Risk factors for hypotension in regional spinal anesthesia for cesarean section. Role of the Waist-to-Hip Ratio and Body Mass Index

2018 ◽  
Vol 46 (1) ◽  
pp. 42-48 ◽  
Author(s):  
María Gabriela López Hernández ◽  
Héctor Julio Meléndez Flórez ◽  
Saúl Álvarez Robles ◽  
Jorge de Lugan Alvarado Arteaga
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Body Mass ◽  
Waist To Hip Ratio

scholarly journals Risk factors mediating the effect of body-mass index and waist-to-hip ratio on cardiovascular outcomes: Mendelian randomization analysis

2020 ◽  
Author(s):  
Dipender Gill ◽  
Verena Zuber ◽  
Jesse Dawson ◽  
Jonathan Pearson-Stuttard ◽  
Alice R Carter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
European Ancestry ◽  
Standard Deviation Increase ◽  
Waist To Hip Ratio ◽  
Increased Risk ◽  
Artery Disease

Background: Higher body-mass index (BMI) and waist-to-hip ratio (WHR) increase the risk of cardiovascular disease, but the extent to which this is mediated by blood pressure, diabetes, lipid traits and smoking is not fully understood. Methods: Using consortia and UK Biobank genetic association summary data from 140,595 to 898,130 participants predominantly of European ancestry, MR mediation analysis was performed to investigate the degree to which genetically predicted systolic blood pressure (SBP), diabetes, lipid traits and smoking mediated an effect of genetically predicted BMI and WHR on risk of coronary artery disease (CAD), peripheral artery disease (PAD) and stroke. Results: The 49% (95% confidence interval [CI] 39%-60%) increased risk of CAD conferred per 1-standard deviation increase in genetically predicted BMI attenuated to 34% (95% CI 24%-45%) after adjusting for genetically predicted SBP, to 27% (95% CI 17%-37%) after adjusting for genetically predicted diabetes, to 47% (95% CI 36%-59%) after adjusting for genetically predicted lipids, and to 46% (95% CI 34%-58%) after adjusting for genetically predicted smoking. Adjusting for all the mediators together, the increased risk attenuated to 14% (95% CI 4%-26%). A similar pattern of attenuation was observed when considering genetically predicted WHR as the exposure, and PAD or stroke as the outcomes. Conclusions: Measures to reduce obesity will lower risk of cardiovascular disease primarily by impacting on downstream metabolic risk factors, particularly diabetes and hypertension. Reduction of obesity prevalence alongside control and management of its mediators is likely to be most effective for minimizing the burden of obesity.

scholarly journals Body mass index and adipokines/cytokines dysregulation in Systemic Sclerosis

2021 ◽  
Author(s):  
F Iannone ◽  
Emanuela Praino ◽  
Cinzia Rotondo ◽  
Dorotea Natuzzi ◽  
Rita Bizzoca ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Systemic Sclerosis ◽  
Body Mass ◽  
Potential Role ◽  
Serum Levels ◽  
Waist To Hip Ratio ◽  
Healthy Donors ◽  
Underweight Patients ◽  
Regulatory Functions

Body fat has regulatory functions through producing cytokines and adipokines whose role in the pathogenesis of Systemic Sclerosis (SSc) is currently emerging. Changes in body mass, either overweight or underweight status, entail a dysregulation of the cytokines/adipokines network that may impact on SSc disease activity. We evaluated serum levels of adipokines and cytokines in SSc patients and correlated them to clinical features and body mass index (BMI) categories. The study included 89 SSc patients and 26 healthy donors (HD). Serum levels of adiponectin, leptin, resistin, visfatin, TNFα, IFNγ, IL-2, IL-10, and IL-17A were measured by Multiplex Immunoassay, and correlated to BMI, waist to hip ratio, and disease specific features. Mann-Whitney U-test or t-Student for unpaired data, Kruskal-Wallis test or ANOVA, were used for comparisons between groups. Spearman’s or Pearson’s test were used for correlation analysis. Serum levels of TNFα, IL-2, leptin, and resistin, were significantly higher in SSc than in HD. The highest levels of IL-17A, IL-2, IL-10, leptin and visfatin were detected in obese SSc patients (p <0.01). Conversely, underweight SSc patients showed the highest TNFα levels (p<0.05), which were negatively correlated with BMI (p=0.05). No correlation between adipokines/cytokines and clinical characteristics was found. Adipokines, IL-2, IL-10 and IL-17A were found to be increased in obese SSc patients, but whether they play a role in the pathogenesis of the disease remains to be investigated. Intriguingly, underweight patients had higher TNFα levels, suggesting a potential role of TNFα in inducing the cachexia observed in long-lasting disease.

scholarly journals Risk factors mediating the effect of body mass index and waist-to-hip ratio on cardiovascular outcomes: Mendelian randomization analysis

2021 ◽  
Author(s):  
Dipender Gill ◽  
Verena Zuber ◽  
Jesse Dawson ◽  
Jonathan Pearson-Stuttard ◽  
Alice R. Carter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
Mendelian Randomization ◽  
European Ancestry ◽  
Standard Deviation Increase ◽  
Waist To Hip Ratio ◽  
Artery Disease

