Obese Body Mass Index Groups Research Articles

Effect of body mass index on the prognosis of children and adolescents with high-grade mature B-cell non-Hodgkin lymphoma.

Little progress has been made in determining the prognostic factors for children and adolescents with high-grade mature B-cell non-Hodgkin lymphoma (HG B-NHL). Based on the important role of body mass index (BMI) in cancer, this study explored the effect of BMI on the prognosis of patients with HG B-NHL. Patients aged <18 years with newly diagnosed HG B-NHL were enrolled. Patients were divided into normal, overweight, obese, and emaciated BMI groups according to the growth criteria for children and adolescents. In total, 435 patients were enrolled in this study. There were 329 (75.6%), 46 (10.6%), 13 (3.0%), and 47 (10.8%) patients stratified into the normal, overweight, obese, and emaciated BMI groups, respectively. The event-free survival and overall survival rates of the entire cohort were 89.3% and 92.4%, respectively. The 5-year event-free survival rate for the patients with obese BMI was worse than those with overweight BMI (76.2% vs. 95.6%, p=.04). The 5-year overall survival rate for the patients with emaciated BMI was worse than those with normal (84.5% vs. 93.1%, p=.04) or overweight BMI (84.5% vs. 97.7%, p=.03). Cox multivariate analysis showed that obese or emaciated BMI at diagnosis was associated with an increased risk of death (p=0.04; HR,2.26) and was identified as an independent adverse prognostic factor in pediatric HG B-NHL. Obese or emaciated BMI at diagnosis is associated with poor prognosis in pediatric HG B-NHL and can be used for risk stratification.

The incidence of diabetes mellitus and its determining factors in a Kurdish population: insights from a cohort study in western Iran

Diabetes mellitus (DM) is among the most widespread non-communicable diseases and poses a substantial global health challenge. The aim of this study was to examine the incidence of DM and its nutritional, anthropometric, laboratory, demographic, and behavioral determinants, as well as comorbidities, within a Kurdish population residing in western Iran. This research was conducted in the Ravansar Non-Communicable Disease (RaNCD) cohort study, followed 9170 participants aged 35–65 years, for an average ± SD of 7.11 ± 1.26 years, from 2015 until 2023. A hierarchical Cox regression model was used to estimates the adjusted hazard ratios (HRs). The incidence of DM was 4.45 (95% CI 3.96, 4.99) per 1000 person-years. We found several significant predictors for DM incidence, including prediabetes, comorbidity, urban residence, total antioxidant capacity (TAC), and the interaction between gender and body mass index (BMI). Prediabetes emerged as the strongest predictor of DM incidence, with a hazard ratio of 10.13 (CI 7.84, 13.09). Additionally, having two diseases (HR = 2.18; 95% CI 1.44, 3.29) or three and more diseases (HR = 3.17; 95% CI 2.06, 4.90) increased the risk of developing DM. Also, the hazard ratios for the effects of gender on DM incidence in the normal, overweight, and obese BMI groups were 0.24, 0.81, and 1.01, respectively. The presence of prediabetes and obesity serve as the crucial indicators for the onset of DM, emphasizing the pressing need for interventions to prevent DM in these circumstances. Furthermore, there are notable disparities between urban and rural populations in this study, warranting further investigations to ascertain the underlying causes of such variations.

Comparison of Bioelectrical Impedance Analyser (BIA) with Dual-Energy X-ray Absorptiometry (DXA) Scan in Assessing the Body Composition of Adult Individuals with Type 2 Diabetes Mellitus

Abstract Introduction: Assessing the body composition is important in adult patients with type 2 diabetes mellitus to prevent and achieve optimum control during treatment. Bioelectrical impedance analysis (BIA), being a more affordable method of assessing the body composition, should therefore be compared with the gold standard dual-energy X-ray absorptiometry (DXA) to look for a correlation between the two and the potential of BIA to be used widely in this population. A cross-sectional observational study was conducted on 60 patients attending the endocrinology outpatient department (OPD) of a tertiary care centre in Kolkata, India. Methods: Body composition was measured by both BIA and DXA. Intra-class correlation (ICC) values were calculated between the two methods for fat mass and fat-free mass for three body mass index (BMI) groups and overall. Results: DXA and BIA correlated well for both fat mass and fat-free mass in the entire study population and in the non-overweight non-obese group (BMI &lt;23) and the obese group (BMI ≥25). However, the overweight group (23 ≥BMI &lt;25) did not correlate well with the above-mentioned parameters. Conclusion: We suggest interchangeable use of the two methods in the non-overweight non-obese (BM I &lt;23) and obese (BMI ≥25) BMI groups of adult subjects with type 2 diabetes mellitus. However, the low correlation for all parameters in the overweight group points towards exercising caution when taking such measurements by BIA and planning a further study with a larger cohort of such individuals to better evaluate the said correlation.

