All-cause and cardiovascular disease mortality in underweight patients with diabetic nephropathy: BioBank Japan cohort

We aimed to determine mortality risk in underweight patients with diabetic nephropathy for microalbuminuria or macroalbuminuria. We analyzed mortality and death-cause data from BioBank Japan, with baseline years 2003–2007. We analyzed mortality rates from all causes and ischemic heart disease, according to body mass index (<18.5, 18.5–21.9, 22–24.9 and ≥25 kg/m²). The mean (standard deviation) of patient age, body mass index, and glycated hemoglobin at enrollment was 61.6 years (11.7 years), 25.0 kg/m² (4.4 kg/m²) and 7.7% (1.5%), respectively. Hazard ratios of all-cause and ischemic heart disease mortality were highest (1.79 [P = 0.0001] and 2.95 [P = 0.027], respectively) in patients with body mass index <18.5 kg/m², as compared with body mass index 22–24.9 kg/m². All-cause mortality risk for body mass index <18.5 kg/m² was similar to that for current smokers (hazard ratio 1.70, P < 0.0001). Underweight could be a predictor of mortality risk in patients with diabetic nephropathy for microalbuminuria or macroalbuminuria.     

Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m²), normal weight (18.5≤BMI<25.0 kg/m²), overweight (25.0≤BMI<30.0 kg/m²), and obese (BMI≥30.0 kg/m²). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m². The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ²=35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.     

甲地孕酮对低体重慢性阻塞性肺疾病患者生活质量影响

目的探讨甲地孕酮（MA）对慢性阻塞性肺疾病（COPD）患者体重、肺功能和运动耐量的影响。方法将42例低体重COPD患者随机分为MA组（口服MA 160 mg/d）和对照组（单纯支持治疗）,观察8周,比较两组体重、肺功能、动脉血气分析及6 min步行距离（6MWD）的变化。结果MA组体重和前白蛋白增加（P〈0.05）;MA组动脉血二氧化碳分压（PaCO2）下降,动脉血氧分压（PaO2）升高（P〈0.05）,FEV1和FVC差异无统计学意义（P〉0.05）;两组6MWD差异无统计学意义（P〉0.05）。结论MA能改善低体重慢性阻塞性肺疾病患者体重和肺通气功能,但不能增加运动耐量。     

低体重对青春期男生负荷做功能力影响的研究

将２７９名１３～１５岁男生按不同身高将体重分为正常体重和低体重两组，进行ＰＷＣ１７０负荷做功能力比较，同时比较形态、机能、素质发育状况。结果提示：低体重青春期少年的机能、素质和负荷做功能力明显降低，和正常体重者比，必须以较高的心率完成相同负荷做功。     

Association between body mass index,body height,and the prevalence of spinal deformities

Background contextThe most common spinal deformities among adolescents are adolescent idiopathic scoliosis (AIS; 2%–3% prevalence) and Scheuermann kyphosis (SK; 1%–8% prevalence). Both are believed to have a genetic influence in their etiology. The association between body mass index (BMI) and body stature and their possible association to spinal deformities is uncertain.Study designA cross-sectional prevalence study.PurposeTo examine the prevalence of all adolescent spinal deformities according to the extent of their severity as well as their possible association to BMI and body height.Outcome measuresSubjects diagnosed as having spinal deformities were classified into one of three severity groups; “Mild,” “Intermediate,” or “Severe,” according to their curve scoliosis or kyphosis measurement with a standing X-ray.MethodsThe data for this study were derived from a medical database containing records of 17-year-old male and female patients before their recruitment into mandatory military service. Information on the disability codes associated with spinal deformities according to the Regulations of Medical Fitness Determination was retrieved. Logistic regression models were used to assess the association between the BMI and body height to various degrees of spinal deformities by severity.ResultsThe study cohort included 829,791 consecutive subjects, of whom 103,249 were diagnosed with spinal deformities (76% were mild in degree). The prevalence of spinal deformities was significantly greater among the underweight male and female patients (p<.001). Increased BMI had a protective effect for developing spinal deformities. The odds ratios for severe spinal deformities were greater compared with mild spinal deformities in the underweight groups. The risk for developing spinal deformities increased significantly with height for both genders (p<.001).ConclusionsAn association between height and the risk for spinal deformities by severity was found for all height groups. Below normal BMI is associated with severity of spinal deformities, whereas above-normal BMI apparently has a protective effect. Body height is also positively associated with the severity of spinal deformities.     

Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders

AIM: To evaluate gastrointestinal (GI) symptoms and breath hydrogen responses to oral fructose-sorbitol (F-S) and glucose challenges in eating disorder (ED) patients.METHODS: GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h, following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day, after an overnight fast on each occasion. Responses to F-S were compared to those of 20 asymptomatic healthy females.RESULTS: F-S provoked GI symptoms in 15 ED patients and one healthy control (P < 0.05 ED vs control). Only one ED patient displayed symptom provocation to glucose (P < 0.01 vs F-S response). A greater symptom response was observed in ED patients with a body mass index (BMI) ≤ 17.5 kg/m² compared to those with a BMI > 17.5 kg/m² (P < 0.01). There were no differences in psychological scores, prevalence of functional GI disorders or breath hydrogen responses between patients with and without an F-S response.CONCLUSION: F-S, but not glucose, provokes GI symptoms in ED patients, predominantly those with low BMI. These findings are important in the dietary management of ED patients.     

The associated risk factors for underweight and overweight high school students in Cambodia

Purpose

Overweight and underweight are one of the leading risk factors for non-communicable diseases (NCDs), but little research on this area has been undertaken in Cambodia. Therefore, this study aimed to measure underweight and overweight and their associated risk behaviors among Cambodian high school students.

Prevalence and associated factors of underweight and overweight/obesity among reproductive-aged women: A pooled analysis of data from South Asian countries (Bangladesh,Maldives, Nepal and Pakistan)

Background and aimsUnderweight and overweight/obesity is a critical public health problem among women in South Asian countries. This study aimed to find the prevalence of underweight and overweight/obesity and discover its associated factors among women of reproductive age in four South Asian countries.MethodsPopulation-representative cross-sectional latest Demographic and Health Survey data from four South Asian countries, considering Bangladesh (2017–18), Maldives (2016–17), Nepal (2016), and Pakistan (2017–18), were pooled for this study. To investigate the factors related with underweight and overweight/obesity in women, a multivariate multinomial logistic regression model was deployed.ResultsThe overall prevalence of underweight and overweight/obesity among reproductive-age women in four South Asian countries was 11.8% and 36.3%, respectively. According to adjusted multivariate multinomial logistic regression analysis, women who lived in Pakistan, were older, had a better education, were from the wealthiest home, were currently in union and had media exposure had a considerably decreased probability of being underweight. In contrast, families with a large number of members had a considerably increased risk of becoming underweight. Additionally, women from the Maldives, older age, secondary education, a higher number of children, women from the richest household, currently in the union, the family had media exposure, and pregnant women have been found significantly positively associated with overweight/obesity. However, Nepalese women, large family members, rural residence, and work involvement were significantly negatively associated with overweight/obesity.ConclusionThe problem of being underweight and overweight/obesity still exists in South Asian countries. Focusing on women's age, education, wealth index, and media exposure, different public health intervention approaches are imperative to reduce unhealthy weight conditions.     

Prevalence and factors associated with obesity among the oldest old

PurposeTo determine the prevalence of overweight and obesity, and to identify factors associated with obesity, among the oldest old.MethodsFor this study, data from follow-up (FU) wave 7 and FU wave 8 of the “Study on Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)” (AgeQualiDe) were used. At FU wave 7, the mean age was 88.9 years (SD: 2.9; 85–100 years). Body-mass-index (BMI) categories were defined according to the World Health Organization (WHO) thresholds: underweight (BMI < 18.5 kg/m²), normal weight (18.5 kg/m² ≤ BMI < 25 kg/m²), overweight (25 kg/m² ≤ BMI < 30 kg/m²), and obesity (BMI ≥ 30 kg/m²). Longitudinal regression analysis was used to determine factors associated with obesity.ResultsAt FU wave 7, 3.0 % were underweight, 48.9 % were normal weight, 37.9 % were overweight, and 10.2 % were obese. Regressions showed that the probability of obesity decreased with age (OR: 0.77 [95 % CI: .593–.999]) and less chronic conditions (OR: 1.32 [95 % CI: 1.11–1.57]). The probability of obesity was not associated with sex, educational level, marital status, social isolation, visual impairment, hearing impairment, depression, and dementia.ConclusionNearly half of the individuals in very late life had excess weight. Thus, excess weight remains a major challenge, even in very old age. Given the demographic ageing in upcoming decades, this is an issue which we should be aware of.     

西安市0～18岁儿童青少年体块指数百分位数

目的：了解体块指数（ＢＭＩ）在儿童期的发育规律,为儿童肥胖的评价提供依据。方法：采用Ｃｏｌｅ的ＬＭＳ法,该法调整了ＢＭＩ分布的偏度。结果：城乡男女生体块指数的发育规律不同,女生比男生早,城市比农村早,并提供了西安市１９９５年０～１８岁儿童青少年体块指数百分位数图。结论：儿童肥胖可采用体块指数百分位数评价,本文计算的年龄别百分位数可作为临床应用的参考标准。