Effect of Increased Body Mass Index on the Accuracy of Estimated Fetal Weight by Sonography in Twins

Objective. The purpose of this study was to determine whether increasing body mass index (BMI) decreases the accuracy of sonographic estimations of fetal weight in twin gestations. Methods. A chart review was conducted, in which 361 charts of patients with twin gestations over a 2‐year period were reviewed. A total of 194 patients had sonographic examinations for fetal weight within 6 days of delivery and were included in the analysis. The difference between the sonographically estimated fetal weight was compared with the actual birth weight for each twin and stratified for the patient's BMI. Results. There was a significant increasing trend in mean absolute percent errors with increasing BMIs in both twins (P < .05). The mean absolute percent errors for twin A were 6% for patients with a BMI of less than 25 and 9% for those with a BMI of greater than 30. The mean absolute percent errors for twin B were 6.7% for patients with a BMI of less than 25 and almost 11.7% for those with a BMI of greater than 30. There was a significantly increasing trend in mean absolute differences in grams for both twins with increasing gestational age, with almost a 4‐fold increase from less than 28 weeks to greater than 36 weeks in both twins (P < .05). Conclusions. Increasing maternal obesity decreases the accuracy of sonographically determined fetal weight in twin gestations, particularly for twin B.     

Effect of Body Mass Index on Outcomes of Peritoneal Dialysis Patients in India

♦ Objectives: We studied the effect of body mass index (BMI) at peritoneal dialysis (PD) initiation on patient and technique survival and on peritonitis during follow-up.♦ Methods: We followed 328 incident patients on PD (176 with diabetes; 242 men; mean age: 52.6 ± 12.6 years; mean BMI: 21.9 ± 3.8 kg/m²) for 20.0 ± 14.3 months. Patients were categorized into four BMI groups: obese, ≥25 kg/m²; overweight, 23 - 24.9 kg/m²; normal, 18.5 - 22.9 kg/m² (reference category); and underweight, <18.5 kg/m². The outcomes of interest were compared between the groups.♦ Results: Of the 328 patients, 47 (14.3%) were underweight, 171 (52.1%) were normal weight, 53 (16.2%) were overweight, and 57 (17.4%) were obese at commencement of PD therapy. The crude hazard ratio (HR) for mortality (p = 0.004) and the HR adjusted for age, subjective global assessment, comorbidities, albumin, diabetes, and residual glomerular filtration rate (p = 0.02) were both significantly greater in the underweight group than in the normal-weight group. In comparison with the reference category, the HR for mortality was significantly greater for underweight PD patients with diabetes [2.7; 95% confidence interval (CI): 1.5 to 5.0; p = 0.002], but similar for all BMI categories of nondiabetic PD patients.Median patient survival was statistically inferior in underweight patients than in patients having a normal BMI. Median patient survival in underweight, normal, overweight, and obese patients was, respectively, 26 patient-months (95% CI: 20.9 to 31.0 patient-months), 50 patient-months (95% CI: 33.6 to 66.4 patient-months), 57.7 patient-months (95% CI: 33.2 to 82.2 patient-months), and 49 patient-months (95% CI: 18.4 to 79.6 patient-months; p = 0.015). Death-censored technique survival was statistically similar in all BMI categories. In comparison with the reference category, the odds ratio for peritonitis occurrence was 1.8 (95% CI: 0.9 to 3.4; p = 0.086) for underweight patients; 1.7 (95% CI: 0.9 to 3.2; p = 0.091) for overweight patients; and 3.4 (95% CI: 1.8 to 6.4; p < 0.001) for obese patients.♦ Conclusions: In our PD patients, mean BMI was within the normal range. The HR for mortality was significantly greater for underweight diabetic PD patients than for patients in the reference category. Death-censored technique survival was similar in all BMI categories. Obese patients had a greater risk of peritonitis.     

Body Mass Index as a Guide for Diagnosing Prediabetes and Diabetes

The incidence of overweight and obese people has threatened the national healthcare system and the health of individuals who are at an increased risk of type 2 diabetes. An estimated one third of diabetes is undiagnosed in asymptomatic patients. This article describes how screening for prediabetes and diabetes can reduce both physical and financial costs and improve health care outcomes by early detection. A hemoglobin Alc (HbgAlc) can be cost effective through a single blood draw detailing the patient's average serum glucose over the previous 3 months. Electronic health records have the capacity to calculate body mass index, which could prompt HbgAlc screening.     

Effect of Body Mass Index on Stroke Rehabilitation

Objective

To investigate the association between body mass index (BMI) and the functional progress of patients with stroke, admitted to a rehabilitation hospital.

Design

A retrospective cohort study.

Setting

A freestanding university rehabilitation hospital stroke unit.

Participants

All patients (N=819) admitted to the stroke unit of a rehabilitation hospital during the study.

Interventions

Not applicable.

Main Outcome Measures

The primary study outcome measure was the FIM efficiency of patients by BMI category.

Results

For the 819 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age and sex, the FIM efficiency differed by BMI. The underweight group had the lowest FIM efficiency, followed by the obese and normal-weight subgroups. The overweight group had the highest FIM efficiency (P=.05) when compared with the obese subgroup.

