Bioelectric impedance is a better indicator of obesity in men with schizophrenia than body mass index

Body mass index (BMI) is commonly used as an indicator of obesity, although in both clinical and research settings the use of bioelectric impedance analysis (BIA) is commonplace. The purpose of this study was to examine the relationship between BMI, BIA and percentage body fat to determine whether either is a superior indicator of obesity in men with schizophrenia. The reference method of deuterium dilution was used to measure total body water and, subsequently, percentage body fat in 31 men with schizophrenia. Comparisons with the classification of body fat using BMI and BIA were made. The correlation between percentage body fat and BMI was 0.64 whereas the correlation between percentage body fat and BIA was 0.90. The sensitivity and specificity in distinguishing between obese and overweight participants was 0.55 and 0.80 for BMI and 0.86 and 0.75 for BIA. BIA proved to be a better indicator of obesity than BMI. BMI misclassified a large proportion of men with schizophrenia as overweight when they had excess adiposity of sufficient magnitude to be considered as obese. Because of the widespread use of BMI as an indicator of obesity among people with schizophrenia, the level of obesity among men with schizophrenia may be in excess of that previously indicated.     

Physical activity practice,body image and visual impairment: A comparison between Brazilian and Italian children and adolescents

The aim of this study was to analyze the physical activity and body image of children and adolescents with visual impairment (VI) in Brazil and Italy. For this, 41 children and adolescents with VI (19 Brazilian and 22 Italian) aged 10.22 ± 2.19 years old (18 girls and 23 boys) answered the Physical Activity Questionnaire for Children (PAQ-C), the Offer Self-Image Questionnaire (OSIQ), and an instrument with information about the disability, body weight and height. We analyzed the relationship between data from PAQ-C and OSIQ, as well as the gender, level of disability (blindness or low vision) and country using independent Mann–Whitney test. Body mass index (BMI) values were higher for Brazilian youths, with more than half of them classified as overweight and obese. Italian youths exhibited values of body image that were more positive and only 27% presented overweight or obesity. Blind children and adolescents were less active than those with low vision, but no differences were found between countries or genders. In Brazil, we detected significant correlations (p > 0.05) between physical activity, body image and BMI, which more active youths presenting lower values of BMI and a better perception of body image. Physical activity seems to have a positive influence on body image and BMI for children and adolescents with VI, thus it should be encouraged especially for those with higher disability degrees.     

Body mass index and its impact on migraine prevalence and severity in female patients: Preliminary results

Background and purposeA strikingly increasing number of obese patients causes a great interest in potential medical problems resulting from abnormal body weight. Many conditions are associated with obesity. The severity and risk of migraine may be connected with a body weight. We would like to assess a correlation between body mass index (BMI) and frequency and duration of migraine.Materials and methodsWe collected data of 53 female patients with migraine and 36 healthy persons (25 women) as a control group. Mean duration of migraine attacks and their mean frequency were based on patients’ diaries. The patients reported their height. Weight was measured by the authors. We consequently calculated BMI and performed statistics on SAS 9.2.ResultsThe mean BMI of the migraine group was 24.27 ± 4.47. Forty-nine percent of patients had normal BMI (18.5–25), 30% patients were overweight (>25) and 13% were obese (>30). The mean BMI among controls was 22.69 ± 2.96. Eighty-four percent of the control group had normal BMI, 12% was overweight and 5% was obese. An association of BMI in women with frequency of migraine episodes per month occurred remarkable when adjusted for age. Difference of a mean BMI value between the migraine and the control group was nearly statistically significant. Body mass index and duration of the episodes revealed similarly strong correlation.ConclusionsIncreased BMI correlates with frequency of migraine. Its influence on a risk of the headaches and their duration remains to be specified.     

Body mass index in patients with Multiple Sclerosis: a meta-analysis

ABSTRACT

Background: The impact of nutrition and diet on the etiology of Multiple Sclerosis (MS) has been evaluated through a number of studies. Only a limited number reported findings on the association between body mass index (BMI) and MS. We systematically assessed whether BMI differs between MS patients and healthy individuals.

Methods: The PubMed database was searched for available studies assessing the relationship between BMI and MS until April 2018. Random effects models were applied for evaluating the association of mean BMI between MS, relapsing-remitting MS (RRMS) patients, females, or males with MS, and their respective healthy control groups.

