Objective:To study the extent of undernutrition at district level and the socio-economic determinants of underweight children aged 0-71 months in West Bengal.Methods:The data were accessed from the Reproductive and Ch...Objective:To study the extent of undernutrition at district level and the socio-economic determinants of underweight children aged 0-71 months in West Bengal.Methods:The data were accessed from the Reproductive and Child Health Survey(RCHS-II),which contained information of 7 SSO children and their parents.Information of socio-economic variables about the associated families of these children had also been taken for our study.This study computed weight-for-age z-scores to assess the nutritional status of the children using WHO(2006) reference.Results:The prevalence of underweight varied over the districts.Districts with very high prevalence of underweight children were Murshidabad,Burdwan,Purulia,Medinipur, Howrah and South 24 Parganas.High prevalent districts for both boys and girls were Jalpaiguri and Coochbihar.Low prevalent districts for both boys and girls were South Dinajpur,Nadia and Kolkata.The percentage of underweight children were more in rural areas among Muslim families with illiterate parents and low standard of living.In Murshidabad,Bankura,Nadia, Medinipur and South 24 Parganas districts,i.e.,where prevalence of underweight children were higher,the rural and urban differences were less.The characteristics like religion,parents’ educational status and standard of living index showed significant effect on the children’s weights.Conclusions:Public intervention programs on the parent’s education and the standard of living of the households at district level should be given high priority to combat the children’s undernutrition problems so far as weight for age is concerned.展开更多
Introduction: Although there are several reports on the prevalence of underweight or obesity in low birth weight (LBW, th percentile and ≥90th percentile of the body mass index (BMI), respectively, based on reference...Introduction: Although there are several reports on the prevalence of underweight or obesity in low birth weight (LBW, th percentile and ≥90th percentile of the body mass index (BMI), respectively, based on reference values for Japanese children. Results: LBW children had accelerated growth from birth to age 3.5 years, but at Age 5, both sexes had significantly lesser height and weight z-scores, with notably lesser BMI percentile scores for girls, compared with NBW children. The prevalence of underweight was significantly higher in the LBW children throughout the study period. There were no significant differences in the prevalence of obesity between the two groups, except for at birth. Multiple regression analysis revealed that small-for-gestational age was associated with underweight at Age 5 years. Conclusions: This study indicates that, up to Age 5, underweight is a more serious problem than obesity in LBW children. Our results suggest that careful observation of growth from early infancy is necessary to prevent the occurrence of underweight in early infancy.展开更多
Objectives:Underweight remains a health problem among Indonesian children,and the incidence of overweight continuously increases.This study aims to determine factors associated with underweight and overweight in schoo...Objectives:Underweight remains a health problem among Indonesian children,and the incidence of overweight continuously increases.This study aims to determine factors associated with underweight and overweight in school-aged children in Indonesia.Methods:This study is a cross-sectional investigation on parents and children aged 6e13 years in elementary schools in Makassar,Indonesia.The participants included 877 children and their parents.Anthropometric data were obtained using standardized equipment,and sociodemographic and lifestyle data were determined using a questionnaire.The nutritional status of the children was assessed based on the child growth standard prescribed by the WHO.Results:The prevalence rates of underweight and overweight among the children were 14.5%and 20.4%,respectively.Underweight was more prevalent in boys.Factors such as mother's level of education,having an underweight father,and playing outdoors on weekends for more than 2 h were significantly associated with underweight children.By contrast,mothers with high levels of education,overweight parents,sleeping for less than 9 h,and playing outdoors on weekends for less than 1 h were significantly associated with overweight children.展开更多
