Normal Body Mass Index Range Research Articles

CLINICAL SIGNIFICANCE OF PSOAS MUSCLE COMPOSITION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract Background Total psoas muscle cross sectional area, as identified with computed tomography (CT), has been associated with clinical outcomes in various disease states. Unfortunately, total psoas CSA does not differentiate muscle density nor fat, both of which may be abnormal in obesity. Using a novel CT method to partition psoas muscle into low and high density muscle, recent studies have demonstrated low and high attenuating psoas muscle may be superior to total psoas CSA in identifying sarcopenic obesity. The impact of varying muscle composition in patients with inflammatory bowel disease is unknown. Methods We conducted a retrospective cohort study of IBD patients from a tertiary care center. Psoas muscle composition was determined using a novel and validated CT method. High and low attenuating bilateral psoas muscle was measured at the level of the 3rd lumbar vertebra. Clinical remission, surgery, hospitalization, and corticosteroid use were stratified by low and high density muscle and evaluated 6 weeks from the index CT. Results We identified 115 consecutive patients with a routine CT scan. Majority of patients had a greater quantity of low-density muscle (LDM), 95% had CD and 71% were not in clinical remission at the time of baseline CT. Of those with a greater quantity of LDM, 68% had history of IBD surgery and 60% were current/former smokers. The mean pre-CT body mass index (BMI) for the greater quantity LDM was significantly higher (p=0.002) than the mean pre-CTE BMI for those with low LDMC. Seventy percent with greater quantity of low-density muscle were either overweight or obese and 20% had a normal range BMI. Six months after the baseline CT, 53% in the lower quantity LDM had clinical remission, whereas 33.3% had remission in the high LDMC (p=0.05). Patients with greater quantity LDM were more likely to require corticosteroids in the 6 months after index CT, as compared to those with lower quantity LDM (p=0.02). Conclusion This observational study showed an association between greater quantity of LDM and obesity and worse IBD-related outcomes. This is the first study to evaluate the impact of muscle composition on IBD outcomes and our results offer a novel tool to risk stratify patients with IBD. Our study is limited by the retrospective nature, limited sample size, and narrow longitudinal follow-up. Larger prospective studies with greater longitudinal follow-up are needed to confirm our retrospective findings.

Improved work organization to increase the productivity in manual brick manufacturing unit of West Bengal, India

In India, the manual brick making process is physical demanding jobs where millions of workers earn their livelihood. The study attempts to improve the organization of the work in brick manufacturing units and makes operations for the betterment and enhances its productivity. Observation studies and posture analysis were performed among them by the OWAS method. A detailed plan and time study were done, and accordingly, modifications of the processes were also carried out. The body mass index (BMI) of both groups of brickfield workers was 18.58 (±2.53) (brick molders) and 19.24 (±2.72) (brick carriers) respectively, suggesting that the workers had a normal range of BMI. Working postures of brickfield workers are of high risk as indicated by the OWAS system. In this study, an attempt was made to organize the manual brick making operation for enhancing productivity. The existing process of Brick making involved some unnecessary steps, which hamper the rate of work and consequently productivity, is also affected. This study eliminates the real steps and enhances 32% productivity in time and also recommends the ergonomic intervention to reduce biomechanical stress among brickfield workers.

Junk Food Consumption, Physical Activity and Nutritional Status of Adolescent School Children: A Case Study in Ratnapura District of Sri Lanka

Junk food is rich in fats, sugar, salt and calories. Excess consumption of junk food leads to various health and nutritional disorders. The association between junk food consumption at breakfast of adolescent school children, their physical activity level and BMI status was determined in the current study. A cross-sectional study involving 300 male and female students of the age range 12-14 years from four randomly selected schools in Ratnapura district was conducted in 2019. Information regarding physical activity, breakfast practices and energy expenditure was obtained using a pre-tested questionnaire filled by the students. The criteria recommended by the International Obesity Task Force (IOTF) were used to define obesity and overweight, sex and age-specific body mass index (BMI). The study showed, although 72% of the students were aware of the unhealthiness of the junk food habit and more than 85% of the parents were aware and students were knowledgeable about the nutrient facts, 72.7% consumed it due to the taste and the rest due to its convenience. The frequent junk food consumers at breakfast were more obese (p = 0.002) and overweight (p =0.003) compared to occasional junk food eaters most of whom were in the normal BMI range. A negative correlation was observed between BMI and energy expenditure (Pearson correlation = -0.49) where a higher BMI was observed with inactive (p < 0.001) or minimally active (p < 0.002) students. A nutritional transition from underweight to overweight and obesity related to junk food consumption is evident from the above data in Ratnapura district of Sri Lanka.

