic scores and partner unfaithfulness, and inversely with female hip circumference. ConclusionIn this mid-aged Spanish sample perceived stress and insomnia were significantly correlated and related to various female and partner issues.

Prevalence of radiographic primary hip and knee osteoarthritis in a representative Central European population

The aim of our study was to determine the radiographic prevalence of hip and knee osteoarthritis and compare our results with prevalence data reported by other studies, as no similar study had been performed in Hungary previously. Our aim was also to investigate the usefulness of the different radiological scoring methods for the definition of osteoarthritis. Patients who earlier reported complaints and gave written consent were asked to participate in a clinical follow-up. In the 682 participants Harris hip score, visual analogue pain scale values for both joints, Knee Society score and knee functional score were calculated. Weight-bearing radiographs were taken of both joints. Kellgren-Lawrence radiological evaluation was performed and osteoarthritis prevalence was defined. Hip osteoarthritis was found in 109 cases (16.49%), and knee osteoarthritis was found in 111 cases (16.54%). Harris hip score, Knee Society score, functional score and visual analogue scale values were significantly worse in people with radiographically proven osteoarthritis compared to the control group (p < 0.05). Significantly higher osteoarthritis prevalence of both joints was found in those with increased body mass index values. Age also plays a significant role in the development of both hip and knee osteoarthritis. No significant difference was observed between male and female participants regarding osteoarthritis prevalence. The Kellgren-Lawrence score with a cut-off value of 2 or more is a useful evaluation method for the detection of osteoarthritis prevalence in epidemiological studies; according to our observations, in clinical practice a cut-off value of three or more is more relevant.

Body Size of Twins Compared with Siblings and the General Population: From Birth to Late Adolescence

We examined whether and when differences in body size disappear over time and whether twins attain normal final height and body mass index (BMI). Height, weight, and BMI data of twins at ages 1, 4, and 18 years were compared with data from their nontwin siblings. Second, twin and sibling data were compared with population standards. In addition to height, weight, and BMI, data on body proportions at age 18 years were analyzed. At the age of 18 years, twins were as tall as their siblings but were significantly leaner. Compared with children from the general population, adolescent twins attained the same height and BMI. Birth weight was shown to have a considerable effect on height in adolescent twins. Twins attained normal final height compared with siblings and children from the general population. No differences in BMI were shown between 18-year-old twins and children from the general population, whereas the siblings of twins had increased BMI values compared with the general population.

Association between obesity and alteration of sperm DNA integrity and mitochondrial activity

OBJECTIVE: Obesity is a cause of alterations in human health. In male infertility, increased body mass index (BMI) values are associated with alterations in endocrine function and may contribute to testicular hyperthermia due to deposition of fat around the pampiniform plexus. We set out to assess if increased BMI values are associated to alteration in sperm functional integrity.

Concurrent and separate effects of body mass index and waist-to-hip ratio on 24-year mortality in the Population Study of Women in Gothenburg: Evidence of age-dependency

Obesity is generally assumed to be an important risk factor for death and morbidity. However, the association between excess body weight and all-cause mortality among younger and older women and the impact of body mass index (BMI) and waist-to-hip ratio (WHR) concurrently is not fully understood. In 1968-1969 we initiated a prospective study comprising a population sample of 1,462 women from Gothenburg, Sweden. During a 24 year period, until 1992-1993, 265 women had died. A multivariable Cox Proportional Hazards Regression model was used to estimate the relative risk of death in relation to BMI and WHR, with age and other covariates of age-specific interest as smoking, physical activity at work and leisure time and serum triglyceride concentration, at start of the study. BMI and WHR were analyzed as independent variables. Younger women (38 and 46 years at baseline) presented a statistically significant non-linear (U-shaped) relation between BMI and mortality. Among older women (50, 54 and 60 years at baseline), a significant negative linear relationship with decreasing mortality in relation to increasing BMI values was seen. For all women a higher WHR was related to an increased risk of death. The lowest risk of death among younger women corresponded to a low WHR and a BMI within the middle range. For older women the highest survival was observed for those with lowest WHR and highest BMI. Thus, in older women a high BMI seems not to be an increased risk as long as adiposity is not centrally located.