Results: We included 25 studies. The mean BMI of MS patients during the course of the disease and RRMS patients was significantly different from the mean BMI of their healthy counterpart individuals [standardized mean difference (SMD) (95% confidence interval (CI)): ?0.25 (?0.44, ?0.06), P_Z = 0.01 and SMD (95%): ?0.27 (?0.54, ?0.01), P_Z = 0.04, respectively]. The mean BMI of females with MS was significantly differentfrom that of corresponding healthy females [SMD (95% CI): ?0.52 (?0.96, ?0.07), P_Z = 0.02]. Moreover, the mean BMI was significantly different between males with MS and healthy males [SMD (95% CI): ?0.75 (?1.33, ?0.18), P_Z = 0.01].

Conclusions: Statistically significantly lower mean BMI was revealed in the overall MS patients’ group during the MS course than in healthy controls. The same difference was revealed in all parts of the meta-analysis demonstrating a significantly lower BMI in patients with RRMS, in females, and in males with MS, when compared to their respective healthy individuals.     

长期氯氮平治疗的男性精神分裂症病人身体质量指数与精神病理症状的关系

目的探讨长期氯氮平治疗男性精神分裂症病人的身体质量指数（BMI）与精神病理症状的关系。方法对222例长期氯氮平治疗的慢性男性精神分裂症病人进行横断面调查,检测病人的身高和体重,并记录病人服药情况。同时用PANSS量表检测其精神病理症状。结果与正常人群的BMI分布相比,长期氯氮平治疗病人超重和肥胖的比例明显增加（P〈0.05）。以BMI进行分组,肥胖、超重、正常体重组和低体重组之间PANSS阴性症状量表（P〈0.001）、一般病理症状量表（P〈0.05）和总分（P〈0.001）之间均存在显著差异。与正常体重组和低体重组相比,肥胖组和超重组在PANSS阴性症状量表、一般病理症状量表和总分上均较低（P〈0.05,P〈0.01）。Pearson相关分析表明：BMI与PANSS总分（r=-0.248,df=222,P=0.000）PANSS阴性症状量表分（r=-0.256,df=222,P=0.000）和一般病理症状量表分均呈显著负相关（r=-0.19,df=222,P=0.004）,而与PANSS阳性症状无显著相关（P=0.23）。结论长期服用氯氮平的男性精神分裂症病人BMI明显增加;而且病人BMI越高,其临床症状、尤其是阴性症状和一般病理症状就越轻。     

Variation of circadian activity rhythm according to body mass index in children

Background/objectivesThis study aimed to examine the variations of circadian activity rhythm of children according to objective body mass index (BMI) values, using a novel statistical framework (ie, Functional Linear Modeling, FLM), separately for school- and weekend days.MethodsA total of 107 participants (60 females; mean age: 10.25 ± 0.48 years) wore an actigraph for seven days during a regular school-week. While valid actigraphic data during school days were available for each of these children, this number decreased to 53 (31 females; mean age: 10.28 ± 0.51 years) during weekend days.ResultsExamining the school days, significantly higher motor activity in participants with higher BMI was observed from around 4:00 a.m. to 6:00 a.m., with a peak about 5:00 a.m. On the contrary, applying the FLM to the weekend days actigraphic data, no significantly different variation of circadian activity rhythm was observed, according to BMI.ConclusionsIn this specific sample of children, during school days, higher BMI is associated with higher activity level in a specific time window in the second half of nocturnal sleep. The lack of significant findings during weekend days could be explained because of higher variability of get-up time and/or the reduced sample size. Future longitudinal studies could explore if the higher motor activity in that specific time window qualifies as a predictive marker of the development of overweight and obesity. If so, early preventive strategies directed towards those at higher risk could be effectively implemented.     

Polysomnographically determined sleep and body mass index in patients with insomnia

We assessed associations between polysomnographically determined sleep, especially the amount of slow-wave sleep (SWS), and body mass index (BMI) in patients with insomnia. One hundred and forty-one insomniacs and 55 healthy volunteers completed overnight polysomnographic recordings, and we measured height and body weight. No significant correlations were obtained between total sleep time and BMI among insomniacs. Compared with normal volunteers, insomnia patients exhibited longer sleep latency and shorter total sleep duration. While the two groups had no significant differences in BMI, insomniacs presented with more N1 but less time spend in SWS and rapid eye movement sleep (REMS). Based on their SWS time, we divided insomnia patients into three groups: short (26.99±13.88), intermediate (59.24±8.12), and long (102.21±26.17) SWS groups. The short-SWS group had significantly greater BMI than the long-SWS group. Further analyses with multiple linear regression showed a significant negative correlation between the amount of SWS and BMI scores in insomniacs, whereas no such correlation was found in healthy volunteers after controlling for potential confounds (e.g., age, sex and AHI). Our study suggests that low amounts of SWS may be associated with higher BMI in patients with insomnia.     

