Mitsuyoshi Takahara1,2, Osamu Iida3, Yoshimitsu Soga4, Akio Kodama5, Hiroto Terashi6, Nobuyoshi Azuma7. 1. Department of Metabolic Medicine, Osaka University Graduate School of Medicine. 2. Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine. 3. Cardiovascular Center, Kansai Rosai Hospital. 4. Department of Cardiology, Kokura Memorial Hospital. 5. Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine. 6. Department of Plastic Surgery, Kobe University Graduate School of Medicine. 7. Department of Vascular Surgery, Asahikawa Medical University.
Abstract
AIM: Recent studies suggested that past history of obesity or maximum body mass index (BMI) in the past was a strong prognostic predictor in a general population. The current study aimed to survey the distribution of current and maximum BMIs and to investigate their prognostic impact in patients with critical limb ischemia (CLI), whose prognosis was poor even after revascularization. METHODS: We analyzed a database of a prospective, multicenter registry in Japan, including 499 CLI patients undergoing revascularization. Their current and maximum BMIs were surveyed at registration. The distribution and the impact on the prognosis were explored. RESULTS: The estimated means (95% confidence intervals) of current and maximum BMIs were respectively 22.0 (21.7 to 22.3) and 25.3 (24.8 to 25.8) kg/m2; the difference was 3.3 (2.9 to 3.7) kg/m2. The prevalence of current obesity (BMI ≥ 25 kg/m2) was 18% (15% to 22%), whereas 48% (43% to 53%) had ever been obese (maximum BMI ≥ 25 kg/m2). Past obesity was not rare even in currently lean subjects (BMI ＜18.5 kg/m2), with the prevalence of 18% (7% to 29%). Current BMI, but not maximum BMI, was associated with the mortality risk; the adjusted hazard ratios per 5 kg/m2 increase were 0.61 [0.46, 0.81] (P=0.001) and 1.07 [0.87, 1.31] (P=0.55), respectively. CONCLUSION: The prevalence of current obesity was as low as 18% (15% to 22%) in Japanese CLI patients undergoing revascularization, whereas about a half were formerly obese. Maximum BMI was not independently associated with the mortality risk in the population.
AIM: Recent studies suggested that past history of obesity or maximum body mass index (BMI) in the past was a strong prognostic predictor in a general population. The current study aimed to survey the distribution of current and maximum BMIs and to investigate their prognostic impact in patients with critical limb ischemia (CLI), whose prognosis was poor even after revascularization. METHODS: We analyzed a database of a prospective, multicenter registry in Japan, including 499 CLIpatients undergoing revascularization. Their current and maximum BMIs were surveyed at registration. The distribution and the impact on the prognosis were explored. RESULTS: The estimated means (95% confidence intervals) of current and maximum BMIs were respectively 22.0 (21.7 to 22.3) and 25.3 (24.8 to 25.8) kg/m2; the difference was 3.3 (2.9 to 3.7) kg/m2. The prevalence of current obesity (BMI ≥ 25 kg/m2) was 18% (15% to 22%), whereas 48% (43% to 53%) had ever been obese (maximum BMI ≥ 25 kg/m2). Past obesity was not rare even in currently lean subjects (BMI ＜18.5 kg/m2), with the prevalence of 18% (7% to 29%). Current BMI, but not maximum BMI, was associated with the mortality risk; the adjusted hazard ratios per 5 kg/m2 increase were 0.61 [0.46, 0.81] (P=0.001) and 1.07 [0.87, 1.31] (P=0.55), respectively. CONCLUSION: The prevalence of current obesity was as low as 18% (15% to 22%) in Japanese CLIpatients undergoing revascularization, whereas about a half were formerly obese. Maximum BMI was not independently associated with the mortality risk in the population.
Entities:
Keywords:
Critical limb ischemia; Maximum body mass index; Past obesity; Prognosis
Authors: J Ignacio de Ulíbarri; A González-Madroño; N G P de Villar; P González; B González; A Mancha; F Rodríguez; G Fernández Journal: Nutr Hosp Date: 2005 Jan-Feb Impact factor: 1.057
Authors: Mark R Nehler; Sue Duval; Lihong Diao; Brian H Annex; William R Hiatt; Kevin Rogers; Armen Zakharyan; Alan T Hirsch Journal: J Vasc Surg Date: 2014-05-10 Impact factor: 4.268
Authors: Joseph L Mills; Michael S Conte; David G Armstrong; Frank B Pomposelli; Andres Schanzer; Anton N Sidawy; George Andros Journal: J Vasc Surg Date: 2013-10-12 Impact factor: 4.268