Normal Body Mass Index Group Research Articles

The Effect of Body Mass Index on Outcome Following Ambulatory High Ligation and Stripping for Lower Varicose Veins: A Prospective Cohort Study.

ObjectivesThe effects of body mass index (BMI) on the outcome of high ligation and stripping (HLS) in an ambulatory center remain unclear. This study aims to investigate the outcomes of HLS in an ambulatory center based on BMI in the Chinese population.DesignThis was a prospective cohort study with mid-term follow-up.Materials and Methods170 eligible patients were included in the study and the data of Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, Venous Clinical Severity Score (VCSS), Visual Analogue Score (VAS), Aberdeen Varicose Veins Questionnaire (AVVQ), Quality of Recovery (QoR-15), and postoperative complications at predetermined time points were collected.ResultsA total of 170 patients (236 limbs) with a mean age of 53.87 ± 9.96 years (range, 24–80 years) and a mean BMI of 23.86 ± 2.96 kg/m2 were included. Of the group, 50.6% were women, and 66 patients received bilateral procedures. Through curve fitting, a BMI less than 28 and a BMI of 28 or higher were found to have a negative [−0.1 (−0.3, 0.1) 0.296] and positive [0.7 (0.2, 1.2) 0.006] relationship trend, respectively, with the improvement of VCSS at 6 weeks after surgery. Through smooth curve fitting, BMI was shown to have a negative relationship trend on the improvement of VCSS at 6 months after surgery. After multivariable risk adjustment for potential confounding factors, BMI was not found to be associated with the improvement of VCSS and AVVQ at 6 weeks after surgery, as well as the improvement of AVVQ at 6 months after surgery (all p-values >0.05). Six months after surgery, BMI was shown to have a negative relationship trend on the improvement of VCSS, and obese patients showed lower VCSS improvement than patients of normal BMI [−1.3 (−1.9, −0.7) <0.0001]. Six weeks after surgery, postoperative complications such as paresthesia were found to be significantly higher in the obese group than in the non-obese group (p < 0.05). At 6 months after surgery, the obese group showed significantly higher complications of the legs compared with the normal BMI group (p < 0.05).ConclusionsOur results showed that obesity is a risk factor for prognosis and postoperative complications following ambulatory HLS.

Association of Elevated Body Mass Index and Outcomes of Arthroscopic Treatment for Osteochondral Lesions of the Talus.

Background:Osteochondral lesions of the talus (OLTs) are a common condition found in patients with chronic ankle pain after previous ankle sprains. Surgical management is indicated after conservative management has failed.Hypothesis/Purpose:This study evaluates the influence of body mass index (BMI) on the early clinical outcomes of arthroscopic debridement and microfracture of OLTs.Methods:A total of 252 patients with symptomatic OLTs who failed conservative management underwent arthroscopic debridement and microfracture of OLTs over the affected ankle between 2007 and 2017. Patients from this cohort were divided into 2 groups based on BMI: the normal BMI group (NB Group) (BMI 18.5-25.0) and overweight and obese BMI group (OB Group) (BMI ≥25). Visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and the physical and mental component summaries of the 36-Item Short-Form Health Survey (PCS and MCS, respectively) were prospectively collected from the cohort during their standard postoperative outpatient follow-up.Results:The NB Group (n=105) and OB Group (n=147) were well matched demographically. The operative duration was significantly shorter for the NB Group compared to the OB Group. Patients from both groups had significant improvements in VAS, AOFAS, and PCS scores postoperatively at 6 and 24 months after surgery (P < .05). Between both groups, patients had comparable VAS, AOFAS, and PCS scores at preoperation, 6 months postoperation, and 24 months postoperation (P > .05). However, MCS in the OB Group was lower at 24 months postoperatively compared with the NB Group (P < .05). The OB Group reported better satisfaction scores (82.4% vs 72.6%, P < .05), and a greater proportion had their expectations met (88.2% vs 77.9%, P < .05).Conclusion:A BMI ≥25 was not associated with worse postoperative pain and functional outcomes, but rather was found to be associated with greater satisfaction and fulfillment. However, patients with BMI ≥25 required longer procedure duration and had poorer MCS scores at 24 months after surgery.Level of Evidence: Level III, retrospective cohort study.

Efficacy and tolerability of colonoscopies in overweight and obese patients: Results from a national database on gastrointestinal endoscopic outcomes.

