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At least 883 records · Page 49Linked to original sources
PubMed1998

The associations of body size and body composition with left ventricular mass: impacts for indexation in adults.

OBJECTIVES: We investigated the relationship between body size, body composition and left ventricular mass (LVM) in adults, and assessed the impact of different indexations of LVM on its associations with gender, adiposity and blood pressure. BACKGROUND: The best way to normalize LVM for body size to appropriately distinguish physiologic adaptation from morbid heart morphology was discussed. METHODS: We undertook a community survey of 653 men and 718 women, aged 25 to 74 years. Lean body mass (LBM) was determined by bioelectric impedance analyses and LVM was assessed by two-dimensional guided M-mode echocardiography. RESULTS: After traditional indexations to body height, body height2.7, or body surface area, men had higher LVM than women (p < 0.001). These gender differences disappeared (p > 0.05) when LVM was indexed to LBM. The type of indexation also modified the strength of the association between adiposity and LVM. The estimated impact of body fat on LVM indexed to LBM was less than half that obtained with traditional indexations. In contrast, the magnitude of the associations of blood pressure with LVM was entirely independent of the type of indexation. CONCLUSIONS: This study showed the prominent influence of body composition on adult heart size. Indexation for LBM removed gender differences for LVM and reduced the impact of adiposity, but left the effects of blood pressure unchanged. We suggest that this approach be used for clinical and research applications.

Adaptation, Physiological↗
PubMed1999

A comparison of the Charlson comorbidity index derived from medical record data and administrative billing data.

The objective of this article is to compare the Charlson comorbidity index derived from medical record data (Chart Index) with the same index derived from billing data (ICD-9 Index) to determine how well each predicted inpatient and 30-day mortality, length of stay, and complications among Medicare beneficiaries hospitalized for carotid endarterectomy. Economic and time constraints have increased the need for risk adjusters derived from administrative data, yet few studies have compared these measures with those derived from chart review. Using logistic regression, the Chart Index was found to be a significant predictor of inpatient mortality, 30-day mortality, length of stay, and complications, after controlling for age, gender, and neurologic and medical risk factors (P values = 0.004, 0.056, 0.0001, and 0.042, respectively). The ICD-9 Index approached significance as a predictor of the outcomes (P values = 0.092, 0.100, 0.093, and 0.080, respectively). The Chart Index was shown to be superior to the ICD-9 Index within this patient sample.

Comorbidity↗
PubMed2000

Correlation between Ki-67 index and some clinical aspects of acoustic neuromas (vestibular schwannomas).

Evaluation of the proliferation activity of neuromas has a practical meaning when there are doubts about the complete resection of the tumor. Evaluation of the clinical aspects connected with increased proliferation activity may have a much broader application. The aim of this study was to correlate selected clinical and radiologic aspects of vestibular schwannomas with the results of the Ki-67 index. The studied group included 23 males and 20 females. Unilateral neuromas were stated in 38 cases (mean age, 52.2 years) and bilateral tumors in 5 cases (mean age, 44.2 years). The immunohistochemical tests (Ki-67) were performed on the specimens preserved in formalin and stored in paraffin. The Ki-67 index was estimated in a semiquantitative study. The mean value of Ki-67 index was 1.86%. In case of unilateral neuromas (n = 38), the average Ki-67 index was 1.74%. In 5 cases of bilateral tumors, the index amounted to 2.79% (P = 0.278). No significant correlation was found by comparing the value of the Ki-67 index with the age of patients (P = 0.410: r = 0.128). Significant differences in the value of the Ki-67 index were noted in the sub-groups of tumors that were evaluated radiologically as growing and stable. The mean value of Ki-67 index was 3.17% in the first subgroup; in stable neuromas, it was significantly lower, amounting to 1.11% (P = 0.020). Such results may confirm that the growth rate of vestibular schwannomas varies and may explain the difficulties in estimating the growth of neuromas on the basis of clinical aspects only.