Conclusions

Among patients admitted to an acute rehabilitation hospital for stroke rehabilitation, overweight patients had better functional progress than did patients in the other weight categories.     

体重指数及OGTT对血清瘦素水平的影响

目的 :观察肥胖者血清瘦素水平的变化及糖负荷对瘦素分泌的影响 ,进而探讨瘦素在人类肥胖发生中的作用。方法 :测定 2 0例非肥胖及 2 0例肥胖者空腹及OGTT后血清瘦素、胰岛素、血糖水平 ,同时测定糖化血红蛋白、甘油三酯及胆固醇水平。结果 :(1)肥胖组血清瘦素水平明显高于非肥胖组 (P <0 .0 0 1) ;(2 )与空腹状态相比 ,糖负荷后血清胰岛素水平升高 ,而瘦素水平呈下降趋势 ,但无显著差异 (P >0 .0 5 ) ;(3)相关分析显示 ,空腹血清瘦素水平与性别、体重指数 (BMI)和胰岛素水平具有相关性。结论 :人类肥胖的发生可能与瘦素抵抗而不是瘦素缺乏有关。短期血胰岛素水平升高对血清瘦素水平无明显影响     

体质量指数对慢性阻塞性肺疾病急性加重期预后的影响

目的探讨体质量指数(BMI)对慢性阻塞性肺疾病急性加重期(AECOPD)预后的影响。方法将58例AECOPD患者按BMI值分为A组(BMI<21kg.m-2)32例、B组(BMI≥21kg.m-2)26例,观察2组患者的住院时间、死亡率及AECOPD发作频率。结果 A组患者住院时间明显长于B组[(23±9)d vs(16±7)d,P<0.05],死亡率及AECOPD发作频率均明显高于B组[12.5%vs 3.8%,(1.4±0.7)次.年-1 vs(0.8±0.6)次.年-1,均P<0.05],且更易出现呼吸衰竭。结论低BMI是影响AECOPD患者预后的重要因素之一。     

体重指数与急性胰腺炎严重程度、预后的相关性研究

目的：探讨体重指数在急性胰腺炎病情发展中的影响与作用。方法：于2002年6月至2008年1月,入选在本院消化科住院的所有急性胰腺炎患者,重症胰腺炎（SAP）患者192例,轻症胰腺炎（MAP）患者408例。分析入院时体重指数（BMI）与急性胰腺炎严重程度、预后的相关性。结果：随着体重指数的增加,重型胰腺炎的患病率逐渐升高（P〈0.01）;全身并发症的发生率逐渐升高（P〈0.01）;疾病死亡率也逐渐升高（P〈0.01）。多元回归分析表明,BMI是导致急性胰腺炎患者死亡的重要危险因素。结论：不同的体重指数水平与急性胰腺炎的严重程度、预后密切相关,体重指数可作为急性胰腺炎严重程度、预后的预测指标。     

Self-Reported vs Measured Body Mass Indices in Migraineurs

Objective.— To compare and contrast body mass indices calculated based on self-reported height and weight as compared with measured height and weight in migraine patients. Background.— Obesity is a risk factor for multiple neurological disorders including stroke, dementia, and migraine chronification. In addition, several cytokines and adipocytokines associated with migraine are modulated by body mass. The body mass index (BMI) is a commonly used anthropometric measure to estimate total body fat and is often calculated based on patient's self-reported height and weight. Methods.— This was a retrospective study evaluating consecutive migraine patients presenting to a headache clinic. Demographic characteristics and self-reported height and weight were obtained from a standardized questionnaire that each new patient completes upon presentation to the clinic. In addition, as depression has been shown to be associated with both migraine and obesity, information in regards to major depression utilizing the Patient Healthcare Questionnaire-9 was extracted as well. Following completion of the questionnaire, body mass indices are routinely measured, with height measured to the nearest 0.5 inch utilizing a mounted stadiometer, and weight measured with a standard scale to the nearest 0.5 lb. After this information was extracted from the charts, BMI was then calculated for both self-reported and measured body mass indices. Using the measured body mass indices as a standard, this was then compared and contrasted to the patient's self-reported body mass indices. Results.— A total of 110 patients were included in the study. Patients were predominantly female (91%) with a mean age of 38.6 ± 11.6 years. Of the total patients included, no significant difference in self-reported height (mean 64.7 ± 3.1 inches) as compared with measured height (mean 64.5 ± 3.4 inches) was seen, P = .463. However, self-reported weight (169 ± 41.3) was underestimated as compared with the measured weight (173.5 ± 43.2), P = .001. And, the self-reported BMI (28.4 ± 6.8) was significantly less than the measured BMI (29.4 ± 7.5), P < .001. Conclusions.— In our study, the self-reported mean weight and BMI for migraineurs was significantly less than the measured mean weight and BMI, and was of greater magnitude in the obese migraineurs. This suggests that conclusions drawn from studies evaluating obesity utilizing self-reported BMI in migraineurs may undercall the effect of total body obesity.     

