Body surface area, height, and body fat percentage as more sensitive risk factors of cancer and cardiovascular disease

Summary Objective: Identification of risk factors for bleeding and prospective evaluation of two bleeding risk scores in the treatment of acute venous thromboembolism. Design: Secondary analysis of a prospective, randomized, assessor-blind, multicenter clinical trial. Setting: One university and 2 regional teaching hospitals. Patients: 188 patients treated with heparin or danaparoid for acute venous thromboembolism. Measurements: The presenting clinical features, the doses of the drugs, and the anticoagulant responses were analyzed using univariate and multivariate logistic regression analysis in order to evaluate prognostic factors for bleeding. In addition, the recently developed Utrecht bleeding risk score and Landefeld bleeding risk index were evaluated prospectively. Results: Major bleeding occurred in 4 patients (2.1%) and minor bleeding in 101 patients (53.7%). For all (major and minor combined) bleeding, body surface area ≤2 m2 (odds ratio 2.3, 95% Cl 1.2-4.4; p = 0.01), and malignancy (odds ratio 2.4, 95% Cl 1.1-4.9; p = 0.02) were confirmed to be independent risk factors. An increased treatment-related risk of bleeding was observed in patients treated with high doses of heparin, independent of the concomitant activated partial thromboplastin time ratios. Both bleeding risk scores had low diagnostic value for bleeding in this sample of mainly minor bleeders. Conclusions: A small body surface area and malignancy were associated with a higher frequency of bleeding. The bleeding risk scores merely offer the clinician a general estimation of the risk of bleeding. In patients with a small body surface area or in patients with malignancy, it may be of interest to study whether limited dose reduction of the anticoagulant drug may cause less bleeding without affecting efficacy.

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Pulmonary valve replacement following repair of tetralogy of Fallot: comparison of outcomes between bio- and mechanical prostheses

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezab099 ◽

2021 ◽

Author(s):

Dong-Hee Kim ◽

Eun Seok Choi ◽

Bo Sang Kwon ◽

Tae-Jin Yun ◽

Seul Gi Cha ◽

...

Keyword(s):

Risk Factors ◽

Surface Area ◽

Body Surface Area ◽

Valve Replacement ◽

Body Surface ◽

Pulmonary Valve ◽

Pulmonary Valve Replacement ◽

Prosthesis Failure ◽

Mechanical Prosthesis ◽

Mechanical Prostheses

Abstract OBJECTIVES The aims of this study were to evaluate and compare the outcomes after pulmonary valve replacement (PVR) with a mechanical prosthesis (MP) and a bioprosthesis (BP). METHODS From 2004 through 2017, a total of 131 patients, who had already been repaired for tetralogy or Fallot or its variants, underwent their first PVR with an MP or a BP. Outcomes of interests were prosthesis failure (stenosis >3.5 m/s, regurgitation >mild or infective endocarditis) and reintervention. RESULTS The median age at PVR was 19 years. BP and MP were used in 88 (67.2%) and 43 (32.8%) patients, respectively. The median follow-up duration was 7.4 years, and the 10-year survival rate was 96.4%. Risk factors for prosthesis failure were smaller body surface area [hazard ratio (HR) 0.23 per 1 m2, P = 0.047] and smaller prosthesis size (HR 0.73 per 1 mm, P = 0.039). Risk factors for prosthesis reintervention were smaller body surface area (HR 0.11 per 1 m2, P = 0.011) and prosthesis size (HR 0.67 per 1 mm, P = 0.044). Probability of prosthesis failure and reintervention at 10 years were 24.6% (19.5% in BP vs 34.8% in MP, P = 0.34) and 7.8% (5.6% in BP vs 11.9% in MP, P = 0.079), respectively. Anticoagulation-related major thromboembolic events were observed in 4 patients receiving an MP. CONCLUSIONS MP might not be superior to BP in terms of prosthesis failure or reintervention. MP should be carefully considered for highly selected patients in the era of transcatheter PVR.

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Early Risk Factors for Obesity in the First 1000 Days—Relationship with Body Fat and BMI at 2 Years

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158179 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8179

Author(s):

Mercedes Díaz-Rodríguez ◽

Celia Pérez-Muñoz ◽

Jesús Carretero-Bravo ◽

Catalina Ruíz-Ruíz ◽

Manuel Serrano-Santamaría ◽

...

