scholarly journals Obesity and Overweight Are Independently Associated with Greater Survival in Critically Ill Diabetic Patients: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wentao Huang ◽  
Yongsong Chen ◽  
Guoshu Yin ◽  
Nasui Wang ◽  
Chiju Wei ◽  
...  

Background. The relationship between obesity and the outcomes of critically ill diabetic patients is not completely clear. We aimed to assess the effects of obesity and overweight on the outcomes among diabetic patients in the intensive care unit (ICU). Methods. Critically ill diabetic patients in the ICU were classified into three groups according to their body mass index. The primary outcomes were 30-day and 90-day mortality. ICU and hospital length of stay (LOS) and incidence and duration of mechanical ventilation were also assessed. Cox regression models were developed to evaluate the relationship between obesity and overweight and mortality. Results. A total of 6108 eligible patients were included. The 30-day and 90-day mortality in the normal weight group were approximately 1.8 times and 1.5 times higher than in the obesity group and overweight group, respectively ( P < 0.001 , respectively). Meanwhile, the ICU (median (IQ): 2.9 (1.7, 5.3) vs. 2.7 (1.6, 4.8) vs. 2.8 (1.8, 5.0)) and hospital (median (IQ): 8.3 (5.4, 14.0) vs. 7.9 (5.1, 13.0) vs. 8.3 (5.3, 13.6)) LOS in the obesity group and overweight group were not longer than in the normal weight group. Compared with normal weight patients, obese patients had significantly higher incidence of mechanical ventilation (58.8% vs. 64.7%, P < 0.001 ) but no longer ventilation duration (median (IQ): 19.3 (7.0, 73.1) vs. 19.0 (6.0, 93.7), P = 1 ). Multivariate Cox regression showed that obese and overweight patients had lower 30-day (HR (95% CI): 0.62 (0.51, 0.75); 0.76 (0.62, 0.92), respectively) and 90-day (HR (95% CI): 0.60 (0.51, 0.70); 0.79 (0.67, 0.93), respectively) mortality risks than normal weight patients. Conclusions. Obesity and overweight were independently associated with greater survival in critically ill diabetic patients, without increasing the ICU and hospital LOS. Large multicenter prospective studies are needed to confirm our findings and the underlying mechanisms warrant further investigation.

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9675
Author(s):  
Huijuan Wang ◽  
Pingping Wang ◽  
Yu Wu ◽  
Xiukun Hou ◽  
Zechun Peng ◽  
...  

Objective To explore the relationship between body mass index (BMI) and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC). Methods The clinical data of 1,579 patients with PTC, admitted to our hospital from May 2016 to March 2017, were retrospectively analyzed. According to the different BMI of patients, it can be divided into underweight recombination (BMI < 18.5 kg/m), normal body recombination (18.5 ≤ BMI < 24.0 kg/m2), overweight recombination (24.0 ≤ BMI < 28.0 kg/m2) and obesity group (BMI ≥ 28.0 kg/m2). The clinicopathological characteristics of PTC in patients with different BMIs group were compared. Results In our study, the risk for extrathyroidal extension (ETE), advanced T stage (T III/IV), and advanced tumor-node-metastasis stage (TNM III/IV) in the overweight group were higher, with OR (odds ratio) = 1.99(1.41–2.81), OR = 2.01(1.43–2.84), OR = 2.94(1.42–6.07), respectively, relative to the normal weight group. The risk for ETE and T III/IV stage in the obese group were higher, with OR = 1.82(1.23–2.71) and OR = 1.82(1.23–2.70), respectively, relative to the normal weight group. Conclusion BMI is associated with the invasiveness of PTC. There is a higher risk for ETE and TNM III/IV stage among patients with PTC in the overweight group and for ETE among patients with PTC in the obese group.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Shan Chen ◽  
Peizhen Zhang