体重指数、腰围值与高脂血症相关性的研究

目的 :探讨体重指数、腰围值与血胆固醇 (TC)、甘油三酯 (TG)的相关关系。方法 :对 75 1名 2 0 5 9岁某火电建设公司职工体检资料进行体重指数、腰围值与TG、TC的相关分析。结果 :15 7人超重占 2 0 .9% ,199人肥胖占 2 6 .5 % ,35 7人正常占 4 7.5 % ,38例过轻占 5 .1%。BMI值越高 ,TC(r =0 .113,P <0 .0 1)、TG(r =1.0 0 0 ,P <0 .0 1)的含量越高。腰围 (WC)值越大 ,TC(r=0 .372 ,P <0 .0 1)、TG(r=0 .4 0 1,P <0 .0 1)的含量越高。结论 :体重指数、腰围值与血胆固醇、甘油三酯具有显著的正相关性。     

利用其他人体营养学指标预测老年患者的体重及体质指数

目的 探讨老年住院患者体重和体质指数与其他人体营养学指标的关系,建立利用人体营养学指标推算体重与体质指数的方程。方法选择300名住院老年患者,收集其人体营养学指标（体重、身高、上臂围、小腿围、三头肌皮褶厚度、肩胛下皮褶厚度和腹部皮褶厚度等）,运用多元逐步回归分析方法,建立体重、体质指数与以上营养学指标的回归方程。结果各人体营养学指标与体重、体质指数的相关性较好（r〉0．4）;通过建立体重、体质指数与其他人体营养学指标的五元、三元回归方程,得出各方程的决定系数均大于0．8;选用五元回归方程时可获得较为精确的体重、体质指数值,选用三元回归方程则可降低临床工作量。结论 在必要时可使用回归方程来预测卧床老年患者的体重、体质指数值;但应注意对卧床老年患者进行早期肢体功能锻炼,以避免肌肉萎缩而增加体重、体质指数值的偏差。     

青少年高血压与空腹血浆Ghrelin水平及体质指数的关系

【目的】探讨青少年高血压与空腹血浆Ghrelin水平及体质指数（BMI）的关系。【方法】选取秦皇岛市13～15岁青少年158名,根据血压分为高血压组（n=48）和血压正常对照组（n=110）,测量身高、体质量,计算体质量指数（BMI）。空腹静脉采血,测量空腹血糖、三酰甘油、高密度脂蛋白胆固醇（HDL-C）、真胰岛素和血浆Ghrelin水平。【结果】高血压组BMI、真胰岛素和HOMA-IR水平高于对照组[分别（25．1±4．7）比（21．8±3．9）kg／m2,t=4．474;（2．8±0．5）比（2．6±0．6）IU／L,t=2．184;（1．3±0．6）比（1．1±0．6）,t=1．985;均P〈0．053,两组Ghrelin、空腹血糖、三酰甘油和HDL-C水平差异无统计学意义。Ghrelin与收缩压和舒张压无相关。收缩压和舒张压均与BMI（分别r=0．531,0．376;均P〈0．01）、ln（HOMA-IR）（分别r=0．242,0．185;均P〈0．01）、1n（真胰岛素）（分别r=0．243,0．204;均P〈0．01）呈正相关。行多元线性回归显示,BMI是收缩压和舒张压的独立影响因素（分别β=1．759,0．776;均P〈0．01）。【结论】青少年高血压与BMI密切相关。     

成都地区中老年人群体重指数对高血压患病率及血压水平的影响

目的：研究成都地区中老年人群体重指数（BMI）与高血压患病率及血压水平的关系。方法：按照随机抽样的方法抽取样本,对711人（平均年龄为63.28±6.25岁;男性占57.8%）进行了相关调查,调查内容中包括身高、体重、血压及脉搏等。结果：成都地区中老年人群的超重及肥胖所占比重较大（约45%）,按BMI分组（〈18.5 kg/m~2,18.5～23.9 kg/m~2,24～27.9 kg/m~2,≥28.0 kg/m~2）的高血压患病率分别是31.6%,54.8%,64.4%,82.8%,差异有统计学意义。采用logistic回归分析发现在调整年龄、性别、腰围及尿酸等后,BMI对高血压的患病率有独立影响。在整个人群及女性病人中,血压随着BMI的升高而有升高的趋势,差异有统计学意义。结论：成都地区中老年人群超重及肥胖所占比重较大。BMI可以影响高血压的患病率及影响女性病人的血压水平,是高血压的独立危险因素。     

不同体质指数对高热患者药物降温效果的影响

正人体正常腋温一般为36~37℃,当下丘脑体温调节中枢受致热源的刺激时,机体温度调定点水平将上移,从而导致产热增多,散热减少,当体温升高大于0.5℃即为发热[1-2],是临床患者常见症状。目前,针对发热患者常采用口服对乙酰氨基酚、布诺芬或阿司匹林等退热药物进行降温处理,其作用机制主要是通过抑制中枢神经系统前列腺素的合成,使外周血管扩张、皮肤血流增加、出汗,因而使散热增加,降温效果显