Body Mass Index Units Research Articles

The Impact of BMI on Heart Rate During Suspension Laryngoscopy Operation in Patients With Laryngeal Lesions: A Prospective Cohort Study.

Suspension laryngoscopy can trigger vagal reflexes, leading to a decrease in heart rate, a phenomenon that is more common in patients with a high body mass index (BMI). This study aims to systematically evaluate the effect of BMI on heart rate during suspension laryngoscopy (SL-HR) in patients with laryngeal lesions. We employed univariate generalized linear regression and stratified analyses to assess the relationship between BMI and changes in SLHR, adjusting for confounders such as age, gender, intubation type, and depth. A generalized additive model with spline smoothing was utilized to evaluate the BMI-HR relationship, with piecewise linear regression to identify specific cutoff points. We conducted a prospective study of 205 patients who underwent general anesthesia for suspension laryngoscopy. Multivariate linear regression analysis indicated that, after adjusting for covariates, each one-unit increase in BMI was associated with a decrease of 1.04 beats per minute in SL-HR (β=-1.04 [95% CI, -1.85 to -0.23]). Curve fitting revealed a gradual decline in SL-HR with increasing BMI, plateauing at around 60 beats per minute. The decrease in SL-HR became more pronounced as BMI approached 30kg/m², with further analysis revealing an inflection point at a BMI of 28.8kg/m², where each additional unit of BMI correlated with a 6.5 beats per minute decrease in heart rate (β =-6.5 [95% CI, -10.1 to -2.8], P <0.001). Patients with high BMI are more prone to vagal reflexes during suspension laryngoscopy, resulting in significant reductions in heart rate, especially when BMI exceeds 28.8kg/m². Therefore, close monitoring of heart rate changes is crucial in this patient demographic, along with considering prophylactic anticholinergic agents to mitigate vagal reflex effects.

Preconception health inequalities in Northern Ireland: a focus on obesity and folic acid supplement use from 255,117 pregnancies

Obesity prevalence is rising globally. Living with obesity can lead to increased reproductive challenges and compromise preconception health, defined as the overall health of non-pregnant individuals of childbearing age (15-49 years)(1). Folic acid supplement use, considered a key preconception health behaviour, is pivotal for the prevention of neural tube defects in offspring(2). Guidelines suggest women with obesity take a higher dose (5mg/day) to reduce the risk of fetal complications(3). This research explored trends in Body Mass Index (BMI) in the preconception and early pregnancy period in Northern Ireland (NI) and the prevalence of folic acid supplement use across BMI categories, exploring differences based on deprivation.Anonymised national data collected in the Northern Ireland MATernity System (NIMATS) were accessed via the UK Secure eResearch Platform Data, provided by the HSC Honest Broker Service. The NI Multiple Deprivation Measure (NIMDM) (2017) aggregates the rankings of seven specific domains into a single ranking, used to categorise deprivation into quintiles for comparison (Q1 highest deprivation vs Q5 least deprivation). Healthy weight, overweight, and obesity were classified as BMI 18.5–24.99kg/m2, 25.00–29.99kg/m2 and ≥30kg/m2, respectively. Folic acid supplement use was self-reported. Multiple linear regressions explored trends in BMI between 2011 and 2021 and χ2 tests explored associations between BMI categories and folic acid supplement use from 2014-2021. The ‘Healthy Reproductive Years’ Patient and Public Involvement and Engagement (PPIE) advisory panel (aged 18-45 years), were involved throughout the study.The analyses included a total of 255,117 pregnancies, with missing data addressed per variable.The percentage of women entering pregnancy with a healthy BMI decreased between 2011 and 2021 (48.65%, n = 12,144, and 39.55%, n = 4,316, respectively), while the percentage of women with obesity increased over the same period (18.11%, n = 4,520, and 27.36%, n = 2,986, respectively). Regression models suggested an average increase of ∼1 unit of BMI per calendar year in women entering pregnancy (p&lt;0.001). There were higher proportions of pregnancies conceived by women with overweight or obesity in the highest deprivation quintile (Q1, 53.57%) compared to the least deprivation (Q5, 46.37%). Folic acid supplement use was mostly initiated after conception (59.03%) rather than before (37.54%), as recommended. Among women living with obesity, preconception supplement use of 5mg of folic acid was low (8.74%, n = 2,990). Lower proportions were observed for preconception supplement use of 400mcg among women in the quintile of greatest deprivation (Q1, 21.41%) versus least deprivation (Q5, 44.06%).Analyses demonstrated an increased number of women entering pregnancy with an elevated BMI and suboptimal preconception folic acid supplement use, particularly for women with obesity. It highlights significant health inequalities according to NIMDM regarding obesity and folic acid supplement use. There is a need to address modifiable preconception health risks, particularly for those from lower socioeconomic groups.