Abstract PO1-03-02: Impact of Body Mass Index (BMI) on the efficacy of different adjuvant chemotherapy schedules in patients with breast cancer: analysis from the randomized phase III GIM2 trial

Abstract Background: The long-term results of the Italian randomized phase III GIM2 study showed that, in women with node-positive breast cancer (BC), dose-dense (DD) chemotherapy significantly improved both disease-free survival (DFS) and overall survival (OS) compared with standard-interval (SI) chemotherapy. Obesity has been identified as an independent poor prognostic factor in patients with BC, with a potential negative impact on the efficacy and toxicity of systemic therapies. Nevertheless, the specific influence of body mass index (BMI) on the efficacy of different adjuvant chemotherapy schedules (DD or SI) remains a subject of debate. This analysis aimed to investigate this hypothesis in patients enrolled in the GIM2 trial. Methods: GIM2 was a randomized multicentric phase III trial that compared different chemotherapy schedule (DD vs SI) and regimen (FEC-P vs EC-P) in 2091 node-positive early breast cancer patients. BMI (kg/m2) was categorized as follows: &amp;lt; 18.5 (underweight), 18.5 to &amp;lt; 25 (lean), 25 to &amp;lt; 30 (overweight), and ≥ 30 (obese). The primary endpoint was to assess association between BMI and DFS and OS. Survival estimates were compared using the Kaplan-Meier method and log-rank test. Univariate and multivariable Cox proportional hazard models, adjusted for relevant prognostic factors, were used. Results: A total of 1925 patients were included in the present analysis, of whom 31.6% (n=632) were overweight and 19.3% (n=386) obese. Median age was 52 years. Overweight-obesity condition was significantly associated with postmenopausal status, greater representation of T2-T4 tumors with N &amp;gt; 2 in both patients in the DD and SI arm. After a median follow-up of 15.0 years (IQR 8.4-16.3), compared to patients with normal BMI, those who were overweight or obese at diagnosis had a higher risk of experiencing a DFS event (Hazard Ratio [HR] 1.11 95% CI 0.94-1.31 and HR 1.37 95%CI 1.14-1.65, respectively, p=0.003) and OS event (HR 1.11 95% CI 0.89-1.38 and HR 1.59 95%CI 1.26-2.01, respectively, p=0.0003). No significant interaction was found between BMI and treatment schedule in terms of DFS (p for interaction=0.56) nor OS (p for interaction=0.19). At the multivariate analysis, in the DD arm, adjusted HR (aHR) for DFS and for OS were 1.01 (95% CI 0.75- 1.35) and 1.04 (95% CI 0.72-1.52) for obese vs. normal BMI groups, and 0.88 (95% CI 0.68- 1.15) and 0.77 (95%CI 0.54-1.10) for overweight vs. normal BMI groups, respectively. In the SI arm, aHRs for DFS and OS were 1.24 (95% CI 0.94- 1.63) and 1.35 (95%CI 0.96- 1.90) for obese vs. normal BMI groups, and 1.04 (95%CI 0.82- 1.33) and 1.01 (95% CI 0.74-1.40) for overweight vs. normal BMI groups, respectively. Similar results were observed when considering hormone receptor-positive and negative BC separately. Conclusion: In the GIM2 trial, BMI was prognostic but not predictive of different benefit to adjuvant chemotherapy. In high-risk patients, DD schedule should be considered the preferred schedule irrespective of BMI. Citation Format: Francesca Poggio, Eva Blondeaux, Marco Tagliamento, Marta Perachino, Simone Nardin, Benedetta Conte, Sabino De Placido, Mario Giuliano, Valeria Forestieri, Michelino De Laurentiis, Adriano Gravina, Giancarlo Bisagni, Anita Rimanti, Anna Turletti, Cecilia Nisticò, Angela Vaccaro, Francesco Cognetti, Alessandra Fabi, Simona Gasparro, Ornella Garrone, Ylenia Urracci, Maria Grazia Alicicco, Mauro Mansutti, Paola Poletti, Pierpaolo Correale, Claudia Bighin, Fabio Puglisi, Filippo Montemurro, Giuseppe Colantuoni, Luca Boni, Matteo Lambertini, Lucia Del Mastro. Impact of Body Mass Index (BMI) on the efficacy of different adjuvant chemotherapy schedules in patients with breast cancer: analysis from the randomized phase III GIM2 trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-03-02.

Impact of Extremes of BMI on Outcomes following Lung Resection.

