scholarly journals Correlation of body mass index and abnormal uterine bleeding in premenopausal women

Author(s):  
Kumarasamy Akalyaa ◽  
Pattacheravanda Nanaiah Shakuntala ◽  
Ramaiah Renuka

Background: As the rate of obesity is increasing in women in the recent years, the incidence of endometrial cancer increases as the body mass index (BMI) increases. Despite the clear evidence linking endometrial cancer and obesity, there is limited public awareness of this relationship. This study was undertaken to evaluate the association of BMI and endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB).Methods: An analytical case control study was conducted in 100 women between the age group of 40 to 55, with AUB in the Department of Obstetrics and Gynecology, ESIC-PGIMSR Bangalore between January 2018 and June 2019. The menstrual patterns and endometrial pattern by histopathology were analysed in women with BMI of 18.5 to 24.99 and ≥25.Results: The mean age of women participated in the study group of between 40- 55 years was 44.83. The mean duration of symptoms was 10.18 months in the cases group and 8.52 months in the control group. The menstrual patterns were comparable and there was no significant difference in both the groups. The mean endometrial thickness, mean BMI, hyperplasia with or without atypia were all higher in the cases group. The frequency of occurrence of atypical endometrial hyperplasia was higher in women with increasing BMI.Conclusions: We found increased BMI to be an important independent risk factor for the development of endometrial hyperplasia with atypia which is a precursor to endometrial carcinoma in premenopausal women with AUB. 

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Giannella ◽  
Lillo Bruno Cerami ◽  
Tiziano Setti ◽  
Ezio Bergamini ◽  
Fausto Boselli

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.


2018 ◽  
Vol 28 (2) ◽  
pp. 29566
Author(s):  
Magali Santos Lumertz ◽  
Ângela De Moura ◽  
Leonardo Araújo Pinto ◽  
Paulo Augusto Moreira Camargos ◽  
Paulo José Cauduro Marostica

AIMS: To compare clinical, laboratory and spirometric parameters of preschoolers (ages from three to six years old) with cystic fibrosis identified by abnormal newborn screening test (NS group), with data of patients whose diagnostic suspicion arose from characteristic clinical signs and symptoms (CS group).METHODS:  Retrospective cohort study, with a sample obtained from the medical charts of patients who received specialized and multidisciplinary outpatient follow-up. All the included children had a confirmed diagnosis of cystic fibrosis by sweat electrolyte testing and/or genetic sequencing. Variables included sex, weight, height, body mass index, number of hospitalizations per year, Pseudomonas aeruginosa colonization, presence of pancreatic insufficiency and Shwachman score, which covers four domains: general activity, nutrition, radiological examination and physical evaluation, each one scored between 5 and 25 points. A total score ≤40 points indicates severe state, and ≥86 points indicates excellent state. For comparison of pulmonary function, data from the last spirometry performed before the age of six years were used. Outcomes were compared by chi-square or Student's t test, with a significance limit of 0.05.RESULTS: Twenty-four patients were included in the study, seven children in the NS group and 17 children in the CS group. The children of the NS group started follow-up with a mean age of 1.51±2.04 months, and those of the CS group started with 3.77±1.80 months (p=0.014). The mean Shwachman score was 94.40±2.19 in the NS vs. 87.67±8.00 in the CS group (p=0.018). The mean Z score for body mass index was 0.95±1.02 in the NS group vs. 0.51±1.05 in the CS group (p=0.051). Spirometric variables had slightly higher values in the NS group, with no statistically significant difference between groups.CONCLUSIONS: The results suggest that those patients diagnosed with cystic fibrosis from the neonatal screening test suspicion benefited from an early intervention, being able to initiate pulmonary function tests and receive treatment and counseling earlier. Evaluation of clinical parameters with the Shwachman score showed that benefits could be already observed at the preschool age.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1638
Author(s):  
Antonio Viñuela ◽  
Juan José Criado-Álvarez ◽  
Javier Aceituno-Gómez ◽  
Carlos Durantez-Fernández ◽  
José Luis Martín-Conty ◽  
...  

(1) Objective: This study analyzes the evolution of the body mass index (BMI) throughout the academic year associated with changes in the lifestyle associated with the place where students live during the course, lifestyle design, and health strategies for the university community. (2) Methods: A total of 93 first-year nursing students participated in this study. Data were collected throughout the course by administering self-reported questionnaires about eating habits and lifestyles, weight, and height to calculate their BMI and place of residence throughout the course. Data were analyzed using statistical analysis (Mann–Whitney, chi-square, Student’s t-test, repeated-measures analysis of variance, and least significant difference tests). (3) Results: We found that the mean BMI increases significantly throughout the course among all students regardless of sex, age, eating habits, or where they live during the course. At the beginning of the course, the mean BMI was 22.10 ± 3.64. The mean difference between the beginning of the course and the middle has a value of p-value < 0.015 and between the middle of the course and the end a p-value < 0.009. The group that increased the most is found among students who continue to live in the family nucleus rather than those who live alone or in residence. Students significantly changed their eating and health habits, especially those who live alone or in residence. (4) Conclusions: There is an increase in BMI among students. It is necessary to carry out seminars or talks that can help students understand the importance of good eating practices and healthy habits to maintain their weight and, therefore, their health, in the short, medium, and long term and acquire a good quality of life.


