Abstract 18402: Impact of Obesity on Outcomes After Percutaneous Coronary Intervention in Japanese Population: Obesity Paradox with High Waist Circumference but Not High BMI

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kenji Sakamoto ◽  
Seiji Hokimoto ◽  
Shuichi Oshima ◽  
Koichi Nakao ◽  
Kazuteru Fujimoto ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Central Obesity ◽  
Japanese Patients ◽  
Coronary Intervention ◽  
Obesity Paradox ◽  
High Waist Circumference ◽  
Significant Difference ◽  
Low Bmi ◽  
The Impact ◽  
High Bmi

Introduction: Although the counterintuitive association between obesity and mortality has been termed the obesity paradox, the evaluation of obesity was inconsistent, and evidence for an obesity paradox among past studies has been also less consistent. Hypothesis: This inconsistency may be due, in part, to a discrepancy between central obesity, estimated by waist circumference (WC), and body mass index (BMI) as patterns of adiposity. Methods: To elucidate the impact of obesity, 2817 subjects with both WC and BMI data were enrolled from the data of Kumamoto Intervention Conference Study (KICS), a multicenter registry, enrolling consecutive patients undergoing PCI in 15 centers from August 2008 to March 2011 in Japan. Subjects were stratified according to patterns of adiposity (WC or BMI), utilizing NCEP-ATPIII criteria and WHO classification. Results: Subjects’ mean age was 69.8 years, and 28% were female. There were 68 deaths during 12-month follow up. Although obesity defined by WC (ObWC) was associated with lower mortality compared with non-obesity (no-ObWC, p=0.013), no difference was shown between obesity, defined by BMI (ObBMI), and non-obesity (no-ObBMI) (p=0.201). When dividing into 4 categories based on high/low of WC and BMI, subjects with high WC and high BMI had the lowest mortality (1.6%) compared to other 3 categories (high WC low BMI; 1.7%, low WC high BMI; 2.4%, or low WC and low BMI; 3.1%). Kaplan-Meier analysis for all cause mortality showed a significant difference between ObWC and no-ObWC (Log Rank p=0.010), but comparable in BMI (ObOMI vs no-ObBMI, p=0.295). This discrepancy was also observed in the analysis for cardiac death (Figure). In multivariate analysis, in addition to age and CKD, ObWC was an independent predictor for the low mortality (OR; 0.582, 95% CI; 0.342-0.991, p=0.046). Conclusions: In Japanese patients with known CAD who undergo PCI, central obesity but not BMI is associated with the paradoxical protective effect of obesity.

scholarly journals Neck Circumference, a Novel Predictor of Overweight/ Obesity in School Children in Pokhara

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 32-39
Author(s):  
Manisha Maskey ◽  
KK Dutta Gupta ◽  
Meraj Ahmed
Keyword(s):  
Waist Circumference ◽  
School Children ◽  
Good Predictor ◽  
Central Obesity ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Neck Circumference ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
High Bmi

Background: Calculating BMI in an individual is a standard anthropometric procedure to estimate overweight/obesity. But it has been observed to be a bad predictor of central obesity. On the other hand, waist circumference, in many studies, has been found to be a good predictor of central obesity but not so frequently used because of tendency to vary throughout the day. In the recent years, NC has been found to have a good correlation with both BMI and WC. The aim of this study was to find out whether neck circumference is a good predictor of Overweight/Obesity or not. Methods: This was a cross sectional study carried out among the school children, aged 12 to 15 years, in Pokhara city, Nepal. In total, 408 students, 238 males and 170 females were screened. Anthropometric markers of obesity measured: included body mass index (BMI), waist circumference (WC), and compared with neck circumference (NC) of the same subjects. Pearson’s correlation test was used to see the correlation between NC with BMI and WC, and receiver operating characteristic curve analysis was used to determine the best cut off value of neck circumference in predicting high BMI. Results: Among 408 students, 238 (58.3%) were male and 170 (41.7%) were female. Among them 37 (9.1%) were overweight and 32 (7.8%) were obese. All the anthropometric parameters were significantly higher in cases, except height in male, than in controls. NC was significantly correlated with age, BMI, and waist circumference in both boys and girls. The best cut-off value of neck circumference by ROC to identify boys with a high BMI was 29.5 with sensitivity of (76%), specificity (54%), and for girls was 28.5 with sensitivity of (97%), specificity (48%). Conclusion: Statistically significant positive correlation was found between NC with BMI and WC. The value of NC as a screening tool has been found comparably lower in compare to WC.

