Underweight Body Mass Index Research Articles

Long-term weight patterns and physical activity in gallstones

While obesity, rapid weight loss, and sedentary lifestyles contribute to gallstones, the impacts of long-term weight patterns and physical activity on gallstone risk have not been extensively studied at the population level. Using Korea’s population-based health database, we created a cohort of 5,062,154 subjects who received over five consecutive biannual health check-ups from 2002 to 2018. Gallstone risk was calculated using hazard ratios (HRs) based on weight patterns (gain, loss, and cycling) and physical activity. Adjustments were made for covariates, such as body mass index (BMI), waist circumference, diabetes, and life style factors. Subgroup analysis was performed by sex and age groups (< 45 and ≥ 45 years). All groups with weight changes showed increased HRs 1.32 (95% CI 1.07–1.65) for > 20% weight loss, 1.13 (0.96–1.33) for > 20% weight gain, 1.04 (1.02–1.06) for weight cycling, 1.03 (1.01–1.05) for 5–20% weight gain, and 1.02 (1.00–1.04) for 5–20% weight loss. Risk increased with weight loss or gain in underweight or overweight BMI categories, respectively, and in any weight change for normal BMI. Males and older individuals had higher risks with weight loss, while females and younger individuals had higher risks with weight gain. Weight cycling increased risk for both sexes. Regular physical activity reduced gallstone risk in weight changers to levels similar to weight maintainers, with the highest reduction in those with > 20% weight gain (61%) and the lowest in weight cycling (1%). The risks of gallstones associated with weight gain, loss, or cycling can be mitigated by regular physical activity. The risks vary by sex and age.

Variation in surgical treatment by body mass index in patients with invasive lobular carcinoma of the breast

PurposePatients with invasive lobular carcinoma (ILC) face high rates of positive margins and completion mastectomy, which can be improved with the use of specific techniques, such as oncoplastic surgery. However, prior studies have shown that type of breast cancer surgery performed is also associated with patient factors such as elevated body mass index (BMI). Thus, this study investigates whether BMI impacts the type of surgical interventions in patients with ILC.MethodsA retrospective analysis of 705 patients with stage I–III ILC from an institutional database was conducted. Patients were stratified by BMI (underweight, normal weight, overweight, obese). Pearson’s Chi-square, ANOVA, and multivariable logistic regression were used to evaluate the relationship between BMI and surgical procedures.ResultsBreast-conserving surgery (BCS) was the initial operation in 60% of patients, with no significant difference by BMI. Among those undergoing BCS, patients with obese BMI were significantly more likely to undergo oncoplastic surgery (46.9% vs. 7.7%, 37.3%, and 33.6% for underweight, normal, and overweight, respectively, p = 0.032). Obese BMI patients undergoing mastectomy were less likely to have reconstruction compared to those with underweight, normal weight, and overweight BMI (44.2% vs. 50%, 71.1%, and 64.1%, p = 0.002).ConclusionOverweight/obese BMI patients with ILC underwent different surgical interventions compared to those with lower BMI. While initial BCS rates were similar, overweight/obese patients had higher oncoplastic surgery rates in BCS and lower reconstruction rates in mastectomy. Further research is needed to understand BMI’s impact on surgical decisions and outcomes in ILC.

The association between maternal fruit consumption before and during pregnancy and fetal growth: The Lanzhou birth cohort study

BackgroundThe association between maternal fruit consumption and fetal growth remains inconsistent. The current study aimed to determine whether maternal fruit consumption was associated with low birth weight (LBW) or small for gestational age (SGA) babies. MethodsA large birth cohort study was conducted in Lanzhou, China, from 2010 to 2012 and included 10,076 pregnant women at the 1st, 2nd, and 3rd trimester of pregnancy for analysis. Fruit consumption in the 1st, 2nd, and 3rd trimester of pregnancy was measured by a self-designed food frequency questionnaire (FFQ) and divided into three groups: 1) inadequate fruit consumption: <200 g/d for the1st, 2nd, and 3rd trimester; 2) adequate fruit consumption: 200–350 g/d for the 1st trimester or 200–400 g/d for the 2nd and 3rd trimester; 3) excessive fruit consumption: >350 g/d for the 1st trimester or > 400 g/d for the 2nd and 3rd trimester. A case-control study was used to analyze the association between fruit intake during pregnancy and low birth weight infants. ResultsCompared to adequate fruit consumption, excessive fruit consumption throughout each trimester of pregnancy was associated with a lower risk of LBW, with an odds ratio (OR) ranging from 0.70 to 0.79 (95 % confidence interval, CI: 0.57–0.98); while inadequate fruit consumption was associated with a higher risk of infant LBW, with an OR ranging from 1.26 to 1.36 (95%CI: 1.04–1.66). After stratifying by mother's pre-pregnancy body mass index (BMI), the results were similar among women with underweight BMI. No significance was found between fruit consumption and SGA in the general population. Still, stratified analyses showed that inadequate fruit consumption was associated with an increased risk of SGA in underweight mothers, with an OR ranging from 1.66 to 1.79 (95%CI: 1.13–2.64). ConclusionsFruit consumption during pregnancy reduces the risk of LBW in Chinese women, especially in women with low pre-pregnancy BMI.