Adolescent↗
PubMed2002

Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain.

OBJECTIVE: The purpose of this study was to examine body mass index and pregnancy weight gain as risk factors for primary cesarean delivery in nulliparous women in a middle-class private practice. STUDY DESIGN: Primiparous women who delivered in a private practice setting between February 1993 and July 13, 2001, were included. CIs along with Z statistics for paired count data were used to assess the statistical significance and relative importance of the relationships of body mass index and maternal weight gain to cesarean delivery. The effect of body mass index was examined as related to known confounders such as gestational age, birth weight, maternal age, and maternal height. RESULTS: The overall cesarean delivery rate for primiparous women was 21.76%. Risk of cesarean delivery increased consistently and significantly (P <.0001) with increasing body mass index. This effect was primarily mediated through an increase in cesarean delivery carried out for cephalopelvic disproportion/failure to progress. In our practice, the primiparous woman whose body mass index is >30 kg/m(2) is six times more likely to have a cesarean delivery for the diagnosis of cephalopelvic disproportion/failure to progress than the primiparous woman whose body mass index is <20 kg/m(2). This differential in cesarean delivery rate persisted when controlled for birth weight and gestational age and continues to persist when maternal age and height are also controlled. Excessive pregnancy weight gain exerted a statistically significant effect on cesarean delivery rate. This increase was primarily related to cephalopelvic disproportion/failure to progress among the nonobese women. CONCLUSION: Maternal body mass index is related strongly to the ability of primiparous women to be delivered vaginally without great difficulty. In fact, lean patients are excellent labor performers, particularly in contrast with obese patients. The relationship of increased body mass index to increased cesarean delivery is due to an increased rate of cephalopelvic disproportion/failure to progress. Excessive pregnancy weight gain is associated with a doubling of cephalopelvic disproportion/failure to progress rate in nonobese patients.

Adult↗
PubMed2002

Health benefits of low glycaemic index foods, such as pulses, in diabetic patients and healthy individuals.

The present paper covers the health benefits of low glycaemic index foods, such as pulses. Nutritional factors potentially play a crucial role in health and disease. A low-fat, high-carbohydrate diet is often recommended as a part of a healthy life-style. Historical works have shown that carbohydrate foods differ in their ability to affect post-ingestive glycaemia. The glycaemic index concept allows a ranking of carbohydrate-rich foods in terms of their blood glucose raising potential. Pulses are foods with very low glycaemic index values. Numerous studies have documented the health benefits that can be obtained by selecting foods of low glycaemic index. These benefits are of crucial importance in the dietary treatment of diabetes mellitus: glycaemic control is improved as well as several metabolic parameters, such as blood lipids. The results of human studies have been confirmed by animal experiments in the field of diabetes. Diets with low glycaemic index value improve the prevention of coronary heart disease in diabetic and healthy subjects. In obese or overweight individuals, low-glycaemic index meals increase satiety and facilitate the control of food intake. Selecting low glycaemic index foods has also demonstrated benefits for healthy persons in terms of post-prandial glucose and lipid metabolism. Several public health organizations have recently integrated consideration of the glycaemic index in their nutritional recommendations for patients with metabolic diseases and for the general population.

Adult↗
PubMed2004

Body mass index in relation to adult asthma among 135,000 Norwegian men and women.

The authors estimated the association between asthma and body mass index in a 1963-2002 study of 135,000 Norwegians aged 14-60 years who were followed on average for 21 years. Cox proportional hazards regression models were fitted to estimate the relative risk of asthma adjusting for smoking, education, and physical activity. Compared with persons with a body mass index (weight (kg)/height (m)(2)) of less than 25, overweight (body mass index: 25-29) men and women had relative risks of asthma of 1.27 (95% confidence interval (CI): 1.13, 1.43) and 1.30 (95% CI: 1.17, 1.45), respectively, while obese (body mass index: >/=30) men and women had relative risks of 1.78 (95% CI: 1.35, 2.34) and 1.99 (95% CI: 1.67, 2.37), respectively. Stratified analyses revealed a similar association between body mass index and asthma for never smokers, ever smokers, persons with less than or equal to 12 years of education, and persons with more than 12 years of education. Analyses including all the covariates gave results similar to those not adjusting for these factors. The risk of asthma increased steadily with body mass index, from a body mass index of 20 in men and of 22 in women. In men, the risk of asthma increased by 10% with each unit of increased body mass index between 25 and 30. The similar value for women was 7%. Overweight or obese persons reported asthma more often than did thinner persons after adjustment for smoking, education, and physical activity.