Body mass index (BMI) has been shown to be an independent predictor of survival following lung resection surgery. This study aimed to quantify the short- to midterm impact of abnormal BMI on postoperative outcomes. Lung resections at a single institution were examined between 2012 and 2021. Patients were divided into low BMI (<18.5), normal/high BMI (18.5-29.9), and obese BMI (>30). Postoperative complications, length of stay, and 30- and 90-day mortality were examined. A total of 2,424 patients were identified. Of these patients, 2.6% (n = 62) had a low BMI, 67.4% (n = 1,634) had a normal/high BMI, and 30.0% (n = 728) had an obese BMI. Overall postoperative complications were higher in the low BMI group (43.5%) when compared with normal/high (30.9%) and obese BMI group (24.3%) (p = 0.0002). Median length of stay was significantly higher in the low BMI group (8.3 days) compared with 5.2 days in the normal/high and obese BMI groups (p < 0.0001). Ninety-day mortality was higher in the low (16.1%) compared with the normal/high (4.5%) and obese BMI groups (3.7%) (p = 0.0006). Subgroup analysis of the obese cohort did not elucidate any statistically significant differences in overall complications in the morbidly obese. Multivariate analysis determined that BMI is an independent predictor of reduced postoperative complications (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.97; p < 0.0001) and 90-day mortality (OR, 0.96; 95% CI, 0.92-0.99; p = 0.02). Low BMI is associated with significantly worse postoperative outcomes and an approximate fourfold increase in mortality. In our cohort, obesity is associated with reduced morbidity and mortality following lung resection surgery, confirming the existence of the obesity paradox.

A Descriptive Research of Decreased Heart Rate Variability as a Risk Factor for Cardiovascular Disease in Young, Healthy Adults with Low and High BMI Indexes

Background and objectives: HRV is used to evaluate autonomic nervous system input to the heart. Several studies have examined the effect of HRV on underweight status. To assess HRV in age-matched young people with varying BMI categories. Methods: This cross-sectional study was conducted on healthy young adults between the ages of 18 and 25. Variables of anthropometrics were measured. ECG was recorded for 5 minutes in lead II setup. Kubios HRV analyzer was used to evaluate heart rate variability. Results: HRV indices were lower in the underweight, overweight, and obese BMI groups compared to the normal weight group. Both genders exhibit an inverted U-shaped association between BMI and HF log power based on second-order polynomial regression. The correlation between BMI, waist circumference, and body fat (%) and HRV indices demonstrates a substantial relationship with heart rate variability, with waist circumference (WC) exhibiting a stronger relationship than BMI. Comparing HRV parameters between men and women of different BMI groups reveals that women exhibited more heart rate variability than men across BMI groups. Conclusion: Underweight individuals share the same elevated cardiovascular risk as the obese, and abdominal obesity is a more accurate predictor of cardiovascular risk than the body mass index (BMI).

A comparative study to determine clinical and spirometric profile among patients of asthma in different body mass index groups

Background: Overweight and obesity is the most common co-morbidity and disease modifier of asthma; it has been associated with increased risk of asthma exacerbations, worse respiratory symptoms and poor asthma control. The objective of study was to determine the relation of body mass index (BMI) with the level of asthma control and to study the clinical presentation and spirometric profile of asthma patients from different BMI groups. Materials and methods: The descriptive prospective study done among confirmed asthmatic patients who were attending the Department of Pulmonary Medicine, outpatient department (OPD) and inpatient department (IPD). The study was demographic, clinical and spirometric parameters in asthmatic patients who were on optimal pharmacotherapy among different BMI categories. Results: Total 144 diagnosed asthma patients were included; the overall mean age of the study group was 34.27 ± 11.7 years and the majority of patients 50 (34.72%) were between 18-27 years of age group. Moderate asthma (FEV1 60-79) was observed to be the most common in all BMI groups. The severe asthma (FEV1 &lt;60) was observed with BMI &gt; 30kg/m2 in asthma patients (p=0.27). Conclusions: The poor control of asthma was significantly frequent in the overweight and obese BMI group, regardless of the findings of no differences in spirometry. Our results suggest that obese individuals with asthma show a higher incidence of one-year follow-up hospitalization due to exacerbation symptoms than non-obese individuals.