Objective Overweight was a global public health problem. In recent years, the number of overweight people in China had been increasing. Being overweight had a serious impact on health. 31.1% of overweight people had aggregation of risk factors for cardiovascular metabolic diseases. And overweight people were more likely to suffer from some diseases, such as hypertension, diabetes, dyslipidemia and arthritis. This study compared the gas metabolism index differences between overweight and normal weight women when they did exercise under different load, and summarized gas metabolism characteristics of overweight women, in order to lay the foundation for instructing overweight women to do exercise scientifically, reduce the risk factors of chronic diseases such as cardiovascular disease, and enhance and improve physical fitness and health. Methods Adult women between 20 and 30 years were taken as subjects. After measuring their height and weight, they were divided into normal weight group (BMI=18~23.9kg/m2) and overweight group (BMI>24kg/m2) according to body mass index (BMI). There were 15 participants in each group. After the baseline test, using modified Bruce treadmill protocol, the air metabolism indexes of two groups were determined by Cortex MetaMax 3B portable gas metabolic analyzer, including oxygen uptake(VO2), minute ventilation(MV), breathing frequency(BF), expiratory end-tidal CO2concentration(ETCO2), expiratory end-tidal O2concentration (ETO2), arterial blood carbon dioxide partial pressure (PaCO2), carbon dioxide output(VCO2), oxygen pulse and maximal voluntary ventilation(MMV), etc. The differences of gas metabolism indexes among resting, exercise, and recovery stages were compared and analyzed. Results (1) Most of indexes such as VO2, VCO2, and MV rose gradually with the load increase during exercise stress test except for ETO2and PaCO2. VO2, PaCO2, VCO2and ETCO2of overweight group were significantly lower than normal weight group during the same load. PaCO2of overweight group at grade 4 was significant lower than normal weight group by 5.6 mmHg (P<0.05). VCO2of overweight group at grade 5 was significant lower than normal weight group by 0.6L/min (P<0.05). ETCO2 of overweight group at grade 3 and 4 were significant lower than normal weight group about 0.5% and 0.6% respectively (P<0.05). (2) During recovery stage, most of indexes decreased gradually, such as MV and BF, while ETO2presented a rising trend. At a certain time during the recovery stage, ETCO2of overweight group was significantly lower than normal weight group (5.3% vs 5.8%), while MMV, MV and oxygen pulse were significantly higher than normal weight group (P<0.05). MMV of overweight group at 2, 3 and 4 minutes were significant lower than normal weight group by1L/min, 1L/min and 0.9L/min, at the same time, MV of overweight group were significant lower than normal weight group by17.8L/min, 20.1L/min and 16.9L/min. The oxygen pulse of overweight group during whole 5 minutes recovery period were significantly higher than normal weight group by 2.7L/min, 3.9L/min, 3.9L/min, 2.9L/min and 2.0L/min. (3) The gaseous metabolism between two groups was significantly different when they did 7.1 and 10.2 METs exercise. Conclusions Although there was no difference in gas metabolism between overweight and normal weight adult women in resting state, the respiratory function of overweight women was weaker than normal weight women during exercise, especially at the intensities of 7.1 and 10.2 METs. During the recovery period after exercise stress test, the recovery rate of gas metabolism in overweight adult women was slower than that of normal weight women.


2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Nirav R. Patel ◽  
Mary J. Ward ◽  
Debra Beneck ◽  
Susanna Cunningham-Rundles ◽  
Aeri Moon

Background. In adults, it has been shown that obesity is associated with gastroesophageal reflux disease (GERD) and GERD-related complications. There are sparse pediatric data demonstrating associations between childhood overweight and GERD.Objective. To investigate the association between childhood overweight and RE.Methods. We performed a retrospective chart review of 230 children (M :  : 116) who underwent esophagogastroduodenoscopy (EGD) with biopsies between January 2000 and April 2006. Patient demographics, weight, height, clinical indications for the procedure, the prevalence of BMI classification groups, the prevalence of RE and usage of anti-reflux medications were reviewed. For these analyses, the overweight group was defined to include subjects with 85th percentile. The normal weight group was defined to include subjects with BMI 5th to 85th percentile.Results. Among the 230 subjects, 67 (29.1%) had BMI percentiles above the 85th percentile for age and gender. The prevalence of RE in the overweight group did not differ significantly from that in the normal weight group (23.9% versus 24.5%, resp.). Overweight subjects taking anti-reflux medications clearly demonstrated a higher prevalence of biopsy-proven RE compared to overweight subjects not taking anti-reflux medications (34.1% versus 7.7%, ).Conclusions. There was no significant difference in the prevalence of biopsy-proven RE in the overweight group compared to the normal weight group. However, the prevalence of RE was significantly higher in overweight subjects on anti-reflux medications compared to overweight subjects not taking anti-reflux medications. This finding emphasizes the importance of early recognition and treatment of GERD for the overweight pediatric patients with symptoms in conjunction with weight loss program for this population to reduce long-term morbidities associated with GERD.