Trends in body mass index for people with and without HIV: Pooled analysis of nationally-representative health surveys from 10 countries and 173,800 adults in Africa.

It remains unclear if and how body mass index (BMI) levels have changed over time in HIV endemic regions. We described trends in mean BMI and prevalence of overweight between 2003-2019 in 10 countries in Africa including people living with (PLWH) and without (PLWoH) HIV. We pooled Demographic and Health Surveys (DHS) from countries where ≥2 surveys >4 years apart were available with height/weight measurements and HIV tests. HIV status was ascertained with a finger-prick dried blood spot (DBS) specimen tested in a laboratory. The DBS is taken as part of the regular DHS procedures. We summarized age and socioeconomic status standardized sex-specific mean BMI (kg/m2) and prevalence of overweight (BMI ≥25 kg/m2) by HIV status. We fitted country-level meta-regressions to ascertain if changes in ART coverage were correlated with changes in BMI. Before 2011, women LWH (22.9 [95% CI: 22.2-23.6]) and LWoH (22.6 [95% CI: 22.3-22.8]) had similar mean BMI. Over time, mean BMI increased more in women LWH (+0.8 [95% CI: 0.7-0.8] BMI units) than LWoH (+0.2 [95% CI: 0.2-0.3]). Before 2013, the mean BMI was similar between men LWH (21.1 (95% CI: 20.3-21.9)) and LWoH (20.8 (95% CI: 20.6-21.1)). Over time, mean BMI increased more in men LWoH (+0.3 [95% CI: 0.3-0.3]) than LWH (+0.1 [95% CI: 0.1-0.1]). The same profile was observed for prevalence of overweight. ART coverage was not strongly associated with BMI changes. Mean BMI and prevalence of overweight were similar in PLWH and PLWoH, yet in some cases the estimates for PWLH were on track to catch up with those for PLWoH. BMI monitoring programs are warranted in PLWH to address the rising BMI trends.

Low-, moderate-, and high-risk obesity in association with cost drivers, costs over the lifecycle, and life expectancy

BackgroundThe prevalence of low-, moderate-, and high-risk obesity has been increasing globally. Our aim was to estimate the societal burden of these three obesity classes in the Austrian population by taking a societal–annual perspective and an individual–life-cycle perspective. Secondly, we sought to identify the respective cost drivers and the effects on life expectancy.MethodsWe used population-weighted survey data on the distribution of body mass index (BMI) and data on relative risks regarding 83 diseases. Using fractional polynomial regressions, we estimated relative risks per BMI unit for about 30 cost-intensive diseases up to BMI values of 50. The approach for the cost analysis was based on the use of population-attributable fractions applied to direct medical and indirect cost data. Macro-disease-specific data regarding cost factors came from cost-of-illness statistics and administrative sources.ResultsAbout 8.2% of deaths and 4.6% of health expenditure are attributable to obesity in Austria in 2019, causing 0.61% of GDP loss. A third of annual direct and indirect costs came from class 2 and class 3 obesity. From an individual perspective, life-cycle costs of class 2 and class 3 obesity were 1.9 and 3.6 times the costs of class 1 obesity, respectively. At the age of 45, people with high-risk obesity are about to lose approximately 4.9 life years and 9.7 quality-adjusted life years.ConclusionsWe have extended the method of population-attributable fractions, allowing us to estimate differences in the life-cycle direct medical and indirect costs between low-, moderate-, and high-risk obesity. We found that the lifetime costs of obesity are strikingly different between obesity classes, which has been veiled in the societal—annual perspective. Our findings provide a foundation for evaluating public health interventions aimed at combating obesity in order to mitigate the escalating individual and societal burden resulting from obesity prevalence and complications in the future.

Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes

BackgroundHigher maternal pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and perinatal outcomes. However, whether these associations are causal remains unclear.MethodsWe explored the relation of maternal pre-/early-pregnancy BMI with 20 pregnancy and perinatal outcomes by integrating evidence from three different approaches (i.e. multivariable regression, Mendelian randomisation, and paternal negative control analyses), including data from over 400,000 women.ResultsAll three analytical approaches supported associations of higher maternal BMI with lower odds of maternal anaemia, delivering a small-for-gestational-age baby and initiating breastfeeding, but higher odds of hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, gestational diabetes, pre-labour membrane rupture, induction of labour, caesarean section, large-for-gestational age, high birthweight, low Apgar score at 1 min, and neonatal intensive care unit admission. For example, higher maternal BMI was associated with higher risk of gestational hypertension in multivariable regression (OR = 1.67; 95% CI = 1.63, 1.70 per standard unit in BMI) and Mendelian randomisation (OR = 1.59; 95% CI = 1.38, 1.83), which was not seen for paternal BMI (OR = 1.01; 95% CI = 0.98, 1.04). Findings did not support a relation between maternal BMI and perinatal depression. For other outcomes, evidence was inconclusive due to inconsistencies across the applied approaches or substantial imprecision in effect estimates from Mendelian randomisation.ConclusionsOur findings support a causal role for maternal pre-/early-pregnancy BMI on 14 out of 20 adverse pregnancy and perinatal outcomes. Pre-conception interventions to support women maintaining a healthy BMI may reduce the burden of obstetric and neonatal complications.FundingMedical Research Council, British Heart Foundation, European Research Council, National Institutes of Health, National Institute for Health Research, Research Council of Norway, Wellcome Trust.

Urinary Incontinence in Midlife According to Weight Changes Across and After Childbearing Years

Introduction and HypothesisThe objective was to investigate how weight change across and after the childbearing years was associated with urinary incontinence (UI) in midlife.MethodsData were obtained from 35,645 women responding to the Maternal Follow-up questionnaire in the Danish National Birth Cohort in 2013–2014. Outcome was self-reported UI and its subtypes. Exposures were changes in body mass index (BMI) across and after the childbearing years. Adjusted odds ratios were estimated using logistic regression.ResultsAt follow-up, the mean age was 44 years and 32% experienced UI. Compared with stable weight, weight gain across the childbearing years of > 1 to 3, > 3 to 5 or > 5 BMI units increased the odds of any UI by 15%, 27%, and 41% respectively. For mixed UI, the odds increased by 23%, 41%, and 68% in these groups. Weight gain after childbearing showed the same pattern, but with a higher increase in the odds of mixed UI (25%, 60%, and 95% in the respective groups). Women with any weight loss during this period had 9% lower odds of any UI than women with a stable weight.ConclusionsWeight gain across and after childbearing increased the risk of UI in midlife, especially the subtype mixed UI. Weight loss after childbearing decreased the risk.

Clinical Predictors of Pulsatile Tinnitus in Patients With Idiopathic Intracranial Hypertension: An Age-Matched Cohort Study.

Pulsatile tinnitus (PT) occurs in many but not all patients with idiopathic intracranial hypertension (IIH). It is poorly understood why some patients with IIH develop PT, yet others do not. The purpose of this study was to determine if any clinical findings differ between those with and without PT in IIH, potentially shedding light on a pathophysiologic mechanism. Age-matched cohort analysis of patients with documented IIH and presence or absence of PT was performed, collecting data including body mass index (BMI), blood pressure, visual acuity, cerebrospinal fluid (CSF) opening pressure, sleep apnea, migraines, and transient visual obscurations, among others. Independent-sample t test and χ2 test were used to analyze continuous and binary variables, respectively, with multivariate analysis conducted including variables statistically significant on univariate analysis. Eighty subjects with IIH met the inclusion criteria (40 PT+, 40 PT-). CSF opening pressure showed no significant difference between the two groups. The PT+ cohort was found to have an average BMI of 45.1 kg/m 2 , which was significantly higher than the PT- group (37.7 kg/m 2 ; p = 0.0023). PT+ pulse pressure (60.1 mm Hg) was also significantly higher than the PT- group (51.6 mm Hg; p = 0.019). PT+ patients were also significantly more likely to have sleep apnea ( p < 0.001) and migraines ( p = 0.0036). Multiple logistic regression revealed an adjusted odds ratio of 13.9 for sleep apnea, 4.1 for migraines, and 1.01 for every increase in unit of BMI. Among patients with IIH, presence of PT is associated with higher BMI and pulse pressure, and increased incidence of sleep apnea and migraines. Given no significant difference in CSF pressures between the two groups, PT may not be a product of increased disease severity but may be related to sequelae of obesity, such as increased pulse pressure and sleep apnea.