Gestational weight gain as a mediator of the relationship between pre-pregnancy body mass index and the risk of preterm birth: A four-way decomposition analysis.

The aim of the present study was to examine and quantify whether the association between preterm birth (PTB) and pre-pregnancy body mass index (BMI) is mediated by gestational weight gain (GWG). This is a secondary analysis of a large randomized community non-inferiority trial using a cohort design. The data of 26 101 pregnant women in their first trimester who sought prenatal care and met eligibility criteria were included. The four-way decomposition method was applied to screen for all types of association effects of pre-pregnancy BMI on the risk of PTB. These effects include the total, direct, and various indirect effects including pure mediation via GWG, interactive effects with GWG, and mediated interaction with GWG, all adjusted for potential confounders. Among the study participants, 24 461 (93.7%) had term deliveries, while 1640 (6.3%) experienced PTB. The results of the study showed that there was a positive association between pre-pregnancy BMI among those with BMI more than 25 kg/m2 and the risk of PTB and this association was negatively mediated and interacted by GWG, which differed quantitatively between those who had inadequate, adequate, or excessive GWG. The total association effect showed that the risk was lowest for those who had underweight pre-pregnancy BMI and adequate GWG (excess relative risk [RR]: 0.06, 95% CI: 0.01-0.11, P value: 0.022) and was highest for those who had obese pre-pregnancy BMI and excessive GWG (excess RR: 0.67, 95% CI: 0.35-1.00, P value <0.001). The findings of the present prospective population-based study demonstrated that pre-pregnancy BMI >25 kg/m2 is directly and positively associated with the risk of preterm birth. The highest risk of preterm birth was observed among individuals with an obese pre-pregnancy BMI who also experienced excessive GWG.

The prevalence of gestational diabetes among underweight and normal weight women worldwide: a scoping review.

Gestational diabetes (GDM) affects nearly 15% of pregnancies worldwide and is increasing globally. While this growth is thought to be primarily from overweight and obesity, normal and underweight women are affected as well, particularly in low and middle-income countries. However, GDM in non-overweight women remains understudied. Thus, we examined the prevalence among normal and underweight women globally. A comprehensive literature search was performed in Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library. Studies retrieved were screened for eligibility against predefined inclusion/exclusion criteria. Prevalence of GDM among women with normal and underweight body mass index (BMI) was extracted, and average prevalence was calculated globally, by World Health Organization region, and by country. Pregnancy outcomes were described when available. A total of 145 studies were included. The average global prevalence of GDM among non-overweight women (BMI <25 kg/m2) was 7.3% and among underweight women (BMI <18.5 kg/m2) was 5.0%. GDM prevalence in non-overweight women was highest in Asia (average 12.1%) and lowest in the African region (0.7%). The countries with the highest prevalence were Vietnam (21.1%), Finland (19.8%), Poland (19.3%), Bangladesh (18.65%), and China (17.7%). The average global prevalence of large for gestational age infants (LGA) born to non-overweight women with GDM was 9.9%, which is lower than the average prevalence in the general population with GDM (14%). GDM is more common than previously recognized in non-overweight women, particularly in Asia, but also in European countries. Non-overweight women with GDM had lower prevalence of LGA babies compared to prior reported prevalence in all women with GDM, though data on pregnancy outcomes was limited. These findings challenge guidelines that recommend restriction of weight gain for GDM management. Further research on the pathophysiology and complications of GDM in women who are not overweight should be urgently conducted to inform appropriate management guidelines and support optimal pregnancy outcomes.

Obesity and Survival After Immune Checkpoint Inhibition for Head and Neck Squamous Cell Carcinoma