BACKGROUND Many systematic reviews have focused on assessing the effect of body mass index(BMI)on the outcomes and complications associated with total hip arthroplasty(THA)and total knee arthroplasty(TKA),but primaril...BACKGROUND Many systematic reviews have focused on assessing the effect of body mass index(BMI)on the outcomes and complications associated with total hip arthroplasty(THA)and total knee arthroplasty(TKA),but primarily dealt with obesity compared to normal weight(NW).None of these reviews attempted to assess the effect of low BMI or underweight(UW)compared to NW in patients undergoing THA or TKA.AIM This review aims to compare specific operative outcomes such as operation duration,length of hospital stay,and post-operative complications including mortality,infections,deep vein thrombosis,etc.along with re-hospitalization and reoperation rates between UW and NW patients undergoing THA,TKA or both.METHODS An electronic search was performed in PubMed,Scopus,Excerpta Medica database(EMBASE),Web of Science(WoS),and Cochrane Central Register of Controlled Trials(CENTRAL)along with a manual search.The quality of the studies was assessed using the Newcastle-Ottawa scale for cohort studies.The data were subjected to both qualitative and quantitative analysis.RESULTS Thirteen retrospective and five prospective cohort studies were included.The quality of included studies was assessed to be good to fair.The length of hospital stay after TKA or THA was found to be significantly higher for UW patients when compared to NW patients,with a mean difference:0.3995%CI:[0.06,0.72],P=0.02(in days).Studies presenting both THA and TKA together as total joint arthroplasty showed an increased incidence of mortality in patients treated with THA or TKA alone,Odds ratio:4.1895%CI:[2.88,6.07].A higher incidence of post-ope-rative complications was also observed in UW patients undergoing THA.CONCLUSION UW patients undergoing THA or TKA had a higher incidence of post-operative complications and were associated with a higher readmission rate.Moreover,UW patients were associated with an increased incidence of mortality in the studies that reported THA and TKA together.展开更多
Background: The optimal rate of feeding advancement after initiation of early enteral nutrition (EEN) for underweight, critically ill patients is unknown. Methods: We conducted a retrospective chart review in intensiv...Background: The optimal rate of feeding advancement after initiation of early enteral nutrition (EEN) for underweight, critically ill patients is unknown. Methods: We conducted a retrospective chart review in intensive care unit (ICU) patients with a body mass index (BMI) < 20.0 kg/m<sup>2</sup>. Patients were categorized into Group R, which reached the energy target within 3 days of EEN initiation, and Group S, which reached the energy target 4 or more days after EEN initiation. Results: A total of 65 patients with a median age of 73 years were included in the study. No significant differences were observed between the two groups for all-cause mortality, ICU-free days, or length of hospital stay. Ventilator-free days (VFDs) were significantly fewer in Group R than in Group S (18.0 [0.0 - 22.0] vs. 21.0 [16.3 - 24.8] days;P = 0.046). A significantly higher number of patients requiring mechanical ventilation (MV) at hospital discharge were observed in Group R than in Group S (29% vs. 8%;P = 0.030). Multivariable analyses with adjustment for confounders found that days required to reach target energy intake after EEN initiation were significantly and independently associated with the requirement for MV at hospital discharge, but not with VFDs. Conclusion: A slow rate of feeding advancement after initiation of EEN in critically ill patients having a BMI of <20.0 kg/m<sup>2</sup> might be associated with a reduced requirement for MV at hospital discharge. These results require confirmation in a large multicenter trial of underweight, critically ill patients.展开更多