EFFECT OF THIAMINE, BMI, SLEEP DURATION, AND ANXIETY IN NEUROTIC, STRESS, AND SOMATOFORM DISORDER

Neurotic, stress, and somatoform disorders are one of the diagnosis group characterized by anxiety symptoms. Thiamine or vitamin B1 levels, Body Mass Index (BMI), and sleep duration have been associated partially with anxiety disorders in the health population. The aim of this study is to examined the relationship between thiamine levels, BMI, and sleep duration with anxiety symptoms among people with neurotic, stress, and somatoform disorders. This study is observational with cross-sectional design and engage patients with neurotic, stress, and somatoform disorders as participant. The data gathered comprised thimine levels measured using the liquid chromatography-mass spectrometry (LC-MS/MS), BMI measured based on data of the patient's weight and height, and sleep duration obtained through a questionnaire. Anxiety levels were evaluated using the Zung Self-Rating Questionnaire (SAS). Linear regression was performed for data analysis. The findings indicated that there was no significant relationship between vitamin B1 levels and anxiety levels. However, this study suggested that an increase of 1 hour in sleep duration (coefficient = -2.784, p = 0.007) and an increase of 1 unit in BMI (coefficient = -0.824, p = 0.022) were associated with a statistically significant decrease in anxiety index. This study demonstrated significant relationship between BMI and sleep duration with anxiety symptoms in patients with neurotic, stress, and somatoform disorders. Further study is required to understand the mechanisms of this relationship and its implications for the treatment of patients with neurotic, stress, and somatoform disorders.

Hyperlipoproteinemia(a) in coronary artery disease patients: who are patients with very high levels and how do they respond to the PCSK9 antibody therapy?

Abstract Introduction Lipoprotein(a) [Lp(a)] is a considerable risk factor for coronary artery disease [CAD] and a possible target for novel risk management therapy. On the one hand, increased Lp(a) levels may help select at-risk CAD patients who are better candidates for PCSK9 antibody therapy; on the other hand, PCSK9 antibody therapy has been shown to reduce Lp(a) levels. Purpose The aim of our study was two-fold: i) to appraise the prevalence and characteristics of CAD patients with elevated Lp(a), and ii) to identify possible predictors of Lp(a) levels reduction in CAD patients on PCK9 antibody therapy. Methods Consecutive patients with established CAD referred for cardiac rehabilitation from 2020 to 2022 were included and had Lp(a) serum levels measured using the Lp(a) assay on the RX Daytona+ automated biochemistry analyzer. Clinical and demographic predictors of Lp(a) &amp;gt;50 mg/dL and &amp;gt;100 mg/dL were assessed (namely age, sex and traditional risk factors). Furthermore, in patients with CAD and increased Lp(a) levels (&amp;gt;100 mg/dL, which makes them eligible for full reimbursement of alirocumab or evolocumab as per national insurance policy), clinical and demographic predictors of Lp(a) levels reduction after 12 weeks of PCSK9 antibody therapy were assessed. Results We included 518 patients (average age 58 years, 21% females): 84 (16.2%) had Lp(a) levels &amp;gt;100 mg/dL and 137 (26.4%) had Lp(a) levels &amp;gt;50 mg/dL. Only the female sex was independently associated with increased Lp(a) levels &amp;gt;100 mg/dL and &amp;gt;50 mg/dL (32.1%, p=0.008 and 27.7%, p=0.030, respectively). In 57 patients on PCSK9 antibody therapy based on Lp(a) &amp;gt;100 mg/dL, cigarette smoking and body mass index (BMI) were independent baseline-adjusted predictors of Lp(a) reduction after 3 months of PCSK9 antibody therapy; non-smokers had 27.5 mg/dL greater decrease in Lp(a) as compared to smokers (p=0.004), and BMI was associated with a decrease of 2.6 mg/dL per unit of BMI (p=0.020), respectively. Conclusion In patients with established CAD, the female sex is the only independent clinical predictor of increased Lp(a) levels, suggesting Lp(a) may be an important driver of CAD, especially in women. Conversely, Lp(a) reduction with PCSK9 antibody therapy was associated only with lifestyle risk factors (namely smoking and BMI), suggesting the possibility that lifestyle modification could improve response to treatment to PCSK9 inhibitors and should be researched further in prospective studies.