For patients treated with immune checkpoint inhibitors (ICIs), recent data suggest that obesity has a beneficial effect on survival outcomes in various cancer types. Reports on this association in head and neck cancer are limited. To compare overall survival (OS) to 5 years and functional outcomes in patients with head and neck squamous cell carcinoma (HNSCC) treated with ICIs based on pretreatment body mass index (BMI). This retrospective population-based cohort study used data obtained from the TriNetX Global Collaborative Network database to identify patients with HNSCC who received ICI treatment between January 1, 2012, and December 31, 2023, resulting in a total of 166 patients (83 with BMI of 20.0-24.9 [normal BMI] and 83 with BMI of ≥30.0 [obesity BMI]) after propensity score matching (PSM) for pretreatment medical comorbidities and oncologic staging. Normal BMI vs obesity BMI. Overall survival and functional outcomes (dysphagia, tracheostomy dependence, and gastrostomy tube dependence) were measured to 5 years after ICI treatment and compared between patients with obesity BMI and normal BMI. Additional analyses compared OS and functional outcomes in the cohort with normal BMI and cohorts with overweight BMI (25.0-29.9) and underweight BMI (<20.0). Among the 166 patients included in the PSM analysis (112 men [67.1%]; mean [SD] age, 62.9 [15.4] years), obesity BMI was associated with significantly improved OS at 6 months (hazard ratio [HR], 0.54 [95% CI, 0.31-0.96]), 3 years (HR, 0.56 [95% CI, 0.38-0.83]), and 5 years (HR, 0.62 [95% CI, 0.44-0.86]) after ICI treatment, compared with patients with normal BMI. Obesity BMI was also associated with decreased risk of gastrostomy tube dependence at 6 months (odds ratio [OR], 0.41 [95% CI, 0.21-0.80]), 1 year (OR, 0.41 [95% CI, 0.21-0.78]), 3 years (OR, 0.35 [95% CI, 0.18-0.65]), and 5 years (OR, 0.34 [95% CI, 0.18-0.65]). Obesity was also associated with decreased risk for tracheostomy dependence at 1 year (OR, 0.52 [95% CI, 0.28-0.90]), 3 years (OR, 0.45 [95% CI, 0.45-0.90]), and 5 years (OR, 0.45 [95% CI, 0.45-0.90]). There were no differences in rates of dysphagia or immune-related adverse events between cohorts at any points. Using population-level data for patients with HNSCC treated with ICIs, these results suggest that having obesity was associated with improved 6-month, 3-year, and 5-year OS compared with having normal BMI. Additionally, obesity was associated with decreased gastrostomy and tracheostomy tube dependence compared with normal BMI. Further investigation is required to understand the mechanism of these findings.

Baseline anemia and its associated factors among adult cancer patients at Northwest Amhara Regional State Referral Hospitals, Northwest Ethiopia, 2021.

Currently, the problem of cancer has been increasing around the world, predominantly in middle- and low-income countries. Anemia, a major and often overwhelming health burden for cancer patients, significantly distorts their quality of life. It is well-established that the length of treatment increases the frequency of anemia, with hematological malignancies experiencing nearly double the rate compared to solid tumors. Despite this established knowledge, data on the prevalence of anemia among cancer patients in Ethiopia remains scarce, according to the investigators. This study aimed to assess the prevalence of baseline anemia and associated factors among adult cancer patients at Northwest Amhara Comprehensive Specialized Hospitals, oncology treatment units, Northwest Ethiopia, in 2021. This study employed an institutional-based cross-sectional design and was conducted in Northwest Amhara Comprehensive Specialized Hospitals. A systematic random sampling technique was used to select 315 participants. The data were collected using interviewer-administered questionnaires and chart reviews of existing medical records using a structured and pretested questionnaire format. The data were entered into Epi. Data version 4.6 and analyzed using Stata version 14.0. Bivariable and multivariable logistic regression were carried out to identify factors associated with anemia. Adjusted odds ratios with a 95% confidence interval and variables with a p-value of < 0.05 were considered significantly associated with anemia. The prevalence of baseline anemia among adult patients with cancer was found to be 34.84%. Being a woman (AOR = 1.97; 95% CI: 1.00-3.87), being underweight (AOR = 1.96; 95% CI: 1.09-3.52), and having stage III cancer (AOR = 2.35; 95% CI: 1.12-3.01) were significantly associated with anemia. The prevalence of baseline anemia among adult cancer patients was significant. Women, cancer patients with an underweight body mass index, and those diagnosed with clinical-stage III cancer were more likely to have baseline anemia. For health policymakers and healthcare providers, it is better to give special attention to female patients, patients who are underweight, and patients with advanced-stage cancer to reduce the risk of developing the outcome. This would allow for timely intervention to manage anemia and potentially improve treatment tolerance and quality of life for cancer patients.

Predictors for Failed Removal of Nasogastric Tube in Patients With Brain Insult.

