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Sample records for abdominal obesity dyslipidemia

  1. [Childhood obesity and dyslipidemia].

    PubMed

    Gómez-Díaz, Rita Angélica; Wacher-Rodarte, Niels H

    2014-01-01

    Screening and treatment of plasma lipid abnormalities secondary to obesity are among the interventions that should be implemented in children who are overweight or obese, in order to prevent a cardiovascular event. Dyslipidemias are a group of asymptomatic diseases that are commonly caused by abnormal levels of lipoproteins in blood; they are a comorbidity that is commonly related to obesity, without considering the age of the patient. Among dyslipidemias, hypertriglyceridemia has the highest prevalence. The etiology of the dyslipidemia should be identified; it allows the proper selection of therapy for the patients and their family. The goal is the prevention of cardiovascular complications. Reduced caloric intake and a structured physical activity plan should be considered for initial treatment for all the overweight and obese patients. For adherence to treatment to be successful, the participation of the primary care physician and a multidisciplinary team is required. With treatment, the risks and complications can be reduced. The participation of a specialist in handling the pediatric obese patient with dyslipidemia should be limited to severe cases or those at risk for having pancreatitis.

  2. Obesity and Dyslipidemia in South Asians

    PubMed Central

    Misra, Anoop; Shrivastava, Usha

    2013-01-01

    Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome) including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI) and waist circumference (WC), it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m2 for overweight and ≥25 kg/m2 for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity) for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more research on

  3. Effects of the New Dual PPARα/δ Agonist GFT505 on Lipid and Glucose Homeostasis in Abdominally Obese Patients With Combined Dyslipidemia or Impaired Glucose Metabolism

    PubMed Central

    Cariou, Bertrand; Zaïr, Yassine; Staels, Bart; Bruckert, Eric

    2011-01-01

    OBJECTIVE We evaluated the metabolic effects and tolerability of GFT505, a novel dual peroxisome proliferator–activated receptor α/δ agonist, in abdominally obese patients with either combined dyslipidemia or prediabetes. RESEARCH DESIGN AND METHODS The S1 study was conducted in 94 patients with combined dyslipidemia while the S2 study was conducted in 47 patients with prediabetes. Participants were randomly assigned in a double-blind manner to GFT505 at 80 mg/day or placebo for 28 (S1) or 35 (S2) days. Primary efficacy end points were changes from baseline at week 4 in both fasting plasma triglycerides and HDL cholesterol in the S1 group and 2-h glucose upon oral glucose tolerance test in the S2 group. RESULTS In comparison with placebo, GFT505 significantly reduced fasting plasma triglycerides (S1: least squares means −16.7% [95% one-sided CI −∞ to −5.3], P = 0.005; S2: −24.8% [−∞ to −10.5], P = 0.0003) and increased HDL cholesterol (S1: 7.8% [3.0 to ∞], P = 0.004; S2: 9.3% [1.7 to ∞], P = 0.009) in both studies, whereas LDL cholesterol only decreased in S2 (−11.0% [ −∞ to −3.5], P = 0.002). In S2, GFT505 did not reduce 2-h glucose (−0.52 mmol/L [−∞ to 0.61], P = 0.18) but led to a significant decrease of homeostasis model assessment of insulin resistance (−31.4% [−∞ to 12.5], P = 0.001), fasting plasma glucose (−0.37 mmol/L [−∞ to −0.10], P = 0.01) and fructosamine (−3.6% [−∞ to −0.20], P = 0.02). GFT505 also reduced γ glutamyl transferase levels in both studies (S1: −19.9% [−∞ to −12.8], P < 0.0001; S2: −15.1% [−∞ to −1.1], P = 0.004). No specific adverse safety signals were reported during the studies. CONCLUSIONS GFT505 may be considered a new drug candidate for the treatment of lipid and glucose disorders associated with the metabolic syndrome. PMID:21816979

  4. [Dyslipidemia and obesity 2011. Similarities and differences].

    PubMed

    Ceska, R; Vrablík, M; Sucharda, P

    2011-03-01

    We shall open our overview of issues related to obesity and hyperlipoproteinemia (HLP) or dyslipidemia with a notoriously known truth (that some are still reluctant to accept): HLP/DLP is not obesity. It is certainly not possible to put an equal sign between subcutaneous fat and the level of plasma lipids and lipoproteins. On the other hand, it is obvious that there is a number of connecting links between HLP/DLP and obesity. These associations on one side and differences on the other are the focus of this review paper. (1) HLP/DLP as well as obesity represent a group of high incidence metabolic diseases (gradually evolving from epidemic to pandemic) that affect several tens of percent of inhabitants. (2) Both HLP/DLP and obesity often occur concurrently, often as a result of unhealthy lifestyle. However, genetic factors are also been studies and it is possible that mutual predispositions for the development of both diseases will be identified. At present, it is only possible to conclude that obesity worsens lipid metabolism in genetically-determined HLP. (3) Both these metabolic diseases represent a risk factor for other pathologies, cardiovascular diseases are the most important common complication of both conditions (central type of obesity only). Concurrent presence of HDL/DLP and obesity is often linked to other diagnoses, such as type 2 diabetes mellitus (DM2T), hypertension, pro-coagulation or pro-inflammatory states; all as part of so called metabolic syndrome. (4) Patients with metabolic syndrome and, mainly, central obesity usually have typical dyslipidemia with reduced HDL-cholesterol (HDL-C) and sometimes hypertriglyceridaemia. Current treatment of HDL/DLP aims to first impact on the primary aim, i.e. LDL-cholesterol (LDL-C), and than influence HDL-C. (5) It seems that the therapeutic efforts in HLP/DLP and obesity will go in the same direction. I will skip the trivial (and difficult to accept by patients) dietary changes. Pharmacotherapy, however

  5. Dyslipidemia in Overweight and Obese School-Aged Children.

    PubMed

    Finn, Pamela

    2015-09-01

    Dyslipidemia often affects overweight and obese adolescents and can be present along with hypertension, insulin resistance, type 2 diabetes, and polycystic ovarian syndrome. This article is the third of six discussing the comorbidities of childhood obesity and will focus on the individual parts of the lipid profile and the impact of dyslipidemia on the heart and other body systems. Since few pharmacologic therapies are approved to treat dyslipidemia in children and adolescents younger than 18, treatment consists of lifestyle changes that can be supported and modeled by the school nurse. The school nurse can also be an advocate for a healthy lifestyle in the school district and community. More success in the treatment of dyslipidemia will be realized with less attention to changing the individual and more attention to changing the wider populations, including schools and the community. PMID:26219905

  6. Atherogenic Dyslipidemia and Cardiovascular Risk Factors in Obese Children

    PubMed Central

    D'Adamo, Ebe; Guardamagna, Ornella; Chiarelli, Francesco; Liccardo, Daniela; Ferrari, Federica; Nobili, Valerio

    2015-01-01

    Childhood obesity when associated with serum lipoprotein changes triggers atherosclerosis. Evidences suggest that the atherosclerotic process begins in childhood and that the extent of early atherosclerosis of the aorta and coronary arteries can be associated with lipoprotein levels and obesity. Furthermore, many studies in childhood demonstrate an important relationship between parameters of insulin sensitivity, body fat distribution, and the development of lipid abnormalities. This review focuses on the most recent findings on the relationship between obesity, dyslipidemia, and cardiovascular risk in children. PMID:25663838

  7. [Obesity and dyslipidemia in Tunisian bipolar subjects].

    PubMed

    Ezzaher, Asma; Haj Mouhamed, Dhouha; Mechri, Anwar; Neffati, Fadoua; Douki, Wahiba; Gaha, Lotfi; Najjar, Mohamed Fadhel

    2010-01-01

    This study aims to investigate the prevalence of obesity and overweight and their association with lipid parameters in bipolar patients. Our study included 130 patients with bipolar disorder and 130 control subjects aged respectively 37.9 +/- 12.1 and 37.2 +/- 13.1 years. Obesity was evaluated by body mass index (BMI). Concentrations of total cholesterol, triglycerides, cLDL and cHDL were determined by enzymatic methods and ApoA1, ApoB and Lp(a) by techniques immunoturbidimetric. The prevalence of obesity in patients is 30.1% vs 12.3% in controls. A significant increase in BMI was noted in patients compared with controls regardless of sex and tobacco status and in patients aged less than 35 years and those consumers of alcohol. The majority of obese and overweight patients are treated with valproic acid. We found increase in cholesterol (4.41 +/- 1.02 vs 3.90 +/- 0.98 mmol/L), in cLDL (2.13 +/- 1.09 vs 1.29 +/- 0.56 mmol/L) and in Lp(a) (236 +/- 207 vs 163 +/- 150 mg/L) and decrease in HDLc (0.98 +/- 0.28 vs 1.09 +/- 0.36 mmol/L), more frequent at the obese patients and those presenting an overweight. In conclusion, in bipolar patients, obesity and overweight are frequent and associated with perturbations in lipid profile particularly an increase in total cholesterol, cLDL and Lp(a) and decrease in cHDL that increase the risk of cardiovascular disease. PMID:20478770

  8. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  9. A case of abdominal pain with dyslipidemia: difficulties diagnosing cholesterol ester storage disease.

    PubMed

    Cameron, S J; Daimee, U; Block, R C

    2015-01-01

    Cholesterol ester storage disease is an exceptionally rare dyslipidemia with less than 150 cases reported in the medical literature. The diagnosis of Cholesterol Ester Storage Disease is often missed by virtue of the fact that the symptoms mimic both inborn metabolic defects and hepatic steatosis. Patients with Cholesterol Ester Storage Disease usually present with atypical complaints including abdominal pain from altered gut motility. Blood analysis typically reveals abnormal liver function tests with coincident dyslipidemia. We present a case of a young woman with Cholesterol Ester Storage Disease who was followed over two decades. We discuss issues common to her initial protracted diagnosis with management options over time.

  10. Physical activity and abdominal obesity in youth.

    PubMed

    Kim, YoonMyung; Lee, SoJung

    2009-08-01

    Childhood obesity continues to escalate despite considerable efforts to reverse the current trends. Childhood obesity is a leading public health concern because overweight-obese youth suffer from comorbidities such as type 2 diabetes mellitus, nonalcoholic fatty liver disease, metabolic syndrome, and cardiovascular disease, conditions once considered limited to adults. This increasing prevalence of chronic health conditions in youth closely parallels the dramatic increase in obesity, in particular abdominal adiposity, in youth. Although mounting evidence in adults demonstrates the benefits of regular physical activity as a treatment strategy for abdominal obesity, the independent role of regular physical activity alone (e.g., without calorie restriction) on abdominal obesity, and in particular visceral fat, is largely unclear in youth. There is some evidence to suggest that, independent of sedentary activity levels (e.g., television watching or playing video games), engaging in higher-intensity physical activity is associated with a lower waist circumference and less visceral fat. Several randomized controlled studies have shown that aerobic types of exercise are protective against age-related increases in visceral adiposity in growing children and adolescents. However, evidence regarding the effect of resistance training alone as a strategy for the treatment of abdominal obesity is lacking and warrants further investigation.

  11. Plasma adipocytokines and antioxidants-status in Korean overweight and obese females with dyslipidemia

    PubMed Central

    Ha, Ae Wha; Jeong, Su Youn; Kang, Nam E

    2014-01-01

    BACKGROUD/OBEJECTIVES It is hypothesized that obese people with dyslipidemia is more likely to have increased oxidative stress and decreased antioxidant status, in comparison with the controls who were obese without dyslipidemia. Thus, the aims of the present study were to determine the dietary intakes, plasma adipokines, and antioxidative systems between obese with dyslipidemia and obese without dyslipidemia were investigated. SUBJECTS/METHODS Female subjects who were between 20 and 55 years old, and whose BMI was 23 or greater were recruited. Subjects who met the criteria of BMI ≥ 23, total cholesterol ≥ 200 mg/dL, LDL cholesterol ≥ 130 mg/dL, and TG ≥ 110 mg/dL were categorized Obese with dyslipidemia. Anthropometric measurements and blood biochemical tests were conducted. The diet survey was conducted by a trained dietitian using two days of 24 hour dietary recall. The lipid peroxidation, the plasma total antioxidant capacity (TAC), the activities of antioxidantive enzymes, and various antioxidantive vitamins levels were determined. RESULTS Plasma adiponectin and leptin levels were also determined. There were no significant differences for age, Body Mass index (BMI), and body fat (%), waist-size between two groups. Obese with dyslipidemia had significantly high levels of total cholesterol, triglyceride, LDL-cholesterol, the ratio of total cholesterol/HDL-C, and the ratio of HDL-C/LDL-C, respectively. Blood alkaline phosphatase level was statistically different between the two groups (P < 0.05). No statistical significance in dietary intake between two groups was shown. In case of obese with dyslipidemia group, the levels of GSH-Px (P < 0.05) and catalase (P < 0.05) as well as adjusted blood retinol (P < 0.05) and tocopherol level (P < 0.05) were significantly low. However, the plasma concentration of leptin was significantly high (P < 0.05). CONCLUSIONS Obesity with dyslipidemia was shown to have high arthtrogenic index, depleted antioxidant status, and

  12. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association.

    PubMed

    Bays, Harold E; Toth, Peter P; Kris-Etherton, Penny M; Abate, Nicola; Aronne, Louis J; Brown, W Virgil; Gonzalez-Campoy, J Michael; Jones, Steven R; Kumar, Rekha; La Forge, Ralph; Samuel, Varman T

    2013-01-01

    The term "fat" may refer to lipids as well as the cells and tissue that store lipid (ie, adipocytes and adipose tissue). "Lipid" is derived from "lipos," which refers to animal fat or vegetable oil. Adiposity refers to body fat and is derived from "adipo," referring to fat. Adipocytes and adipose tissue store the greatest amount of body lipids, including triglycerides and free cholesterol. Adipocytes and adipose tissue are active from an endocrine and immune standpoint. Adipocyte hypertrophy and excessive adipose tissue accumulation can promote pathogenic adipocyte and adipose tissue effects (adiposopathy), resulting in abnormal levels of circulating lipids, with dyslipidemia being a major atherosclerotic coronary heart disease risk factor. It is therefore incumbent upon lipidologists to be among the most knowledgeable in the understanding of the relationship between excessive body fat and dyslipidemia. On September 16, 2012, the National Lipid Association held a Consensus Conference with the goal of better defining the effect of adiposity on lipoproteins, how the pathos of excessive body fat (adiposopathy) contributes to dyslipidemia, and how therapies such as appropriate nutrition, increased physical activity, weight-management drugs, and bariatric surgery might be expected to impact dyslipidemia. It is hoped that the information derived from these proceedings will promote a greater appreciation among clinicians of the impact of excess adiposity and its treatment on dyslipidemia and prompt more research on the effects of interventions for improving dyslipidemia and reducing cardiovascular disease risk in overweight and obese patients.

  13. The role of antidepressants in the treatment of abdominal obesity.

    PubMed

    Rosmond, R; Björntorp, P

    2000-06-01

    The pathophysiology of abdominal obesity is unclear and controversial. Recent evidence now suggests that inadequate cortisol secretion is associated with abnormalities in glucose, insulin and lipid metabolism, including hypertension, bringing the importance of the hypothalamic-pituitary-adrenal (HPA) axis in the pathogenesis of abdominal obesity to the forefront. In addition, abnormal gonadal steroid concentrations and impaired plasma growth hormone levels accompany the abdominally obese state. Since the reproductive and growth axes are inhibited at many levels by various components of the HPA axis, increasing cortisol levels results in further depression of testosterone and growth hormone concentrations. Over the last decade, antidepressant (serotoninergic) drugs have proved useful as equalizers of HPA axis hyperactivity. Such therapy may interrupt the vicious circle of a hyperactive HPA axis leading to increasing abdominal obesity and endocrine perturbations that, in turn, leads to progressive accumulation of abdominal fat. Additionally, preliminary results indicate that serotoninergic agents decrease abdominal fat mass with improvements in related risk factors.

  14. Dyslipidemia is Associated with Unfit and Overweight-Obese Children and Adolescents

    PubMed Central

    Reuter, Cézane Priscila; da Silva, Priscila Tatiana; Renner, Jane Dagmar Pollo; de Mello, Elza Daniel; Valim, Andréia Rosane de Moura; Pasa, Luiza; da Silva, Rafaela; Burgos, Miria Suzana

    2016-01-01

    Background Both poor aerobic fitness and obesity, separately, are associated with abnormal lipid profiles. Objective To identify possible relationships of dyslipidemia with cardiorespiratory fitness and obesity, evaluated together, in children and adolescents. Methods This cross-sectional study included 1,243 children and adolescents (563 males and 680 females) between 7 and 17 years of age from 19 schools. Obesity was assessed using body mass index (BMI) measurements, and cardiorespiratory fitness was determined via a 9-minute run/walk test. To analyze the lipid profile of each subject, the following markers were used: total cholesterol, cholesterol fractions (high-density lipoprotein and low-density lipoprotein) and triglycerides. Data were analyzed using SPSS v. 20.0, via prevalence ratio (PR), using the Poisson regression. Results Dyslipidemia is more prevalent among unfit/overweight-obese children and adolescents compared with fit/underweight-normal weight boys (PR: 1.25; p = 0.007) and girls (PR: 1.30, p = 0.001). Conclusions The prevalence of dyslipidemia is directly related to both obesity and lower levels of cardiorespiratory fitness. PMID:26885973

  15. Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors

    PubMed Central

    Kelishadi, Roya; Mirmoghtadaee, Parisa; Najafi, Hananeh; Keikha, Mojtaba

    2015-01-01

    Background: The adverse health effects of abdominal obesity are well documented in adults, but such association remains to be determined in the pediatric age group. This study aims to perform a systematic review on the association between abdominal obesity and cardio-metabolic factors such as dyslipidemia, hypertension, and hyperglycemia among children and adolescents. Materials and Methods: A systematic literature search was conducted using PubMed, Scopus and Google Scholar databases to May 2014. Two independent reviewers identified relevant papers in several steps. After studying the titles and texts of documents, repeated and irrelevant ones were excluded. The search was refined to the English language. We did not consider any time limitation. Studies with different measuring methods of abdominal obesity were included. Studies with abdominal obese patients secondary to other disease were excluded from the study. In final, the data of association of cardio-metabolic risk factors and abdominal obesity extracted from studies. Results: Overall, 3966 articles were reviewed, and 61 of them were studied according to the inclusion and exclusion criteria. Waist circumference (WC), waist-to-height ratio, and waist-to-hip ratio were the most common indexes used for defining abdominal obesity. The association of high blood pressure with increasing WC was seen in several studies. The association of other cardio-metabolic risk factors was seen in some studies. Conclusion: Whatever the definition used for abdominal obesity and whatever the methods used for anthropometric measurements, central body fat deposition in children and adolescents increases the risk of cardio-metabolic risk factors. Therefore, more attention should be paid to abdominal obesity of children and adolescents both in clinical practice and in epidemiological studies. PMID:26109978

  16. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women.

    PubMed

    Ross, Robert; Freeman, Jennifer; Hudson, Robert; Janssen, Ian

    2002-11-01

    The independent relationships between visceral and abdominal sc adipose tissue (AT) depots, muscle composition, and insulin sensitivity were examined in 40 abdominally obese, premenopausal women. Measurements included glucose disposal by euglycemic clamp, muscle composition by computed tomography, abdominal and nonabdominal (e.g. leg) AT by magnetic resonance imaging and cardiovascular fitness. Glucose disposal rates were negatively related to visceral AT mass (r = -0.42, P < 0.01). These observations remained significant (P < 0.01) after control for nonabdominal and abdominal sc AT, muscle attenuation, and peak oxygen uptake. Total, abdominal, or leg sc AT or muscle attenuation was not significantly (P > 0.10) related to glucose disposal. Subdivision of abdominal sc AT into anterior and posterior depots did not alter the observed relationships. Further analysis matched two groups of women for abdominal sc AT but with low and high visceral AT. Women with high visceral AT had lower glucose disposal rates compared with those with low visceral AT (P < 0.05). A similar analysis performed on two groups of women matched for visceral AT but high and low abdominal sc AT revealed no statistically different values for insulin sensitivity (P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal, abdominal sc AT, muscle composition, and cardiovascular fitness. Subdivision of abdominal sc AT did not provide additional insight into the relationship between abdominal obesity and metabolic risk.

  17. Challenges in the pharmacologic management of obesity and secondary dyslipidemia in children and adolescents.

    PubMed

    Kennedy, Mary Jayne; Jellerson, Kevin D; Snow, Michael Z; Zacchetti, Michelle L

    2013-10-01

    The rise in childhood obesity has lead to an increased number of children with lipid abnormalities and the predominance of a combined dyslipidemic pattern characterized by a moderate-to-severe elevation in triglycerides, normal-to-mild mild elevation in LDL cholesterol and reduced HDL cholesterol. Although recently published National Heart, Lung and Blood Institute (NHLBI) guidelines represent a significant step forward in managing primary dyslipidemias in pediatric patients, there is still no general consensus regarding the pharmacologic treatment of obesity-related lipid abnormalities in children. The use of early pharmacologic intervention to control dyslipidemias and reduce cardiovascular risk in young children is only expected to increase given the steady increase in obesity and emergence of atherosclerotic disease in pre-adolescents. Despite the increasing use of lipid-lowering therapy in children over the last few years, diet and lifestyle modification remain the first line therapy. Given the challenges of instituting and maintaining lifestyle modification in pediatric patients, however, it is likely that institution of drug therapy may be required in many children. Of all the medications currently available, the fibric acid derivatives have a cholesterol lowering profile that is most likely to be effective in obese children with the high TG/low HDL phenotype and data from a recently published study of gemfibrozil in children with metabolic syndrome are promising. However, additional information regarding the short and long-term safety and efficacy of fibrate therapy in children with obesity-related lipid disorders is needed before use of these agents can be recommended.

  18. Abdominal adiposity and insulin resistance in obese men.

    PubMed

    Ross, Robert; Aru, James; Freeman, Jennifer; Hudson, Robert; Janssen, Ian

    2002-03-01

    We examined the independent relationships among various visceral and abdominal subcutaneous adipose tissue (AT) depots, glucose tolerance, and insulin sensitivity in 89 obese men. Measurements included an oral glucose tolerance test (OGTT), glucose disposal by euglycemic clamp, and abdominal and nonabdominal (e.g., peripheral) AT by magnetic resonance imaging (MRI). OGTT glucose and glucose disposal rates were related (P < 0.05) to visceral AT (r = 0.50 and -0.41, respectively). These observations remained significant (P < 0.05) after control for nonabdominal and abdominal subcutaneous AT, and maximal O(2) consumption (VO(2 max)). Abdominal subcutaneous AT was not a significant correlate (P > 0.05) of any metabolic variable after control for nonabdominal and visceral AT and VO(2 max). Division of abdominal subcutaneous AT into deep and superficial depots and visceral AT into intra- and extraperitoneal AT depots did not alter the observed relationships. Further analysis matched two groups of men for abdominal subcutaneous AT but also for low and high visceral AT. Men with high visceral AT had higher OGTT glucose values and lower glucose disposal rates compared with those with low visceral AT values (P < 0.05). A similar analysis performed on two groups of men matched for visceral AT but also for high and low abdominal subcutaneous AT revealed no statistically different values for any metabolic variable (P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal and abdominal subcutaneous AT and cardiovascular fitness. Subdivision of visceral and abdominal subcutaneous AT by MRI did not provide additional insight into the relationship between abdominal obesity and metabolic risk in obese men.

  19. Differences in the management of hypertension, diabetes mellitus and dyslipidemia between obesity classes.

    PubMed

    Martínez-St John, D R J; Palazón-Bru, A; Gil-Guillén, V F; Sepehri, A; Navarro-Cremades, F; Orozco-Beltrán, D; Carratalá-Munuera, C; Cortés, E; Rizo-Baeza, M M

    2016-01-01

    We did not find any paper that assessed clinical inertia in obese patients. Therefore, no paper has compared the clinical inertia rates between morbidly and nonmorbidly obese patients. A cross-sectional observational study was carried out. We analysed 8687 obese patients ⩾40 years of age who attended their health-care center for a checkup as part of a preventive program. The outcome was morbid obesity. Secondary variables were as follows: failure in the management of high blood pressure (HBP), high blood cholesterol (HBC) and high fasting blood glucose (HFBG); gender; personal history of hypertension, dyslipidemia, diabetes, smoking and cardiovascular disease; and age (years). We analysed the association between failures and morbid obesity by calculating the adjusted odds ratio (OR). Of 8687 obese patients, 421 had morbid obesity (4.8%, 95% confidence interval (CI): 4.4-5.3%). The prevalence rates for failures were as follows: HBP, 34.7%; HBC, 35.2%; and HFBG, 12.4%. Associated factors with morbid obesity related with failures were as follows: failure in the management of HBP (OR=1.42, 95% CI: 1.15-1.74, P=0.001); failure in the management of HBC (OR=0.73, 95% CI: 0.58-0.91, P=0.004); and failure in the management of HFBG (OR=2.24, 95% CI: 1.66-3.03, P<0.001). Morbidly obese patients faced worse management for HBP and HFBG, and better management for HBC. It would be interesting to integrate alarm systems to avoid this problem.

  20. Cardiovascular Disease Risk of Abdominal Obesity versus Metabolic Abnormalities

    PubMed Central

    Wildman, Rachel P.; McGinn, Aileen P.; Lin, Juan; Wang, Dan; Muntner, Paul; Cohen, Hillel W.; Reynolds, Kristi; Fonseca, Vivian; Sowers, MaryFran R.

    2011-01-01

    It remains unclear whether abdominal obesity increases cardiovascular disease (CVD) risk independent of the metabolic abnormalities which often accompany it. Therefore, the objective of the current study was to evaluate the independent effects of abdominal obesity versus metabolic syndrome and diabetes on the risk for incident coronary heart disease and stroke. The Framingham Offspring, Atherosclerosis Risk in Communities, and Cardiovascular Health studies were pooled to assess the independent effects of abdominal obesity (waist circumference >102 cm for men and >88 cm for women) versus metabolic syndrome (excluding the waist circumference criterion) and diabetes on risk for incident coronary heart disease and stroke in 20,298 men and women aged ≥45 years. The average follow-up was 8.3 (standard deviation 1.9) years. There were 1,766 CVD events. After adjustment for demographic factors, smoking, alcohol intake, number of metabolic syndrome components and diabetes, abdominal obesity was not significantly associated with an increased risk of CVD (hazard ratio [95% confidence interval] 1.09 [0.98, 1.20]). However, after adjustment for demographics, smoking, alcohol intake, and abdominal obesity, having 1–2 metabolic syndrome components, the metabolic syndrome, and diabetes were each associated with a significantly increased risk of CVD (2.12 [1.80, 2.50], 2.82 [1.92, 4.12] and 5.33 [3.37, 8.41], respectively). Although abdominal obesity is an important clinical tool for identification of individuals likely to possess metabolic abnormalities, these data suggest that the metabolic syndrome and diabetes are considerably more important prognostic indicators of CVD risk. PMID:20725064

  1. Long-term ingestion of monosodium L-glutamate did not induce obesity, dyslipidemia or insulin resistance: a two-generation study in mice.

    PubMed

    Nakamura, Hidehiro; Kawamata, Yasuko; Kuwahara, Tomomi; Smriga, Miro; Sakai, Ryosei

    2013-01-01

    The use of monosodium glutamate (MSG) as a flavor enhancer spans more than 100 y and there are many studies indicating the safety of general use of MSG. Recently, however, Collison et al. (2010) reported a two-generation study with a low dose of MSG that caused abdominal obesity, insulin resistance and dyslipidemia in mice. Due to public health concerns over metabolic syndrome, their report merits careful analysis. The present study attempted to repeat the Collison et al. findings. Groups of male or female C57BL/6J mice were fed a control diet or one supplemented with high-fructose corn syrup (HFCS) at a level of 20%. Drinking water control was provided or treatment groups were given 0.064% MSG solution (w/v). Diets and MSG administration continued throughout mating and during gestation and lactation periods. To further investigate the effects of ingestion of MSG, the offspring were continued on the same dosing conditions until they reached 32 wk of age. MSG administration in mice fed a normal or a HFCS diet throughout gestation and for 32 wk after birth, did not affect growth, girth size, abdominal fat weight or body composition. This study reports that MSG did not trigger insulin resistance, dyslipidemia or hepatic steatosis, regardless of the diet, not reproducing the results of the above-mentioned study (Collison et al., 2010). PMID:23727643

  2. Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

    PubMed Central

    2013-01-01

    Background Previous studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents. Methods Cross-sectional study. Subjects: 182 obese sedentary children and adolescents (aged 6 to 16 y), identified by the body mass index (BMI). Measurements: Body composition and trunk fat by dual-energy X-ray absorptiometry- DXA; lipid profile, blood pressure and pubertal stage were also assessed. NAFLD was classified as absent (0), mild (1), moderate (2) and severe (3), and intra-abdominal and subcutaneous abdominal fat thickness were identified by ultrasound. The MS was identified according to the cut offs proposed by World Health Organization adapted for children and adolescents. The chi-square test was used to compare categorical variables, and the binary logistic regression indicated the magnitude of the associations adjusted by potential cofounders (sex, age, maturation, NAFLD and HOMA-IR). Results Higher quartile of SCAT was associated with elevated blood pressure (p = 0.015), but not associated with NAFLD (p = 0.665). Higher IAAT was positively associated with increased dyslipidemia (p = 0.001), MS (p = 0.013) and NAFLD (p = 0.005). Intermediate (p = 0.007) and highest (p = 0.001) quartile of IAAT were also associated with dyslipidemia, independently of age, sex, maturation, NAFLD and HOMA-IR (homeostatic model assessment-insulin resistance). Conclusion Obese children and adolescents, with higher IAAT are more prone to develop MS and NAFLD than those with higher values of SCAT, independent of possible confounding variables. PMID:23919592

  3. Abdominal fat and metabolic risk in obese children and adolescents.

    PubMed

    Revenga-Frauca, J; González-Gil, E M; Bueno-Lozano, G; De Miguel-Etayo, P; Velasco-Martínez, P; Rey-López, J P; Bueno-Lozano, O; Moreno, L A

    2009-12-01

    The aim of this study was to investigate fat distribution, mainly abdominal fat, and its relationship with metabolic risk variables in a group of 126 children and adolescents (60 males and 66 females) aged 5.0 to 14.9. According to IOTF criteria, 46 were classified as normal weight, 28 overweight and 52 obese. Weight, height, waist (WC) and hip circumferences were measured. The body mass index (BMI) was calculated. Total body fat, trunkal and abdominal fat were also assessed by dual energy x-ray absorptiometry (DXA). Glucose, insulin, HDL-Cholesterol, triglycerides (TG), ferritine, homocystein and C-reactive protein (CRP) were measured. Obesity status was related with insulin concentrations, CRP, TG and HDL. Obese patients had higher abdominal fat and higher CRP values than overweight and normal subjects. All markers of central body adiposity were related with insulin and lipid metabolism; however, they were not related with homocystein or ferritin. A simple anthropometric measurement, like waist circumference, seems to be a good predictor of the majority of the obesity related metabolic risk variables. PMID:20358355

  4. Impact of hypertension, overall obesity and abdominal obesity on diabetes incidence in Shanghai residents with different glucose levels.

    PubMed

    Qian, Qiaohui; Li, Xu; Feng, Bo

    2012-06-01

    The impact of hypertension, overall obesity and abdominal obesity, individually or collectively, on diabetes incidence over a period of 5 years in residents with different glucose levels is diverse, with abdominal obesity having an impact in both non-diabetic hyperglycaemia and normal groups.

  5. Effects of supplementation with curcuminoids on dyslipidemia in obese patients: a randomized crossover trial.

    PubMed

    Mohammadi, Akram; Sahebkar, Amirhossein; Iranshahi, Mehrdad; Amini, Maral; Khojasteh, Roshanak; Ghayour-Mobarhan, Majid; Ferns, Gordon A

    2013-03-01

    Dyslipidemia is a leading risk factor for cardiovascular disease and is also a common feature of obesity. Curcumin is a bioactive phytochemical with well-known antioxidant, anti-inflammatory, and cardioprotective properties. The present study investigated the hypolipidemic activity of curcumin in obese individuals. Participants (n = 30) were treated with curcuminoids (1 g/day), or placebo in a randomized, double-blind, placebo-controlled, crossover trial. Serum concentrations of total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, together with anthropometric parameters and high-sensitivity C-reactive protein were measured before and after each treatment period. Anthropometric parameters including weight, BMI, waist circumference, hip circumference, arm circumference, and body fat remained statistically unchanged by the end of trial (p > 0.05). As for the lipid profile parameters, serum triglycerides were significantly reduced following curcumin supplementation (p = 0.009). However, curcuminoids were not found to affect serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein (p > 0.05). In summary, the findings of the present study indicated that curcuminoid supplementation (1 g/day for 30 days) leads to a significant reduction in serum triglycerides concentrations but do not have a significant influence on other lipid profile parameters as well as body mass index and body fat.