Five-year changes in weight and risk of atrial fibrillation in women and men from the Danish diet, cancer, and health cohort

Abstract Background Overweight and obesity are causal risk factors for atrial fibrillation (AF).(1) Mendelian randomization studies indicated a higher risk of AF with each unit increase in body mass index (BMI).(1) In observational studies, weight gain was associated with a higher risk of incident AF compared to stable weight.(2,3) However, the results are conflicting regarding the association between weight loss and risk of incident AF.(4,5). Purpose We aimed to assess the association between five-year changes in weight and absolute and relative rates of incident AF in women and men from the Danish Diet, Cancer, and Health Cohort. Methods In the Danish cohort study Diet, Cancer, and Health, participants were invited to attend a recruitment research examination and a second examination 5 years later. Height, weight, and several lifestyle factors were assessed at both examinations. We calculated BMI and BMI changes between first and second examination. BMI changes were categorized into following groups: &amp;lt;-5 kg/m2, ≥-5 to &amp;lt;-2.5 kg/m2, ≥-2.5 to &amp;lt;2.5 kg/m2, ≥2.5 to &amp;lt;5 kg/m2 and ≥5 kg/m2. Diagnoses of AF and comorbidities were retrieved from the Danish National Patient Registry. We used multivariable-adjusted Cox proportional hazards models to assess hazard ratios (HR) of AF according to changes in BMI. Results 43,758 participants without prior AF were included in the study. The median age was 62 (25th-75th percentile, 58-66) years and 54% were women. Over 15.7 years median follow-up time 5,312 participants had incident AF. From the first to the second measure, 39,076 (89%) of participants had stable weight, 2,627 (6%) lost weight, and 2,055 (5%) gained weight. The incidence rates of AF per 1,000 person-years were 8.4 (95% CI 8.1-8.6) among participants with stable weight, 12.4 (95% CI 9.6-16.1) among those with weight loss ≥5 kg/m2, and 15.4 (95% CI 11.7-20.2) among those who gained ≥5 kg/m2. Compared to participants with stable weight, individuals who gained ≥2.5 to &amp;lt;5 kg/m2 had a higher hazard of AF (HR 1.24, 95% CI 1.09-1.41). Among participants who gained ≥5 kg/m2 the rate of AF was also higher compared to stable weight (HR 1.95, 95% CI 1.48-2.56). There was no statistically significant association between weight loss, regardless of degree, and rate of AF. Figure 1 shows the HR of AF by BMI changes from first to second measure compared to stable weight using restricted cubic splines. In sex-stratified analyses, the association between weight gain of ≥5 BMI units (kg/m2) and higher AF rate was present for both women and men. Conclusions In this cohort study, five-year weight gain was associated with higher long-term risk of AF compared to stable weight. However, we found no associations between weight loss and long-term risk of AF.Figure 1

Genetic causal association of adiposity, body fat distribution with incident heart failure in a European cohort: A linear and non-linear Mendelian randomisation analysis

Abstract Background Excess adiposity has been associated with higher risk of heart failure in observational studies. However, these observational studies are prone to residual confounding and the shape and strength of the independent associations of adiposity measures with heart failure is uncertain. Purpose This study aimed to compare the associations of usual and genetically determined general and central adiposity measures on incident heart failure in a European population cohort. Methods The MR analysis was performed in a cohort of 326,300 adults (mean age 55.9 years, 56% women) of European ancestry with complete genetic data and no prior cardiac and vascular disease recruited from UK general population in 2006-2010. Resurvey on a subset of 20,346 participants was conducted in 2012-13. Regression dilution ratios (RDR) of the different adiposity measures were calculated using Pearson’s correlation method to obtain usual levels of each adiposity measure. Participants were followed up by linkage to electronic health records for incident heart failure events. Externally weighted genetic risk scores (GRS) for body mass index (BMI) and waist circumference (WC) adjusted for BMI (WCadjBMI) were constructed using single nucleotide polymorphisms (SNPs) that were genome-wide significant for BMI and WC as reported by the Genetic Investigation of ANthropometric Traits (GIANT) consortium. Associations of usual measured adiposity measures and genetically predicted usual adiposity (76-SNP BMI-GRS [pleiotropic for other adiposity measures], 36-SNP BMI-GRS [non-pleiotropic for other adiposity measures] and 68-SNP WCadjBMI-GRS) with incident HF subtypes were determined using Cox proportional hazards regression models. The shapes of the associations of genetically predicted adiposity with heart failure at different levels of adiposity measures were examined using localized average causal effects within strata of residual adiposity measures after adjustment for GRS and correction for regression dilution. Hazard ratios (HRs) are presented as per equivalent 5 usual BMI units higher adiposity measure. Results Over a median follow-up of 12.8 years, there were 6,570 first-ever incident HF events. A positive non-linear association (J-shape) was observed between genetically predicted BMI and heart failure with while positive log-linear association was observed for genetically predicted WCadjBMI. Consistent with the observational analyses, the hazard ratio per 5 BMI units equivalent higher genetically predicted WCadjBMI were notably stronger (68-SNP WCadjBMI GRS: HR 2.03, 95% CI1.04-3.97) than for genetically predicted BMI (36-SNP GRS-BMI: HR 1.78, 95% CI 1.12-2.81 and 76-SNP GRS-BMI: HR 1.99, 95% CI 1.62-2.45). Conclusion The findings provide evidence for increased heart failure risk at extremes of BMI and also confirm the stronger causal role of central adiposity over general adiposity in heart failure across the whole range of waist circumference.Figure 1Figure 2

