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Obesity and post-op complications

Obesity, incisional hernia and post-op infection show genetic variants

Obesity, as measured by BMI, is associated with the development of postoperative incisional hernia and infection

Obesity and two post-operative complications linked with it - incisional hernia and post-op infection - have associated genetic variants in common, according to research led by Vanderbilt University Medical Center, Nashville. The outcomes are featured in the study, ‘Association of Genetic Risk of Obesity with Postoperative Complications Using Mendelian Randomization’, published in the World Journal of Surgery.

The extent to which obesity and genetics determine postoperative complications is not completely understood. Therefore, the researchers performed a retrospective study using two population cohorts with electronic health record (EHR) data. The first included 736,726 adults with BMI recorded between 1990 and 2017 at Vanderbilt University Medical Center. The second cohort consisted of 65,174 individuals from 12 institutions contributing EHR and genome-wide genotyping data to the Electronic Medical Records and Genomics (eMERGE) Network.

The researchers used pairwise logistic regression analyses to measure the association of BMI categories with postoperative complications derived from International Classification of Disease-9 codes, including postoperative infection, incisional hernia, and intestinal obstruction. A genetic risk score was constructed from 97 obesity-risk single-nucleotide polymorphisms for a Mendelian randomization study to determine the association of genetic risk of obesity on postoperative complications. Logistic regression analyses were adjusted for sex, age, site, and race/principal components.

The results revealed that individuals with overweight or obesity had increased risk of incisional hernia (odds ratio [OR] 1.7–5.5, p < 3.1 × 10−20), and people with obesity had increased risk of postoperative infection (OR 1.2–2.3, p < 2.5 × 10−5). In the eMERGE cohort, genetically predicted BMI was associated with incisional hernia (OR 2.1 [95% CI 1.8–2.5], p = 1.4 × 10−6) and postoperative infection (OR 1.6 [95% CI 1.4–1.9], p = 3.1 × 10−6). Association findings were similar after limitation of the cohorts to those who underwent abdominal procedures.

“Clinical and Mendelian randomisation studies suggest that obesity, as measured by BMI, is associated with the development of postoperative incisional hernia and infection,” the authors concluded.

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