  6. The androgen receptor confers protection against diet-induced atherosclerosis, obesity, and dyslipidemia in female mice

    PubMed Central

    Fagman, Johan B.; Wilhelmson, Anna S.; Motta, Benedetta M.; Pirazzi, Carlo; Alexanderson, Camilla; De Gendt, Karel; Verhoeven, Guido; Holmäng, Agneta; Anesten, Fredrik; Jansson, John-Olov; Levin, Malin; Borén, Jan; Ohlsson, Claes; Krettek, Alexandra; Romeo, Stefano; Tivesten, Åsa

    2015-01-01

    Androgens have important cardiometabolic actions in males, but their metabolic role in females is unclear. To determine the physiologic androgen receptor (AR)–dependent actions of androgens on atherogenesis in female mice, we generated female AR-knockout (ARKO) mice on an atherosclerosis-prone apolipoprotein E (apoE)–deficient background. After 8 weeks on a high-fat diet, but not on a normal chow diet, atherosclerosis in aorta was increased in ARKO females (+59% vs. control apoE-deficient mice with intact AR gene). They also displayed increased body weight (+18%), body fat percentage (+62%), and hepatic triglyceride levels, reduced insulin sensitivity, and a marked atherogenic dyslipidemia (serum cholesterol, +52%). Differences in atherosclerosis, body weight, and lipid levels between ARKO and control mice were abolished in mice that were ovariectomized before puberty, consistent with a protective action of ovarian androgens mediated via the AR. Furthermore, the AR agonist dihydrotestosterone reduced atherosclerosis (−41%; thoracic aorta), subcutaneous fat mass (−44%), and cholesterol levels (−35%) in ovariectomized mice, reduced hepatocyte lipid accumulation in hepatoma cells in vitro, and regulated mRNA expression of hepatic genes pivotal for lipid homeostasis. In conclusion, we demonstrate that the AR protects against diet-induced atherosclerosis in female mice and propose that this is mediated by modulation of body composition and lipid metabolism.—Fagman, J. B., Wilhelmson, A. S., Motta, B. M., Pirazzi, C., Alexanderson, C., De Gendt, K., Verhoeven, G., Holmäng, A., Anesten, F., Jansson, J.-O., Levin, M., Borén, J., Ohlsson, C., Krettek, A., Romeo, S., Tivesten, A. The androgen receptor confers protection against diet-induced atherosclerosis, obesity, and dyslipidemia in female mice. PMID:25550469

  7. Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity.

    PubMed

    Assunção, Monica L; Ferreira, Haroldo S; dos Santos, Aldenir F; Cabral, Cyro R; Florêncio, Telma M M T

    2009-07-01

    The effects of dietary supplementation with coconut oil on the biochemical and anthropometric profiles of women presenting waist circumferences (WC) >88 cm (abdominal obesity) were investigated. The randomised, double-blind, clinical trial involved 40 women aged 20-40 years. Groups received daily dietary supplements comprising 30 mL of either soy bean oil (group S; n = 20) or coconut oil (group C; n = 20) over a 12-week period, during which all subjects were instructed to follow a balanced hypocaloric diet and to walk for 50 min per day. Data were collected 1 week before (T1) and 1 week after (T2) dietary intervention. Energy intake and amount of carbohydrate ingested by both groups diminished over the trial, whereas the consumption of protein and fibre increased and lipid ingestion remained unchanged. At T1 there were no differences in biochemical or anthropometric characteristics between the groups, whereas at T2 group C presented a higher level of HDL (48.7 +/- 2.4 vs. 45.00 +/- 5.6; P = 0.01) and a lower LDL:HDL ratio (2.41 +/- 0.8 vs. 3.1 +/- 0.8; P = 0.04). Reductions in BMI were observed in both groups at T2 (P < 0.05), but only group C exhibited a reduction in WC (P = 0.005). Group S presented an increase (P < 0.05) in total cholesterol, LDL and LDL:HDL ratio, whilst HDL diminished (P = 0.03). Such alterations were not observed in group C. It appears that dietetic supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity.

  8. Associations of Obesity and Dyslipidemia with Intake of Sodium, Fat, and Sugar among Koreans: a Qualitative Systematic Review

    PubMed Central

    Wang, Hye Won; Cheon, Se Young; Lee, Hwa Jung; Hwang, Kyung Mi; Yoon, Hae Seong

    2016-01-01

    A qualitative systematic review was performed to identify associations of obesity and dyslipidemia with intake of sodium, fat, and sugar among Koreans. We reviewed 6 Korean research databases (KMbase, KoreaMed, NDSL, DBpia, RISS, KISS) with the keywords “sodium intake,” “fat intake,” and “sugar intake.” Total of 11 studies were investigated in this present study. Of these articles, 7 studies were related to sodium intake, 2 studies had a relation to fat intake, and 2 studies were associated with sugar intake. We indicated general characteristics, concentration of serum lipids, nutrition intake, and statistically significant results. High sodium intake contributed to increased etiology of hypertriglyceridemia, high-density lipoprotein (HDL) hypocholesterolemia, and a risk of being overweight. Fat intake was significantly associated with body fat, low-density lipoprotein (LDL) hypercholesterolemia, and HDL hypocholesterolemia. Sugar intake from coffee drinks and sugar-sweetened beverages contributed to increased HDL hypocholesterolemia and continuous metabolic syndrome score. This qualitative review among Koreans represented that intake of sodium, fat, and sugar has a positive relationship with cause of obesity-related diseases. Especially, this present study has a great significance in terms of considered study that intake of the potentially hazardous nutrients among Koreans has an association with obesity and dyslipidemia. However, further studies such as randomized controlled trials on associations between sodium, fat, and sugar and obesity and dyslipidemia need to be continuously required in order to conduct quantitative systematic reviews and a meta-analysis for Koreans. PMID:27812518

  9. OBESITY AND DYSLIPIDEMIA IN BEHAVIORALLY HIV-INFECTED YOUNG WOMEN: ADOLESCENT TRIALS NETWORK (ATN) STUDY 021

    PubMed Central

    Mulligan, Kathleen; Harris, D. Robert; Monte, Dina; Stoszek, Sonia; Emmanuel, Patricia; Hardin, Dana S.; Kapogiannis, Bill G.; Worrell, Carol; Meyer, William A.; Sleasman, John; Wilson, Craig M.

    2009-01-01

    Background The goal of this study was to determine the nature and prevalence of abnormalities in lipids, glucose metabolism, and body composition in behaviorally HIV-infected young women and their relationship to different classes of antiretroviral therapy (ART) regimens. Methods We conducted a cross-sectional multicenter study in behaviorally infected women ages 12-24 years (HIVpos; N=173) and seronegative controls (HIVneg; N=61). HIVpos women were categorized as ART-naïve (N=85), on a non-nucleoside reverse transcriptase inhibitor-containing regimen (NNRTI; N=33), on a protease inhibitor-containing regimen (PI; N=36), or on a non-NNRTI/non-PI containing regimen (N=19). Measurements included fasting lipids; glucose and insulin before and 2 hours after an oral glucose challenge; high-sensitivity C-reactive protein (hsCRP); anthropometry; fat distribution (dual energy X-ray absorptiometry); and ART and medical histories. Race-adjusted results were compared across groups and within HIVpos groups. Results The median age was 20 (range 14-24) years. 77% of HIVpos were African American, 35% smoked cigarettes, and 32% reported exercising regularly. More than 40% had a BMI ≥25 kg/m2. Triglycerides; total, HDL, and non-HDL cholesterol; and hsCRP differed significantly among groups, with higher levels most common among those on ART. Indices of glucose metabolism did not differ among groups. In general, cholesterol, hsCRP, and indices of glucose metabolism worsened as BMI increased. Conclusions Obesity, dyslipidemia, and inflammation were prominent in HIV-infected adolescent women and, coupled with other risk factors, may accelerate the lifetime risk of cardiovascular disease and other adverse events. These results underscore the need for a multifaceted approach to addressing risk reduction in this population. PMID:19947855

  10. Abdominal obesity is an independent risk factor for increased carotid intima- media thickness in obese children.

    PubMed

    Hacihamdioğlu, Bülent; Okutan, Vedat; Yozgat, Yilmaz; Yildirim, Düzgün; Kocaoğlu, Murat; Lenk, Mustafa Koray; Ozcan, Okan

    2011-01-01

    We aimed in this study to investigate carotid intima-media thickness (IMT) in obese children and evaluate the relationship of IMT to various cardiovascular risk factors. One-hundred four obese children (9.3 +/- 2.5 years) and 30 healthy age-matched control subjects were enrolled in the study. All children were assessed for fasting levels of glucose, insulin, lipid profile, skinfold thickness (SFT), waist circumference (WC), and blood pressure (BP). Insulin resistance was estimated by the homeostasis model assessment (HOMA) index. Carotid IMT measurements and non-alcoholic fatty liver disease (NAFLD) were diagnosed with ultrasonographic findings. IMT was significantly higher in obese children compared to controls (0.49 +/- 0.05 vs. 0.40 +/- 0.02 mm, p < 0.001). Significant positive correlations were found between increased carotid IMT and body fat percentage (BFP), body mass index (BMI), age, height, systolic BP, WC, SFT, triglyceride and insulin levels, and insulin resistance index. In a linear logistic regression analysis, the only parameter affecting the increase in carotid IMT was WC (beta: 0.589, p < 0.001). Furthermore, IMT was increased significantly in obese children with NAFLD when compared to obese children without NAFLD (0.54 +/- 0.04 vs. 0.48 +/- 0.05 mm, p < 0.001). Children with abdominal obesity are at increased risk for atherosclerosis, and WC can be used to determine the atherosclerosis risk in obese children.

  11. Obesity and the Risk for Surgical Site Infection in Abdominal Surgery.

    PubMed

    Winfield, Robert D; Reese, Stacey; Bochicchio, Kelly; Mazuski, John E; Bochicchio, Grant V

    2016-04-01

    Obesity is a risk factor for surgical site infection (SSI) after abdominal procedures; however, data characterizing the risk of SSI in obese patients during abdominal procedures are lacking. We hypothesized that obesity is an independent risk factor for SSI across wound classes. We analyzed American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data for 2011. We calculated body mass index (BMI), classifying patients according to National Institute of Health (NIH) BMI groups. We excluded records in which height/weight was not recorded and patients with BMI less than 18.5. We examined patients undergoing open abdominal procedures, performing univariate and multivariate analyses to assess the relative contribution of obesity to SSI. Study criteria were met by 89,148 patients. Obese and morbidly obese patients had significantly greater SSI rates in clean and clean-contaminated cases but not contaminated or dirty/infected cases. Logistic regression confirmed obesity and morbid obesity as being independently associated with the overall SSI development, specifically in clean [Obesity odds ratio (OR) = 1.757, morbid obesity OR = 2.544, P < 0.001] and clean-contaminated (obesity OR = 1.239, morbid obesity OR = 1.287, P < 0.001) cases. Obesity is associated with increased risk of SSI overall, specifically in clean and clean-contaminated abdominal procedures; this is independent of diabetes mellitus. Novel techniques are needed to reduce SSI in this high-risk patient population.

  12. Obesity-related dyslipidemia associated with FAAH, independent of insulin response, in multigenerational families of Northern European descent

    PubMed Central

    Zhang, Yi; Sonnenberg, Gabriele E; Baye, Tesfaye Mersha; DeLaForest, Jack Ann; MacKinney, Erin; Hillard, Cecilia J; Kissebah, Ahmed H; Olivier, Michael; Wilke, Russell A

    2010-01-01

    A more thorough understanding of the genetic architecture underlying obesity-related lipid disorders could someday facilitate cardiometabolic risk reduction through early clinical intervention based upon improved characterization of individual risk. In recent years, there has been tremendous interest in understanding the endocannabinoid system as a novel therapeutic target for the treatment of obesity-related dyslipidemia. Aims N-arachidonylethanolamine activates G-protein-coupled receptors within the endocannabinoid system. Fatty acid amide hydrolase (FAAH) is a primary catabolic regulator of N-acylethanolamines, including arachidonylethanolamine. Genetic variants in FAAH have inconsistently been associated with obesity. It is conceivable that genetic variability in FAAH directly influences lipid homeostasis. The current study characterizes the relationship between FAAH and obesity-related dyslipidemia, in one of the most rigorously-phenotyped obesity study cohorts in the USA. Materials & methods Members of 261 extended families (pedigrees ranging from 4 to 14 individuals) were genotyped using haplotype tagging SNPs obtained for the FAAH locus, including 5 kb upstream and 5 kb downstream. Each SNP was tested for basic obesity-related phenotypes (BMI, waist and hip circumference, waist:hip ratio, fasting glucose, fasting insulin and fasting lipid levels) in 1644 individuals within these 261 families. Each SNP was also tested for association with insulin responsiveness using data obtained from a frequently sampled intravenous glucose tolerance test in 399 individuals (32 extended families). Results A well characterized coding SNP in FAAH (rs324420) was associated with increased BMI, increased triglycerides, and reduced levels of high-density lipoprotein cholesterol. Mean (standard deviation) high-density lipoprotein cholesterol level was 40.5 (14.7) mg/dl for major allele homozygotes, 39.1 (10.4) mg/dl for heterozygotes, and 34.8 (8.1) mg/dl for minor allele

  13. Body Mass Index Is Better than Other Anthropometric Indices for Identifying Dyslipidemia in Chinese Children with Obesity

    PubMed Central

    Jing, Jin; Ma, Jun; Chen, Yajun; Li, Xiuhong; Yang, Wenhan; Guo, Li; Jin, Yu

    2016-01-01

    Background Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used in screening and predicting obesity in adults. However, the best identifier of metabolic complications in children with obesity remains unclear. This study evaluated lipid profile distribution and investigated the best anthropometric parameter in association with lipid disorders in children with obesity. Methods A total of 2243 school children aged 7–17 years were enrolled in Guangzhou, China, in 2014. The anthropometric indices and lipid profiles were measured. Dyslipidemia was defined according to the US Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. The association between anthropometry (BMI, WC, and WHR) and lipid profile values was examined using chi-square analysis and discriminant function analysis. Information about demography, physical activity, and dietary intake was provided by the participant children and their parents. Results Children aged 10–14 and 15–17 years old generally had higher triglyceride values but lower median concentration of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol compared with children aged 7–9 years old (all P < 0.001). These lipid parameters fluctuated in children aged 10–14 years old. The combination of age groups, BMI, WC and WHR achieved 65.1% accuracy in determining dyslipidemic disorders. BMI correctly identified 77% of the total dyslipidemic disorders in obese children, which was higher than that by WHR (70.8%) (P< 0.05). Conclusion The distribution of lipid profiles in Chinese children differed between younger and older age groups, and the tendency of these lipid levels remarkably fluctuated during 10 to 14 years old. BMI had better practical utility in identifying dyslipidemia among school-aged children with obesity compared with other anthropometric measures. PMID:26963377

  14. Educational inequality in the occurrence of abdominal obesity: Pró-Saúde Study

    PubMed Central

    Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

    2015-01-01

    OBJECTIVE To estimate the degree of educational inequality in the occurrence of abdominal obesity in a population of non-faculty civil servants at university campi. METHODS In this cross-sectional study, we used data from 3,117 subjects of both genders aged 24 to 65-years old, regarding the baseline of Pró-Saúde Study, 1999-2001. Abdominal obesity was defined according to abdominal circumference thresholds of 88 cm for women and 102 cm for men. A multi-dimensional, self-administered questionnaire was used to evaluate education levels and demographic variables. Slope and relative indices of inequality, and Chi-squared test for linear trend were used in the data analysis. All analyses were stratified by genders, and the indices of inequality were standardized by age. RESULTS Abdominal obesity was the most prevalent among women (43.5%; 95%CI 41.2;45.9), as compared to men (24.3%; 95%CI 22.1;26.7), in all educational strata and age ranges. The association between education levels and abdominal obesity was an inverse one among women (p < 0.001); it was not statistically significant among men (p = 0.436). The educational inequality regarding abdominal obesity in the female population, in absolute terms (slope index of inequality), was 24.0% (95%CI 15.5;32.6). In relative terms (relative index of inequality), it was 2.8 (95%CI 1.9;4.1), after the age adjustment. CONCLUSIONS Gender inequality in the prevalence of abdominal obesity increases with older age and lower education. The slope and relative indices of inequality summarize the strictly monotonous trend between education levels and abdominal obesity, and it described educational inequality regarding abdominal obesity among women. Such indices provide relevant quantitative estimates for monitoring abdominal obesity and dealing with health inequalities. PMID:26465669

  15. [Overweight and abdominal obesity in adults in aquilombocommunity in Bahia State, Brazil].

    PubMed

    Soares, Daniela Arruda; Barreto, Sandhi Maria

    2014-02-01

    This study analyzes nutritional status, estimates the prevalence of overweight and abdominal obesity, and investigates factors associated with these outcomes in a two-stage random sample of adults (> 20 years) in quilombos (communities that descend from African slaves) in Vitória da Conquista, Bahia State, Brazil, in 2011. Among 739 participants, prevalence rates were 31.8% and 10.2% for overweight and obesity, respectively, and 55.7% for increased waist-to-height ratio (> 0.50). Prevalence of overweight was higher among 30-39-year-olds, while abdominal obesity was more frequent among older individuals. Female sex, eating chicken or beef with untrimmed fat, and hypertension were associated with higher odds of overweight and abdominal obesity, while smoking and single marital status were associated with lower odds. The results show high prevalence rates for overweight and abdominal obesity in these very poor and socially isolated communities. Specific preventive and control measures are urgently needed.

  16. Distribution of abdominal obesity and fitness level in overweight and obese korean adults.

    PubMed

    Kim, Sue; Kim, Ji-Young; Lee, Duk-Chul; Lee, Hye-Sun; Lee, Ji-Won; Jeon, Justin Y

    2014-01-01

    Background. Abdominal obesity and its relative distribution are known to differ in association with metabolic characteristics and cardiorespiratory fitness. This study aimed to determine an association between fitness level and abdominal adiposity in overweight and obese adults. Methods. 228 overweight and obese individuals were classified as either cardiorespiratory unfit or fit based on their recovery heart rate. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), the visceral-to-subcutaneous adipose tissue ratio (VAT/SAT ratio), and cardiometabolic characteristics were analyzed to examine the relationship between recovery heart rate and abdominal adiposity components. Results. After adjustments for age and sex, significant relationships of recovery heart rate and VAT, SAT, and VAT/SAT ratio were found; however, SAT was not significantly associated after further adjustment for body mass index (BMI) (r = 0.045, P = 0.499), whereas VAT (r = 0.232, P < 0.001) and VAT/SAT ratio (r = 0.214, P = 0.001) remained associated. Through stepwise multiple regression analyses after adjustment for age, sex, BMI, lifestyle factors, mean blood pressure, fasting glucose, HOMA-IR, lipid profiles, and hsCRP, recovery heart rate was identified as an independent variable associated with VAT (β = 0.204, P < 0.001) and VAT/SAT ratio (β = 0.163, P = 0.008) but not with SAT (β = 0.097, P = 0.111). Conclusions. Cardiorespiratory fitness level is independently associated with VAT and the VAT/SAT ratio but not with SAT in overweight and obese adults. PMID:24723950

  17. Impact of obesity on recovery and pulmonary functions of obese women undergoing major abdominal gynecological surgeries.

    PubMed

    Moustafa, Ahmed A M; Abdelazim, Ibrahim A

    2016-06-01

    To determine impact of obesity on recovery parameters and pulmonary functions of women undergoing major abdominal gynecological surgeries. Eighty women undergoing major gynecological surgeries were included in this study. Anesthesia was induced by remifentanil bolus, followed by propofol and cisatracurium to facilitate oro-tracheal intubation and was maintained by balanced anesthesia of remifentanil intravenous infusion and sevoflurane in oxygen and air. Time from discontinuation of maintenance anesthesia to fully awake were recorded at 1-min intervals and time from discontinuation of anesthesia until patient was transferred to post-anesthesia care unit (PACU) and discharged from PACU was also recorded. Pulmonary function tests were performed before surgery and repeated 4 h, days 1, 2 and 3 post-operative for evaluation of forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate. Occurrence of post-operative complications, re-admission to ICU, hospital stay and morbidities were also recorded. Induction of anesthesia using remifentanil bolus injection resulted in significant decrease of heart rate and arterial pressures compared to pre-operative and pre-induction values. Recovery times were significantly shorter in obese compared to morbidly obese women. Post-operative pulmonary function tests showed significant deterioration compared to pre-operative measures but showed progressive improvement through first 3 post-operative days. Hospital stay was significantly shorter for obese compared to morbid obese women. Obesity delays recovery from general anesthesia, adversely affects pulmonary functions and increases post-operative complications. Remifentanil infusion and sevoflurane could be appropriate combination for obese and morbidly obese women undergoing major surgeries.

  18. Relationship between overall and abdominal obesity and periodontal disease among young adults.

    PubMed

    Amin, H El-Sayed

    2010-04-01

    To assess overall and abdominal obesity and their relation to periodontal disease among young adults, body mass index (BMI) and waist circumference (WC) were measured and clinical attachment loss (CAL), gingival index (GI) and Community Periodontal Index (CPI) were estimated. The sample comprised 380 adults (170 males and 210 females) aged 20-26 years. There was a significant correlation between both BMI and WC and CAL, GI and CPI in females. In males, a significant correlation was only recorded between WC and GI and CPI. Overall and abdominal obesity in young adult females and abdominal obesity in males were significantly associated with periodontal disease. PMID:20795429

  19. Obese Mexican American children have elevated MCP-1, TNF-alpha, monocyte concentration, and dyslipidemia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Obesity is an independent risk factor for chronic disease. The prevalence of obesity is especially high among Mexican American children. Peripheral blood monocytes are altered with obesity contributing to elevated systemic inflammation and increased risk of chronic disease. In addition, obesity alte...

  20. Obesity and Its Metabolic Complications: The Role of Adipokines and the Relationship between Obesity, Inflammation, Insulin Resistance, Dyslipidemia and Nonalcoholic Fatty Liver Disease

    PubMed Central

    Jung, Un Ju; Choi, Myung-Sook

    2014-01-01

    Accumulating evidence indicates that obesity is closely associated with an increased risk of metabolic diseases such as insulin resistance, type 2 diabetes, dyslipidemia and nonalcoholic fatty liver disease. Obesity results from an imbalance between food intake and energy expenditure, which leads to an excessive accumulation of adipose tissue. Adipose tissue is now recognized not only as a main site of storage of excess energy derived from food intake but also as an endocrine organ. The expansion of adipose tissue produces a number of bioactive substances, known as adipocytokines or adipokines, which trigger chronic low-grade inflammation and interact with a range of processes in many different organs. Although the precise mechanisms are still unclear, dysregulated production or secretion of these adipokines caused by excess adipose tissue and adipose tissue dysfunction can contribute to the development of obesity-related metabolic diseases. In this review, we focus on the role of several adipokines associated with obesity and the potential impact on obesity-related metabolic diseases. Multiple lines evidence provides valuable insights into the roles of adipokines in the development of obesity and its metabolic complications. Further research is still required to fully understand the mechanisms underlying the metabolic actions of a few newly identified adipokines. PMID:24733068

  1. Abdominal obesity and chronic stress interact to predict blunted cardiovascular reactivity.

    PubMed

    Singh, Kulwinder; Shen, Biing-Jiun

    2013-10-01

    Abdominal obesity and chronic stress have independent effects on cardiac autonomic regulation, and may also interact to influence cardiovascular reactivity. In addition to main effects, we hypothesized that abdominal obesity and chronic stress would interact and predict blunted cardiovascular reactivity. One hundred and twenty-two undergraduate students engaged in two stressful laboratory tasks while cardiovascular activity was assessed. Results indicated that higher abdominal obesity significantly predicted blunted systolic blood pressure (SBP) and mean arterial pressure (MAP) change, while chronic stress was not directly associated with any measure of cardiovascular reactivity. Furthermore, there was a significant interaction between abdominal obesity and chronic stress on SBP and MAP change such that among participants with higher chronic stress, higher abdominal obesity was significantly associated with reduced SBP and MAP reactivity. In addition, body-mass index (BMI), a measure of overall obesity, also had both main and interaction effects with chronic stress to predict blunted cardiovascular reactivity. These results suggest that abdominally obese individuals may incur difficulty in mounting appropriately-sized cardiovascular responses during acute stress, particularly when under high levels of chronic stress.

  2. Duration of Abdominal Obesity Beginning in Young Adulthood and Incident Diabetes Through Middle Age

    PubMed Central

    Reis, Jared P.; Hankinson, Arlene L.; Loria, Catherine M.; Lewis, Cora E.; Powell-Wiley, Tiffany; Wei, Gina S.; Liu, Kiang

    2013-01-01

    OBJECTIVE To examine whether the duration of abdominal obesity determined prospectively using measured waist circumference (WC) is associated with the development of new-onset diabetes independent of the degree of abdominal adiposity. RESEARCH DESIGN AND METHODS The Coronary Artery Risk Development in Young Adults Study is a multicenter, community-based, longitudinal cohort study of 5,115 white and black adults aged 18–30 years in 1985 to 1986. Years spent abdominally obese were calculated for participants without abdominal obesity (WC >102 cm in men and >88 cm in women) or diabetes at baseline (n = 4,092) and was based upon repeat measurements conducted 2, 5, 7, 10, 15, 20, and 25 years later. RESULTS Over 25 years, 392 participants developed incident diabetes. Overall, following adjustment for demographics, family history of diabetes, study center, and time varying WC, energy intake, physical activity, smoking, and alcohol, each additional year of abdominal obesity was associated with a 4% higher risk of developing diabetes [hazard ratio (HR) 1.04 (95% CI 1.02–1.07)]. However, a quadratic model best represented the data. HRs for 0, 1–5, 6–10, 11–15, 16–20, and >20 years of abdominal obesity were 1.00 (referent), 2.06 (1.43–2.98), 3.45 (2.28–5.22), 3.43 (2.28–5.22), 2.80 (1.73–4.54), and 2.91 (1.60–5.29), respectively; P-quadratic < 0.001. CONCLUSIONS Longer duration of abdominal obesity was associated with substantially higher risk for diabetes independent of the degree of abdominal adiposity. Preventing or at least delaying the onset of abdominal obesity in young adulthood may lower the risk of developing diabetes through middle age. PMID:23248193

  3. Alveolar recruitment maneuver and perioperative ventilatory support in obese patients undergoing abdominal surgery

    PubMed Central

    Forgiarini Júnior, Luiz Alberto; Rezende, Juliana Castilhos; Forgiarini, Soraia Genebra Ibrahim

    2013-01-01

    The development of abdominal surgery represents an alternative therapy for the morbidly obese; however, patients undergoing this surgical procedure often experience postoperative pulmonary complications. The use of alveolar recruitment maneuvers and/or perioperative ventilatory strategies is a possible alternative to reduce these complications, focusing on the reduction of postoperative pulmonary complications. In this review, the benefits of perioperative ventilatory strategies and the implementation of alveolar recruitment maneuvers in obese patients undergoing abdominal surgery are described. PMID:24553513

  4. Abdominal Obesity Indicators: Waist Circumference or Waist-to-hip Ratio in Malaysian Adults Population

    PubMed Central

    Ahmad, Norfazilah; Adam, Samia Ibrahim Mohamed; Nawi, Azmawati Mohammed; Hassan, Mohd Rohaizat; Ghazi, Hasanain Faisal

    2016-01-01

    Background: Waist circumference (WC) is an accurate and simple measure of abdominal obesity as compared to waist–hip ratio (WHR). The aim of this study was to determine the correlation between body mass index (BMI) with WC and WHR and suggest cutoff points for WC among Rural Malaysian adults. Methods: A cross-sectional study was conducted among 669 respondents from three villages in Tanjung Karang, located in the district of Kuala Selangor. Data collection was carried out by guided questionnaires and anthropometric measures. Results: The prevalence of abdominal obesity for BMI was almost similar for both gender across Caucasian and Asian BMI cutoff points. Based on Caucasian cutoff points, the prevalence of abdominal obesity for WC was 23.8% (male) and 66.4% (female) while for WHR was 6.2% (male) and 54.2% (female). Asian cutoff points gave higher prevalence of abdominal obesity compared to that of WC among male respondents and WHR for both genders. WC showed strong and positive correlation with BMI compared to WHR (in male WC r = 0.78, WHR r = 0.24 and in female WC r = 0.72, WHR r = 0.19; P < 0.001). Receiver operating characteristic curve analysis suggested WC cutoff points of 92.5 cm in men and 85.5 cm in women is the optimal number for detection of abdominal obesity. Conclusions: WC is the best indicator as compared with WHR for abdominal obesity for Malaysian adults. PMID:27330688

  5. Fenugreek seed extract inhibit fat accumulation and ameliorates dyslipidemia in high fat diet-induced obese rats.

    PubMed

    Kumar, Parveen; Bhandari, Uma; Jamadagni, Shrirang

    2014-01-01

    This study investigated the inhibitory effect of aqueous extract of Trigonella foenum-graecum seeds (AqE-TFG) on fat accumulation and dyslipidemia in high fat diet- (HFD-) induced obese rats. Female Wistar rats were fed with HFD ad libitum, and the rats on HFD were treated orally with AqE-TFG or orlistat ((HFD for 28 days+AqE-TFG (0.5 and 1.0 g/kg) or orlistat (10 mg/kg) from day 8 to 28), respectively. Treatment with AqE-TFG produced significant reduction in body weight gain, body mass index (BMI), white adipose tissue (WAT) weights, blood glucose, serum insulin, lipids, leptin, lipase, and apolipoprotein-B levels and elevation in adiponectin levels. AqE-TFG improved serum aspartate amino transferase (AST), alanine amino transferase (ALT), and lactate dehydrogenase (LDH) levels. AqE-TFG treatment reduced the hepatic and cardiac thiobarbituric acid reactive substances (TBARS) and elevated the antioxidant enzyme (glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT)) levels. In addition, liver and uterine WAT lipogenic enzyme (fatty acid synthetase (FAS) and glucose-6-phosphate dehydrogenase (G6PD)) activities were restored towards normal levels. These findings demonstrated the preventive effect of AqE-TFG on fat accumulation and dyslipidemia, due to inhibition of impaired lipid digestion and absorption, in addition to improvement in glucose and lipid metabolism, enhancement of insulin sensitivity, increased antioxidant defense, and downregulation of lipogenic enzymes. PMID:24868532

  6. RISK FACTORS FOR ABDOMINAL OBESITY IN CHILDREN AND ADOLESCENTS FROM CRACOW, POLAND (1983-2000).

    PubMed

    Suder, Agnieszka; Chrzanowska, Maria

    2015-03-01

    The aim of this study was to determine abdominal obesity risk factors in two successive cohorts of children and adolescents aged 4-18 from Cracow, Poland, examined during the years of political transformation. The influence of biological, socio-demographic and lifestyle factors on abdominal obesity was analysed by calculating odds ratios and 95% confidence intervals using logistic regression analysis. It was found that for girls obesity in both parents (OR=4.31; 95% CI 1.73-20.70) and high birth weight (OR=1.78; 95% CI 1.12-2.82) were significant risk factors for abdominal obesity in the 1983 cohort. In the 2000 cohort obesity in both parents for boys and girls (boys: OR=5.85; 95% CI 1.36-25.10; girls: OR=4.82; 95% CI 1.17-19.77), low level of parental education in girls (OR=2.06; 95% CI 1.15-3.69), having only one son (OR=1.96; 95% CI 1.36-3.40), parents' smoking habits in girls (OR=2.94; 95% CI 1.46-5.91) and lack of undertaking physical activity in sport clubs in boys (OR=6.11; 95% CI 1.46-25.47) were significant abdominal obesity risk factors. Higher number of hours of leisure time physical activity (OR=0.89; 95% CI 0.81-0.97) significantly lowered the risk of abdominal obesity in boys in the 2000 cohort. The greater differentiation of abdominal obesity risk factors in the 2000 cohort in comparison to the 1983 cohort may have resulted from the social and economic changes taking place in Poland at the end of the 20th century.

  7. Abdominal Obesity, Race and Chronic Kidney Disease in Young Adults: Results from NHANES 1999-2010

    PubMed Central

    Sarathy, Harini; Henriquez, Gabriela; Abramowitz, Matthew K.; Kramer, Holly; Rosas, Sylvia E.; Johns, Tanya; Kumar, Juhi; Skversky, Amy; Kaskel, Frederick; Melamed, Michal L.