P-94: The effect of Body Mass Index on IVF outcome

ObjectiveThe objective of this study was to evaluate the effect of Body Mass Index (BMI) on In Vitro Fertilization (IVF) outcomes.DesignThis was a retrospective analysis of patients undergoing routine IVF. Patients were grouped into 5 categories based on BMI: <21 (group 1), 21-25 (group 2), 26-30 (group 3), 30-35 (group 4), and >36 (group 5). None of the patients were diagnosed as having polycystic ovarian stimulation syndrome. All patients were less than 36 years of age at stimulation start. To control for possible confounding of embryo quality at transfer and BMI grouping, sub-analyses were performed that included only patients that received two “top quality” embryos at transfer.Materials and methodsAll patients underwent ovarian stimulation with injectible gonadotropins and received hCG to induce final follicle maturation. A transvaginal oocyte retrieval was performed 36 hr post hCG injection. Fertilization was achieved either by insemination or ICSI and embryo transfer was performed on days 3, 4 or 5 post oocyte retrieval. At the time of transfer, Day 3 embryos were evaluated and assigned a quality score based on morphological characteristics (number of cells, blastomere multinucleation, degree of fragmentation, and blastomere symetry). Day 4 embryos were scored based on degree of compaction and symetry of compaction. Day 5 embryos were scored based degree of blastocoel formation, integrity of the inner cell mass and integrity of the trophoblast. Clinical pregnancy was defined as an intrauterine gestation sac with documentation of fetal heart beat.ResultsView Large Image Figure ViewerDownload (PPT)ConclusionIncreasing BMI values appear to have a negative impact on pregnancy outcome for IVF. ObjectiveThe objective of this study was to evaluate the effect of Body Mass Index (BMI) on In Vitro Fertilization (IVF) outcomes. The objective of this study was to evaluate the effect of Body Mass Index (BMI) on In Vitro Fertilization (IVF) outcomes. DesignThis was a retrospective analysis of patients undergoing routine IVF. Patients were grouped into 5 categories based on BMI: <21 (group 1), 21-25 (group 2), 26-30 (group 3), 30-35 (group 4), and >36 (group 5). None of the patients were diagnosed as having polycystic ovarian stimulation syndrome. All patients were less than 36 years of age at stimulation start. To control for possible confounding of embryo quality at transfer and BMI grouping, sub-analyses were performed that included only patients that received two “top quality” embryos at transfer. This was a retrospective analysis of patients undergoing routine IVF. Patients were grouped into 5 categories based on BMI: <21 (group 1), 21-25 (group 2), 26-30 (group 3), 30-35 (group 4), and >36 (group 5). None of the patients were diagnosed as having polycystic ovarian stimulation syndrome. All patients were less than 36 years of age at stimulation start. To control for possible confounding of embryo quality at transfer and BMI grouping, sub-analyses were performed that included only patients that received two “top quality” embryos at transfer. Materials and methodsAll patients underwent ovarian stimulation with injectible gonadotropins and received hCG to induce final follicle maturation. A transvaginal oocyte retrieval was performed 36 hr post hCG injection. Fertilization was achieved either by insemination or ICSI and embryo transfer was performed on days 3, 4 or 5 post oocyte retrieval. At the time of transfer, Day 3 embryos were evaluated and assigned a quality score based on morphological characteristics (number of cells, blastomere multinucleation, degree of fragmentation, and blastomere symetry). Day 4 embryos were scored based on degree of compaction and symetry of compaction. Day 5 embryos were scored based degree of blastocoel formation, integrity of the inner cell mass and integrity of the trophoblast. Clinical pregnancy was defined as an intrauterine gestation sac with documentation of fetal heart beat. All patients underwent ovarian stimulation with injectible gonadotropins and received hCG to induce final follicle maturation. A transvaginal oocyte retrieval was performed 36 hr post hCG injection. Fertilization was achieved either by insemination or ICSI and embryo transfer was performed on days 3, 4 or 5 post oocyte retrieval. At the time of transfer, Day 3 embryos were evaluated and assigned a quality score based on morphological characteristics (number of cells, blastomere multinucleation, degree of fragmentation, and blastomere symetry). Day 4 embryos were scored based on degree of compaction and symetry of compaction. Day 5 embryos were scored based degree of blastocoel formation, integrity of the inner cell mass and integrity of the trophoblast. Clinical pregnancy was defined as an intrauterine gestation sac with documentation of fetal heart beat. Results ConclusionIncreasing BMI values appear to have a negative impact on pregnancy outcome for IVF. Increasing BMI values appear to have a negative impact on pregnancy outcome for IVF.