Effect of Isotonic Exercise on Cardiovascular Parameters in Medical Students with Different Body Mass Indices: A Cross-sectional Study

Introduction: Obesity is a known risk factor for hypertension. Baseline Heart Rate (HR) and blood pressure are known to scale linearly with Body Mass Index (BMI) values. Recent studies have reported an exaggerated acute response of blood pressure and HR to exercise. Aim: To assess the effect of isotonic exercise on cardiovascular parameters among individuals with different body mass indices in students at Osmania Medical College and look for any association between BMI and cardiovascular responses to isotonic exercise. Materials and Methods: A cross-sectional study was conducted in the Department of Physiology at Osmania Medical College, Hyderabad, Telangana, India, from January 2022 to December 2023, involving 100 healthy individuals with different body mass indices in the age group of 17 years-30 years. The subjects were divided into four groups based on their BMI. Baseline HR, Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP) were measured for all participants. Subsequently, the participants performed isotonic exercise for three minutes. Post-exercise HR, SBP, and DBP were measured immediately. One-way ANOVA was used to determine the significance of HR, SBP, DBP, Mean Arterial Pressure (MAP), and Pulse Pressure (PP) among the different BMI groups. A p-value of &lt;0.05 was considered statistically significant. Results: A total of 100 subjects (28 males, 72 females) with a mean age of 18.64±0.92 years participated in the study. Significant differences were observed in pre-exercise HR (p=0.0002), SBP, DBP, and MAP (p&lt;0.001), and post-exercise HR, SBP, DBP, and MAP (p&lt;0.001) among the different BMI groups. Overweight and obese individuals showed an increased tendency for an exaggerated increase in HR. Changes in PP and MAP, affected by a combination of SBP and DBP, also showed statistical significance. Furthermore, there was an increased tendency for an exaggerated increase in blood pressure in the overweight and obese BMI groups. Conclusion: Individuals with higher BMI exhibit exaggerated increases in SBP, Mean and PP, as well as HR. Additionally, obese individuals demonstrated a significant elevation in DBP. The response of blood pressure and HR after exercise in overweight/obese individuals suggests a higher risk of developing hypertension and other cardiovascular diseases.

Association between Obesity Indexes and Thyroid Cancer Risk in Korean Women: Nested Case-Control Study.

Simple SummaryRegarding the association between obesity and thyroid cancer, most previous studies have focused only on body mass index (BMI), but other measures of obesity have not been studied much with inconsistent results. This study showed a significant association between increased abdominal obesity indexes, such as waist circumference (WC, ≥85.0 cm) and waist-height ratio (WHTR ≥ 0.5) as well as BMI (≥25.0 Kg/m2), and increased risk of thyroid cancer. In addition, people who had both abnormally obese levels of BMI and other obesity indexes including WC, waist–hip ratio, or WHTR showed an increased risk of thyroid cancer, compared to those with normal levels of BMI and each obesity index. These results provide evidence of the contribution of both total and central adiposity across the lifespan to thyroid cancer incidence. Risk factor modifications must be considered to explain the current thyroid cancer epidemic.Objective: This study aimed to identify the association between various obesity indexes, including waist circumference (WC), waist–hip ratio (WHR), waist–height ratio (WHTR), and BMI, and their combinations with body mass index (BMI) and thyroid cancer risk. Methods: Of the 65,639 participants who completed a follow-up survey of the Health Examinee Study (HEXA), a prospective cohort of the Korean Genome and Epidemiology Study, 412 female incident thyroid cancer cases, and 1648 birth year- and enrollment year-matched female controls were included. Multiple conditional logistic regression was used to estimate the association between obesity indexes and thyroid cancer risk. Results: The risk of developing thyroid cancer was increased by 1.37-fold (95% confidence interval (CI) = 1.03–1.81) higher in the obese BMI group (≥25.0 Kg/m2) compared to that in the normal BMI group (<23.0 Kg/m2). Obesity in terms of WC (≥85.0 cm) and WHTR (≥0.5) was associated with an increased risk of thyroid cancer (OR 1.55, 95% CI = 1.16–2.07; OR 1.37, 95% CI = 1.07–1.75, respectively). However, increased WHR levels did not show any significant association. Women with both obese levels of BMI (≥25.0 Kg/m2) and other obesity indexes (WC ≥ 85.0 cm, WHR ≥ 0.85, or WHTR ≥ 0.5) showed an increased risk of thyroid cancer with OR of 1.63 (95% CI = 1.14–2.31), 1.49 (95% CI = 1.05–2.12), and 1.42 (95% CI = 1.04–1.94), compared to those with normal levels of BMI and each obesity index. Conclusion: These results provide evidence of the contribution of both total and central adiposity across the lifespan of thyroid cancer incidence. Risk factor modifications must be considered to explain the current thyroid cancer epidemic.

Maternal Underweight and Obesity Are Associated with Placental Pathologies in Human Pregnancy.