Background and study aims Gastroenterologists are encountering a rising number of obese patients requiring colonoscopy. Existing literature regarding colonoscopy outcomes in this population is scant and conflicting. We analyzed a nationwide cohort of patients to identify the effects of body mass index (BMI) on colonoscopy success, efficacy, and tolerability. Patients and methods The Clinical Outcomes Research Initiative (CORI) endoscopic database was queried for all colonoscopies in adults between 2008–2014. Patients were stratified into four cohorts based on BMI classification for comparison. Multivariable analysis was performed to identify the effect of BMI on procedure outcome, efficacy and tolerability. Results Of 41,401 procedures, 27,696 met study inclusion criteria. Of these, 49.4 % were performed for colorectal cancer screening, most commonly under anesthesia directed sedation. Patient discomfort was the reason for an incomplete colonoscopy in 18.7 % of all cases, and more frequent among the overweight and obese cohorts. An inadequate bowel preparation was most common in the class III obesity cohort. Compared to the normal BMI group, a BMI ≥ 30 and < 40 kg/m 2 was associated with an increased odds of an incomplete colonoscopy ( P = 0.001for overweight, P = 0.0004 for class I/II obesity), longer procedure ( P < 0.05 for all) and poorer tolerance ( P < 0.0001 for class I/II obesity, P = 0.016 for class III obesity). Anesthesia-administered sedation was more commonly used than endoscopist directed sedation amongst the obese cohort compared with the normal BMI cohort ( P < 0.0001). Conclusions Endoscopists should consider the increased odds of incomplete colonoscopy, longer procedures, and poorer tolerance when performing colonoscopy in obese patients to improve clinical management and procedural outcome.

Impact of body mass index on perioperative and oncological outcomes in elderly patients undergoing minimally invasive McKeown esophagectomy for esophageal squamous cell carcinoma.

BackgroundThe association between elevated body mass index (BMI) and perioperative and oncological outcomes among elderly patients undergoing minimally invasive McKeown esophagectomy (MIE) remains unclear.MethodsWe performed a single‐center retrospective analysis of 526 consecutive patients aged 65 years or older who underwent MIE for esophageal squamous cell carcinoma (SCC) between January 2016 and December 2019. Two groups were stratified by BMI: normal (18.5 ≤ BMI < 24 kg/m2) and elevated groups (BMI ≥ 24 kg/m2). A 1:1 propensity score matching (PSM) analysis was used to compare perioperative and oncological outcomes between the two groups.ResultsA total of 480 elderly patients were eventually enrolled, with a mean age of 70.2 years (range: 65–87), and 185 patients were eligible for elevated BMI, with a mean BMI of 26.3 ± 1.9 kg/m2. Compared with the normal BMI group, the elevated BMI group had prolonged operation time (261.7 ± 57.2 vs. 278.9 ± 62.7 mins, p = 0.002) and increased incidence of intraoperative hypoxemia (12.2% vs. 21.6%, p = 0.006). The differences in intraoperative estimated blood loss, transfusion, new‐onset arrhythmia, and conversion rates and postoperative outcomes regarding pulmonary and surgical complications, intensive care unit and 30‐day readmissions, the length of hospital stay, and oncological outcomes regarding R0 dissection, and the number of dissected lymph nodes between two groups were comparable. After a 1:1 PSM analysis, there was no significant difference in both perioperative and oncological outcomes between two groups.ConclusionsAmong elderly patients undergoing MIE for esophageal SCC, there was insufficient evidence to demonstrate that elevated BMI could increase perioperative and oncological adverse outcomes.

Prognostic Observational Analysis of BMI, Leptin, and Adiponectin in Children With Acute Lymphocytic Leukemia Undergoing Remission-Induction Chemotherapy.

BackgroundThe survival rate of children and adolescents with acute lymphoblastic leukemia (ALL) has progressively improved. However, ALL survivors often have adverse effects after treatment, such as an increased risk of obesity. Obesity has been associated with reduced survival.ObjectiveWe investigated the relationship between obesity, adipocytokine levels, and ALL short-term outcomes.MethodsWeight and height were measured, and body mass index (BMI) was calculated at patient diagnosis and discharge. Leptin and Adiponectin levels and Minimal Residual Disease (MRD) were measured before therapy, at days 19 of remission-induction therapy, and at the end of remission-induction therapy (days 46). The relationship between BMI, adipocytokine levels, and MRD was then determined.ResultsCompared to the normal BMI group, children with an abnormal increase in BMI had an increase in MRD at day 19 and 46 (P = 0.04 and P = 0.008), and showed a positive correlation (P = 0.014). In addition, we found a positive correlation between weight, hip circumference at diagnosis and at day 19, and MRD at day 46. Both BMI and fat concentric distribution affected the outcome of ALL children. A higher BMI was also associated with a significant increase in Leptin levels at diagnosis. Leptin resistance should be considered in ALL children with high BMI.ConclusionBMI affects the outcome of ALL patients. Early interventions such as regular weight, height monitoring, and dietary assessments should be preferably initiated during remission-induction chemotherapy.

Correlation of Body Mass Index on Semen Parameters.