Adolescent↗
PubMed2005

Clinical characteristics of an anatomical hand index measured in patients with rheumatoid arthritis as a potential outcome measure.

OBJECTIVES: To determine the clinical characteristics of an anatomical hand index previously reported as a potential measure of joint deformity and outcome in patients with rheumatoid arthritis. METHODS: The hand index (open hand span - closed hand span/lateral height of the hand) was measured in a cross-sectional study of 145 out-patients with rheumatoid arthritis with disease durations 0-55 yr. Subsets of patients were restudied at mean follow-ups of approximately 9 months and 4 yr. RESULTS: The hand index fell gradually with disease duration. Correlations were demonstrated with the Sharp index (r = - 0.39, P = 0.000) and to a lesser extent with disease activity score (r = - 0.28, P = 0.001). At 260 +/- 115 days the hand index worsened by 0.09 units (P = 0.09, NS). At 51.6 +/- 5.4 months the index showed a fall from 1.96 +/- 0.73 to 1.61 +/- 0.65 (P = 0.000). During the same interval the Sharp index increased from 60 +/- 68 to 80 +/- 71 (P = 0.000). CONCLUSIONS: Measurement of simple hand dimensions can demonstrate worsening of hand deformity with time in patients with rheumatoid arthritis. We suggest that more sophisticated analysis of digital hand images, as used in our original study, might yield additional information and increase the sensitivity of an anatomical hand index as an outcome measure in rheumatoid arthritis.

Anthropometry↗
PubMed1997

Relationship of body mass index to subsequent mortality among seriously ill hospitalized patients. SUPPORT Investigators. The Study to Understand Prognoses and Preferences for Outcome and Risks of Treatments.

OBJECTIVE: To determine if body mass Index (BMI = weight [kg]/height [m]2), predictive of mortality in longitudinal epidemiologic studies, was also predictive of mortality in a sample of seriously ill hospitalized subjects. DESIGN: Prospective, multicenter study. SETTING: Five tertiary care medical centers in the United States. PATIENTS: Patients > or = 18 yrs of age who had one of nine illnesses of sufficient severity to anticipate a 6-month mortality rate of 50% were enrolled at five participating sites in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were asked their current height and weight as part of the demographic data. Stratifying body mass index by percentile rank (< or = 15, 15 to 85, and > or = 85th percentiles), risk ratios for mortality were calculated by Cox Proportional Hazards using the 15th to 85th percentile of body mass index as the reference group while controlling for multiple variables such as prior weight loss, albumin, and Acute Physiology Score. A body mass index in the < or = 15th percentile was associated with an excess risk of mortality (risk ratio = 1.23; p < .001) within 6 months. High body mass index (> or = 85th percentile) was not significantly related to risk of mortality. CONCLUSIONS: Body mass index, a simple anthropometric measure of nutrition employed in community epidemiologic studies, has now been demonstrated to be a predictor of mortality in an acutely ill population of adults at five different tertiary centers. Even when controlling for multiple disease states and physiologic variables and removing from the analysis all patients with significant prior weight loss, a body mass index below the 15th percentile remained a significant and independent predictor of mortality. Examination of patient vs. proxy data did not change the results. Future studies examining variables predictive of mortality should include body mass index, even in acutely ill populations with a poor probability of survival.