Five-year changes in weight and risk of atrial fibrillation in the Danish Diet, Cancer, and Health Cohort.

Obesity is a major risk factor for atrial fibrillation (AF). Compared with stable weight, gaining weight was associated with a higher risk of incident AF in observational studies. The results, however, are conflicting regarding weight loss and risk of AF. This study aimed to assess the association between 5-year weight changes and risk of incident AF. The study was based on participants from the Danish Diet, Cancer, and Health Cohort. Body mass index (BMI) was assessed at a baseline examination and at a second examination 5 years later. Diagnoses of AF and co-morbidities were retrieved from the Danish National Patient Registry. In total, 43 758 participants without prior AF were included. The median age was 61 years and 54% were female. During a median follow-up of 15.7 years, 5312 individuals had incident AF (incidence rate 8.6/1000 person-years). Compared with stable weight, weight gain between 2.5 and 5 BMI units (kg/m2) was associated with a higher risk of AF [hazard ratio (HR) 1.24, 95% confidence interval (CI) 1.09-1.41]. Weight gain of 5 or more BMI units (kg/m2) was associated with a HR of 1.95 (95% CI 1.48-2.56) of incident AF. However, there was no statistically significant association between weight loss and risk of AF. Five-year weight gain was associated with greater risk of AF compared with stable weight in the Danish Diet, Cancer, and Health Cohort. There was no statistically significant association between weight loss and risk of AF.

MBSAQIP database: are the data reliable?

BackgroundThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database collects data from all accredited centers in the US. A prior study showed data quality issues limiting use of up to 20% of the 2015 database. ObjectivesTo evaluate the completeness and data quality (internal validity, accuracy, and consistency) of the MBSAQIP database between 2015 and 2019. SettingUnited States. MethodsAll subsets of data from the MBSAQIP Participant User Data File (PUDF) were compiled into one main file. Completeness, internal validity, accuracy, and consistency were evaluated. Completeness was determined via missing values. Internal validity was assessed using the percentage of patients with a body mass index (BMI) < 30 kg/m2 who underwent primary bariatric surgery. Accuracy was evaluated using reported versus calculated BMI. Consistency was assessed using the percentage of patients with a gain of >5 or a loss of >20 units of BMI change in 30 days. Effects across years were assessed using a chi-squared test. ResultsMissing data for age, BMI, and ASA was consistently low (<2.5%) with no significant difference across years. Only .02% of patients who underwent a primary bariatric procedure had a reported BMI <30 kg/m2. The mean difference between reported versus calculated BMI was −.02 units. A maximum of .33% of patients gained >5 units of BMI, and a maximum of .85% of patients lost > 20 units of BMI in early follow-up. ConclusionsWhile the MBSAQIP is a database with acceptable data quality and minimal changes from 2015–2019, ongoing efforts are needed to improve data.

The effect of body mass index reduction on intraocular pressure in a large prospective cohort of apparently healthy individuals in Israel.

To investigate the effect of change in body mass index (BMI) on intraocular pressure (IOP) in a large cohort of apparently healthy volunteers who underwent an annual comprehensive screening examinations. This study included individuals who were enrolled in the Tel Aviv Medical Center Inflammation Survey (TAMCIS) and had IOP and BMI measurements at their baseline and follow up visits. Relationships between BMI and IOP and the effect of change in BMI on IOP were investigated. A total of 7,782 individuals had at least one IOP measurement at their baseline visit, and 2,985 individuals had ≥2 visits recorded. The mean (SD) IOP (right eye) was 14.6 (2.5) mm Hg and mean (SD) BMI was 26.4 (4.1) kg/m2. IOP positively correlated with BMI levels (r = 0.16, p<0.0001). For individuals with morbid obesity (BMI≥35 kg/m2) and ≥2 visits, a change in BMI between the baseline and first follow-up visits correlated positively with a change in the IOP (r = 0.23, p = 0.029). Subgroup analysis of subjects who had a reduction of at least 2 BMI units showed a stronger positive correlation between change in BMI and change in IOP (r = 0.29, p<0.0001). For this subgroup, a reduction of 2.86 kg/m2 of BMI was associated with a reduction of 1 mm Hg in IOP. BMI loss correlated with reduction in IOP, and this correlation was more pronounced among morbidly obese individuals.