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Oloruntoba A. Ekun ◽  
Isiaq T. Salau ◽  
Nora C. Madu

Background: Hypertension is a chronic disease that has been recognized as an important global public health disorder. It is a leading risk factor for stroke, heart failure, kidney diseases, and sudden death; as such its effective management may go a long way in preventing some of these possible complications. In humans, trace elements play key roles in normal metabolic activities that are required for healthy living. It has been hypothesized that trace elements are key to normal heart functions. Thus, deficiency in one or more trace elements may result(s) in or accentuate heart disease(s). This study, therefore, assessed trace elements in hypertensive and control volunteers. Methods: A total number of two hundred and fifty-six(256) participants comprising of one hundred and sixtynine (169) hypertensive and eighty-seven (87) normotensive control volunteers participated in this study. Anthropometric data and blood samples were collected from all participants. The blood samples were collected into plain vacutainer and were allowed to clot. The samples were centrifuged and the serum from each sample was aspirated and analyzed for trace elements {Selenium (Se), Copper (Cu), Zinc (Zn), Iron (Fe)} using atomic absorption spectrophotometer and calcium using Cobas C-111. Results: There was no significant difference (p>0.05) between the mean age and weight of the participants. However, the mean body mass index (BMI), systolic, and diastolic blood pressure in hypertensive volunteers were significantly higher (p<0.05) than the controls. The mean Cu and Fe were higher (p<0.05) in hypertensive volunteers whereas the mean Zn, Se, and calcium were not different (p>0.05) between the two groups that participated in this study. There were positive associations between body mass index, systolic blood pressure (p<0.05), and Cu whereas negative correlations existed between body mass index, Zn, and Se, among hypertensive volunteers. Conclusion: From this study, it appears that high blood pressure among Nigerian population is associated with elevated serum copper (Cu) and iron (Fe) trace elements. These may play a part in accentuation of hypertension in some of the volunteers if not properly monitored. Also hypertensive individuals also presented an increased body mass index (BMI) which could also complicate effective management of hypertension .


2019 ◽  
Vol 47 (5) ◽  
pp. 461-468
Author(s):  
Usha Gurunathan ◽  
Lisa M Stanton ◽  
Rachael M Weir ◽  
Karen E Hay ◽  
Bronwyn L Pearse

Surgery and obesity are known risk factors for thromboembolic events due to the presence of a hypercoagulable state. Rotational thromboelastometry is a viscoelastic assay that can provide a measure of hypercoagulability via a comprehensive assessment of the coagulation process. This prospective study investigates haemostatic changes over time, presence of hypercoagulability and the association between body mass index and thromboelastometry results in patients undergoing major orthopaedic surgery. Fifty adult patients undergoing total hip or knee replacement surgery had serial thromboelastometry measures performed prior to and following surgery, and on postoperative days 1 and 3. A hypercoagulable state, defined by an ExTEM maximum clot firmness G score ≥11 dyne/cm2, was present in 28% of the patients at baseline. The mean ExTEM maximum clot firmness G score increased by an average of three units from 10 (95% confidence interval (CI) 9–11) dyne/cm2 at baseline to 13 (95% CI 13–14) dyne/cm2 on postoperative day 3, with 85% of patients having a G score ≥11 dyne/cm2. A decrease in ExTEM and InTEM clot formation time and an increase in ExTEM, InTEM and FibTEM clot amplitude at 10 minutes, alpha angle and maximum clot firmness were observed by postoperative day 3 ( P <  0.001). There was no significant difference in the mean thromboelastometry values between patients with a body mass index <35 kg/m2or ≥35 kg/m2. Although a modest association between body mass index and the ExTEM maximum clot firmness G score was observed with exploratory data analysis, further study is required in a large cohort to test the effects of confounders, validate these findings, and determine their clinical importance.


