Desempeño del índice de masa corporal para el diagnóstico de obesidad por medio de absorciometría de rayos X de energía dual (DEXA) en pacientes con artritis reumatoide

Tello-Winniczuk, Nina; Vega‐Morales, David; García-Hernández, Pedro Alberto; Esquivel-Valerio, Jorge Antonio; Elizondo, Mario Alberto Garza; Arana-Guajardo, Ana Cecilia

doi:10.1016/j.reuma.2016.02.003

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…1) . Twenty-seven studies (29 articles) assessed BMI 44,[46][47][48][49][50][51][52][53][54][58][59][60][61][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] , and 15 (19 articles) reported on waist measurements such as WC [43][44][45][46][47][49][50][51][52][53][57][58][59][60]62,63 , WHR [43][44][45][46][47][49][50]…”

Section: Resultsmentioning

confidence: 99%

“…Studies using CT or MRI applied a cut-off of ≥ 100 cm 2 or ≥ 130 cm 2 of visceral adipose tissue area to provide reference data for both women and men. Fourteen studies were community-based 44,46,51,58,[62][63][64][66][67][68]70,73,75,76,78 , fourteen were primary care-or hospitalbased 45,47,49,50,[52][53][54]57,[59][60][61]69,72,74,77 , two were community-and hospital-based 43,48,55,56 , one study was based in the army 65 and one did not report its setting 71 . Six studies included patients with various diseases or physical or cognitive disabilities 50,[52][53][54]59,61,66,74 .…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, we rated the risk of bias for six as low 52,53,58,60,63,67,70 , for 16 as unclear [43][44][45][46][47][54][55][56][57]59,62,65,66,69,71,[73][74][75]77 and for ten as high [48][49][50][51]61,64,68,72,76,78 . The reasons for the high risk of bias ratings included convenience sampling, inappropriate exclusion criteria for study participants and lack of predefined thresholds for index and reference tests.…”

Section: Resultsmentioning

confidence: 99%

“…The reasons for the high risk of bias ratings included convenience sampling, inappropriate exclusion criteria for study participants and lack of predefined thresholds for index and reference tests. Eleven studies were conducted in Asia 44,46,47,49,51,60,63,68,70,71,75,78 , ten studies in North America 50,[52][53][54]58,65,66,[72][73][74]77 , eight in South America 43,45,[55][56][57]59,61,62,67,69 and three 48,64,76 in Europe. Twenty-two studies were publicly funded, eight studies did not report their funding 48,49,64,65,68,69,71,76 and two received sponsoring from pharmaceutical companies 57,61 .…”

Section: Resultsmentioning

confidence: 99%

“…The 27 included studies 44,[46][47][48][49][50][51][52][53][54][58][59][60][61][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] reported varying cut-offs for BMI to determine obesity. Thresholds ranged from 19.6 to 30 kg/m 2 for women and from 23.5 to 30 kg/m 2 for men.…”

Section: Body Mass Index (Bmi)mentioning

confidence: 99%

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The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