Binge eating,body mass index,and gastrointestinal symptoms

Objective

Symptoms of both gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) are frequently reported by individuals who binge eat. Higher body mass index (BMI) has also been associated with these disorders and with binge eating (BE). However, it is unknown whether BE influences GERD/IBS and how BMI might affect these associations. Thus, we examined the potential associations among BE, GERD, IBS, and BMI.

Methods

Participants were from the Swedish Twin study of Adults: Genes and Environment (STAGE) and provided information on disordered eating behavior, BMI, gastrointestinal (GI) disorders, and commonly comorbid psychiatric and somatic illnesses. Key features of GERD and IBS were identified to create modified definitions of both disorders that were used as primary outcome variables. Logistic regression models were applied to determine the association between BE and each GERD/IBS both independently and in the context of BMI and other commonly comorbid psychiatric and somatic morbidities.

Results

Prevalence estimates for GERD and IBS were higher among women than men (all p-values < .001). Only the association between BE and IBS was significant in both men and women after adjustment for BMI and the psychiatric/somatic morbidities.

Conclusion

BE appears to be an important consideration in the presence of IBS symptoms in both men and women, even when considering the impact of BMI and other commonly comorbid conditions. This association underscores the importance of routine assessment of BE in patients presenting with IBS to effectively manage the concurrent presentation of these problems.     

Lithium-induced changes in the body mass index

A total of 117 manic-depressives who had been on lithium for a mean duration of 4.7 years were examined before lithium therapy and subsequently at intervals. Information relating to pre-lithium height and weight and current weight were determined and used to calculate the body mass index (BMI) for each individual. Other relevant variables such as age, sex, cumulative lithium dose, duration of therapy, thyroid profile and serum lithium levels were recorded. The results indicated that, although there was a nonsignificant increase in BMI for the whole population, lithium and sex were not significant predictors of any increase in BMI. In nearly 27% of patients BMI actually slightly decreased during lithium therapy. The overall conclusions from this study are that, in the population studied, lithium may not have exerted any pharmacological effects to increase BMI.     

Association of upper and lower gastrointestinal tract symptoms with body mass index in an Australian cohort

Food modulates gastrointestinal (GI) function and GI symptoms could alter food intake, but it is not established whether or not obese people experience more or less GI symptoms. We aimed at evaluating the association between body mass index (BMI) and specific GI symptoms in the community. Population-based random samples from Sydney, Australia (n = 777) completed a validated questionnaire. The association of each GI symptom with BMI (kg m(-2)) categories was assessed using logistic regression analysis adjusting for potential confounders. The prevalence of obesity (BMI > or =30 kg m(-2)) was 22%. There were univariate associations (adjusting for age, sex, education level, alcohol and smoking) between increased BMI category and heartburn (OR = 1.9, 95% CI 1.4, 2.5), acid regurgitation (OR = 2.1, 95% CI 1.4, 2.9), increased bloating (OR = 1.3, 95%CI 1.1, 1.6), increased stool frequency (OR = 1.4, 95% CI 1.1, 1.7), loose and watery stools (OR = 1.5, 95% CI 1.1, 2.0) and upper abdominal pain (OR = 1.3, 95% CI 1.03, 1.6). Early satiety was associated with a lower BMI category but this was not significant after adjustment (OR = 0.8, 95% CI 0.6, 1.1). Lower abdominal pain, postprandial fullness, nausea and vomiting were not associated with BMI category. In a regression model adjusting for sex, education, smoking, alcohol and all GI symptoms, older age, less early satiety and increased stool frequency and heartburn were all independently associated with increasing BMI (all P < 0.01). Heartburn and diarrhoea were associated with increased BMI, while early satiety was associated with a lower BMI in this population.     

Adaptive behaviour and quality of life in school-age children with congenital visual disorders and different levels of visual impairment

