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Obesity01:24

Obesity

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The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
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In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
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Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

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Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
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Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
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Multidisciplinary Approach to Obesity Management: A Case Report
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Obesity is associated with postinjury hypercoagulability.

Jason M Samuels1, Ernest E Moore, Julia R Coleman

  • 1From the Department of Surgery (J.M.S., J.R.C., J.J.S., A.B., A.S.), University of Colorado Denver; Department of Surgery (E.E.M., M.J.C., A.G., J.C.), Denver Health Medical Center; Department of Pediatrics (C.C.S.); and School of Public Health (A.S.), University of Colorado Aurora, Colorado.

The Journal of Trauma and Acute Care Surgery
|June 25, 2019
PubMed
Summary

Obesity (body mass index [BMI] ≥30 kg/m) is linked to a hypercoagulable state post-injury, showing increased clot strength and resistance to fibrinolysis. This study suggests obesity may be protective against hyperfibrinolysis in trauma patients.

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Area of Science:

  • Trauma research
  • Coagulation science
  • Obesity medicine

Background:

  • Obesity is linked to hypercoagulability and increased venous thromboembolic events (VTE) risk in the general population.
  • A hypercoagulable state post-injury in obese individuals is hypothesized, characterized by increased clot strength and resistance to fibrinolysis.

Purpose of the Study:

  • To investigate the association between obesity (BMI ≥30 kg/m) and a hypercoagulable state post-injury.
  • To analyze clot strength and fibrinolysis resistance in obese trauma patients.

Main Methods:

  • Prospective analysis of trauma patients within 60 minutes post-injury using rapid thrombelastography.
  • Stratification by BMI (≥30 kg/m vs. <30 kg/m) and analysis of activated clotting time, clot formation rate, maximum clot strength (MA), and % clot lysis 30 minutes after MA (LY30).
  • Definitions: Fibrinolysis shutdown (SD) as LY30 < 0.6%; hyperfibrinolysis (HF) as LY30 > 7.6%.

Main Results:

  • Obesity (BMI30) was independently associated with lower odds of diminished clot strength (MA < 55 mm) and hyperfibrinolysis (HF).
  • Obesity was associated with higher odds of fibrinolytic shutdown (SD).
  • No significant independent association was found with clot formation rate or VTEs after adjustment.

Conclusions:

  • Obesity appears protective against diminished clot strength and hyperfibrinolysis in trauma patients.
  • Obesity is associated with an increased risk of fibrinolytic shutdown (SD) in severely injured patients, suggesting relative hypercoagulability.
  • Findings may explain higher VTE rates in obese individuals observed in other studies.