Keyword(s):

Risk Factors ◽

Weight Gain ◽

Body Fat ◽

Early Pregnancy ◽

Body Fat Percentage ◽

Z Score ◽

Fat Percentage ◽

Early Risk ◽

Early Risk Factors ◽

Increased Risk

(1) Background: Obesity is defined as an excessive accumulation of body fat. Several early developmental factors have been identified which are associated with an increased risk of childhood obesity and increased adiposity in childhood. The primary objective of the present study is to analyse the effect of various early risk factors on Body Mass Index (BMI) and body fat percentage at 2 years of age. (2) Methods: A prospective cohort study design was used, with the sample consisting of 109 mother-child pairs from whom data were collected between early pregnancy and 2 years old. Adiposity was determined based on skinfold measurements using the Brooks and Siri formulae. Mean comparison tests (Student’s t-test and ANOVAs) and multiple linear regression models were used to analyse the relationship between early programming factors and dependent variables. (3) Results: Maternal excess weight during early pregnancy (β = 0.203, p = 0.026), gestational smoking (β = 0.192, p = 0.036), and accelerated weight gain in the first 2 years (β = − 0.269, p = 0.004) were significantly associated with high body fat percentage. Pre-pregnancy BMI and accelerated weight gain in the first 2 years were associated with high BMI z-score (β = 0.174, p = 0.047 and β = 0.417, p = 0.000 respectively). The cumulative effect of these variables resulted in high values compared to the baseline zero-factor group, with significant differences in BMI z-score (F = 8.640, p = 0.000) and body fat percentage (F = 5.402, p = 0.002) when three factors were present. (4) Conclusions: The presence of several early risk factors related to obesity in infancy was significantly associated with higher BMI z-score and body fat percentage at 2 years of age. The presence of more than one of these variables was also associated with higher adiposity at 2 years of age. Early prevention strategies should address as many of these factors as possible.

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Association of Non-alcoholic Fatty Liver Disease with Body Fat Percentage in Normal-Weight Individuals

Shiraz E-Medical Journal ◽

10.5812/semj.108643 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Zeynab Hatamizargaran ◽

Mohammadreza Sasani ◽

Masoumeh Akhlaghi

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Body Fat ◽

Fatty Liver Disease ◽

Density Lipoprotein ◽

Normal Weight ◽

Body Fat Percentage ◽

Fat Percentage ◽

Study Results

Background: Recent data have suggested that nonalcoholic fatty liver disease (NAFLD) can occur in normal-weight subjects. This study examined the association of body fat percentage (BF%) with NAFLD and its risk factors in normal-weight individuals. Objectives: The present study aimed to explain the influence of body fat on the risk of NAFLD. Methods: A total of 59 subjects with body mass index (BMI) within the range of 18.5 - 24.9 kg/m2 were selected from referrals to two major university polyclinics in Shiraz, Iran, from April to June 2019. Fatty liver grade, anthropometric characteristics, body composition, and cardiometabolic risk factors were measured in this study. Results: Waist circumference (P = 0.012), fat mass (P < 0.001), triglycerides (TG) (P = 0.027), very-low-density lipoprotein (VLDL) (P = 0.007), and TG/high-density lipoprotein cholesterol (HDL-C) ratio (P = 0.003) increased; however, skeletal muscle mass decreased (P < 0.001) across the tertiles of BF%. The average of fatty liver grade was similar in the first and second tertiles; nevertheless, the fatty liver grade of participants in the third tertile was significantly higher (1.3 ± 0.9 vs. 0.4 ± 0.7; P = 0.005). In ordinal regression analysis, BF% (1.13; 95% CI: 1.04 - 1.22; P = 0.003), BMI (1.95; 95% CI: 1.02 - 3.74; P = 0.045), VLDL (1.77; 95% CI: 1.00 - 3.12; P = 0.049), and TG/HDL-C ratio (2.21; 95% CI: 1.26 - 3.86; P = 0.006) had positive associations with NAFLD; nonetheless, HDL-C (0.33; 95% CI: 0.16 - 0.67; P = 0.002) and dietary cholesterol (0.97; 95% CI: 0.95 - 0.997; P = 0.028) had inverse associations with NAFLD after the adjustments for age, gender, BMI, and physical activity. Conclusions: The results of this study suggested that within normal weight ranges, NAFLD occurs more frequently in individuals with higher BF%. In addition, BF% can be used as an important marker in NAFLD screening.

