Body mass index stratification in hospitalized Italian adults with congenital heart disease in relation to complexity, diagnosis, sex and age

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 29; no. 4; pp. 367 - 377
• Main Authors: Malavazos, A.E., Capitanio, G., Chessa, M., Matelloni, I.A., Milani, V., Stella, E., Al Kassem, L.F., Sironi, F., Boveri, S., Giamberti, A., Masocco, M., Ranucci, M., Menicanti, L., Morricone, L.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-04-2019
• Subjects: Adiposity; Adolescent; Adult; Adult with congenital heart disease (ACHD); Age Distribution; Aged; Body Mass Index; Body mass index (BMI); Female; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - physiopathology; Humans; Inpatients; Italian population; Italy - epidemiology; Male; Middle Aged; Obesity - diagnosis; Obesity - epidemiology; Obesity - physiopathology; Prevalence; Prognosis; Retrospective Studies; Risk Assessment; Risk Factors; Sex Distribution; Thinness - diagnosis; Thinness - epidemiology; Thinness - physiopathology; Young Adult; Italy; ACHD; NCDs; Adult with congenital heart disease (ACHD); Body mass index (BMI); PFO; Italian population; CHD; BMI; WHO
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2019.01.009

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.
•Underweight was higher in our selected population of symptomatic ACHD than in the Italian reference population.•Complex cardiac defects had the highest prevalence of underweight and the lowest prevalence of overweight and obesity.•Overweight was lower in our symptomatic ACHD patients than in Italians, but obesity level was similar.•Overweight and obesity prevalence increased with age in almost all ACHD patients.