Sommer

Teufer

Szelag

et al. 2020

Sci Rep

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the aim of this systematic review was to assess the performance of anthropometric tools to determine obesity in the general population (CRD42018086888). Our review included 32 studies. To detect obesity with body mass index (BMI), the meta-analyses rendered a sensitivity of 51.4% (95% CI 38.5-64.2%) and a specificity of 95.4% (95% CI 90.7-97.8%) in women, and 49.6% (95% CI 34.8-64.5%) and 97.3% (95% CI 92.1-99.1%), respectively, in men. For waist circumference (WC), the summary estimates for the sensitivity were 62.4% (95% CI 49.2-73.9%) and 88.1% for the specificity (95% CI 77.0-94.2%) in men, and 57.0% (95% CI 32.2-79.0%) and 94.8% (95% CI 85.8-98.2%), respectively, in women. The data were insufficient to pool the results for waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) but were similar to BMI and WC. In conclusion, BMI and WC have serious limitations for use as obesity screening tools in clinical practice despite their widespread use. No evidence supports that WHR and WHtR are more suitable than BMI or WC to assess body fat. However, due to the lack of more accurate and feasible alternatives, BMI and WC might still have a role as initial tools for assessing individuals for excess adiposity until new evidence emerges. Obesity is widely recognised as a pandemic public health problem. According to the World Health Organization (WHO), in 2016 more than 650 million adults worldwide were obese 1. These numbers have almost tripled since 1975 2. Obesity increases the risk for many chronic diseases, such as diabetes mellitus, cardiovascular diseases and cancers 3 , and is possibly associated with mental health disorders 4. Associations have been shown to be strongest between obesity and the incidence of diabetes mellitus, particularly in women (risk ratio [RR] 12.41, 95% confidence interval [CI] 9.03-17.06). Primary care is considered one of the main settings for the prevention, screening and management of obesity 5. Individual studies indicate that patients are more likely to lose weight when they receive recommendations for lifestyle changes from their primary care physicians 6. Because it can be difficult for physicians to accurately determine obesity solely through visually inspecting their patients 7 , they need a reliable, efficient screening tool in order to ensure that those who need management and treatment receive it. WHO conceptualises obesity as "abnormal or excessive fat accumulation that may impair health" 1. It is most commonly assessed using body mass index (BMI), a simple and quick anthropometric tool that has a low cost. Adults with a BMI greater than or equal to 30 are classified as being obese 1 (Table 1). However, several researchers and professional associations 8-14 consider the use of BMI as the primary clinical index of obesity insufficient. They have called for a new definition that fully accounts for the complexity of the disease relating to the quantity, distribution and secretory function of adipose tissue. A substantial body of evidence has shown that obesity (BMI ≥ 30) is ass...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Body Mass Index (Bmi)mentioning

confidence: 99%

See 3 more Smart Citations

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

Sommer

Teufer

Szelag

et al. 2020

Sci Rep

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Effect of dietary interventions on nutritional status in patients with rheumatoid arthritis and spondyloarthritis - A systematic review and meta-analysis

Olsen,

Halse,

Skeie

et al. 2024

Clinical Nutrition

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Assessment of nutritional status by dual X-Ray absorptiometry in women with rheumatoid arthritis

et al. 2019

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Rheumatoid arthritis (RA) has been related to an impairment of the nutritional status. Body mass index (BMI) has been used but questions arise about how to properly evaluate nutritional status in RA patients. Few studies have evaluated it by dual-energy X-ray absorptiometry. In women with RA, to analyze: their nutritional status compared to that of a control population, differences between the prevalence of impairment of nutritional status measured by dual energy X ray absorptiometry (DXA) and by classical methods used in clinical care, determinants of nutritional status, prevalence of sarcopenia. Case–control study including 89 women with RA. The control group was composed by 100 patients affected by non-inflammatory rheumatic disorders. Study variables included age, RA duration, history, activity and disability, and in relation to nutritional status: BMI, serum albumin (ALB), whole body DXA assessment, and skeletal muscle index (SMI). Mean age of patients was 62 ± 8 years, mean duration of RA was 14 ± 9 years, mean disease activity score (DAS28) was 3.7 ± 1.4 and mean Health Assessment Questionnaire was 0.88 ± 0.77. BMI was 27.43 ± 5.16 Kg/m 2 in patients and 27.78 ± 3.98 Kg/m 2 in controls ( P : ns). ALB was within normal range in all patients. By whole body DXA, RA patients presented a statistically significant lower lean mass in all locations and lower fat mass in limbs than controls. Patients had a redistribution of fat mass to trunk. Lean mass directly correlated with fat mass. Neither BMI nor ALB correlated with DXA parameters. BMI, appendicular lean mass and SMI correlated inversely with disease duration. Trunk lean mass correlated inversely, and fat mass directly, with RA disability parameters. RA patients fulfilled criteria of sarcopenia in 44% of cases versus 19% of controls ( P <.001). In RA patients, regarding SMI, BMI showed a high specificity to detect sarcopenia (94% of the patients with low BMI had sarcopenia) but low sensitivity (47% of the patients with normal BMI or overweight had sarcopenia). RA patients have an impairment of nutritional status associated to disease duration that looks like sarcopenia and that is not predicted by BMI.

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Desempeño del índice de masa corporal para el diagnóstico de obesidad por medio de absorciometría de rayos X de energía dual (DEXA) en pacientes con artritis reumatoide

Cited by 7 publications

References 14 publications

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis

Effect of dietary interventions on nutritional status in patients with rheumatoid arthritis and spondyloarthritis - A systematic review and meta-analysis

Assessment of nutritional status by dual X-Ray absorptiometry in women with rheumatoid arthritis

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