objective To analyze the impact of body mass index (BMI) on medical and surgical complications of colorectal cancer patients served by West China Hospital, based on the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on September 27, 2021. The data included BMI, surgical complications, liver nodules, liver function, renal nodules, renal function, operation history, medical complications, diabetes, hypertension, pneumonia, pulmonary nodules, pulmonary function, heart disease, thrombosis, and cardiac function. Results After scanning, 5 305 data rows were included. BMI was divided by Chinese four classification methods. The analysis results showed that in terms of surgical complications, obese patients were more likely to be complicated with surgical complications of digestive system (χ2= 43.883, P<0.001) and reproductive system (χ2=13.139, P=0.004). Lean patients were more likely to have surgical complications of urinary system (χ2=223.415, P<0.001), and obese patients had liver function (H=61.521, P<0.001) and renal function (H=9.994, P=0.019) might be even worse. In terms of operation history, BMI in colorectal cancer patients had nothing to do with the number of times of operation (H=6.262, P=0.100), and operation history of each system or department (P>0.05). Regarding to medical complications, with the increase of BMI, the risk of colorectal cancer patients with diabetes mellitus (χ2=118.597, P<0.001), or hypertension (χ2= 163.334, P< 0.001) increased. Patients with low BMI were more likely to have pneumonia (H=7.899, P= 0.048) and worse pulmonary function (H=40.673, P<0.001). Conclusions The analysis results of DACCA database show that BMI is not related to the occurrence of any special surgical history included in the research. Because the internal and external complications of patients are closely related to the treatment plan and prognosis, we should pay more attention to the obese patients in the process of clinical treatment, and they are more likely to have multisystemic abnormalities and various abnormal indicators than other patients. For thin patients, we should pay more attention to their lung function and inflammatory lesions, so as to improve the clinical therapeutic effect.
ObjectiveTo investigate the effect of body mass index (BMI) on the short- and medium-term effectiveness of unicompartmental knee arthroplasty (UKA) in the treatment of anterior medial compartmental osteoarthritis of knee joint.MethodsThe clinical data of 55 patients (61 knees) with anterior medial compartmental osteoarthritis of knee joint treated with minimally invasive UKA between May 2014 and May 2019 were retrospectively analyzed. According to BMI, the patients were divided into 3 groups: normal body mass group [group A, BMI 18.50-24.99 kg/m2, 23 cases (25 knees)], overweight group [group B, BMI 25.00-29.99 kg/m2, 23 cases (25 knees)], obesity group [group C, BMI 30.00-39.99 kg/m2, 9 cases (11 knees)]. There was no significant difference in gender, age, sides, disease duration, and preoperative American Special Surgery Hospital (HSS) score, pain visual analogue scale (VAS) score, and knee range of motion (ROM) among 3 groups (P>0.05). The operation time, intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 1 week were recorded and compared among 3 groups. The HSS score, VAS score, and ROM were used to evaluate the knee function and pain improvement.ResultsThere was no significant difference in the operation time, the intraoperative dominant blood loss, and the postoperative decreased amount of hemoglobin at 1 week among 3 groups (P>0.05). All the 55 patients were followed up 5-60 months, with an average of 24 months. No complication such as infection, fat embolism, or deep venous thrombosis of lower extremity occurred after operation. The anteroposterior and lateral X-ray films of the knee joint showed that no dislocation or loosening of the prosthesis occurred and the position of the prosthesis was good. At last follow-up, the HSS score, VAS score, and ROM of the 3 groups were significantly improved when compared with preoperative ones (P<0.05); but there was no significant difference among 3 groups (P>0.05).ConclusionFor obese and overweight patients with anterior medial compartmental osteoarthritis of the knee joint, the use of minimally invasive UKA can achieve satisfactory short- and medium-term effectiveness, and the long-term effectiveness needs further follow-up.
ObjectiveTo analyze the latest epidemiological status of breast cancer in China, trends in morbidity and mortality from 1990 to 2019, and related prognostic risk factors.MethodsData on incidence and mortality of Chinese female breast cancer, their related age-standardized rates (ASRs) from 1990 to 2019, and attributable risk factors were obtained from the Global Burden of Disease (GBD) database, and data on disability-adjusted life years (DALYs) of 34 provinces in China were obtained from literature. Joinpoint regression analysis was used to analyze the trends of ASRs. The exposure levels of each attributable risk factor and the increased cancer burden were analyzed.ResultsThe incidence of breast cancer in Chinese females increased annually, from 17.07/100 000 in 1990 to 35.61/100 000 in 2019, while the mortality rate initially increased and decreased, and then exhibited an upward trend after 2016 and there was no obvious variation from 1990 (9.16/100 000) to 2019 (9.02/100 000). Among the 34 provinces of China, Shandong Province had the most serious breast cancer burden, while Macao Special Administrative Region had the lowest. Among the seven prognostic risk factors, high body mass index (BMI) contributed the most to the breast cancer burden and the exposure risk of a diet high in red meat had shown a significant increasing trend in the past 30 years. Therefore, the disease burden caused by a high red meat diet would be increasing.ConclusionsThe incidence rate of breast cancer in Chinese females is increasing. With the development of social economy and the change of people’s dietary habits, the breast cancer burden in China trends to become heavier and heavier. Therefore, it is necessary to conduct the "three early" prevention and treatment and advocate healthy and reasonable diet and living habits to reduce the burden of breast cancer to improve prognosis and quality of life.
