The impact of obesity on the immune response to infection

The impact of body mass index on the physiology of patients with polytrauma

PURPOSE

Obesity is a growing problem in industrial nations. The aim was to test the hypothesis that overweight patients face early physiologic impairment.

METHODS

A total of 651 patients were included in this retrospective study, with an injury severity score greater than 16 and 16 years or older. The sample was subdivided into 3 groups: body mass index (BMI) less than 25 kg/m(2), BMI of 25 to 30 kg/m(2), and BMI greater than 30 kg/m(2). Physiologic scores-Murray, Goris, Marshall and Sequential Organ Failure Assessment scores-were analyzed at admission and at the day of their maximum. Analysis of variance and χ(2) tests were used, and the significance level was set at P < .05.

RESULTS

All 4 scores showed significant differences at their maxima according to the 3 BMI groups, respectively: Murray score (P < .001), Goris score (P < .05), Marshall score (P < .001), and Sequential Organ Failure Assessment score (P <.05). The injury severity score values of the 3 groups at admission were 27.6 ± 12.0, 29.6 ± 13.2, and 25.3 ± 9.2, respectively (P < .05). The overall mortality rates in the 3 groups were 15.1%, 21.0%, and 20%, respectively (P < .001).

CONCLUSIONS

Anticipating BMI-specific critical trauma problems will become mandatory for effective polytrauma treatment in industrialized nations given their increasing prevalence of obesity.

Immunological complications of obesity

Current approaches for the treatment of obesity, including diet and lifestyle changes, have not been successful in curtailing the obesity epidemic. The higher incidence of inflammation-associated chronic disease and greater susceptibility to infection in obese people represents a growing health threat. Improved understanding of the immunological processes that regulate obesity may yield new treatments for obesity-associated disorders.