{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:03:06Z","timestamp":1770897786078,"version":"3.50.1"},"reference-count":66,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Remembering the 15 Endowment"},{"name":"Leon Hess Professorship for Burn Injuries Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EBJ"],"abstract":"<jats:p>Background: Weight extremes are linked to morbidity, yet their impact on burn outcomes remains underinvestigated. Prior studies suggest an \u2018obesity paradox\u2019, showing survival benefits and better functional outcomes in obese patients. Methods: This study used the global real-world database TriNetX to assess the association between body mass index (BMI) and clinical outcomes in adult burn patients, categorized using WHO definitions. After 1:1 propensity score matching for demographics, burn severity, and smoke inhalation injury, clinical outcomes were analyzed over a six-month period following burn injury. Outcomes included mortality, sepsis, pneumonia, acute kidney injury (AKI), cardiovascular events, graft complications, skin infections, and psychological impairment. Results: After matching, 9736 patients were included in the underweight versus normal weight comparison, 72,274 in overweight versus normal weight, 71,195 in obesity versus normal weight, and 9732 in underweight versus obesity. Underweight patients were associated with higher mortality and increased risks of sepsis, pneumonia, cardiovascular events, and psychological impairment. Overweight and obese patients showed higher survival rates and overall better clinical outcome associations. Conclusions: These findings are consistent with the previously described \u2018obesity paradox\u2019 in burn care and identify underweight burn patients as a distinct high-risk subgroup.<\/jats:p>","DOI":"10.3390\/ebj7010012","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:48:34Z","timestamp":1770889714000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Influence of BMI on Mortality and Clinical Outcomes After Burns"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2487-9009","authenticated-orcid":false,"given":"Julia","family":"Kleinhapl","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA"},{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2297-616X","authenticated-orcid":false,"given":"Rudy","family":"Ji","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6991-2057","authenticated-orcid":false,"given":"Lucineia","family":"Gainski Danielski","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4609-2767","authenticated-orcid":false,"given":"George","family":"Golovko","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4671-5023","authenticated-orcid":false,"given":"Alen","family":"Palackic","sequence":"additional","affiliation":[{"name":"Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4259-4129","authenticated-orcid":false,"given":"Philong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4736-7307","authenticated-orcid":false,"given":"Ludwik K.","family":"Branski","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA"},{"name":"Shriners Children\u2019s Texas, Galveston, TX 77550, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2972-3440","authenticated-orcid":false,"given":"Steven E.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7443-750X","authenticated-orcid":false,"given":"Celeste C.","family":"Finnerty","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar E.","family":"Suman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, July 21). Body Mass Index (BMI). Available online: https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/topic-details\/GHO\/body-mass-index?introPage=intro_3.html."},{"key":"ref_2","first-page":"e984","article-title":"Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association","volume":"143","author":"Poirier","year":"2021","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Yang, M., Liu, S., and Zhang, C. (2022). The Related Metabolic Diseases and Treatments of Obesity. Healthcare, 10.","DOI":"10.3390\/healthcare10091616"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Viester, L., Verhagen, E.A.L.M., Oude Hengel, K.M., Koppes, L.L.J., van der Beek, A.J., and Bongers, P.M. (2013). The Relation between Body Mass Index and Musculoskeletal Symptoms in the Working Population. BMC Musculoskelet. Disord., 14.","DOI":"10.1186\/1471-2474-14-238"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1001\/jama.289.2.187","article-title":"Years of Life Lost Due to Obesity","volume":"289","author":"Fontaine","year":"2003","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1001\/jama.2012.113905","article-title":"Association of All-Cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-Analysis","volume":"309","author":"Flegal","year":"2013","journal-title":"JAMA"},{"key":"ref_7","first-page":"179","article-title":"Prevalence of Obesity-Related Multimorbidity and Its Health Care Costs among Adults in the United States","volume":"31","author":"Ezendu","year":"2025","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S2213-8587(22)00033-X","article-title":"Body-Mass