Prevalence of hypercholesterolemia in Saudi Arabia, epidemiological study

The objective of this study was to look at the pattern of serum total cholesterol concentration (TCC) distribution and the prevalence of hypercholesterolemia (HC) in Saudi Arabia. A cross-sectional national epidemiological household survey was carried out, consisting of 4539 Saudi subjects, over the age of 15 years. The sample was adjusted for gender, age, regional and residency, and urban versus rural population distribution. The following details were taken for each subject: height, weight, calculation of body mass index (BMI) and random blood samples for total cholesterol measurements. It was found that the mean TCC for all female subjects was significantly higher than for male subjects (4.24 versus 4 mmol/l). The mean TCC of female subjects, aged 40–59 years was higher, but not significantly so, than for male subjects (4.5 versus 4.4 mmol/l). There was a progressive increase in TCC with age, reaching a maximum at the fifth and sixth decades for male and female subjects, respectively. There was a progressive increase in mean TCC with increasing BMI values for male and female subjects with higher values of mean TCC for female subjects for any given BMI value. The prevalence of HC, 5.2–6.2 mmol/l was 9% and 11% for all male and female subjects, respectively ( P = 0.74), whereas the prevalence of HC, >6.2 mmol/l was 7% and 8% for male and female subjects, respectively ( P = 0.52). The prevalence of HC 5.2–6.2 mmol/l for subjects aged 40–59 years was 14% and 10% for male and female subjects, respectively ( P = 0.67), whereas the prevalence of HC >6.2 mmol/l was 9% and 11% for male and female subjects, respectively ( P = 0.6). There was a progressive increase in the prevalence of HC with age for male and female subjects. The prevalence of HC >5.2 mmol/l increased with increasing BMI values. The prevalence of HC of female subjects was significantly higher than for male subjects among normal weight groups. The prevalence of HC (>6.2 mmol/l) for female subjects was higher, however, not significant than for male subjects among overweight and obese groups. The prevalence of HC, whether for male or female subjects, was higher among diabetics when compared with non-diabetic subjects. The prevalence of HC (>6.2 mmol/l) among male subjects was higher for smokers when compared with non-smokers. It was concluded that Saudi subjects have lower prevalence of HC than the European and American populations. This can partially be explained by the younger nature of the population. The prevalence of HC is likely to increase in the near future with the increasing percentage of the aged population in the community, and with the effects of a longer exposure to the acquired western life-style and nutritional habits, which is showing an impact with the increase in the prevalence of obesity. The cause of coronary heart disease is multifactorial, HC being one of the main contributors. Therefore, there is a need to study, in detail, the prevalence of other risk factors, such as: obesity, smoking, hypertension etc. There is a need to promote health awareness among the population with an emphasis on controlling weight and carrying out periodic cholesterol measurements.

Hepatitis B Surface Antigen, Hepatitis C Virus Antibody, Body Mass Index, and Alcohol Drinking among Workers with Elevated Serum Alanine Aminotransferase

Method. We conducted a case-control study on liver diseases among Japanese workers to examine associations between elevated serum alanine aminotransferase (alanine aminotransferase value ≥ 50 IU/liter) and selected factors such as hepatitis B surface antigen positive, hepatitis C virus antibody positive, body mass index, and alcohol drinking. Out of 3,738 workers (1,477 males and 2,261 females) in a supermarket chain, 91 workers with an elevated serum alanine aminotransferase value (≥ 50 IU/liter) were classified as cases and 182 workers with normal serum alanine aminotransferase value and without an episode of blood transfusion were randomly selected as controls. Results. Prevalence rates of hepatitis B surface antigen positive and hepatitis C virus antibody positive were 4.4 and 23.1% among the overall cases, 2.9 and 11.8% among the cases with 100 > alanine aminotransferase value ≥ 50, and 8.7 and 56.5% among the cases with alanine aminotransferase value ≥ 100. A logistic regression analysis was conducted. Odds ratios were 4.94 for hepatitis B surface antigen positive ( P < 0.05) and 77.19 for hepatitis C virus antibody positive ( P < 0.001). Odds ratios for body mass index increased with increasing body mass index values; 3.32 for 26 > body mass index ≥ 24 ( P < 0.01) and 5.03 for body mass index ≥ 26 ( P < 0.001). No increased risk was observed among regular drinkers of less than 27 g/day of ethanol (odds ratio is 0.23) or of 27-53 g/day of ethanol (odds ratio is 0.47). A slightly increased odds ratio of 1.35 was observed among regular drinkers of 54-81 g/day of ethanol, but this was not statistically significant. Conclusions. Our results suggest that hepatitis C virus and high body mass index are predominant factors in elevated serum alanine aminotransferase levels among Japanese workers, while alcohol drinking is a minor factor.