Maternal underweight and obesity are prevalent conditions, associated with chronic, low-grade inflammation, poor fetal development, and long-term adverse outcomes for the child. The placenta senses and adapts to the pregnancy environment in an effort to support optimal fetal development. However, the mechanisms driving these adaptations, and the resulting placental phenotypes, are poorly understood. We hypothesised that maternal underweight and obesity would be associated with increased prevalence of placental pathologies in term and preterm pregnancies. Data from 12,154 pregnancies were obtained from the Collaborative Perinatal Project, a prospective cohort study conducted from 1959 to 1974. Macro- and microscopic placental pathologies were analysed across maternal prepregnancy body mass index (BMI) to assess differences in the presence of pathologies among underweight, overweight, and obese BMI groups compared to normal weight reference BMI at term and preterm. Placental pathologies were also assessed across fetal sex. Pregnancies complicated by maternalobesity had placentae with increased fetal inflammation at preterm, and increased inflammation of maternal gestational tissues at term. In term pregnancies, increasing maternal BMI associated with increased maternal vascular malperfusion (MVM), odds of an appropriately mature placenta for gestational age, and placental weight, and decreased placental efficiency. Male placentae, independent of maternal BMI, had increased inflammation, MVM, and placental efficiency than female placentae, particularly at term. Maternal underweight and obesity are not inert conditions for the placenta, and the histomorphological changes driven by suboptimal maternal BMI may serve as indicators of adversities experienced in utero and potential predictors of future health trajectories.

The effect of obesity on cost of total laparoscopic hysterectomy.

To test for the association between increasing patient body mass index (BMI) and the cost of total laparoscopic hysterectomy (TLH). Secondary outcomes include the relationship between increasing BMI and both peri- and post-operative morbidity. Retrospective cohort study of patients (N= 510) who underwent TLH between January 2017 and December 2018 at a single public tertiary teaching hospital. Morbid obesity (n= 63) was associated with significantly higher total admission costs ($19 654 vs $17 475 Australian dollars, P= 0.002), operative costs ($9447 vs $8630, P= 0.017) and total costs including readmissions ($20 476 vs $18 399, P= 0.016) when compared to patients with normal BMI (n= 103) and adjusting for age, indication for surgery, additional procedures and conversion to total abdominal hysterectomy. Costs for overweight (n= 134) and obese (n= 210) BMI groups did not differ from costs for the normal BMI group. Increased operative costs observed in the morbidly obese group, were largely driven by the time associated with set-up, transfer and anaesthetic time while surgical and recovery times were not statistically significant. The total cost of TLH is increased in the morbidly obese category of patients. The operative costs appear to be related to pre-operative measures such as theatre set-up and anaesthetic requirements. TLH in the obese and morbidly obese category group is not associated with increased intra-operative or post-operative complications. There may be a role for exploring improvements in managing morbidly obese patients in the pre-operative setting.

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.

Effect of age and menopause on anthropometric parameters in non-obese and obese South Indian women

Background: Men and women show differences in the distribution of body fat. Women tend to store more fat subcutaneously compared to men. Fat distribution changes in postmenopausal women. Understanding the changes in anthropometry with age and menopausal status is important in the context of deriving population, age, and gender-specific cutoff levels for obesity indices. Aims and Objectives: This study was conducted with the objectives of measuring Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) in South-Indian women and determining the effect of age and menopause on the anthropometric parameters in non-obese and obese women. Materials and Methods: 290 women between the age group of 30 to 70 years participated in this analytical cross-sectional study. Age and menopausal status were recorded. Anthropometric parameters such as weight, height, WC, and hip circumference were measured. Body-mass index, WHR, and WHtR were derived. The data were analyzed to compare mean values of anthropometric parameters between premenopausal and postmenopausal women using unpaired t-test. The difference in anthropometric status was also compared between those with Body mass index (BMI) in the non-obese range and those with BMI in the obese range in relation to menopausal status. Results: A higher proportion of women were classified as having abdominal obesity based on WHtR cutoff compared to classifying using WC cutoff. Postmenopausal women showed higher mean values of all measured anthropometric parameters, but the difference was significant only for WHR. When the study subjects were analyzed based on BMI categories, a significant difference between pre and post-menopausal women was recorded in WHtR values in the non-obese BMI group, but not in the obese BMI group when analyzed by unpaired t-test. Conclusion: Anthropometric parameters show an increasing trend as age advances. There is a difference in mean values of all parameters between pre and post-menopausal women, though statistical significance was seen only for WHR and WHtR in different sub-groups based on BMI. Further studies are needed to decide on the need for separate cutoff values for postmenopausal women.