To construct a prognostic model for unsuccessful removal of nasogastric tube (NGT) was the aim of our study. This study examined patients with swallowing disorders receiving NGT feeding due to stroke or traumatic brain injury in a regional hospital. Clinical data was collected, such as age, sex, body mass index (BMI), level of activities of daily living (ADLs) dependence. Additionally, gather information regarding the enhancement in Functional Oral Intake Scale (FOIS) levels and the increase in food types according to the International Dysphagia Diet Standardization Initiative (IDDSI) after one month of swallowing training. A stepwise logistic regression analysis model was employed to predict NGT removal failure using these parameters. Out of 203 patients, 53 patients (26.1%) had experienced a failed removal of NGT after six months of follow-up. The strongest predictors for failed removal were age over 60 years, underweight BMI, total dependence in ADLs, and ischemic stroke. The admission prediction model categorized patients into high, moderate, and low-risk groups for removal failure. The failure rate of NGT removal was high not only in the high-risk group but also in the moderate-risk groups when there was no improvement in FOIS levels and IDDSI food types. Our predictive model categorizes patients with brain insults into risk groups for swallowing disorders, enabling advanced interventions such as percutaneous endoscopic gastrostomy for high-risk patients struggling with NGT removal, while follow-up assessments using FOIS and IDDSI aid in guiding rehabilitation decisions for those at moderate risk.

Cross-sectional and longitudinal associations between PG-SGA criteria with survival of cancer patients.

e23277 Background: Malnutrition is prevalent in cancer patients and is associated with treatment efficacy and clinical outcomes. Whether the available malnutrition assessment tools contain optimal survival prediction value for cancer patients, especially from developing countries, remains unclear. Methods: In this retrospective cohort study, cancer patients were selected from our center between Nov 2019 and Sep 2023. According to the PG-SGA criteria, PG-SGA scores &lt; 4 referred to well-nourished, ≥ 4 PG-SGA scores &lt; 9 referred to malnutrition, and ≥ 9 referred to severe malnutrition. Kaplan-Meier (KM) curves were used to estimate the survival patterns of cancer patients with varied levels of PG-SGA scores. The Cox proportional hazard model was used to evaluate the association between baseline and longitudinal changes of PG-SGA scores with the all-cause mortality of cancer patients. Subgroup analysis with interaction tests was used to determine the high-risk subgroups. A series of sensitive analyses were performed to validate the findings we determined. Results: There were 1,415 cancer patients included in our study, with a mean age of 46 years old. The mean PG-SGA score was 2.42 in non-malnourished patients, 10.10 in malnourished patients, and 12.65 in severely malnourished patients, respectively. The KM curves showed that cancer patients with severe malnourished status (PG-SGA ≥9) presented the lowest short- and long-term survival probability, compared with the other two subgroups. A linear trend was observed between the PG-SGA scores and cancer mortality (p for overall test &lt; 0.001). The Cox regression analysis showed that baseline malnourished status was significantly associated with the survival of cancer patients [≥4 PG-SGA &lt; 9: hazard ratio (HR): 1.46, 95% confidence interval (CI): 1.09 – 1.96, p = 0.012; PG-SGA ≥9: HR = 1.78, 95%CI: 1.34 – 2.37, p &lt; 0.001]. Cancer patients with longitudinal increased PG-SGA scores ( &gt; 2 points) were observed to have a high risk for mortality (HR = 1.69, 95%CI: 1.04 – 2.74, p = 0.033). Compared with longitudinal changes in PG-SGA scores, the baseline PG-SGA scores showed significantly higher predictive power in identifying the risk subgroup (concordance index: 0.646 vs. 0.586, p &lt; 0.001). PG-SGA scores showed more pronounced predicting value among subgroups with features of younger age, normal and underweight body mass index, late cancer stage, without history of diabetes, smoking, radiotherapy, and immunotherapy. A series of sensitive analyses determined consistent correlations. . Conclusions: Our study validates the clinical value of baseline, as well as longitudinal changes of PG-SGA, scored status for predicting the survival of cancer patients. Our findings provide new insights into the identification and prevention strategies for malnourished conditions in cancer patients, resulting in improved cancer-related nursing in resource-limited regions.

Maternal pre-pregnancy BMI influences the associations between bisphenol and phthalate exposures and maternal weight changes and fat accumulation

BackgroundBisphenols and phthalates are two classes of endocrine-disrupting chemicals (EDCs) thought to influence weight and adiposity. Limited research has investigated their influence on maternal weight changes, and no prior work has examined maternal fat mass. We examined the associations between exposure to these chemicals during pregnancy and multiple maternal weight and fat mass outcomes. MethodsThis study included a sample of 318 women enrolled in a Canadian prospective pregnancy cohort. Second trimester urinary concentrations of 2 bisphenols and 12 phthalate metabolites were quantified. Self-reported and measured maternal weights and measured skinfold thicknesses were used to calculate gestational weight gain, 3-months and 3- to 5-years postpartum weight retention, late pregnancy fat mass gain, total postpartum fat mass loss, and late postpartum fat mass retention. Adjusted robust regressions examined associations between chemicals and outcomes in the entire study population and sub-groups stratified by pre-pregnancy body mass index (BMI). Bayesian kernel machine regression examined chemical mixture effects. ResultsAmong women with underweight or normal pre-pregnancy BMIs, MBzP was negatively associated with weight retention at 3- to 5-years postpartum (B = −0.04, 95%CI: −0.07, −0.01). Among women with overweight or obese pre-pregnancy BMIs, MEHP and MMP were positively associated with weight retention at 3-months and 3- to 5-years postpartum, respectively (B's = 0.12 to 0.63, 95%CIs: 0.02, 1.07). DEHP metabolites and MCNP were positively associated with late pregnancy fat mass gain and late postpartum fat mass retention (B's = 0.04 to 0.18, 95%CIs: 0.001, 0.32). Further, the mixture of EDCs was positively associated with late pregnancy fat mass gain. ConclusionIn this cohort, pre-pregnancy BMI was a key determinant of the associations between second trimester exposure to bisphenols and phthalates and maternal weight changes and fat accumulation. Investigations of underlying physiological mechanisms, windows of susceptibility, and impacts on maternal and infant health are needed.