APACHE↗
PubMed2004

Comparison of a disease activity index and patients' self-reported symptom severity in ulcerative colitis.

BACKGROUND: A self-report instrument to measure disease activity in ulcerative colitis was compared with a full-scale measure of clinical and endoscopic activity, the St. Mark's index. We also tested the effects of symptom reporting style on both instruments. METHODS: Disease activity was measured in 94 patients with ulcerative colitis using the St. Mark's index and an instrument consisting of 7 self-reported symptoms. Reporting style was measured as health anxiety, measured with the Illness Behavior Questionnaire, and repressive coping, defined by scores on the Marlow-Crowne questionnaire and the State Anxiety Index. RESULTS: The St. Mark's index and the self-report index were highly correlated (R = 0.98, P < .001). Compared with the St. Mark's index, the self-report index categorized patients into inactive or active disease with a positive predictive value of 100% and negative predictive value of 100%. Reporting style was associated with differences in disease activity in both disease severity scales. CONCLUSIONS: A self-report measurement of ulcerative colitis disease activity is a valid alternative to complete clinical and endoscopic examination in subjects who do not have severe illness. Determination of disease severity in ulcerative colitis is vulnerable to individual biases in symptom reporting style, not only in self-report instruments, but also in an index that includes endoscopy and physical examination.

Adult↗
PubMed2005

Charlson Comorbidity Index can add prognostic information to Rapid Emergency Medicine Score as a predictor of long-term mortality.

OBJECTIVES: To investigate whether co-existing medical disorders, summed up in a comorbidity index, in nonsurgical patients attending the emergency department could predict short-term and long-term mortality, and whether the index could add prognostic information to the Rapid Emergency Medicine Score. METHODS: This was a prospective cohort study. In all, 885 nonsurgical patients, presenting to an adult emergency department and admitted to a medical department of a 1200-bed university hospital during 2 months, were enrolled consecutively. The Rapid Emergency Medicine Score (including blood pressure, oxygen saturation, respiratory rate, pulse rate, age and Glasgow coma scale) was calculated within 20 min in all those admitted to the emergency department. The history of coexisting disorders (Charlson Comorbidity Index) was collected from the medical records. RESULTS: In a univariate analysis, the Charlson Comorbidity Index could predict both short-term and long-term mortality in nonsurgical emergency department patients. An increase of one point in the 16-point Charlson Comorbidity Index scale was associated with a hazard ratio of 1.15 (95% CI 1.04-1.28, P<0.0001) for 7-day mortality and 1.28 (95% CI 1.23-1.33, P<0.0001) for 5-year mortality. The Rapid Emergency Medicine Score could also predict both short-term and long-term mortality (hazard ratio for an increase of one point in the 26-point Rapid Emergency Medicine Score scale was 1.33 (95% CI 1.28-1.39, P<0.0001) for 7-day mortality and 1.25 (95% CI 1.22-1.28, P<0.0001) for 5-year mortality. The Charlson Comorbidity Index could also add prognostic information to the Rapid Emergency Medicine Score as a predictor of long-term mortality, but it could not independently predict short-term (3-day, 7-day) mortality when forced into the same multivariate logistic model as the Rapid Emergency Medicine Score (hazard ratio for one point increase in the Charlson Comorbidity Index was 1.20 for 5-year mortality (95% CI 1.15-1.25, P<0.0001). CONCLUSION: Information on coexisting disorders (Charlson Comorbidity Index) can prognosticate both short-term and long-term mortality in the nonsurgical emergency department. It can also add prognostic information to the Rapid Emergency Medicine Score as a predictor of long-term mortality.

Aged↗
PubMed2006

The thenar index: an objective assessment and classification of thenar atrophy based on static hand imprints and clinical implications.