Abstract Background Higher body mass index (BMI) and waist-to-hip ratio (WHR) increase the risk of cardiovascular disease, but the extent to which this is mediated by blood pressure, diabetes, lipid traits, and smoking is not fully understood. Methods Using consortia and UK Biobank genetic association summary data from 140,595 to 898,130 participants predominantly of European ancestry, Mendelian randomization mediation analysis was performed to investigate the degree to which systolic blood pressure (SBP), diabetes, lipid traits, and smoking mediated an effect of BMI and WHR on the risk of coronary artery disease (CAD), peripheral artery disease (PAD) and stroke. Results The odds ratio of CAD per 1-standard deviation increase in genetically predicted BMI was 1.49 (95% CI 1.39 to 1.60). This attenuated to 1.34 (95% CI 1.24 to 1.45) after adjusting for genetically predicted SBP (proportion mediated 27%, 95% CI 3% to 50%), to 1.27 (95% CI 1.17 to 1.37) after adjusting for genetically predicted diabetes (41% mediated, 95% CI 18% to 63%), to 1.47 (95% CI 1.36 to 1.59) after adjusting for genetically predicted lipids (3% mediated, 95% −23% to 29%), and to 1.46 (95% CI 1.34 to 1.58) after adjusting for genetically predicted smoking (6% mediated, 95% CI −20% to 32%). Adjusting for all the mediators together, the estimate attenuated to 1.14 (95% CI 1.04 to 1.26; 66% mediated, 95% CI 42% to 91%). A similar pattern was observed when considering genetically predicted WHR as the exposure, and PAD or stroke as the outcome. Conclusions Measures to reduce obesity will lower the risk of cardiovascular disease primarily by impacting downstream metabolic risk factors, particularly diabetes and hypertension. Reduction of obesity prevalence alongside control and management of its mediators is likely to be most effective for minimizing the burden of obesity.

scholarly journals Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

2020 ◽  
Vol 41 (S1) ◽  
pp. s377-s377
Author(s):  
Feah Visan ◽  
Jenalyn Castro ◽  
Yousra Siam Shahada ◽  
Naser Al Ansari ◽  
Almunzer Zakaria
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Body Mass ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

scholarly journals Assessment of Risk Factors Associated with Cardiovascular Diseases in Overweight Women

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3658
Author(s):  
María-José Castro ◽  
José-María Jiménez ◽  
María López ◽  
María-José Cao ◽  
Manuel Durán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Cardiovascular Risk ◽  
Body Mass ◽  
Premenopausal Women ◽  
Hdl Cholesterol ◽  
Breast Volume ◽  
Anthropometric Measures ◽  
Waist To Hip Ratio ◽  
Cholesterol Ratio

The assessment of anthropometric variables has been shown to be useful as a predictor of cardiovascular risk in overweight and obese patients. The aim of this study was to determine the usefulness of the relationship between breast volume and body mass index as an indicator of cardiovascular risk in premenopausal women with overweight and mild obesity. A prospective observational study of 93 premenopausal women was performed. Evaluation of anthropometric measures included age, body mass index, waist and hip circumferences, breast projection, and ptosis. Cardiovascular risk factors were evaluated using the Framingham cardiovascular risk score, the triglycerides/HDL cholesterol ratio and the waist-hip ratio. Ninety-three women were included, with a mean 36.4 ± 7.5 years. Mean BMI was 27.3 ± 1.9 kg/m2, waist-to-Hip ratio was 0.8 ± 0.07, and mammary volume was 1045 ± 657.4 cm3. Mean body fat mass was 30.6 + 3.6% and mean visceral fat was 6.6 + 3.2%. The mean triglycerides to HDL ratio was 1.7 ± 0.8 and waist-to-hip ratio was 0.8 ± 0.07. Breast volume related to body mass index can be used as a predictor of cardiovascular risk in premenopausal women who are overweight and mildly obese.

scholarly journals THE ROLE OF ORTHOSTATIC TEST IN PROGNOSIS OF ARTERIAL HYPERTENSION DEVELOPMENT IN YOUNG ADULTS

The Clinician ◽  
2018 ◽  
Vol 12 (2) ◽  
pp. 16-21
Author(s):  
E. V. Sklyannaya
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Young Adults ◽  
Arterial Hypertension ◽  
Body Mass ◽  
Orthostatic Test ◽  
Group 2 ◽  
Observation Period ◽  
Group 1

The aimof this study was to assess the role of orthostatic test in prognosis of arterial hypertension (AH) in young adults.Materials and methods.842 young adults 20–29 years old with the level of blood pressure (BP) <140/90 mm Hg were enrolled in a prospective study. Active orthostatic test was performed. Observation period was 5 years. After that 2 groups were assigned according to BP level: group 1 – with AH (BP level >140/90 mm Hg), group 2 – with normal BP level (<140/90 mm Hg).Results.Physiological type of orthostatic reaction was found in 542 persons (64.4 %), primary hypersympathicotonic type – in 79 (9.4 %), secondary hypersympathicotonic – in 93 (11.1 %), hyposympathicotonic – in 94 (11.2 %), sympathicoasthenic – in 34 (4.0 %). 78 persons were withdrawn from the study for different reasons during observation period. AH was diagnosed in 144 (18.8 %) persons (group 1), normal BP – in 620 (81.2 %) participants (group 2). In group 1 hypersympathicotonic response to orthostatic test was observed in 102 (70.8 %) persons, in group 2 – in 47 (7.6 %) participants (р <0,001). By the results of univariate logistic regression analysis male sex (OR 10.8; 95 % CI 7.6–15.3), body mass index >25 kg/m2 (OR 7.2; 95 % CI 5.7–9.1), smoking (OR 5.6; 95 % CI 4.5–7.0), high normal BP (OR 10.7; 95 % CI 6.9–14.5) and hypersympathicotonic orthostatic response (OR 13.6; 95 % CI 10.0–18.7) were significant risk factors of AH. By the results of multivariate analysis body mass index >25 kg/m2, high normal BP and hypersympathicotonic orthostatic response were independent risk factors.Conclusion.Hypersympathicotonic orthostatic response with increased body mass index and high normal BP are the risk factors of AH development during next 5 years in young adults. It is reasonable to use orthostatic test in assessing the risk of AH development in young people.

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