Pre-pregnancy body mass index and low birthweight: Secondary data analysis using health insurance claims data in Japan.

For women, being underweight increases their susceptibility to osteoporosis, anemia, and other conditions and affects the weight of their infants and the well-being of future generations. This study examined the association between low pre-pregnancy body mass index (BMI) and low birthweight using health insurance claims data and health checkup data, including weight measurements. We used health insurance claims data and health checkup data (JMDC, Tokyo, Japan) of women and their newborns in Japan between 2006 and 2020. We used checkup data, which included more accurate weight measurements and blood test-based diagnoses of anemia and hyperlipidemia compared to self-reported data. Maternal pre-pregnancy BMI was compared across three groups: underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), and overweight (BMI ≥25.0 kg/m2). The primary outcome was low birthweight (<2500 g), and secondary outcome was preterm childbirth. Logistic regression analyses were conducted to compare outcomes in the three groups by BMI. The underweight BMI group was considered as the reference group. A subgroup analysis was performed by maternal age. In total, 16 363 mothers (underweight, 3418 [21%], normal weight, 11 493 [70%], and overweight, 1452 [8.9%]) were included. The risk of primary outcome (low birthweight) was significantly lower in the normal weight group than in the underweight group (4.6% vs. 5.7%; adjusted odds ratio 0.78 [95% confidence interval: 0.65-0.96]). In the subgroup analyses, no significant differences were noted in the incidences of low birthweight and preterm childbirth between maternal age groups. Pre-pregnancy BMI was associated with an increased risk of delivering low-birthweight infant. Awareness about the importance of women's pre-pregnancy health and appropriate BMI may reduce the incidence of low birthweight.

CORRELATION OF BODY MASS INDEX (BMI) WITH SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN RURAL INDIAN PATIENTS

Objective: Body mass index (BMI) is positively and independently associated with morbidity and mortality from hypertension, cardiovascular disease, type II diabetes mellitus, and other chronic diseases. In Caucasian and Asian populations, a strong association has been depicted between BMI and mortality. Overweight and obesity increase the risks of high BP, coronary heart disease, ischemic stroke, type II diabetes mellitus, and certain cancers. Worldwide, about 58% of diabetes mellitus and 21% of ischemic heart disease are attributable to BMI above 21 kg/m2. The combination of blood pressure and Body Mass Index (BMI) contribute more than 60% cases of cardiovascular disease. The main objective was to determine the correlation between BMI and blood pressure of rural Indian patients. Design and method: This cross sectional study used 310 patients who visited our hospital in rural India from January 15,2021 to February 15,2021. Data were collected directly by measuring the blood pressure, weight and height to determine BMI. BMI was derived from booking weight (kilograms) and height (meters). Using this, the patients were categorized as underweight (&lt;18.5 kg/m2), normal or lean BMI (18.5–22.9 kg/m2), overweight (23.0 –24.9 kg/m2) and obese (&gt; 25 kg/m2) based on the revised consensus guidelines for India. Descriptive analysis and Spearman correlation test were used to analyze the data. Results: The results of the bivariate analysis using Spearman correlation test showed that there was significant relationship between BMI and systolic blood pressure (p &lt; 0.001, r = 0.375) or diastolic blood pressure (p &lt;0.001, r = 0.432). This study shows that higher BMI was associated with increase in systolic as well as diastolic blood pressure. Conclusions: This study shows statistically significant relationship between Body Mass Index (BMI) and systolic and diastolic blood pressure in rural Indian patients. Weight gain seems to be an important risk factor for development of hypertension. Weight loss has been recommended for obese hypertensive patients and has been shown to be most effective non pharmacological treatment approach. Physical activity and caloric restriction should be promoted to control the obesity epidemic which will significantly reduce global cardiovascular disease burden.