2003 ◽  
Vol 17 (3) ◽  
pp. 183-189 ◽  
Author(s):  
Feifei Wang ◽  
Alyssa B. Schultz ◽  
Shirley Musich ◽  
Tim McDonald ◽  
David Hirschland ◽  
...  

Purpose. To explore the relationship between the 1998 National Heart, Lung, and Blood Institute (NHLBI) weight guidelines and concurrent medical costs. Design. Cross-sectional study. Setting. In a nationwide manufacturing corporation (General Motors Corporation). Subjects. A total of 177,971 employees, retirees, and their adult dependents who were enrolled in Indemnity/PPO health insurance plan during the years 1996 and 1997 and completed one health risk appraisal (HRA) in the same period. Measures. The participants were categorized into six weight groups according to the NHLBI 1998 guidelines (body mass index [BMI] <185, 185–24.9, 25–29.9, 30–34.9, 35–39.9, ≥40 kg/m2). The height and weight data were collected by self-reported values on an HRA or biometric screening completed during 1996 to 1997. To represent the typical medical costs in a given group, the median, instead of mean, medical charges were used in this article. The annual median medical charges (including drug charges) for years 1996 and 1997 were compared among the six weight groups by using Wilcoxon rank sum tests. The differences in median charges were also tested between the normal weight group and the other five groups for each of the 10 gender-age subgroups (five age groups: 19–44, 45–54, 55–64, 65–74, 75+). Results. Overall median medical costs were consistent with the NHLBI weight guidelines. The normal-weight group costs the least and both underweight and overweight-obesity groups cost more. The median medical costs of the six weight groups were $3184, $2225, $2388, $2801, $3182, and $3753, respectively, with statistical differences existing between any two groups of the last five categories. The underweight groups, especially in females, were not consistent with the guidelines in the two young groups (ages 19–44 and 45–54). An inconsistent relationship between medical costs and BMI groups was seen in the oldest males (age 75+). Conclusions. The six weight groups defined by the 1998 NHLBI guidelines are consistent with concurrent medical costs. Except for the underweight group (BMI < 18.5 kg/m2), medical costs gradually increased with BMI. Given that the prevalence of obesity continues to increase in western countries, effective weight control programs would help avoid a substantial amount of medical costs associated with overweight/obesity and related diseases.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyohei Yugawa ◽  
Shinji Itoh ◽  
Norifumi Iseda ◽  
Takeshi Kurihara ◽  
Yoshiyuki Kitamura ◽  
...  

AbstractBody mass index (BMI) is well known to be associated with poor prognosis in several cancers. The relationship between BMI and the long-term outcomes of patients with intrahepatic cholangiocarcinoma (ICC) is incompletely understood. This study investigated the relationships of BMI with clinicopathological characteristics and patient outcomes, focusing on metabolic activity and immune status. The relationship between BMI and the maximum standardized uptake value (SUVmax) on fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was analyzed. In addition, immunohistochemistry was performed for programmed cell death-ligand 1 (PD-L1), cluster of differentiation 8 (CD8), and forkhead box protein P3 (Foxp3). Seventy-four patients with ICC were classified into normal weight (BMI < 25.0 kg/m2, n = 48) and obesity groups (BMI ≥ 25.0 kg/m2, n = 26), respectively. Serum carbohydrate antigen 19–9 levels were higher in the obesity group than in the normal weight group. Tumor size and the intrahepatic metastasis rate were significantly larger in the obesity group. Patients in the obesity group had significantly worse prognoses than those in the normal weight group. Moreover, BMI displayed a positive correlation with SUVmax on 18F-FDG PET/CT (n = 46, r = 0.5152). Patients with high 18F-FDG uptake had a significantly higher rate of PD-L1 expression, lower CD8 + tumor-infiltrating lymphocyte (TIL) counts, and higher Foxp3 + TIL counts. The elevated BMI might predict the outcomes of patients with ICC. Obesity might be associated with ICC progression, possibly through alterations in metabolic activity and the immune status.