Background and Objectives: Human immunodeficiency virus infection (HIV) is a global healthcare problem. Progression of HIV infection is commonly associated with decreasing weight. In the early phases of HIV infection,...Background and Objectives: Human immunodeficiency virus infection (HIV) is a global healthcare problem. Progression of HIV infection is commonly associated with decreasing weight. In the early phases of HIV infection, factors associated with weight changes are not completely known. This study evaluated the body mass index (BMI) and its potential risk factors in drug-naive HIV subjects in Owerri, Eastern Nigeria. Methodology: This was a cross-sectional study of HIV subjects. BMI was determined. Relevant investigations were performed. Potential risk factors of BMI were analyzed at different BMI categories. Association of variables with BMI and the strength of variables to predict BMI, underweight and obesity were determined. Results: The mean BMI of the HIV subjects was 26.2 ± 5.4 kg/m2. Underweight was present in 24 (6.1%), overweight in 150 (38.4%) and obesity in 84 (21.5%) of the HIV subjects. High spot urine creatinine (SUCr), high 24-hour urine osmolality (24HUOsm), high serum cholesterol and high hemoglobin predicted BMI in HIV subjects. Low 24HUOsm predicted under weight, whereas low 24-hour urine protein (24 HUP) and high 24HUOsm predicted obesity in HIV subjects. Conclusion: The prevalence of underweight was low (6.1%), overweight high (38.4%) and obesity high (21.5%) in HIV subjects. High SUCr, high 24HUOsm, high serum cholesterol and high hemoglobin were predictors of BMI in HIV subjects. Low 24HUOsm was a predictor of underweight, while low 24HUP and high 24HUOsm were predictors of obesity in HIV subjects. Abnormalities of serum lipids, renal function, and anemia were common in HIV subjects who were underweight and in those obese. Underweight HIV subjects should be evaluated at the early stages for dyslipidemia, renal damage and anemia.展开更多
Dear Editor,The classification for underweight adults,defined as a body mass index(BMI;<18.5 kg/m²)by the World Health Organization(WHO),has been consistent globally with respect to populations.Although the WH...Dear Editor,The classification for underweight adults,defined as a body mass index(BMI;<18.5 kg/m²)by the World Health Organization(WHO),has been consistent globally with respect to populations.Although the WHO has recognized that body composition and health risks differ according to ethnicity by offering adjusted BMI cut-offs for overweight and obesity(23-24.9 kg/m^(2)for overweight and≥25 kg/m^(2)for obesity)in Asian-populations.展开更多
BACKGROUND Childhood obesity is a significant public health concern,particularly amongst children with chronic kidney disease requiring kidney transplant(KT).Obesity,defined as a body mass index(BMI)of 30 kg/m^(2) or ...BACKGROUND Childhood obesity is a significant public health concern,particularly amongst children with chronic kidney disease requiring kidney transplant(KT).Obesity,defined as a body mass index(BMI)of 30 kg/m^(2) or greater,is prevalent in this population and is associated with disease progression.While BMI in-fluences adult KT eligibility,its impact on pediatric transplant outcomes remains unclear.This study investigates the effect of BMI on graft survival and patient outcomes,addressing gaps in the literature and examining disparities across BMI classifications.AIM To assess the impact of BMI classifications on graft and patient survival following KT.METHODS A retrospective cohort study analyzed 23081 pediatric transplant recipients from the Standard Transplant Analysis and Research database(1987-2022).Patients were grouped into six BMI categories:Underweight,healthy weight,overweight,and Class 1,2,and 3 obesity.Data were analyzed using one-way way analysis of variance,Kruskal-Wallis tests,Chi-squared tests,Kaplan-Meier survival analysis with log-rank tests,and Cox proportional hazard regressions.Statistical significance was set at P<0.05.RESULTS Class 3 obese recipients had lower 1-year graft survival(88.7%)compared to healthy-weight recipients(93.1%,P=0.012).Underweight recipients had lower 10-year patient survival(81.3%,P<0.05)than healthy-weight recipients.Class 2 and 3 obese recipients had the lowest 5-year graft survival(67.8%and 68.3%,P=0.013)and Class 2 obesity had the lowest 10-year graft survival(40.7%).Cox regression identified increases in BMI category as an independent predictor of graft failure[hazard ratio(HR)=1.091,P<0.001]and mortality(HR=1.079,P=0.008).Obese patients experienced longer cold ischemia times(11.6 and 13.1 hours vs 10.2 hours,P<0.001).Class 3 obesity had the highest proportion of Black recipients(26.2%vs 17.9%,P<0.001).CONCLUSION Severe obesity and underweight status are associated with poorer long-term outcomes in pediatric KT recipients,emphasizing the need for nuanced transplant eligibility criteria addressing obesity-related risks and socioeconomic disparities.展开更多
Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospe...Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.展开更多
目的基于中国第五次国民体质监测数据,探讨老年人体重异常与体质水平的关系。方法以中国第五次国民体质监测数据库中60~79岁老年人为研究对象,通过体质量指数(body mass index,BMI)将体重划分为低体重、正常体重、超重和肥胖4组,并将低...目的基于中国第五次国民体质监测数据,探讨老年人体重异常与体质水平的关系。方法以中国第五次国民体质监测数据库中60~79岁老年人为研究对象,通过体质量指数(body mass index,BMI)将体重划分为低体重、正常体重、超重和肥胖4组,并将低体重、超重和肥胖视为体重异常。收集老年人心肺耐力(2 min原地高抬腿次数)、下肢肌肉力量(30 s坐站次数)、柔韧素质(坐位体前屈)、平衡能力(闭眼单脚站立时间)和反应能力(选择反应时间)等体质指标结果,通过四分位数切点将各体质指标划分为优秀、良好、及格、不及格4个等级水平。控制人口学信息(包括年龄、性别、居住地城乡属性、受教育程度、退休前职业、婚姻状况、锻炼、抽烟、睡眠情况以及体质自我评价等)影响因素后,采用二分类Logistic回归分析体质指标与体重异常之间的关系。结果共39927名60~79岁老年人纳入本研究,其中男性19777人(49.5%),女性20150人(50.5%),平均年龄(69.2±5.6)岁。老年人低体重、超重和肥胖检出率分别为2.3%、41.8%和16.7%,且低体重检出率随年龄增长显著升高(P<0.001)。肥胖、低体重老年人体质水平均显著低于正常组。回归分析结果显示,心肺耐力与老年人体重异常之间存在显著相关性,与优秀组相比,其他水平组的老年男性低体重风险增加51.6%~68.9%(女性:31.8%~41.3%),超重风险增加4.7%~23.6%(女性:5.0%~25.8%),肥胖风险增加5.6%~57.5%(女性:15.2%~66.6%)。下肢肌肉力量与老年女性体重异常之间存在显著相关性,与优秀组相比,其他水平组的老年女性超重风险增加22.1%~44.5%,肥胖风险增加38.1%~61.1%,而在男性老年人中则未发现明确相关性。同时,柔韧素质、平衡能力和反应能力与体重异常的关系尚不明确。结论中国60~79岁老年人存在低体重与超重/肥胖双重负担,低水平的心肺耐力、肌肉力量(女性)与老年人的体重异常显著相关,保持良好的心肺耐力和肌肉力量水平可能有利于老年人体重异常状况的改善。展开更多
Aim:To examine the impact of underweight body mass index(BMI)values on breast reconstruction outcomes.Methods:The American College of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP)database was retro...Aim:To examine the impact of underweight body mass index(BMI)values on breast reconstruction outcomes.Methods:The American College of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP)database was retrospectively reviewed for all patients who underwent breast reconstruction between 2006 and 2011.Patients were first stratified by breast reconstruction modality into prosthetic or autologous cohorts,and second by BMI values into underweight(BMI<18.5),normal to overweight(reference,BMI 18.5-29.99),moderate obesity(BMI 30-34.99),severe obesity(BMI 35-39.99),and morbid obesity cohorts.Multivariate logistic regression models were used to determine independent predictors of complications.Results:With regard to prosthetic breast reconstruction patients,obese patients demonstrated increased rates of surgical complications,while underweight patients did not have any differences on multivariable analysis.With respect to autologous reconstruction,risk-adjusted multivariate regression models showed a dose dependent response between obesity and risk for surgical complications and reoperation,but not for underweight patients.Conclusion:On multivariable analysis of over 4,600 patients,there were no significant differences in the rates of adverse events between underweight patients(BMI<18.5)and their reference-weight counterparts,in spite of a significant increase in surgical and medical complication rates in underweight patients on univariate analysis.展开更多
Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to ...Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.展开更多
Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and ...Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and increased metabolic demands. Previous studies have shown high malnutrition rates in hospitalized children due to illness-related metabolic demands, decreased appetite, and inadequate intake. Our objective was to assess the growth and nutritional status of children admitted to King Abdullah University Hospital (KAUH) and identify the prevalence of undernutrition and associated factors. Methods: This prospective, cross-sectional cohort study was conducted at KAUH from July to December 2022. We included children aged 2 months to 16 years, excluding those with conditions altering growth parameters. Data were collected through pediatric data sheets, physical examinations, and laboratory tests. Anthropometric measurements were taken, and growth was assessed using CDC growth charts. Nutritional anemia was defined as hemoglobin 16. Results: A total of 111 patients were included (56.8% male, median age 65 months). Most patients had normal height (82%) and weight (86.5%) upon admission. However, 14.4% were stunted, 11.7% were underweight, 14.4% were overweight, and 3.6% were obese. Growth impairment correlated with higher anemia rates (p = 0.042). Nutritional anemia was present in 12% of patients. No significant relation was found between breastfeeding history and growth retardation, but maternal perception of malnutrition correlated well with actual malnutrition. Conclusion: Our study found a malnutrition prevalence of 19.8%, highlighting the need for systematic nutritional screening in hospitalized children. The study’s limitations include its small sample size and specific patient population, suggesting the need for larger, multicenter studies for more generalizable results.展开更多