(184) The Prevalence of Sexual Dysfunction in Women Seeking Infertility Treatment in Vietnam

Abstract Introduction Sexual function plays a crucial role in women's psychosocial and overall well-being, significantly impacting their quality of life. Any decline in sexual function can have detrimental effects on the affected individuals' quality of life Objective (i) To describe the prevalence of sexual dysfunction in women seeking infertility treatment at the Andrology and Fertility Hospital of Hanoi, Viet Nam, and (ii) to analyze the factors associated with sexual dysfunction in the study population. Methods This was a cross-sectional descriptive study. All women (1.039) seeking infertility treatment at the Andrology and Fertility Hospital from December 30, 2022, to March 30, 2023 participate in the study. They were invited to scan a QR code and complete the research questionnaire. Female sexual dysfunction is assessed based on the FSFI scale included six domains: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain (comprising 19 questions). The data were extracted into Excel, cleaned, and analyzed using STATA 17.0 software. The analysis of factors associated with female sexual dysfunction was conducted using logistic regression models. Results Among the 1039 participants in the study, the mean age was 30.9±5.3 years. The overall score for female sexual dysfunction was 25.09 ± 6.20, with individual component scores. The prevalence of female sexual dysfunction was 49.7%. There is a positive correlation among the six components of female sexual dysfunction, p&amp;lt;0.01. In the multivariate regression model, the risk of female sexual dysfunction is higher among individuals who work away from home, have an underweight body mass index, have a poor relationship with their partner, have had no sexual intercourse in the past 4 weeks, experience fear of pain, anxiety, and body image concerns during sexual activity, have infrequent or no discussions with their partner regarding sexual desires, preferred positions, and stimulation, and are dissatisfied with their sexual life. Conclusions Half of the women seeking infertility in late-stage medical care experience sexual dysfunction. Factors that increase the risk of sexual dysfunction include having a job far from home, being underweight based on body mass index, having a poor overall relationship with a partner, not engaging in sexual activity in the past four weeks, fear of pain, anxiety, body image concerns during sexual intercourse, and limited or lack of communication with a partner about sexual issues such as desires, preferred positions, and stimulation. Additionally, dissatisfaction with one's sexual life contributes to the occurrence of sexual dysfunction. Therefore, early screening and timely intervention are necessary for this group of individuals. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Andrology and Fertility Hospital of Hanoi.

Body mass index as a dominant risk factor for metabolic syndrome among indonesian adults: a 6-year prospective cohort study of non-communicable diseases

BackgroundNon-communicable diseases (NCDs), notably cardiovascular disease and type 2 diabetes mellitus, are largely driven by metabolic syndrome (MetS), a cluster of critical risk factors. Despite extensive research, the progression of MetS, especially in Indonesia, has received limited attention. This research tracks adult MetS risk dynamics in a populous Bogor District cohort, providing crucial insights into its evolving nature.MethodsThis prospective open cohort study analysed secondary data from the Special Research - Cohort Study of Non-Communicable Diseases by the Ministry of Health, Republic of Indonesia from 2011 to 2018. The final sample was 1,376 Indonesian adult participants, all residents of Bogor District. MetS outcome, dietary assessment, physical activity, and biomarkers were analysed every two consecutive years.ResultsThe risk of overweight and obese participants developing MetS was 2.4 and 4.4 times higher, respectively (95% CI: 1.176–3.320 and 3.345–5.740) than those with body mass index (BMI) in the normal range. Participants who reported less intentional physical exercise had a MetS risk 1.5 times higher (95% CI: 1.034–2.109) than those with more intentional physical exercise. The role of diet is also significant, evidenced by a 30% reduction in MetS risk for people with fat intakes in the 2nd quartile compared to the 1st quartile (95% CI: 0.505–0.972). Meanwhile, a carbohydrate intake in the 2nd quartile increased the risk of MetS 1.5 times (95% CI: 1.063–2.241) in comparison with the 1st quartile.ConclusionsNotably, participants with underweight BMI exhibited the highest cumulative survival of MetS, while those with obese BMI recorded the lowest cumulative survival. There is an urgent need for strategic interventions to enhance the existing early detection and NCD monitoring program. This involves a targeted focus on promoting a community-based healthy lifestyle in the Bogor District. The study emphasizes the importance of tailored public health measures to address specific risk factors identified in the local context, aiming to mitigate the prevalence and impact of MetS in the population.

Association between body composition standards and eating disorder medical claims among active-duty service women.