Abstract 12908: Effects of Metabolic Syndrome on In-Stent Restenosis After PCI: Obesity Paradox and Sex-Associated Differences

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kenji Sakamoto ◽  
Naohiro Komura ◽  
Kenichi Tsujita ◽  
Kenshi Yamanaga ◽  
Noriaki Tabata ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Obesity Paradox ◽  
Target Lesion ◽  
Positive Influence ◽  
Female Patients ◽  
Stent Restenosis ◽  
The Impact ◽  
In Stent Restenosis

Background: The impact of metabolic syndrome (MetS) on the efficacy of PCI remains controversial. Hypothesis: This controversy may be due in part to a positive influence of obesity (the “obesity paradox”) among the factors included in the definition of MetS. Fat distribution also varies by sex, possibly confounding the impact of obesity. Methods: To elucidate the possible effects of obesity in MetS patients on in-stent restenosis (ISR) or target lesion revascularization (TLR), 546 patients treated with coronary stents (BMS or DES) were stratified according to the presence of MetS with or without obesity, using NCEP-ATP III guidelines. Waist circumference or BMI (in patients without waist circumference data) was used for diagnosis of obesity. Follow-up angiography was scheduled 8 to 9 months after PCI to obtain ISR, which was defined as %diameter stenosis (%DS)>50%. Results: Mean age of the subjects was 70.5±9.8 years, and 32.1% were female. By standard criteria, 286 patients (52.4%) were diagnosed as MetS, and 320 patients (58.6%) met criteria for obesity. Among MetS patients, 61 patients (21.3% of MetS patients) were categorized as non-obesity. At 8 to 9 months follow-up, % DS, ISR rates, and TLR rates had trends to be higher in MetS than no-MetS (ISR; 26.6% in MetS, 20.0% in non-MetS, p=0.085). These parameters showed no difference between obesity and non-obesity (ISR; 23.8% in obesity, 23.0% in non- obesity, p=0.918, TLR; 14.1% in obesity, 15.0% in non-obesity, p=0.805). In patients with MetS (Figure), however, the ratio of %DS and ISR were significantly greater in the absence of obesity in female patients, whereas no difference was observed in male patients. In multivariate analysis, non-obesity was an independent predictor for ISR or TLR in female patients with MetS. Conclusions: Overall, obesity was not related to ISR or TLR after PCI. In female MetS patients, however, comorbidity of obesity appeared to be paradoxically protective.

Abstract 12728: Untreated Sleep Apnea Syndrome is Associated With Higher Incidence of Cardiovascular Events After Percutaneous Coronary Intervention

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kazuhiro Fujiyoshi ◽  
Yoshiyasu Minami ◽  
Kohki Ishida ◽  
Miwa Ishida ◽  
Ken-ichiro Wakabayashi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Sleep Apnea ◽  
Cardiovascular Events ◽  
Sleep Apnea Syndrome ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Apnea Syndrome ◽  
The Impact

