Body mass index as a biomarker for the evaluation of the “Obesity Paradox” among inpatients

Tojek, Krzysztof; Wustrau, Beata; Czerniak, Beata; Korzycka-Wilińska, Wanda; Winiarski, Piotr; Banaszkiewicz, Zbigniew; Budzyński, Jacek

doi:10.1016/j.clnu.2017.12.005

Cited by 13 publications

(11 citation statements)

References 40 publications

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“…Therefore, prior to undergoing surgery for cancer, every patient should be evaluated in relation to nutritional status. However, the standard parameters of nutritional status assessment, particularly body weight and body mass index (BMI), are not particularly useful in predicting in-hospital complications [ 7 , 8 ]. Moreover, anthropometric parameters cannot identify a depletion in muscle mass that may be masked by a stable body weight or weight gain due to an increase in fat mass or swelling [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Body composition among patients undergoing surgery for colorectal cancer

Tojek

Banaszkiewicz

Budzyński

2021

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Introduction Nutritional status assessment is an important part of preoperative patient evaluation, but the standard anthropometric parameters do not appear to be adequate. Aim To determine the changes in the values of bioelectrical impedance analysis (BIA) parameters in patients 3 months after undergoing surgery for colorectal cancer (CRC). Material and methods BIA and nutritional status assessment parameters were determined in 80 patients prior to undergoing surgery for CRC. The results 3 months after surgery for 64 of those patients were then compared with their initial assessments. Results According to standard WHO ranges, 54% of the patients were diagnosed as being overweight and 29% as obese. The percentage of patients categorized as obese amounted to 56% when this was defined as high fat mass. Moderate sarcopaenia, defined as a low skeletal muscle index (SMI) or low percentage of skeletal muscle mass, was diagnosed in 21% and 29% of patients, respectively. Patients with postoperative weakness that made it impossible for them to attend the control visit had a lower preoperative skeletal muscle mass ( p = 0.01) and SMI value ( p = 0.001). Parameters of BIA did not discriminate patients with postoperative complications, which occurred in 23% of individuals enrolled. Conclusions A significant proportion of the patients undergoing surgery for CRC were overweight or obese, which could mask the sarcopaenia that presented in 21–29% of them. Sarcopaenia was the only parameter predictive of a postoperative decrease in performance status.

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Section: Introductionmentioning

confidence: 99%

Body composition among patients undergoing surgery for colorectal cancer

Tojek

Banaszkiewicz

Budzyński

2021

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“…Historically, biomarker were coined only to biological uid, tissues, and chemicals that has been related and used to evaluate the disease conditions [23]. Nowadays, the term biomarker can also be used in various aspects outside biological samples as long as it is helpful in diagnosis, measuring, and monitoring disease conditions [21,24]. HIV guidelines globally are focusing on HIV treatment and disease monitoring, giving less attention to emerging problems like CMetS, makes the standard of ART care imperfect [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Biomarkers and prevalence of cardiometabolic syndrome among people living with HIV/AIDS, Addis Ababa, Ethiopia: a hospital-based, observational study.

Woldu¹,

Minzi²,

Shibeshi³

et al. 2021

Preprint

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Background Although marked improvements in life expectancy have been observed with the rapid expansion of Antiretroviral Therapy (ART), Cardiometabolic Syndrome (CMetS) is becoming a serious challenge for People Living with HIV/AIDS (PLWHA). The present study aimed in determining biomarkers and prevalence of CMetS in PLWHA. Methods A hospital-based, observational study was carried out between January 2019 & February 2020 among HIV infected adults (n = 288). Binary logistic regression was used to estimate odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between the outcomes against the predictor variables. Results The current study revealed that the prevalence of CMetS was 28.5% (82/288) using the National Cholesterol Education Program (NCEP)-2005 definition; and it was 43.5% (126/288) using the International Diabetes Federation (IDF)-2005. Male gender was less likely to be associated with CMetS (OR = .086, C.I. 0.025–0.292, p < 0.001) using the NCEP-2005 definition. Individuals with longer duration on ART have an increased odds of CMetS using both the NCEP-2005 (OR = 1.024, C.I. 1.005–1.043, p = 0.014) and the IDF-2005 (OR = 1.251, C.I. 1.061–1.472, p = 0.007) definitions. The age at which ART initiated yet have an impact on the outcomes of CMetS (NCEP-2005: OR = 1.27, C.I. 1.031–1.564, p = 0.025), indicating that individuals who started ART treatment at older age are more likely to have CMetS than their younger counterparts. The study further verified that, individuals with increased waist-grid (central adiposity) were more likely to have CMetS using both the NCEP-2005 (OR = 1.21, C.I. 1.029–1.418, p = 0.021) and the IDF-2005 (OR = 1.730 C.I. 1.454–2.058, p < 0.001) definitions. PLWHA with increased in DBP (OR = 1.164, C.I.1.080–1.254, p < 0.001), Triglyceride (OR = 1.027, C.I. 0.015–0.039, p < 0.001), and low density lipoproteins (OR = 1.075, C.I. 0.020–0.134, p = 0.007) were more likely to have CMetS using the NCEP-2005 definition. PLWHA without comorbidity were less likely to have CMetS (NCEP-2005: OR = 0.086, C.I. 0.025–0.292, p < 0.001). Conclusions The prevalence of CMetS in the study area was high. Risk factors associated with CMetS were waist circumference, gender, duration on ART; ART initiated age, waist-grid, and comorbidity. Biomarkers that were more likely contributed to the prevalence of CMetS include triglyceride, low density lipoproteins, and systolic blood pressure.