Index and Risk of Obesity-Related Complex Multimorbidity: An Observational Multicohort Study","volume":"10","author":"Strandberg","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2333794X19891305","DOI":"10.1177\/2333794X19891305","article-title":"Childhood and Adolescent Obesity in the United States: A Public Health Concern","volume":"6","author":"Sanyaolu","year":"2019","journal-title":"Glob. Pediatr. Health"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Emmerich, S., Fryar, C., Stierman, B., and Ogden, C. (2024). Obesity and Severe Obesity Prevalence in Adults: United States, August 2021\u2013August 2023.","DOI":"10.15620\/cdc\/159281"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1038\/ijo.2008.102","article-title":"Global Burden of Obesity in 2005 and Projections to 2030","volume":"32","author":"Kelly","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_12","first-page":"354","article-title":"Direct Medical Costs of Obesity in the United States and the Most Populous States","volume":"27","author":"Cawley","year":"2021","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ward, Z.J., Bleich, S.N., Long, M.W., and Gortmaker, S.L. (2021). Association of Body Mass Index with Health Care Expenditures in the United States by Age and Sex. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0247307"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1038\/s41387-024-00352-9","article-title":"Assessing the Economic Impact of Obesity and Overweight on Employers: Identifying Opportunities to Improve Work Force Health and Well-Being","volume":"14","author":"Dall","year":"2024","journal-title":"Nutr. Diabetes"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e13535","DOI":"10.1111\/obr.13535","article-title":"Economic Burden of Childhood Overweight and Obesity: A Systematic Review and Meta-analysis","volume":"24","author":"Ling","year":"2023","journal-title":"Obes. Rev."},{"key":"ref_16","unstructured":"Fryar, C.D., Carroll, M.D., and Afful, J. (2025, July 29). Prevalence of Underweight Among Adults Aged 20 and over: United States, 1960\u20131962 Through 2017\u20132018. NCHS Health E-Stats, Available online: https:\/\/www.cdc.gov\/nchs\/data\/hestat\/underweight-adult-17-18\/ESTAT-Underweight-Adult-H.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128\u00b79 Million Children, Adolescents, and Adults","volume":"390","author":"Abdeen","year":"2017","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"154229","DOI":"10.1016\/j.metabol.2020.154229","article-title":"The Effect of Underweight on Female and Male Reproduction","volume":"107","author":"Boutari","year":"2020","journal-title":"Metabolism"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Cuntz, U., Quadflieg, N., and Voderholzer, U. (2023). Health Risk and Underweight. Nutrients, 15.","DOI":"10.3390\/nu15143262"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/S2213-8587(18)30288-2","article-title":"Association of BMI with Overall and Cause-Specific Mortality: A Population-Based Cohort Study of 3\u00b76 Million Adults in the UK","volume":"6","author":"Bhaskaran","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ng, T.P., Jin, A., Chow, K.Y., Feng, L., Nyunt, M.S.Z., and Yap, K.B. (2017). Age-Dependent Relationships between Body Mass Index and Mortality: Singapore Longitudinal Ageing Study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0180818"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/geronb\/gbaa013","article-title":"The Role of Underweight in Active Life Expectancy Among Older Adults in Japan","volume":"76","author":"Minagawa","year":"2021","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1203\/PDR.0b013e31818d1c8a","article-title":"Mitochondrial Energy Production Correlates With the Age-Related BMI","volume":"65","author":"Wortmann","year":"2009","journal-title":"Pediatr. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1002\/mhs2.7","article-title":"Prevalence of Underweight in People with Severe Mental Illness: Systematic Review and Meta-Analysis","volume":"1","author":"Khan","year":"2023","journal-title":"Ment. Health Sci."},{"key":"ref_25","unstructured":"Segal, Y., and Gunturu, S. (2025, August 05). Psychological Issues Associated With Obesity, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK603747\/."