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Obesity contributes to increased risk of infections in men, women

13 Aug 2019

Individuals with obesity are at an elevated risk of developing infections, particularly that of the skin in both men and women, and those of the gastrointestinal and urinary tracts and sepsis in women only, according to a study.

The study population comprised 39,163 adults: 64 percent were women and 36 percent were men. Of the women, 63 percent had normal body weight, 29 percent were overweight, and 8 percent were obese; the corresponding proportions in men were 53 percent, 41 percent and 6 percent. In both genders, obese individuals had lower educational attainment, less likely to consume alcohol, more likely to be ex-smokers, engaged less in physical activity and more likely to have comorbidities at baseline.

Over a follow-up of 19 years (mean, 15.4 years), 12,652 individuals (32 percent) developed at least one infection requiring healthcare attention. There were 27,675 infections recorded, with a mean of 2.2 infections per person.

Cox analysis revealed an increased incidence of any infection in obese women (hazard ratio [HR], 1.22, 95 percent CI, 1.12–1.33) and obese men (HR, 1.25, 1.09–1.43) relative to normal-weight individuals.

With regard to specific infections, higher incidences were observed for skin infections in both genders (obese women: HR, 1.76, 1.47–2.12; obese men: HR, 1.74, 1.33–2.28), and for gastrointestinal tract infections (HR, 1.44, 1.19–1.75), urinary tract infections (HR, 1.30, 1.08–1.55) and sepsis (HR, 2.09, 1.46–2.99) in females only.

The mechanisms by which obesity may heighten the risk of infections involve impaired immunity via a leptin resistance, as well as altered respiratory physiology, skin folds and diminished peripheral blood perfusion, researchers explained. Additional studies differentiating by infectious agent are needed to draw conclusions about infections of different origins.

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