Body Mass Index and Associated Factors of Obesity and Underweight in a General Out-patient Population in a Tertiary Hospital in Nigeria
American Journal of Internal Medicine
Volume 4, Issue 5, September 2016, Pages: 85-92
Received: Oct. 5, 2016;
Accepted: Oct. 13, 2016;
Published: Nov. 7, 2016
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Ernest Ndukaife Anyabolu, Department of Medicine, Imo State University Teaching Hospital, Orlu, Nigeria; Department of Medicine, Federal Medical Centre, Owerri, Nigeria; Department of Medicine, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
There is increasing incidence of abnormal weight changes in Sub-Saharan Africa, including Nigeria. Factors which influence body mass index (BMI) in developing countries have not been completely identified. Weight changes may be observed even in general out patients, unrelated to the major complaints for which the patients are presenting in clinics. This study was set out to evaluate BMI and potential risk factors of underweight and obesity in subjects attending the general out-patient clinic in Federal Medical Centre, Owerri, Nigeria. This was a cross-sectional study conducted on general out patients. Body mass index was determined. Relevant investigations were performed. Association of weight changes with their potential risk factors and the strength of variables to predict BMI, underweight and obesity were determined. The mean BMI of the subjects was 25.5± 6.5kg/m2. Underweight was present in 14(10.3%), normal weight in 57(41.9%), overweight in 24(17.6%) and obesity in 41(30.1%) of the subjects. There was significant association between BMI and hemoglobin (Hb), 24-hour urine osmolality (24HUOsm), serum cholesterol, serum low density lipoprotein cholesterol (LDL), serum high density lipoprotein cholesterol (HDL), as well as serum triglyceride. There was significant but poor correlation between BMI and spot urine protein (SUP), spot urine creatinine (SUCr), spot urine osmolality (SUOsm), serum cholesterol, serum triglyceride, serum HDL, serum LDL, as well as Hb. Spot urine protein, SUOsm, and Hb predicted BMI. Furthermore, SUOsm, serum cholesterol, serum HDL and serum LDL predicted obesity. The prevalence of underweight (10.3%) and obesity (30.1%) were high in the general out patients. Abnormalities of serum lipids, proteinuric renal disease with dilute urine were common in these subjects. There is a need for clinicians to routinely assess BMI and further search for anemia, dyslipidemia and renal damage in subjects with underweight and obesity attending the general out-patient clinics.
Ernest Ndukaife Anyabolu,
Body Mass Index and Associated Factors of Obesity and Underweight in a General Out-patient Population in a Tertiary Hospital in Nigeria, American Journal of Internal Medicine.
Vol. 4, No. 5,
2016, pp. 85-92.
Barness LA, Opitz JM, Gilbert-Barness E. Obesity: Genetic, molecular, and environmental aspects. Am J Med Genet A. 2007; 143A (24): 3016-3034.
World Health Organization. Obesity and overweight fact sheet. IOTF report. 2015. Available at http://www.who.int/mediacentre/factsheets/fs311/en/.
Popkin BM, Adair LS, Wen Ng S. NOW AND THEN: The Global Nutrition Transition: The Pandemic of Obesity in Developing Countries. Nutr Rev. 2012 Jan; 70(1): 3–21. doi: 10.1111/j.1753-4887.2011.00456.
Segula D (2014) Complications of obesity in adults: A short review of the literature. Malawi Med J 26: 20-24.
Ungefroren H, Gieseler F, Fliedner S, Lehnert H (2015) Obesity and cancer. Horm Mol Biol Clin Investig 21: 5-15.
Iloh GUP, Ikwudinma AO, Obiegbu NP (2013) Obesity and Its Cardio-metabolic Co-morbidities Among Adult Nigerians in a Primary Care Clinic of a Tertiary Hospital in South-Eastern, Nigeria. J Family Med Prim Care 2: 20-26.
Hummen R, Syrjanen J (2013) Obesity and the risk and outcome of infection. Int J Obes (Lond) 37: 333-340.
Nguyen DM, El-Serag HB. The Epidemiology of Obesity. Gastroenterol Clin North Am. 2010 Mar; 39(1): 1–7. doi: 10.1016/j.gtc.2009.12.014.
Okafor C I, Gezawa I D, Sabir A A, Raimi T H, Enang O. Obesity, overweight, and underweight among urban Nigerians. Niger J Clin Pract [serial online] 2014 [cited 2016 Sep 28]; 17:743-9. http://www.njcponline.com/text.asp?2014/17/6/743/144389
Little M, Humphries S, Patel K, Dewey C. Factors associated with BMI, underweight, overweight, and obesity among adults in a population of rural south India: a cross-sectional study. BMC Obes. 2016; 3: 12. doi: 10.1186/s40608-016-0091-7.
Obesity and overweight Fact sheet Updated June 2016 http://www.who.int/mediacentre/factsheets/fs311/en/.