    2016-01-01

    Objective Kidney dysfunction in obesity may be independent of and may precede the development of hypertension and/or diabetes mellitus. We aimed to examine if abdominal obesity is associated with early markers of CKD in a young healthy population and whether these associations differ by race and/or ethnicity. Methods We analyzed data from the NHANES 1999–2010 for 6918 young adults ages 20–40 years. Abdominal obesity was defined by gender criteria of waist circumference. CKD markers included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Race stratified analyses were done overall and in subgroups with normal blood pressures, normoglycemia and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria. Results Abdominal obesity was present in over one-third of all young adults and was more prevalent among non-Hispanic blacks (45.4%) versus Mexican-Americans (40.6%) or non-Hispanic whites (37.4%) (P-value = 0.004). Mexican-American young adults with abdominal obesity had a higher odds of albuminuria even among those with normal blood pressure, normal glucose, and normal insulin sensitivity [adjusted odds ratio 4.5; 95% confidence interval (1.6–12.2), p = 0.004]. Less than 5% of young adults with albuminuria of all races and ethnicities had been told they had kidney disease. Conclusion Abdominal obesity in young adults, especially in Mexican-Americans, is independently associated with albuminuria even with normal blood pressures, normoglycemia and normal insulin levels. Greater awareness of CKD is needed to protect this young population from long-standing exposure to abdominal obesity and early progressive renal disease. PMID:27224643

  8. The Impact of Abdominal Obesity Status on Cardiovascular Response to the Mediterranean Diet

    PubMed Central

    Bédard, Alexandra; Dodin, Sylvie; Corneau, Louise; Lemieux, Simone

    2012-01-01

    We investigated the impact of abdominal obesity status on the cardiovascular response to a fully controlled 4-week isoenergetic Mediterranean diet (MedDiet). Thirty-eight abdominally obese individuals (waist circumference >102 cm in men and >88 cm in women) and thirty-one nonabdominally obese individuals were recruited and studied before and after the MedDiet. All analyses were adjusted for the slight decrease in body weight, which occurred during the MedDiet (mean: 0.9 ± 1.2 kg). A group by time interaction was noted for waist circumference (P = 0.02), abdominally obese subjects showing a significant decrease and nonabdominally obese subjects a nonsignificant increase (resp., −1.1 and +0.3%). The MedDiet resulted in decreases in total cholesterol, LDL-C, HDL-C, apolipoprotein B, A-1, and A-2, total cholesterol/HDL-C ratio, LDL-C/HDL-C ratio, and systolic and diastolic blood pressure (time effect: P < 0.05). For all variables related to glucose/insulin homeostasis, no change was observed except for a decrease in 2 h glucose concentrations (time effect: P = 0.03). No group by time interaction was observed in any of the metabolic variables studied. Results from our study suggest that the adoption of the MedDiet leads to beneficial metabolic effects, irrespective of the abdominal obesity status. PMID:23133745

  9. Association between meal intake behaviour and abdominal obesity in Spanish adults.

    PubMed

    Keller, Kristin; Rodríguez López, Santiago; Carmenate Moreno, Margarita M

    2015-09-01

    The study aims to evaluate the association between abdominal obesity with meal intake behaviour such as having a forenoon meal, having an afternoon meal and snacking. This cross-sectional study includes n = 1314 participants aged 20-79 who were interviewed during the Cardiac health "Semanas del Corazon" events in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Waist circumference, weight and height were assessed to determine abdominal obesity (waist circumference: ≥88 cm in women and ≥102 cm in men) and BMI, respectively. The intake of forenoon and afternoon meal and snacking between the participants' regular meals were assessed with a questionnaire that also included individual risk factors. The information obtained about diet was required to calculate an Unhealthy Habit Score and a score reflecting the Achievement of Dietary Guidelines. Adjusted logistic regressions were used to examine the association between abdominal obesity and the mentioned meal intake behaviour controlling for sex, age, individual risk factors, BMI and diet. Having an afternoon meal (OR 0.60; 95% CI (0.41-0.88)) was negatively associated with abdominal obesity after adjusting for all confounders, whereas the positive association of snacking (OR 1.39; 95% CI (1.05-1.85)) was not independent of BMI (OR 1.25; 95% CI (0.84-1.87)). Taking a forenoon meal did not show any associations (OR 0.92; 95% CI (0.63-1.34)) with abdominal obesity. The results obtained could be helpful in the promotion of healthy habits in nutritional education programmes and also in health programmes preventing abdominal obesity.

  10. The prevalence of hypertension, obesity and dyslipidemia in individuals of over 30 years of age belonging to minorities from the pasture area of Xinjiang

    PubMed Central

    2010-01-01

    Background The prevalence of population-wide hypertension, obesity and dyslipidemia has not been well studied in the pasture area of Xinjiang. The present epidemiological study was performed to determine the prevalence of hypertension, obesity and dyslipidemia in minority populations from the pasture area of Xinjiang and to discuss the potential risk factors for hypertension. Methods A population-based, cross-sectional study in the Xinjiang pasture area was performed which included 2251 participants aged over 30 years (90.33% participation rate) of whom 71.26% were Kazaks. Several risk factors were considered: hypertension (defined as systolic or diastolic blood pressure or both of at least 140/90 mmHg measured on one occasion or treatment for hypertension) overweight/obesity (body mass index ≥ 25 kg/m2) alcohol intake, smoking/tobacco use and dyslipidemia. Outcomes were prevalence of hypertension, obesity and dyslipidemia and the associated risk factors of hypertension detected by multivariate logistic regression analysis taking into account various metabolic and lifestyle characteristics. Results The prevalence of hypertension, overweight/obesity and dyslipidemia in all participants from the pasture area of Xinjiang was 51.9%, 47.9% and 49.2% respectively. Independently, the prevalence and awareness of hypertension was 52.6% and 15.3% among Kazaks (n = 1604), 54.6% and 14.1% among Uygurs (n = 418), 39.5% and 16.1% among Mongolians (n = 81) and 43.9% and 18.2% among non-Xinjiang-born Han immigrants (n = 148). The prevalence of overweight/obesity in Kazaks, Uygurs, Mongolians and Han immigrants was 46.7%, 48.9%, 62.5% and 50.3%, respectively. The prevalence of dyslipidemia in the four ethnic groups mentioned was 53.5%, 34.8%, 49.3% and 47.3%, respectively. The mean blood pressure in all participants was 136/86 mmHg (pre-hypertensive), the mean BMI was 24.7 kg/m2. Based on multiple logistic regression analysis, the significant risk factors for hypertension were

  11. The relationships between intra-abdominal echogenicity, cardiometabolic risk factors and physical performance in obese children.

    PubMed

    Yoo, Ji Won; Lee, Nam-Gi; Kim, Hee-Jung; Cho, Hyo-Min; You, Joshua H

    2014-01-01

    While the abdominal adipose tissue has been identified as an important pathomarker for the cardiometabolic syndrome in adults, the relationships between the cardiometabolic risk factors and abdominal adipose morphology or physical performance levels have not been examined in children with obesity. Therefore, the specific aim of this study was to investigate the relationships between risk factors (BMI and physical activity levels and abdominal fat layers including subcutaneous, intra-abdominal preperitoneal and mesenteric fat thickness in children with obesity. 30 children with obesity (mean ± SD = 10.0 ± 4.5 yrs; 9 girls; BMI > 20) underwent physical performance (curl-ups, sit and reach, push-ups, and a 400-m run), ultrasound measurement of thickness of fat composition of the abdomen, blood pressure, oxygen consumption. Pearson correlation analysis showed significant correlations, ranging from -0.523- 0.898 between the intra-abdominal adipose tissue thickness, cardiometabolic risk factors (BMI, blood pressure, heart rate), and the curl-up physical performance test. In conclusion, the present study provides a compelling evidence that the intra-abdominal adipose tissue morphological characteristics were associated with BMI, physical performance, and most importantly cardiometabolic risk factors (blood pressure and heart rate), which eventually contribute to the development of cardiometabolic syndrome in adulthood.

  12. [Rational therapy of patients with essential hypertension and abdominal obesity with concomitant subclinical hypothyroidism].

    PubMed

    Pligovka, V M

    2014-11-01

    It was determined the characteristics of lipid status of patients with essential hypertension, abdominal obesity with concomitant subclinical hypothyroidism--mostly increased levels of total and LDL cholesterol. In assessing the effectiveness of statin therapy in combination with levothyroxine replacement therapy compared with statin monotherapy, combination therapy showed the best result in terms of achievement of target levels of both total cholesterol and LDL. The obtained results allow us to recommend the use of combination therapy for patients with hypertension, abdominal obesity with concomitant subclinical hypothyroidism in order to achieve the target values of LDL and thus to reduce the cardiovascular risk of these patients.

  13. Increased hepatic CD36 expression contributes to dyslipidemia associated with diet-induced obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The etiology of type 2 diabetes often involves diet-induced obesity (DIO), which is associated with elevated plasma fatty acids and lipoprotein associated triglycerides. Since aberrant hepatic fatty acid uptake may contribute to this, we investigated whether increased expression of a fatty acid tran...

  14. Abdominal wall pain in obese women: frequently missed and easily treated

    PubMed Central

    Mishriki, Yehia Yousri

    2009-01-01

    Chronic abdominal pain is a common symptom with an extensive differential diagnosis. The work-up is frequently costly, yet many patients elude definitive diagnosis. We describe 12 obese women with long-standing abdominal pain, many of whom eluded diagnosis but who met criteria for abdominal wall pain. Each patient underwent a focused history and physical examination which included checking for Carnett’s sign and performing a “pinch test”. All patients had positive Carnett’s sign and pinch tests. An injection of local anaesthetic, with or without corticosteroid, completely relieved the pain within 10 min. Of the six patients seen in follow-up, four remained pain free and two responded to a second injection of local anaesthetic. Abdominal wall pain is an under-appreciated cause of chronic abdominal pain. Diagnosis is often straightforward and treatment with a local injection of anaesthetic is both diagnostic and curative. PMID:21686788

  15. Beneficial effects of Ginkgo biloba extract on insulin signaling cascade, dyslipidemia, and body adiposity of diet-induced obese rats.

    PubMed

    Banin, R M; Hirata, B K S; Andrade, I S; Zemdegs, J C S; Clemente, A P G; Dornellas, A P S; Boldarine, V T; Estadella, D; Albuquerque, K T; Oyama, L M; Ribeiro, E B; Telles, M M

    2014-09-01

    Ginkgo biloba extract (GbE) has been indicated as an efficient medicine for the treatment of diabetes mellitus type 2. It remains unclear if its effects are due to an improvement of the insulin signaling cascade, especially in obese subjects. The aim of the present study was to evaluate the effect of GbE on insulin tolerance, food intake, body adiposity, lipid profile, fasting insulin, and muscle levels of insulin receptor substrate 1 (IRS-1), protein tyrosine phosphatase 1B (PTP-1B), and protein kinase B (Akt), as well as Akt phosphorylation, in diet-induced obese rats. Rats were fed with a high-fat diet (HFD) or a normal fat diet (NFD) for 8 weeks. After that, the HFD group was divided into two groups: rats gavaged with a saline vehicle (HFD+V), and rats gavaged with 500 mg/kg of GbE diluted in the saline vehicle (HFD+Gb). NFD rats were gavaged with the saline vehicle only. At the end of the treatment, the rats were anesthetized, insulin was injected into the portal vein, and after 90s, the gastrocnemius muscle was removed. The quantification of IRS-1, Akt, and Akt phosphorylation was performed using Western blotting. Serum levels of fasting insulin and glucose, triacylglycerols and total cholesterol, and LDL and HDL fractions were measured. An insulin tolerance test was also performed. Ingestion of a hyperlipidic diet promoted loss of insulin sensitivity and also resulted in a significant increase in body adiposity, plasma triacylglycerol, and glucose levels. In addition, GbE treatment significantly reduced food intake and body adiposity while it protected against hyperglycemia and dyslipidemia in diet-induced obesity rats. It also enhanced insulin sensitivity in comparison to HFD+V rats, while it restored insulin-induced Akt phosphorylation, increased IRS-1, and reduced PTP-1B levels in gastrocnemius muscle. The present findings suggest that G. biloba might be efficient in preventing and treating obesity-induced insulin signaling impairment.

  16. Excess weight and abdominal obesity in postmenopausal Brazilian women: a population-based study

    PubMed Central

    2013-01-01

    Background The menopause is associated with a tendency to gain weight. Several alterations in fat deposits occur, leading to changes in the distribution of body fat. There are strong indications that, in middle age, obesity is associated with increased mortality. This study set out to determine the factors associated with the prevalence of overweight and abdominal obesity in postmenopausal women in a population-based study in Brazil. Methods The sample included 456 women, aged 45–69 years, residing in the urban area of Maringa, Parana. Systematic sampling, with a probability proportional to the size of the census sector, was performed. Behavioral, economic, and sociodemographic data were collected, and body mass index (BMI) and waist circumference (WC) were determined. Results According to BMI criteria (≥25.0 kg/m2), 72.6% of the women were overweight, and according to WC (≥88 cm), 63.6% had abdominal obesity. Based on logistic regression analysis, the factors that were most closely associated with overweight were: having three or more children (odds ratio (OR): 1.78; 95% confidence interval (CI): 1.06–3.00); and not taking hormone replacement therapy (OR: 1.69; 95% CI: 1.06–2.63). The prevalence of abdominal obesity was positively associated with greater parity (OR: 1.34, 95% CI: 1.05–1.72) and age older than 65 years (OR: 1.50; 95% CI: 1.03–2.19). Conclusions This study found that the prevalences of overweight and abdominal obesity were higher for postmenopausal women who had three or more children. Age over 65 years was also a risk factor for abdominal obesity and no use of hormonal replacement therapy was a risk factor for overweight. PMID:24228934

  17. Associations of breaks in sedentary time with abdominal obesity in Portuguese older adults.

    PubMed

    Júdice, Pedro B; Silva, Analiza M; Santos, Diana A; Baptista, Fátima; Sardinha, Luís B

    2015-01-01

    In older adults, sedentary time is positively associated with obesity. The manner in which it is accumulated, i.e., the number of breaks in sedentary time, might be also important. We examined the cross-sectional associations of breaks in sedentary time with abdominal obesity in 301 older adults (111 men and 190 women) aged 75.0 ± 6.8 years. Sedentary time (counts min(-1) < 100) and physical activity were objectively measured by accelerometry, worn during waking hours for at least three consecutive days. A break was defined as an interruption (≥ 100 counts min(-1) < 2020) in sedentary time while performing light intensity physical activities. Sedentary time was expressed as the number of daily breaks in sedentary time or hourly breaks in sedentary time. Abdominal obesity was defined by waist circumference (men >102 cm; women >88 cm). Using binary logistic regression analyses, the odds for abdominal obesity decreased 7 % for each additional hourly break in sedentary time in women (OR = 0.93, 95 % CI: 0.87-1.00), but not men, independently of total sedentary time and moderate-to-vigorous physical activity. The odds for abdominal obesity were 3.21 times higher (p = 0.039) for women in quartile 1 (<225 breaks day(-1)) of daily breaks in sedentary time compared to those in quartile 4 (>353 breaks day(-1)) of daily breaks in sedentary time.These findings indicate that older women who interrupt their sedentary time more frequently are less likely to present abdominal obesity. Public health recommendations regarding breaking-up sedentary time complementary to those for physical activity are likely to be relevant.

  18. Abdominal obesity: a marker of ectopic fat accumulation.

    PubMed

    Smith, Ulf

    2015-05-01

    In the early 1980s, we analyzed the metabolic profile of 930 men and women and concluded that an abdominal distribution of fat for a given BMI is associated with increased insulin resistance and risk of developing type 2 diabetes and cardiovascular disease. The correlation between abdominal fat and metabolic dysfunction has since been validated in many studies, and waist circumference is now a criterion for the diagnosis of metabolic syndrome. Several mechanisms for this relationship have been postulated; however, we now know that visceral fat is only one of many ectopic fat depots used when the subcutaneous adipose tissue cannot accommodate excess fat because of its limited expandability.

  19. Abdominal Obesity and Insulin Resistance in People Exposed to Moderate-to-High Levels of Dioxin

    PubMed Central

    Chang, Jung-Wei; Chen, Hsiu-Ling; Su, Huey-Jen; Lee, Ching-Chang

    2016-01-01

    Obesity, a risk factor for developing metabolic complications, is a major public health problem. Abdominal obesity is strongly accompanied by a cluster of metabolic abnormalities characterized by insulin resistance. The link between persistent organic pollutants (POPs) and insulin resistance has been investigated in animal and epidemiological studies. We aimed to examine whether insulin resistance is greater in people with abdominal obesity (AO) and concomitant exposure to serum dioxins (PCDD/Fs). We conducted a cross-sectional descriptive study of 2876 participants living near a PCDD/Fs contaminated area. Seventeen 2,3,7,8-substituted PCDD/Fs congeners were measured, and then the associations between the main predictor variable, serum TEQDF-1998, abdominal obesity (AO), dependent variables, and insulin resistance were examined. Twelve of the 17 congeners, widely distributed among PCDDs, and PCDFs, had trends for associations with abdominal adiposity. In men, the highest quintiles of 1,2,3,7,8-PeCDF; 1,2,3,7,8-PeCDD; 2,3,7,8-TCDD; 2,3,7,8-TCDF; and 2,3,4,7,8-PeCDF had the top five adjusted odds ratios (AORs) + 95% confidence intervals (CIs):[4.2; 2.7–6.4], [3.6; 2.3–5.7], [3.2; 2.1–5.0], [3.0; 2.0–4.5], and [2.9; 1.9–4.7], respectively. In women, the highest quintiles of 1,2,3,4,7,8,9-HpCDF; 1,2,3,6,7,8-HxCDF; and 1,2,3,4,6,7,8-HpCDF had the top three AORs + 95% CIs:[3.0; 1.9–4.7], [2.0; 1.3–3.1], and [1.9; 1.3–2.9], respectively. After confounding factors had been adjusted for, men, but not women, with higher serum TEQDF-1998 levels or abdominal obesity had a significantly (Ptrend < 0.001) greater risk for abnormal insulin resistance. The groups with the highest joint serum TEQDF-1998 and abdominal obesity levels were associated with elevated insulin resistance at 5.0 times the odds of the groups with the lowest joint levels (AOR 5.23; 95% CI: 3.53–7.77). We hypothesize that serum TEQDF-1998 and abdominal obesity affect the association with

  20. Prevalence of obesity and abdominal obesity from four to 16 years old children living in the Mexico-USA border.

    PubMed

    Bacardí-Gascón, Montserrat; Jones, Elizabeth G; Jiménez-Cruz, Arturo

    2013-01-01

    The prevalence of obesity among Mexicans is alarming in both the child and adult populations. The objective of this study was to determine the levels of overweight, obesity and abdominal obesity in pre-school (PS), elementary (ES), and middle high (MHS) public school children from Tijuana. From February to April of 2011, a bietapic random sample was selected by cluster method of 30 PS, 30 ES, and 30 MHS children. And a sample of 30 groups for each level was chosen. Twenty elementary teachers and eight graduate students were trained at one central location on how to take anthropometric measurements using a portable scale, a stadiometer, and a measuring tape to determine weight, height, and waist circumference. Body Mass Index values were computed and compared to age/gender BMI percentiles according to WHO criteria. Waist circumference for-age at the 90th percentile from NHANES III (Mexican-American) was used to define abdominal obesity. The sample was composed of 646 PS children, 961 ES children, and 1,095 MHS children. Their ages ranged from 4- 16 years. Results showed an overall prevalence of overweight and obesity in younger than 5y preschool children (> 2 SD) of 23.1%, in ≥ 5 y PS (> 1 SD) of 33.8%, in ES children of 46.3%, and in MHS children of 41.9%. Abdominal obesity in PS children was 18%, in ES children was 16.7%, and in MHS children was 15.2%. These results warrant immediate and comprehensive actions to prevent a critical public health problem in Mexico.

  1. Prevalence of obesity and abdominal obesity from four to 16 years old children living in the Mexico-USA border.

    PubMed

    Bacardí-Gascón, Montserrat; Jones, Elizabeth G; Jiménez-Cruz, Arturo

    2013-01-01

    The prevalence of obesity among Mexicans is alarming in both the child and adult populations. The objective of this study was to determine the levels of overweight, obesity and abdominal obesity in pre-school (PS), elementary (ES), and middle high (MHS) public school children from Tijuana. From February to April of 2011, a bietapic random sample was selected by cluster method of 30 PS, 30 ES, and 30 MHS children. And a sample of 30 groups for each level was chosen. Twenty elementary teachers and eight graduate students were trained at one central location on how to take anthropometric measurements using a portable scale, a stadiometer, and a measuring tape to determine weight, height, and waist circumference. Body Mass Index values were computed and compared to age/gender BMI percentiles according to WHO criteria. Waist circumference for-age at the 90th percentile from NHANES III (Mexican-American) was used to define abdominal obesity. The sample was composed of 646 PS children, 961 ES children, and 1,095 MHS children. Their ages ranged from 4- 16 years. Results showed an overall prevalence of overweight and obesity in younger than 5y preschool children (> 2 SD) of 23.1%, in ≥ 5 y PS (> 1 SD) of 33.8%, in ES children of 46.3%, and in MHS children of 41.9%. Abdominal obesity in PS children was 18%, in ES children was 16.7%, and in MHS children was 15.2%. These results warrant immediate and comprehensive actions to prevent a critical public health problem in Mexico. PMID:23822701

  2. Prevalence of obesity and dyslipidemia in middle-aged men and women in Tanzania, Africa: relationship with resting energy expenditure and dietary factors.

    PubMed

    Njelekela, Marina; Kuga, Sachiko; Nara, Yasuo; Ntogwisangu, Josiah; Masesa, Zablon; Mashalla, Yohana; Ikeda, Katsumi; Mtabaji, Jacob; Yamori, Yukio; Tsuda, Kinsuke

    2002-10-01

    The prevalence of obesity and dyslipidemia and the mean frequency of intake of selected dietary factors were studied in 545 participants aged 46-58 y and living in three areas in Tanzania. The prevalence of obesity (body mass index of > or = 30 kg/m2) was 22.5% among women and 5.4% among men, p < 0.001. Higher rates of obesity were observed in both men and women in an urban (U) area of Dar. The prevalence of dyslipidemia [(TC-HDL-C)/HDL-C > 5] among men was higher in a pastoralists (P) population of the Maasai in Monduli (22.6%) than in Dar (9.6%) and rural (R) Handeni (7.3%, p < 0.05). The mean resting energy expenditure (REE) was higher in subjects from the rural and pastoralists populations than in urban dwellers (0.024 kcal/min/kg, p < 0.001). The three areas showed different dietary patterns with subjects from the urban area consuming coconut milk (4 d/wk, p < 0.001) and meat (2.5 d/wk, p < 0.05), more often than the rural population of Handeni which had the highest consumption of green vegetables (4.2 d/wk, p < 0.001). Participants from Monduli had the highest consumption of milk per day (1,219 mL/d, p < 0.001). A simple correlation analysis showed that body mass index (BMI) correlated positively with the frequency of intake of coconut milk, fish and meat, and negatively with REE and milk consumption. Total cholesterol (TC) was negatively correlated with the frequency of intake of green vegetables, fish and the REE, and correlated positively with meat consumption and BMI in both genders. Independent of other factors, important contributors to obesity and dyslipidemia in this population were dietary factors such as meat (p < 0.001) and fish (p < 0.05), and a lower REE (p < 0.05). These findings suggest that unhealthy diet and lower energy expenditure are important contributors to obesity and dyslipidemia in Tanzania. PMID:12656207

  3. Castration influences intestinal microflora and induces abdominal obesity in high-fat diet-fed mice.

    PubMed

    Harada, Naoki; Hanaoka, Ryo; Horiuchi, Hiroko; Kitakaze, Tomoya; Mitani, Takakazu; Inui, Hiroshi; Yamaji, Ryoichi

    2016-03-10

    Late-onset hypogonadism (i.e. androgen deficiency) raises the risk for abdominal obesity in men. The mechanism for this obesity is unclear. Here, we demonstrated that hypogonadism after castration caused abdominal obesity in high-fat diet (HFD)-fed, but not in standard diet (SD)-fed, C57BL/6J mice. Furthermore, the phenotype was not induced in mice treated with antibiotics that disrupt the intestinal microflora. In HFD-fed mice, castration increased feed efficiency and decreased fecal weight per food intake. Castration also induced in an increase of visceral fat mass only in the absence of antibiotics in HFD-fed mice, whereas subcutaneous fat mass was increased by castration irrespective of antibiotics. Castration reduced the expression in the mesenteric fat of both adipose triglyceride lipase and hormone-sensitive lipase in HFD-fed mice, which was not observed in the presence of antibiotics. Castration decreased thigh muscle (i.e. quadriceps and hamstrings) mass, elevated fasting blood glucose levels, and increased liver triglyceride levels in a HFD-dependent manner, whereas these changes were not observed in castrated mice treated with antibiotics. The Firmicutes/Bacteroidetes ratio and Lactobacillus species increased in the feces of HFD-fed castrated mice. These results show that androgen (e.g. testosterone) deficiency can alter the intestinal microbiome and induce abdominal obesity in a diet-dependent manner.

  4. Castration influences intestinal microflora and induces abdominal obesity in high-fat diet-fed mice

    PubMed Central

    Harada, Naoki; Hanaoka, Ryo; Horiuchi, Hiroko; Kitakaze, Tomoya; Mitani, Takakazu; Inui, Hiroshi; Yamaji, Ryoichi

    2016-01-01

    Late-onset hypogonadism (i.e. androgen deficiency) raises the risk for abdominal obesity in men. The mechanism for this obesity is unclear. Here, we demonstrated that hypogonadism after castration caused abdominal obesity in high-fat diet (HFD)-fed, but not in standard diet (SD)-fed, C57BL/6J mice. Furthermore, the phenotype was not induced in mice treated with antibiotics that disrupt the intestinal microflora. In HFD-fed mice, castration increased feed efficiency and decreased fecal weight per food intake. Castration also induced in an increase of visceral fat mass only in the absence of antibiotics in HFD-fed mice, whereas subcutaneous fat mass was increased by castration irrespective of antibiotics. Castration reduced the expression in the mesenteric fat of both adipose triglyceride lipase and hormone-sensitive lipase in HFD-fed mice, which was not observed in the presence of antibiotics. Castration decreased thigh muscle (i.e. quadriceps and hamstrings) mass, elevated fasting blood glucose levels, and increased liver triglyceride levels in a HFD-dependent manner, whereas these changes were not observed in castrated mice treated with antibiotics. The Firmicutes/Bacteroidetes ratio and Lactobacillus species increased in the feces of HFD-fed castrated mice. These results show that androgen (e.g. testosterone) deficiency can alter the intestinal microbiome and induce abdominal obesity in a diet-dependent manner. PMID:26961573

  5. Prevalence of abdominal obesity in Abia State, Nigeria: results of a population-based house-to-house survey

    PubMed Central

    Ijezie, Innocent Chukwuonye; Chuku, Abali; Onyeonoro, Ugochukwu Uchenna; Okpechi, Ikechi Gareth; Madukwe, Okechukwu Ojoemelam; Umeizudike, Theophilus Ifeanyichukwu; Ogah, Okechukwu Samuel

    2013-01-01

    Background and objective Abdominal obesity is associated with the risk of developing disorders, such as diabetes and hypertension. The objective of this study was to investigate the prevalence of abdominal obesity in Abia State, Nigeria. Materials and methods We carried out a cross-sectional study aimed at ascertaining the prevalence of abdominal obesity in Abia State, Nigeria. Participants in the study were recruited from communities in the three senatorial zones in the state. Screening for abdominal obesity was carried out in these subjects using waist circumference (the National Cholesterol Education Program Third Adult Treatment Panel criteria were used). The World Health Organization Stepwise Approach to Surveillance of chronic disease risk factors was used. Body mass index, anthropometric measurements, and other relevant data were also collected. Results Data on waist circumference were obtained from 2,807 subjects. The prevalence of obesity using body mass index in the population was 11.12%. In men and women, it was 7.73%, and 14.37%, respectively. The prevalence of abdominal obesity in the population was 21.75%. In men and women, it was 3.2% and 39.2%, respectively. Conclusion The prevalence of abdominal obesity is high in Nigeria, and needs to be monitored because it is associated with increased cardiovascular risk. PMID:23946664

  6. High lipolytic activity and dyslipidemia in a spontaneous hypertensive/NIH corpulent (SHR/N-cp) rat: a genetic model of obesity and type 2 diabetes mellitus.

    PubMed

    Atgié, C; Hadj-Sassi, A; Bukowiecki, L; Mauriège, P

    2009-03-01

    In order to better understand the link between obesity and type 2 diabetes, lipolysis and its adrenergic regulation was investigated in various adipose depots of obese adult females SHR/N-cp rats. Serum insulin, glucose, free fatty acids (FFA), triglycerides (TG) and glycerol were measured. Adipocytes were isolated from subcutaneous (SC), parametrial (PM) and retroperitoneal (RP) fat pads. Total cell number and size, basal lipolysis or stimulated by norepinephrine (NE) and BRL 37344 were measured in each depot. Obese rats were hyperinsulinemic and hyperglycemic, suggesting high insulin resistance. They presented a marked dyslipidemia, attested by increased serum FFA and TG levels. High serum glycerol levels also suggest a strong lipolytic rate. Obese rats showed an excessive development of all fat pads although a more pronounced effect was observed in the SC one. The cellularity of this depot was increased 8 fold when compared to lean rats, but these fat cells were only 1.5 to 2-fold larger. SC adipocytes showed a marked increase in their basal lipolytic activity but a lack of change in responsiveness to NE or BRL 37344. The association between high basal lipolysis and increased cellularity yields to a marked adipose cell lipolytic rate, especially from the SC region. SHR/N-cp rats were characterized by a hyperplasic type of obesity with an excessive development of the SC depot. The dyslipidemia, attested by an altered serum lipid profile could be attributed to excessive lipolysis that contributes to increased FFA levels, and to early development of insulin resistance through a lipotoxicity effect.

  7. Relationship of internalized racism to abdominal obesity and blood pressure in Afro-Caribbean women.

    PubMed

    Tull, S E; Wickramasuriya, T; Taylor, J; Smith-Burns, V; Brown, M; Champagnie, G; Daye, K; Donaldson, K; Solomon, N; Walker, S; Fraser, H; Jordan, O W

    1999-08-01

    Racism is associated with increased psychosocial stress and blood pressure in blacks. However, little is known of the relationship of racism to other features of insulin resistance syndrome. This study examined the relationship of internalized racism to abdominal obesity and elevated blood pressure in a population of black Caribbean women aged 20-55 years. One hundred thirty-three randomly selected women from the island of Barbados comprised the study sample. Data collected included anthropometric and blood pressure measurements, and information about internalized racism, anxiety, and depression. The stress measures including anxiety, depression, and internalized racism were significantly correlated with waist circumference (r = .25, r = .21, and r = .25). After adjusting for age, education, anxiety, and depression, internalized racism remained significantly correlated with waist circumference. The odds ratio associated with development of abdominal obesity among those with high internalized racism (OR = 2.4 [95% CI, 1.1,5.3]) was significant (P < .05) after adjusting for age, education, and body mass index. Blood pressure was not independently related to internalized racism. Studies comparing black-white differences in diseases for which abdominal obesity is a risk factor (eg, diabetes and cardiovascular disease) should take into account the potential role of internalized racism in defining the differences between ethnic groups.

  8. Oxidation of nonplasma fatty acids during exercise is increased in women with abdominal obesity.

    PubMed

    Horowitz, J F; Klein, S

    2000-12-01

    We evaluated plasma fatty acid availability and plasma and whole body fatty acid oxidation during exercise in five lean and five abdominally obese women (body mass index = 21 +/- 1 vs. 38 +/- 1 kg/m(2)), who were matched on aerobic fitness, to test the hypothesis that obesity alters the relative contribution of plasma and nonplasma fatty acids to total energy production during exercise. Subjects exercised on a recumbent cycle ergometer for 90 min at 54% of their peak oxygen consumption. Stable isotope tracer methods ([(13)C]palmitate) were used to measure fatty acid rate of appearance in plasma and the rate of plasma fatty acid oxidation, and indirect calorimetry was used to measure whole body substrate oxidation. During exercise, palmitate rate of appearance increased progressively and was similar in obese and lean groups between 60 and 90 min of exercise [3.9 +/- 0.4 vs. 4.0 +/- 0.3 micromol. kg fat free mass (FFM)(-1). min(-1)]. The rate of plasma fatty acid oxidation was also similar in obese and lean subjects (12.8 +/- 1.7 vs. 14.5 +/- 1.8 micromol. kg FFM(-1). min(-1); P = not significant). However, whole body fatty acid oxidation during exercise was 25% greater in obese than in lean subjects (21.9 +/- 1.2 vs. 17.5 +/- 1.6 micromol. kg FFM(-1). min(-1); P < 0.05). These results demonstrate that, although plasma fatty acid availability and oxidation are similar during exercise in lean and obese women, women with abdominal obesity use more fat as a fuel by oxidizing more nonplasma fatty acids.

  9. Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension

    PubMed Central

    Thoenes, Martin; Reil, Jan-Christian; Khan, Bobby Varkey; Bramlage, Peter; Volpe, Massimo; Kirch, Wilhelm; Böhm, Michael

    2009-01-01

    Background Overweight and obesity are frequently associated with preventable death and have emerged as a major challenge to public health. There is an ongoing debate on the role of abdominal obesity and its value in predicting cardiovascular and renal outcomes. The present analysis evaluates the prevalence of microalbuminuria (MAU) and conventional cardiovascular risk factors in relation to measures of general and abdominal obesity. Methods In this multinational, observational study, 20828 hypertensive out-patients from 26 countries including Europe, North and Latin America, Middle East, and Asia were analyzed. Urinary dipstick screening for MAU was performed as well as data on patient demographics, anthropometric measures, cardiovascular risk factors, comorbid conditions, and cardiovascular drug therapy collected. MAU prevalence was determined by a stepwise logistic regression analysis with cardiovascular risk factors as univariate. Results In the univariate analysis, MAU prevalence systematically increased with body mass index (BMI) from 54.4% (1st tertial) to 62.1% (3rd tertial) (p < 0.0001), an increase which was also observed for waist circumference (WC). At any level of BMI, MAU increased with WC from 53.5%, 54.8%, and 55.0% (1st tertial of WC in all three BMI tertials) to 61.4%, 62.1%, and 64.0% (3rd tertial of WC in all BMI tertials) (p < 0.0001). In the multivariate analysis, WC, but not BMI was independently associated with MAU. Furthermore, overweight/obesity were associated with the presence of modifiable and nonmodifiable risk factors. Conclusion An abnormal WC, but not BMI appears to be independently associated with MAU, an early marker of cardiovascular and renal risk. Increasing WC confers an incremental risk for MAU at any level of BMI, underlining the prognostic importance of abdominal fat accumulation beyond general obesity. PMID:19649308

  10. Evaluation of the impact of abdominal obesity on glucose and lipid metabolism disorders in adults with Down syndrome.