Objective To investigate the effect of body mass index (BMI) on the short-term effectiveness of high tibial osteotomy (HTO) in the treatment of varus knee arthritis. Methods The clinical data of 84 patients (84 knees) with varus knee arthritis treated with HTO between May 2016 and August 2020 were retrospectively analyzed. According to BMI, the patients were divided into normal group (32 patients in group A, BMI<25 kg/m2), overweight group (27 patients in group B, BMI>30 kg/m2), and obese group (25 patients in group C, BMI>30 kg/m2). The BMI of groups A, B, and C were (23.35±0.89), (26.65±1.03), and (32.05±1.47) kg/m2, respectively. There was no significant difference (P>0.05) in gender, age, surgical side, disease duration, and preoperative Hospital for Special Surgery (HSS) score, visual analogue scale (VAS) score, knee range of motion, and hip-knee-ankle angle (HKA) between groups. The operation time, intraoperative dominant blood loss, and the decrease of hemoglobin on the 3rd day after operation were recorded and compared between groups. The improvement of knee joint function and pain status were evaluated by knee joint HSS score, knee range of motion, and VAS score before and after operation, and measuring the HKA of patients on X-ray film. During the follow-up, the X-ray films of the knee joint were reexamined to observe the position of the internal fixator and the healing of osteotomy. Results All patients completed the operation successfully and were followed up 8-40 months (mean, 19.3 months). There was no significant difference in follow-up time, operation time, intraoperative dominant blood loss, and the decrease of hemoglobin on the 3rd day after operation between groups (P>0.05). No operative complications such as severe vascular or nerve injury occurred. After operation, deep venous thrombosis of lower extremities occurred in 1 case in groups A and B respectively, and fat liquefaction of surgical incision occurred in 2 cases in group C. There was no significant difference in the incidence of perioperative complications between groups (3.1% vs. 3.7% vs. 8.0%) (P=0.689). During the follow-up, there was no bone nonunion, plate fracture or loosening. At last follow-up, HSS score, VAS score, knee range of motion, and HKA significantly improved in the 3 groups when compared with those before operation (P<0.05), but there was no significant difference in the differences of the above indexes between groups before and after operation (P>0.05). Conclusion BMI does not affect the short-term effectiveness of HTO in the treatment of varus knee arthritis. HTO can be selected for overweight and obese patients after standard medical treatment is ineffective.
Objective To evaluate the impact of body mass index （BMI） on short-term outcomes after intersphi-ncteric resection （ISR） for rectal cancer and anal cancer. Methods One hundred and ninety-nine cases of rectal cancer and anal cancer who were treated in Department of Gastrointestinal Surgery of West China Hospital of Sichuan University from Jan. 2009 to Dec. 2011 were enrolled retrospectively，and these cases were divided into underweight group （n=23），normal group （n=114），and overweight group （n=62） according to BMI. Postoperative indexes in early rehabilitation and complication of 3 groups were studied and compared. Results On the recovery indexes after ISR in early stage，there were no significant differences on the duration of first flatus，first defecation，first oral intake，first ambulation，and hospital stay among 3 groups （P＞0.05）. On the tube management，there were no significant differences on the duration of pulling out nasogastric tube and urinary catheter （P＞0.05），but duration of pulling out drain was longer in normal group and over-weight group （P＜0.05）. There were no significant differences on the incidence of postoperative complications among the 3 groups （P＞0.05），including anastomotic leakage，anastomotic bleeding，perianal infection，ileus，gastric retention，urinary retention， septicemia，wound infection，and recto-vaginal fistula. Conclusions BMI has little impact on short-term outcomes after ISR. Obesity does not increase the incidence of common complications for patients after ISR and does not influence recovery indexes with proper postoperative managements.
ObjectiveTo evaluate the relationship between some clinical laboratory tests, such as levels of fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC), and benign prostatic hyperplasia (BPH). MethodsA total of 146 male patients were included in this study. All the subjects were from the clinic of West China Hospital and Sichuan Cancer Hospital from January 2012 to July 2013. Serum FINS, TG, TC and prostate specific antigen (PSA) were tested, respectively. Prostate volume (PV) was measured by ultrasound. ResultsFINS, PAS and annual prostate growth rate increased significantly in the large PV group compared with the small PV group (P<0.01). There was no significant association of PV with body mass index and other laboratory tests like serum TC and TG. PV and annual prostate growth rate increased significantly in the group of high FINS level compared with the group of low FINS level (P<0.01). PV was positively correlated with FINS (r=0.159, P<0.05); and annual prostate growth rate was positively correlated with FINS (r=0.201, P<0.05). ConclusionHyperinsulinism may play an important role in the pathogenesis of BPA.