BACKGROUND: The aims of this study were to test the effectiveness of the subjective clinical evaluation and to search for any possibility of constituting an objective assessment system for the diagnosis of thenar atrophy based on static hand imprints. METHODS: Static hand imprints were obtained from normal subjects (group A, n = 116) and carpal tunnel syndrome patients with thenar atrophy (group B, n = 26). Thenar index and the bilateral thenar index ratio were defined. Cutoff values were considered by analyses with receiver operating characteristic curves. RESULTS: No statistically significant difference could be demonstrated in thenar index values of dominant and nondominant hands between genders and age groups (p > 0.05). A statistically significant difference was observed between severity groups in group B (p < 0.05). There was a statistically significant difference between thenar index and bilateral thenar index ratio values of groups A and B (p < 0.05). Cutoff values were considered a thenar index of 31 and a bilateral thenar index ratio of 0.8, which revealed acceptable specificity (95.3 percent) and sensitivity (77.4 percent). A new quantitative classification for thenar atrophy severity is proposed. CONCLUSIONS: Understanding the true onset and natural progression of thenar atrophy can only be anticipated with the aid of an objective assessment system. Currently, this method should be regarded as a system for patient records and comparison for presurgical and postsurgical data. The authors believe that the thenar index classification has some merit for future use. It seems that additional objective and scientific evaluation systems and novel approaches are still needed to demystify the true nature of carpal tunnel syndrome.

Adult↗
PubMed1993

Utility of Ramfjord index teeth to assess periodontal disease progression in longitudinal studies.

The feasibility of using the Ramfjord index teeth to estimate whole-mouth periodontal disease activity was investigated. Whole-mouth examinations were carried out semi-annually over a 36-month period in 98 maintenance patients previously treated for adult periodontitis. Recurrent periodontitis was defined as either a 3-mm or greater probing depth increase from baseline, or a 2-mm or greater probing depth increase together with 2-mm or greater of relative attachment loss measured from a reference stent. Whole-mouth disease activity was compared to Ramfjord index teeth data, with and without adjustment. Adjustment was made by multiplying disease activity rates on Ramfjord index teeth by the ratio formed from the sum of all teeth present over the sum of all Ramfjord index teeth in the study population. Without adjustment, Ramfjord index teeth markedly underestimated subjects with recurrent disease activity when compared to whole-mouth findings. However, with adjustment, the hypothesis that upper and lower limits on whole-mouth incidence of recurrent periodontitis could be estimated from Ramfjord index teeth disease-activity rates were not rejected (P > 0.20, z-test) at any 6-month interval. At 5 of 6 examinations, the % of disease active subjects as determined from whole-mouth evaluations was below the upper limit for disease incidence calculated, with 95% confidence, from point estimates derived from adjusted Ramfjord index teeth data. Partial-mouth examinations with appropriate adjustment of Ramfjord index teeth data may be useful for assessing periodontal disease progression in longitudinal population studies of human periodontitis.

Adult↗
PubMed2006

Tonsil size and body mass index are important factors for efficacy of simple tonsillectomy in obstructive sleep apnoea syndrome.

OBJECTIVES: To evaluate the efficacy of simple tonsillectomy to treat obstructive sleep apnoea syndrome (OSAS) in adults. DESIGN: Prospective study. SETTING: Tertiary referral centre. PARTICIPANTS: Thirty patients (28 males) underwent simple tonsillectomy under general anaesthesia. The patients' mean age was 33.2 +/- 6.8 years and body mass index was 30.7 +/- 6.0 kg/m2. Seven patients (23%) were classified with grade 4, 16 patients (53%) with grade 3, and seven patients (23%) with grade 2 according to the tonsil size of Friedman's classification. MAIN OUTCOME MEASURES: The number of apnoea episodes per hour (apnoea index), the number of apnoea and hypopnoea episodes per hour (apnoea-hypopnoea index), lowest nocturnal oxygen saturation and oxygen desaturation time were measured during overnight polysomnography before and after surgery. A successful tonsillectomy was defined as an apnoea-hypopnoea index improvement ratio of > or =50% and an apnoea-hypopnoea index <20 after operation. RESULTS: Apnoea-hypopnoea index decreased from 69.0 +/- 28.4/h to 30.1 +/- 24.0/h (P < 0.0001). Simple tonsillectomy was successful in all six patients with body mass index <25 kg/m2. Concerning success rate of simple tonsillectomy with tonsil, size 2 was lowest (42.9%). Eight of the 13 patients who used continuous positive airway pressure before simple tonsillectomy did not use continuous positive airway pressure after simple tonsillectomy because of a significant reduction of excessive daytime sleepiness. Continuous positive airway pressure decreased significantly after simple tonsillectomy from 13.6 +/- 2.5 cmH2O preoperatively to 10.6 +/- 1.3 cmH2O postoperatively (P < 0.05). CONCLUSIONS: These data suggest that simple tonsillectomy is a beneficial modality to treat OSAS in selected patients (larger tonsil, low body mass index), even in adults.