Studies done to determine relation of increase in Body mass index and semen parameters have shown conflicting results, some showing negative correlation others showing none. This study aimed to find out if there is any association between them in our population. A cross-sectional study was performed in an infertility clinic in 2018/19 reviewing records from which Body mass index of male partner and results of semen analysis noted. Participants were grouped according to Body mass index; normal: 18.5-24.99 kg/m2, overweight: 25-29.99 kg/m2 and obese: >30 kg/m2. Different semen parameters such as volume, total count, concentration and motility were compared between different Body mass index groups to determine if there is any association between them. Total 249 participants enrolled with mean Body mass index of 25.1 + 3.4 years. Semen volume decreased with increase in Body mass index (p value 0.063) and sperm count was lower in overweight and obese group compared to normal Body mass index group (p value 0.449) suggesting insignificant negative correlation of Body mass index with semen volume and sperm count. However there was insignificant weak positive correlation of Body mass index with sperm concentration and progressive motility (p value 0.668 and 0.973 respectively). Overweight persons were 3.14 times likely to have hypovolemia (OR:3.14; 95%CI: 1.51-6.53) and obese persons were 1.19 times likely to have oligospermia (OR:1.19 95% CI: 0.42-3.36) compared to persons with normal Body mass index. Body mass index has insignificant negative correlation with semen volume and total sperm count and persons with higher Body mass index were more likely to have hypovolemia and oligospermia compared to person with normal Body mass index.

Correlation Between Components of Malnutrition Diagnosed by Global Leadership Initiative on Malnutrition Criteria and the Clinical Outcomes in Gastric Cancer Patients: A Propensity Score Matching Analysis.

ObjectiveMalnutrition is recognized as a risk factor for poor outcome in patients with gastric cancer (GC). In 2018, the Global Leadership Initiative on Malnutrition (GLIM) published standardized criteria for the diagnosis of malnutrition. Our aim was to investigate whether any of the components of the GLIM diagnostic criteria were related to worse clinical outcomes in patients with GC.MethodsThis study analyzed patients with GC who underwent radical gastrectomy in our hospital between 2014 and 2019. A preoperative nutritional assessment was performed for each patient. Matching was based on the presence of three GLIM components: high weight loss (WL), low body mass index (BMI), and low skeletal muscle index (SMI).ResultsThe analysis included 1,188 patients, including 241 (20.3%) with high WL, 156 (13.1%) with low BMI, and 355 (29.9%) with low SMI. Before matching, patients who met the GLIM component criteria were mostly associated with older age, low nutritional reserves, and late tumor progression. After matching, the clinical characteristics of the three cohorts were balanced. In the matched queue, the survival prognosis of the high WL group was worse than that of the non-WL group, and the postoperative complication rate was higher in the low SMI group than in the normal SMI group (P <0.05). In addition, the clinical outcomes in the low and normal BMI groups were similar (P >0.05).ConclusionOf the GLIM criteria, high WL and low SMI may be associated with poor clinical outcomes in patients with GC, while a low BMI may not be associated with outcome.

Abstract P3-12-14: Attenuated negative prognostic effect of progesterone receptor negativity in postmenopausal ER+ breast cancer with normal BMI (&amp;lt;25): A nation-wide study in Korean Breast Cancer Society and the institutional cohort

Abstract Purpose Loss of progesterone receptor (PR) expression is a poor prognostic factor in ER+/HER2- breast cancer. A growing body of evidence suggests that PR expression is affected by endogenous estrogen level and modulated by body mass index (BMI). Using Korean Breast Cancer Society Registry (KBCSR) and institutional database, we evaluated survival outcome by PR expression in the postmenopausal groups stratified by BMI. Moreover, we investigated 21-gene recurrence score to assess intrinsic tumor biology. Method Data from the KBCSR for patients diagnosed with invasive breast cancer when aged over 50 years were reviewed, and 33,314 with BMI were included. Of these, we investigated overall survival (OS) of women at age of 60 and older with a median follow-up of 56 months (n=9,492). In the institutional cohort with ER+HER2- breast cancer women at age of 50 and older (n=703), the landmark survival analyses were performed to address the 5-years recurrence-free survival (RFS). In the subset of the institutional cohort, 21-gene recurrence scores were identified in individuals (n=470). Normal weight is defined as BMI less than 25kg/m2. Result Among the postmenopausal women from the KBCSR, the PR- was significantly associated with adverse OS (hazard ratio [HR], 1.39; 95% CI, 1.16-1.67; p&amp;lt;0.001) in high BMI group (≥25) whereas in normal BMI group (&amp;lt;25) did not (HR, 1.07; 95% CI, 0.89-1.29; p=0.498) (interaction p=0.046). In the institutional cohort with ER+/HER2- postmenopausal women (age&amp;gt;50), RFS was superior in the PR+ than in the PR- in the postmenopausal with high BMI (≥25). In contrast, RFS was not separated by PR in the normal BMI group (&amp;lt;25). When we compared the 21-gene recurrence score according to PR, the scores were significantly lower in the PR+ than in the PR- regardless of BMI. Conclusion In ER+/HER2- aged postmenopausal breast cancer women with normal BMI who have low estrogen environment, negative prognostic effect of absence of PR expression is attenuated. Bad tumor biology of PR- cancer is conserved irrespective of BMI. We support the hypothesis that weight control to reduce endogenous estrogen produced by adipose tissue is beneficial for postmenopausal women with ER+ breast cancer. Citation Format: Soong June Bae, Jawon Hwang, Janghee Lee, Jung Hwan Ji, Chihhao Chu, Jee Hung Kim, Sung Gwe Ahn, Joon Jeong. Attenuated negative prognostic effect of progesterone receptor negativity in postmenopausal ER+ breast cancer with normal BMI (&amp;lt;25): A nation-wide study in Korean Breast Cancer Society and the institutional cohort [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-14.