Introduction: Sleep apnea syndrome (SAS) is a risk factor of cardiovascular disease. However, the impact of SAS on the clinical course after percutaneous coronary intervention (PCI) remains to be elucidated. Methods: A total of 206 consecutive patients who underwent PCI were included. The incidence of major adverse cardiovascular events (MACE) at 3-year was compared among patients with untreated SAS (untreated SAS group; n=60), those with SAS treated by continuous positive alveolar pressure (CPAP group; n=20) and those without SAS (non-SAS group; n=96). MACE included cardiac death, non-fatal myocardial infarction, target vessel revascularization (TVR), and non-TVR (NTVR). Results: There was no significant difference in baseline clinical characteristics among the untreated SAS group, the CPAP group and the non-SAS groups, other than in age (74.1 ± 9.6 vs. 71.2 ± 0.33 vs. 68.2 ± 10.7, p = 0.002) and hemoglobin A1c levels (6.54 ± 0.87 vs. 6.61 ± 0.58 vs. 6.09 ± 0.70 %, p < 0.001). The incidence of MACE, TLR and TVR was significantly higher in the untreated SAS group than in the CPAP group and the Non-SAS group although there was no significant difference in the incidence of NTVR among the three groups (Figure). The untreated SAS was independently associated with the incidence of 3-year MACE (odds ratio 3.24, 95% confidence interval 1.36-8.20, p = 0.008). Conclusions: The incidence of MACE was significantly higher in patients with untreated SAS than in those treated with CPAP and those without SAS after PCI. The present findings may highlight the importance of SAS management in patients requiring PCI.

2014 CRL Build Study of Life Insurance Applicants

2016 ◽  
Vol 46 (1) ◽  
pp. 13-19
Author(s):  
Michael Fulks ◽  
Vera F. Dolan ◽  
Robert L. Stout
Keyword(s):  
Blood Pressure ◽  
Relative Risk ◽  
Laboratory Test ◽  
Primary Study ◽  
Reference Laboratory ◽  
Cox Regression Analysis ◽  
Relative Mortality ◽  
Low Bmi ◽  
The Impact ◽  
High Bmi

Objective Determine the impact of build on insurance applicant mortality accounting for smoking, laboratory test values and blood pressure. Method The study consisted of 2,051,370 applicants tested at Clinical Reference Laboratory between 1993 and 2007 with build and cotinine measurements available whose body mass index (BMI) was between 15 and 47. Vital status was determined as of September, 2011 by the Social Security Death Master File. Excluded from the primary study were applicants with HbA1c values ≥6.5%, systolic BP ≥141 mmHg, albumin values ≤3.3 g/dL or total cholesterol values ≤130 mg/dL. Relative mortality was determined by Cox regression analysis for bands of BMI split by age, sex and smoking status (urine cotinine positive). Results A majority of applicants had BMI &gt;24 (overweight or obese by WHO criteria). After the exclusions noted above, relative mortality does not increase by &gt;34% unless BMI is &lt;20 (&lt;18 for female non-smokers age 18 to 59) or BMI is &gt;34. BMI values in the range of 22 to 24 and 25 to 29, overall, had similar and the lowest relative risks. For most nonsmokers, risk was lowest in the lower of these two BMI bands but for smokers (and non-smoking males age 60 to 89) risk was lowest in the higher BMI band. Additional analysis showed limited reduction in relative risk by accounting for all laboratory test values as well as continuing the exclusions. Eliminating the exclusions resulted in only a modest increase in relative risk because the mortality rate of the reference band increased as well. Conclusion After excluding elevated HbA1c and blood pressure (associated with high BMI) and low albumin and cholesterol (associated with low BMI) which are usually evaluated separately, mortality varies by a limited degree for BMI 20 to 34. Accounting for the mortality impact of other test values, in addition to the exclusions noted, reduced mortality associated with high BMI to a limited extent, but had little impact on mortality associated with low BMI.

scholarly journals Impact of Metabolic Syndrome Factors on Testosterone and SHBG in Type 2 Diabetes Mellitus and Metabolic Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mukhtar Mohammed ◽  
Molham AL-Habori ◽  
Ahmed Abdullateef ◽  
Riyadh Saif-Ali
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Linear Regression ◽  
Univariate Analysis ◽  
Stepwise Linear Regression ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Low Testosterone ◽  
The Impact