    PubMed

    Real de Asua, Diego; Parra, Pedro; Costa, Ramón; Moldenhauer, Fernando; Suarez, Carmen

    2014-11-01

    We aimed to describe anthropometric differences in weight-related disorders between adults with Down syndrome (DS) and healthy controls, as well as their disparate impact on glucose and lipid metabolism disorders. We underwent a cross-sectional study of 49 consecutively selected, community-residing adults with DS and 49 healthy controls in an outpatient clinic of a tertiary care hospital in Madrid, Spain. Siblings of adults with DS were studied as controls in 42 cases. Epidemiological data (age and gender), anthropometric data (body mass index, waist circumference, and waist-to-height ratio [WHR]), coexisting clinical conditions, and laboratory data (fasting glucose, insulin, glycated hemoglobin, creatinine, thyroid hormones, and lipid profile) were measured and compared between the groups. Adults with DS were significantly younger and more often male, with a higher prevalence of overweight and obesity than controls. Adults with DS also had a higher WHR, and more frequently presented abdominal obesity. Moreover, insulin resistance measured using the homeostatic model assessment was more prevalent among adults with DS and abdominal obesity. However, lipid profiles were similar between groups. The kappa correlation index for the diagnosis of abdominal obesity between waist circumference and WHR was 0.24 (95%CI: 0.13-0.34). We concluded that the prevalence of overweight, obesity, and abdominal obesity was higher in adults with DS than in controls. Adults with DS and abdominal obesity showed higher indexes of insulin resistance than their non-obese peers. WHR was a useful tool for the evaluation of abdominal obesity in this population.

  11. Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis.

    PubMed

    Bendsen, Nathalie T; Christensen, Robin; Bartels, Else M; Kok, Frans J; Sierksma, Aafje; Raben, Anne; Astrup, Arne

    2013-02-01

    A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake > 500 mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21-126 days) results in weight gain (0.73 kg; P < 0.0001), but data from four studies comparing intake of alcoholic beer with intake of no alcohol did not support this finding. Generally, experimental studies had low-quality data. In conclusion, the available data provide inadequate scientific evidence to assess whether beer intake at moderate levels (<500 mL/day) is associated with general or abdominal obesity. Higher intake, however, may be positively associated with abdominal obesity.

  12. [Secondary dyslipidemias].

    PubMed

    Vargová, V; Pytliak, M; Mechírová, V

    2012-03-01

    Dyslipidemias rank among the most important preventabile factors of atherogenesis and its progression. This topic is increasingly being discussed as e.g. more than 50% of Slovak population die on atherosclerotic complications. According to etiology we distinguish primary dyslipidemias with strictly genetic background and secondary ones with origin in other disease or pathological state. Secondary dyslipidemias accompany various diseases, from common (endocrinopathies, renal diseases etc) to rare ones (thesaurismosis etc.) and represents one of symptoms of these diseases. Apart from particular clinical follow up of diagnosed dysipidemias, basic screening and secondary causes as well as treatment due to updated guidelines is recuired. In this review we present the most frequent dyslipidemias of clinical practice.

  13. Dyslipidemia in Children and Adolescents: When and How to Diagnose and Treat?

    PubMed Central

    2014-01-01

    Recently, the incidence and prevalence of obesity and dyslipidemia are increasing. Dyslipidemia is associated with significant comorbidities and complications, and with cardiovascular risk factors (obesity, diabetes mellitus, hypertension and smoking). The main objectives of this article are that describe the prevalence of dyslipidemia in Korean children and adolescents and review the diagnosis and management of dyslipidemia in children and adolescents. PMID:25061583

  14. The epidemiology and molecular mechanisms linking obesity, diabetes, and cancer.

    PubMed

    Ferguson, Rosalyn D; Gallagher, Emily J; Scheinman, Eyal J; Damouni, Rawan; LeRoith, Derek

    2013-01-01

    The worldwide epidemic of obesity is associated with increasing rates of the metabolic syndrome and type 2 diabetes. Epidemiological studies have reported that these conditions are linked to increased rates of cancer incidence and mortality. Obesity, particularly abdominal obesity, is associated with insulin resistance and the development of dyslipidemia, hyperglycemia, and ultimately type 2 diabetes. Although many metabolic abnormalities occur with obesity and type 2 diabetes, insulin resistance and hyperinsulinemia appear to be central to these conditions and may contribute to dyslipidemia and altered levels of circulating estrogens and androgens. In this review, we will discuss the epidemiological and molecular links between obesity, type 2 diabetes, and cancer, and how hyperinsulinemia and dyslipidemia may contribute to cancer development. We will discuss how these metabolic abnormalities may interact with estrogen signaling in breast cancer growth. Finally, we will discuss the effects of type 2 diabetes medications on cancer risk. PMID:23810003

  15. Smoking Is Associated with More Abdominal Fat in Morbidly Obese Patients

    PubMed Central

    Casagrande, Daniela; Wagner, Mario; Mottin, Cláudio

    2015-01-01

    Introduction While the association between cigarette smoking and abdominal fat has been well studied in normal and overweight patients, data regarding the influence of tobacco use in patients with morbid obesity remain scarce. The aim of this study is to evaluate body fat distribution in morbidly obese smokers. Methods We employed a cross-sectional study and grouped severely obese patients (body mass index [BMI] >40 kg/m2 or >35 kg/m2 with comorbidities) according to their smoking habits (smokers or non-smokers). We next compared the anthropometrical measurements and body composition data (measured by electric bioimpedance) of both groups. We analyzed the effect of smoking on body composition variables using univariate and multiple linear regression (MLR); differences are presented as regression coefficients (b) and their respective 95% confidence intervals. Results We included 536 morbidly obese individuals, 453 (84.5%) non-smokers and 83 (15.5%) smokers. Male smokers had a higher BMI (b=3.28 kg/m2, p=0.036), larger waist circumference (b=6.07 cm, p=0.041) and higher percentage of body fat (b=2.33%, p=0.050) than non-smokers. These differences remained significant even after controlling for confounding factors. For females, the only significant finding in MLR was a greater muscle mass among smokers (b=1.34kg, p=0.028). No associations were found between tobacco load measured in pack-years and anthropometric measures or body composition. Discussion Positive associations between smoking and BMI, and waist circumference and percentage of body fat, were found among male morbidly obese patients, but not among females. To the best of our knowledge, this study is the first investigation of these aspects in morbidly obese subjects. We speculate that our findings may indicate that the coexistence of morbid obesity and smoking helps to explain the more serious medical conditions, particularly cardiovascular diseases and neoplasms, seen in these patients. PMID:25978682

  16. Unsaturated Oral Fat Load Test Improves Glycemia, Insulinemia and Oxidative Stress Status in Nondiabetic Subjects with Abdominal Obesity

    PubMed Central

    Martinez-Hervas, Sergio; Navarro, Inmaculada; Real, Jose T.; Artero, Ana; Peiro, Marta; Gonzalez-Navarro, Herminia; Carmena, Rafael; Ascaso, Juan F.

    2016-01-01

    Aims To evaluate the changes in glycemia, insulinemia, and oxidative stress markers during an oral fat load test in nondiabetic subjects with abdominal obesity and to analyze the association between postprandial oxidative stress markers and postprandial glucose and insulin responses. Methods We included 20 subjects with abdominal obesity (waist circumference > 102 cm for men and > 88 cm for women) and 20 healthy lean controls (waist circumference < 102 cm for men and < 88 cm for women). After 12 hours of fasting we performed a standardized fat load test (0–8 hours) with supracal® (50 g/m2). We determined metabolic parameters, oxidized and reduced glutathione, and malondialdehyde. Results In both groups, insulin, HOMA, oxidized/reduced glutathione ratio, and malondialdehyde significantly decreased in the postprandial state after the OFLT. All these parameters were significantly higher in the abdominal obesity group at baseline and during all the postprandial points, but the reduction from the baseline levels was significantly higher in the abdominal obesity group. Conclusion Unsaturated fat improves insulin resistance and oxidative stress status. It is possible that a consumption of unsaturated fat could be beneficial even in subjects with abdominal obesity in postprandial state. PMID:27537847

  17. Influence of acute aerobic exercise on adiponectin oligomer concentrations in middle-aged abdominally obese men.

    PubMed

    Numao, Shigeharu; Katayama, Yasutomi; Hayashi, Yoichi; Matsuo, Tomoaki; Tanaka, Kiyoji

    2011-02-01

    Exercise intensity may induce changes in total adiponectin and adiponectin oligomer levels. However, the effects of acute aerobic exercise on total adiponectin and adiponectin oligomers in middle-aged abdominally obese men remain unknown. The purpose of this study was to investigate the influence of aerobic exercise intensity on changes in the concentrations of total adiponectin and adiponectin oligomers (high-molecular weight [HMW] and middle- plus low-molecular weight [MLMW] adiponectin), and the endocrine mechanisms involved in exercise-induced changes in adiponectin oligomer profiles in middle-aged abdominally obese men. Using a crossover design, 9 middle-aged abdominally obese men (age, 54.1 ± 2.4 years; body mass index, 27.9 ± 0.6 kg/m²) underwent 2 trials that consisted of 60 minutes of stationary cycle exercise at either moderate-intensity (ME) or high-intensity (HE) aerobic exercise (50% or 70% of peak oxygen uptake, respectively). Blood samples were collected to measure the concentrations of adiponectin oligomers, hormones (catecholamines, insulin, and growth hormone), metabolites (free fatty acid, glycerol, triglyceride, and glucose), and cytokines (interleukin-6 and tumor necrosis factor-α). After exercise, plasma catecholamine concentrations were higher during HE than during ME (P < .05). Total adiponectin concentration decreased at the end of HE (P < .05), but remained unchanged after ME. The HMW adiponectin concentration did not change at either intensity, whereas the MLMW concentration decreased at the end of HE (P < .05). The ratio of HMW to total adiponectin concentration increased significantly (P < .05), whereas the ratio of MLMW to total adiponectin concentration decreased significantly (P < .05), at the end of HE. The percentage changes in epinephrine concentration from baseline to the end of exercise were correlated with the percentage changes in total adiponectin concentration (r = -0.67, P < .05) and MLMW adiponectin concentration (r

  18. The Third National Health and Morbidity Survey: prevalence of obesity, and abdominal obesity among the Malaysian elderly population.

    PubMed

    Suzana, S; Kee, C C; Jamaludin, A R; Noor Safiza, M N; Khor, G L; Jamaiyah, H; Geeta, A; Ahmad Ali, Z; Rahmah, R; Ruzita, A T; Ahmad Fauzi, Y

    2012-03-01

    Obesity is an emerging public health threat in the elderly population in developing countries. Hence, the Third National Health and Morbidity Survey has assessed 4746 individuals aged 60 years and older recruited through a household survey to determine the prevalence of adiposity using body mass index and waist circumference. The national's prevalence of overweight and obesity in men was 29.2% (95% confidence interval [CI] = 27.2-31.3) and 7.4% (95% CI = 6.4-8.6), respectively. However, the prevalence decreased with age. The figures in women were 30.3% (95% CI = 28.5-32.1) and 13.8% (95% CI = 12.5-15.2), respectively. The prevalence of abdominal obesity was 21.4% (95%CI = 20.2-22.6), with 7.7% (95% CI = 6.7-9.0) in men and 33.4% (95% CI = 31.4-35.3) in women. Predictors of adiposity include the following: Malay and Indian ethnicity, higher education level, higher household income, from urban area, and being married. In conclusion, adiposity affects about one third of the Malaysian elderly population, especially those of the younger age group, women, and those with higher socioeconomic status.

  19. Dysregulation of the Peripheral and Adipose Tissue Endocannabinoid System in Human Abdominal Obesity

    PubMed Central

    Blüher, Matthias; Engeli, Stefan; Klöting, Nora; Berndt, Janin; Fasshauer, Mathias; Bátkai, Sádor; Pacher, Pál; Schön, Michael R.; Jordan, Jens; Stumvoll, Michael

    2008-01-01

    The endocannabinoid system has been suspected to contribute to the association of visceral fat accumulation with metabolic diseases. We determined whether circulating endocannabinoids are related to visceral adipose tissue mass in lean, subcutaneous obese, and visceral obese subjects (10 men and 10 women in each group). We further measured expression of the cannabinoid type 1 (CB1) receptor and fatty acid amide hydrolase (FAAH) genes in paired samples of subcutaneous and visceral adipose tissue in all 60 subjects. Circulating 2-arachidonoyl glycerol (2-AG) was significantly correlated with body fat (r = 0.45, P = 0.03), visceral fat mass (r = 0.44, P = 0.003), and fasting plasma insulin concentrations (r = 0.41, P = 0.001) but negatively correlated to glucose infusion rate during clamp (r = 0.39, P = 0.009). In visceral adipose tissue, CB1 mRNA expression was negatively correlated with visceral fat mass (r = 0.32, P = 0.01), fasting insulin (r = 0.48, P < 0.001), and circulating 2-AG (r = 0.5, P < 0.001), whereas FAAH gene expression was negatively correlated with visceral fat mass (r = 0.39, P = 0.01) and circulating 2-AG (r = 0.77, P < 0.001). Our findings suggest that abdominal fat accumulation is a critical correlate of the dysregulation of the peripheral endocannabinoid system in human obesity. Thus, the endocannabinoid system may represent a primary target for the treatment of abdominal obesity and associated metabolic changes. PMID:17065342

  20. Abdominal obesity and structure and function of the heart in healthy male Koreans: The ARIRANG study.

    PubMed

    Son, Jung-Woo; Sung, Joong Kyung; Lee, Jun-Won; Youn, Young Jin; Ahn, Min-Soo; Ahn, Sung Gyun; Yoo, Byung-Su; Lee, Seung-Hwan; Yoon, Junghan; Koh, Sang Baek; Kim, Jang-Young

    2016-09-01

    Although central obesity is a more powerful predictor of cardiovascular disease (CVD) than general obesity, there is limited information on structural and functional changes of the heart in central obesity. Therefore, we evaluated the association between abdominal obesity and geometric and functional changes of the heart in healthy males. A total of 1460 healthy males aged 40 to 70 years without known CVD from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population were included. All individuals underwent conventional 2-dimensional echocardiography and tissue Doppler imaging to measure left atrial (LA) and left ventricle (LV) geometry and function. Increasing tertiles of waist circumference (WC) were associated with stepwise increases in LA volume, LV end-diastolic dimension, LV mass to height, deceleration time of E wave, and lower E/A ratio (all P trends <0.001). In multivariable logistic regression models, the odds ratios for LA enlargement, LV hypertrophy, LV enlargement, and diastolic dysfunction comparing the upper tertile of WC (>89 cm) to the lowest tertile (<82 cm) were 2.81 (95% confidence interval [CI] 2.24-3.54), 3.65 (95% CI 2.54-5.26), 4.23 (95% CI 2.61-6.87), and 1.75 (95% CI 1.37-2.22), respectively. LV ejection fraction and relative wall thickness were not increased with increasing WC. The association between WC and LA enlargement, LV enlargement, and diastolic dysfunction persisted after stratification by body mass index tertiles. Central obesity may be a stronger predictor than general obesity of geometric and functional changes in the LV and LA. PMID:27684832

  1. Protective effects of Lactobacillus rhamnosus GG against dyslipidemia in high-fat diet-induced obese mice.

    PubMed

    Kim, Bobae; Park, Kun-Young; Ji, Yosep; Park, Soyoung; Holzapfel, Wilhelm; Hyun, Chang-Kee

    2016-04-29

    Recent reports suggest that gut microbiota can be a major determinant of dyslipidemia and non-alcoholic fatty liver disease (NAFLD) and its modulation by treating probiotics is a valid strategy to exert a protective effect. In this study, high-fat diet (HFD)-fed mice were orally administrated with Lactobacillus rhamnosus GG (LGG) for 13 weeks. Significant reductions in the weights of the liver, mesenteric and subcutaneous adipose tissues were observed in LGG-treated HFD-fed mice compared to LGG-non-treated controls. The serum levels of triglyceride and cholesterol were also significantly reduced in LGG-treated mice. Gut microbial composition analysis showed that shifts in the diversity of dominant gut bacteria were caused by HFD and restored by LGG treatment. A remarkable decrease of hepatic fat content was also observed in LGG-treated mice, accompanied by downregulated expressions of lipogenic and pro-inflammatory genes in the liver. LGG-treated mice had lower expression levels of genes involved in cholesterol synthesis, but conversely, higher expression levels of cholesterol efflux-related genes compared to LGG-non-treated controls. The cholesterol-lowering effect of LGG was also found to be mediated by suppression of FXR and FGF15 signaling, resulting in the upregulation of hepatic CYP7A1. Our findings confirm a therapeutic potential of probiotics for ameliorating dyslipidemia and NAFLD.

  2. Protective effects of Lactobacillus rhamnosus GG against dyslipidemia in high-fat diet-induced obese mice.

    PubMed

    Kim, Bobae; Park, Kun-Young; Ji, Yosep; Park, Soyoung; Holzapfel, Wilhelm; Hyun, Chang-Kee

    2016-04-29

    Recent reports suggest that gut microbiota can be a major determinant of dyslipidemia and non-alcoholic fatty liver disease (NAFLD) and its modulation by treating probiotics is a valid strategy to exert a protective effect. In this study, high-fat diet (HFD)-fed mice were orally administrated with Lactobacillus rhamnosus GG (LGG) for 13 weeks. Significant reductions in the weights of the liver, mesenteric and subcutaneous adipose tissues were observed in LGG-treated HFD-fed mice compared to LGG-non-treated controls. The serum levels of triglyceride and cholesterol were also significantly reduced in LGG-treated mice. Gut microbial composition analysis showed that shifts in the diversity of dominant gut bacteria were caused by HFD and restored by LGG treatment. A remarkable decrease of hepatic fat content was also observed in LGG-treated mice, accompanied by downregulated expressions of lipogenic and pro-inflammatory genes in the liver. LGG-treated mice had lower expression levels of genes involved in cholesterol synthesis, but conversely, higher expression levels of cholesterol efflux-related genes compared to LGG-non-treated controls. The cholesterol-lowering effect of LGG was also found to be mediated by suppression of FXR and FGF15 signaling, resulting in the upregulation of hepatic CYP7A1. Our findings confirm a therapeutic potential of probiotics for ameliorating dyslipidemia and NAFLD. PMID:27018382

  3. Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults.

    PubMed

    Maki, Kevin C; Reeves, Matthew S; Farmer, Mildred; Yasunaga, Koichi; Matsuo, Noboru; Katsuragi, Yoshihisa; Komikado, Masanori; Tokimitsu, Ichiro; Wilder, Donna; Jones, Franz; Blumberg, Jeffrey B; Cartwright, Yolanda

    2009-02-01

    This study evaluated the influence of a green tea catechin beverage on body composition and fat distribution in overweight and obese adults during exercise-induced weight loss. Participants (n = 132 with 107 completers) were randomly assigned to receive a beverage containing approximately 625 mg of catechins with 39 mg caffeine or a control beverage (39 mg caffeine, no catechins) for 12 wk. Participants were asked to maintain constant energy intake and engage in >or=180 min/wk moderate intensity exercise, including >or=3 supervised sessions per week. Body composition (dual X-ray absorptiometry), abdominal fat areas (computed tomography), and clinical laboratory tests were measured at baseline and wk 12. There was a trend (P = 0.079) toward greater loss of body weight in the catechin group compared with the control group; least squares mean (95% CI) changes, adjusted for baseline value, age, and sex, were -2.2 (-3.1, -1.3) and -1.0 (-1.9, -0.1) kg, respectively. Percentage changes in fat mass did not differ between the catechin [5.2 (-7.0, -3.4)] and control groups [-3.5 (-5.4, 1.6)] (P = 0.208). However, percentage changes in total abdominal fat area [-7.7 (-11.7, -3.8) vs. -0.3 (-4.4, 3.9); P = 0.013], subcutaneous abdominal fat area [-6.2 (-10.2, -2.2) vs. 0.8 (-3.3, 4.9); P = 0.019], and fasting serum triglycerides (TG) [-11.2 (-18.8, -3.6) vs. 1.9 (-5.9, 9.7); P = 0.023] were greater in the catechin group. These findings suggest that green tea catechin consumption enhances exercise-induced changes in abdominal fat and serum TG.

  4. Preventive and ameliorating effects of citrus D-limonene on dyslipidemia and hyperglycemia in mice with high-fat diet-induced obesity.

    PubMed

    Jing, Li; Zhang, Yu; Fan, Shengjie; Gu, Ming; Guan, Yu; Lu, Xiong; Huang, Cheng; Zhou, Zhiqin

    2013-09-01

    D-limonene is a major constituent in citrus essential oil, which is used in various foods as a flavoring agent. Recently, d-limonene has been reported to alleviate fatty liver induced by a high-fat diet. Here we determined the preventive and therapeutic effects of d-limonene on metabolic disorders in mice with high-fat diet-induced obesity. In the preventive treatment, d-limonene decreased the size of white and brown adipocytes, lowered serum triglyceride (TG) and fasting blood glucose levels, and prevented liver lipid accumulations in high-fat diet-fed C57BL/6 mice. In the therapeutic treatment, d-limonene reduced serum TG, low-density lipoprotein cholesterol (LDL-c) and fasting blood glucose levels and glucose tolerance, and increased serum high-density lipoprotein cholesterol (HDL-c) in obese mice. Using a reporter assay and gene expression analysis, we found that d-limonene activated peroxisome proliferator-activated receptor (PPAR)-α signaling, and inhibited liver X receptor (LXR)-β signaling. Our data suggest that the intake of d-limonene may benefit patients with dyslipidemia and hyperglycemia and is a potential dietary supplement for preventing and ameliorating metabolic disorders.

  5. Dietary taurine and nutrients intake and anthropometric and body composition data by abdominal obesity in Korean male college students.

    PubMed

    Sung, Min Jung; Chang, Kyung Ja

    2009-01-01

    The purpose of this study was to investigate the relationship between abdominal obesity and dietary taurine intake, nutrient intake, anthropometric data and body composition in Korean male college students. One hundred seventy four subjects were divided into 2 groups based on abdominal obesity as estimated by waist circumference (cm) (Lee et al. 2006): normal group (waist circumference (cm): < 90 cm, n = 141), obese group (waist circumference (cm): > or = 90 cm, n = 33). A three day-recall method was used to assess diet (2 weekdays and 1 weekend). Anthropometric data and body composition were measured with Inbody 3.0 (Bioelectrical Impedance Fatness Analyzer). Average dietary intake of taurine in the normal and obese groups was 123.1 +/- 78.8 mg/day and 128.4 +/- 79.6 mg/day, respectively. There was no significant difference in dietary taurine and nutrient intake between the normal and obese groups. However, data of anthropometric measurements and body composition in the obese group were significantly elevated compared to those of the normal group. In the normal group, dietary taurine intake was positively correlated with nutrient intake (p < 0.01), the exception being the intake of plant lipid and of animal calcium. In the obese group, dietary taurine intake was positively correlated with the intake of energy foods and of animal lipid (p < 0.05). There were positive correlations between dietary taurine intake, weight and hip circumference (p < 0.05) in the normal group. However, there was no significant correlation between dietary taurine intake and anthropometric and body composition data in the obese group. Therefore, the data suggest that further study is warranted to examine the relationship between dietary taurine intake and abdominal obesity.

  6. Quantification of Abdominal Fat Depots in Rats and Mice during Obesity and Weight Loss Interventions

    PubMed Central

    KN, Bhanu Prakash; Gopalan, Venkatesh; Lee, Swee Shean; Velan, S. Sendhil

    2014-01-01

    Background & Aims Obesity is a leading healthcare issue contributing to metabolic diseases. There is a great interest in non-invasive approaches for quantitating abdominal fat in obese animals and humans. In this work, we propose an automated method to distinguish and quantify subcutaneous and visceral adipose tissues (SAT and VAT) in rodents during obesity and weight loss interventions. We have also investigated the influence of different magnetic resonance sequences and sources of variability in quantification of fat depots. Materials and Methods High-fat diet fed rodents were utilized for investigating the changes during obesity, exercise, and calorie restriction interventions (N = 7/cohort). Imaging was performed on a 7T Bruker ClinScan scanner using fast spin echo (FSE) and Dixon imaging methods to estimate the fat depots. Finally, we quantified the SAT and VAT volumes between the L1–L5 lumbar vertebrae using the proposed automatic hybrid geodesic region-based curve evolution algorithm. Results Significant changes in SAT and VAT volumes (p<0.01) were observed between the pre- and post-intervention measurements. The SAT and VAT were 44.22±9%, 21.06±1.35% for control, −17.33±3.07%, −15.09±1.11% for exercise, and 18.56±2.05%, −3.9±0.96% for calorie restriction cohorts, respectively. The fat quantification correlation between FSE (with and without water suppression) sequences and Dixon for SAT and VAT were 0.9709, 0.9803 and 0.9955, 0.9840 respectively. The algorithm significantly reduced the computation time from 100 sec/slice to 25 sec/slice. The pre-processing, data-derived contour placement and avoidance of strong background–image boundary improved the convergence accuracy of the proposed algorithm. Conclusions We developed a fully automatic segmentation algorithm to quantitate SAT and VAT from abdominal images of rodents, which can support large cohort studies. We additionally identified the influence of non-algorithmic variables including

  7. The Effects of Combined Exercise on Health-Related Fitness, Endotoxin, and Immune Function of Postmenopausal Women with Abdominal Obesity.

    PubMed

    Park, Sung-Mo; Kwak, Yi-Sub; Ji, Jin-Goo

    2015-01-01

    This study was conducted to examine the effects of combined exercise on health-related fitness, endotoxin concentrations, and immune functions of postmenopausal women with abdominal obesity. 20 voluntary participants were recruited and they were randomly allocated to the combined exercise group (n = 10) or the control group (n = 10). Visceral obesity was defined as a visceral-to-subcutaneous fat ratio ≥ 0.4 based on computed tomography (CT) results. Body composition, exercise stress testing, fitness measurement, CT scan, and blood variables were analyzed to elucidate the effects of combined exercise. The SPSS Statistics 18.0 program was used to calculate means and standard deviations for all variables. Significant differences between the exercise group and control group were determined with 2-way ANOVA and paired t-tests. The exercise group's abdominal obesity was mitigated due to visceral fat reduction; grip strength, push-ups, and oxygen uptake per weight improved; and HDL-C and IgA level also increased, while TNF-α, CD14, and endotoxin levels decreased. Lowered TNF-α after exercise might have an important role in the obesity reduction. Therefore, we can conclude that combined exercise is effective in mitigating abdominal obesity, preventing metabolic diseases, and enhancing immune function.

  8. Association Between Duration of Overall and Abdominal Obesity Beginning in Young Adulthood and Coronary Artery Calcification in Middle Age

    PubMed Central

    Reis, Jared P.; Loria, Catherine M.; Lewis, Cora E.; Powell-Wiley, Tiffany M.; Wei, Gina S.; Carr, J. Jeffrey; Terry, James G.; Liu, Kiang

    2014-01-01

    IMPORTANCE Younger individuals are experiencing a greater cumulative exposure to excess adiposity over their lifetime. However, few studies have determined the consequences of long-term obesity. OBJECTIVE To examine whether the duration of overall and abdominal obesity was associated with the presence and 10-year progression of coronary artery calcification (CAC), a subclinical predictor of coronary heart disease. DESIGN, SETTING, AND PARTICIPANTS Prospective study of 3275 white and black adults aged 18 to 30 years at baseline in 1985–1986 who did not initially have overall obesity (body mass index [BMI] ≥30) or abdominal obesity (men: waist circumference [WC] >102 cm; women: >88 cm) in the multicenter, community-based Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants completed computed tomography scanning for the presence of CAC during the 15-, 20-, or 25-year follow-up examinations. Duration of overall and abdominal obesity was calculated using repeat measurements of BMI and WC, respectively, performed 2, 5, 7, 10, 15, 20, and 25 years after baseline. MAIN OUTCOMES AND MEASURES Presence of CAC was measured by computed tomography at the year 15 (2000–2001), year 20 (2005–2006), or year 25 (2010–2011) follow-up examinations. Ten-year progression of CAC (2000–2001 to 2010–2011) was defined as incident CAC in 2010–2011 or an increase in CAC score of 20 Agatston units or greater. RESULTS During follow-up, 40.4% and 41.0% developed overall and abdominal obesity, respectively. Rates of CAC per 1000 person-years were higher for those who experienced more than 20 years vs 0 years of overall obesity (16.0 vs 11.0, respectively) and abdominal obesity (16.7 vs 11.0). Approximately 25.2% and 27.7% of those with more than 20 years of overall and abdominal obesity, respectively, experienced progression of CAC vs 20.2% and 19.5% of those with 0 years. After adjustment for BMI or WC and potential confounders, the hazard ratios for CAC

  9. Histological and biochemical study of the superficial abdominal fascia and its implication in obesity

    PubMed Central

    Kumar, Pramod; Aithal, Srinivas Kodavoor; Kotian, Sushma R.; Thittamaranahalli, Honnegowda; Bangera, Hemalatha; Prasad, Keerthana; Souza, Anne D.

    2016-01-01

    The advancement of liposculpturing and fascial flaps in reconstructive surgery has renewed interest in the superficial fascia of abdomen. Its histological and biochemical composition may play a vital role in maintaining strength and elasticity of the fascia. Hence, study of abdominal fascia for the elastic, collagen, and hydroxyproline contents is desirable to understand asymmetrical bulges and skin folds and in improving surgical treatment of obesity. Samples of superficial fascia were collected from of upper and lower abdomen from 21 fresh cadavers (15 males and 6 females). Samples were stained using Verhoeff–Van Gieson stain. Digital images of superficial fascia were analyzed using TissueQuant software. The samples were also subjected to hydroxyproline estimation. The superficial fascia was formed by loosely packed collagen fibers mixed with abundant elastic fibers and adipose tissue. Elastic contents and collagen contents of superficial fascia were significantly more in the upper abdomen than that in the lower abdomen in males. Hydroxyproline content of superficial fascia of upper abdomen was significantly more than that of lower abdomen in both males and females. The elastic, collagen and hydroxyproline contents of superficial fascia of upper abdomen were higher compared to the lower abdomen. This may be a reason for asymmetric bulging over abdomen and more sagging fold of skin in the lower abdomen than in the upper abdomen. This study may therefore be helpful in finding new ways to manage obesity and other body contour deformities. PMID:27722011

  10. Prevalence of General and Abdominal Obesity in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study

    PubMed Central

    Esmaili, Haleh; Bahreynian, Maryam; Qorbani, Mostafa; Motlagh, Mohammad Esmaeel; Ardalan, Gelayol; Heshmat, Ramin; Kelishadi, Roya

    2015-01-01

    Background: Pediatric obesity is one of the predisposing risk factors for many non-communicable diseases. Objectives: The purpose of this study was to estimate the national prevalence of general and abdominal obesity among Iranian children and adolescents. Patients and Methods: This cross-sectional nation-wide study was performed in 30 provinces in Iran among 14880 school students aged 6 – 18 years, selected by multistage random cluster sampling. The World Health Organization growth curve was used to categorize Body Mass Index (BMI). Obesity was defined as BMI equal to or higher than the age- and gender-specific 95th percentile; abdominal obesity was considered as waist-to-height ratio of more than 0.5. Results: Data of 13486 out of 14880 invited students were complete (response rate of 90.6%). They consisted of 6543 girls and 75.6% urban residents, and had a mean age of 12.45 (95% CI: 12.40 - 12.51) years. The prevalence rate of general and abdominal obesity was 11.89% (13.58% of boys vs. 10.15% of girls) and 19.12% (20.41% of boys vs. 17.79% of girls), respectively. The highest frequency of obesity was found in the middle school students (13.87% general and 20.84% abdominal obesity). The highest prevalence of general obesity was found in Boushehr (19%) followed by Guilan and Mazandaran (18.3%, 18.3%), while the lowest prevalence was observed in Hormozgan (2.6%). The highest frequency of abdominal obesity was found in Mazandaran (30.2%), Ardabil (29.2%) and Tehran (27.9%). Provinces such as Sistan-Baloochestan (8.4%), Hormozagan (7.4%), and Kerman (11.4%) had the lowest prevalence of abdominal obesity. The Southern and South Eastern provinces had the lowest prevalence of general obesity (2.6% and 5.6%) and abdominal obesity (7.4% and 8.8%). Moreover, the highest prevalence of obesity was found in North and North West Iran by maximum frequency of 18.3% general obesity and 30.2% of abdominal obesity. Conclusions: The results showed a high prevalence of general and

  11. Establishing abdominal height cut-offs and their association with conventional indices of obesity among Arab children and adolescents

    PubMed Central

    Al-Daghri, Nasser; Alokail, Majed; Al-Attas, Omar; Sabico, Shaun; Kumar, Sudhesh

    2010-01-01

    BACKGROUND AND OBJECTIVES: Obesity, particularly childhood obesity is common in the Middle East, but no studies have examined the relationship of sagittal abdominal diameter (SAD) or abdominal height to conventional markers of obesity in this region. This is the first study to document the association of SAD with measures of obesity among Arab children and adolescents. METHODS: Nine hundred sixty-four Saudi children aged 5-17 years (365 prepubertal, including 146 boys and 219 girls; 249 pubertal, including 125 boys and 124 girls; and 350 postpubertal, including 198 boys and 152 girls) were included in this cross-sectional study. RESULTS: SAD was significantly correlated with indices of obesity regardless of gender, but was strongest among pubertal boys. The cut-off values were as follows: for prepubertal children, 14 cm (equivalent to 50th percentile among girls and 60th percentile among boys); for pubertal children, 15 cm for girls (30th percentile) and 16 cm for boys (50th percentile), and for postpubertal, 21.5 cm for girls (70th percentile) and 22 cm for boys (80th percentile). CONCLUSION: SAD is a reliable indicator of visceral obesity among Arab children and adolescents in particular. Prospective studies should be done to determine whether such an association translates to a promising risk factor for hard endpoints such as diabetes mellitus and coronary heart disease. PMID:20427937

  12. Socio-Demographic and Dietary Factors Associated with Excess Body Weight and Abdominal Obesity among Resettled Bhutanese Refugee Women in Northeast Ohio, United States

    PubMed Central

    Bhatta, Madhav P.; Assad, Lori; Shakya, Sunita

    2014-01-01

    Studies of obesity and related health conditions among the Bhutanese, one of the largest refugee groups resettled in the United States in the past five years, are limited. This study examined the factors associated with excess body weight (body mass index ≥ 23 kg/m2) and abdominal obesity (waist circumference > 80 cm) in a community-based sample of 18–65 year old Bhutanese refugee women in Northeast Ohio. A Nepali-language questionnaire was used to measure socio-demographic and dietary factors. Height, weight, and waist circumference were measured to define excess body weight and abdominal obesity. The mean (±standard deviation) age of the 108 participants was 36.5 (±12.2) years and length of time in the U.S. was 19.4 (±11.9) months. Overall, 64.8% and 69.4% of the women had excess body weight and abdominal obesity, respectively. Age was significantly associated with both excess body weight (odds ratio: 1.10; 95% confidence interval: 1.05–1.16) and abdominal obesity (1.09; 1.04–1.14). Consuming meat (4.01; 1.14–14.60) was significantly associated with excess body weight but not abdominal obesity. These findings suggest the need for lifestyle and dietary change education programs among this new and vulnerable group to reduce the prevalence of excess body weight and abdominal obesity and their health consequences. PMID:24968209

  13. Joint association of nicotinic acetylcholine receptor variants with abdominal obesity in American Indians: the Strong Heart Family Study.