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41572-020-0145-5","article-title":"Burn Injury","volume":"6","author":"Jeschke","year":"2020","journal-title":"Nat. Rev. Dis. Primer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1067\/msy.2000.108059","article-title":"Persistence of Muscle Catabolism after Severe Burn","volume":"128","author":"Hart","year":"2000","journal-title":"Surgery"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1093\/jbcr\/irz115","article-title":"The Influence of Obesity on Treatment and Outcome of Severely Burned Patients","volume":"40","author":"Tapking","year":"2019","journal-title":"J. Burn Care Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1093\/jbcr\/irac014","article-title":"Burn Outcomes at Extremes of Body Mass Index: Underweight Is as Problematic as Morbid Obesity","volume":"43","author":"Tolley","year":"2022","journal-title":"J. Burn Care Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/j.surg.2023.02.014","article-title":"Impact of Elevated Body Mass Index on Burn Injury-Associated Mortality in a Representative US Sample","volume":"173","author":"Dhanasekara","year":"2023","journal-title":"Surgery"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1097\/SLA.0b013e3182984d19","article-title":"Mild obesity is protective after severe burn injury","volume":"258","author":"Jeschke","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.burns.2015.08.020","article-title":"Understanding the Long-Term Impacts of Burn on the Cardiovascular System","volume":"42","author":"Duke","year":"2016","journal-title":"Burns"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/BCR.0b013e31825aeaac","article-title":"Long-Term Functional Outcomes in the Elderly after Burn Injury","volume":"33","author":"Palmieri","year":"2012","journal-title":"J. Burn Care Res. Off. Publ. Am. Burn Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1093\/jbcr\/irz173","article-title":"Obesity Paradox in the Burn Patient","volume":"41","author":"Lester","year":"2020","journal-title":"J. Burn Care Res. Off. Publ. Am. Burn Assoc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1007\/s11886-024-02098-3","article-title":"Obesity Paradox in Transcatheter Aortic Valve Replacement","volume":"26","author":"Madanat","year":"2024","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_36","first-page":"1407","article-title":"Postdiagnosis Body Mass Index and Risk of Mortality in Colorectal Cancer Survivors: A Prospective Study and Meta-Analysis","volume":"25","author":"Schlesinger","year":"2014","journal-title":"Cancer Causes Control"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.bbmt.2005.12.033","article-title":"Effect of Body Mass Index on Mortality of Patients with Lymphoma Undergoing Autologous Hematopoietic Cell Transplantation","volume":"12","author":"Navarro","year":"2006","journal-title":"Biol. Blood Marrow Transplant. J. Am. Soc. Blood Marrow Transplant."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e26936","DOI":"10.1097\/MD.0000000000026936","article-title":"The Obesity Paradox and Orthopedic Surgery","volume":"100","author":"Hennrikus","year":"2021","journal-title":"Medicine"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1177\/0003134820968524","article-title":"The Obesity Paradox in Emergency General Surgery Patients","volume":"88","author":"Maloney","year":"2022","journal-title":"Am. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1007\/s00268-020-05398-1","article-title":"The Obesity Paradox in the Trauma Patient: Normal May Not Be Better","volume":"44","author":"Dvorak","year":"2020","journal-title":"World J. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jamcollsurg.2009.11.008","article-title":"Verified Centers, Nonverified Centers, or Other Facilities: A National Analysis of Burn Patient Treatment Location","volume":"210","author":"Zonies","year":"2010","journal-title":"J. Am. Coll. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/BCR.0b013e31815f31b4","article-title":"Analysis of Admissions and Outcomes in Verified and Nonverified Burn Centers","volume":"29","author":"Palmieri","year":"2008","journal-title":"J. Burn Care Res. Off. Publ. Am. Burn Assoc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.burns.2010.08.010","article-title":"Body Mass Index (BMI) and Mortality in Patients with Severe Burns: Is There a \u201cTilt Point\u201d at Which Obesity Influences Outcome?","volume":"37","author":"Ghanem","year":"2011","journal-title":"Burns"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1016\/j.burns.2014.04.016","article-title":"Obese Patients in a Burn Care Unit: A Major Challenge","volume":"40","author":"Liodaki","year":"2014","journal-title":"Burns"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1002\/oby.23235","article-title":"Regional and Sociodemographic Differences in Average BMI among US Children in the ECHO Program","volume":"29","author":"Bekelman","year":"2021","journal-title":"Obesity"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"514674","DOI":"10.1155\/2010\/514674","article-title":"Global and National Socioeconomic Disparities in Obesity, Overweight, and Underweight Status","volume":"2010","author":"Moore","year":"2010","journal-title":"J. Obes."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.burnso.2023.12.006","article-title":"Burn Size Estimation: A Remarkable History with Clinical Practice Implications","volume":"8","author":"Carrougher","year":"2024","journal-title":"Burn. Open"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/S0094-1298(20)30126-7","article-title":"Fluid Volume and Electrolyte Changes of the Early Postburn Period","volume":"1","author":"Baxter","year":"1974","journal-title":"Clin. Plast. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.burns.2008.03.008","article-title":"Burn Resuscitation","volume":"35","author":"Alvarado","year":"2009","journal-title":"Burns"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.burns.2020.10.001","article-title":"Is the Parkland Formula Still the Best Method for Determining the Fluid Resuscitation Volume in Adults for the First 24 Hours after Injury?\u2014A Retrospective Analysis of Burn Patients in Germany","volume":"47","author":"Daniels","year":"2021","journal-title":"Burns"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"107397","DOI":"10.1016\/j.burns.2025.107397","article-title":"Too Much or Too Little? Fluid Resuscitation in the First 24 h after Severe Burns: Evaluating the Parkland Formula\u2014A Retrospective Analysis of Adult Burn Patients in Austria, Germany, and Switzerland 2015\u20132022","volume":"51","author":"Aigner","year":"2025","journal-title":"Burns"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"214","DOI":"10.4266\/acc.2023.01571","article-title":"Microbial Infections in Burn Patients","volume":"39","author":"Roy","year":"2024","journal-title":"Acute Crit. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1089\/sur.2013.134","article-title":"Infection in Burns","volume":"17","author":"Norbury","year":"2016","journal-title":"Surg. Infect."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/jbcr\/irz017","article-title":"Outcomes in Burn-Injured Patients Who Develop Sepsis","volume":"40","author":"Rech","year":"2019","journal-title":"J. Burn Care Res. Off. Publ. Am. Burn Assoc."},{"key":"ref_55","first-page":"126","article-title":"Early Detection of Pneumonia as a Risk Factor for Mortality in Burn Patients in Menoufiya University Hospitals, Egypt","volume":"26","author":"Mgahed","year":"2013","journal-title":"Ann. Burn. Fire Disasters"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/obr.12055","article-title":"Body Mass Index and Risk of Pneumonia: A Systematic Review and Meta-Analysis","volume":"14","author":"Phung","year":"2013","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/000313481608200418","article-title":"Obesity and the Risk for Surgical Site Infection in Abdominal Surgery","volume":"82","author":"Winfield","year":"2016","journal-title":"Am. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.cmi.2017.02.013","article-title":"Body Mass Index and the Risk of Infection\u2014From Underweight to Obesity","volume":"24","author":"Dobner","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/0196-6553(88)90003-X","article-title":"Obesity and Diabetes as Risk Factors for Postoperative Wound Infections after Cardiac Surgery","volume":"16","author":"Lillenfeld","year":"1988","journal-title":"Am. J. Infect. Control"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"21501319221096917","DOI":"10.1177\/21501319221096917","article-title":"Network Analysis of Depressive Symptomatology in Underweight and Obese Adults","volume":"13","author":"Saintila","year":"2022","journal-title":"J. Prim. Care Community Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.jad.2025.03.126","article-title":"New Insights on Underlying Shared Genetic Architectures and Causality of Underweight and Depression in East Asian Populations","volume":"380","author":"Chen","year":"2025","journal-title":"J. Affect. Disord."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1038\/ijo.2008.268","article-title":"Depression and Anxiety among US Adults: Associations with Body Mass Index","volume":"33","author":"Zhao","year":"2009","journal-title":"Int. J. Obes."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Boulet, N., Briot, A., Galitzky, J., and Bouloumi\u00e9, A. (2022). The Sexual Dimorphism of Human Adipose Depots. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102615"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"C58","DOI":"10.1152\/ajpcell.00106.2021","article-title":"Burn-Induced Hypermetabolism and Skeletal Muscle Dysfunction","volume":"321","author":"Knuth","year":"2021","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/SHK.0b013e31816e3373","article-title":"Characterization of the inflammatory response during acute and post-acute phases after severe burn","volume":"30","author":"Gauglitz","year":"2008","journal-title":"Shock"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0140-6736(16)31469-6","article-title":"The Metabolic Stress Response to Burn Trauma: Current Understanding and Therapies","volume":"388","author":"Porter","year":"2016","journal-title":"Lancet"}],"container-title":["European Burn Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-1991\/7\/1\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:02:21Z","timestamp":1770894141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-1991\/7\/1\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":66,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["ebj7010012"],"URL":"https:\/\/doi.org\/10.3390\/ebj7010012","relation":{},"ISSN":["2673-1991"],"issn-type":[{"value":"2673-1991","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}