Objective. Several studies have often reported low testosterone and SHBG to be associated with type 2 DM and the metabolic syndrome (MetS). Our objective was to determine the impact of metabolic syndrome and diabetic parameters on testosterone and SHBG in both MetS subjects and type 2 DM patients. Methods. In this study, 120 Yemeni male aged 30–70 years old were enrolled, 30 of whom were healthy subjects with BMI < 25 kg/m2 that served as control, 30 MetS, 30 type 2 DM without MetS, and 30 type 2 DM with MetS according to IDF criteria. Results. Testosterone (free and total) and SHBG were significantly lower in MetS subjects and modestly reduced in type 2 DM with and without MetS. Stepwise linear regression showed free and total testosterone to be negatively affected by waist circumference, and univariate analysis shows this significant difference to disappear when adjusted for waist circumference. On the other hand, stepwise linear regression showed SHBG to be positively affected by testosterone and age and negatively affected by FBG and TG. Univariate analysis shows this observed significant difference to disappear when adjusted for testosterone. Conclusion. Abdominal obesity is a major determinant of low testosterone levels irrespective of diabetes status. Thus, supporting evidence suggesting that the causative relationship between the often low testosterone and type 2 DM might be bidirectional or even multidirectional and interrelated with obesity, MetS, and IR.

scholarly journals PENGARUH BRISK WALKING (JALAN CEPAT) TERHADAP FUNGSI HATI PADA OBESITAS SENTRAL

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Heri Nuryanto ◽  
Frans E. N. Wantania ◽  
B. J. Waleleng
Keyword(s):  
Waist Circumference ◽  
Liver Function ◽  
Central Obesity ◽  
Control Group ◽  
P Value ◽  
Brisk Walking ◽  
Group Data ◽  
Significant Difference ◽  
Before And After ◽  
Post Test

Abstract: Central obesity is considered as a risk factor that strongly associated with several chronic diseases. Men with waist circumference ≥ 90 cm and women with waist circumference ≥80 cm are stated as central obesity. This study aimed to determine the effect of brisk walking on liver function in central obesity. This was an experimental field study with a non-randomized pre-post one group test and control group. This study used consecutive sampling method. There were 30 samples divided into two groups; 15 samples were given intervention and 15 samples as the control group. Data were analyzed with Wilcoxon signed ranks test.   The results showed that brisk walking for 1 month decreased the SGPT and SGOT levels, however, statistically there was no significant difference before and after intervention with a p value >0.05. Conclusion: There was no significant influence of brisk walking on liver function in central obesity. Keywords: central obesity, liver function, brisk walking  Abstrak: Obesitas sentral dianggap sebagai faktor risiko yang berkaitan erat dengan beberapa penyakit kronis. Laki-laki dengan lingkar pinggang ≥90 cm atau perempuan dengan lingkar pinggang ≥80 cm dinyatakan sebagai obesitas sentral. Penelitian ini bertujuan untuk mengetahui pengaruh brisk walking (jalan cepat) terhadap fungsi hati pada obesitas sentral.  Metode penelitian ini yaitu eksperimental lapangan dengan rancangan non – randomized pre-post test with control. Sampel ditentukan dengan teknik pengambilan sampel konsekutif sampling. Terdapat 30 sampel yang dibagi menjadi 2 kelompok yakni 15 sampel yang diberi perlakuan dan 15 sampel sebagai kontrol. Data dianalisis dengan SPSS 20 dan uji Wilcoxon Signed Ranks Test. Hasil penelitian memperlihatkan terjadi penurunan kadar enzim hati SGPT dan SGOT pada sampel yang melakukan brisk walking selama 1 bulan tetapi secara statistik tidak ada perbedaan bermakna sebelum dan sesudah mendapatkan perlakuan dengan nilai p > 0,05.  Simpulan: Tidak terdapat pengaruh bermakna dari brisk walking (jalan cepat) terhadap fungsi hati pada obesitas sentral. Kata kunci: obesitas sentral,  fungsi hati,  brisk walking