One-anastomosis gastric bypass (OAGB) in patients with BMI &lt; 30 kg/m2 and diabetes mellitus type 2 (DM2)

Introduction: type-2 diabetes mellitus (DM2) is a major health problem, as it leads to increased morbidity and mortality. Metabolic surgery has shown good results in glycemic control; however, its use has not become popular. Objectives: to evaluate DM2 remission, as well as changes in body mass index (BMI), in overweight diabetic patients after undergoing metabolic surgery. Methods: a retrospective review was carried out of all patients with DM2 and BMI between 25 and 29.9 kg/m2 who underwent laparoscopic one-anastomosis gastric bypass (OAGB) as metabolic procedure between 2016 and 2019. Results: a total of 15 patients were included with a mean age of 46.6 ± 11.25 years. Mean BMI was 28.41 ± 0.94 kg/m2. Average duration was 5.4 ± 2.79 years, and presurgical fasting glucose was 288.53 ± 65.22 mg/dL. Preoperative glycated hemoglobin (HbA1c) was 9.58 ± 1.66 %. Two years after surgery HbA1c was 5.21 ± 0.26 %. The remission rate of DM2 was 100 %. All patients maintained a normal BMI range. Conclusions: OAGB is a valid alternative for complete DM2 remission no matter if it is not accompanied by some degree of obesity, since in this case the length of the biliopancreatic limb and common channel is modified to make a less malabsorptive procedure.

Association of Body Mass Index and Waist to Hip Ratio With Gallstone Disease in Patients Visiting Rural Tertiary Care Center in North India

Introduction. In India the prevalence of gall stone disease varies in different parts of India. Malhotra in 1996 conducted an epidemiological study in Indian Railway employees and showed that North Indians has 7 times higher prevalence of gall stones compared to South Indian employees. It is said that Gall bladder is a disease of "Fatty, Fertile, Females in their Forties". In our daily routine we observe that it is found not only in fatty females but common in average built patients also. Material and Methods. Study includes patients visiting to BPS GMC Khanpur Kalan with diagnosis of gall stone diseases and operated at our center with sample size of 135. Body mass index (BMI) and Waist to Hip ratio are calculated using their standard formulas. All data was compiled in IBM SPSS statistics (20.0). Result. Normal BMI is considered up to 25 and more than 50% patients lie in normal BMI range. Only 13% of cases lie in obese group that is BMI greater than 30. Waist to hip ratio, maximum patients that is BMI greater than 30. Waist to hip ratio, maximum patients that is (83%) lie in group more than 0.85. Minimum Waist to Hip ratio is .77 and maximum Waist to Hip ratio is 1.45. Out of 135 patients 90 patients are having high Waist to Hip ratio. Conclusion. Waist to Hip Ratio (abdominal adiposity) is better indicator of Gall stone diseases than BMI.

Association of Weight Loss Between Early Adulthood and Midlife With All-Cause Mortality Risk in the US

Describing potential mortality risk reduction associated with weight loss between early adulthood and midlife is important for informing primary and secondary prevention efforts for obesity. To examine the risk of all-cause mortality among adults who lost weight between early adulthood and midlife compared with adults who were persistently obese over the same period. Combined repeated cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey III (1988-1994) and continuous waves collected in 2-year cycles between 1999 and 2014. The data analysis was conducted from February 10, 2019, to April 20, 2020. Individuals aged 40 to 74 years at the time of survey (baseline) were included in the analyses (n = 24 205). Weight history was assessed by self-reported weight at age 25 years, at 10 years before baseline (midlife: mean age, 44 years; interquartile range, 37-55), and measured weight at baseline. Body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) at each time was categorized as normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Weight change patterns were assessed from age 25 years (early adulthood) to 10 years before baseline (midlife). Incident all-cause mortality using linked data from the National Death Index. Of the 24 205 participants, 11 617 were women (49.0%) and 11 567 were non-Hispanic White (76.9%). The mean (SD) BMI was 29.0 (6.1) at baseline. During a mean (SD) follow-up of 10.7 (7.2) years, 5846 deaths occurred. Weight loss from obese to overweight was associated with a 54% (hazard ratio, 0.46; 95% CI, 0.27-0.77) reduction in mortality risk compared with individuals with stable obesity between early adulthood and midlife. An estimated 3.2% (95% CI, 1.6%-4.9%) of early deaths could have been avoided if those who maintained an obese BMI instead lost weight to an overweight BMI by midlife. Overall, an estimated 12.4% (95% CI, 8.1%-16.5%) of early deaths may be attributable to having weight in excess of the normal BMI range at any point between early and mid-adulthood. In this study, weight loss from obesity to overweight between early adulthood through midlife appeared to be associated with a mortality risk reduction compared with persistent obesity. These findings support the importance of population-based approaches to preventing weight gain across the life course and a need for greater emphasis on treating obesity early in life.