Obesity, Comorbidities, and the Associated Risk among Patients Who Underwent Total Knee Arthroplasty in Alberta.

Obesity, a common risk factor for osteoarthritis (OA), accelerates joint deterioration resulting in the need for early total knee arthroplasty (TKA). The role of obesity in the management of OA remains a controversial topic. In this study, we examined whether obesity along with other comorbidities is associated with peri/postoperative complications in patients who underwent primary unilateral TKA in Alberta, Canada. A retrospective secondary analysis was performed on data extracted from data repository of patients (n = 15,151) who underwent TKA between 2012 and 2016. The sample was divided into five groups based on body mass index (BMI) classification developed by the World Health Organization. The associations between dependent variable (presence or absence of a complication or comorbidity) with the independent variables (year of surgery, age, sex, length of surgery, and BMI groups) were examined using binomial logistic regression. Results showed that obese classes I, II, and III, irrespective of other covariates, were more likely to have diabetes and pulmonary embolism (p < 0.001) compared with the normal BMI group. Patients with obese class III compared with the patients in normal BMI group were more likely to have deep wound infection (p = 0.04). Patients with comorbidities were more likely to have a blood transfusion, infection, pulmonary embolism, and readmission. Patients in higher BMI groups or with comorbidities were more likely to experience peri/postoperative complications following TKA, though the level of risk depends on the severity of obesity. These findings may be used by health care providers to educate patients in higher BMI groups about the risks of TKA and optimize comorbidities prior to the surgery.

The Relationship Between Triglyceride Glucose Index and Vitamin D in Type 2 Diabetes Mellitus.

PurposeThe study aimed to investigate the relationship between 25-hydroxyvitamin D [25(OH) D] and triglyceride glucose index (TyG) levels in male and female patients with type 2 diabetes mellitus (T2DM).Patients and MethodsThis cross-sectional study recruited 592 patients with type 2 diabetes. The subjects were divided into the non-vitamin D deficiency group [25(OH)D≥20ng/mL] and the vitamin D deficiency group [25(OH)D<20ng/mL]. The triglyceride glucose (TyG) index is calculated using the following formula, ln[fasting triglycerides (mg/dL)*fasting blood glucose (mg/dL)/2]. Participants were divided into high TyG group and low TyG group, with the median of TyG as the boundary. All participants were divided into male and female groups and normal Body mass index (BMI) and high BMI groups, and then divided into high TyG group and low TyG group.ResultsWe found that TyG levels are independently and negatively correlated with vitamin D levels in male patients with T2DM. In the female group, there was no significant correlation between TyG and vitamin D levels, regardless of an adjusted or unadjusted confounding factor. Subgroup analysis showed that the correlation between TyG and the risk of vitamin D deficiency in the normal BMI group was significantly stronger than that in the high BMI group.ConclusionThis study indicates that vitamin D deficiency is related to high TyG level in patients with T2DM for males, and this relationship is not significant for female patients. The risk of vitamin D deficiency is significantly correlated with high TyG level in normal BMI group. However, there was no statistically significant difference between TyG level and the risk of vitamin D deficiency in the high BMI group. Difference between TyG level and the risk of vitamin D deficiency.

