====== Obesity in traumatic brain injury ======

[[Obesity]] is associated with chronic [[inflammation]], which may impact [[recovery]] from [[mild traumatic brain injury]] (mTBI). The objective was to assess the role of obesity in recovery of symptoms, functional outcome and inflammatory blood biomarkers after mTBI.

[[TRACK-TBI]] is a prospective study of patients with acute mTBI (Glasgow Coma Scale=13-15) who were enrolled ≤24 hours of injury at an emergency department of level 1 trauma centres and followed for 12 months. A total of 770 hospitalised patients who were either obese ([[body mass index]] (BMI) >30.0) or healthy mass (BMI=18.5-24.9) were enrolled. Blood concentrations of high-sensitivity [[C reactive protein]] (hsCRP), interleukin (IL) 6, IL-10, tumour necrosis factor alpha; Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Quality of Life After Brain Injury and Glasgow Outcome Score-Extended reflecting injury-related functional limitations at 6 and 12 months were collected.

After adjusting for age and gender, obese participants had higher concentrations of hsCRP 1 day after injury (mean difference (MD)=0.65; 95% CI: 0.44 to 0.87, p<0.001), at 2 weeks (MD=0.99; 95% CI: 0.74 to 1.25, p<0.001) and at 6 months (MD=1.08; 95% CI: 0.79 to 1.37, p<0.001) compared with healthy mass participants. Obese participants had higher concentrations of IL-6 at 2 weeks (MD=0.37; 95% CI: 0.11 to 0.64, p=0.006) and 6 months (MD=0.42; 95% CI: 0.12 to 0.72, p=0.006). Obese participants had higher RPQ total score at 6 months (MD=2.79; p=0.02) and 12 months (MD=2.37; p=0.049).

Obesity is associated with higher [[symptom]]atology at 6 and 12 months and higher concentrations of blood inflammatory markers throughout recovery following mTBI
((Eagle SR, Puccio AM, Nelson LD, McCrea M, Giacino J, Diaz-Arrastia R, Conkright W, Jain S, Sun X, Manley G, Okonkwo DO; TRACK-TBI Investigators. Association of obesity with mild traumatic brain injury symptoms, inflammatory profile, quality of life and functional outcomes: a TRACK-TBI Study. J Neurol Neurosurg Psychiatry. 2023 Jun 27:jnnp-2023-331562. doi: 10.1136/jnnp-2023-331562. Epub ahead of print. PMID: 37369556.)).