Clinical Nutrition and Cardiovascular Prevention Unit and High Speciality Center for Dietetics, Nutritional Education and Cardiometabolic Prevention, I.R.C.C.S.Policlinico San Donato, San Donato Milanese, Italy.
Clinical Nutrition and Cardiovascular Prevention Unit and High Speciality Center for Dietetics, Nutritional Education and Cardiometabolic Prevention, I.R.C.C.S.Policlinico San Donato, San Donato Milanese, Italy.
Nutr Metab Cardiovasc Dis. 2019 Apr;29(4):367-377. doi: 10.1016/j.numecd.2019.01.009. Epub 2019 Jan 29.
Adults with congenital heart disease (ACHD) are at risk of overweight and obesity, two major health problems, though underweight can be a negative prognostic factor too. Awareness of the body mass index (BMI) in ACHD is very limited. The present study describes the use and prevalence of BMI in Italian symptomatic hospitalized ACHD patients in relation to complexity by Bethesda system classification, diagnosis, sex and age.
We classified 1388 ACHD patients, aged 18-69 years, on the basis of their BMI, and compared them to the Italian reference population. In our total ACHD population we found a significantly higher prevalence of underweight compared to the Italian reference population (6.34% vs 3.20%). ACHD women were more underweight than men. Underweight decreased with age. Overweight was significantly less frequent in the total ACHD population (26.73% compared to 31.70%) in the Italian reference population. Men were more likely to be overweight than women. In statistical terms obesity was similar in the Italian reference population (10.50%) and our ACHD population (9.58%). Both overweight and obesity increased with age. Results were comparable using a diagnostic anatomical-functional classification and the Bethesda system classification.
In our cohort of ACHD the prevalence of underweight was double that of the Italian reference population. The prevalence of overweight was lower, while obesity was similar. Since BMI does not account for differences in body fat distribution, a future aim will be to quantify the visceral component of the adipose tissue in ACHD patients and examine their body composition in order to reflect their risk of acquired cardiovascular disease better, and either to maintain or achieve an adequate visceral component.
成人先天性心脏病（ACHD）患者存在超重和肥胖风险，这是两个主要的健康问题，尽管体重过轻也可能是一个负面的预后因素。对 ACHD 患者的体重指数（BMI）的认识非常有限。本研究描述了意大利症状性住院 ACHD 患者根据贝塞斯达系统分类、诊断、性别和年龄的复杂性，使用 BMI 及其流行情况。
我们根据 BMI 将 1388 名年龄在 18-69 岁的 ACHD 患者进行分类，并将其与意大利参考人群进行比较。在我们的 ACHD 患者总人群中，我们发现体重过轻的比例明显高于意大利参考人群（6.34%比 3.20%）。女性 ACHD 患者比男性更易体重过轻。随着年龄的增长，体重过轻的比例下降。超重在 ACHD 患者总人群中明显比意大利参考人群中更少见（26.73%比 31.70%）。男性超重的可能性高于女性。从统计学上讲，意大利参考人群（10.50%）和我们的 ACHD 患者人群（9.58%）中肥胖的比例相似。超重和肥胖随着年龄的增长而增加。使用诊断解剖功能分类和贝塞斯达系统分类的结果相似。
在我们的 ACHD 患者队列中，体重过轻的比例是意大利参考人群的两倍。超重的比例较低，而肥胖的比例相似。由于 BMI 不能反映身体脂肪分布的差异，未来的目标将是量化 ACHD 患者体内脂肪组织的内脏成分，并检查他们的身体成分，以便更好地反映他们获得心血管疾病的风险，并保持或达到适当的内脏成分。