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Abstract P026: Early Repolarization Pattern is Associated With Increased Left Ventricular Mass and Left Ventricular Hypertrophy: Results From the Dallas Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.p026 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

David A McNamara ◽

Ari Bennett ◽

Jarett D Berry ◽

Mark S Link

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Left Ventricular ◽

Percent Body Fat ◽

Early Repolarization ◽

Heart Study ◽

Dallas Heart Study

Introduction: Recent studies have shown an association between early repolarization pattern (ERP) ECG morphology and sudden cardiac death. The role of left ventricular mass (LVM) as a potential mediator of ERP has not been well explored. Methods: Participants in the Dallas Heart Study who underwent an ECG and cardiac MRI (CMR) were assessed for ERP, defined as J-point elevation ≥1 mm in any 2 contiguous leads. We compared participants with and without ERP by age, gender, race/ethnicity, established cardiovascular risk factors of diabetes, hypertension and hyperlipidemia, lean body mass and percent body fat, and CMR-derived LVM, LVM/body surface area, and LVH defined by standard criteria, using Student’s T-tests and chi-squared tests where appropriate. Results: Of the 3,015 participants in our study, 276 (9.2%) had ERP. Participants with ERP were younger (43±9 vs 44±10 yrs, p=0.04), more prevalent in blacks than non-blacks (14 vs 5.0%, p<0.00001), and in men than women (18 vs 2.0%, p<0.00001). Baseline cardiovascular risk factors were not significantly different. Participants with ERP demonstrated higher lean body mass (59±10 vs 52±11 kg, p<0.00001) and lower percent body fat (27±8 vs 36±9%, p<0.00001). The presence of ERP was associated with greater LVM, increased LVM/body surface area, and the presence of LVH in the overall population and in analyses stratified by sex (Table 1). Conclusion: In a large, multi-ethnic cohort, ERP is associated with increased total LVM, increased LVM/body surface area, and LVH. These novel associations may provide insight into the biology of ERP. Further studies investigating the relationship of LVM and LVH with ERP are warranted.

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Identification of risk factors for bleeding during treatment of acute venous thromboembolism with heparin or low molecular weight heparin

Blood ◽

10.1182/blood.v78.9.2337.2337 ◽

1991 ◽

Vol 78 (9) ◽

pp. 2337-2343 ◽

Cited By ~ 138

Author(s):

HK Nieuwenhuis ◽

J Albada ◽

JD Banga ◽

JJ Sixma

Keyword(s):

Risk Factors ◽

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Performance Status ◽

Bleeding Tendency ◽

Who Grade ◽

Risk Of Bleeding ◽

History Of ◽

Acute Venous Thromboembolism

Abstract In a prospective double-blind trial, we treated 194 patients with acute venous thromboembolism with heparin or low molecular weight heparin (LMWH; Fragmin). To evaluate the most important prognostic factors for bleeding, the presenting clinical features of the patients, the patients' anticoagulant responses, and the doses of the drugs were analyzed using univariate and multivariate regression analyses. No significant differences in clinical risk factors associated with bleeding were observed between heparin and LMWH. The univariate analyses ranked the parameters in the following order of importance: World Health Organization (WHO) performance status, history of bleeding tendency, cardiopulmonary resuscitation, recent trauma or surgery, leukocyte counts, platelet counts, duration of symptoms, and body surface area. Patients with WHO grade 4 had an eightfold increase in risk of bleeding as compared with WHO grade 1. Assessment of the individual contribution of each variable using multivariate regression analysis showed that the WHO performance status was the most important independent factor predicting major bleeding. A history of a bleeding tendency, recent trauma or surgery, and body surface area were also independent risk factors. The risk of bleeding was influenced by two factors related to the treatment, the patient's anticoagulant response as measured with the anti-Xa assay and the dose of the drug expressed as U/24 h/m2. An increased risk of bleeding was only observed at mean anti-Xa levels greater than 0.8 U/mL for both drugs. Significantly more major bleedings occurred in patients treated with high doses of the drugs, an observation that was independent of the concomitant anti-Xa levels. It should be considered whether choosing an appropriate initial dose adapted to the patient's body surface area and clinical risk factors can improve the efficacy to safety ratio of heparin treatment.

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