Clinical impact of obesity-related factors in perioperative management of esophageal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 39-39
Author(s):  
HIROYA TAKEUCHI ◽  
Yuji Kikuchi ◽  
Hirofumi Kawakubo ◽  
Koichi Suda ◽  
Yuko Kitagawa
Keyword(s):  
Esophageal Cancer ◽  
Surgical Site Infection ◽  
Anastomotic Leakage ◽  
The Body ◽  
Obese Patients ◽  
Site Infection ◽  
Related Factors ◽  
Significant Difference ◽  
The Impact ◽  
High Bmi

39 Background: Obese patients with esophageal cancer have been increasing worldwide. However, the impact of obesity on esophagectomy still remains controversial. In this study, we clarified the relations between obesity and postoperative outcomes after esophagectomy in patients with esophageal cancer. Methods: A total of 215 patients who underwent esophagectomy for esophageal cancer between 2008 and 2014 were retrospectively assessed. We qualified the body mass index (BMI), visceral fat area (VFA) and subcutaneous fat area (SFA) using CYNAPSE VINCENT™. Clincopathological factors, postoperative morbidity, and survival after esophagectomy were assessed with these obesity-related factors. Results: The mean BMI, VFA, and SFA were 22.0 kg/m², 83.0cm², and 87.3cm². BMI, VFA and SFA were significantly correlated each other (P < 0.001). The prevalence of diabetes mellitus and hypertension were significantly more in high SFA than normal SFA (20% vs 10%, 30% vs 14%). When the patients were divided to two groups according to BMI (< 25 or ≥25kg/m²), VFA ( < 100 or ≥100cm²) and SFA ( < 100 or ≥100cm²), operative time was significantly longer in high SFA (P = 0.03) than normal SFA, and tended to be longer in high BMI, but blood loss were similar in each groups. Maximum level of postoperative CRP was significantly higher in high BMI (P < 0.001), in high VFA (P < 0.001), and in high SFA (P < 0.001). Length of systemic inflammatory response syndrome was significantly longer in high BMI than normal BMI (1.9 days vs 1.4 days P = 0.04), and length of ventilator support was significantly longer in high SFA than normal SFA (3.0 days vs 2.2 days P = 0.006). The incidence of anastomotic leakage and surgical site infection were significantly higher in high SFA than normal SFA (27% vs 10%, 37% vs 19%). There were no significant difference in overall survival, however, patients in high VFA tended to be longer survival than those in normal VFA (P = 0.078). Conclusions: Anastomotic leakage and surgical site infection occurred more frequently in high SFA. It might be useful to examine SFA preoperatively in obese patients with esophageal cancer for prevention of postoperative complications. Patients in high VFA tended to be longer survival than those in normal VFA.

Abstract 3: Impact Of Transport To Critical Care Centers Vs. Non-critical Care Hospitals On Outcomes From Out-of-hospital Cardiac Arrest In Osaka, Japan

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kentaro Kajino ◽  
Taku Iwami ◽  
Mohamud Daya ◽  
Naohiro Yonemoto ◽  
Tatuya Nishiuchi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Coronary Intervention ◽  
Primary Outcome Measure ◽  
Confounding Variables ◽  
Significant Difference ◽  
Stratified Analysis ◽  
The Impact ◽  
Hospital Cardiac Arrest ◽  
Better Than