Influence of BMI on adenosine deaminase and stroke outcomes in mechanical thrombectomy subjects

BackgroundEmergent Large Vessel Occlusion (ELVO) strokes are ischemic vascular events for which novel biomarkers and therapies are needed. The purpose of this study is to investigate the role of Body Mass Index (BMI) on protein expression and signaling at the time of ELVO intervention. Additionally, we highlight the protein adenosine deaminase (ADA), which is a deaminating enzyme that degrades adenosine, which has been shown to be neuroprotective in ischemia. We investigate the relationship between ADA and BMI, stroke outcomes, and associated proteomic networks which might aid in personalizing prognosis and future treatment of ELVO stroke. MethodsThe Blood And Clot Thrombectomy And Collaboration (BACTRAC) study is a continually enrolling tissue bank (clinicaltrials.gov NCT03153683) and registry from stroke patients undergoing mechanical thrombectomy (MT). N ​= ​61 human carotid plasma samples were analyzed for inflammatory and cardiometabolic protein expression by Olink Proteomics. Statistical analyses used t-tests, linear, logistic, and robust regressions, to assess the relationship between BMI, proteomic expression, and stroke-related outcomes. ResultsThe 61 subjects studied were broken into three categories: normal weight (BMI 18.5–24.9) which contained 19 subjects, overweight (BMI 25–30) which contained 25 subjects, and obese (BMI ≥30) which contained 17 subjects. Normal BMI group was a significantly older population (mean 76 years) when compared to overweight (mean 66 years) and obese (mean 61 years) with significance of p ​= ​0.041 and p ​= ​0.005, respectively. When compared to normal weight and overweight categories, the obese category had significantly higher levels of adenosine deaminase (ADA) expression (p ​= ​0.01 and p ​= ​0.039, respectively). Elevated levels of ADA were found to have a significant positive correlation with both infarct volume and edema volume (p ​= ​0.013 and p ​= ​0.041, respectively), and were associated with a more severe stroke (NIHSS on discharge) and greater stroke related disability (mRS on discharge) with significance of p ​= ​0.053 and p ​= ​0.032, respectively. ConclusionsWhen examined according to BMI, subjects undergoing MT for ELVO demonstrate significant differences in the expression of certain plasma proteins, including ADA. Levels of ADA were found to be significantly higher in the obese population when compared to normal or overweight groups. Increased levels of ADA in the obese group were predictive of increased infarct volume, edema volume, and worse NIHSS scores and mRS at discharge. These data provide novel biomarker candidates as well as treatment targets while increasing the personalization of stroke prognosis and treatment.

Obesity as a mortality risk factor in the medical ward: a case control study

BackgroundResearch regarding the association between severe obesity and in-hospital mortality is inconsistent. We evaluated the impact of body mass index (BMI) levels on mortality in the medical wards. The analysis was performed separately before and during the COVID-19 pandemic.MethodsWe retrospectively retrieved data of adult patients admitted to the medical wards at the Mount Sinai Health System in New York City. The study was conducted between January 1, 2011, to March 23, 2021. Patients were divided into two sub-cohorts: pre-COVID-19 and during-COVID-19. Patients were then clustered into groups based on BMI ranges. A multivariate logistic regression analysis compared the mortality rate among the BMI groups, before and during the pandemic.ResultsOverall, 179,288 patients were admitted to the medical wards and had a recorded BMI measurement. 149,098 were admitted before the COVID-19 pandemic and 30,190 during the pandemic. Pre-pandemic, multivariate analysis showed a “J curve” between BMI and mortality. Severe obesity (BMI > 40) had an aOR of 0.8 (95% CI:0.7–1.0, p = 0.018) compared to the normal BMI group. In contrast, during the pandemic, the analysis showed a “U curve” between BMI and mortality. Severe obesity had an aOR of 1.7 (95% CI:1.3–2.4, p < 0.001) compared to the normal BMI group.ConclusionsMedical ward patients with severe obesity have a lower risk for mortality compared to patients with normal BMI. However, this does not apply during COVID-19, where obesity was a leading risk factor for mortality in the medical wards. It is important for the internal medicine physician to understand the intricacies of the association between obesity and medical ward mortality.

Association Between Body Mass Index and Cognitive Function in Mild Cognitive Impairment Regardless of APOE ε4 Status.

Background and PurposeIn this study we aimed to find the association between neuropsychological performance and body mass index (BMI) in patients with mild cognitive impairment (MCI). In addition, we investigated the effects of the apolipoprotein E (APOE) genotype in the relationship between the BMI and cognition in MCI.MethodsWe enrolled a cohort of 3,038 subjects with MCI aged 65–90 from the Clinical Research Center for Dementia of South Korea and a dementia cohort of the Ewha Womans University Mokdong Hospital. MCI patients were classified into three subgroups according to the Asian standard of BMI. We compared cognitive performances between groups by one-way analysis of variance. To investigate the effects of the APOE genotype, we used multivariate linear regression models after adjusting for possible confounders.ResultsEven though normal BMI groups were younger, had more females, and had less comorbidities, the higher BMI groups had better cognitive functions. Among subjects with APOE ε4 carriers, there was a positive relationship between the BMI and the memory task alone.ConclusionsOur findings suggested that higher BMI in patients with MCI were associated with better cognitive performance. The effects of the APOE ε4 genotype in the associations between BMI and cognition were distinguishing. Therefore, according to physical status, APOE ε4 genotype-specific strategies in the assessments and treatments may be necessary in elderly patients with MCI.