文摘Objective:To study the extent of undernutrition at district level and the socio-economic determinants of underweight children aged 0-71 months in West Bengal.Methods:The data were accessed from the Reproductive and Child Health Survey(RCHS-II),which contained information of 7 SSO children and their parents.Information of socio-economic variables about the associated families of these children had also been taken for our study.This study computed weight-for-age z-scores to assess the nutritional status of the children using WHO(2006) reference.Results:The prevalence of underweight varied over the districts.Districts with very high prevalence of underweight children were Murshidabad,Burdwan,Purulia,Medinipur, Howrah and South 24 Parganas.High prevalent districts for both boys and girls were Jalpaiguri and Coochbihar.Low prevalent districts for both boys and girls were South Dinajpur,Nadia and Kolkata.The percentage of underweight children were more in rural areas among Muslim families with illiterate parents and low standard of living.In Murshidabad,Bankura,Nadia, Medinipur and South 24 Parganas districts,i.e.,where prevalence of underweight children were higher,the rural and urban differences were less.The characteristics like religion,parents’ educational status and standard of living index showed significant effect on the children’s weights.Conclusions:Public intervention programs on the parent’s education and the standard of living of the households at district level should be given high priority to combat the children’s undernutrition problems so far as weight for age is concerned.
文摘Introduction: Although there are several reports on the prevalence of underweight or obesity in low birth weight (LBW, th percentile and ≥90th percentile of the body mass index (BMI), respectively, based on reference values for Japanese children. Results: LBW children had accelerated growth from birth to age 3.5 years, but at Age 5, both sexes had significantly lesser height and weight z-scores, with notably lesser BMI percentile scores for girls, compared with NBW children. The prevalence of underweight was significantly higher in the LBW children throughout the study period. There were no significant differences in the prevalence of obesity between the two groups, except for at birth. Multiple regression analysis revealed that small-for-gestational age was associated with underweight at Age 5 years. Conclusions: This study indicates that, up to Age 5, underweight is a more serious problem than obesity in LBW children. Our results suggest that careful observation of growth from early infancy is necessary to prevent the occurrence of underweight in early infancy.
文摘Objectives:Underweight remains a health problem among Indonesian children,and the incidence of overweight continuously increases.This study aims to determine factors associated with underweight and overweight in school-aged children in Indonesia.Methods:This study is a cross-sectional investigation on parents and children aged 6e13 years in elementary schools in Makassar,Indonesia.The participants included 877 children and their parents.Anthropometric data were obtained using standardized equipment,and sociodemographic and lifestyle data were determined using a questionnaire.The nutritional status of the children was assessed based on the child growth standard prescribed by the WHO.Results:The prevalence rates of underweight and overweight among the children were 14.5%and 20.4%,respectively.Underweight was more prevalent in boys.Factors such as mother's level of education,having an underweight father,and playing outdoors on weekends for more than 2 h were significantly associated with underweight children.By contrast,mothers with high levels of education,overweight parents,sleeping for less than 9 h,and playing outdoors on weekends for less than 1 h were significantly associated with overweight children.