目的 研究成都地区中老年人群体质量指数（BMI）及腹型肥胖对糖尿病患病率及空腹血糖水平的影响。 方法 2007年5月，采用随机抽样方法抽取50～80岁中老年人685人进行心血管危险因素调查，其男394人，女291人，年龄（63.3 ± 0.2）岁。 结果 成都地区中老年人群的超重和肥胖所占的比例较大（约44.3%），按BMI分组（BMI＜24 kg/m2；24 kg/ m2≤BMI＜28 kg/ m2；BMI≥28 kg/m2）的糖尿病患病率分别为14.0%、18.7%及23.3%，组间差异有统计学意义（P=0.031）。男女分别按腹型肥胖标准分组（男性切点=85 cm，女性切点=80 cm），男性糖尿病患病率在非腹型肥胖及腹型肥胖组分别为17.9%及18.7%组间差异无统计学意义（P=0.849），女性糖尿病患病率分别为9.7%及18.4%，组间差异有统计学意义（P=0.034）。整个人群中，空腹血糖无随BMI增加而升高的趋势（P=0.071）；女性人群中，空腹血糖随腰围的增加而升高（P=0.001）；而在男性人群中无此趋势。在调整相关指标后，logistic回归分析提示BMI对糖尿病患病率独立影响，以BMI正常为参照，超重及肥胖的OR值分别为：1.412 [95%CI （0.818，2.437），P=0.215]及2.200 [95%CI（1.034，5.178），P=0.046]。在调整相关指标后，腹型肥胖在女性人群中对糖尿病患病率独立影响，以非腹型肥胖为参考，腹型肥胖的OR值为：1.394 [95%CI（1.080，3.205），P=0.041]，而在男性人群中无此关系。 结论 成都地区中老年人群超重及肥胖所占的比重较大，BMI可影响糖尿病患病率及空腹血糖水平；腹型肥胖能够影响女性人群糖尿病患病率及空腹血糖水平，但在男性人群中无此关系。
Objective To explore the relationship between obesity and the three targets including blood pressure, glucose, and lipid. Methods A total of 181 adult Tibetans who underwent physical examination between March and September 2015 at Xigaze People's Hospital were enrolled in this study. Their obesity degrees were assessed with body mass index (BMI) and waist circumference (WC) respectively. The levels of blood pressure, glucose, and lipid were compared at the different levels of BMI or WC. Results The incidence of systematic obesity and central obesity in these adults were 57.5% and 79.0%, respectively. Compared the overweight group with the normal BMI group, the systolic pressure and diastolic pressure of the former were 9.26 mm Hg (1 mm Hg=0.133 kPa) [95% confidence interval (CI) (3.46, 15.07) mm Hg, P=0.002] and 7.76 mm Hg [95%CI (3.96, 11.57) mm Hg, P<0.001] higher, respectively. Similarly, the systolic pressure and diastolic pressure of the central obesity group were 8.24 mm Hg [95%CI (1.03, 15.46) mm Hg,P=0.026] and 6.79 mm Hg [95%CI (2.03, 11.55) mm Hg, P=0.006] higher than those in the normal WC group, respectively. For the normal WC or normal BMI subjects, the detection rate of dyslipidemia reached up to 50.0% and 52.6%. Conclusions With the increase of BMI/WC values, the level of blood pressure rises. Even though WC or BMI is normal, the detection rate of dyslipidemia is high.
ObjectiveTo investigate the prevalence of chronic obstructive pulmonary disease (COPD) with lipid metabolism disorders patients in Chengdu. MethodsWe randomly selected four communities from urban and rural areas in Chengdu between February and December, 2010, with multistage cluster random sampling method; 1 931 residents aged from 40 to 70 received special questionnaire from the BOLD Study, lung examination, blood biochemical examination, and physical examination. ResultsThe prevalence of COPD was 60.26% (91/151) with dyslipidemia; while non-COPD was 68.17% (972/1 428), and the difference was significant (P<0.05), in which the most obvious difference is triglycerides (TG). The prevalence of COPD was 6.62% (10/151) with underweight; while non-COPD was 4.97% (71/1 428), and the difference was significant (P<0.001). The prevalence of COPD was 21.19% (32/151) with abdominal obesity; while non-COPD was 30.81% (440/1 428), and the difference was significant (P<0.05). ConclusionThe prevalence of COPD with lipid metabolism disorders is lower than which with non-COPD in Chengdu. It provides an evidence for the nutrition support therapy in the treatment of COPD.
Objective To review recent advancement of the relationship between obesity and gastric cancer. Method We searched PubMed, Medline, EMBASE, Cochrane Library databases, CNKI, and WanFang database for recent clinical trials about the impact of obesity on occurrence, surgery outcomes, and prognosis of gastric cancer. Results Obesity significantly increased the risk of adenocarcinoma of esophagogastric junction (AEG), increased difficulty in radical operation of gastric cancer and complications of perioperative period, but it had no effect on the long-term operative outcomes. The association between obesity and the survival of gastric cancer was not clear. However, the better survival was observed in most researches of gastric cancer patients with excess body weight. Conclusions The relationship between obesity and gastric cancer is very complex, and there is no consistent conclusion. A reasonable body weight by a healthy lifestyle is expected to decline the incidence of AEG.