Elevated Body Mass Index Does Not Adversely Influence the Outcomes of Arthroscopic Treatment for Osteochondral Lesions of the Talus

Category:Ankle; Arthroscopy; Hindfoot; TraumaIntroduction/Purpose:Osteochondral lesion of the talus (OLTs) is a common condition found in patients with chronic ankle pain after previous ankle sprains. Conservative measures such as analgesics, activity modification and immobilisation of the affected ankle are usually applied as first line treatments. Surgical management are indicated after conservative management have failed. This study evaluates the influence of body mass index (BMI) on the early clinical outcomes of arthroscopic debridement and microfracture of OLTs.Methods:An IRB approved study was conducted between 2007 and 2017. A total of 252 patients with symptomatic OLTs who failed conservative management underwent arthroscopic debridement and microfracture of OLTs over the affected ankle. Postoperatively, all patients underwent a standardised postoperative rehabilitation protocol. Patients who underwent previous fractures, previous infections or associated ligamentous injury of the affected ankle were excluded from this study. Patients from this cohort were divided into two groups based on BMI. The normal BMI group (NB-Group) (BMI 18.5-25.0kg/m2) and raised BMI group (RB-Group) (BMI >=25kg/m2). Visual Analogue Score (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot Score as well as the Physical and Mental Components of the Short-Form 36 Questionnaire (PCS and MCS respectively) were prospectively collected from these cohort during their standard postoperative outpatient follow up.Results:A total of 252 patients were reviewed. Patients from either group were otherwise well matched demographically (Table 1). The operative duration was significantly shorter for NB-Group compared to RB-Group. Patients from both groups had significant improvement VAS, AOFAS and PCS scores postoperatively at 6 months and 24 months after surgery (Table 2).Between both groups, patients had comparable VAS, AOFAS as well as PCS scores at preoperative, 6 months postoperative and 24 months postoperatively (p > 0.05). However, MCS in the RB-Group showed a gradual deterioration over 24 months postoperatively and was significantly poorer compared to the NB-Group at 24 months (p = 0.036) (Figure 1).Conclusion:Arthroscopic debridement and microfracture is a reliable procedure, providing significant improvement in pain relief and functional improvement in patients. A raised BMI did not adversely affect pain and functional outcomes. However, patients with raised BMI required a longer duration of procedure and had significantly poorer MCS scores at 24 months after surgery.

Effect of BMI on Tightness of Iliopsoas Muscle in Students due to Prolonged Sitting for Online Classes During COVID-19 Pandemic

Introduction: Muscle tightness is produced by a reduction in a muscle’s capacity to deform. As a result of prolong sitting pelvic position can be changed which can lead to iliopsoas tightness. During the COVID-19 pandemic, as a result of online classes, student’s hours of sitting have increased drastically. Aim: To compare iliopsoas muscle tightness in students who were engaged in prolonged sitting due to online classes with higher Body Mass Index (BMI) and students with normal BMI. Materials and Methods: This cross-sectional study was conducted in Department of Physiotherapy at Institute of Applied Medicine and Research, Ghaziabad, Uttar Pradesh, India, from April 2021 to January 2022 on 101 students. Height and weight of the subject were measured by the ruler and digital weighing machine respectively for the BMI calculation. Two groups were made, group with normal BMI students and group with High BMI students. Using modified Thomas test, iliopsoas muscle were measured for the flexibility. Independent sample t-test was used for statistical analysis. Results: Total 51 students were with normal BMI and 50 were with higher BMI were included in the study. The mean age of the subjects was 19.59 years including 59 females and 42 males. The significantly increased Modified Thomas Test (MTT) angle was found in students with higher BMI when compared to students with normal BMI for both right (p-value=0.003) and left side (p-value &lt;0.001). Iliopsoas muscle tightness was present in more in higher BMI group as compared to normal BMI group. Conclusion: The study concluded that both the groups had the iliopsoas muscle tightness but the students with higher BMI had more muscle tightness.