AN OVERVIEW OF BREAKFAST PATTERNS AND LIFESTYLES ASSOCIATED WITH BODY MASS INDEX IN MALAYSIA

Background: Over the past two decades, a high body mass index (BMI) has become the world’s largest public health concern. There have been numerous studies suggesting that breakfast patterns and lifestyle choices are associated with an individual’s BMI. Purpose: This research aims to describe the distribution of breakfast patterns and lifestyle choices according to BMI in Shah Alam, Malaysia. Method: This is a descriptive study with a cross-sectional design. The respondents in this study are people who live in Shah Alam, Malaysia, and are between the ages of 18 and 35 years old. The instrument used is a questionnaire. Results: The data shows that the majority of respondents who were obese (28.24%) were non-smokers (14.62%), never drank alcohol (15.95%), had not exercised in the past two weeks (17.28%), slept six to eight hours per day (17.28%), and had a pattern of skipping breakfast (23.92%). On other hand, the majority of respondents who were in the normal BMI range (34.55%) were non-smokers (29.57%), never drank alcohol (30.56%), slept six to eight hours per day (18.94%), and had a pattern of eating breakfast (20.60%). Conclusion: Obesity is more common in people who skip breakfast, as weight gain occurs because of unhealthy food choices made to replace breakfast. An unhealthy lifestyle also contributes to a high BMI, including smoking, alcohol consumption, and a sedentary lifestyle.

Obesity-related hypertension: Findings from The Korea National Health and Nutrition Examination Survey 2008-2010.

We aimed to investigate the association of various obesity parameters and phenotypes with hypertension in nationally representative Korean adults. Among adults aged 19 years and older who participated in the Korea National Health and Nutrition Examination Survey in 2008–2010, a total of 16,363 subjects (8,184 men and 8,179 women) were analyzed. Hypertension was defined as blood pressure of 140/90 mm Hg or higher or taking antihypertensive medication. Multiple logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Higher obesity parameters [body mass index (BMI) representing general obesity, waist circumference (WC) representing central obesity, and percentage body fat (PBF) representing elevated body fat] were consistently associated with increased odds of prevalent hypertension (OR, 7.54; 95% CI, 5.89–9.65 for BMI ≥30 vs. 18.5–23; OR, 3.97; 95% CI, 3.41–4.63 for WC ≥95 cm in males and ≥90 cm in females vs. <85 cm in males and <80 cm in females; OR, 3.56; 95% CI, 3.05–4.15 for PBF, highest vs. lowest quartile; all p trends<0.0001). These associations were stronger in the younger age group (<40 years), and were observed in both sexes. Furthermore, even in individuals with normal BMI (18.5–23), the odds of prevalent hypertension were consistently increased in those with central obesity (WC≥90 cm in males, WC≥80 cm in females; normal weight central obesity phenotype) (OR, 1.89; 95% CI, 1.63–2.19) and those with high PBF (highest quartile of PBF; normal weight obesity phenotype) (OR, 1.49; 95% CI, 1.25–1.77). These associations were consistent with updated hypertension guidelines in 2017. Obesity may be positively associated with hypertension, regardless of obesity parameters. Even within normal BMI range, high WC and high PBF may be associated with hypertension.

Association Between Abdominal Waist Circumference and Blood Pressure In Brazilian Adolescents With Normal Body Mass Index: Waist circumference and blood pressure in Adolescents.