文摘BACKGROUND Many systematic reviews have focused on assessing the effect of body mass index(BMI)on the outcomes and complications associated with total hip arthroplasty(THA)and total knee arthroplasty(TKA),but primarily dealt with obesity compared to normal weight(NW).None of these reviews attempted to assess the effect of low BMI or underweight(UW)compared to NW in patients undergoing THA or TKA.AIM This review aims to compare specific operative outcomes such as operation duration,length of hospital stay,and post-operative complications including mortality,infections,deep vein thrombosis,etc.along with re-hospitalization and reoperation rates between UW and NW patients undergoing THA,TKA or both.METHODS An electronic search was performed in PubMed,Scopus,Excerpta Medica database(EMBASE),Web of Science(WoS),and Cochrane Central Register of Controlled Trials(CENTRAL)along with a manual search.The quality of the studies was assessed using the Newcastle-Ottawa scale for cohort studies.The data were subjected to both qualitative and quantitative analysis.RESULTS Thirteen retrospective and five prospective cohort studies were included.The quality of included studies was assessed to be good to fair.The length of hospital stay after TKA or THA was found to be significantly higher for UW patients when compared to NW patients,with a mean difference:0.3995%CI:[0.06,0.72],P=0.02(in days).Studies presenting both THA and TKA together as total joint arthroplasty showed an increased incidence of mortality in patients treated with THA or TKA alone,Odds ratio:4.1895%CI:[2.88,6.07].A higher incidence of post-ope-rative complications was also observed in UW patients undergoing THA.CONCLUSION UW patients undergoing THA or TKA had a higher incidence of post-operative complications and were associated with a higher readmission rate.Moreover,UW patients were associated with an increased incidence of mortality in the studies that reported THA and TKA together.
文摘Background: The optimal rate of feeding advancement after initiation of early enteral nutrition (EEN) for underweight, critically ill patients is unknown. Methods: We conducted a retrospective chart review in intensive care unit (ICU) patients with a body mass index (BMI) < 20.0 kg/m<sup>2</sup>. Patients were categorized into Group R, which reached the energy target within 3 days of EEN initiation, and Group S, which reached the energy target 4 or more days after EEN initiation. Results: A total of 65 patients with a median age of 73 years were included in the study. No significant differences were observed between the two groups for all-cause mortality, ICU-free days, or length of hospital stay. Ventilator-free days (VFDs) were significantly fewer in Group R than in Group S (18.0 [0.0 - 22.0] vs. 21.0 [16.3 - 24.8] days;P = 0.046). A significantly higher number of patients requiring mechanical ventilation (MV) at hospital discharge were observed in Group R than in Group S (29% vs. 8%;P = 0.030). Multivariable analyses with adjustment for confounders found that days required to reach target energy intake after EEN initiation were significantly and independently associated with the requirement for MV at hospital discharge, but not with VFDs. Conclusion: A slow rate of feeding advancement after initiation of EEN in critically ill patients having a BMI of <20.0 kg/m<sup>2</sup> might be associated with a reduced requirement for MV at hospital discharge. These results require confirmation in a large multicenter trial of underweight, critically ill patients.
文摘Background and Objectives: Human immunodeficiency virus infection (HIV) is a global healthcare problem. Progression of HIV infection is commonly associated with decreasing weight. In the early phases of HIV infection, factors associated with weight changes are not completely known. This study evaluated the body mass index (BMI) and its potential risk factors in drug-naive HIV subjects in Owerri, Eastern Nigeria. Methodology: This was a cross-sectional study of HIV subjects. BMI was determined. Relevant investigations were performed. Potential risk factors of BMI were analyzed at different BMI categories. Association of variables with BMI and the strength of variables to predict BMI, underweight and obesity were determined. Results: The mean BMI of the HIV subjects was 26.2 ± 5.4 kg/m2. Underweight was present in 24 (6.1%), overweight in 150 (38.4%) and obesity in 84 (21.5%) of the HIV subjects. High spot urine creatinine (SUCr), high 24-hour urine osmolality (24HUOsm), high serum cholesterol and high hemoglobin predicted BMI in HIV subjects. Low 24HUOsm predicted under weight, whereas low 24-hour urine protein (24 HUP) and high 24HUOsm predicted obesity in HIV subjects. Conclusion: The prevalence of underweight was low (6.1%), overweight high (38.4%) and obesity high (21.5%) in HIV subjects. High SUCr, high 24HUOsm, high serum cholesterol and high hemoglobin were predictors of BMI in HIV subjects. Low 24HUOsm was a predictor of underweight, while low 24HUP and high 24HUOsm were predictors of obesity in HIV subjects. Abnormalities of serum lipids, renal function, and anemia were common in HIV subjects who were underweight and in those obese. Underweight HIV subjects should be evaluated at the early stages for dyslipidemia, renal damage and anemia.