BackgroundAdaptive behaviours are vital skills that allow individuals to function independently and are potentially amenable to behavioural interventions. Previous research indicated that adaptive behaviours are reduced in children and adolescents with severe to profound VI, but it was unclear if this was also the case for children with mild to moderate VI.AimThe aim of the study was to assess differences in adaptive behaviour in children with congenital visual disorders and different levels of visual impairment and their influence on quality of life and everyday strengths and difficulties.Methods and proceduresQuestionnaires about adaptive behaviour, strengths and difficulties, and quality of life were completed by parents of school-age children with severe-to-profound VI (S/PVI, n = 9, 0.9 logMAR – light perception only), mild-to-moderate VI (MVI, n = 9, 0.1–0.7 logMAR), or typical sight (control, n = 18, −0.3 to 0.1 logMAR). Differences in questionnaire domains by the severity of VI and relationships between adaptive behaviour and quality of life were analysed in general linear models.Outcomes and resultsThe questionnaire ratings indicated reduced adaptive behaviour, more difficulties, and reduced quality of life in children with S/PVI compared to typically-sighted peers. Effects were smaller for children with MVI, but indicated a significant reduction in quality of life compared to typically-sighted children. The effect of visual impairment on quality of life in school was partially mediated by adaptive behaviour.Conclusion and implicationSevere congenital visual impairment affects adaptive behaviour in children with verbal abilities in the typical range. This effect is less pronounced in children with mild-to-moderate VI, but still impacts on quality of life, particularly in school.     

The effect of age and body mass index on cost of spinal surgery

Complex shifts in demography combined with drastic advancements in spinal surgery have led to a steep increase in often expensive spinal interventions in older and obese patients. A cost analysis, based on hospital charges, was performed retrospectively on the spinal surgery of 787 randomly selected patients who were operated at The Medical Center of Central Georgia, a large urban hospital in Central Georgia. The types of surgery included anterior cervical decompression and fusion (ACDF), lumbar decompression and fusion (LDF), and lumbar microdiscectomy (LMD). The distribution of patient age followed a Gaussian form. The peak age for patients was 50-59 years (28.8%), and there was no statistical difference in age between men and women. The body mass index (BMI) differed (p < 0.01) between males (28.86 kg/m²; range: 18-47 kg/m²) and females (30.69 kg/m²; range: 17-58 kg/m²). The BMI data did not follow a Gaussian distribution for either gender. The hospital cost for spinal surgery increased with age except for male patients who underwent ACDF. For male patients who underwent LDF, the increase in hospital cost was statistically significant between the 40-49-year and the ?70-year age groups. Univariate analysis with type of surgery as a covariate showed that age was a significant determinant of hospital cost (p = 0.000), and BMI was not (p = 0.110); however, the interaction between age and BMI was significant (p = 0.000). Older patients undergoing spinal surgery had lower BMI, more so in males (r = −0.047, p = 0.426) than in females (r = −0.038, p = 0.485). There were linear trends in all gender-spinal surgery categories between age, BMI and hospital cost. Older female patients who underwent LDF tended to have a lower BMI but higher hospital cost, confirming that age was more important than BMI in determining hospital cost in these patients. The increments in cost of spinal surgery in relation to age especially and BMI were, nevertheless, small. We believe that spinal surgery in the elderly should be viewed as a public investment, as the modern concept of retirement involves people working intermittently up to their 80s. Thus, where clinical research on medical costs is to be conducted, cost analysis needs to be expanded to include returns to government in the form of taxes.     

Body mass index and victimization during adolescence: the mediation role of depressive symptoms and self-esteem

Objective

This study applied a multi-method approach to examine the relationship between body mass index (BMI) and the experience of victimization during adolescence by investigating the role of intrapersonal feelings.

Methods

The sample consisted of 2051 adolescents (M=13.8 years, S.D.=0.7; 51% male) from seven high schools in the Netherlands. Participants' weight and height were measured and they completed self-report questionnaires on victimization, depressive symptoms and self-esteem. Self-reported and peer-reported measures of victimization were collected and combined to create three different victimization types (i.e., self/peer-identified, self-identified, and peer-identified).

Results

Hierarchical logistic regression analyses revealed that higher BMI was associated with both self/peer-identified victimization and self-identified victimization. Intrapersonal feelings (i.e., depressive symptoms and self-esteem) were found to mediate these associations. However, BMI was not associated with peer-identified victimization.

Conclusion

These findings suggest that the association between BMI and victimization might be exclusively related to the self-perception of high BMI adolescents. Moreover, the mediation effects indicate that the perception of victimization might be linked to psychological difficulties of adolescents with high BMI. Thus, to fully understand the associations between weight status and victimization, intrapersonal mechanisms need to be examined.     

Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements

In this study we aimed to identify the role of the body mass index (BMI), wrist index and hand anthropometric measures as risk factors for carpal tunnel syndrome (CTS) in both genders. Based on clinical and electrophysiologic diagnostic criteria, 154 female and 44 male CTS patients, as well as 150 female and 44 male age-matched control subjects, were selected. BMI, wrist index, hand shape index, digit index and hand length/height ratio were compared between the CTS patients and the control subjects for each gender separately. Mean BMI was found to be a significant risk factor for CTS in both genders. The wrist index was found to be higher in female (P<0.001) and in male (P=0.034) CTS groups than in the respective control groups. Logistic regression analysis revealed the wrist index to be an independent risk factor in females, but not in males. Shape and digit indices were significantly higher in female CTS patients than in corresponding control subjects, and regression analysis showed the shape and digit indices to be independent risk factors for CTS. In the male CTS group, the shape and digit indices did not significantly differ from their controls. Differences in the hand length/height ratio were not statistically significant in female and male CTS patients compared to their controls and it was not found to be an independent risk factor for CTS.