    PubMed

    Zhu, Yun; Yang, Jingyun; Yeh, Fawn; Cole, Shelley A; Haack, Karin; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

    2014-01-01

    Cigarette smoke is a strong risk factor for obesity and cardiovascular disease. The effect of genetic variants involved in nicotine metabolism on obesity or body composition has not been well studied. Though many genetic variants have previously been associated with adiposity or body fat distribution, a single variant usually confers a minimal individual risk. The goal of this study is to evaluate the joint association of multiple variants involved in cigarette smoke or nicotine dependence with obesity-related phenotypes in American Indians. To achieve this goal, we genotyped 61 tagSNPs in seven genes encoding nicotine acetylcholine receptors (nAChRs) in 3,665 American Indians participating in the Strong Heart Family Study. Single SNP association with obesity-related traits was tested using family-based association, adjusting for traditional risk factors including smoking. Joint association of all SNPs in the seven nAChRs genes were examined by gene-family analysis based on weighted truncated product method (TPM). Multiple testing was controlled by false discovery rate (FDR). Results demonstrate that multiple SNPs showed weak individual association with one or more measures of obesity, but none survived correction for multiple testing. However, gene-family analysis revealed significant associations with waist circumference (p = 0.0001) and waist-to-hip ratio (p = 0.0001), but not body mass index (p = 0.20) and percent body fat (p = 0.29), indicating that genetic variants are jointly associated with abdominal, but not general, obesity among American Indians. The observed combined genetic effect is independent of cigarette smoking per se. In conclusion, multiple variants in the nAChR gene family are jointly associated with abdominal obesity in American Indians, independent of general obesity and cigarette smoking per se.

  14. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study.

    PubMed

    López-Sobaler, Ana M; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18-64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415-2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045-1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m(2), WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m(2), WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future.

  15. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study.

    PubMed

    López-Sobaler, Ana M; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18-64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415-2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045-1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m(2), WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m(2), WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  16. Relation of abdominal obesity to hyperinsulinemia and high blood pressure in men.

    PubMed

    Johnson, D; Prud'homme, D; Després, J P; Nadeau, A; Tremblay, A; Bouchard, C

    1992-11-01

    The relationships between body fatness, adipose tissue distribution, plasma glucose, insulin levels, lipoprotein levels, and resting blood pressure were studied in 81 men aged 36.0 +/- 3.3 years (mean +/- s.d.) (body mass index (BMI): 27.4 +/- 3.8 kg/m2, percentage body fat: 26.4 +/- 6.6%). Systolic and diastolic blood pressures (BP) were significantly associated with the BMI (r = 0.31, r = 0.33, P < 0.01), the waist circumference (r = 0.33, r = 0.27; P < 0.01) as well as with adipose tissue areas measured by computerized tomography (CT) (0.27 < or = r < or = 0.36, P < 0.01). Furthermore, the relative accumulation of subcutaneous abdominal fat, as estimated by the ratio of abdominal to femoral adipose tissue areas measured by CT, was positively correlated with systolic and diastolic BP (P < 0.01). Fasting plasma insulin level (r = 0.30, P < 0.01) as well as the insulin area measured during an oral glucose tolerance test (0.34 < or = r < or = 0.37, P < 0.01) were significantly correlated with blood pressure. Systolic and diastolic BP were significantly associated with HDL2-cholesterol (C) as well as with the HDL2-C/HDL3-C ratio (-0.24 < or = r < or = -0.34), whereas triglycerides (r = 0.23) and the HDL-C/C ratio (r = -0.23) were significantly correlated with diastolic BP only (P < 0.05). Multivariate analysis indicated that the insulin area was the most important variable associated with blood pressure and that this association was independent of total body fatness and regional adipose tissue distribution. Plasma insulin levels explained 14% and 11% of the variance observed in the systolic and diastolic blood pressures respectively. These results suggest that most of the association between abdominal obesity and high blood pressure is mediated by the hyperinsulinemia and/or the related insulin resistant state.

  17. Effect of fructooligosaccharides fraction from Psacalium decompositum on inflammation and dyslipidemia in rats with fructose-induced obesity.

    PubMed

    Merino-Aguilar, Héctor; Arrieta-Baez, Daniel; Jiménez-Estrada, Manuel; Magos-Guerrero, Gil; Hernández-Bautista, René Javier; Susunaga-Notario, Ana Del Carmen; Almanza-Pérez, Julio Cesar; Blancas-Flores, Gerardo; Román-Ramos, Rubén; Alarcón-Aguilar, Francisco Javier

    2014-01-29

    Psacalium decompositum, commonly known as "Matarique," is a medicinal plant used in Mexico for diabetes mellitus empirical therapy. Previous studies have shown that the fructooligosaccharides (FOS) present in the roots of this plant exhibit a notable hypoglycemic effect in animal models; this effect might be associated with the attenuation of the inflammatory process and other metabolic disorders. In this study, we examined the effects of FOS fraction administration in a fructose-fed rat model for obesity. Phytochemical chromatographic studies (high performance thin layer chromatography and nuclear magnetic resonance) were performed to verify isolation of FOS. 24 male Wistar rats were maintained for 12 weeks on a diet of 20% HFCS in drinking water and chow. Glucose, cholesterol, triglycerides and liver transaminases levels were measured monthly, after administering FOS fraction intragastrically (150 mg/kg/day for 12 weeks), while the levels of inflammatory cytokines were only quantified at the end of the treatments. Rats treated with FOS fraction decreased body weight, cholesterol, triglycerides, and significantly reduced IL-6, IFN-γ, MCP-1, IL-1β and VEGF levels (p < 0.05). These results suggest that P. decompositum has anti-inflammatory and hypolipidemic properties that might be used as an alternative treatment for the control of obesity.

  18. Effect of Fructooligosaccharides Fraction from Psacalium decompositum on Inflammation and Dyslipidemia in Rats with Fructose-Induced Obesity

    PubMed Central

    Merino-Aguilar, Héctor; Arrieta-Baez, Daniel; Jiménez-Estrada, Manuel; Magos-Guerrero, Gil; Hernández-Bautista, René Javier; Susunaga-Notario, Ana del Carmen; Hernández-Pérez, Elizabeth; López-Díazguerrero, Norma Edith; Almanza-Pérez, Julio Cesar; Blancas-Flores, Gerardo; Román-Ramos, Rubén; Alarcón-Aguilar, Francisco Javier

    2014-01-01

    Psacalium decompositum, commonly known as “Matarique,” is a medicinal plant used in Mexico for diabetes mellitus empirical therapy. Previous studies have shown that the fructooligosaccharides (FOS) present in the roots of this plant exhibit a notable hypoglycemic effect in animal models; this effect might be associated with the attenuation of the inflammatory process and other metabolic disorders. In this study, we examined the effects of FOS fraction administration in a fructose-fed rat model for obesity. Phytochemical chromatographic studies (high performance thin layer chromatography and nuclear magnetic resonance) were performed to verify isolation of FOS. 24 male Wistar rats were maintained for 12 weeks on a diet of 20% HFCS in drinking water and chow. Glucose, cholesterol, triglycerides and liver transaminases levels were measured monthly, after administering FOS fraction intragastrically (150 mg/kg/day for 12 weeks), while the levels of inflammatory cytokines were only quantified at the end of the treatments. Rats treated with FOS fraction decreased body weight, cholesterol, triglycerides, and significantly reduced IL-6, IFN-γ, MCP-1, IL-1β and VEGF levels (p < 0.05). These results suggest that P. decompositum has anti-inflammatory and hypolipidemic properties that might be used as an alternative treatment for the control of obesity. PMID:24481132

  19. Association of Rotating Night Shift Work with BMI and Abdominal Obesity among Nurses and Midwives

    PubMed Central

    Peplonska, Beata; Bukowska, Agnieszka; Sobala, Wojciech

    2015-01-01

    Background Mounting epidemiological evidence suggests that night shift work may contribute to the etiology of increased body weight. The present study aimed to examine association between rotating night shift work and body mass index (BMI), and abdominal adiposity respectively among nurses and midwives. Methods A cross-sectional study was conducted among 724 female nurses and midwives, aged 40-60 years (354 rotating night shift and 370 daytime workers) in Łódź, Poland, between 2008 and 2011. Information about occupational history and potential confounders was collected during personal interviews. Anthropometric measurements of body weight, height, waist (WC) and hip (HC) circumference were made, and body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated. GLM regression models and multinomial logit regression models were fitted to explore the association between night shift work and anthropometric parameters, with adjustment for age, body silhouette at age 20, current smoking status, packyears, marital status, and menopausal hormone therapy use. Results Cumulative night shift work showed significant associations with BMI, WC, HC and WHtR, with BMI increasing by 0.477 kg/m2 per 1000 night duties and by 0.432 kg/m2 per 10000 night shift hours, WC increasing respectively by 1.089 cm and 0.99 cm, and HC by 0.72 cm and WHtR by 0.007 cm for both metrics. Both current and cumulative night work was associated with obesity (BMI≥30kg/m2), with OR=3.9 (95%CI:1.5-9.9), in women reporting eight or more night shifts per month. Conclusion The results of the study support the previously reported relations between night shift work and development of obesity. PMID:26196859

  20. Effects of a multidisciplinary body weight reduction program on static and dynamic thoraco-abdominal volumes in obese adolescents.

    PubMed

    LoMauro, Antonella; Cesareo, Ambra; Agosti, Fiorenza; Tringali, Gabriella; Salvadego, Desy; Grassi, Bruno; Sartorio, Alessandro; Aliverti, Andrea

    2016-06-01

    The objective of this study was to characterize static and dynamic thoraco-abdominal volumes in obese adolescents and to test the effects of a 3-week multidisciplinary body weight reduction program (MBWRP), entailing an energy-restricted diet, psychological and nutritional counseling, aerobic physical activity, and respiratory muscle endurance training (RMET), on these parameters. Total chest wall (VCW), pulmonary rib cage (VRC,p), abdominal rib cage (VRC,a), and abdominal (VAB) volumes were measured on 11 male adolescents (Tanner stage: 3-5; BMI standard deviation score: >2; age: 15.9 ± 1.3 years; percent body fat: 38.4%) during rest, inspiratory capacity (IC) maneuver, and incremental exercise on a cycle ergometer at baseline and after 3 weeks of MBWRP. At baseline, the progressive increase in tidal volume was achieved by an increase in end-inspiratory VCW (p < 0.05) due to increases in VRC,p and VRC,a with constant VAB. End-expiratory VCW decreased with late increasing VRC,p, dynamically hyperinflating VRC,a (p < 0.05), and progressively decreasing VAB (p < 0.05). After MBWRP, weight loss was concentrated in the abdomen and total IC decreased. During exercise, abdominal rib cage hyperinflation was delayed and associated with 15% increased performance and reduced dyspnea at high workloads (p < 0.05) without ventilatory and metabolic changes. We conclude that otherwise healthy obese adolescents adopt a thoraco-abdominal operational pattern characterized by abdominal rib cage hyperinflation as a form of lung recruitment during incremental cycle exercise. Additionally, a short period of MBWRP including RMET is associated with improved exercise performance, lung and chest wall volume recruitment, unloading of respiratory muscles, and reduced dyspnea. PMID:27175804

  1. Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The optimal exercise modality for reductions of abdominal obesity and risk factors for type 2 diabetes in youth is unknown. We examined the effects of aerobic exercise (AE) versus resistance exercise (RE) without caloric restriction on abdominal adiposity, ectopic fat, and insulin sensitivity and se...

  2. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Steffen, Annika; Huerta, José-Maria; Weiderpass, Elisabete; Bueno-de-Mesquita, H B As; May, Anne M; Siersema, Peter D; Kaaks, Rudolf; Neamat-Allah, Jasmine; Pala, Valeria; Panico, Salvatore; Saieva, Calogero; Tumino, Rosario; Naccarati, Alessio; Dorronsoro, Miren; Sánchez-Cantalejo, Emilio; Ardanaz, Eva; Quirós, J Ramón; Ohlsson, Bodil; Johansson, Mattias; Wallner, Bengt; Overvad, Kim; Halkjaer, Jytte; Tjønneland, Anne; Fagherazzi, Guy; Racine, Antoine; Clavel-Chapelon, Françoise; Key, Tim J; Khaw, Kay-Tee; Wareham, Nick; Lagiou, Pagona; Bamia, Christina; Trichopoulou, Antonia; Ferrari, Pietro; Freisling, Heinz; Lu, Yunxia; Riboli, Elio; Cross, Amanda J; Gonzalez, Carlos A; Boeing, Heiner

    2015-08-01

    General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR = 1.19; 95% CI, 0.63-2.22 and HR = 3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR = 0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR = 1.91; 1.09-3.37, and HR = 2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation.

  3. Red Blood Cells from Individuals with Abdominal Obesity or Metabolic Abnormalities Exhibit Less Deformability upon Entering a Constriction

    PubMed Central

    Zeng, Nancy F.; Mancuso, Jordan E.; Zivkovic, Angela M.; Smilowitz, Jennifer T.; Ristenpart, William D.

    2016-01-01

    Abdominal obesity and metabolic syndrome (MS) are multifactorial conditions associated with increased risk of cardiovascular disease and type II diabetes mellitus. Previous work has demonstrated that the hemorheological profile is altered in patients with abdominal obesity and MS, as evidenced for example by increased whole blood viscosity. To date, however, no studies have examined red blood cell (RBC) deformability of blood from individuals with obesity or metabolic abnormalities under typical physiological flow conditions. In this study, we pumped RBCs through a constriction in a microfluidic device and used high speed video to visualize and track the mechanical behavior of ~8,000 RBCs obtained from either healthy individuals (n = 5) or obese participants with metabolic abnormalities (OMA) (n = 4). We demonstrate that the OMA+ cells stretched on average about 25% less than the healthy controls. Furthermore, we examined the effects of ingesting a high-fat meal on RBC mechanical dynamics, and found that the postprandial period has only a weak effect on the stretching dynamics exhibited by OMA+ cells. The results suggest that chronic rigidification of RBCs plays a key role in the increased blood pressure and increased whole blood viscosity observed in OMA individuals and was independent of an acute response triggered by consumption of a high-fat meal. Trial Registration ClinicalTrials.gov NCT01803633 PMID:27258098

  4. Atherogenic dyslipidemia.

    PubMed

    Manjunath, C N; Rawal, Jayesh R; Irani, Paurus Mehelli; Madhu, K

    2013-11-01

    Atherogenic dyslipidemia (AD) refers to elevated levels of triglycerides (TG) and small-dense low-density lipoprotein and low levels of high-density lipoprotein cholesterol (HDL-C). In addition, elevated levels of large TG rich very low-density lipoproteins, apolipoprotein B and oxidised low-density lipoprotein (LDL), and reduced levels of small high-density lipoproteins plays a critical role in AD. All three elements of AD per se have been recognised as independent risk factor for cardiovascular disease. LDL-C/HDL-C ratio has shown excellent risk prediction of coronary heart disease than either of the two risk markers. Asian Indians have a higher prevalence of AD than western population due to higher physical inactivity, low exercise and diet deficient in polyunsaturated fatty acids (PUFA). The AD can be well managed by therapeutic lifestyle changes with increased physical activities, regular exercise, and diets low in carbohydrates and high in PUFA such as omega-3-fatty acids, as the primary intervention. This can be supplemented drug therapies such as statin monotherapy or combination therapy with niacin/fibrates. Rosuvastatin is the only statin, presently available, to effectively treat AD in diabetes and MS patients. PMID:24381869

  5. Prevalence of undiagnosed and inadequately treated type 2 diabetes mellitus, hyperension, and dyslipidemia in morbidly obese patients who present for bariatric surgery

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Context: Pharmacotherapy is considered the primary treatment modality for metabolic diseases, such as diabetes mellitus (DM), hypertension (HTN), and dyslipidemia (DYS). Objective: We hypothesize that these metabolic diseases become exceedingly difficult to treat with pharmacotherapy in morbidly ob...

  6. [Educational inequality in the occurrence of abdominal obesity according to gender and color/race: the Pro-Health Study, 1999-2001 and 2011-2012].

    PubMed

    Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

    2016-02-01

    Cross-sectional data from the Pro-Health Study in 1999-2001 and 2011-2012 revealed important gender and color/race differences in the size and variation across time in educational inequalities related to abdominal obesity. Probability of obesity increased steadily in women (independently of color/race) and men (brown/black) with less schooling. These gradients were quantified according to the relative index of inequality (RII). Over the course of the decade, there was a reduction in inequality in brown/black women (ΔRII: 0.5; 95%CI: 0.2-1.1), underlying a relatively higher increase in the prevalence of abdominal obesity in women with more schooling. RII was stable in white women and brown/black men, indicating a similar increase in the prevalence of abdominal obesity in educational subgroups. The association between schooling and abdominal obesity was affected by the multiple interaction of socio-demographic factors. Our results recommend joint stratification by gender and color/race in the study of socioeconomic inequalities related to abdominal obesity.

  7. [Educational inequality in the occurrence of abdominal obesity according to gender and color/race: the Pro-Health Study, 1999-2001 and 2011-2012].

    PubMed

    Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

    2016-02-01

    Cross-sectional data from the Pro-Health Study in 1999-2001 and 2011-2012 revealed important gender and color/race differences in the size and variation across time in educational inequalities related to abdominal obesity. Probability of obesity increased steadily in women (independently of color/race) and men (brown/black) with less schooling. These gradients were quantified according to the relative index of inequality (RII). Over the course of the decade, there was a reduction in inequality in brown/black women (ΔRII: 0.5; 95%CI: 0.2-1.1), underlying a relatively higher increase in the prevalence of abdominal obesity in women with more schooling. RII was stable in white women and brown/black men, indicating a similar increase in the prevalence of abdominal obesity in educational subgroups. The association between schooling and abdominal obesity was affected by the multiple interaction of socio-demographic factors. Our results recommend joint stratification by gender and color/race in the study of socioeconomic inequalities related to abdominal obesity. PMID:26981869

  8. Abdominal obesity modifies the risk of hypertriglyceridemia for all-cause and cardiovascular mortality in hemodialysis patients.

    PubMed

    Postorino, Maurizio; Marino, Carmen; Tripepi, Giovanni; Zoccali, Carmine

    2011-04-01

    Hypertriglyceridemia is the most prevalent lipid alteration in end-stage renal disease, and we studied the relationship between serum triglycerides and all-cause and cardiovascular death in these patients. Since abdominal fat modifies the effect of lipids on atherosclerosis, we analyzed the interaction between serum lipids and waist circumference (WC) as a metric of abdominal obesity. In a cohort of 537 hemodialysis patients, 182 died, 113 from cardiovascular causes, over an average follow-up of 29 months. In Cox models that included traditional and nontraditional risk factors, there were significant strong interactions between triglycerides and WC to both all-cause and cardiovascular death. A fixed (50 mg/dl) excess in triglycerides was associated with a progressive lower risk of all-cause and cardiovascular mortality in patients with threshold WC <95 cm but with a progressive increased risk in those above this threshold. A significant interaction between cholesterol and WC with all-cause and cardiovascular death emerged only in models excluding the triglycerides-WC interaction. Neither high-density lipoprotein (HDL) nor non-HDL cholesterol or their interaction terms with WC were associated with study outcomes. Thus, the predictive value of triglycerides and cholesterol for survival and atherosclerotic complications in hemodialysis patients is critically dependent on WC. Hence, intervention studies in end-stage renal disease should specifically target patients with abdominal obesity and hyperlipidemia.

  9. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study

    PubMed Central

    López-Sobaler, Ana M.; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18–64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415–2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045–1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m2, WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m2, WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  10. The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. NHANES 1999-2006

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The goal of this study was to examine the association between breakfast skipping and type of breakfast consumed with overweight /obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome. Three breakfast groups were identified (breakfast skippers, ready-to-eat-cereal ...

  11. Comparison of robot-assisted total laparoscopic hysterectomy and total abdominal hysterectomy for treatment of endometrial cancer in obese and morbidly obese patients.

    PubMed

    Nevadunsky, N; Clark, R; Ghosh, S; Muto, M; Berkowitz, R; Vitonis, A; Feltmate, C

    2010-12-01

    The objective of our study was to compare clinical and pathologic outcomes of robot-assisted and open abdominal techniques for treatment of uterine cancer in obese patients. Institutional review board approval was obtained. Patient demographic data, pathological data, and surgical data were collected by retrospective chart review. Data were analyzed using SAS statistical software. One-hundred and eighty-nine consecutive cases of suspected uterine cancer were identified from October 2003 until January 2009. Of these, 116 patients (61%) had a body mass index (BMI) over 30. There were 66 completed robot-assisted hysterectomies (RAHs), 43 total abdominal hysterectomies (TAHs), and seven patients that were converted from RAH to open abdominal hysterectomy. There were no significant differences in preoperative patient demographics, including body mass index (BMI), medical co-morbidities, or preoperative cytology, except for parity. There were no differences in postoperative grade, stage, lymph vascular space invasion, positive pelvic washings, mean number of pelvic lymph nodes, or proportion of patients undergoing pelvic lymphadenectomy. Length of stay and estimated blood loss were lower for the robotic technique; RAHs had a significantly longer operative time, however. Postoperative blood transfusions and wound infections were more frequent in the TAH group. Of the RAH group there were seven conversions to TAH (10%). Differences in surgical times with and without lymphadenectomy were least in patients in the largest BMI category of >50. Length of time required for RAH was significantly longer then TAH in obese and morbidly obese patients, however benefits to patients of a minimally invasive approach included reduced incidence of wound infections, reduced transfusion rates, reduced blood loss, and shortened length of stay. These data also suggest the greatest advantage of robotic technology over laparotomy in patients with BMI over 50. PMID:27627953

  12. Association of Smoking in Adolescence With Abdominal Obesity in Adulthood: A Follow-Up Study of 5 Birth Cohorts of Finnish Twins

    PubMed Central

    Pietiläinen, Kirsi; Kantonen, Suvi; Rissanen, Aila; Kaprio, Jaakko

    2009-01-01

    Objectives. We studied the association of adolescent smoking with overweight and abdominal obesity in adulthood. Methods. We used the FinnTwin16, a prospective, population-based questionnaire study of 5 consecutive and complete birth cohorts of Finnish twins born between 1975 and 1979 (N = 4296) and studied at four points between the ages of 16 and 27 years to analyze the effect of adolescent smoking on abdominal obesity and overweight in early adulthood. Results. Smoking at least 10 cigarettes daily when aged 16 to 18 years increased the risk of adult abdominal obesity (odds ratio [OR]=1.77; 95% confidence interval [CI] = 1.39, 2.26). After we adjusted for confounders, the OR was 1.44 (95% CI = 1.11, 1.88), and after further adjustment for current body mass index (BMI), the OR was 1.34 (95% CI = 0.95, 1.88). Adolescent smoking significantly increased the risk of becoming overweight among women even after adjustment for possible confounders, including baseline BMI (OR = 1.74; 95% CI = 1.06, 2.88). Conclusions. Smoking is a risk factor for abdominal obesity among both genders and for overweight in women. The prevention of smoking during adolescence may play an important role in promoting healthy weight and in decreasing the morbidity related to abdominal obesity. PMID:19059868

  13. Low CD36 and LOX-1 Levels and CD36 Gene Subexpression Are Associated with Metabolic Dysregulation in Older Individuals with Abdominal Obesity.

    PubMed

    Madrigal-Ruíz, Perla-Monserrat; Navarro-Hernández, Rosa-Elena; Ruíz-Quezada, Sandra-Luz; Corona-Meraz, Fernanda-Isadora; Vázquez-Del Mercado, Mónica; Gómez-Bañuelos, Eduardo; Castro-Albarran, Jorge; Sandoval-García, Flavio; Flores-Alvarado, Luis-Javier; Martín-Marquez, Beatriz-Teresita

    2016-01-01

    Background. Obesity study in the context of scavenger receptors has been linked to atherosclerosis. CD36 and LOX-1 are important, since they have been associated with atherogenic and metabolic disease but not fat redistribution. The aim of our study was to determinate the association between CD36 and LOX-1 in presence of age and abdominal obesity. Methods. This is a cross-sectional study that included 151 healthy individuals, clinically and anthropometrically classified into two groups by age (<30 and ≥30 years old) and abdominal obesity (according to World Health Organization guidelines). We excluded individuals with any chronic and metabolic illness, use of medication, or smoking. Fasting blood samples were taken to perform determination of CD36 mRNA expression by real-time PCR, lipid profile and metabolic and low grade inflammation markers by routine methods, and soluble scavenger receptors (CD36 and LOX-1) by ELISA. Results. Individuals ≥30 years old with abdominal obesity presented high atherogenic index, lower soluble scavenger receptor levels, and subexpression of CD36 mRNA (54% less). On the other hand, individuals <30 years old with abdominal adiposity presented higher levels in the same parameters, except LOX-1 soluble levels. Conclusion. In this study, individuals over 30 years of age presented low soluble scavenger receptors levels pattern and CD36 gene subexpression, which suggest the chronic metabolic dysregulation in abdominal obesity. PMID:27525284

  14. Low CD36 and LOX-1 Levels and CD36 Gene Subexpression Are Associated with Metabolic Dysregulation in Older Individuals with Abdominal Obesity.

    PubMed

    Madrigal-Ruíz, Perla-Monserrat; Navarro-Hernández, Rosa-Elena; Ruíz-Quezada, Sandra-Luz; Corona-Meraz, Fernanda-Isadora; Vázquez-Del Mercado, Mónica; Gómez-Bañuelos, Eduardo; Castro-Albarran, Jorge; Sandoval-García, Flavio; Flores-Alvarado, Luis-Javier; Martín-Marquez, Beatriz-Teresita

    2016-01-01

    Background. Obesity study in the context of scavenger receptors has been linked to atherosclerosis. CD36 and LOX-1 are important, since they have been associated with atherogenic and metabolic disease but not fat redistribution. The aim of our study was to determinate the association between CD36 and LOX-1 in presence of age and abdominal obesity. Methods. This is a cross-sectional study that included 151 healthy individuals, clinically and anthropometrically classified into two groups by age (<30 and ≥30 years old) and abdominal obesity (according to World Health Organization guidelines). We excluded individuals with any chronic and metabolic illness, use of medication, or smoking. Fasting blood samples were taken to perform determination of CD36 mRNA expression by real-time PCR, lipid profile and metabolic and low grade inflammation markers by routine methods, and soluble scavenger receptors (CD36 and LOX-1) by ELISA. Results. Individuals ≥30 years old with abdominal obesity presented high atherogenic index, lower soluble scavenger receptor levels, and subexpression of CD36 mRNA (54% less). On the other hand, individuals <30 years old with abdominal adiposity presented higher levels in the same parameters, except LOX-1 soluble levels. Conclusion. In this study, individuals over 30 years of age presented low soluble scavenger receptors levels pattern and CD36 gene subexpression, which suggest the chronic metabolic dysregulation in abdominal obesity.

  15. Low CD36 and LOX-1 Levels and CD36 Gene Subexpression Are Associated with Metabolic Dysregulation in Older Individuals with Abdominal Obesity

    PubMed Central

    Castro-Albarran, Jorge; Sandoval-García, Flavio; Flores-Alvarado, Luis-Javier

    2016-01-01

    Background. Obesity study in the context of scavenger receptors has been linked to atherosclerosis. CD36 and LOX-1 are important, since they have been associated with atherogenic and metabolic disease but not fat redistribution. The aim of our study was to determinate the association between CD36 and LOX-1 in presence of age and abdominal obesity. Methods. This is a cross-sectional study that included 151 healthy individuals, clinically and anthropometrically classified into two groups by age (<30 and ≥30 years old) and abdominal obesity (according to World Health Organization guidelines). We excluded individuals with any chronic and metabolic illness, use of medication, or smoking. Fasting blood samples were taken to perform determination of CD36 mRNA expression by real-time PCR, lipid profile and metabolic and low grade inflammation markers by routine methods, and soluble scavenger receptors (CD36 and LOX-1) by ELISA. Results. Individuals ≥30 years old with abdominal obesity presented high atherogenic index, lower soluble scavenger receptor levels, and subexpression of CD36 mRNA (54% less). On the other hand, individuals <30 years old with abdominal adiposity presented higher levels in the same parameters, except LOX-1 soluble levels. Conclusion. In this study, individuals over 30 years of age presented low soluble scavenger receptors levels pattern and CD36 gene subexpression, which suggest the chronic metabolic dysregulation in abdominal obesity. PMID:27525284

  16. Takeaway food consumption and its associations with diet quality and abdominal obesity: a cross-sectional study of young adults

    PubMed Central

    Smith, Kylie J; McNaughton, Sarah A; Gall, Seana L; Blizzard, Leigh; Dwyer, Terence; Venn, Alison J

    2009-01-01

    Background Few studies have investigated the associations of takeaway food consumption with overall diet quality and abdominal obesity. Young adults are high consumers of takeaway food so we aimed to examine these associations in a national study of young Australian adults. Methods A national sample of 1,277 men and 1,585 women aged 26–36 completed a self-administered questionnaire on demographic and lifestyle factors, a 127 item food frequency questionnaire, usual daily frequency of fruit and vegetable consumption and usual weekly frequency of takeaway food consumption. Dietary intake was compared with the dietary recommendations from the Australian Guide to Healthy Eating. Waist circumference was measured for 1,065 men and 1,129 women. Moderate abdominal obesity was defined as ≥ 94 cm for men and ≥ 80 cm for women. Prevalence ratios (PR) were calculated using log binomial regression. Takeaway food consumption was dichotomised, with once a week or less as the reference group. Results Consumption of takeaway food twice a week or more was reported by more men (37.9%) than women (17.7%, P < 0.001). Compared with those eating takeaway once a week or less, men eating takeaway twice a week or more were significantly more likely to be single, younger, current smokers and spend more time watching TV and sitting, whereas women were more likely to be in the workforce and spend more time watching TV and sitting. Participants eating takeaway food at least twice a week were less likely (P < 0.05) to meet the dietary recommendation for vegetables, fruit, dairy, extra foods, breads and cereals (men only), lean meat and alternatives (women only) and overall met significantly fewer dietary recommendations (P < 0.001). After adjusting for confounding variables (age, leisure time physical activity, TV viewing and employment status), consuming takeaway food twice a week or more was associated with a 31% higher prevalence of moderate abdominal obesity in men (PR: 1.31; 95% CI: 1

  17. Mildly compromised tetrahydrobiopterin cofactor biosynthesis due to Pts variants leads to unusual body fat distribution and abdominal obesity in mice.