Background: Recent studies suggest that specialized hospital care including hypothermia and early percutaneous coronary intervention (PCI) influences the outcome of out-of -hospital cardiac arrest (OHCA) patients. In Japan, selected hospitals are certificated as “Critical Care Centers (CCC)” based on their expertise and ability to provide these higher levels of care. We hypothesized that the outcomes of patients with OHCA who were transported to CCC is better than if they were transported to non-critical care hospitals (NCCH) in Osaka, Japan. Materials and Methods: All adults with OHCA of presumed cardiac etiology, treated by the emergency medical services (EMS) systems, and transported to a hospital in Osaka, Japan from January 1, 2005 to December 31, 2006 were studied using a prospective Utstein style population cohort database. Primary outcome measure was one month neurologically favorable survival (CPC ≤ 2). Outcomes of patients transported to CCC were compared to patients transported to NCCH using multiple logistic regression to adjust for the following confounding variables; gender, age, witnessed status, bystander CPR, location, transport time and initial rhythm. We also performed a stratified analysis based on whether the patients achieved ROSC prior to arrival at the hospital. Results: Of 6,943 OHCA of presumed cardiac etiology, 6,706 cases were transported. Of these, 1,780 were transported to CCC while 4,926 were transported to NCCH. Neurologically favorable survival at one-month was greater in the CCC group [103 (5.8 %) versus 119 (2.4 %), p < 0.001]. Transportation to CCC was a significant predictor [OR = 1.7, 95% CI interval (1.3 – 2.4)] of neurologically favorable survival after adjustment for confounding variables. In the stratified analysis, the impact of the CCC was not significant difference in patients transported after field ROSC. [OR = 1.4, 95% CI interval (0.92 – 2.22)] On the other hand, the impact of the CCC was even greater in patients transported prior to field ROSC. [OR = 2.4, 95% CI interval (1.3 – 4.5)] Conclusions: The outcomes of patients with OHCA with or without field ROSC who were transported to Critical Care Centers was better than if they were transported to Non-Critical Care Hospitals.

scholarly journals Obesity paradox in Japanese patients after percutaneous coronary intervention: An observation cohort study

2013 ◽  
Vol 62 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Hidehiro Kaneko ◽  
Junji Yajima ◽  
Yuji Oikawa ◽  
Shingo Tanaka ◽  
Daisuke Fukamachi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cohort Study ◽  
Japanese Patients ◽  
Coronary Intervention ◽  
Obesity Paradox ◽  
Percutaneous Coronary

scholarly journals Lower Bmi-1 Expression May Predict Longer Survival of Colon Cancer Patients

2016 ◽  
Vol 39 (6) ◽  
pp. 2421-2426 ◽  
Author(s):  
Xiaodong Li ◽  
Xiao Zheng ◽  
Bin Xu ◽  
Dachuan Zhang ◽  
Yun Xu ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Normal Tissue ◽  
Tumor Tissue ◽  
Survival Rates ◽  
Clinicopathological Characteristics ◽  
Significant Difference ◽  
Low Bmi ◽  
Immunohistological Staining ◽  
High Bmi

Background: This study aimed to investigate the Bmi-1 expression and the clinical significance in colon cancer (CC). Patients and Methods: Bmi-1 expression in tumor tissue and the corresponding normal tissue was detected using immunohistological staining. The correlations between Bmi-1 expression and clinicopathological characteristics and the overall survival (OS) time were analyzed. Results: The median H-scores of Bmi-1 in CC tissues and the corresponding tissues were 80.0 (0-270) and 5.0 (0-90), with no statistically significant difference (Z=-13.7, P<0.001). Bmi-1 expression in CC tissues was not statistically correlated with any characteristics. The median OS times for CC patients with high or low Bmi-1 expression were 53.7 months and 44.9 months, respectively, with no statistically significant difference (P = 0.123). The survival rates of patients with low Bmi-1 expression were higher than those of patients with high Bmi-1 expression but the differences were not statistically significant. Conclusion: Bmi-1 expression in CC tissue is significantly higher than that in corresponding normal tissue. While there may be a trend towards improved survival, this is not statistically significant.

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