Body mass index estimation and measurement by healthcare professionals

Background: Severe obesity has increased more than three-fold in prevalence over the past fifteen years in Europe and the United States. Correctly identifying severe obesity permits access to mortality-reducing interventions. We aimed to determine the accuracy of healthcare professionals (HCPs) in recognising severe obesity and the frequency of body mass index (BMI) assessment by HCPs. Methods: We performed two cross-sectional surveys: one of 206 HCPs in Ireland and Canada and another of 515 Irish hospital healthcare records. The first survey evaluated BMI estimation from photographs and the second examined recording of weight and height during outpatient clinic visits. Results: HCPs underestimated the BMI of severely obese people by an average of 22% to 39%. For a patient with a BMI of 52 kg/m2, 35.4% of family physicians appreciated that the patient was severely obese (BMI > 40 kg/m2) compared with 81.0% of endocrinologists. During clinic visits only 18.1% (n = 75), 1% (n = 4) and 0% (n = 0) of patients had their respective weights, heights and BMIs recorded. Conclusions: HCPs frequently fail to recognise severe obesity from photographs and, in our centre, do not routinely record weight or height. Whether patient outcomes can be improved by measuring weight and height during every HCP encounter warrants further study.

女性出生体重与成年期高血压的关联及代际关联研究

目的分析女性出生体重与成年期血压水平及高血压患病的关联,探讨出生体重及高血压的代际关联。方法 2012年11月~2016年12月期间在上海闵行区11 660名有直系血缘关系的2~4代女性中进行了横断面调查,收集人口学特征、出生信息、生活方式及疾病史等数据。对20岁及以上研究对象行身高、体重、腰臀围、血压测量。采用线性、非线性回归和通径分析方法进行数据分析。结果出生体重每增加1.0 kg,成年期收缩压、舒张压和脉压分别变化-0.2(95%CI:-0.6~0.7)、-0.3(95%CI:-0.6~0.2)和0.3(95%CI-0.2~0.8)mm Hg(均有P<0.05)。出生体重与成年后高血压患病风险关联差异无统计学意义(OR=0.9,95%CI:0.7~1.0,P=0.140)。与出生体重2.5~kg的女性相比,调整年龄等混杂因素后,出生体重<2.5,3.0~,3.5~kg及≥4.0 kg的女性成年后患高血压的OR(95%CI)值分别为0.8(0.5~1.2)、1.0(0.9~1.2)、0.8(0.6~1.0)和0.7(0.4~1.2)。通径分析结果显示,母女两代人群的出生体重、血压水平及高血压患病状况均相关(均有P<0.05),但未见母亲出生体重对女儿血压水平影响。结论女性出生体重与成年期血压水平及高血压患病风险无显著的代际关联。