Adult↗
PubMed2001

Fetal and early life growth and body mass index from birth to early adulthood in 1958 British cohort: longitudinal study.

OBJECTIVES: To determine the influence of birth weight on body mass index at different stages of later life; whether this relation persists after accounting for potential confounding factors; and the role of indicators of fetal growth (birth weight relative to parental size) and childhood growth. DESIGN: Longitudinal study of the 1958 British birth cohort. SETTING: England, Scotland, and Wales. PARTICIPANTS: All singletons born 3-9 March 1958 (10 683 participants with data available at age 33). MAIN OUTCOME MEASURES: Body mass index at ages 7, 11, 16, 23, and 33 years. RESULTS: The relation between birth weight and body mass index was positive and weak, becoming more J shaped with increasing age. When adjustments were made for maternal weight, there was no relation between birth weight and body mass index at age 33. Indicators of poor fetal growth based on the mother's body size were not predictive, but the risk of adult obesity was higher among participants who had grown to a greater proportion of their eventual adult height by age 7. In men only, the effect of childhood growth was strongest in those with lower birth weights and, to a lesser extent, those born to lighter mothers. CONCLUSIONS: Maternal weight (or body mass index) largely explains the association between birth weight and adult body mass index, and it may be a more important risk factor for obesity in the child than birth weight. Birth weight and maternal weight seem to modify the effect of childhood linear growth on adult obesity in men. Intergenerational associations between the mother's and her offspring's body mass index seem to underlie the well documented association between birth weight and body mass index. Other measures of fetal growth are needed for a fuller understanding of the role of the intrauterine environment in the development of obesity.

Adolescent↗
PubMed1998

Application of the MRC brain tumour prognostic index to patients with malignant glioma not managed in randomised control trial.

OBJECTIVES: The MRC brain tumour prognostic index, which uses clinical variables to place patients in different outcome categories, has not been evaluated on a cohort outside a randomised controlled trial. The aims of this study were to (a) determine in a large cohort of patients, derived solely from one centre and not in a clinical trial, whether the MRC prognostic index stratified patients for outcome; (b) compare actual outcomes with those obtained in the original studies; and (c) examine whether neuropathological diagnosis was an independent prognostic variable. METHODS: The MRC prognostic index was calculated for 236 patients with either glioblastoma or anaplastic astrocytoma managed at a dedicated neuro-oncology clinic in Edinburgh between 1989 and 1995. RESULTS: For this mixed population of malignant glioma the median survival was 8.6 months. Two year survival was 72.2% for patients with an MRC index score of 1-10; 36.3% for those with an index score of 11-15; 25.1% for those scoring 16-20; 20.4% with those scoring 21-25; 4.8% with those scoring 26-33; and 0% for those scoring 34-38. Exclusion of 79 patients who would not have been eligible for the MRC studies from which the index was derived, because they were either too old or did not receive radiotherapy, still resulted in a similar pattern of stratification but with significantly improved median survival times for the lowest two categories. Multivariate analysis of prognostic variables in the Edinburgh cohort showed that patients with anaplastic astrocytoma did significantly better than those with glioblastoma (p<0.001). CONCLUSIONS: Although there were some differences in median survival times between the patients in the original MRC studies and the Edinburgh cohort in similar prognostic categories and a tendency to improved two year survivorship in the Edinburgh cohort these differences have arisen because (a) the Edinburgh cohort was accrued about 10 years later than the study has shown that even outside the setting of a prospective controlled trial and with relaxed inclusion criteria the Medical Research Council (MRC) prognostic index is a robust predictor of outcome in patients with malignant glioma. Survival clearly declines as the prognostic index increases. Moreover, the prognostic model can be substantially improved by the addition of histology data, although there is some evidence that this will require complex modelling procedures.