文摘Dear Editor,The classification for underweight adults,defined as a body mass index(BMI;<18.5 kg/m²)by the World Health Organization(WHO),has been consistent globally with respect to populations.Although the WHO has recognized that body composition and health risks differ according to ethnicity by offering adjusted BMI cut-offs for overweight and obesity(23-24.9 kg/m^(2)for overweight and≥25 kg/m^(2)for obesity)in Asian-populations.
文摘BACKGROUND Childhood obesity is a significant public health concern,particularly amongst children with chronic kidney disease requiring kidney transplant(KT).Obesity,defined as a body mass index(BMI)of 30 kg/m^(2) or greater,is prevalent in this population and is associated with disease progression.While BMI in-fluences adult KT eligibility,its impact on pediatric transplant outcomes remains unclear.This study investigates the effect of BMI on graft survival and patient outcomes,addressing gaps in the literature and examining disparities across BMI classifications.AIM To assess the impact of BMI classifications on graft and patient survival following KT.METHODS A retrospective cohort study analyzed 23081 pediatric transplant recipients from the Standard Transplant Analysis and Research database(1987-2022).Patients were grouped into six BMI categories:Underweight,healthy weight,overweight,and Class 1,2,and 3 obesity.Data were analyzed using one-way way analysis of variance,Kruskal-Wallis tests,Chi-squared tests,Kaplan-Meier survival analysis with log-rank tests,and Cox proportional hazard regressions.Statistical significance was set at P<0.05.RESULTS Class 3 obese recipients had lower 1-year graft survival(88.7%)compared to healthy-weight recipients(93.1%,P=0.012).Underweight recipients had lower 10-year patient survival(81.3%,P<0.05)than healthy-weight recipients.Class 2 and 3 obese recipients had the lowest 5-year graft survival(67.8%and 68.3%,P=0.013)and Class 2 obesity had the lowest 10-year graft survival(40.7%).Cox regression identified increases in BMI category as an independent predictor of graft failure[hazard ratio(HR)=1.091,P<0.001]and mortality(HR=1.079,P=0.008).Obese patients experienced longer cold ischemia times(11.6 and 13.1 hours vs 10.2 hours,P<0.001).Class 3 obesity had the highest proportion of Black recipients(26.2%vs 17.9%,P<0.001).CONCLUSION Severe obesity and underweight status are associated with poorer long-term outcomes in pediatric KT recipients,emphasizing the need for nuanced transplant eligibility criteria addressing obesity-related risks and socioeconomic disparities.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[grant number 2021-I2M-1-037]the National Natural Science Foundation of China[grant numbers 82373647,and 82473697].
文摘Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.