    PubMed

    Korner, Germaine; Scherer, Tanja; Adamsen, Dea; Rebuffat, Alexander; Crabtree, Mark; Rassi, Anahita; Scavelli, Rossana; Homma, Daigo; Ledermann, Birgit; Konrad, Daniel; Ichinose, Hiroshi; Wolfrum, Christian; Horsch, Marion; Rathkolb, Birgit; Klingenspor, Martin; Beckers, Johannes; Wolf, Eckhard; Gailus-Durner, Valérie; Fuchs, Helmut; Hrabě de Angelis, Martin; Blau, Nenad; Rozman, Jan; Thöny, Beat

    2016-03-01

    Tetrahydrobiopterin (BH4) is an essential cofactor for the aromatic amino acid hydroxylases, alkylglycerol monooxygenase, and nitric oxide synthases (NOS). Inborn errors of BH4 metabolism lead to severe insufficiency of brain monoamine neurotransmitters while augmentation of BH4 by supplementation or stimulation of its biosynthesis is thought to ameliorate endothelial NOS (eNOS) dysfunction, to protect from (cardio-) vascular disease and/or prevent obesity and development of the metabolic syndrome. We have previously reported that homozygous knock-out mice for the 6-pyruvolytetrahydropterin synthase (PTPS; Pts-ko/ko) mice with no BH4 biosynthesis die after birth. Here we generated a Pts-knock-in (Pts-ki) allele expressing the murine PTPS-p.Arg15Cys with low residual activity (15% of wild-type in vitro) and investigated homozygous (Pts-ki/ki) and compound heterozygous (Pts-ki/ko) mutants. All mice showed normal viability and depending on the severity of the Pts alleles exhibited up to 90% reduction of PTPS activity concomitant with neopterin elevation and mild reduction of total biopterin while blood L-phenylalanine and brain monoamine neurotransmitters were unaffected. Yet, adult mutant mice with compromised PTPS activity (i.e., Pts-ki/ko, Pts-ki/ki or Pts-ko/wt) had increased body weight and elevated intra-abdominal fat. Comprehensive phenotyping of Pts-ki/ki mice revealed alterations in energy metabolism with proportionally higher fat content but lower lean mass, and increased blood glucose and cholesterol. Transcriptome analysis indicated changes in glucose and lipid metabolism. Furthermore, differentially expressed genes associated with obesity, weight loss, hepatic steatosis, and insulin sensitivity were consistent with the observed phenotypic alterations. We conclude that reduced PTPS activity concomitant with mildly compromised BH4-biosynthesis leads to abnormal body fat distribution and abdominal obesity at least in mice. This study associates a novel

  18. The interaction between the interleukin 6 receptor gene genotype and dietary energy intake on abdominal obesity in Japanese men.

    PubMed

    Song, Yixuan; Miyaki, Koichi; Araki, Jungo; Zhang, Ling; Omae, Kazuyuki; Muramatsu, Masaaki

    2007-07-01

    Previous reports have shown that the Asp358Ala (T/G) polymorphism of the interleukin 6 receptor (IL6R) gene is associated with obesity and type 2 diabetes mellitus, but few studies have examined this association in the Japanese population. We performed the current study to investigate the relationship between the IL6R Asp358Ala (T/G) polymorphism and obesity in healthy Japanese men. Two hundred eighty-five healthy Japanese men (age, 46.1 +/- 11.5 years [mean +/- SD]; waist circumference [WC], 83.9 +/- 9.3 cm; body mass index, 23.3 +/- 3.3 kg/m(2)) employed by a Japanese company were enrolled in this study. Height, weight, and WC were measured, and daily energy intake levels were assessed by self-reported questionnaires. Genotyping of polymorphisms was performed by using melting curve analysis; no association was found between IL6R genotype and WC or body mass index. However, when the subjects were stratified by IL6R genotype, an association between WC and dietary energy intake level was found in the TT + GT-type subjects (P for linear regression = .048), but not in GG subjects (P for linear regression = .555). In addition, logistic regression analysis revealed that the interaction of IL6R (GG vs TT + GT) genotypes and dietary energy intake levels affected risk for abdominal obesity (P for interaction = .030). We concluded that the IL6R Asp358Ala (T/G) polymorphism appears to interact with energy intake and affect abdominal obesity in Japanese men. The interaction of this genotype and energy intake warrants further study.

  19. The Combined Effects of Obesity, Abdominal Obesity and Major Depression/Anxiety on Health-Related Quality of Life: the LifeLines Cohort Study

    PubMed Central

    Nigatu, Yeshambel T.; Reijneveld, Sijmen A.; de Jonge, Peter; van Rossum, Elisabeth; Bültmann, Ute

    2016-01-01

    Background Obesity and major depressive disorder (MDD)/anxiety disorders often co-occur and aggravate each other resulting in adverse health-related outcomes. As little is known about the potential effects of interaction between obesity and MDD and/or anxiety disorders on health-related quality of life (HR-QoL), this study was aimed at examining these combined effects. Methods We collected data among N = 89,332 participants from the LifeLines cohort study. We categorized body weight using body mass index (kg/m2) as normal weight (18.5–24.99), overweight (25–29.9), mild obesity (30–34.9) and moderate/severe obesity (≥ 35); we measured abdominal obesity using a waist circumference of ≥102 and ≥ 88 cm for males and females, respectively. MDD and anxiety disorders were diagnosed with the Mini-International Neuropsychiatric Interview. HR-QoL was assessed using the RAND-36 questionnaire to compute physical and mental quality of life scores. We used binary logistic and linear regression analyses. Results The combined effect of obesity and MDD and/or anxiety disorders on physical QoL was larger than the sum of their separate effects; regression coefficients, B (95%-confidence interval, 95%-CI) were: - 1.32 (-1.75; -0.90). However, the combined effect of obesity and major depression alone on mental QoL was less than the additive effect. With increasing body weight participants report poorer physical QoL; when they also have MDD and/or anxiety disorders participants report even poorer physical QoL. In persons without MDD and/or anxiety disorders, obesity was associated with a better mental QoL. Conclusions Obesity and MDD and/or anxiety disorders act synergistically on physical and mental QoL. The management of MDD and/or anxiety disorders and weight loss may be important routes to improve HR-QoL. PMID:26866920

  20. Association of neck circumference with general and abdominal obesity in children and adolescents: the weight disorders survey of the CASPIAN-IV study

    PubMed Central

    Kelishadi, Roya; Djalalinia, Shirin; Motlagh, Mohammad Esmaiel; Rahimi, Ali; Bahreynian, Maryam; Arefirad, Tahereh; Ardalan, Gelayol; Safiri, Saeid; Hasani, Motahare; Asayesh, Hamid; Mansourian, Morteza; Qorbani, Mostafa

    2016-01-01

    Objectives This study aimed to evaluate the association of neck circumference (NC) with obesity to determine the sex-specific and age-specific optimal cut-off points of this measure in association with obesity in a national sample of the Iranian paediatric population. Methods This survey on weight disorders was conducted among a national sample of Iranian children and adolescents, aged 6–18 years. Using the area under the curve (AUC) of the receiver operator characteristic curves, we evaluated the association of NC with general and abdominal obesity. Results This national survey was conducted among 23 043 school students (50.8% boys) with a mean age (SD) of 12.55 (3.31) years. A significant association was documented between NC and other anthropometric measures in both sexes and in the whole population. In all age groups and genders, NC performed relatively well in classifying participants to overweight (AUC: 0.67 to 0.75, p<0.001), general obesity (AUC: 0.81 to 0.85, p<0.001) and abdominal obesity (AUC: 0.73 to 0.78, p<0.001). Conclusions NC can be considered as a simple time-saving clinical tool for obesity detection in large population-based studies in children and adolescents. It is significantly correlated with indices of adiposity and can reliably identify children with general and abdominal obesity in the Iranian paediatric population. PMID:27694487

  1. Abdominal obesity explains the positive rural-urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa.

    PubMed

    Ntandou, Gervais; Delisle, Hélène; Agueh, Victoire; Fayomi, Benjamin

    2009-03-01

    This cross-sectional study was designed to verify the hypothesis that there is a positive rural-urban gradient in the overall prevalence of the metabolic syndrome (MetS) and its components and that the differences are associated with socioeconomic status, a sedentary lifestyle, and poor diet quality. A sample of 541 Beninese adults apparently healthy was randomly selected from rural (n = 170), semi-urban (n = 171), and urban (n = 200) areas. The MetS was defined according to the International Diabetes Federation. Diet and physical activity were assessed with a 3-day recall. Socioeconomic and additional lifestyle information was obtained during personal interviews. A positive rural-urban gradient (rural to semi-urban to urban) was observed for the overall prevalence of the MetS (4.1%, 6.4%, and 11%, respectively; P = .035), which reflected that of abdominal obesity (28.2%, 41.5%, 52.5%; P < .001) but not for the other prominent features of the MetS, that is, high blood pressure (HBP; 24.1%, 21.6%, and 26.5%; P > .05) and reduced high-density lipoprotein cholesterol (HDL-C; 25.3%, 18.1%, 37.5%; P < .001). Diet quality and physical activity were higher in rural and semi-urban compared to urban subjects. Physical activity appeared protective for obesity, HBP, and low HDL-C. Micronutrient adequacy was an independent predictor of HDL-C and was associated with a lower likelihood of HBP. Socioeconomic status was positively associated with abdominal obesity only, which was more widespread in women than in men. This study shows that the nutrition transition is ongoing in Benin and suggests that cardiovascular disease risk could be reduced substantially by promoting physical activity and a more adequate diet.

  2. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3

    PubMed Central

    Pradeepa, Rajendra; Anjana, Ranjit Mohan; Joshi, Shashank R.; Bhansali, Anil; Deepa, Mohan; Joshi, Prashant P.; Dhandania, Vinay K.; Madhu, Sri Venkata; Rao, Paturi Vishnupriya; Geetha, Loganathan; Subashini, Radhakrishnan; Unnikrishnan, Ranjit; Shukla, Deepak Kumar; Kaur, Tanvir; Mohan, Viswanathan; Das, Ashok Kumar

    2015-01-01

    Background & objectives: Overweight and obesity are rapidly increasing in countries like India. This study was aimed at determining the prevalence of generalized, abdominal and combined obesity in urban and rural India. Methods: Phase I of the ICMR-INDIAB study was conducted in a representative population of three States [Tamil Nadu (TN), Maharashtra (MH) and Jharkhand (JH)] and one Union Territory (UT)[Chandigarh (CH)] of India. A stratified multi-stage sampling design was adopted and individuals ≥20 yr of age were included. WHO Asia Pacific guidelines were used to define overweight [body mass index (BMI) ≥23 kg/m2 but <25 kg/m2), generalized obesity (GO, BMI≥25kg/m2), abdominal obesity (AO, waist circumference ≥90 cm for men and ≥80cm for women) and combined obesity (CO, GO plus AO). Of the 14,277 participants, 13,800 subjects (response rate, 96.7%) were included for the analysis (urban: n=4,063; rural: n=9737). Results: The prevalence of GO was 24.6, 16.6, 11.8 and 31.3 per cent among residents of TN, MH, JH and CH, while the prevalence of AO was 26.6, 18.7, 16.9 and 36.1 per cent, respectively. CO was present in 19.3, 13.0, 9.8 and 26.6 per cent of the TN, MH, JH and CH population. The prevalence of GO, AO and CO were significantly higher among urban residents compared to rural residents in all the four regions studied. The prevalence of overweight was 15.2, 11.3, 7.8 and 15.9 per cent among residents of TN, MH, JH and CH, respectively. Multiple logistic regression analysis showed that female gender, hypertension, diabetes, higher socio-economic status, physical inactivity and urban residence were significantly associated with GO, AO and CO in all the four regions studied. Age was significantly associated with AO and CO, but not with GO. Interpretation & conclusions: Prevalence of AO as well as of GO were high in India. Extrapolated to the whole country, 135, 153 and 107 million individuals will have GO, AO and CO, respectively. However, these figures

  3. PER2 variants are associated with abdominal obesity, psycho-behavioral factors and attrition in the dietary treatment of obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose was to test for association between polymorphisms in the circadian clock-related gene PER2 and attrition in patients prone to withdrawal from a behavioral weight-reduction-program based on the Mediterranean Diet. 454 overweight/obese subjects (women= 380, men= 74), aged 20-65 years, who ...

  4. Prevalence of Abdominal Obesity in Spanish Children and Adolescents. Do We Need Waist Circumference Measurements in Pediatric Practice?

    PubMed Central

    Schröder, Helmut; Ribas, Lourdes; Koebnick, Corinna; Funtikova, Anna; Gomez, Santiago F.; Fíto, Montserat; Perez-Rodrigo, Carmen; Serra-Majem, Lluis

    2014-01-01

    Background Evidence indicates that central adiposity has increased to a higher degree than general adiposity in children and adolescents in recent decades. However, waist circumference is not a routine measurement in clinical practice. Objective This study aimed to determine the prevalence of abdominal obesity based on waist circumferences (WC) and waist to height ratio (WHtR) in Spanish children and adolescents aged 6 to 17 years. Further, the prevalence of abdominal obesity (AO) among normal and overweight individuals was analyzed. Design Data were obtained from a study conducted from 1998 to 2000 in a representative national sample of 1521 children and adolescents aged 6 to 17 years (50.0% female) in Spain. WC and WHtR measurements were obtained in addition to BMI. AO was defined as WHtR ≥0.50 (WHtR-AO), sex and age specific WC≥90th percentile (WC-AO1), and sex and age specific WC cut-off values associated with high trunk fat measured by by dual-energy X-ray absorptiometry (WC-AO2). Results IOTF- based overweight and obsity prevalence was 21.5% and 6.6% in children and 17.4% and 5.2% in adolescents, respectively. Abdominal obesity (AO) was defined as WHtR≥0.50 (WHtR-AO), sex- and age-specific WC≥90th percentile (WC-AO1), and sex- and age-specific WC cut-off values associated with high trunk fat measured by dual-energy X-ray absorptiometry (WC-AO2). The respective prevalence of WHtR-AO, WC-AO1, and WC-AO2 was 21.3% (24.6% boys; 17.9% girls), 9.4% (9.1% boys; 9.7% girls), and 26.8% (30.6% boys;22.9% girls) in children and 14.3% (20.0% boys; 8.7% girls), 9.6% (9.8% boys; 9.5% girls), and 21.1% (28.8% boys; 13.7% girls) in adolescents. Conclusion The prevalence of AO in Spanish children and adolescents is of concern. The high proportion of AO observed in young patients who are normal weight or overweight indicates a need to include waist circumference measurements in routine clinical practice. PMID:24475305

  5. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese

    PubMed Central

    Fan, Huimin; Li, Xiaolin; Zheng, Liang; Chen, Xiaoli; lan, Qin; Wu, Hong; Ding, Xugang; Qian, Dingguang; Shen, Yixin; Yu, Zuoren; Fan, Lieying; Chen, Ming; Tomlinson, Brian; Chan, Paul; Zhang, Yuzhen; Liu, Zhongmin

    2016-01-01

    Obesity is usually considered to predispose to atherosclerotic cardiovascular disease (ASCVD) but milder degrees of obesity or overweight may be protective in some elderly populations. We examined the relationships between general and abdominal obesity indices with ASCVD and its risk factors in elderly (aged ≥65 years) Shanghai community residents Among the 3950 participants, 21.5% had ASCVD, 56.2% had body mass index (BMI) ≥24 kg/m2, 50.1% had high waist circumference (WC) and 77.1% had waist-to-height ratio (WHtR) ≥0.50. WHtR increased with age in both men and women whereas WC increased with age only in women and BMI decreased with age only in men. The optimal WHtR cut-off value to predict the risk of ASCVD determined by receiver operating characteristic analysis was WHtR ≥0.53 with a prevalence of 55.8%. Having abdominal obesity was significantly associated with prevalent ASCVD with WHtR ≥0.53 having a higher value for the odds ratio than high WC, whereas high BMI was not associated. All three indices predicted high glucose, triglycerides and hsCRP levels but only the WHtR ≥0.53 showed a significant association with physical activity. Abdominal obesity indices, but not BMI, predicted prevalent ASCVD and its risk factors in this elderly Chinese population. PMID:26882876

  6. Endocrine system and obesity.

    PubMed

    Ashburn, Doyle D; Reed, Mary Jane

    2010-10-01

    Obesity is associated with significant alterations in endocrine function. An association with type 2 diabetes mellitus and dyslipidemia has been well documented. This article highlights the complexities of treating endocrine system disorders in obese patients.

  7. The association between abdominal obesity and characteristics of migraine attacks in Iranian adults

    PubMed Central

    Sadeghi, Omid; Askari, Gholamreza; Maghsoudi, Zahra; Ghiasvand, Reza; Khorvash, Fariborz

    2016-01-01

    Background: Migraine is a primary headache disorder that affects the neurovascular system. Recent studies have shown that migraine patients with general obesity have higher characteristics of migraine attacks compared with normal weight patients, but data on central obesity are scarce. This study was done to assess the relationship between central obesity and the characteristics of migraine attacks in migraine patients. Materials and Methods: This cross-sectional study was conducted on 129 migraine patients (28 men and 101 women), aged 15–67 years, in Isfahan, Iran. Anthropometric measurements such as waist circumference (WC), hip circumference (HC), waist–hip ratio (WHR) and waist–height ratio (WHtR), as well as characteristics of migraine attacks such as severity, frequency, duration, and headache diary result (HDR) was determined for each participant. Linear regression was used to examine the association between anthropometric measurements and characteristics of migraine attacks. P value less than 0.05 was considered significant. Results: WC, WHR, and WHtR were positively associated with the severity (P-value: WC: 0.002, WHR: 0.002, WHtR: 0.001) and frequency (P-value: WC: 0.006, WHR: 0.01, WHtR: 0.002) of migraine attacks. Moreover, we found a significant association between WC (P = 0.001), WHR (P = 0.004), and WHtR (P < 0.001) with HDR. No significant relationship was observed between central obesity indicators and duration of migraine attacks. Conclusions: Central obesity indicators were positively associated with the severity and frequency of migraine attacks as well as HDR, but not with duration of attacks. Based on our findings, it can be concluded that weight loss may decrease the characteristics of migraine attacks. PMID:27186204

  8. Infrequent breakfast consumption is associated with higher body adiposity and abdominal obesity in Malaysian school-aged adolescents.

    PubMed

    Nurul-Fadhilah, Abdullah; Teo, Pey Sze; Huybrechts, Inge; Foo, Leng Huat

    2013-01-01

    Unhealthy dietary pattern increases the risk of obesity and metabolic disorders in growing children and adolescents. However, the way the habitual pattern of breakfast consumption influences body composition and risk of obesity in adolescents is not well defined. Thus, the aim of the present study was to assess any associations between breakfast consumption practices and body composition profiles in 236 apparently healthy adolescents aged 12 to 19 years. A self-administered questionnaire on dietary behaviour and lifestyle practices and a dietary food frequency questionnaire were used. Body composition and adiposity indices were determined using standard anthropometric measurement protocols and dual energy χ-ray absorptiometry (DXA). Mean age of the participants was 15.3±1.9 years. The majority of participants (71.2%) fell in the normal body mass index (BMI) ranges. Breakfast consumption patterns showed that only half of the participants (50%) were consuming breakfast daily. Gender-specific multivariate analyses (ANCOVA) showed that in both boys and girls, those eating breakfast at least 5 times a week had significantly lower body weight, body mass index (BMI), BMI z-scores, waist circumference, body fat mass and percent body fat (%BF) compared to infrequent breakfast eaters, after adjustment for age, household income, pubertal status, eating-out and snacking practices, daily energy intakes, and daily physical activity levels. The present findings indicate that infrequent breakfast consumption is associated with higher body adiposity and abdominal obesity. Therefore, daily breakfast consumption with healthy food choices should be encouraged in growing children and adolescents to prevent adiposity during these critical years of growth. PMID:23520556

  9. Improvement in insulin sensitivity following a 1-year lifestyle intervention program in viscerally obese men: contribution of abdominal adiposity.

    PubMed

    Borel, Anne-Laure; Nazare, Julie-Anne; Smith, Jessica; Alméras, Natalie; Tremblay, Angelo; Bergeron, Jean; Poirier, Paul; Després, Jean-Pierre

    2012-02-01

    The objectives of the study were to quantify the effect of a 1-year healthy eating-physical activity/exercise lifestyle modification program on insulin sensitivity in viscerally obese men classified according to their glucose tolerance status and to evaluate the respective contributions of changes in body fat distribution vs changes in cardiorespiratory fitness (CRF) to the improvements in indices of plasma glucose/insulin homeostasis. Abdominally obese, dyslipidemic men (waist circumference ≥90 cm, triglycerides ≥1.69 mmol/L, and/or high-density lipoprotein cholesterol <1.03 mmol/L) were recruited. The 1-year intervention/evaluation was completed by 104 men. Body weight, composition, and fat distribution were assessed by dual-energy x-ray absorptiometry/computed tomography. Cardiorespiratory fitness and cardiometabolic risk profile were measured. After 1 year, insulin sensitivity improved in association with decreases in both visceral (VAT) and subcutaneous adiposity (SAT) as well as with the improvement in CRF, regardless of baseline glucose tolerance. Further analyses were performed according to changes in glucose tolerance status: improvement (group I, n = 39), no change (group N, n = 50), or worsening (group W, n = 15) after 1 year. Groups I and N improved their insulin sensitivity and their CRF, whereas group W did not, while losing less VAT than groups I and N. Multiple regressions showed that reduction in VAT was associated with an improvement in homeostasis model assessment of insulin resistance, whereas reduction in SAT was rather associated with improvement of the insulin sensitivity index of Matsuda. Changes in CRF were not independently associated with changes in indices of plasma glucose/insulin homeostasis. A 1-year lifestyle intervention improved plasma glucose/insulin homeostasis in viscerally obese men, including those with normal glucose tolerance status at baseline. Changes in SAT and VAT but not in CRF appeared to mediate these improvements

  10. Magnetic Resonance Imaging of Changes in Abdominal Compartments in Obese Diabetics during a Low-Calorie Weight-Loss Program

    PubMed Central

    Vogt, Lena J.; Steveling, Antje; Meffert, Peter J.; Kromrey, Marie-Luise; Kessler, Rebecca; Hosten, Norbert; Krüger, Janine; Gärtner, Simone; Aghdassi, Ali A.; Mayerle, Julia; Lerch, Markus M.; Kühn, Jens-Peter

    2016-01-01

    Objectives To investigate changes in the fat content of abdominal compartments and muscle area during weight loss using confounder-adjusted chemical-shift-encoded magnetic resonance imaging (MRI) in overweight diabetics. Methods Twenty-nine obese diabetics (10/19 men/women, median age: 59.0 years, median body mass index (BMI): 34.0 kg/m2) prospectively joined a standardized 15-week weight-loss program (six weeks of formula diet exclusively, followed by reintroduction of regular food with gradually increasing energy content over nine weeks) over 15 weeks. All subjects underwent a standardized MRI protocol including a confounder-adjusted chemical-shift-encoded MR sequence with water/fat separation before the program as well at the end of the six weeks of formula diet and at the end of the program at 15 weeks. Fat fractions of abdominal organs and vertebral bone marrow as well as volumes of visceral and subcutaneous fat were determined. Furthermore, muscle area was evaluated using the L4/L5 method. Data were compared using the Wilcoxon signed-rank test for paired samples. Results Median BMI decreased significantly from 34.0 kg/m2 to 29.9 kg/m2 (p < 0.001) at 15 weeks. Liver fat content was normalized (14.2% to 4.1%, p < 0.001) and vertebral bone marrow fat (57.5% to 53.6%, p = 0.018) decreased significantly throughout the program, while fat content of pancreas (9.0%), spleen (0.0%), and psoas muscle (0.0%) did not (p > 0.15). Visceral fat volume (3.2 L to 1.6 L, p < 0.001) and subcutaneous fat diameter (3.0 cm to 2.2 cm, p < 0.001) also decreased significantly. Muscle area declined by 6.8% from 243.9 cm2 to 226.8 cm2. Conclusion MRI allows noninvasive monitoring of changes in abdominal compartments during weight loss. In overweight diabetics, weight loss leads to fat reduction in abdominal compartments, such as visceral fat, as well as liver fat and vertebral bone marrow fat while pancreas fat remains unchanged. PMID:27110719

  11. Dyslipidemia in Dermatological Disorders

    PubMed Central

    Shenoy, Chetana; Shenoy, Manjunath Mala; Rao, Gururaja K.

    2015-01-01

    Dyslipidemias are one of the common metabolic disorders. A link between dermatological disorders like psoriasis and dyslipidemia has been established in the recent past. Many dermatological disorders could have a systemic inflammatory component which explains such association. Chronic inflammatory dermatological disorders could also have other metabolic imbalances that may contribute to dyslipidemia. Presence of such abnormal metabolism may justify routine screening of these disorders for associated dyslipidemia and other metabolic abnormalities and early treatment of such comorbidities to improve quality of life. Some of the drugs used by dermatologists such as retinoids are also likely to be a cause of dyslipidemia. Hence, it is imperative that the dermatologists obtain scientific knowledge on the underlying mechanisms involved in dyslipidemia and understand when to intervene with therapies. A systematic review of the English language literature was done by using Google Scholar and PubMed. In this review, attempts are made to list the dermatological disorders associated with dyslipidemia; to simplify the understanding of underlying mechanisms; and to give a brief idea about the interventions. PMID:26713286

  12. Interrelationships between changes in anthropometric variables and computed tomography indices of abdominal fat distribution in response to a 1-year physical activity-healthy eating lifestyle modification program in abdominally obese men.

    PubMed

    Villeneuve, Nicole; Pelletier-Beaumont, Emilie; Nazare, Julie-Anne; Lemieux, Isabelle; Alméras, Natalie; Bergeron, Jean; Tremblay, Angelo; Poirier, Paul; Després, Jean-Pierre

    2014-04-01

    The objectives were to (i) measure the effects of a 1-year lifestyle modification program on body fat distribution/anthropometric variables; (ii) determine the interrelationships between changes in all these variables; and (iii) investigate whether there is a selective reduction in deep (DSAT) vs. superficial subcutaneous adipose tissue (SSAT) at the abdominal level following a 1-year lifestyle modification program. Anthropometric variables, body composition and abdominal and midthigh fat distribution were assessed at baseline and after 1 year in 109 sedentary, dyslipidemic and abdominally obese men. Reductions in anthropometric variables, skinfold thicknesses (except the trunk/extremity ratio) and fat mass as well as an increase in fat-free mass were observed after 1 year (p < 0.0001). Decreases in abdominal adipose tissue volumes were also noted (-23%, -26%, -18%, -19%, -17%, p < 0.0001 for total adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, DSAT and SSAT, respectively). Adipose tissue areas at midthigh also decreased (-18%, -18%, -17%, p < 0.0001 for total, deep, and subcutaneous adipose tissue, respectively). A reduction (-9%, p < 0.0001) in low-attenuation muscle area and an increase (+1%, p < 0.05) in normal-attenuation muscle area were also observed. There was a positive relationship between changes in visceral adipose tissue and changes in DSAT (r = 0.65, p < 0.0001) or SSAT (r = 0.63, p < 0.0001). Although absolute changes in DSAT were greater than changes in SSAT, relative changes in both depots were similar, independent of changes in visceral adipose tissue. The 1-year lifestyle modification program therefore improved the body fat distribution pattern and midthigh muscle quality in abdominally obese men.

  13. Impact of weight loss with or without exercise on abdominal fat and insulin resistance in obese individuals: a randomised clinical trial.

    PubMed

    Trussardi Fayh, Ana Paula; Lopes, André Luiz; Fernandes, Pablo Rober; Reischak-Oliveira, Alvaro; Friedman, Rogério

    2013-08-28

    Evidence supports an important contribution of abdominal obesity and inflammation to the development of insulin resistance (IR) and CVD. Weight loss in obese individuals can reduce inflammation and, consequently, IR, but the role of training remains unclear. The aim of this study was to evaluate the effects of body weight reduction with and without exercise over abdominal fat tissue (primary outcome) and IR. In this randomised clinical trial, forty-eight obese individuals (age 31·8 (SD 6·0) years, BMI 34·8 (SD 2·7) kg/m2) were randomised to either a diet-only group (DI) or a diet and exercise group (DI þ EXE). Treatment was maintained until 5% of the initial body weight was lost. At baseline and upon completion, the following parameters were analysed: biochemical parameters such as glycaemia and insulin for the determination of homeostasis model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP) and abdominal computed tomography for the determination of visceral and subcutaneous adipose tissue. A total of thirteen individuals dropped out before completing the weight-loss intervention and did not repeat the tests. In both the DI (n 18) and DI þ EXE (n 17) groups, we observed significant and similar decreases of visceral adipose tissue (difference between means: 7·9 (95% CI 29·5, 25·2) cm2, P¼0·36), hs-CRP (difference between means: 20·06 (95% CI 20·19, 0·03) mg/l, P¼0·39) and HOMA (difference between means: 20·04 (95% CI 20·17, 0·08), P¼0·53). In the present study, 5% weight loss reduced abdominal fat and IR in obese individuals and exercise did not add to the effect of weight loss on the outcome variables.

  14. Abdominal Obesity and Association With Atherosclerosis Risk Factors: The Uberlândia Heart Study.

    PubMed

    Roever, Leonardo S; Resende, Elmiro S; Diniz, Angélica L D; Penha-Silva, Nilson; Veloso, Fernando C; Casella-Filho, Antonio; Dourado, Paulo M M; Chagas, Antonio C P

    2016-03-01

    Ectopic visceral fat (VF) and subcutaneous fat (SCF) are associated with cardiovascular risk factors. Gender differences in the correlations of cardiovascular disease risk factors and ectopic fat in the Brazilian population still lacking. Cross-sectional study with 101 volunteers (50.49% men; mean age 56.5 ± 18, range 19-74 years) drawn from the Uberlândia Heart Study underwent ultrasonography assessment of abdominal visceral adipose tissue with convex transducer of 3.5 MHz of frequency. The thickness of VF was ultrasonographically measured by the distance between the inner face of the abdominal muscle and the posterior face of abdominal aorta, 1 cm above the umbilicus. The SCF thickness was measured with a 7.5 MHz linear transducer transversely positioned 1 cm above the umbilical scar. The exams were always performed by the same examiner. Ectopic fat volumes were examined in relation to waist circumference, blood pressure, and metabolic risk factors. The VF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.10), HDL cholesterol (P < 0.005, r = 0.15), total cholesterol (P < 0.01, r = 0.10), waist circumference (P < 0.0001, r = 0.43), systolic blood pressure (P < 0.001, r = 0.41), and diastolic blood pressure (P < 0.001, r = 0.32) in women, and with the levels of triglycerides (P < 0.002, r = 0,14), HDL cholesterol (P < 0.032, r = 0.07), glucose (P < 0.001, r = 0.15), alanine aminotransferase (ALT) (P < 0.008, r = 0.12), gamma-GT (P < 0.001, r = 0.30), waist circumference (P < 0.001, r = 0.52), systolic blood pressure (P < 0.001, r = 0.32), and diastolic blood pressure (P < 0.001, r = 0.26) in men. SCF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.34), LDL cholesterol (P < 0.001, r = 0.36), total cholesterol (P < 0.05, r = 0.36), waist circumference (P

  15. Do obese but metabolically normal women differ in intra-abdominal fat and physical activity levels from those with the expected metabolic abnormalities? A cross-sectional study

    PubMed Central

    2010-01-01

    Background Obesity remains a major public health problem, associated with a cluster of metabolic abnormalities. However, individuals exist who are very obese but have normal metabolic parameters. The aim of this study was to determine to what extent differences in metabolic health in very obese women are explained by differences in body fat distribution, insulin resistance and level of physical activity. Methods This was a cross-sectional pilot study of 39 obese women (age: 28-64 yrs, BMI: 31-67 kg/m2) recruited from community settings. Women were defined as 'metabolically normal' on the basis of blood glucose, lipids and blood pressure. Magnetic Resonance Imaging was used to determine body fat distribution. Detailed lifestyle and metabolic profiles of participants were obtained. Results Women with a healthy metabolic profile had lower intra-abdominal fat volume (geometric mean 4.78 l [95% CIs 3.99-5.73] vs 6.96 l [5.82-8.32]) and less insulin resistance (HOMA 3.41 [2.62-4.44] vs 6.67 [5.02-8.86]) than those with an abnormality. The groups did not differ in abdominal subcutaneous fat volume (19.6 l [16.9-22.7] vs 20.6 [17.6-23.9]). A higher proportion of those with a healthy compared to a less healthy metabolic profile met current physical activity guidelines (70% [95% CIs 55.8-84.2] vs 25% [11.6-38.4]). Intra-abdominal fat, insulin resistance and physical activity make independent contributions to metabolic status in very obese women, but explain only around a third of the variance. Conclusion A sub-group of women exists who are metabolically normal despite being very obese. Differences in fat distribution, insulin resistance, and physical activity level are associated with metabolic differences in these women, but account only partially for these differences. Future work should focus on strategies to identify those obese individuals most at risk of the negative metabolic consequences of obesity and on identifying other factors that contribute to metabolic status

  16. Inverse Relationship between the Inflammatory Marker Pentraxin-3, Fat Body Mass, and Abdominal Obesity in End-Stage Renal Disease

    PubMed Central

    Miyamoto, Tetsu; Rashid Qureshi, Abdul; Heimbürger, Olof; Bárány, Peter; Carrero, Karin; Sjöberg, Bodil; Lindholm, Bengt; Stenvinkel, Peter

    2011-01-01

    Summary Background and objectives Pentraxin-3 (PTX3) belongs to the same pentraxin superfamily of acute-phase reactants as C-reactive protein (CRP). Abdominal fat accumulation in ESRD is considered a chronic inflammatory state, but the relationship of PTX3 to this phenomenon is unknown. This study assesses plausible associations between PTX3 and surrogates of fat mass deposits in dialysis patients. Design, setting, participants, & measurements Circulating levels of PTX3, CRP, and IL-6 were cross-sectionally analyzed in relation to anthropometric and nutritional surrogate markers of fat tissue in two cohorts comprising 156 prevalent hemodialysis (HD) and 216 incident dialysis patients. Results In both cohorts, PTX3 was negatively associated with body mass index (BMI) and fat body mass index (FBMI) derived from anthropometrics and leptin, whereas there was a positive association with adiponectin. In prevalent HD patients, those with larger waist circumference (above gender-specific median values) had lower PTX3, higher CRP, and higher IL-6 levels. This was also true in multivariate analyses. In both cohorts, multivariate regression analyses showed that PTX3 was negatively and CRP (or IL-6) was positively associated with FBMI. Conclusions Although CRP and IL-6 were directly associated with body fat, PTX3 levels showed negative correlations with surrogates of adipose tissue in two independent cohorts of ESRD patients. Understanding the underlying reasons behind these opposite associations may have clinical relevance given the survival advantage described for obese patients on dialysis. PMID:22157708

  17. [Systolic pressure, abdominal obesity and body fat, metabolic syndrome predictors in Spanish preschoolers].