Obesity is the most common chronic disease in adolescents. In adults, waist circumference (WC) is associated with the presence of cardiovascular risk factors and is also a better predictor of cardiovascular (CV) risk than body mass index (BMI). The association between WC and CV risk factors in adolescents has been poorly explored so far, mainly in those within the normal BMI range.Objective:To evaluate the association between WC and elevated blood pressure (BP) in adolescents with a normal BMI.Methods:Cross-sectional analysis of 73,399 scholars between 12 and 17 years old from the ERICA study, a school-based, national representative study with Brazilian adolescents. Only those within the normal range of BMI were included. The WC was categorized into quartiles for sex and age (Q1 to Q4). For the analysis, BP values ≥ 90th percentile were considered to indicate elevated BP, what includes hypertension and pre-hypertension. The Poisson Regression model was used and the prevalence ratio was estimated.Results:A total of 53,308 adolescents with normal BMI were included. Prevalence of elevated BP in the overall group was 18.0%. In female adolescents with WC in the lowest quartile for their age, the prevalence of elevated BP was 7.3% (12–14 years) and 6.9% (15–17 years), increasing in the upper quartile to 15.2% and 19.5% respectively, with a prevalence ratio (PR) indicating chance at least two times higher for elevated BP in Q4 (p < 0.001). Similarly, this was observed in boys, with a prevalence of elevated BP of 10.0% and 18.9% in Q1, increasing to 21.4% and 49.6% in Q4 (p < 0.001).Conclusion:In adolescents, there is a strong association of increased WC with BP elevation, even when the BMI is adequate.

Insomnia, Psychosocial Well-Being, and Weight Control Behaviors Among Healthy-Weight Adolescent Females: Brief Report.

Weight control behaviors (WCBs) typically involve appearance- or health-driven behaviors that may be influenced by physiological, psychological, or social factors. Sleep disturbances like insomnia are an important area of research for adolescent populations, as early intervention may result in improvements in other physical and mental health domains. The purpose of this study was to investigate the relationship of insomnia, psychosocial well-being, and current WCBs in healthy-weight female adolescents. Female adolescents (N = 323; Mage = 12.33 ± .04) who had healthy body mass index (BMI) levels completed self-report items on insomnia, depression, self-esteem, and physical self-concept. Multivariate analysis of covariance (MANCOVA), controlling for age, was conducted to further examine differences in insomnia and psychosocial variables among the WCB groups. Compared to those who were trying to stay the same weight or not trying to do anything about their weight, the girls who were trying to lose weight had significantly greater insomnia and depression symptoms, and lower self-esteem, with small to medium effect sizes. Clinicians working with adolescent girls should include assessments of WCBs in addition to measures of insomnia symptoms, even for adolescent girls within a normal BMI range, as these are common and frequently co-occurring phenomena. Additional research is needed to further disentangle these complicated relationships.

Local anaesthetic repair of paraumbilical hernia as a safe option across a range of body mass indices

Local anaesthetic repair of paraumbilical hernia (PUH) is a commonly performed operation. The aim of this study was to investigate whether local anaesthesia (LA) repair of PUH was feasible in patients with a high body mass index (BMI) and whether BMI had an impact on patient reported pain scores. Patients undergoing PUH repair under the care of single consultant in a district general hospital between March 2010 and January 2018 were recruited. Patient demographics, BMI, duration of operation, volume of LA infiltrated and grade of operating surgeon were available from the consultant's database. The database also included prospectively recorded patient reported pain scores based on a numerical scale (0-100) and overall patient satisfaction measured as a percentage. Patients were divided into three BMI categories: <25kg/m2, 25-30kg/m2 and >30 kg/m2. A total of 123 patients underwent PUH repair under LA during the study period. Six patients had no recorded BMI and were excluded from the analysis. Of the remaining 117 patients, 36 (31%) were in the normal BMI range, 35 (30%) in the overweight range and 46 (39%) in the obese range. There was no statistically significant difference between the BMI groups in terms of volume of LA used, duration of operation, postoperative pain scores or patient satisfaction. LA repair of PUH is feasible for patients with a raised BMI and does not result in higher postoperative pain scores or the need for higher doses of LA.

Differences in Frequency of Visits to Pediatric Primary Care Practices and Emergency Departments by Body Mass Index.

To examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. A retrospective study was conducted using 1 year of electronic health records following an index primary care visit for children 3 to 17 years old in 2016. Index visits occurred at >40 pediatric practices affiliated with a Northeastern health system. Using normal BMI as a reference group, we examined the extent to which children's BMI percentile categories were associated with primary care visits, emergency department (ED) visits, hospitalizations, and ED visit acuity. Age, sex, race/ethnicity, and insurance status were used as covariates. Of those with biologically plausible values for height and weight (n=30,352), the prevalences of overweight, obesity, and severe obesity were 16.3%, 12.4%, and 5.7%, respectively. Children outside of the normal BMI range made more primary care visits; however, relative patterns of ED utilization were not consistent. Children with obesity versus normal BMI were less likely to have ED visits of high acuity. Risk of hospitalization was higher among children with overweight or severe obesity. Children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations. Further investigation is needed to explore the drivers of these differences in utilization, such as the impact of stigma and perceived weight bias on care-seeking patterns, and to examine the role of settings outside of primary care in pediatric weight management.

Obesity Prevalence and Determinants among Young Adults, with Special Focus on Normal-Weight Obesity; A Cross-Sectional Study in Mumbai.

Background:India has >135 million obese individuals at present. Body mass index (BMI) has been used to assess obesity until recent times. Later, studies have shown that central body fat (BF) measurements as a reliable predictor of metabolic diseases. Hence, normal-weight obesity (NWO) is defined. Those with a normal range of BMI but increased fat percentage are found to be having metabolic syndromes at a very early life. The young adult group is specifically focused on the study with diet and physical activity as potential determinants; as an intervention at the right time can prevent the development of many noncommunicable diseases.Objectives:The aim of this study is to estimate the prevalence of obesity and its determinants with special reference to NWO.Materials and Methods:A cross-sectional study was conducted based on diet, physical activity, and other lifestyle factors on a sample of 269 young adults. Using Harpenden skinfold calipers, BF percentage was calculated based on Jackson and Pollock and Siri's equation. Binary logistic regression was also applied appropriately.Results:The proportion of obesity was 42.01%, and that of NWO was 16.1%. Sex, high protein diet, number of restaurant visits, less homemade tiffin intake, heavy physical activity, alcohol intake were found to be significantly associated with obesity. Intake of fish, physical activity, protein diet, day-time sleep were found to be significantly associated with NWO.Conclusion:The study emphasizes the need for including BF percentage in addition to BMI in regular clinical practice. It may help in preventive and promotive efforts.

Study of relationship between physiological factors and handgrip strength on bone mineral density in healthy men and women - A cross-sectional study

Background: Age, gender, diet, and body mass index (BMI) are important physiological factors that can affect muscle strength and bone mineral density (BMD). Obesity and osteoporosis are two important and developing public health problems worldwide. Aims and Objectives: This study aims to know the relationship between physiological factors such as age, gender, diet, BMI, and handgrip strength (HGS) on BMD in healthy men and women. Materials and Methods: A total of 198 participants of age 30–70 years were included in the study. BMI was calculated using Quetelet index. Measurement of HGS was done using a handgrip dynamometer following standard methods. HGS max in kg and endurance time (ET) in seconds were recorded. BMD was recorded using bone sonometer, in the distal end of tibia. Results: Age had a weak negative correlation with BMD, HGS max, and ET. BMD had a weak negative correlation with BMI though statistically not significant. BMI among vegetarian (V) and non-vegetarian (NV) group with normal BMI range, occurrence of osteoporosis was higher among vegetarian. In overweight/obese, osteoporosis was higher among NV, though statistically not significant. There was no significant gender difference in BMD between V and NV. ET was statistically significant in NV females. HGS max and ET were higher among NV males but statistically not significant. Conclusion: There is no significant relation between BMI, diet, and HGS max on BMD in V and NV. Hence, we can conclude that well-planned and balanced vegetarian diet is equally nutritious as NV diet for good muscle strength and bone composition.

Body Mass Index at Presentation of Inflammatory Bowel Disease in Children.

PurposeThe evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis.MethodsRetrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity.ResultsWe had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2–17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows—obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%).ConclusionOur data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy.