Impact of BMI and smoking in adolescence and at the start of pregnancy on birth weight

BackgroundBirth weight is an indicator of intra-uterine conditions but also a determinant for future health. The importance of preconception health for a healthy birth weight has been emphasized, but evidence is lacking on how modifiable factors in adolescence, such as body mass index (BMI) and smoking, affect future pregnancy outcome. We evaluated associations between BMI and smoking in adolescence and at the start of pregnancy and birth weight of the first-born child.MethodsThis longitudinal study included 1256 mothers, born 1962–1992, and their first-born children, born between 1982–2016. Self-reported questionnaire information on weight, height and smoking at age 19 was cross-linked with national register data obtained at the start of pregnancy and with the birth weights of the children. Univariable and multivariable linear regressions were performed to determine the impact of maternal factors at 19 years of age and at the start of the pregnancy respectively, and the importance of BMI status at these points of time for the birth weight of the first child.ResultsBMI and smoking at the start of the pregnancy displayed strong associations with birth weight in a multivariable analysis, BMI with a positive association of 14.9 g per BMI unit (95% CI 6.0; 23.8 p = 0.001) and smoking with a negative association of 180.5 g (95% CI -275.7; -85.4) p = 0.0002). Smoking and BMI at 19 years of age did not show this association. Maternal birth weight showed significant associations in models at both time-points. Becoming overweight between age 19 and the start of the pregnancy was associated with a significantly higher birth weight (144.6 (95% CI 70.7;218.5) p = 0.0002) compared to mothers with normal weight at both time points.ConclusionsOur findings indicate that the time period between adolescence and first pregnancy could be a window of opportunity for targeted health promotion to prevent intergenerational transmission of obesity.

Allergies, body mass and hospitalization due to arbovirus infection: A prospective surveillance study in Machala, Ecuador.

Dengue, chikungunya, and Zika are arboviruses that cause 390 million infections annually. Risk factors for hospitalization are poorly understood. Communities affected by these diseases have an escalating prevalence of allergies and obesity, which are linked to immune dysfunction. We assessed the association of allergies or body mass with hospitalization for an arbovirus infection. From 2014 to 2017, we recruited participants with a clinical diagnosis of arbovirus infection. Arbovirus infections were laboratory-confirmed and allergies were self-reported. Mid-upper arm circumference (MUAC), weight, and height were measured. We used two logistic regression models to assess the relationships between hospitalization and allergies and between hospitalization and body mass (MUAC for participants <20 years old and body mass index (BMI) for adults ≥20 years old). Models were stratified by age group and adjusted for confounders. For allergies, 41 of 265 were hospitalized. There was no association between allergies and hospitalization. For body mass, 34 of 251 were hospitalized. There was a 43% decrease in hospitalization odds for each additional centimetre MUAC among children (aOR 0.566, 95% CI 0.252-1.019) and a 12% decrease in hospitalization odds for each additional BMI unit among adults (aOR 0.877, 95% CI 0.752-0.998). Our work encourages the exploration of the underlying mechanisms.

The Assessment of Body Mass Index as a Risk Factor for Chronic Periodontitis

Background: Obesity is one of the highly emerging chronic disease. It is a major health concern now a days. The BMI of more than 35% of the adults were in the overweight category in 2008 but now the values are reported to be exceeded. The study aimed to assess the relationship between body mass index and chronic periodontitis. Study Design: It is a cross-sectional study with statistical approach, conducted at Karachi medical and dental college, Karachi Material and Methods: The study was conducted on 200 patients visited the dentist department of the hospital. The study was conducted for six month duration from Jan 2022 to June 2022. The ethical and review board of the hospital approved the study. Results: Among 200, 100 specimens belong to the normal weight category, 73 are overweight, and 27 are from the obese category. In each category, all the specimens are from similar age groups, but more males were present in the overweight and obese categories. Complete data analysis of these patients was performed. Then logistic regression analysis was performed, and it was predicted that periodontitis has a direct relation with the body mass index (BMI). About a 17% risk rate increases with an increase in each unit of BMI. Conclusion: This study supports the hypotheses of the association of obesity with periodontal issues. The body mass index is a factor for the assessment of different health risk factors. The body mass index and smoking are linked with periodontal issues. Smokers and obese people specifically young obese have a more critical periodontal state. Keywords: Body mass index and periodontitis.