Analysis of spirometric variables with increasing body mass index in normal and overweight healthy individuals

Background: The relationship between the parameters of body mass index (BMI) and lung function has been established by numerous studies done earlier. Those studies have been done mainly on obese individuals, but only a very few studies have been done in people with normal BMI or overweight group. Our aim is to analyze the various spirometric variables, namely forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow (FEF 25%–75%), and peak expiratory flow rate (PEFR), with respect to increase in the BMI in otherwise normal healthy subjects. Methods: The present study design is a randomized experimental parallel-group study. Sixty individuals who were otherwise healthy without any respiratory illness were selected for this study. Their anthropometric measurements were taken. Based on WHO classification, the subjects were grouped as follows: Group I with a BMI of 18.5–24.9 as a normal weight group and Group II with a BMI of 25–29.9 as the overweight group. Using Medispiror, the spirometric variables were determined. Analysis of spirometric variables, namely FEV1, FVC, FEF 25%–75%, and PEFR, were all done using the appropriate statistical method. Results: The results showed that there was a significant decrease in all spirometric variables except PEFR with an increase in BMI. However, the decrease in FVC was relatively more than the decrease in FEV1. Conclusion: This study can be concluded that there is a significant decrease in spirometric variables, namely FEV1, FVC, and FEF 25%–75%, as the BMI increases even in normal individuals who are not obese.

A prospective cohort study on BMI levels and risk of acute pancreatitis

Objective: To investigate the effects of body mass index (BMI) levels at different baseline on the risk of new-onset acute pancreatitis (AP). Methods: The subjects were from the Kailuan Study Cohort and divided into 3 groups according to baseline BMI levels: BMI<24 kg/m2, normal weight; BMI 24-28 kg/m2, overweight; BMI≥28 kg/m2, obesity. The incidence of new-onset AP in these three groups was analyzed. The survival curve was plotted by Kaplan-Meier method, the cumulative incidence was calculated and tested by log-rank method. Multivariate Cox proportional hazards regression model was used to calculate HR of baseline BMI levels for AP. Results: A total of 123 841 subjects were included and followed up for (11.94±2.13) years, during which, 395 cases were found with AP. The incidence of AP was 2.67 per 10 000 person years in total population, and the incidences of AP were 2.20, 2.72 and 3.58 per 10 000 person-years in the normal, overweight and obesity groups, respectively. The cumulative incidences of AP was 0.32%, 0.40% and 0.49% in normal, overweight and obesity groups, respectively, which showed a significant inter-group difference by log-rank test (χ 2=13.17,P<0.01). The results of multivariable adjusted Cox proportional hazards regression model analysis indicated that obesity group (HR=1.45, 95%CI: 1.10-1.92) had a higher risk for AP compared with the normal BMI group. The subgroup analyses by age and sex showed that compared with the normal weight group,the HRs for AP in the obesity group was 1.58(95%CI:1.14-2.19) and 1.40(95%CI:1.03-1.90) among subjects younger than 60 years old and male subjects, respectively. After excluded onset AP within two years from baseline,with a control group from normal weight,the results of multivariate Cox proportional hazards regression model analysis indicated that the AP in the obesity group was 1.60 (95%CI: 1.18-2.15). Conclusion: Obesity may increase the risk of developing AP, particularly among young and middle-aged men.

APOE‐ε4 status moderates the relationship between body mass index and hippocampal structure in older African Americans

AbstractBackgroundGrowing evidence suggests that traditional body mass index (BMI) cutoff values may overestimate adiposity and its health consequences in African Americans. Further, while obesity disproportionately affects African Americans, obesity is inconsistently associated with Alzheimer’s disease (AD) in older adulthood. Examining the influence of BMI and its interaction with the strongest genetic risk factor of AD, the APOE‐ε4 allele, on hippocampal‐dependent cognitive performance and medial temporal lobe (MTL) structure may provide insights into the complex relationship between obesity and AD in older African Americans.MethodAnalyses included 70 cognitively normal older African Americans (mean age=69.50 years, SD=7.18; mean education=14.12 years, SD 2; 38.60% APOE‐4 allele carriers) who completed cognitive testing, saliva sampling for APOE genotyping, and structural neuroimaging to extract MTL cortical region/hippocampal subfield volumes and surface areas. Cognitive tests included the following measures of generalization and episodic memory: Concurrent Discrimination and Transfer Task, Acquired Equivalence Task, and Rey Auditory Verbal Learning Test. ANCOVAs were used to compare BMI groups (normal: 18‐24.9 kg/m2; overweight: 25‐29.9 kg/m2; class 1 obesity: 30‐34.9 kg/m22) and to test for BMIxAPOE interactions on cognitive and neuroimaging outcomes, while controlling for age, sex, education, literacy, and depressive symptomology.ResultThere was a statistically significant difference between BMI groups on Concurrent Discrimination and Transfer Task performance, p=.01, partial η 2=.18. The normal and class 2 obesity group committed significantly greater errors than either the overweight or class 1 obesity group, ps &lt; .05. Significant BMIxAPOE interactions were identified for the following hippocampal subfield volumes and surface areas: left DG/CA3 and left CA1, ps &lt; .05. For APOE‐ε4 non‐carriers, the normal BMI group had significantly smaller left DG/CA3 and CA1 subfields than the other groups. Among APOE‐ε4 carriers, the class 2 obesity group had smaller left DG/CA3 and CA1 subfields than the other groups.ConclusionBeing overweight may confer cognitive protection in older African Americans. However, obesity appears to be selectively detrimental to hippocampal subfield structure among APOE‐ε4 carriers while normal BMI may be deleterious to hippocampal subfield structure among APOE‐ε4 non‐carriers.