IntroductionPrevious studies showed that high and low body mass index (BMI) was associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in mCRC is unclear. We aimed to assess efficacy outcomes according to BMI in patient with metastatic colorectal cancer treated with bevacizumab plus FOLFOX chemotherapy regimen in second-line treatment.Material and methodsThe analysis of 237 patients with metastatic colorectal cancer treated with bevacizumab plus FOLFOX in the second line (treated from January 2014 to August 2018) in 4 reference oncological centers in Poland.ResultsThe median age of the patients was 65 years (range 34–82). The median overall survival (OS) and progression-free survival (PFS) of the all 237 patient was 14.6 and 8.8 months, respectively. Comparison of obese patient (BMI > 30 kg/m2) vs. overweight patients (BMI ≥ 25 to < 30 kg/m2) vs. normal BMI range patients revealed a significant improvement of median OS (17.5 vs. 14.3 vs. 13.1 months, p = 0.01) and median PFS (9.4 vs. 9.1 vs. 7.3 months, p = 0.03). The Cox hazard model showed that the BMI class is an important risk factor. However, the Cox model also showed that the significance of the BMI class applies only to patients with BMI < 25 kg/m2. This rule applies to both OS and PFS. The regression analysis also confirmed that there is a statistically significant relationship between the length of OS and PFS and the BMI value. Higher BMI was associated with a better prognosis. There were no differences in responses to treatment bevacizumab and FOLFOX chemotherapy and number adverse events according to BMI values.ConclusionsPatients with mCRC treated with chemotherapy with bevacizumab in second-line treatment with higher BMI compared with normal weight patients have better prognosis in terms of PFS and OS. In this group, we found no evidence of changes in safety profile depending on BMI. Nevertheless, further large randomized studies are needed to assess the body weight on the effectiveness of chemotherapy in combination with bevacizumab.

278 A Real World Comparison of Body Surface Area Formulae

Estimated body surface area (BSA) formulae are utilised throughout medicine; common uses including chemotherapy dosing, calculation of eGFR (estimated glomerular filtration rate), and indexation of cardiac chamber size on echocardiography. We hypothesised that traditional isometric BSA formulae would diverge at the extremes of bodyweight. The biometric data of 1108 consecutive patients attending the echocardiography laboratory were collected. A literature review was conducted to identify BSA formulae used in medical literature. BSA was calculated using 28 different BSA formulae, which included two sets of gender specific formulae. Median BMI (body mass index) was 28.0 kg/m2 (IQR 8.5 kg/m2). Median BSA was 1.95 m2 (IQR 0.18m2). There was a clear correlation between the lines of best fit for the relatively normal BMI range of 20-30, however above a BMI of 30kg/m2 the lines diverged significantly, with the greatest disparity seen at BMI >60 kg/m2. Median variance between the groups was not statistically significant between the underweight (BMI<20kg/m2) normal weight (BMI 20-24.9 kg/m2) and overweight groups (25-29.9m2). Variance between the BSA formulae results significantly increased in class I obesity (BMI 30-34.9 kg/m2) [p<0.001], class II obesity (BMI 35-39.9 kg/m2) [p<0.001], and class III obesity (BMI 30-34.9 kg/m2) [p<0.001]. Increasing BMI is associated with a greater discrepancy between body surface area formulae. In an increasingly obese population this has profound implications in the normalization of cardiac pathology on echocardiography.

Obesity Is Associated with Earlier Pubertal Onset in Boys.

Pubertal timing in boys is associated with body mass index (BMI). Studies consistently report an inverse correlation of BMI and pubertal timing within the normal BMI range. However, observations in obese boys are conflicting with different studies reporting either early or delayed pubertal onset in obese boys. We aimed to assess the association of male pubertal timing with age-specific BMI (zBMI) in obese boys. A total of 218 obese boys (zBMI > +2SD, with a median age at baseline of 10.8 years (range 4.2-17.0), were recruited as part of a prospective outpatient childhood obesity intervention program at Nordsjællands Hospital, Hillerød, Denmark, between 2009 and 2017. Serving as controls, we included 660 healthy boys participating in the population-based COPENHAGEN Puberty Study (-2SD < zBMI ≤ +2SD, 2006-2014). Subanalyses were performed on overweight controls (+1SD < zBMI ≤ +2SD). The clinical assessment of pubertal development by Tanner staging, including testis volume using a Prader's orchidometer, was performed by trained physicians. The timing of pubertal milestones was estimated by probit analyses. Timing of testicular volume ≥ 4 mL, genital stage ≥ 2, and pubarche. The mean (95% confidence interval [CI]) age of onset of pubertal event in obese boys was as follows: testicular volume ≥ 4 mL, 11.3 years (11.0-11.6); genital stage ≥ 2, 11.6 yrs (11.3-11.9); and pubarche, 11.9 years (11.5-12.3). Testicular volume ≥ 4 mL occurred significantly earlier in obese boys compared to controls (-2SD < zBMI ≤ +2SD) (P = 0.01). We did not observe significant differences for either the timing of pubarche nor the genital stage ≥ 2 (P = 0.06 and P = 0.94, respectively). We demonstrate that testicular enlargement in obese boys occurs significantly earlier compared to a population-based normal-weight reference cohort.