Adult↗
PubMed2006

The glycemic index: methodology and use.

The glycemic index concept owes much to the dietary fiber hypothesis that fiber would reduce the rate of nutrient absorption and increase the value of carbohydrate foods in the maintenance of health and treatment of disease. However, properties and components of food other than its fiber content contribute to the glycemic and endocrine responses postprandially. The aim of the glycemic index classification of foods was therefore to assist in the physiological classification of carbohydrate foods which, it was hoped, would be of relevance in the prevention and treatment of chronic diseases such as diabetes. Over the past two decades low glycemic index diets have been reported to improve glycemic control in diabetic subjects, to reduce serum lipids in hyperlipidemic subjects and possibly to aid in weight control. In large cohort studies, low glycemic index or glycemic load diets (glycemic index multiplied by total carbohydrate) have also been associated with higher levels of high-density lipoprotein cholesterol, reduced C-reactive protein concentrations and with a decreased risk of developing diabetes and cardiovascular disease. More recently, some case-control and cohort studies have also found positive associations between the dietary glycemic index and the risk of colon, breast and other cancers. While the glycemic index concept continues to be debated and there remain inconsistencies in the data, sufficient positive findings have emerged to suggest that the glycemic index is an aspect of diet of potential importance in the treatment and prevention of chronic diseases.

Blood Glucose↗
PubMed2002

Left ventricular hypertrophy evaluation in obese hypertensive patients: effect of left ventricular mass index criteria.

PURPOSE: To evaluate left ventricular mass (LVM) index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA) and for height2 (LVM/h2). The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI): <27; 27-30; >/= 30kg/m2. RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height2 provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH) has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height2 allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.

Adolescent↗
PubMed2005

Body mass index as a predictor of complications after operative treatment of acetabular fractures.

BACKGROUND: Obesity, a growing public health concern, is often thought to be an important risk factor for postoperative complications. We hypothesized that body mass index is predictive of complications after operative treatment of acetabular fractures. METHODS: A retrospective chart review identified 169 consecutive patients in whom an acetabular fracture had been treated with open reduction and internal fixation at a level-1 trauma center. The patients were stratified into four classes according to their body mass index: normal (<25), overweight (> or =25 but <30), obese (> or =30 but <40), and morbidly > or =40). The perioperative outcomes that were evaluated included estimated blood loss, wound infection, nerve palsy, deep venous thrombosis, pulmonary embolism, and heterotopic ossification. Multivariate general linear models were used to test for the relationship between body mass index and perioperative outcomes while controlling for potential intervening variables (including surgical approach, fracture type, and surgeon experience). Odds ratios were calculated as well. RESULTS: When body mass index was measured as a continuous variable, it was found to have a significant relationship with estimated blood loss (p = 0.003), prevalence of wound infection (p = 0.002), and prevalence of deep venous thrombosis (p = 0.03). Odds ratio analysis revealed that obese subjects (body mass index of > or =30) were 2.1 times more likely than patients of normal weight (body mass index of <25) to have an estimated blood loss of >750 mL and 2.6 times more likely to have a deep venous thrombosis. Morbidly obese patients (body mass index of > or =40) were five times more likely to have a wound infection. CONCLUSIONS: Body mass index is predictive of complications after operative treatment of acetabular fractures.

Acetabulum↗