2018 ◽  
Vol 9 (2) ◽  
pp. 31-35
Author(s):  
Pravin Shrestha ◽  
Smita Shrestha ◽  
Vibha Mahato

Background: Abnormal Uterine Bleeding is defined as any deviation from a normal menstrual pattern. It is one of the common presentation in extremes of ages. However endometrial hyperplasia and carcinoma are commoner in perimenopausal and postmenopausal women warranting investigations like ultrasonography and endometrial biopsy.Aims and Objective: The aim of the study was to note the endometrial thickness by transabdominal ultrasonography and observe the histopathological pattern in women presenting with abnormal Uterine Bleeding.Material and Methods: Premenopausal women more than 45 years of age and the postmenopausal patients, without any pelvic pathology were included in the study. Endometrial thickness was measured by transabdominal sonography and endometrial biopsy was done. Tissue obtained was sent for histopathological examination.Results: A total of 105 patients were studied. Majority (92%) of patients were premenopausal. Proliferative Endometrium (32%) was the most common finding in premenopausal and atrophic endometrium (37.5%) in postmenopausal group. Malignancy was higher in a postmenopausal group (12.5%) as compared to the premenopausal group (2%). Malignancy was not seen when endometrial thickness was less than 11mm in the premenopausal age group. Endometrial hyperplasia was also more common when the thickness was more than 11mm.In postmenopausal group12.5% of patients, had complex hyperplasia.25% had simple hyperplasia and malignancy was seen in 12.5% of patients. When endometrial thickness was less than 5 mm, hyperplasia and malignancy was not seen.Conclusion: Measurement of Endometrial thickness and histopathological workup in patients above 45 years presenting with abnormal uterine bleeding will be helpful in detecting endometrial hyperplasia and carcinoma.Asian Journal of Medical Sciences Vol.9(2) 2018 31-35


2018 ◽  
Vol 9 (1) ◽  
pp. 21-26
Author(s):  
Jasim N Al-Asadi

Background: Handgrip is a predictor of physical fitness, hand functions, and nutritional status. It is affected by many factors including age, sex, body mass index, and hand dimensions.Aims and Objectives: To assess the handgrip strength among medical students and to examine its correlation with body mass index and hand dimensions.Materials and Methods: This cross-sectional study included 256 students of both sexes selected from College of Medicine, Basrah University, Iraq using non-probability purposive sampling method. Their anthropometric parameters including height, weight, and hand dimensions were assessed using routine techniques. The handgrip was measured by using a handheld dynamometer. Hand preference was determined by asking which hand was used to write.Results: The mean age of the participants was 21.1 ± 1.9 years. The mean of handgrip strength was 34.1 ± 11.9 Kg. Males had significantly (P <0.001) greater handgrip strength than females. Statistically significant correlation was detected between body mass index, hand dimensions and handgrip strength. The right-handed students scored significantly higher grip strength with their preferred hand. While among left-handed students, no significant difference in handgrip strength was noticed between left and right hands. Multivariate logistic regression analysis showed that gender, hand span, height, and body mass index were independent determinants of handgrip strength. They accounted for 70.6% of the variation in handgrip strength.Conclusion: A significant effect of body mass index and hand span on handgrip strength among medical students was observed.Asian Journal of Medical Sciences Vol.9(1) 2018 21-26


2019 ◽  
Vol 30 (2) ◽  
pp. 187-192
Author(s):  
Ross Harrison ◽  
Hui Zhao ◽  
Charlotte C Sun ◽  
Shuangshuang Fu ◽  
Shannon D Armbruster ◽  
...  

IntroductionSome experts have argued that obesity-related malignancies such as endometrial cancer are a “teachable moment” that lead to meaningful changes in health behaviors. It is unclear if endometrial cancer survivors lose weight following treatment. Our goal with this investigation was to evaluate post-treatment changes in body mass index (BMI) and attitudes towards health behaviors in endometrial cancer survivors.MethodsIncident endometrial cancer cases undergoing surgery between 2009–2015 were identified in the Marketscan Commercial database and linked with BMI data and health behavior questionnaires from the Marketscan Health Risk Assessment database. Patients were excluded for insufficient BMI data. Standard statistical methods, including the two-sample Wilcoxon rank sum test, χ2 test, and McNemar’s test, were used.Results655 patients with a median age of 54 (IQR 49-58) were identified and analyzed. Median duration of follow-up was 595 days (IQR 360–1091). Mean pre- and post-treatment BMI was 35.5 kg/m2 (median 35.0; IQR 27.0–42.3) and 35.6 kg/m2 (median 34.3; IQR 28.0–42.0), respectively. Median BMI change in the entire cohort was 0 kg/m2 (IQR −1.0 to 2.0). Weight gain (n=302; 46.1%) or no change in weight (n=106; 16.2%) was seen in most patients. Among the 302 patients who gained weight, the mean pre-treatment BMI was 34.0 kg/m2 and mean increase was 2.8 kg/m2 (median 2.0; IQR 1.0–3.4). Among the 247 cases who lost weight, the mean pre-treatment BMI was 38.6 kg/m2 and mean decrease was 3.2 kg/m2 (median 2.0; IQR 1.0–4.0). No pre- to post-treatment differences were observed in health behavior questionnaires regarding intention to better manage their diet, exercise more, or lose weight.DiscussionMost endometrial cancer survivors gain weight or maintain the same weight following treatment. No post-treatment changes in attitudes regarding weight-related behaviors were observed. The systematic delivery of evidence-based weight loss interventions should be a priority for survivors of endometrial cancer.


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