The association between patient body mass index and perioperative outcomes following radical cystectomy: An analysis using the American College of Surgeons National Surgical Quality Improvement Program database.

Radical cystectomy is a highly morbid procedure, with 30-day perioperative complication rates approaching 50%. Our objective was to determine the effect of patients' body mass index (BMI) on perioperative outcomes following radical cystectomy for bladder cancer. We identified 3930 eligible patients who underwent radical cystectomy for non-metastatic bladder cancer using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. The primary exposure was preoperative BMI, categorically operationalized in four strata according to the World Health Organization criteria: <18.5 kg/m2, 18.5-25 kg/m2, 25-30 kg/m2, and >30 kg/m2. Our primary outcome was major perioperative complication comprising mortality, reoperation, cardiac event, or neurological event. BMI was significantly associated with rates of major complications (p=0.003): major complications were experienced by 17.0% of patients with BMI <18.5 kg/m2, 7.8% of patients with BMI 18.5-25 kg/m2, 7.9% of patients with BMI 25-30 kg/m2, and 10.8% of patient with BMI >30 kg/m2. Following multivariable adjustment for relevant demographic, comorbidity, and treatment factors, compared to patients with BMI 18.5-25 kg/m2, patients with BMI <18.5 kg/m2 (odds ratio [OR] 2.28, 95% confidence interval [CI] 1.07-4.78) and BMI >30 kg/m2 (OR 1.59, 95% CI 1.17-2.16) were significantly more likely to experience a major complication in the 30 days following cystectomy. Among the secondary outcomes, significant differences were identified in rates of pulmonary complications (p=0.003), infectious complications (p<0.001), bleeding requiring transfusion (p=0.01), and length of stay (p=0.001). Patients who are outside of a normal BMI range are more likely to experience major complications following radical cystectomy for bladder cancer.

651P - Obese and overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab

BackgroundPrevious studies showed that high and low body mass index (BMI) is associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI is associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in patients with mCRC is unclear. The aim of the study was to assess the efficacy outcomes according to BMI range in patients with mCRC treated with bevacizumab plus FOLFOX (oxaliplatin, 5-fluorouracyl, folinic acid) chemotherapy regimen. MethodsThe analysis included patients with mCRC receiving bevacizumab plus FOLFOX in the second line treatment. Patients were divided into three study groups according to BMI range: >30kg/m2 (obese patients), ≥ 25 - < 30kg/m2 (overweight patients), <25 (normal weight patients). The median PFS (progression-free survival) and OS (overall survival) of the treated patients was compared based on the BMI range. Analysis of Kaplan-Meier survival, univariate ANOVA, chi-squared tests for categorical variables were used. Analysis of variance (ANOVA) was used to determining the significance of impact on quantitative variables, while for qualitative variables chi-squared tests were used to compare patient from different BMI groups. ResultsThe study included 237 patients with mCRC. The median age of the patients was 65 years (range 34–82). The study group included 54% of males. The median OS and PFS in the study group was 14.6 and 8.8 months, respectively. The comparison of obese vs overweight vs normal BMI range patients revealed a significant difference in mOS (17.5 vs 14.3 vs 13.1 months, p=0.01) and mPFS (9.4 vs 9.1 vs 7.3 months, p=0.03). The regression analysis (Pearson’s linear correlation) also confirmed that there is a statistically significant relationship between the length of OS and PFS and the BMI value. Higher BMI was associated with a better prognosis. The location of the primary lesion on the left side of the colon, less than two metastatic sites and CEA within the normal range before start of the treatment was linked with statistically longer OS. ConclusionsObese and overweight patients presented longer OS and PFS compared with normal weight patients with mCRC cancer treated with bevacizumab plus FOLFOX chemotherapy regimen. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.