Association between non-alcoholic fatty liver disease with the susceptibility and outcome of COVID-19: A retrospective study.

This study aims to evaluate the effect of non‐alcoholic fatty liver disease (NAFLD) on the susceptibility and consequences of coronavirus disease 2019 (COVID‐19). We retrospectively collected data from 218 adult COVID‐19 patients who showed no evidence of excessive alcohol consumption and underwent abdominal ultrasound examinations. Of these patients, 39.4% patients had been diagnosed with NAFLD, which indicates a much higher prevalence of NAFLD than that reported in the general population. Significantly elevated white blood cell count (p = 0.008), alanine aminotransferase (p = 0.000), aspartate aminotransferase (p = 0.006) and C reactive protein (p = 0.012) were found in the patients with NAFLD. These patients also had significantly higher proportions of hypertension (p = 0.006) and diabetes (p = 0.049) than the non‐NAFLD cases. No significant differences existed in the severity, mortality, viral shedding time and length of hospital stay between patients with or without NAFLD in the sample population. However, subgroup analyses found that in patients with normal body mass index (BMI), NAFLD sufferers were more likely to experience a severe event (30.0% vs 11.5%, p = 0.021). Kaplan‐Meier curve (log‐rank p = 0.017) and Cox regression (HR = 3.26, 95% CI: 1.17–9.04, p = 0.023) analyses confirmed that before and after adjusting for gender, age and comorbidities, NAFLD patients with normal BMI had a higher incidence of suffering severe events. People with NAFLD may have a higher proportion of COVID‐19. NAFLD may be correlated with the severity of COVID‐19 patients in the normal BMI group.

Surface landmarks for anterior lumbar access: is fluoroscopy necessary?

Background Context: Anterior lumbar fusion surgery is increasing by an estimated 24% annually in the United States. There is a paucity of precise anatomic guidelines to help surgeons determine the appropriate anterior access incision site. Purpose: The purpose of this study is to compare the available anterior surface landmarks for the L4/L5 and L5/S1 disk levels to the disk levels determined by fluoroscopy, with the goal of creating a guide for surgical incision sites in anterior lumbar access surgery. Study design: A prospective, observational cohort study of consecutive patients undergoing anterior lumbar spinal exposure for anterior lumbar interbody fusion (ALIF), total disk replacement (TDR), or a combination of the two procedures at levels L4/L5 and/or L5/S1. Patient Sample: All patients (n=183) undergoing primary ALIF and/or TDR surgery from June 2018 to April 2021 at the study sites were assessed for inclusion, and 18 patients were excluded. The remaining 165 patients were included in the study, and a total of 208 surgical levels were exposed. Outcome Measures: Mean, standard deviation, and 95% confidence interval (CI) were calculated. At each level, the distance from the symphysis pubis to the target disk level (SD distance) and the distance from the symphysis pubis to the umbilicus (SU distance) were measured, and the SD/SU ratio was calculated. Paired 2-tailed t tests were used to assess significant differences (p<.05). An R2 (coefficient of determination) test was used to assess variability of the SD distance, SU distance, and SD/SU ratio at each level. Methods: All physiologic and anatomic measures were collected prospectively by the investigators, including intraoperative measurements of SD and SU. Demographic and previous health history data were collected at the time of study enrollment. Results: The mean age of the 165 study participants was 48±14 years (range 18–80 years), and 97 (61%) were male. A total of 208 disk levels were exposed: 140 at L5/S1 and 68 at L4/L5. For the L5/S1, the SD ranged from 0 to 12.5 cm, with a mean of 5.2±1.9 cm (95% CI 4.88–5.52). For the L4/L5 level, the SD ranged from 6 to 15.5 cm, with a mean of 10.7±2.3 cm (95% CI 10.2–11.2). SD/SU ratios at both levels were lower in overweight (body mass index [BMI] 25–29.9) and obese (BMI 30–34.9) groups than in normal body mass index groups. There was no significant difference in SD/SU ratios between females and males at either L5/S1 (p=.39) or L4/L5 (p=.66). Conclusion: Clinically important variability in SD distances (≥9.5 cm) was observed for both the L5/S1 and L4/L5 disk levels. SD/SU ratios provided more consistent estimates of disk location than SD distance alone, but they still displayed substantial variability. Thus, intraoperative fluoroscopy remains mandatory to accurately plan the surgical incision for anterior lumbar access surgery.