Eating disorders are a worldwide public health concern with the United States having a particularly high prevalence. Eating disorders are of particular concern to the Department of Defense and Military Health System (MHS) because body composition standards are in place for active-duty service members. We conducted a cross-sectional study of active-duty service women (ADSW) ages 18 and older in the U.S. Army, Air Force, Navy, and Marine Corps during fiscal years (FY) 2018-2019. Utilizing claims data from the MHS Data Repository (MDR), we identified ADSW with a Body Mass Index (BMI) measure during the study period and compared their BMI to Service-specific requirements and diagnosis of an eating disorder. We identified a total of 161,209 ADSW from the MDR in FYs 2018-2019 with a recorded BMI, of whom 61,711 (38.3%) had a BMI exceeding the maximum BMI Service-specific standards during the study period and 0.5% had an eating disorder diagnosis. Increased risk of an eating disorder was found in ADSW with an Underweight BMI. Further, we found that there was no association of disordered eating diagnoses among ADSW who were near the maximum height/weight standard set by their Service. There appears to be no association between body composition standards of the Services and eating disorder diagnoses in ADSW. We were not able to investigate unhealthy habits around diet or exercise directly related to body composition standards.

FACTORS AFFECTING THE AGE OF MENOPAUSE IN PADANG CITY IN 2023

AbstractMenopause is characterized by a consecutive period of amenorrhea lasting 12 months without anyunderlying causes or surgical interventions. The age at which menopause occurs can be influenced byvarious factors, including menarche, number of childbirths, body mass index, and the utilization ofhormonal contraceptives. This study aims to determine the factors that influence the incidence ofmenopause in Padang. This study is an analytical research with a cross-sectional study design. Theresearch was conducted in the working areas of all primary public health centers in Padang fromJanuari 2023 to September 2023. The sample consisted of middle-aged women who visited theworking areas of all primary public health centers during the study period. This study is using aquestionnaire as the research instrument and employing the simple random sampling technique toobtain a sample size of 124 participants. The data analysis was conducted using the Chi- Square test,and utilize the statistical software SPSS. A significant relationship between variables was defined if thep-value &lt; 0.05. The results of this study revealed that the majority of respondents experienced earlymenarche (36.3%), had multiparous pregnancies (33.9%), had underweight body mass index (33.1%),used hormonal contraceptives (52.4%), and experienced late menopause (40.3%). The analysisshowed a significant relationship (p&lt;0.05) between the age of menarche (p=0.036) and parity(p=0.002) with the occurrence of menopause. However, there was no significant relationship (p&gt;0.05)between body mass index (p=0.141) and history of contraceptive use (p=0.069) with the occurrenceof menopause. This study found a significant relationship between the age of menarche and paritywith the occurrence of menopause, while there was no significant relationship between body massindex and history of contraceptive use with the occurrence of menopause among middle-aged womenvisiting the primary public health center areas in Padang.

Prospective cohort study on tuberculosis incidence and risk factors in the elderly population of eastern China

BackgroundTuberculosis continues to be a significant public health concern in China, particularly among the elderly population. This study aimed to assess the risk factors of tuberculosis among elderly individuals in China through a cohort study, focusing on this high-risk population. MethodsThe population-based census was strategically designed to cover diverse regions and demographics across the city. The survey captured demographic and lifestyle information, as well as a clinical examination. Participants were prospectively followed up over a specified duration to monitor the incidence of tuberculosis cases. ResultsAfter a follow-up period of more than 7 years, 246 individuals developed tuberculosis, resulting in an incidence rate of 92.21 per 100,000 person-years (95 % CI 81.2–104.3). In multivariate analysis, the following factors were found to have significant associations with active tuberculosis. Increasing age correlated with a higher risk of active tuberculosis (AHR = 1.03 per 1-year increase in age, 95%CI: 1.01, 1.04, P < 0.001). Males continued to have a higher risk compared to females (HR = 2.73, 95%CI: 2.08, 3.58, P < 0.001). Individuals with a normal Body Mass Index (BMI) faced nearly three times higher risk compared to their obese counterparts (HR = 2.87, 95 % CI: 1.51, 5.46, P = 0.001). Conversely, those with an underweight BMI had a ten-fold higher risk compared to the obese group (HR = 9.89, 95 % CI: 4.92, 19.85, P < 0.001). Elderly individuals who quit smoking had a 1.35-fold increased risk compared to non-smokers (HR = 1.35, 95%CI: 1.12, 1.64, P < 0.001). ConclusionsTuberculosis incidence among the elderly population in China remained alarmingly high. This finding emphasizes the urgent need for implementing proactive case detection measures specifically tailored to address the specific needs of this vulnerable demographic, particularly in individuals who are male, have a history of former or current smoking, and have a low BMI. Moreover, we must not underestimate the influence of former smoking on tuberculosis risk.

Associations of body habitus and its changes with incident dementia in older adults.