Perioperative outcomes in obese women with uterine cancer

Objectives: Obesity is a known independent risk factor for endometrial cancer that is continuing to increase in incidence throughout the United States. There is limited data on perioperative outcomes among women with endometrial cancer and obesity, especially in the era of increasing prevalence of minimally invasive surgery. We examined the association between obesity and perioperative outcomes in patients who underwent hysterectomy for uterine cancer. Methods: The National Surgical Quality Improvement Program (NSQIP) database was utilized to identify women with uterine cancer who underwent hysterectomy between the years of 2007 and 2018. Patients were classified into body mass index (BMI) groups: normal (<25), overweight (25-29.9), and obese (≥30). Analyses were also performed that stratified the obese BMI group into 30-39.9, 40-49.9, and ≥50. Multivariable logistic regression models were developed to determine clinical and demographic factors associated with perioperative morbidity and mortality. The associations between BMI group and route of hysterectomy and performance of lymph node dissection were examined using log-linear regression models. Results: A total of 42,075 endometrial cancer patients including 15.2% who were normal weight, 20.1% who were overweight and 64.8% who were obese were identified. Compared to normal BMI and overweight patients, obese patients were more likely to undergo minimally invasive hysterectomy (73.7% for obese, 72.0% for overweight, 71.6% for normal BMI; P=0.0018) and were less likely to have a lymph node dissection during surgery (53.3% for obese, 60.0% for overweight, 58.9% for normal BMI; P<0.0001). There were no differences in perioperative outcomes based on three BMI groups (normal, overweight, and obese with BMI ≥30). However, compared to women with normal BMI, those with BMI ≥50 were more likely to have any complications (6.8% vs 4.4%; aRR 1.30; 95% CI, 1.07-1.58), severe (Clavian IV) complications (3.3% vs. 1.8%; aRR 1.53; 95% CI, 1.15-2.04), readmission (6.8% vs. 4.4%; aRR 1.37; 95% CI, 1.12-1.66), and reoperation (2.4% vs 1.2%; aRR 1.76; 95% CI, 1.24-2.49). Perioperative mortality was not statistically different among any of the obese cohorts compared to those with normal BMI. Conclusions: Obese women with endometrial cancer who undergo hysterectomy are more likely to have minimally invasive procedures and less likely to have lymph node dissections. Those with BMI ≥50 are at higher risk for severe perioperative complications and reoperation. Obesity is a known independent risk factor for endometrial cancer that is continuing to increase in incidence throughout the United States. There is limited data on perioperative outcomes among women with endometrial cancer and obesity, especially in the era of increasing prevalence of minimally invasive surgery. We examined the association between obesity and perioperative outcomes in patients who underwent hysterectomy for uterine cancer. The National Surgical Quality Improvement Program (NSQIP) database was utilized to identify women with uterine cancer who underwent hysterectomy between the years of 2007 and 2018. Patients were classified into body mass index (BMI) groups: normal (<25), overweight (25-29.9), and obese (≥30). Analyses were also performed that stratified the obese BMI group into 30-39.9, 40-49.9, and ≥50. Multivariable logistic regression models were developed to determine clinical and demographic factors associated with perioperative morbidity and mortality. The associations between BMI group and route of hysterectomy and performance of lymph node dissection were examined using log-linear regression models. A total of 42,075 endometrial cancer patients including 15.2% who were normal weight, 20.1% who were overweight and 64.8% who were obese were identified. Compared to normal BMI and overweight patients, obese patients were more likely to undergo minimally invasive hysterectomy (73.7% for obese, 72.0% for overweight, 71.6% for normal BMI; P=0.0018) and were less likely to have a lymph node dissection during surgery (53.3% for obese, 60.0% for overweight, 58.9% for normal BMI; P<0.0001). There were no differences in perioperative outcomes based on three BMI groups (normal, overweight, and obese with BMI ≥30). However, compared to women with normal BMI, those with BMI ≥50 were more likely to have any complications (6.8% vs 4.4%; aRR 1.30; 95% CI, 1.07-1.58), severe (Clavian IV) complications (3.3% vs. 1.8%; aRR 1.53; 95% CI, 1.15-2.04), readmission (6.8% vs. 4.4%; aRR 1.37; 95% CI, 1.12-1.66), and reoperation (2.4% vs 1.2%; aRR 1.76; 95% CI, 1.24-2.49). Perioperative mortality was not statistically different among any of the obese cohorts compared to those with normal BMI. Obese women with endometrial cancer who undergo hysterectomy are more likely to have minimally invasive procedures and less likely to have lymph node dissections. Those with BMI ≥50 are at higher risk for severe perioperative complications and reoperation.

