Body mass index stratification in hospitalized Italian adults with congenital heart disease in relation to complexity, diagnosis, sex and age
Introduction
The prognosis of children with congenital heart disease (CHD) has changed over the last decades, primarily due to improvements in surgical techniques and interventional catheterization. As a consequence, the population of adults with congenital heart disease (ACHD) has increased [1], [2], [3] and its prevalence is estimated at four per thousand adults [1], [4].
This new population of patients is now exposed to the environmental and behavioral risk factors [5], [6], [7] entailed in chronic diseases - also referred to as non-communicable diseases (NCDs), such as overweight and obesity, which have become two major health problems throughout the world [8], [9], [10]. However, underweight is a risk factor too, and is associated with increased mortality [8], [11]. The body mass index (BMI) is the most widely used measure, defined by the World Health Organization (WHO) to classify weight status, and it correlates with all-causes mortality [8], [12].
In Italy, the latest data from the National Health Institute monitoring system called Passi declared a prevalence of underweight, overweight and obesity in the adult population as respectively 3.2%, 31.7% and 10.5% [13]. Excessive weight and underweight are important health concerns for ACHD patients, since they can both be markers of increased risk and negative prognostic factors [14]. However, data about the weight status of ACHD patients are few and non-homogenous, maybe reflecting national differences [14], [15], [16].
The aim of the present study was to describe, for the first time, the prevalence of underweight, normal weight, overweight and obesity in a wide sample of Italian ACHD patients hospitalized in our Centre, in relation to diagnosis, sex and age.
Section snippets
Methods
We gathered data from the Pediatric and Adult Congenital Heart Centre database and from the Department of Cardiothoracic, Vascular Anesthesia and Intensive Care database at the IRCCS Policlinico San Donato University Hospital (Milan, Italy).
We considered a selected population consisting of patients who were hospitalized for cardiac surgery or for catheterization. Data was obtained at hospital admission before any intervention and comprised information on diagnosis, intervention technique, age,
Results
The study comprised 1388 adult symptomatic patients with congenital heart defects who were hospitalized for cardiac surgery or catheterization. Their mean ± SD age was 41.45 ± 13.18 years. Table 2, Table 3 show all the data analyzed, with the stratification by sex and age that follows two different approaches: defect complexity (in accordance with Bethesda system classification) and diagnostic anatomical-functional classification. There were 776 females (55.91%) and 612 males (44.09%); 467 aged
Discussion
To the best of our knowledge, this is the first retrospective study in Italy focusing on BMI of ACHD hospitalized patients, who represent a selected population of symptomatic ACHD.
This could affect the generalizability to the total ACHD population, which is estimable in Italy in 80.000–100.000 individuals [21].
The main observations on this population are the following:
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Underweight was double that of the Italian reference population. ACHD women were more underweight than ACHD men. Underweight was
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflicts of interest
The authors declare they have no competing interests to declare.
Acknowledgments
Pistuddi V., Ravasi D.
References (33)
- et al.
Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis
J Am Coll Cardiol
(2011) - et al.
Mortality associated with adult congenital heart disease: trends in the US population from 1979 to 2005
Am Heart J
(2009) - et al.
What nature used to allow to die, don't let modern habits damage after repair: preventable obesity risk in congenital heart disease – editorial
Can J Cardiol
(2015) - et al.
Height, weight and body mass index in adults with congenital heart disease
Int J Cardiol
(2015) - et al.
Body weights in adults with congenital heart disease and the obesity frequency
Am J Cardiol
(2017) - et al.
32nd Bethesda Conference: “Care of the adult with congenital heart disease
JACC Journal
(2001) - et al.
Wasting as independent risk factor for mortality in chronic heart failure
Lancet
(1997) - et al.
Social burden and lifestyle in adults with congenital heart disease
Am J Cardiol
(2012) - et al.
Risk estimates for atherosclerotic cardiovascular disease in adults with congenital heart disease
Am J Cardiol
(2017) - et al.
Lifestyle modification for the prevention of morbidity and mortality in adult congenital heart disease
Congenit Heart Dis
(2016)
Grown-up congenital heart (GUCH) disease: current needs and provision of service for adolescents and adults with congenital heart disease in the UK
Heart
Management of Cardiovascular Risk Factors in Adults With Congenital Heart Disease
J Am Heart Assoc
Prevalence of cardiovascular risk factors in adults with congenital heart disease
Eur J Cardiovasc Prev Rehabil
Body-mass index and all-cause mortality: individual-participant- data meta-analysis of 239 prospective studies in four continents
Lancet
Obesity: preventing and managing the global epidemic
World Health Organ Tech Rep Ser
Global burden of obesity in 2005 and projections to 2030
Int J Obes
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