文摘目的基于中国第五次国民体质监测数据,探讨老年人体重异常与体质水平的关系。方法以中国第五次国民体质监测数据库中60~79岁老年人为研究对象,通过体质量指数(body mass index,BMI)将体重划分为低体重、正常体重、超重和肥胖4组,并将低体重、超重和肥胖视为体重异常。收集老年人心肺耐力(2 min原地高抬腿次数)、下肢肌肉力量(30 s坐站次数)、柔韧素质(坐位体前屈)、平衡能力(闭眼单脚站立时间)和反应能力(选择反应时间)等体质指标结果,通过四分位数切点将各体质指标划分为优秀、良好、及格、不及格4个等级水平。控制人口学信息(包括年龄、性别、居住地城乡属性、受教育程度、退休前职业、婚姻状况、锻炼、抽烟、睡眠情况以及体质自我评价等)影响因素后,采用二分类Logistic回归分析体质指标与体重异常之间的关系。结果共39927名60~79岁老年人纳入本研究,其中男性19777人(49.5%),女性20150人(50.5%),平均年龄(69.2±5.6)岁。老年人低体重、超重和肥胖检出率分别为2.3%、41.8%和16.7%,且低体重检出率随年龄增长显著升高(P<0.001)。肥胖、低体重老年人体质水平均显著低于正常组。回归分析结果显示,心肺耐力与老年人体重异常之间存在显著相关性,与优秀组相比,其他水平组的老年男性低体重风险增加51.6%~68.9%(女性:31.8%~41.3%),超重风险增加4.7%~23.6%(女性:5.0%~25.8%),肥胖风险增加5.6%~57.5%(女性:15.2%~66.6%)。下肢肌肉力量与老年女性体重异常之间存在显著相关性,与优秀组相比,其他水平组的老年女性超重风险增加22.1%~44.5%,肥胖风险增加38.1%~61.1%,而在男性老年人中则未发现明确相关性。同时,柔韧素质、平衡能力和反应能力与体重异常的关系尚不明确。结论中国60~79岁老年人存在低体重与超重/肥胖双重负担,低水平的心肺耐力、肌肉力量(女性)与老年人的体重异常显著相关,保持良好的心肺耐力和肌肉力量水平可能有利于老年人体重异常状况的改善。
文摘Aim:To examine the impact of underweight body mass index(BMI)values on breast reconstruction outcomes.Methods:The American College of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP)database was retrospectively reviewed for all patients who underwent breast reconstruction between 2006 and 2011.Patients were first stratified by breast reconstruction modality into prosthetic or autologous cohorts,and second by BMI values into underweight(BMI<18.5),normal to overweight(reference,BMI 18.5-29.99),moderate obesity(BMI 30-34.99),severe obesity(BMI 35-39.99),and morbid obesity cohorts.Multivariate logistic regression models were used to determine independent predictors of complications.Results:With regard to prosthetic breast reconstruction patients,obese patients demonstrated increased rates of surgical complications,while underweight patients did not have any differences on multivariable analysis.With respect to autologous reconstruction,risk-adjusted multivariate regression models showed a dose dependent response between obesity and risk for surgical complications and reoperation,but not for underweight patients.Conclusion:On multivariable analysis of over 4,600 patients,there were no significant differences in the rates of adverse events between underweight patients(BMI<18.5)and their reference-weight counterparts,in spite of a significant increase in surgical and medical complication rates in underweight patients on univariate analysis.
文摘Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.
文摘Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and increased metabolic demands. Previous studies have shown high malnutrition rates in hospitalized children due to illness-related metabolic demands, decreased appetite, and inadequate intake. Our objective was to assess the growth and nutritional status of children admitted to King Abdullah University Hospital (KAUH) and identify the prevalence of undernutrition and associated factors. Methods: This prospective, cross-sectional cohort study was conducted at KAUH from July to December 2022. We included children aged 2 months to 16 years, excluding those with conditions altering growth parameters. Data were collected through pediatric data sheets, physical examinations, and laboratory tests. Anthropometric measurements were taken, and growth was assessed using CDC growth charts. Nutritional anemia was defined as hemoglobin 16. Results: A total of 111 patients were included (56.8% male, median age 65 months). Most patients had normal height (82%) and weight (86.5%) upon admission. However, 14.4% were stunted, 11.7% were underweight, 14.4% were overweight, and 3.6% were obese. Growth impairment correlated with higher anemia rates (p = 0.042). Nutritional anemia was present in 12% of patients. No significant relation was found between breastfeeding history and growth retardation, but maternal perception of malnutrition correlated well with actual malnutrition. Conclusion: Our study found a malnutrition prevalence of 19.8%, highlighting the need for systematic nutritional screening in hospitalized children. The study’s limitations include its small sample size and specific patient population, suggesting the need for larger, multicenter studies for more generalizable results.