Our study confirmed BMI as an independent risk factor for CTS in both genders. Hand and wrist anthropometrics were found to be independent risk factors for CTS in females, but not in males.     

体质量指数对全膝人工关节表面置换后功能的影响

背景：目前有一些研究考虑到了体质量指数对全膝人工关节表面置换后功能的影响,但是大部分病例数较少,随访时间较短。目的：观察体质量指数对全膝人工关节表面置换后功能的影响。方法：选择北京大学人民医院骨关节科收治的骨关节炎患者320例,均接受初次膝关节髌骨置换,其中双膝置换200例,共520个膝关节,左膝置换219个,右膝置换301个。由同一组医生采用同一种假体(均为Scorpio后稳定型膝关节假体)对320例患者行全膝人工关节表面置换治疗。按体质量指数分为4组(超重组：体质量指数25.1~27.0 kg/m2,肥胖组：体质量指数27.1~30.0 kg/m2,病理性肥胖组：体质量指数> 30 kg/m2,对照组：体质量指数< 25 kg/m2)。按1989年美国纽约特种外科医院评分标准(HSS),记录置换前及随访时膝关节评分和功能评分,以及膝关节最大屈曲度、伸直度数和并发症。结果与结论：320例患者均通过门诊复查进行随访,随访时间12~46个月,平均28.3个月。置换前超重组、肥胖组、病理性肥胖组功能评分较对照组低(P < 0.05),但关节评分无显著性差异。在最后的随访中发现,无论膝评分和功能评分各组置换后均明显提高,各组提高的幅度无显著性差异(P > 0.05)。肥胖组和病理性肥胖组围置换期并发症明显增高(P < 0.05),181膝中有14膝(9.2%)合并伤口并发症,1膝(0.5%)感染,2膝(1.3%)内侧副韧带损伤,感染发生于置换后10周内并与伤口并发症有关;而超重组258膝中有6膝(2.3%)合并伤口并发症;对照组81膝中有1膝(1%)合并伤口并发症。围置换期无死亡和肺栓塞病例。提示体质量指数对全膝人工关节表面置换后早期的功能恢复无明显影响。     

Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals

Introduction

Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects.

Body fat distribution in Parkinson's disease: An MRI-based body fat quantification study

IntroductionThere is some evidence that Parkinson's Disease (PD) patients have lower body weight and lower fat mass when compared to healthy subjects and that lower body weight and fat mass influence disease risk and progression. It remains unclear, however, if weight loss of fat mass loss occurs only in a subgroup of patients and whether fat distribution is altered during PD. The aim of this study was to prospectively investigate adipose tissue content and distribution in PD patients.MethodsThe body fat composition of PD patients (N = 54) was compared with age matched healthy controls (N = 55) using a magnetic resonance imaging (MRI)-based method. A longitudinal MRI scan was acquired in 25 PD patients after a mean follow up period of 12 months.ResultsThe volume of total body fat as well as of visceral fat showed no difference between PD patients and healthy controls at baseline or at follow up. However, PD patients displayed decreased subcutaneous fat tissue (p = 0.01) and a higher visceral to subcutaneous fat ratio as compared to controls (p = 0.004). After follow up, 16 PD patients did not lose weight, while 9 PD patients lost between 0.5 and 10 kg.ConclusionFat distribution is altered in PD patients, with an increased ratio of visceral to subcutaneous fat.     

Increased body mass index associated with autonomic dysfunction in Parkinson's disease

BackgroundThe association between Parkinson's disease (PD) and body mass index (BMI) has not been established. In this study, we investigated the correlation between BMI and autonomic dysfunction in patients with PD.MethodsClinical features, BMI, cardiac ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy and the coefficient of variation of the electrocardiographic R–R interval (CVRR) were analyzed in 124 patients with PD who were naïve to anti-parkinsonian drugs.ResultsBMI was negatively correlated with early heart-to-mediastinum ratio and CVRR in patients with PD, regardless of disease duration and severity.ConclusionsAutonomic dysfunction and BMI increase were associated with each other. Physicians should consider the possibility of autonomic dysfunction in PD patients with high BMI.