Physiologically Based Pharmacokinetic Modelling to Identify Physiological and Drug Parameters Driving Pharmacokinetics in Obese Individuals.

Obese individuals are often underrepresented in clinical trials, leading to a lack of dosing guidance. This study aimed to investigate which physiological parameters and drug properties determine drug disposition changes in obese using our physiologically based pharmacokinetic (PBPK) framework, informed with obese population characteristics. Simulations were performed for ten drugs with clinical data in obese (i.e., midazolam, triazolam, caffeine, chlorzoxazone, acetaminophen, lorazepam, propranolol, amikacin, tobramycin, and glimepiride). PBPK drug models were developed and verified first against clinical data in non-obese (body mass index (BMI) ≤ 30 kg/m2) and subsequently in obese (BMI ≥ 30 kg/m2) without changing any drug parameters. Additionally, the PBPK model was used to study the effect of obesity on the pharmacokinetic parameters by simulating drug disposition across BMI, starting from 20 up to 60 kg/m2. Predicted pharmacokinetic parameters were within 1.25-fold (71.5%), 1.5-fold (21.5%) and twofold (7%) of clinical data. On average, clearance increased by 1.6% per BMI unit up to 64% for a BMI of 60 kg/m2, which was explained by the increased hepatic and renal blood flows. Volume of distribution increased for all drugs up to threefold for a BMI of 60 kg/m2; this change was driven by pKa for ionized drugs and logP for neutral and unionized drugs. Cmax decreased similarly across all drugs while tmax remained unchanged. Both physiological changes and drug properties impact drug pharmacokinetics in obese subjects. Clearance increases due to enhanced hepatic and renal blood flows. Volume of distribution is higher for all drugs, with differences among drugs depending on their pKa/logP.

Prevalence of Female and Male Vegan and Non-Vegan Endurance Runners and the Potential Associations of Diet Type and BMI with Performance-Results from the NURMI Study (Step 1).

This study aims to investigate vegetarian and mixed diet type prevalences among distance runners at running events around the world and associations with running-related patterns and performance. Following a cross-sectional approach, linear regression analyses were carried out to identify potential associations among body mass index (BMI), diet type, and average best performance times of half-marathon and marathon events for males and females. From a sample of 3835 runners who completed an online questionnaire, 2864 all-distance runners (age: 37 years; 57% females) were included in inferential analyses and categorized into dietary subgroups according to self-reports: 994 vegans (34.7%), 598 vegetarians (20.9%), and 1272 omnivores (44.4%). Significant associations were identified between kind of diet and best average time to finish (i) half-marathons in females where vegans (p = 0.001) took longer than omnivores, (ii) half-marathons in males where vegans (p < 0.001) and vegetarians (p = 0.002) took longer than omnivores, and (iii) marathons in males where vegans (p < 0.001) and vegetarians (p = 0.043) averaged slower than omnivores. Increased units of BMI (+1.0) in males influenced best runtimes: 2.75 (3.22–2.27) min slower for HM and 5.5 (5.69–4.31) min slower for M. The present study did not take detailed confounders into account such as runner motives or training behaviors; however, the results may provide valuable insight for running event organizers, nutrition experts, coaches, and trainers advising runners who adhere to a general diet type regarding the basic question of who participates in running events around the world.

Monitoring osteoarthritis: A simple mathematical model

Osteoarthritis (OA) is a kind of joint inflammation which can be ascribed to the age, obesity, gender, depression, genetic predisposition, and cyclic or heavy cartilage loading. There is no definitive treatment for OA; hence, as far as possible the best practical resort is the prevention. We herein propose a simple mathematical model that receives the age, obesity, gender,and overloading by considering the impact of cartilage self-repair and predicts the cartilage damage. Python programming language using Numpy library was used for modeling and solver module. Assuming body mass index (BMI) > 27, we assumed that with the damage to cartilage increases by 6.5% with an increase of each BMI unit, whereas for a BMI <27 the cartilage damage can be ignored. The model predicted that the critical damge occurs is between ages of 44 and 64. In this timeframe, damage to the cartilage increases by 10%, which is roughly in line with the clinical data. Moreover, the impact of gender on the cartilage damage is not pronounced. The proposed simple mathematical model helps physiotherapists to privide themselves with a possibility of a timely rough prediction of the cartilage damage and probably making smarter decisions for invasive interventions.