Faculty of Medicine

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    Impact of anthropometric factors on outcomes in atrial fibrillation patients: analysis on 10 220 patients from the European Society of Cardiology (ESC)-European Heart Rhythm Association (EHRA) EurObservational Research Programme on Atrial Fibrillation (EORP-AF) general long-term registry
    (Oxford University Press (OUP), 2022-06-07)
    Boriani, Giuseppe
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    Vitolo, Marco
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    Malavasi, Vincenzo L
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    Proietti, Marco
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    Fantecchi, Elisa
    Abstract Aim To investigate the association of anthropometric parameters [height, weight, body mass index (BMI), body surface area (BSA), and lean body mass (LBM)] with outcomes in atrial fibrillation (AF). Methods and results Ten-thousand two-hundred twenty patients were enrolled [40.3% females, median age 70 (62–77) years, followed for 728 (interquartile range 653–745) days]. Sex-specific tertiles were considered for the five anthropometric variables. At the end of follow-up, survival free from all-cause death was worse in the lowest tertiles for all the anthropometric variables analyzed. On multivariable Cox regression analysis, an independent association with all-cause death was found for the lowest vs. middle tertile when body weight (hazard ratio [HR] 1.66, 95%CI 1.23–2.23), BMI (HR 1.65, 95%CI 1.23–2.21), and BSA (HR 1.49, 95%CI 1.11–2.01) were analysed in female sex, as well as for body weight in male patients (HR 1.61, 95%CI 1.25–2.07). Conversely, the risk of MACE was lower for the highest tertile (vs. middle tertile) of BSA and LBM in males and for the highest tertile of weight and BSA in female patients. A higher occurrence of haemorrhagic events was found for female patients in the lowest tertile of height [odds ratio (OR) 1.90, 95%CI 1.23–2.94] and LBM (OR 2.13, 95%CI 1.40–3.26). Conclusions In AF patients height, weight, BMI, BSA, and LBM were associated with clinical outcomes, with all-cause death being higher for patients presenting lower values of these variables, i.e. in the lowest tertiles of distribution. The anthropometric variables independently associated with other outcomes were also different between male and female subjects.
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    CORRELATION BETWEEN ANTHROPOMETRIC INDICATORS OF OBESITY: BODY MASS INDEX (BMI) AND WAIST CIRCUMFERENCE (WC) IN STUDENT POPULATION FROM FROM NORTH MACEDONIA
    (Macedonian Association of Anatomists, 2022)
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    The body mass index (BMI) allows for assessing the prevalence of overweight/obesity within a population and determining general obesity. Waist circumference (WC) is a simple and practical anthropometric measure for assessing central adiposity. This study aims to describe the correlation between BMI and WC and examined their significance as indicators of obesity in students. In total, 839 university students aged 18-20 (411 male and 428 female) from Skopje, R. North Macedonia were analyzed. The following anthropometric parameters and indices were considered: weight, height, waist circumference and BMI using a standard protocol. A male had a mean BMI of 24.28 kg/ m2and a mean WC of 88.01 cm. Females had a mean BMI of 21.56 kg/m2and a mean WC of 74.17 cm. There was a strong positive significant correlation between the BMI and the WC in males (r = 0.81), and a positive correlation in females ( r =0.72). In the identification of overweight/obesity, WC identified significantly more participants than the BMI (255 vs 186). Both the BMI as well as the WC detect people at risk for weight-related diseases, but these results suggest that WC is a better predictor to detect subjects at high risk for abdominal obesity. The determination of obesity based on anthropometric indicators is still an important method for early prevention of serious consequences of obesity among the student population.
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    The Association between Asthma and Obesity in Children -1 Inflammatory and Mechanical Factors
    (ID Design / Scientific Foundation Spiroski, 2019-04-29)
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    BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterized by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.