2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Dalia Ramzy Ibrahim ◽  
Mervat Elsayed Taha ◽  
Amaal Mohamed Kamal

Chemerin is an adipokine secreted by adiopose tissue and has a role in obesity and hypertension. This study aims at assessing the level of the adipokine chemerin in obesity and/or hypertension and correlating its level with the inflammatory marker hs-CRP and predictors of atherosclerosis as lipid profile, insulin resistance, systolic (SBP) and diastolic blood pressure (DBP).Volunteers were divided into 4 equal groups according to body mass index (BMI) and blood pressure: normal weight group (BMI ≤ 24.9 kg/m2), overweight group (BMI = 25.0 – 29.9 kg/m2), normotensive obese group (BMI ≥ 30.0 kg/m2) and hypertensive obese group (BMI ≥ 30.0 kg/m2). Chemerin, high-sensitivity C-reactive protein (hs-CRP), lipid profile, fasting blood glucose (FBG) and fasting insulin (FI) were evaluated in the mentioned groups.The results showed that there were significant increases of chemerin, hs-CRP, low density lipoprotein (LDL), SBP and DBP in hypertensive obese group compared to normotensive obese , overweight and normal weight groups. Moreover the only significant positive correlation between chemerin and hs-CRP was observed in the obese hypertensive group. The normotensive obese group showed significant increases of hs-CRP, LDL, triglyceride (TG), FBG, FI and the homeostasis model assessment-insulin resistance index (HOMA-IR) compared to the overweight and normal weight groups. Regarding the overweight group, there were significant increases in chemerin, hs-CRP, cholesterol, LDL, TG compared to the normal weight group, while the HDL levels were significantly lower compared to the two obese groups. These results revealed that the pro-inflammatory adipokine chemerin increases in obesity associated with hypertension, leading to the suggestion that there is a definite dysregulation of the pro-inflammatory and anti-inflammatory parameters towards the pro-inflammatory when hypertension and obesity are associated.            


2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Yao Qiu ◽  
Lizhi Sun ◽  
Xiaolin Hu ◽  
Xin Zhao ◽  
Hongyan Shi ◽  
...  

Abstract Purpose People with obesity have a compromised browning capacity of adipose tissue when faced with sympathetic stimuli. This study aimed to determine whether norepinephrine treatment can enhance the induction of precursor cells from human white adipose tissue to differentiate into adipocytes that express key markers of beige adipocytes, and if there is a difference in this capacity between normal weight and overweight individuals. Methods Stromal vascular cells derived from subcutaneous white adipose tissue of normal weight and overweight groups were induced to differentiation, with or without norepinephrine, into adipocytes. Oxygen consumption rate, lipolysis, the expression of uncoupling protein 1 and other thermogenic genes were compared between different adiposity and treatment groups. Results Peroxisome proliferator activated receptor γ- coactivator-1 alpha (PGC-1 α) and uncoupling protein 1 gene expression increased significantly in the normal weight group, but not in the overweight group, with norepinephrine treatment. The increments of lipolysis and oxygen consumption rate were also higher in adipocytes from the normal weight group with norepinephrine treatment, as compared with those of the overweight group. PR domain containing protein 16 (PRDM 16) gene expression was higher in the normal weight group compared with that in the overweight group, while there were no significant changes found with norepinephrine treatment in either the normal weight or overweight group. Conclusions Adipogenic precursor cells derived from overweight individuals were less prone to differentiate into beige-like adipocytes when facing sympathetic stimuli than normal weight ones, resulting in the compromised sympathetic-induced browning capacity in subcutaneous white adipose tissue in overweight individuals, which occurred before the onset of overt obesity.


2021 ◽  
Vol 12 ◽  
Author(s):  
Hui Li ◽  
Huan Wang ◽  
Jing Zhu ◽  
Jianmin Xu ◽  
Yuqing Jiang ◽  
...  