    PubMed

    Gutiérrez Hervás, Ana Isabel; Rizo Baeza, María Mercedes; Martínez Amorós, Natalia; Cortés Castell, Ernesto

    2015-05-01

    Se plantea como objetivo determinar la presencia de predictores de síndrome metabólico en niños de 2 a 7 años en relación a su estado nutricional. Método: Estudio descriptivo con análisis cuantitativo en 260 niños de 2-7 años (135 niñas y 125 niños), 66% del total censados. Se midieron parámetros antropométricos y tensión arterial y se calcularon IMC, grasa corporal según Hoffman e índice cintura-talla (ICT). Se realizaron subgrupos con Z-Score del IMC según edad y sexo (bajo peso, normopeso, sobrepeso y obesidad), según grasa corporal (normal y con exceso), ICT (normal y obesidad abdominal) y tensión sistólica (normotensos e hipertensos según edad y sexo). Se utilizó como variable principal la clasificación según Z-Score del IMC. Resultados: La prevalencia combinada de sobrepeso y obesidad fue del 27%, sin diferencias por sexo. El estado nutricional relacionó significativamente con tensión arterial, grasa corporal e índice cintura-talla. Mayor porcentaje de obesos con tensión arterial sistólica alta que de normonutridos (OR=4.1; IC95% 1.7-9.8; p.

  18. Elevated Serum Retinol and Low Beta-Carotene but not Alpha-Tocopherol Concentrations Are Associated with Dyslipidemia in Brazilian Adolescents.

    PubMed

    Albuquerque, Mellina Neyla de Lima; Diniz, Alcides da Silva; Arruda, Ilma Kruze Grande de

    2016-01-01

    The purpose of this study was to investigate the status of retinol, beta-carotene, and alpha-tocopherol serum concentrations in adolescents with dyslipidemia. A case series dyslipidemia study was conducted, with an attached control group, including 104 adolescents of public schools in Recife during the months of March/April 2013. Retinol, beta-carotene and alpha-tocopherol serum concentrations were analysed by high efficiency liquid chromatography. Sociodemographic, anthropometric, clinical and biochemical variables were analysed. Dyslipidemic adolescents had high serum concentrations of both retinol (p=0.007) and beta-carotene/apolipoprotein A-I ratio (p=0.034); they also had low concentrations of beta-carotene/total cholesterol (p<0.0001) and beta-carotene/apolipoprotein B ratios (p=0.033) when compared to the controls. The alpha-tocopherol serum status was not associated with dyslipidemia. Overweight, abdominal obesity, lipid profile markers, and systolic and diastolic blood pressures were more prevalent in dyslipidemic adolescents. The findings show an association between vitamin A and dyslipidemia in adolescents. However, additional investigations of this risk group are necessary to clarify the mechanisms of action of this nutrient in the pathogenesis of this syndrome, aiming at reducing cardiometabolic risks as of earlier ages. PMID:27264090

  19. A multicomponent nutrient bar promotes weight loss and improves dyslipidemia and insulin resistance in the overweight/obese: Chronic inflammation blunts these improvements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Poor diets are a major cause of obesity-associated metabolic dysregulation. It is difficult for many people to change dietary patterns. We hypothesized that dietary-induced metabolic dysregulation, and consequent increased risk of disease, is due in large part to what poor diets are lacking; a nutri...

  20. Apigenin Ameliorates Dyslipidemia, Hepatic Steatosis and Insulin Resistance by Modulating Metabolic and Transcriptional Profiles in the Liver of High-Fat Diet-Induced Obese Mice

    PubMed Central

    Jung, Un Ju; Cho, Yun-Young; Choi, Myung-Sook

    2016-01-01

    Several in vitro and in vivo studies have reported the anti-inflammatory, anti-diabetic and anti-obesity effects of the flavonoid apigenin. However, the long-term supplementary effects of low-dose apigenin on obesity are unclear. Therefore, we investigated the protective effects of apigenin against obesity and related metabolic disturbances by exploring the metabolic and transcriptional responses in high-fat diet (HFD)-induced obese mice. C57BL/6J mice were fed an HFD or apigenin (0.005%, w/w)-supplemented HFD for 16 weeks. In HFD-fed mice, apigenin lowered plasma levels of free fatty acid, total cholesterol, apolipoprotein B and hepatic dysfunction markers and ameliorated hepatic steatosis and hepatomegaly, without altering food intake and adiposity. These effects were partly attributed to upregulated expression of genes regulating fatty acid oxidation, tricarboxylic acid cycle, oxidative phosphorylation, electron transport chain and cholesterol homeostasis, downregulated expression of lipolytic and lipogenic genes and decreased activities of enzymes responsible for triglyceride and cholesterol ester synthesis in the liver. Moreover, apigenin lowered plasma levels of pro-inflammatory mediators and fasting blood glucose. The anti-hyperglycemic effect of apigenin appeared to be related to decreased insulin resistance, hyperinsulinemia and hepatic gluconeogenic enzymes activities. Thus, apigenin can ameliorate HFD-induced comorbidities via metabolic and transcriptional modulations in the liver. PMID:27213439

  1. Apigenin Ameliorates Dyslipidemia, Hepatic Steatosis and Insulin Resistance by Modulating Metabolic and Transcriptional Profiles in the Liver of High-Fat Diet-Induced Obese Mice.

    PubMed

    Jung, Un Ju; Cho, Yun-Young; Choi, Myung-Sook

    2016-01-01

    Several in vitro and in vivo studies have reported the anti-inflammatory, anti-diabetic and anti-obesity effects of the flavonoid apigenin. However, the long-term supplementary effects of low-dose apigenin on obesity are unclear. Therefore, we investigated the protective effects of apigenin against obesity and related metabolic disturbances by exploring the metabolic and transcriptional responses in high-fat diet (HFD)-induced obese mice. C57BL/6J mice were fed an HFD or apigenin (0.005%, w/w)-supplemented HFD for 16 weeks. In HFD-fed mice, apigenin lowered plasma levels of free fatty acid, total cholesterol, apolipoprotein B and hepatic dysfunction markers and ameliorated hepatic steatosis and hepatomegaly, without altering food intake and adiposity. These effects were partly attributed to upregulated expression of genes regulating fatty acid oxidation, tricarboxylic acid cycle, oxidative phosphorylation, electron transport chain and cholesterol homeostasis, downregulated expression of lipolytic and lipogenic genes and decreased activities of enzymes responsible for triglyceride and cholesterol ester synthesis in the liver. Moreover, apigenin lowered plasma levels of pro-inflammatory mediators and fasting blood glucose. The anti-hyperglycemic effect of apigenin appeared to be related to decreased insulin resistance, hyperinsulinemia and hepatic gluconeogenic enzymes activities. Thus, apigenin can ameliorate HFD-induced comorbidities via metabolic and transcriptional modulations in the liver. PMID:27213439

  2. [Obesity and cancer: «Dangerous friendship»].

    PubMed

    González Svatetz, Carlos A; Goday Arnó, Alberto

    2015-07-01

    Obesity and cancer are one of the most important health problems is Spain. Between 23 and 28% of the adult population in Spain are obese, 39% are overweight and 36% have abdominal obesity. The association between obesity and type 2 diabetes mellitus, hypertension, dyslipidemia and sleep obstructive apnea is well known. On the contrary, the association between obesity and cancer is less known, because the recent evidence on it. Several prospective studies have shown during the last years the strong relationship between obesity and cancer of colon, breast in post-menopausal women, endometrial, kidney and pancreas as well as esophageal adenocarcinoma. Furthermore there is recent evidence showing that liver, gallbladder, thyroid and ovarian cancer as well as leukemia, multiple myeloma and Hodgkin lymphomas are probably associated with obesity, yet more studies are needed. A better knowledge of the relation between cancer and obesity will allow improving the prevention strategies against cancer, a more efficient early detection, and a more suitable treatment of obesity and overweight. Although the mechanisms of carcinogenesis of obesity are not well established, avoiding overweight and obesity are considered one of the best approaches to reduce the risk of cancer. Therefore the general population must be aware that cancer is one of the most important hazards associated with the current obesity epidemic in our society.

  3. Prevalence and Risk Factors Associated with Dyslipidemia in Chongqing, China

    PubMed Central

    Qi, Li; Ding, Xianbin; Tang, Wenge; Li, Qin; Mao, Deqiang; Wang, Yulin

    2015-01-01

    The increasing prevalence of dyslipidemia has become a worldwide public health problem, and the prevalence varies widely according to socioeconomic, cultural and ethnic characteristics. Chongqing has experienced rapid economic development and is now the economic center of Southwestern China. There are scant data on serum lipid profile of residents in Chongqing, the largest municipality directly under the Central Government in China. We conducted a cross-sectional study in a representative sample of 5375 residents of Chongqing, aged ≥18 years, and estimated the prevalence of dyslipidemia and its associated risk factors. According to the National Cholesterol Education Program-Adult Treatment Panel III criteria, the age-standardized prevalence of dyslipidemia was 35.5% (34.4% among men and 37.6% among women). Among the 2009 patients with dyslipidemia, 44.2% had isolated hypertriglyceridemia, 14.7% had isolated hypercholesterolemia, 13.2% had mixed hyperlipidemia, and 28.0% had isolated low high-density lipoprotein cholesterol. The peak prevalence of dyslipidemia in men was between 30 and 39 years (48.2%), and then declined gradually; in women, the prevalence of dyslipidemia increased with age, with the peak prevalence occurring after age 60 (46.3%). Multivariable logistic regression analysis revealed that dyslipidemia was associated with age, education level, physical activity, obesity and central obesity for both men and women. In conclusion, the results indicated dyslipidemia, particularly hypertriglyceridemia and low high-density lipoprotein cholesterol, are very common in Chongqing. To prevent dyslipidemia, it is essential to conduct appropriate intervention programs aimed at risk factor reduction and implement routine screening programs for blood lipid levels in Chongqing, China. PMID:26516874

  4. Prevalence and Risk Factors Associated with Dyslipidemia in Chongqing, China.

    PubMed

    Qi, Li; Ding, Xianbin; Tang, Wenge; Li, Qin; Mao, Deqiang; Wang, Yulin

    2015-10-01

    The increasing prevalence of dyslipidemia has become a worldwide public health problem, and the prevalence varies widely according to socioeconomic, cultural and ethnic characteristics. Chongqing has experienced rapid economic development and is now the economic center of Southwestern China. There are scant data on serum lipid profile of residents in Chongqing, the largest municipality directly under the Central Government in China. We conducted a cross-sectional study in a representative sample of 5375 residents of Chongqing, aged ≥18 years, and estimated the prevalence of dyslipidemia and its associated risk factors. According to the National Cholesterol Education Program-Adult Treatment Panel III criteria, the age-standardized prevalence of dyslipidemia was 35.5% (34.4% among men and 37.6% among women). Among the 2009 patients with dyslipidemia, 44.2% had isolated hypertriglyceridemia, 14.7% had isolated hypercholesterolemia, 13.2% had mixed hyperlipidemia, and 28.0% had isolated low high-density lipoprotein cholesterol. The peak prevalence of dyslipidemia in men was between 30 and 39 years (48.2%), and then declined gradually; in women, the prevalence of dyslipidemia increased with age, with the peak prevalence occurring after age 60 (46.3%). Multivariable logistic regression analysis revealed that dyslipidemia was associated with age, education level, physical activity, obesity and central obesity for both men and women. In conclusion, the results indicated dyslipidemia, particularly hypertriglyceridemia and low high-density lipoprotein cholesterol, are very common in Chongqing. To prevent dyslipidemia, it is essential to conduct appropriate intervention programs aimed at risk factor reduction and implement routine screening programs for blood lipid levels in Chongqing, China. PMID:26516874

  5. Efficacy of two different materials used in auricular acupressure on weight reduction and abdominal obesity.

    PubMed

    Hsieh, Ching Hsiu; Su, Tsann-Juu; Fang, Yu-Wen; Chou, Pei-Hsuan

    2012-01-01

    The current study was designed to test the efficacy of different materials used in an auricular acupressure program on weight reduction, changes to waist circumference and waist-to-hip ratio. This study used a randomized design with two groups who were treated with auricular acupressure using Semen Vaccariae or the Japanese Magnetic Pearl. Both groups consisted of Asian young adults with a waist circumference ≥ 80 cm in the females and ≥ 90 cm in the males. At completion of the eight-week treatment period, the total sample size was 56 young adults who ranged in age from 18 to 20 years old. Each participant was met with weekly for ten-minute sessions during which ear acupressure treatment was performed. Sessions continued for eight weeks wherein both groups received acupressure with the Japanese Magnetic Pearl or Semen Vaccariae on the ear acupoints. While both groups showed significant reductions (p ≤ 0.05) to body weight and waist circumference after eight weeks of treatments, the group treated with Semen Vaccariae group showed a more effective weight loss over the short term. Given that auricular acupressure is a safe and cost-effective treatment for weight loss, our results suggest that auricular acupressure is a reasonable option for the treatment of overweight and obesity in young adults. PMID:22809026

  6. Dyslipidemia in Psoriasis: A Case Controlled Study

    PubMed Central

    Nakhwa, Y. C.; Rashmi, R.; Basavaraj, K. H.

    2014-01-01

    Multiple observational studies have demonstrated associations of psoriasis with metabolic syndrome including obesity, diabetes, hypertension, dyslipidemia, and osteoporosis. However there is paucity of Indian studies on dyslipidemia in psoriasis. The aim of this study was to assess the serum lipids in psoriasis and to investigate the association of lipids with disease severity and its duration. 100 cases of psoriasis (75/M, 25/F), between 15 and 72 years, were recruited with age and sex matched 73 controls. Using Psoriasis Area Severity Index (PASI) cases were graded into mild, moderate, and severe psoriasis. Serum total cholesterol and triglycerides were analyzed using enzymatic method. Using independent t-test, significant elevation of serum cholesterol, triglycerides, high density lipoprotein (HDL) and very low density lipoprotein was observed (P < 0.05) when compared to controls. The levels of low density lipoproteins were comparable in cases and controls. Lipid aberrations in hypertensive patients were significant. There was a decrease in HDL levels with increase in disease severity. A fall in the levels of HDL was seen in cases with long term psoriasis. There is a strong association of dyslipidemia with psoriasis. There exist racial and ethnic variation in the prevalence of psoriasis; however, dyslipidemia is consistently seen in diverse population. Whether genetic factors are implicated in lipid derangements in psoriasis needs further research. PMID:27433517

  7. Congenital lipodystrophies and dyslipidemias.

    PubMed

    Prieur, Xavier; Le May, Cedric; Magré, Jocelyne; Cariou, Bertrand

    2014-09-01

    Lipodystrophies are rare acquired and genetic disorders characterized by the selective loss of adipose tissue. One key metabolic feature of patients with congenital inherited lipodystrophy is hypertriglyceridemia. The precise mechanisms by which the lack of adipose tissue causes dyslipidemia remain largely unknown. In recent years, new insights have arisen from data obtained in vitro in adipocytes, yeast, drosophila, and very recently in several genetically modified mouse models of generalized lipodystrophy. A common metabolic pathway involving accelerated lipolysis and defective energy storage seems to contribute to the dyslipidemia associated with congenital generalized lipodystrophy syndromes, although the pathophysiological changes may vary with the nature of the mutation involved. Therapeutic management of dyslipidemia in patients with lipodystrophy is primarily based on specific approaches using recombinant leptin therapy. Preclinical studies suggest a potential efficacy of thiazolidinediones that remains to be assessed in dedicated clinical trials.

  8. Influence of Abdominal Obesity on the Lipid-Lipoprotein Profile in Apoprotein E2/4 Carriers: The Effect of an Apparent Duality

    PubMed Central

    Villeneuve, Sylvia; Brisson, Diane; Gaudet, Daniel

    2015-01-01

    Background. Apolipoprotein (Apo) E plays a key role in the handling of lipoprotein particles with ApoE2 and ApoE4 frequently having opposite effects compared to ApoE3. Some individuals simultaneously carry both E2 and E4 alleles. The impact of the ApoE2/4 genotype on lipid concentrations and its consequences on health remain poorly documented. Objective. This study compared the lipid profile between ApoE2/4 carriers and other ApoE genotypes in relation to the waist circumference. Methods. Cholesterol, triglyceride (TG), and ApoB concentrations were measured among 2,680 Caucasians. Multivariate logistic regression models were used to estimate the contribution of ApoE2/4 to various dyslipidemic profiles associated with abdominal obesity. Results. In presence of abdominal obesity, the lipid profile was as deteriorated in ApoE2/4 carriers as in carriers of other ApoE genotypes. There was a more pronounced effect on TG-rich lipoproteins, particularly in ApoE2/2 (a feature of type III dysbetalipoproteinemia), and non-high-density lipoprotein (HDL) cholesterol in ApoE4/4. Compared to ApoE2/2, ApoE2/4 carriers presented lower very-low-density lipoprotein (VLDL) cholesterol concentrations and VLDL-cholesterol/TG ratios, with or without obesity, and higher low-density lipoprotein (LDL) cholesterol concentrations. Conclusion. In presence of abdominal obesity, the influence of the ApoE2 allele could be less pronounced than that of ApoE4 among ApoE2/4 individuals. PMID:26605088

  9. HPMC supplementation reduces abdominal fat content, intestinal permeability, inflammation, and insulin resistance in diet-induced obese mice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cationic hydroxyethyl cellulose (cHEC) , was fed to hamsters to determine if this new soluble fiber had an effect on hypercholesterolemia and dyslipidemia associated with cardiovascular disease. In this study, Golden Syrian hamsters were supplemented with 3-8% cHEC or microcrystalline cellulose (MC...

  10. Diabetes, Dyslipidemia, and Heart Protection

    MedlinePlus

    ... and Heart Protection What is dyslipidemia? Cholesterol and triglycerides, known as lipids, are fatty substances that the ... lipoprotein (HDL or “good”) cholesterol • High levels of triglycerides (fats in the blood) Dyslipidemia contributes to atherosclerosis (“ ...

  11. Management of dyslipidemia in children

    PubMed Central

    2009-01-01

    Dyslipidemia is an important etiologic factor in the development of cardiovascular disease (CVD), which is a leading cause of death worldwide As CVD begins in childhood, and as dyslipidemia is an important risk factor for CVD, screening and treatment of dyslipidemia in adolescents and children becomes an important health matter. This review deals with issues related to screening, diagnosis and treatment of dyslipidemia in children and adolescents. PMID:19995441

  12. Management of Septic Open Abdomen in a Morbid Obese Patient with Enteroatmospheric Fistula by Using Standard Abdominal Negative Pressure Therapy in Conjunction with Intrarectal One.

    PubMed

    Yetisir, Fahri; Salman, A Ebru; Acar, Hasan Zafer; Özer, Mehmet; Aygar, Muhittin; Osmanoglu, Gokhan

    2015-01-01

    Introduction. Management of open abdomen (OA) with enteroatmospheric fistula (EAF) in morbid obese patient with comorbid disease is challenging. We would like to report the management of septic OA in morbid obese patient with EAF which developed after strangulated recurrent giant incisional hernia repair. We would also like to emphasize, in this case, the conversion of EAF to ileostomy by the help of second Negative Pressure Therapy (NPT) on ostomy side, and the chance of new EAF occurrence was reduced with intrarectal NPT. Case Presentation. 62-year-old morbid obese woman became an OA patient with EAF after strangulated recurrent giant hernia. EAF was converted to ostomy with pezzer drain by the help of second NPT on ostomy. Colonic distention was reduced with the third NPT application via rectum. Abdominal reapproximation anchor (ABRA) system was used for delayed abdominal closure. Conclusions. Using the 2nd NPT on ostomy side may help in the maturation of the ostomy created in a difficult condition in an open abdomen. Using the 3rd NPT through rectum may decrease the chance of EAF formation by reducing the pressure difference between intraluminal pressure and extraluminal pressure in hollow viscera. PMID:26779360

  13. Management of Septic Open Abdomen in a Morbid Obese Patient with Enteroatmospheric Fistula by Using Standard Abdominal Negative Pressure Therapy in Conjunction with Intrarectal One

    PubMed Central

    Yetisir, Fahri; Salman, A. Ebru; Acar, Hasan Zafer; Özer, Mehmet; Aygar, Muhittin; Osmanoglu, Gokhan

    2015-01-01

    Introduction. Management of open abdomen (OA) with enteroatmospheric fistula (EAF) in morbid obese patient with comorbid disease is challenging. We would like to report the management of septic OA in morbid obese patient with EAF which developed after strangulated recurrent giant incisional hernia repair. We would also like to emphasize, in this case, the conversion of EAF to ileostomy by the help of second Negative Pressure Therapy (NPT) on ostomy side, and the chance of new EAF occurrence was reduced with intrarectal NPT. Case Presentation. 62-year-old morbid obese woman became an OA patient with EAF after strangulated recurrent giant hernia. EAF was converted to ostomy with pezzer drain by the help of second NPT on ostomy. Colonic distention was reduced with the third NPT application via rectum. Abdominal reapproximation anchor (ABRA) system was used for delayed abdominal closure. Conclusions. Using the 2nd NPT on ostomy side may help in the maturation of the ostomy created in a difficult condition in an open abdomen. Using the 3rd NPT through rectum may decrease the chance of EAF formation by reducing the pressure difference between intraluminal pressure and extraluminal pressure in hollow viscera. PMID:26779360

  14. Pediatric guidelines for dyslipidemia.

    PubMed

    Daniels, Stephen R

    2015-01-01

    Clinical guidelines are developed to assist clinicians in complex clinical decision making. Modern guideline development includes a systematic review and grading of relevant literature and then using the evidence review to construct recommendations for clinical care which are also graded regarding the level of evidence supporting them. Pediatric guidelines for dyslipidemia were first published in 1992. There was then a gap during which no formal guidelines were developed. In 2011, the National Heart, Lung, and Blood Institute Integrated Guidelines for Cardiovascular Disease Risk Reduction in Children were published. This included an evidence review and clinical recommendations regarding dyslipidemia. This review process began in 2006. The evidence review ended in 2008, and they were published in 2011 because of an extensive and prolonged review process. These guidelines recommend universal screening for dyslipidemia at age 9 to 11 y with a focus on identifying young individuals with genetic dyslipidemia such as familial hypercholesterolemia. The guidelines also include lifestyle recommendations and recommendations for pharmacologic treatment for children with markedly elevated low-density lipoprotein cholesterol. The guideline process should include review of the implementation of guidelines in practice and should also include ongoing review of the guidelines with respect to a growing evidence base with new research findings.

  15. Sagittal Abdominal Diameter to Measure Visceral Adipose Tissue in Overweight or Obese Adolescent Children and Its Role as A Marker of Insulin Resistance

    PubMed Central

    Yashoda, H.T.; Boraiah, Ganga; Vishwa, Suma

    2015-01-01

    Background Measurement of sagittal abdominal diameter using a revalidated caliper is simple, inexpensive, non-invasive method. It strongly correlates with insulin resistance and can be used as a surrogate marker to predict risk for Type II Diabetes Mellitus. Aim To assess visceral abdominal fat by measuring sagittal abdominal diameter using sliding calipers and to predict insulin resistance in obese or overweight adolescent children. Study design Explorative study for Paediatric age group among over weight and obese children aged 10-18 years in urban population in a Tertiary Care Centre. Materials and Methods Paediatric population satisfying ADA guidelines for diagnosis of prediabetes were included in the study. Anthropometric measurements with SAD were recorded. Blood was collected to investigate for prediabetes and insulin resistance using HOMA-IR. Results Out of 924 subjects who gave assent to participate in study 108 fulfilled ADA criteria. 33 subjects who didn’t come for the follow up were excluded. Out of 75 subjects 12 were detected to have insulin resistance (16%) and 63 were normal (84%). Pearson’s partial correlation of HOMA-IR and OGTT with SAD has demonstrated it to be better correlation with Insulin Resistance (IR) than other anthropometric measurements. Fasting Glucose correlated better with Waist Hip Circumference. Conclusion Insulin Resistance was diagnosed in 16% of the population and these had high levels of insulin resistance. SAD in relation to glucose metabolism, had a better correlation with OGTT followed by HOMA-IR and fasting Insulin. SAD with anthropometric measurements had better correlation all the parameters other than Waist Circumference, which had negative correlation. SAD can be used in evaluation of obese or overweight children for evaluation. PMID:26673888

  16. Lifetime cigarette smoking is associated with abdominal obesity in a community-based sample of Japanese men: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).

    PubMed

    Fujiyoshi, Akira; Miura, Katsuyuki; Kadowaki, Sayaka; Azuma, Koichiro; Tanaka, Sachiko; Hisamatsu, Takashi; Arima, Hisatomi; Kadota, Aya; Miyagawa, Naoko; Takashima, Naoyuki; Ohkubo, Takayoshi; Saitoh, Yoshino; Torii, Sayuki; Miyazawa, Itsuko; Maegawa, Hiroshi; Murata, Kiyoshi; Ueshima, Hirotsugu

    2016-12-01

    Studies from Western countries suggest that smokers tend to display greater abdominal obesity than non-smokers, despite showing lower weight. Whether this holds true in a leaner population requires clarification. Using indices of abdominal obesity including visceral adipose tissue, we examined whether lifetime cigarette smoking is associated with unfavorable fat distribution among Japanese men. From 2006 to 2008, we conducted a cross-sectional investigation of a community-based sample of Japanese men at 40-64 years old, free of cardiovascular diseases and cancer. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography. We divided participants into four groups: never-smokers; and tertiles of pack-years of smoking among ever-smokers. Using multivariable linear regression, we calculated adjusted means of obesity indices (VAT, SAT, VAT-SAT ratio [VSR], and waist-hip ratio [WHR]) for each group, and mean differences between consecutive groups. We analyzed 513 men (median age, 58.2 years; current smokers, 40.1%). Two-thirds showed body mass index (BMI) < 25 kg/m(2) (median, 23.5 kg/m(2)). Overall, greater lifetime smoking group was associated with greater WHR and VSR. On average, one higher smoking group was associated with 0.005 higher WHR (95% CI, 0.001-0.008; P = 0.005) and 0.041 greater VSR (95% CI, 0.009-0.073; P = 0.012) after adjustment for potential confounders, including BMI. In this sample of relatively lean Japanese men, greater lifetime smoking was associated with a metabolically more adverse fat distribution. Although smoking is commonly associated with lower BMI, minimizing the amount of lifetime smoking should be advocated. PMID:27413686

  17. Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003-2012.

    PubMed

    Murakami, Kentaro; Livingstone, M Barbara E

    2016-05-28

    The association between eating frequency (EF) and adiposity in young populations is inconsistent. This cross-sectional study examined associations of EF, meal frequency (MF) and snack frequency (SF) with adiposity measures in US children aged 6-11 years (n 4346) and adolescents aged 12-19 years (n 6338) participating in the National Health and Nutrition Examination Survey 2003-2012. Using data from two 24-h dietary recalls, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours or others). When analysed without adjustment for the ratio of reported energy intake:estimated energy requirement (EI:EER), all measures of EF, MF and SF showed inverse or null associations with overweight (BMI≥85th percentile of BMI-for-age) and abdominal obesity (waist circumference≥90th percentile) in both children and adolescents. After adjustment for EI:EER, however, EF and SF, but not MF, showed positive associations in children, irrespective of the definition of meals and snacks. In adolescents, after adjustment for EI:EER, positive associations were observed for EF (abdominal obesity only), SF based on energy contribution and MF based on self-report, whereas there was an inverse association between MF based on energy contribution and overweight. In conclusion, higher SF and EF, but not MF, were associated with higher risks of overweight and abdominal obesity in children, whereas associations varied in adolescents, depending on the definition of meals and snacks. Prospective studies are needed to establish the associations observed here. PMID:27001436

  18. Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003-2012.

    PubMed

    Murakami, Kentaro; Livingstone, M Barbara E

    2016-05-28

    The association between eating frequency (EF) and adiposity in young populations is inconsistent. This cross-sectional study examined associations of EF, meal frequency (MF) and snack frequency (SF) with adiposity measures in US children aged 6-11 years (n 4346) and adolescents aged 12-19 years (n 6338) participating in the National Health and Nutrition Examination Survey 2003-2012. Using data from two 24-h dietary recalls, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours or others). When analysed without adjustment for the ratio of reported energy intake:estimated energy requirement (EI:EER), all measures of EF, MF and SF showed inverse or null associations with overweight (BMI≥85th percentile of BMI-for-age) and abdominal obesity (waist circumference≥90th percentile) in both children and adolescents. After adjustment for EI:EER, however, EF and SF, but not MF, showed positive associations in children, irrespective of the definition of meals and snacks. In adolescents, after adjustment for EI:EER, positive associations were observed for EF (abdominal obesity only), SF based on energy contribution and MF based on self-report, whereas there was an inverse association between MF based on energy contribution and overweight. In conclusion, higher SF and EF, but not MF, were associated with higher risks of overweight and abdominal obesity in children, whereas associations varied in adolescents, depending on the definition of meals and snacks. Prospective studies are needed to establish the associations observed here.

  19. Obesity

    MedlinePlus

    Morbid obesity; Fat - obese ... is because the body stores unused calories as fat. Obesity can be caused by: Eating more food ... use your BMI to estimate how much body fat you have. Your waist measurement is another way ...

  20. Ability of self-reported estimates of dietary sodium, potassium and protein to detect an association with general and abdominal obesity: comparison with the estimates derived from 24 h urinary excretion.

    PubMed

    Murakami, Kentaro; Livingstone, M Barbara E; Sasaki, Satoshi; Uenishi, Kazuhiro

    2015-04-28

    As under-reporting of dietary intake, particularly by overweight and obese subjects, is common in dietary surveys, biases inherent in the use of self-reported dietary information may distort true diet-obesity relationships or even create spurious ones. However, empirical evidence of this possibility is limited. The present cross-sectional study compared the relationships of 24 h urine-derived and self-reported intakes of Na, K and protein with obesity. A total of 1043 Japanese women aged 18-22 years completed a 24 h urine collection and a self-administered diet history questionnaire. After adjustment for potential confounders, 24 h urine-derived Na intake was associated with a higher risk of general obesity (BMI≥25 kg/m2) and abdominal obesity (waist circumference≥80 cm; both P for trend=0·04). For 24 h urine-derived protein intake, positive associations with general and abdominal obesity were observed (P for trend=0·02 and 0·053, respectively). For 24 h urine-derived K intake, there was an inverse association with abdominal obesity (P for trend=0·01). Conversely, when self-reported dietary information was used, only inverse associations between K intake and general and abdominal obesity were observed (P for trend=0·04 and 0·02, respectively), with no associations of Na or protein intake. In conclusion, we found positive associations of Na and protein intakes and inverse associations of K intake with obesity when using 24 h urinary excretion for estimating dietary intakes. However, no association was observed based on using self-reported dietary intakes, except for inverse association of K intake, suggesting that the ability of self-reported dietary information using the diet history questionnaire for investigating diet-obesity relationships is limited.

  1. Partly replacing meat protein with soy protein alters insulin resistance and blood lipids in postmenopausal women with abdominal obesity.

