Endocrine Abstracts

JOINT3993

Introduction: Obesity in adults is commonly classified using BMI, with values over 30 kg/m² indicating obesity. However, BMI has limitations as it doesn’t accurately reflect body composition. Fat mass percentage (FM%) is a more precise measure, and can be estimated using various methods, with bioimpedancemetry being a cost-effective, accurate, and radiation-free option. According to the Consensus Statement of the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN and EASO) on sarcopenic obesity, obesity is defined as a body fat percentage (FM%) higher than 30% in men and 40% in women, respectively.

Objective: To compare body composition, complications, and need for aggressive therapies in post-critical obese patients, using two definitions of obesity: FM% > 30% in men and > 40% in women, vs BMI > 30 kg/m².

Methods: Prospective observational study including 75 patients admitted to the ICU for severe COVID-19 pneumonia. Demographic, clinical and analytical data were collected during admission, medical history and a complete morphofunctional assessment was performed 14 days after hospital discharge with bioimpedancemetry and phase angle, nutritional ultrasound, dynamometry and functional tests. Two mutually exclusive groups were established, one defined as BMI>30kg/m² and the other as high FM% with normal BMI, and the differences between them were analyzed.

Results: .

Conclusions: Patients with BMI < 30 kg/m² but with FM > 30% (men) or > 40% (women) have differences in body composition parameters (BIA, nutritional ultrasound and dynamometry) and are also associated with a higher prevalence of diabetes mellitus and worse clinical outcomes during admission (longer hospital stay). In terms of body composition, there are differences especially in parameters related to muscle mass, but also in proinflammatory parameters.