BackgroundWhether female BMI impacts the DNA repair ability in the oocytes after fertilization has not been investigated. The aim of this study is to assess the early embryo quality and reproductive outcomes of oocytes from overweight women when fertilized with sperm with varying degrees of DNA fragmentation.MethodsA total number of 1,612 patients undergoing fresh autologous in vitro fertilization (IVF) cycles was included. These patients were divided into two groups according to maternal body mass index (BMI): normal weight group (18.5–24.9 kg/m2; n=1187; 73.64%) and overweight group (≥25 kg/m2; n=425; 26.36%). Each group was then subdivided into two groups by sperm DNA fragmentation index (DFI): low fragmentation group (&lt;20% DFI, LF) and high fragmentation group (≥20% DFI, HF). Laboratory and clinical outcomes were compared between subgroups.ResultsFor the normal-weight group, there was no statistical significance in embryo quality and reproductive outcomes between the LF and HF groups. But in the overweight group, significantly lower fertilization rate (LF: 64%; HF: 59%; p=0.011), blastocyst development rate (LF: 57%; HF: 44%; p=0.001), as well as high-quality blastocyst rate (LF: 32%; HF: 22%; p=0.034) were found in the HF group, despite the similar pregnancy rates (LF: 56%; HF: 60%; p=0.630).ConclusionsDecreased DNA repair activity in oocytes may be a possible mechanism for the low early development potential of embryos from overweight patients in in vitro fertilization cycles.


2012 ◽  
Vol 35 (4) ◽  
pp. 229 ◽  
Author(s):  
Fatih Poyraz ◽  
Murat Turfan ◽  
Sinan A. Kocaman ◽  
Huseyin U. Yazici ◽  
Nihat Sen ◽  
...  

Purpose: The purpose of this study was to evaluate whether a association exits among overweight and obesity and left ventricular systolic and diastolic functions in patients admitted with first ST-elevation myocardial infarction (STEMI). Methods: The present study was performed on 451 consecutive patients diagnosed with first STEMI (376 men, 75 women; mean age 56.1±10.8 years). The patients were classified into three groups based on their body mass index (BMI) as normal weight (BMI < 25 kg/m2), overweight (BMI: 25-29.9 kg/m2) and obese (BMI > 30 kg/m2). Echocardiographic features were evaluated and compared among the three groups. Results: Mitral annulus E velocities were higher in obese individuals than normal weight group (p < 0.01). In contrast, mitral A velocities were lower (p =0.03); consequently, E\A and E'\A' ratios were lower (both p =0.01) in the obese group with respect to normal weight group. When the correction of entire variations existing among the groups were performed using multivariate linear regressions analyses, it turned out that BMI was independently associated with E/A (β= -0.19, p =0.044) and with E'/A' (β= -0.016, p=0.021). Ejection fraction, wall motion score index and myocardial S velocities were comparable among the study groups (p > 0.05). Conclusion: These results suggest that while obesity has no adverse effect on the left ventricular systolic function, it has unfavorable consequences on the left ventricular diastolic function in the patients with first STEMI. In contrast, no unfavorable effects of overweight on the left ventricular systolic and diastolic function were detected.


Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 87 ◽  
Author(s):  
Koji Nonaka ◽  
Shin Murata ◽  
Kayoko Shiraiwa ◽  
Teppei Abiko ◽  
Hideki Nakano ◽  
...  

Background: Body mass index (BMI) is related to health in the elderly. The purpose of this study was to investigate the physical characteristics in underweight, overweight, and obese Japanese community-dwelling elderly women compared to normal-weight elderly women. Methods: The study participants included 212 community-dwelling elderly women. They were categorized as underweight (BMI < 18.5), normal weight (18.5 ≤ BMI ≤ 22.9), overweight (23 ≤ BMI ≤ 24.9), and obese (BMI ≥ 25). Data on skeletal muscle mass index (SMI), number of trunk curl-ups performed within 30 seconds, knee extension strength, one-leg standing time, and walking speed were recorded. Results: In the underweight group, the number of trunk curl-ups was significantly lower than that of the normal-weight group (p = 0.011) and the correlation between knee extension strength and walking speed was relatively higher than in the normal-weight group (r = 0.612 vs. r = 0.471). In the overweight group, the SMI was significantly increased (p < 0.001), but knee extension strength was not increased (p = 0.235) compared to that of the normal-weight group. In the obese group, one-leg standing time was significantly shorter than in the normal-weight group (p = 0.016). Conclusions: Physical characteristics vary according to BMI and these findings are useful in assessing and planning interventional programs to improve and maintain physical function in elderly women.


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