Correlations between intra-abdominal pressure and obesity-related co-morbidities

Surg Obes Relat Dis. Sep-Oct 2009;5(5):524-8. doi: 10.1016/j.soard.2009.04.003. Epub 2009 Apr 23.

Abstract

Background: Obesity is associated with chronic increases in intra-abdominal pressure (IAP). The aim of the present study was to examine the correlation between the IAP and the number of obesity-related co-morbidities.

Methods: A total of 63 morbidly obese patients who were undergoing bariatric surgery had their IAP measured intraoperatively while in a supine position and under general anesthesia. The IAP readings were obtained through an indwelling urinary bladder catheter. The correlation of obesity-related co-morbidities, including systemic hypertension, type 2 diabetes mellitus, gastroesophageal reflux disease, urinary stress incontinence, lower extremity edema, obstructive sleep apnea, and abdominal wall hernia, and the level of IAP were examined using a stepwise regression analysis model.

Results: Of the 62 patients, 57 were women. The mean age was 44 + or - 11 years, and the body mass index was 49 + or - 10 kg/m(2). Of the 62 patients, 48 (77%) had an elevated IAP (> or = 9 cm H(2)O). A significant and positive correlation was found between the IAP level and the number of obesity-related co-morbidities (Pearson's r = .8; P <.05). Stepwise logistic regression analysis revealed that systemic hypertension, American Society of Anesthesiologists score, and body mass index were predictors of elevated IAP. A normal IAP appeared to offer a protective effect against systemic hypertension.

Conclusion: In this cohort of mainly obese women, the baseline IAP of morbidly obese patients was abnormally elevated. A greater IAP correlated with the presence of a greater number of obesity-related co-morbid conditions. Systemic hypertension was significantly associated with an elevated IAP. Chronic increases in IAP might, in part, be responsible for the pathogenesis of systemic hypertension in the morbidly obese.

MeSH terms

  • Abdominal Cavity / physiology*
  • Adult
  • Bariatric Surgery
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Obesity, Morbid / complications*
  • Obesity, Morbid / physiopathology*
  • Obesity, Morbid / surgery
  • Predictive Value of Tests
  • Pressure
  • Regression Analysis
  • Urinary Catheterization