Chukwuonye II, Chuku A, John C, Ohagwu KA, Imoh ME, et al. (2013) Prevalence of overweight and obesity in adult Nigerians - a systematic review. Diabetes Metab Syndr Obes 6: 43-47.
Gezawa ID, Musa BM, Mijinyawa MS, Talle MA, Shehu YM, et al. (2014) Prevalence of hypertension and its relationship with indices of obesity in Maiduguri, Northeastern Nigeria. Niger J Basic Clin Sci 11: 67-71.
Wahab KW, Sani MU, Yusuf BO, Gbadamosi M, Gbadamosi A, et al. (2011) Prevalence and determinants of obesity - a cross-sectional study of an adult Northern Nigerian population. Int Arch Med 4: 10.
Amira CO, Sokunbi DOB, Dolapo D, Sokunbi A (2011) Prevalence of obesity, overweight and proteinuria in an urban community in South West Nigeria. Nigerian Medical Journal 52: 110-113.
Chukwuonye II, Chuku A, Onyeonoro U, Ukegbu A, Anyabolu E, et al. (2015) Body Mass Index, Prevalence and Predictors of Obesity in Urban and Rural Communities in Abia State South Eastern Nigeria. J Diabetes Metab 6: 570. doi:10.4172/2155-6156.1000570.
Mataix J, López-Frías M, Martínez-de-Victoria E, López-Jurado M, Aranda P, Llopis J. Factors associated with obesity in an adult Mediterranean population: influence on plasma lipid profile. J Am Coll Nutr. 2005 Dec; 24(6):456-65.
Ly KA, †Email author, Ton TG†, Ngo QV, Vo TT, Fitzpatrick AL. Double burden: a cross-sectional survey assessing factors associated with underweight and overweight status in Danang, Vietnam. BMC Public Health201313:35. DOI: 10.1186/1471-2458-13-35.
Anyabolu EN, Chukwuonye II, Arodiwe E, Ijoma CK, Ulasi I. Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria. Indian J Nephrol 2016; 26:10-5.
Anyabolu EN, Chukwuonye II, Mabayoje M, Ejike A, Ijoma CK, Oviasu E, Kadiri S.. Comparison of Spot Urine Protein/Creatinine Ratio, Spot Urine Protein/Osmolality Ratio with Measured 24-Hour Urine Protein in HIV Subjects in Nigeria. J AIDS Clin Res 2015; 6: 445. doi:10.4172/2155-6113.1000445.
Anyabolu EN, Chukwuonye II. Urine Osmolality in Adults Attending a General out-Patient Clinic: Clinical Implications. American Journal of Medicine and Medical Sciences 2016, 6(5): 145-151. DOI: 10.5923/j.ajmms.20160605.01.
WHO (1995) Physical Status: The Use and Interpretation of Anthropometry. Technical Report Series 854, 1-1-9950. World Health Organization, Geneva.
Yeh HC, Lin YS, Kuo CC, Weidemann D, Weaver V, Fadrowski J, Neu A, Navas-Acien A. Urine osmolality in the US population: implications for environmental biomonitoring. Environ Res. 2015 Jan; 136:482-90. doi: 10.1016/j.envres.2014.09.009. Epub 2014 Nov 25.
Hemoglobin concentrations for the diagnosis of anemia and assessment of severity VMNIS | Vitamin and Mineral Nutrition Information System WHO/NMH/NHD/MNM/11.1.
Anyabolu, E. N. (2016) BMI and Risk Factors of Underweight and Obesity in HIV Subjects in Eastern Nigeria. World Journal of AIDS, 6, 8-15. http://dx.doi.org/10.4236/wja.2016.61002.
Mariz Cde A, Albuquerque Mde F, Ximenes RA, Melo HR, Bandeira F, Oliveira TG, Carvalho EH, Silva AP, Miranda Filho Dde B. Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity. Cad Saude Publica. 2011 Oct; 27(10):1997-2008.
Tanner JM. The relation between serum cholesterol and physique in healthy young men. J Physiol 115: 371, 1951.
Montoye HI, Epstein FH, Kjelsberg MO. Relationship between serum cholesterol and body fatness. Amer J Clin Nutr 18: 397, 1966.
Kesaniemi YA, Grundy SM. Increased low density lipoprotein production associated with obesity. Arteriosclerosis. 1983 Mar-Apr;3(2):170-7.
Ruel IL, Gaudet D, Perron P, Bergeron J, Julien P, Lamarche B. Effect of obesity on HDL and LDL particle sizes in carriers of the null P207L or defective D9N mutation in the lipoprotein lipase gene: the Québec LipD Study. International Journal of Obesity (2003) 27, 631–637. doi:10.1038/sj.ijo.0802276.
Després JP, Moorjani S, Tremblay A, Ferland M, Lupien PJ, Nadeau A, Bouchard C. Relation of high plasma triglyceride levels associated with obesity and regional adipose tissue distribution to plasma lipoprotein-lipid composition in premenopausal women. Clin Invest Med. 1989 Dec;12(6):374-80.