Hospital-Based Phenotypic Features and Treatment Outcomes of Chinese Women with Polycystic Ovary Syndrome: The Effect of Body Mass Index and Geographic Distribution

Genetic, lifestyle, and environmental factors contribute to the etiology of polycystic ovary syndrome (PCOS). Increased body mass index (BMI) exacerbates the reproductive and metabolic parameters and reduces the fecundity of women with PCOS. This is a secondary analysis of a large-sample, multicenter, randomized controlled trial conducted at 21 sites in Chinese mainland. A total of 1000 women diagnosed with PCOS were enrolled in this trial. Of these, 998 women with PCOS were included in the analysis. Increased BMI was associated with more severe menstrual irregularities, elevated testosterone level, higher prevalence of metabolic syndrome, and poorer quality of life. The rates of ovulation per woman for the normal, overweight, and obese BMI groups were 83.0%, 78.2%, and 63.6%, respectively (P < 0.001), and the rates of live birth were 23.6%, 18.1%, and 15.3% (P = 0.030). Northern PCOS patients showed more severe reproductive, glucose, and lipid profiles; less exercise; and lower total ovulation rates compared with PCOS patients from Southern China (74.8% vs 81.2%, absolute difference 6.4%, 95% confidence interval 1.2%–11.5%). The results show the typical phenotypic features of Han women with PCOS in Northern and Southern China. The women living in Northern China showed a higher BMI, more severe glycolipid metabolism profiles, and subsequently worse clinical outcomes by the same interventions than those living in Southern China. The difference in phenotypic features can be explained mostly by differences in BMI and the resulting difference in ovulation.

Association of blood pressure and BMI to corrected QT interval in young adults.

Hypertension is often associated with obesity. Uncontrolled hypertension can lead to uncorrected cardiac dysautonomia that makes cardiac repolarization abnormally prolonged. Modern dietary habits, stress, and bad lifestyle habits make young adults vulnerable to hazards of health. We planned to study the association of body mass index (BMI) and blood pressure (BP) with corrected QT (QTc) intervals in young adults. After obtaining the written informed consent, 171 subjects were randomly selected in the age group of 18-35 years. A general history and physical examination were done before recording the BMI and BP. A 12-lead electrocardiogram was recorded and QTc calculated using Bazett's formula. The values obtained were compared and statistical analysis done. Of the 171 subjects 14.03% were hypertensive. The QTc interval was found to be prolonged in females and it is prolonged with age, BMI, and BP. QTc was significantly increased among the prehypertensive and hypertensive group and with the overweight and (or) obese BMI group compared with the normotensives and normal BMI group suggesting an altered autonomic homeostasis. This warrants lifestyle modification at a younger age to reduce the cardiovascular risk.

Do Serum Urate-Associated Genetic Variants Differentially Contribute to Gout Risk According to Body Mass Index? Analysis of the UK Biobank.

To examine whether urate-associated genetic variants differ in their influence on gout risk according to body mass index (BMI). This research was conducted using the UK Biobank Resource (n = 358,728). Participants were divided into 3 groups: BMI <25 kg/m2 (low/normal), BMI ≥25 kg/m2 -<30 kg/m2 (overweight), and BMI ≥30 kg/m2 (obese). Gene-BMI interactions for gout association were tested by logistic regression using a urate genetic risk score (GRS). Compared to participants with a GRS less than the mean, the prevalence of gout was higher in those with a GRS greater than or equal to the mean in the low/normal BMI group (0.27% versus 0.77%), in the overweight BMI group (1.02% versus 3.02%), and in the obese BMI group (2.49% versus 6.23%). A GRS greater than or equal to the mean was positively associated with gout compared to a GRS less than the mean in the low/normal BMI group (odds ratio [OR] 2.89 [95% confidence interval (95% CI) 2.42-3.47]), in the overweight BMI group (OR 3.09 [95% CI 2.84-3.36]), and in the obese BMI group (OR 2.65 [95% CI 2.46-2.86]). There was a mildly attenuated effect of the GRS on gout risk in the obese BMI group compared to the overweight BMI group, but no difference in the effect of the GRS between the low/normal BMI and overweight BMI groups, nor between the low/normal BMI and obese BMI groups. The association of a urate GRS with gout is mildly attenuated in obese individuals compared to overweight individuals. However, genetic variants have a strong effect on gout risk in those with overweight and obese BMIs, with an effect similar to that observed in low/normal BMI.

Effect of body mass index on vital capacity in young adults - A cross-sectional study

