National Hospital of Sri Lanka, Colombo, Sri Lanka.
Diabetes Trial Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
J Obes. 2022 Aug 18;2022:9172365. doi: 10.1155/2022/9172365. eCollection 2022.
Current evidence regarding the association between overweight and obesity and in-hospital morbidity and mortality is inconsistent and South Asian populations are underrepresented.
Data relevant to anthropometry, hospital outcomes, complications, and medical diagnoses of all acute medical admissions to the National Hospital of Sri Lanka were collected over a period of 3 months. Analysis was performed with WHO international (ICs) and Asian obesity cut-offs (ACs).
Sample size was 2,128 (median age: 57 years [IQR: 42, 67], males: 49.7%). High prevalence of overweight (23.5%), generalized obesity (10.4%), central obesity (28.5%), and underweight (15.4%) was observed (ICs). Patients with either generalized or central obesity had significantly higher in-hospital mortality (4.8% versus 2.5%, = 0.031) and acute kidney injury (AKI) (3.9% versus 1.2%) ( = 0.001) compared to normal weight. With ACs, overweight and obesity prevalence increased, without any significant increment in morbidity and mortality, but median length of hospital stay was significantly reduced in patients with generalized obesity compared to normal (3 [IQR: 2, 5] versus 4 [IQR: 2, 6], = 0.014). Infections (44.4%) and cardiovascular diseases (CVDs) (25.9%) were the most common causes of admission. Overweight and generalized obesity or central obesity were associated with increased prevalence of acute CVDs and CVD risk factors and lower prevalence of acute infections, whilst underweight showed an inverse association.
A double burden of malnutrition and diseases were noted among hospital admissions, with obesity being a risk factor for in-hospital all-cause mortality and AKI. Overweight and obesity were associated with increased CVDs and reduced infections. Larger prospective studies are required to characterize these associations among South Asians.
目前有关超重和肥胖与住院发病率和死亡率之间关联的证据不一致，南亚人群代表性不足。
在三个月的时间里，收集了斯里兰卡国家医院所有急性内科住院患者的人体测量学、医院结局、并发症和医疗诊断相关数据。使用世界卫生组织国际（ICs）和亚洲肥胖标准（ACs）进行分析。
样本量为 2128 例（中位数年龄：57 岁[IQR：42，67]，男性：49.7%）。观察到超重（23.5%）、全身性肥胖（10.4%）、中心性肥胖（28.5%）和消瘦（15.4%）的高患病率（ICs）。与正常体重相比，全身性或中心性肥胖患者的住院死亡率（4.8%对 2.5%， = 0.031）和急性肾损伤（AKI）（3.9%对 1.2%， = 0.001）明显更高。使用 ACs 时，超重和肥胖的患病率增加，但发病率和死亡率没有显著增加，但与正常体重相比，全身性肥胖患者的住院时间中位数明显缩短（3[IQR：2，5]对 4[IQR：2，6]， = 0.014）。感染（44.4%）和心血管疾病（CVDs）（25.9%）是最常见的入院原因。超重和全身性肥胖或中心性肥胖与急性 CVD 和 CVD 危险因素的患病率增加以及急性感染的患病率降低有关，而消瘦则呈相反的关联。
在住院患者中，营养不良和疾病的双重负担明显存在，肥胖是住院全因死亡率和 AKI 的危险因素。超重和肥胖与 CVD 增加和感染减少有关。需要更大的前瞻性研究来描述南亚人群中这些关联。
