title: The association between body mass index and the severity of cholecystitis.
abstract: BACKGROUND
  Severe cholecystitis occurs more frequently in males, and the cause of this discrepancy is unknown.
  
  
  METHODS
  A retrospective study was performed on 910 consecutive patients who underwent laparoscopic cholecystectomy for cholecystitis. The patients were classified according to body mass index (BMI) as obese (n = 354, BMI > or =25 kg/m(2)) and nonobese (n = 556; BMI <25).
  
  
  RESULTS
  In males, there was a significant negative correlation between the BMI and the severity of cholecystitis; the proportion of complicated acute cholecystitis was higher in the nonobese patients (21.5%) compared with the obese patients (8.1%) (P = .007) but not for the females (P = .80). A BMI <25 (odds ratio [OR] = 1.92, P = .01), advanced age (OR = 2.52, P < .001), male sex (OR = 1.74, P = .022), and leukocytosis (OR = 1.92, P = .024) were independent predictors for the development of complicated acute cholecystitis.
  
  
  CONCLUSIONS
  There is a negative association between BMI and the inflammation severity of cholecystitis in males, which resulted in a higher incidence of severe cholecystitis in the nonobese male patients.
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hyeon Kook
authors.initials: HK
authors.lastname: Lee
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Seog Ki
authors.initials: SK
authors.lastname: Min