Background: Childhood obesity is rising at an astonishing rate over the last decade globally making the individual highly susceptible to various diseases. It has transformed into a major public health issues in India. These changes may reduce the compliance of the lungs and the thoracic cavity and increase the load on the respiratory muscles. This may end up with the reduction in lung volumes, especially vital capacity (VC). Aim and Objective: The aim of the study is to see the effect of body mass index (BMI) on the VC in young adults. Materials and Methods: This cross-sectional analytical study was undertaken over a period of 12 months in the Physiology Department of Sridev Suman Subharti Medical College on 300 healthy individuals with age of 18–35 years old to determine the baseline anthropometric measurement followed by measurement of one stage VC using a student’s spirometer. Subjects having cardio or pulmonary condition were excluded from the study. Two separate groups were assigned according to BMI normal (Group A) with BMI 25 kg/m2. Mean ± SD of BMI and VC for both groups were calculated. Results: The VC showed a statistically significant decline in overweight/obese individuals. The mean BMI in Group A (normal) was 20.80 ± 2.28, whereas in Group B (obese) was 29.27 ± 2.77. The mean VC was 3.83 ± 0.84 L in normal BMI group as compared to 4.05 ± 0.64 L in obese BMI group. Conclusion: The VC showed a compromised status in overweight/obese individuals. This difference can be attributed to the presence of adipose tissue around the ribcage, in the abdomen and visceral cavity loading the chest wall, leading to small airway collapse and subsequent lowering of the VC.

EP1.04-39 Is Body Mass Index a Prognostic Factor in Patients with Lung Cancer Treated with Immunotherapy?

Non-small cell lung cancer (NSCLC) is a prevalent disease with high mortality and poor response to traditional cytotoxic therapy. Immune checkpoint inhibitors (ICI) approvals were the landmark in the last years for the treatment of lung cancer. With these treatments, many patients with advanced disease are starting to see durable responses and longer survival rates. Several factors like obesity has been previously investigated for its role in cancer and promoting tumor growth, at least partially by inducing a chronic inflammatory state, but it’s unclear how it links to immunotherapy, where inflammation has been linked to treatment response,” High Body mass index (BMI) might have a positive impact in the outcomes of patients who are taking PD-1 or PD-L1 inhibitors, according to a recent study. In this study, we aim to determine if the body mass index (BMI) is a prognostic factor in patients treated with immunotherapy We retrospectively evaluated the outcomes of 30 patients with NSCLC confirmed histology, aged 18 years or older, treated with anti PD-1/PD-L1 from 2016 to 2018. BMI was stratified unto 2 groups: 1) normal and under-weighted (BMI < 25 kg/ m2) and 2) over-weighted and obese (BMI ≥ 25 kg/ m2). Simple descriptive statistics were created for all covariates. After statistical analyses with Kruskal-Wallis equality-of-populations rank test were related to progression free survival (PFS). A total of 30 lung cancer patients were enrolled in this study, divided by gender as 10 female-patients (33,33%) and 20 masculine-patients (66,67%) The median age was 63 years (youngest 41-year-old and oldest 81 years old). According to histology 20 patients have adenocarcinoma (66,67 %) and 10 patients have squamous tumors (33,33%). Analyzing the mutational status, the majority was EGFR Wild type (WT). The majority of patients involved (43,33 %; 13 patients) were given immunotherapy in the third-line setting or beyond. More than half of patients had over-weighted and obese BMI (group 2 – 56,67% (n=17)). The median follow-up was 86 days (1 quartile 35 days and 3rd quartile 291 days (minimum 5 days, maximum 971 days). The median PFS in group 1 was 98 days (1 quartile 56 days and 3rd quartile 407 days (minimum 28 days, maximum 495 days) and in over-weighted and obese was 74 days (1quartil 26 days and 3rd quartile 127 days (minimum 5 days, maximum 971 days). There were no statistical differences in PFS (p= 0,249) between higher or lower BMI groups (group1 vs. group 2). In this single institution cohort, BMI hadn’t a significant effect on outcomes of patients with lung cancer receiving anti PD-1/PD-L1 agents. As a critic to this evaluation we have that is for now a small group of patients and we think it is important to maintain studies in this field as the number of patients under this therapy increases.

T Cells and Natural Killer Cells, but Not B Cells or Antibodies, are Affected in Overweight and Obese Saudi Females

Saudi Arabia has one of the highest adult overweight and obesity rates, especially in females, leading to increased mortality, morbidity, infections, and risk for many diseases. This study determined the counts and percents of lymphocyte subtypes (CD3, CD4, CD8, and CD16 +CD56 cells) and serum IgG, IgA, and IgM concentrations in blood samples collected from sixty-four Saudi female university employees with an age range of 24-52 years. There is only one other study on the counts/numbers of lymphocyte subtypes in overweight and obese Saudi females. Anthropometric measurements were used to categorize the subjects into groups according to the body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Results were all compared to the controls. Antibody concentrations were not significantly different. The CD3and CD4 counts were significantly higher for the obese BMI group and the overweight and obese BMI, respectively. The high-risk WHR group had a significantly lower CD 3% and a significantly higher CD16 + CD56 count. The high-risk WC group had significantly higher CD3 and CD4 counts and a significantly lower CD16 + CD56%. Thus, obesity leads to changes in the cellular adaptive and innate immune systems, while not affecting the humoral adaptive immune system.