This study examined the associations of body mass index (BMI) and waist circumference (WC), as well as their short- and long-term changes over time, with incident dementia in older individuals. Data came from 18,837 community-dwelling individuals aged 65+ years from Australia and the United States, who were relatively healthy without major cognitive impairment at enrolment. Anthropometric measures were prospectively assessed at baseline, as well as change and variability from baseline to year two (three time-points). In a subgroup (n = 11,176), self-reported weight at age 18 and 70+ years was investigated. Dementia cases satisfied DSM-IV criteria. Cox regression was used to examine the associations between anthropometric measures and incident risk of dementia. Compared to normal weight, an overweight (HR: 0.67, 95%CI: 0.57-0.79, p < 0.001) or obese BMI (HR: 0.73, 95%CI: 0.60-0.89, p = 0.002), or a larger WC (elevated, HR: 0.71, 95%CI: 0.58-0.86, p < 0.001; highly elevated, HR: 0.65, 95%CI: 0.55-0.78, p < 0.001; relative to low) at baseline was associated with lower dementia risk. In contrast, substantial increases in BMI (>5%) over 2 years after baseline were associated with higher dementia risk (HR: 1.49, 95% CI: 1.17-1.91, p = 0.001). Increased dementia risk was also seen with an underweight BMI at baseline and a 2-year BMI decrease (>5%), but these associations appeared only in the first 4 years of follow-up. Compared to normal weight at both age 18 and 70+ years, being obese at both times was associated with increased dementia risk (HR: 2.27, 95%CI: 1.22-4.24, p = 0.01), while obesity only at age 70+ years was associated with decreased risk (HR: 0.70, 95%CI: 0.51-0.95, p = 0.02). Our findings suggest that long-term obesity and weight gain in later life may be risk factors for dementia. Being underweight or having substantial weight loss in old age may be early markers of pre-clinical dementia.

An assessment of the relationship between body mass index and minor complications in percutaneous gastrostomy tubes.

The aim of our study was to determine if patients with obesity have different postoperative outcomes than their peers. A single-center retrospective review of all fluoroscopically-guided percutaneous gastrostomy tube, with 183 patients and 90 patients in the BAG and dilator groups, respectively. Patients were stratified, based on body mass index (BMI) percentile and for age. Demographic information and data on medical comorbidities and post-operative complications were collected. All analyses were conducted using Chi-square or Kruskal-Wallis testing. The median BMI was 26.6 kg/m2 with a standard deviation of 7.7. 106 (38.8%) patients were classified in the normal BMI category, 57 (20.9%) were overweight, and 50 (28.3%) were classified as obese. No major complications were reported in either group. 106 patients (38.8%) reported minor complications. The most common complication observed across both groups was procedural pain, with a higher incidence in the balloon group compared to the dilator group (17.5% vs. 12.2%). Dislodgement emerged as the second most common complication, occurring more frequently in the balloon group (12%) compared to the dilator group (6.7%). When considering weight categories, the overall rate of minor complications was highest among underweight patients (57.6%, P = 0.124). Both underweight and normal BMI patients showed a significantly higher incidence of tube dislodgement compared to other BMI categories (27.2% and 9.4%, respectively, P = 0.015). In a multivariable logistic regression, age was associated with an increased risk of minor complications (odds ratio [OR] 1.03, F [1.01, 1.05], P = 0.002). BAG had a greater OR for minor complication rate compared to dilator-assisted gastrostomy, although the difference was not statistically significant (OR 1.19, 95% confidence interval [0.69, 2.06]). Few studies have identified the relationship between BMI and complications related to gastrostomy tube placement. Our study highlights the importance of individualized care for patients across different BMI classes to minimize complications and improve patient outcomes.

Hubungan Intensitas Perilaku Merokok dan Lama Merokok Dengan Indeks Massa Tubuh (IMT)

Body Mass Index (BMI) is an important indicator of nutritional status in measuring health status. Smoking habits can have a negative impact because it can cause users to have poor nutritional status both in the form of underweight and overweight. This study aims to determine the relationship between the intensity of smoking behavior and duration of smoking with Body Mass Index (BMI). This study used a correlation descriptive design and a cross sectional approach. The research sample was 60 respondents who were taken based on inclusion criteria using total sampling technique. The analysis used was bivariate analysis using the chi-square and kolmogrov smirnov test. There were 38 respondents (63.3%) who were classified as light smokers, 47 respondents (78.3%) had habit of smoking &lt;5 years, 28 respondents (46.7%) had normal BMI, 20 respondents had an overweight BMI, and 12 respondents had an underweight BMI. Statistical test results show that there is a significant relationship between the intensity of smoking behavior and Body Mass Index (BMI) with p value (0.043) &lt; alpha (0.05) and there is no significant relationship between smoking duration and Body Mass Index (BMI) with p value (0.558) &gt; alpha (0.05). The intensity of smoking behavior has a significant relationship with Body Mass Index (BMI) and duration of smoking does not have a significant relationship with Body Mass Index (BMI).