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“…Nutritional status is one of the most important determinants of the health condition of a patient requiring hospitalization. Recent reports indicate that the relationship between in-hospital mortality and the body mass index (BMI) values forms the U-shaped curve [1]. The increase in the in-hospital mortality in patients with low body mass (left arm of the curve) is relatively easy to explain.…”

Section: Introductionmentioning

confidence: 99%

“…The increase in the in-hospital mortality in patients with low body mass (left arm of the curve) is relatively easy to explain. It usually results from the final stage of chronic and wasting diseases [1]. Therefore, the course of the right arm of the U-shaped curve draws more attention, as it concerns patients with a better prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the course of the right arm of the U-shaped curve draws more attention, as it concerns patients with a better prognosis. Many studies indicate that it is shifted to the right side, far beyond the BMI WHO's ranges regarded as correct ones [1][2][3][4][5][6][7][8][9]. This effect is often referred to as the "obesity paradox" and consists in a better prognosis of overweight patients and mildly obese patients as compared to patients with normal body weight and with similar severity of atherosclerosis of the lower limbs [10].…”

Section: Introductionmentioning

confidence: 99%

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The association between nutritional and functional status in patients undergoing endovascular intervention due to chronic lower limbs ischemia

Siódmiak

Falkowski

et al. 2018

Medical Research Journal

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Background: The nutritional status and functional status of patients are important prognostic factors. The aim of the study was to assess the relationships between patients' nutritional status and the outcome of endovascular intervention in patients with chronic lower limb ischemia during one-year follow-up. Materials and methods: In 79 consecutive patients subjected to endovascular intervention due to chronic leg ischemia following examinations were performed before and after 3 and 12 month after surgery: physical examination, Minimal Nutritional Assessment (MNA) score, Nutritional Risk Screening 2002 score (NRS2002), Barthel, ADL, IADL scale, ankle-brachial index (ABI), claudication distance on the treadmill and handgrip strength. Results: More than half of patients were initially overweight or obese. Following 3 months after the surgery, improvement in lower limb symptoms was observed, together with significant increase in ABI, claudication distance, total MNA score and IADL scale. The risk associated with malnutrition (MNA questionnaire), Barthel score and hand grip strength showed a statistically significant relationship with the subjective feeling of improvement after surgery. Its absence was more frequent in patients characterized by higher risk of malnutrition, with less muscular strength and poorer fitness. Conclusions: Endovascular treatment of lower limbs ischemia improved not only symptoms of leg ischemia but also the general functional status of patients. The initial nutritional status, functional status and hand grip strength of patients with chronic lower limb ischemia were associated with a better clinical outcome of endovascular intervention.

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Body mass index as a biomarker for the evaluation of the “Obesity Paradox” among inpatients

Cited by 13 publications

References 40 publications

Body composition among patients undergoing surgery for colorectal cancer

Body composition among patients undergoing surgery for colorectal cancer

Biomarkers and prevalence of cardiometabolic syndrome among people living with HIV/AIDS, Addis Ababa, Ethiopia: a hospital-based, observational study.

The association between nutritional and functional status in patients undergoing endovascular intervention due to chronic lower limbs ischemia

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