    PubMed

    van Nielen, Monique; Feskens, Edith J M; Rietman, Annemarie; Siebelink, Els; Mensink, Marco

    2014-09-01

    Increasing protein intake and soy consumption appear to be promising approaches to prevent metabolic syndrome (MetS). However, the effect of soy consumption on insulin resistance, glucose homeostasis, and other characteristics of MetS is not frequently studied in humans. We aimed to investigate the effects of a 4-wk, strictly controlled, weight-maintaining, moderately high-protein diet rich in soy on insulin sensitivity and other cardiometabolic risk factors. We performed a randomized crossover trial of 2 4-wk diet periods in 15 postmenopausal women with abdominal obesity to test diets with 22 energy percent (En%) protein, 27 En% fat, and 50 En% carbohydrate. One diet contained protein of mixed origin (mainly meat, dairy, and bread), and the other diet partly replaced meat with soy meat analogues and soy nuts containing 30 g/d soy protein. For our primary outcome, a frequently sampled intravenous glucose tolerance test (FSIGT) was performed at the end of both periods. Plasma total, LDL, and HDL cholesterol, triglycerides, glucose, insulin, and C-reactive protein were assessed, and blood pressure, arterial stiffness, and intrahepatic lipid content were measured at the start and end of both periods. Compared with the mixed-protein diet, the soy-protein diet resulted in greater insulin sensitivity [FSIGT: insulin sensitivity, 34 ± 29 vs. 22 ± 17 (mU/L)(-1) · min(-1), P = 0.048; disposition index, 4974 ± 2543 vs. 2899 ± 1878, P = 0.038; n = 11]. Total cholesterol was 4% lower after the soy-protein diet than after the mixed-protein diet (4.9 ± 0.7 vs. 5.1 ± 0.6 mmol/L, P = 0.001), and LDL cholesterol was 9% lower (2.9 ± 0.7 vs. 3.2 ± 0.6 mmol/L, P = 0.004; n = 15). Thus, partly replacing meat with soy in a moderately high-protein diet has clear advantages regarding insulin sensitivity and total and LDL cholesterol. Therefore, partly replacing meat products with soy products could be important in preventing MetS. This trial was registered at clinicaltrials

  2. Calcium and vitamin D supplementation is associated with decreased abdominal visceral adipose tissue in overweight and obese adults1234

    PubMed Central

    Rosenblum, Jennifer L; Castro, Victor M; Moore, Carolyn E; Kaplan, Lee M

    2012-01-01

    Background: Several studies suggest that calcium and vitamin D (CaD) may play a role in the regulation of abdominal fat mass. Objective: This study investigated the effect of CaD-supplemented orange juice (OJ) on weight loss and reduction of visceral adipose tissue (VAT) in overweight and obese adults (mean ± SD age: 40.0 ± 12.9 y). Design: Two parallel, double-blind, placebo-controlled trials were conducted with either regular or reduced-energy (lite) orange juice. For each 16-wk trial, 171 participants were randomly assigned to 1 of 2 groups. The treatment groups consumed three 240-mL glasses of OJ (regular or lite) fortified with 350 mg Ca and 100 IU vitamin D per serving, and the control groups consumed either unfortified regular or lite OJ. Computed tomography scans of VAT and subcutaneous adipose tissue were performed by imaging a single cut at the lumbar 4 level. Results: After 16 wk, the average weight loss (∼2.45 kg) did not differ significantly between groups. In the regular OJ trial, the reduction of VAT was significantly greater (P = 0.024) in the CaD group (−12.7 ± 25.0 cm2) than in the control group (−1.3 ± 13.6 cm2). In the lite OJ trial, the reduction of VAT was significantly greater (P = 0.039) in the CaD group (−13.1 ± 18.4 cm2) than in the control group (−6.4 ± 17.5 cm2) after control for baseline VAT. The effect of calcium and vitamin D on VAT remained highly significant when the results of the 2 trials were combined (P = 0.007). Conclusions: The findings suggest that calcium and/or vitamin D supplementation contributes to a beneficial reduction of VAT. This trial is registered at clinicaltrial.gov as NCT00386672, NCT01363115. PMID:22170363

  3. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry.

    PubMed

    Ido, Ayumi; Nakayama, Yuki; Ishii, Kojiro; Iemitsu, Motoyuki; Sato, Koji; Fujimoto, Masahiro; Kurihara, Toshiyuki; Hamaoka, Takafumi; Satoh-Asahara, Noriko; Sanada, Kiyoshi

    2015-01-01

    Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS) risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40-82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA) scan. Muscle thickness (MTH) was measured using B-mode ultrasound scanning in six body regions. Subjects were classified into general obesity (GO) and sarcopenic obesity (SO) groups using the threshold values of one standard deviation below the sex-specific means of either MTH or skeletal muscle index (SMI) measured by DXA. MetS risk score was acquired by standardizing and summing the following continuously distributed variables: visceral fat area, mean blood pressure, HbA1c, and serum triglyceride / high density lipoprotein cholesterol, to obtain the Z-score. Multiple regression analysis revealed that the MetS risk score was independently associated with abdominal MTH in all subjects, but not with MTH in other muscle regions, including the thigh. Although HbA1c and the number of MetS risk factors in the SO group were significantly higher than those in the GO group, there were no significant differences between GO and SO groups as defined by SMI. Ultrasound-derived abdominal MTH would allow a better assessment of sarcopenia in obese patients and can be used as an alternative to the conventionally-used SMI measured by DXA. PMID:26700167

  4. [Role of matrix metalloproteinases and tissue inhibitors of metalloproteinases in hypertension. Pathogenesis of hypertension and obesity].

    PubMed

    Trojanek, Joanna B

    2015-01-01

    Hypertension (HT), obesity and related metabolic disorders are increasing cause diseases with risk of premature death in western societies. Both hypertension and obesity are characterized by similar disorders such as chronic low systemic inflammation, changes in the vessel wall, abdominal obesity, insulin-resistance or dyslipidemia. Chronic, untreated HT leads to adverse changes in internal organs like kidney damage, arterial remodeling and hypertrophy of the left ventricle. The important role metalloproteinases and their inhibitors (TIMPs) in the pathophysiology of hypertension is associated with the degradation of vascular wall components, especially collagen and elastin. The activated RAAS system (renin-angiotensin-aldosterone) is displaying direct impact in the pathogenesis and progress of hypertension. Angiotensin II affects the expression and activation of many growth factors, cytokines and MMPs. The fat tissue of obese people is in the state of low intensity chronic inflammation and undergoes continual process of remodeling. Obesity is one of the direct cause of hypertension.

  5. [METHODS IN ABDOMINAL OBESITY].

    PubMed

    Savchenko, O; Zavalskaya, T; Lizogub, V; Kuzhel, O; Baitser, M; Zapeka, Y

    2015-01-01

    This article describes the anatomical and physiological, histological and topographic features of adipose tissue on the relationship of metabolic syndrome, insulin resistance and cardiovascular disease. An advanced diagnostic techniques of total body fat and visceral fat content quantification as the most metabolically active are described. PMID:27491154

  6. Obesity-related hypertension: possible pathophysiological mechanisms.

    PubMed

    Vaněčková, Ivana; Maletínská, Lenka; Behuliak, Michal; Nagelová, Veronika; Zicha, Josef; Kuneš, Jaroslav

    2014-12-01

    Hypertension is one of the major risk factors of cardiovascular diseases, but despite a century of clinical and basic research, the discrete etiology of this disease is still not fully understood. The same is true for obesity, which is recognized as a major global epidemic health problem nowadays. Obesity is associated with an increasing prevalence of the metabolic syndrome, a cluster of risk factors including hypertension, abdominal obesity, dyslipidemia, and hyperglycemia. Epidemiological studies have shown that excess weight gain predicts future development of hypertension, and the relationship between BMI and blood pressure (BP) appears to be almost linear in different populations. There is no doubt that obesity-related hypertension is a multifactorial and polygenic trait, and multiple potential pathogenetic mechanisms probably contribute to the development of higher BP in obese humans. These include hyperinsulinemia, activation of the renin-angiotensin-aldosterone system, sympathetic nervous system stimulation, abnormal levels of certain adipokines such as leptin, or cytokines acting at the vascular endothelial level. Moreover, some genetic and epigenetic mechanisms are also in play. Although the full manifestation of both hypertension and obesity occurs predominantly in adulthood, their roots can be traced back to early ontogeny. The detailed knowledge of alterations occurring in the organism of experimental animals during particular critical periods (developmental windows) could help to solve this phenomenon in humans and might facilitate the age-specific prevention of human obesity-related hypertension. In addition, better understanding of particular pathophysiological mechanisms might be useful in so-called personalized medicine. PMID:25385879

  7. Obesity-related hypertension: possible pathophysiological mechanisms.

    PubMed

    Vaněčková, Ivana; Maletínská, Lenka; Behuliak, Michal; Nagelová, Veronika; Zicha, Josef; Kuneš, Jaroslav

    2014-12-01

    Hypertension is one of the major risk factors of cardiovascular diseases, but despite a century of clinical and basic research, the discrete etiology of this disease is still not fully understood. The same is true for obesity, which is recognized as a major global epidemic health problem nowadays. Obesity is associated with an increasing prevalence of the metabolic syndrome, a cluster of risk factors including hypertension, abdominal obesity, dyslipidemia, and hyperglycemia. Epidemiological studies have shown that excess weight gain predicts future development of hypertension, and the relationship between BMI and blood pressure (BP) appears to be almost linear in different populations. There is no doubt that obesity-related hypertension is a multifactorial and polygenic trait, and multiple potential pathogenetic mechanisms probably contribute to the development of higher BP in obese humans. These include hyperinsulinemia, activation of the renin-angiotensin-aldosterone system, sympathetic nervous system stimulation, abnormal levels of certain adipokines such as leptin, or cytokines acting at the vascular endothelial level. Moreover, some genetic and epigenetic mechanisms are also in play. Although the full manifestation of both hypertension and obesity occurs predominantly in adulthood, their roots can be traced back to early ontogeny. The detailed knowledge of alterations occurring in the organism of experimental animals during particular critical periods (developmental windows) could help to solve this phenomenon in humans and might facilitate the age-specific prevention of human obesity-related hypertension. In addition, better understanding of particular pathophysiological mechanisms might be useful in so-called personalized medicine.

  8. The utility of dual bioelectrical impedance analysis in detecting intra-abdominal fat area in obese patients during weight reduction therapy in comparison with waist circumference and abdominal CT.

    PubMed

    Yamakage, Hajime; Ito, Ryo; Tochiya, Mayu; Muranaka, Kazuya; Tanaka, Masashi; Matsuo, Yoshiyuki; Odori, Shinji; Kono, Shigeo; Shimatsu, Akira; Satoh-Asahara, Noriko

    2014-01-01

    An increase in intra-abdominal fat area (IAFA) is an essential component of metabolic syndrome (MetS). Waist circumference (WC) is not a precise measure of IAFA, and computed tomography (CT) is unsuitable for frequent monitoring. Here, we examined utility of a dual bioelectrical impedance analysis (Dual BIA) for measuring IAFA in obese patients during weight reduction. Fat distribution was measured by Dual BIA and CT in 100 obese outpatients. All fat areas including total, IAFA, and subcutaneous fat by Dual BIA were more closely correlated with those by CT than WC. Estimated IAFA by Dual BIA was significantly correlated with number of MetS components as well as CT, but WC was not. Furthermore, in 61 obese patients who received 6-month weight reduction therapy, estimated IAFA by Dual BIA showed an earlier and greater decrease as well as that by CT than WC and BMI. In addition, decrease in estimated IAFA by Dual BIA through weight reduction had a higher correlation with decrease in IAFA by CT, than WC. This study is the first to demonstrate that the change in estimated IAFA by Dual BIA was highly correlated with that in IAFA by CT during weight reduction therapy. Our findings also indicate that estimated IAFA by Dual BIA is, potentially, a better indicator of severity of MetS, cardiovascular risk factors, and effectiveness of weight reduction than WC, and equal to IAFA by CT. Estimated IAFA by Dual BIA may be useful for monitoring the effectiveness of weight reduction therapy in obese patients.

  9. Update on the molecular biology of dyslipidemias.

    PubMed

    Ramasamy, I

    2016-02-15

    by genome wide association studies. Secondary factors, obesity, metabolic syndrome, diabetes, renal disease, estrogen and antipsychotics can increase the likelihood of clinical presentation of an individual with predisposed genetic susceptibility to hyperlipoproteinemia. The genetic profiles studied are far from complete and there is room for further characterization of genes influencing lipid levels. Genetic assessment can help identify patients at risk for developing dyslipidemias and for treatment decisions based on 'risk allele' profiles. This review will present the current information on the genetics and pathophysiology of disorders that cause dyslipidemias.

  10. Dyslipidemia in special ethnic populations.

    PubMed

    Pu, Jia; Romanelli, Robert; Zhao, Beinan; Azar, Kristen M J; Hastings, Katherine G; Nimbal, Vani; Fortmann, Stephen P; Palaniappan, Latha P

    2015-05-01

    This article reviews racial/ethnic differences in dyslipidemia-prevalence of dyslipidemia, its relation to coronary heart disease (CHD) and stroke mortality rates, response to lipid-lowering agents, and lifestyle modification. Asian Indians, Filipinos, and Hispanics are at higher risk for dyslipidemia, which is consistent with the higher CHD mortality rates in these groups. Statins may have greater efficacy for Asians, but the data are mixed. Lifestyle modifications are recommended. Culturally-tailored prevention and intervention should be provided to the minority populations with elevated risk for dyslipidemia and considerably more research is needed to determine the best approaches to helping specific subgroups.

  11. Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among adult Egyptian population

    PubMed Central

    Assaad-Khalil, Samir H.; Mikhail, Magued M.; Aati, Talaat Abdel; Zaki, Adel; Helmy, Myriam A.; Megallaa, Magdy H.; Hassanien, Rehab; Rohoma, Kamel H.

    2015-01-01

    Objective: To determine the best anthropometric measurement of obesity, and its optimal cutoff, that best predicts the presence of cardiovascular risk factors among adult Egyptian population. Methods: This is a cross-sectional study including a representative randomly chosen sample of the adult Egyptian population from all Alexandria Districts (the second largest governorate in Egypt) based on the multistage random technique. It included 3209 subjects (1567 men, 1642 women) aged 18–80 years from urban and rural areas. The response rate was 80.2%. History, blood pressure, and anthropometric measurements were taken. Laboratory investigations included fasting lipid profile, fasting plasma glucose, and serum uric acid. Different criteria of metabolic syndrome were used and compared. Receiver operator characteristic curve and Youden index were used to determine predictability and cutoffs. Results: Waist circumference (WC) is the best to predict at least two other components of the metabolic syndrome as defined by the International Diabetes Federation (IDF). The optimal WC cutoffs were 100.5 and 96.25 cm for Egyptian men and women, respectively. The Joint Interim Statement definition (JIS) of metabolic syndrome was the best to predict cardiovascular disease in both genders and diabetes mellitus in women. The prevalence of metabolic syndrome and abdominal obesity was 42.5%, 61%, respectively (ATPIII definition); 43.8%, 61% (American Heart Association definition); 44.3%, 76.4% (IDF definition); 33.8%, 51.7% (IDF definition with Egyptian cutoffs); and 41.5%, 51.7% (JIS with Egyptian cutoffs). Conclusion: WC cutoffs in Egyptians differ from those currently recommended. Prevalence of metabolic syndrome and abdominal obesity is high in Egypt, despite being lower on using the Egyptian cutoffs. PMID:26693432

  12. Approach to identifying and managing atherogenic dyslipidemia

    PubMed Central

    Bosomworth, N. John

    2013-01-01

    Abstract Objective To review the evidence for recognition and management of atherogenic dyslipidemia. Sources of information High-quality randomized trials and meta-analyses were available to address most questions. North American and European guidelines were reviewed. Of these, the Canadian Cardiovascular Society lipid guidelines were most congruent with current literature. Main message Atherogenic dyslipidemia is characterized by low levels of high-density lipoprotein (HDL), high levels of triglycerides, and a high low-density lipoprotein (LDL) particle number. The condition is highly associated with cardiovascular disease (CVD) and is poorly reflected in Framingham risk score and LDL measurements. Obesity, glucose intolerance, diabetes, and metabolic syndrome are rapidly becoming more common, and are often associated with atherogenic dyslipidemia, affecting long-term CVD risk. Recognition in the office is best achieved by non-HDL or total cholesterol–HDL ratio testing. Treatment success lies in optimizing diet and exercise. Of available medications, statins produce the most benefit and can be titrated to patient tolerance rather than to LDL target levels, which have a poor evidence base. The addition of fenofibrate can be considered in patients with high triglyceride and low HDL levels who have responded poorly to or have not tolerated statins. Conclusion Growing obesity prevalence creates a CVD risk that might be missed by LDL cholesterol testing alone. Simple calculations from results of a non-fasting lipid panel produce non-HDL levels and total cholesterol–HDL ratio, both of which are superior for predicting risk in all patients. These metrics should be available in lipid panels. PMID:24235189

  13. Obesity

    MedlinePlus

    Obesity means having too much body fat. It is different from being overweight, which means weighing too ... what's considered healthy for his or her height. Obesity occurs over time when you eat more calories ...

  14. Management of type IIb dyslipidemia.

    PubMed

    Arai, Hidenori; Ishibashi, Shun; Bujo, Hideaki; Hayashi, Toshio; Yokoyama, Shinji; Oikawa, Shinichi; Kobayashi, Junji; Shirai, Kohji; Ota, Takao; Yamashita, Shizuya; Gotoda, Takanari; Harada-Shiba, Mariko; Sone, Hirohito; Eto, Masaaki; Suzuki, Hiroaki; Yamada, Nobuhiro

    2012-01-01

    Although the Japan Atherosclerosis Society guideline for the diagnosis and prevention of atherosclerosis cardiovascular diseases for the Japanese population provides targets for low-density lipoprotein (LDL) cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol to prevent cardiovascular disease in patients with dyslipidemia, there is no guideline specifically targeting the treatment of type IIb dyslipidemia, which is one of the most common types of dyslipidemia, along with type IIa and type IV dyslipidemia. Type IIb dyslipidemia is important because it sometimes accompanies atherogenic lipid profiles, such as small, dense LDL, remnants, low HDL cholesterolemia. It is also associated with type 2 diabetes mellitus, metabolic syndrome, and chronic kidney disease (CKD), and most patients with familial combined hyperlipidemia (FCHL) show this phenotype; therefore, it is assumed that patients with type IIb dyslipidemia have a high risk for cardiovascular disease. Thus, the management of type IIb dyslipidemia is very important for the prevention of cardiovascular disease, so we have attempted to provide a guideline for the management of type IIb dyslipidemia.

  15. [Dynamics the level of visfatin and markers of immune inflammation in hypertensive patients with abdominal obesity using the combination of antihypertensive therapy].

    PubMed

    Andreeva, A A

    2013-12-01

    Today is actively discussing the impact of the new adipocytokin visfatin on the processes of atherosclerosis and inflammation. In this regard, of particular interest is a contingent of patients with hypertension in combination with abdominal obesity (AO). According to the patient should receive an adequate selection of antihypertensive therapy in connection with common pathology. The aim of the study was improved the treatment of hypertensive patients combined with abdominal obesity, which based on determining the level of visfatin and markers of immune inflammation. There were 64 patients which separated on the 1st group of hypertensive patients (n=28), 2d hypertensive with AO (n=36) and the 3d group of 19 healthy individuals. Patients matched for age and sex. All patients were determined in serum the level of visfatin («RayBioteeh», USA) interleukin-6 (IL -6) ("Vector -Best", Russia) interleukin-4 (IL-4) ("Vector -Best ", Russian) and C -reactive protein (CRP) («DRG International Inc.», USA) - ELISA. The treatment was carrying out with a combination of antihypertensive therapy: angiotensin receptor blocker-II of olmesartan medoxomil (10-20 mg dose once daily) with a calcium antagonist amlodipine (5-10 mg once a day) as hypertensive patients with AO, and without. It was noted the achievement of target blood pressure in both groups. On the antihypertensive therapy the 1st group in serum the level of IL-6 and CRP was significantly decreased by 48.7% and 60,6% (p <0,05). Whereas in the 2nd group there were a statistically significant reduction in the level of IL-6 and CRP in serum by 43.6% and 63.4% and detected statistically significant change in the level of serum visfatin 37.3%, respectively (p <0,05). The level of IL-4 in serum was increased in the 1st and 2nd groups by 29.7% and 11.6%, respectively (p>0.05). Conducted combination of antihypertensive therapy reducing the level of visfatin in hypertensive patients with abdominal obesity. As well, as has

  16. Relationship between Serum Ferritin Levels and Dyslipidemia in Korean Adolescents

    PubMed Central

    Kim, Young-Eun; Roh, Yong-Kyun; Ju, Sang-Yhun; Yoon, Yeo-Joon; Nam, Ga-Eun; Nam, Hyo-Yun; Choi, Jun-Seok; Lee, Jong-Eun; Sang, Jung-Eun; Han, Kyungdo

    2016-01-01

    Background Ferritin is associated with various cardiometabolic risk factors such as dyslipidemia, hypertension, obesity, and insulin resistance in adults. We aimed to study the association between serum ferritin levels and dyslipidemia in adolescents, because dyslipidemia is considered an important modifiable cardiovascular risk factor in the young. Methods We analyzed 1,879 subjects (1,026 boys and 853 girls) from the 2009–2010 Korean National Health and Nutrition Examination Survey IV. Subjects were categorized into quartiles according to their lipid parameters, which were classified according to age and gender. Those in the highest quartile groups for total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations were diagnosed as having dyslipidemia. Those in the lowest quartile for high-density lipoprotein cholesterol (HDL-C) values were diagnosed with abnormal levels. Results In boys, total cholesterol, LDL-C, and triglyceride concentrations were significantly correlated with serum ferritin levels. In both boys and girls, serum ferritin levels were negatively associated with HDL-C values, even after adjusting for all covariates. Furthermore, there was no significant correlation between serum ferritin levels and total cholesterol, LDL, and triglyceride concentrations in girls. Conclusion Serum ferritin levels were significantly associated with major dyslipidemia parameters, more prominently in boys than in girls, and this association represents a cardiometabolic risk factor. PMID:27070153

  17. High Discrepancy in Abdominal Obesity Prevalence According to Different Waist Circumference Cut-Offs and Measurement Methods in Children: Need for Age-Risk-Weighted Standardized Cut-Offs?

    PubMed Central

    Prodam, Flavia; Fuiano, Nicola; Diddi, Giuliana; Petri, Antonella; Bellone, Simonetta; Bona, Gianni

    2016-01-01

    Background Waist circumference (WC) is a good proxy measure of central adiposity. Due to the multiplicity of existing WC cut-offs and different measurement methods, the decision to use one rather than another WC chart may lead to different prevalence estimates of abdominal obesity in the same population. Aim of our study was to assess how much the prevalence of abdominal obesity varies in Italian schoolchildren using the different available WC cut-offs. Methods We measured WC at just above the uppermost lateral border of the right ilium in 1062 Italian schoolchildren aged 7–14 years, 499 living in Northern Italy and 563 in Southern Italy. Abdominal obesity was defined as WC ≥90th percentile for gender and age according to nine WC charts. Results We found an extremely high variability in the prevalence of abdominal obesity detected in our study-populations according to the different WC charts, ranging in the overall group from 9.1% to 61.4%. In Northern Italy children it varied from 2.4% to 35.7%, and in Southern ones from 15.1% to 84.2%. Conclusions On the basis of the chosen WC cut-offs the prevalence of abdominal obesity varies widely, because percentile-charts are strongly influenced by the population status in a particular moment. A further rate of variability may lay on the site of WC measurement and on the statistical method used to calculate WC cut-offs. Risk-weighted WC cut-offs measured in a standardized anatomic site and calculated by the appropriate method are needed to simply identify by WC measurement those children at high risk of cardio-metabolic complications to whom specific and prompt health interventions should be addressed. PMID:26745148

  18. Abdominal tap

    MedlinePlus

    Peritoneal tap; Paracentesis; Ascites - abdominal tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap ... abdominal cavity ( most often cancer of the ovaries ) Cirrhosis of the liver Damaged bowel Heart disease Infection ...

  19. Effects of glucomannan-enriched, aronia juice-based supplement on cellular antioxidant enzymes and membrane lipid status in subjects with abdominal obesity.

    PubMed

    Kardum, Nevena; Petrović-Oggiano, Gordana; Takic, Marija; Glibetić, Natalija; Zec, Manja; Debeljak-Martacic, Jasmina; Konić-Ristić, Aleksandra

    2014-01-01

    The aim of this study was to analyze the effects of a 4-week-long consumption of glucomannan-enriched, aronia juice-based supplement on anthropometric parameters, membrane fatty acid profile, and status of antioxidant enzymes in erythrocytes obtained from postmenopausal women with abdominal obesity. Twenty women aged 45-65 with a mean body mass index (BMI) of 36.1 ± 4.4 kg/m(2) and waist circumference of 104.8 ± 10.1 cm were enrolled. Participants were instructed to consume 100 mL of supplement per day as part of their regular diet. A significant increase in the content of n-3 (P < 0.05) polyunsaturated fatty acids in membrane phospholipids was observed, with a marked increase in the level of docosahexaenoic fatty acid (P < 0.05). Accordingly, a decrease in the n-6 and n-3 fatty acids ratio was observed (P < 0.05). The observed effects were accompanied with an increase in glutathione peroxidase activity (P < 0.05). Values for BMI (P < 0.001), waist circumference (P < 0.001), and systolic blood pressure (P < 0.05) were significantly lower after the intervention. The obtained results indicate a positive impact of tested supplement on cellular oxidative damage, blood pressure, and anthropometric indices of obesity.

  20. Effects of Glucomannan-Enriched, Aronia Juice-Based Supplement on Cellular Antioxidant Enzymes and Membrane Lipid Status in Subjects with Abdominal Obesity

    PubMed Central

    Petrović-Oggiano, Gordana; Glibetić, Natalija; Zec, Manja; Debeljak-Martacic, Jasmina; Konić-Ristić, Aleksandra

    2014-01-01

    The aim of this study was to analyze the effects of a 4-week-long consumption of glucomannan-enriched, aronia juice-based supplement on anthropometric parameters, membrane fatty acid profile, and status of antioxidant enzymes in erythrocytes obtained from postmenopausal women with abdominal obesity. Twenty women aged 45–65 with a mean body mass index (BMI) of 36.1 ± 4.4 kg/m2 and waist circumference of 104.8 ± 10.1 cm were enrolled. Participants were instructed to consume 100 mL of supplement per day as part of their regular diet. A significant increase in the content of n-3 (P < 0.05) polyunsaturated fatty acids in membrane phospholipids was observed, with a marked increase in the level of docosahexaenoic fatty acid (P < 0.05). Accordingly, a decrease in the n-6 and n-3 fatty acids ratio was observed (P < 0.05). The observed effects were accompanied with an increase in glutathione peroxidase activity (P < 0.05). Values for BMI (P < 0.001), waist circumference (P < 0.001), and systolic blood pressure (P < 0.05) were significantly lower after the intervention. The obtained results indicate a positive impact of tested supplement on cellular oxidative damage, blood pressure, and anthropometric indices of obesity. PMID:25574495

  1. HPMC supplementation reduces abdominal fat content, intestinal permeability, inflammation, and insulin resistance in diet-induced obese mice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of hydroxypropyl methylcellulose (HPMC), a highly viscous non-fermentable soluble dietary fiber, were evaluated on adipose tissue inflammation and insulin resistance in diet induced obese (DIO) mice fed a high fat (HF) diet supplemented with either HPMC or insoluble fiber. DIO C57BL/6J m...

  2. Regular tart cherry intake alters abdominal adiposity, adipose gene transcription, and inflammation in obesity-prone rats fed a high fat diet.

    PubMed

    Seymour, E M; Lewis, Sarah K; Urcuyo-Llanes, Daniel E; Tanone, Ignasia I; Kirakosyan, Ara; Kaufman, Peter B; Bolling, Steven F

    2009-10-01

    Obesity, systemic inflammation, and hyperlipidemia are among the components of metabolic syndrome, a spectrum of phenotypes that can precede the development of type 2 diabetes and cardiovascular disease. Animal studies show that intake of anthocyanin-rich extracts can affect these phenotypes. Anthocyanins can alter the activity of tissue peroxisome proliferator-activated receptors (PPARs), which affect energy substrate metabolism and inflammation. However, it is unknown if physiologically relevant, anthocyanin-containing whole foods confer similar effects to concentrated, anthocyanin extracts. The effect of anthocyanin-rich tart cherries was tested in the Zucker fatty rat model of obesity and metabolic syndrome. For 90 days, rats were pair-fed a higher fat diet supplemented with either 1% (wt/wt) freeze-dried, whole tart cherry powder or with a calorie- and macronutrient-matched control diet. Tart cherry intake was associated with reduced hyperlipidemia, percentage fat mass, abdominal fat (retroperitoneal) weight, retroperitoneal interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) expression, and plasma IL-6 and TNF-alpha. Tart cherry diet also increased retroperitoneal fat PPAR-alpha and PPAR-gamma mRNA (P = .12), decreased IL-6 and TNF-alpha mRNA, and decreased nuclear factor kappaB activity. In conclusion, in at-risk obese rats fed a high fat diet, physiologically relevant tart cherry consumption reduced several phenotypes of metabolic syndrome and reduced both systemic and local inflammation. Tart cherries may reduce the degree or trajectory of metabolic syndrome, thereby reducing risk for the development of type 2 diabetes and heart disease. PMID:19857054

  3. Regular tart cherry intake alters abdominal adiposity, adipose gene transcription, and inflammation in obesity-prone rats fed a high fat diet.

    PubMed

    Seymour, E M; Lewis, Sarah K; Urcuyo-Llanes, Daniel E; Tanone, Ignasia I; Kirakosyan, Ara; Kaufman, Peter B; Bolling, Steven F

    2009-10-01

    Obesity, systemic inflammation, and hyperlipidemia are among the components of metabolic syndrome, a spectrum of phenotypes that can precede the development of type 2 diabetes and cardiovascular disease. Animal studies show that intake of anthocyanin-rich extracts can affect these phenotypes. Anthocyanins can alter the activity of tissue peroxisome proliferator-activated receptors (PPARs), which affect energy substrate metabolism and inflammation. However, it is unknown if physiologically relevant, anthocyanin-containing whole foods confer similar effects to concentrated, anthocyanin extracts. The effect of anthocyanin-rich tart cherries was tested in the Zucker fatty rat model of obesity and metabolic syndrome. For 90 days, rats were pair-fed a higher fat diet supplemented with either 1% (wt/wt) freeze-dried, whole tart cherry powder or with a calorie- and macronutrient-matched control diet. Tart cherry intake was associated with reduced hyperlipidemia, percentage fat mass, abdominal fat (retroperitoneal) weight, retroperitoneal interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) expression, and plasma IL-6 and TNF-alpha. Tart cherry diet also increased retroperitoneal fat PPAR-alpha and PPAR-gamma mRNA (P = .12), decreased IL-6 and TNF-alpha mRNA, and decreased nuclear factor kappaB activity. In conclusion, in at-risk obese rats fed a high fat diet, physiologically relevant tart cherry consumption reduced several phenotypes of metabolic syndrome and reduced both systemic and local inflammation. Tart cherries may reduce the degree or trajectory of metabolic syndrome, thereby reducing risk for the development of type 2 diabetes and heart disease.

  4. Childhood obesity and obstructive sleep apnea syndrome

    PubMed Central

    Muzumdar, Hiren

    2010-01-01

    The increasing prevalence of obesity in children seems to be associated with an increased prevalence of obstructive sleep apnea syndrome (OSAS) in children. Possible pathophysiological mechanisms contributing to this association include the following: adenotonsillar hypertrophy due to increased somatic growth, increased critical airway closing pressure, altered chest wall mechanics, and abnormalities of ventilatory control. However, the details of these mechanisms and their interactions have not been elucidated. In addition, obesity and OSAS are both associated with metabolic syndrome, which is a constellation of features such as hypertension, insulin resistance, dyslipidemia, abdominal obesity, and prothrombotic and proinflammatory states. There is some evidence that OSAS may contribute to the progression of metabolic syndrome with a potential for significant morbidity. The treatment of OSAS in obese children has not been standardized. Adenotonsillectomy is considered the primary intervention followed by continuous positive airway pressure treatment if OSAS persists. Other methods such as oral appliances, surgery, positional therapy, and weight loss may be beneficial for individual subjects. The present review discusses these issues and suggests an approach to the management of obese children with snoring and possible OSAS. PMID:19875714

  5. Dyslipidemia in Special Ethnic Populations

    PubMed Central

    Romanelli, Robert; Zhao, Beinan; Azar, Kristen M.J.; Hastings, Katherine G.; Nimbal, Vani; Fortmann, Stephen P.; Palaniappan, Latha P.

    2015-01-01

    Synopsis This manuscript reviewed racial/ethnic differences in dyslipidemia, including prevalence of dyslipidemia, its relation to CHD and stroke mortality rates, response to lipid-lowering agents, and lifestyle modification. In particular, among all racial/ethnic groups, Asian Indians, Filipinos and Hispanics are at higher risk for dyslipidemia, which is consistent with the higher coronary heart disease (CHD) mortality rates in these groups. In addition, compared to other racial/ethnic groups, statins may have a higher efficacy for Asians. Studies suggest lower starting dosage in Asians, but the data are mixed. Genetic differences in statin metabolism can in part explain this racial/ethnic difference in statin sensitivity and adverse effects. Furthermore, lifestyle modification is recommended as part of dyslipidemia control and management. Both African Americans and Hispanics have more sedentary behavior and less favorable diet profile. Hispanic subgroups (i.e. Mexican, Puerto Rican, etc.) and Asian (i.e. Chinese, South Asian, etc.) subgroups should be disaggregated for lifestyle interventions due to cultural differences among the subgroups. Further studies are needed to better understand racial/ethnic-specific risk factors contributing to the observed differences in dyslipidemia, CHD, and stroke. Culturally-tailored prevention and intervention should be provided to the minority populations with elevated risk for dyslipidemia and considerably more research is needed to determine the best approaches to helping specific subgroups. PMID:25939303

  6. A case report on management of synergistic gangrene following an incisional abdominal hernia repair in an immunocompromised obese patient

    PubMed Central

    Merali, N.; Almeida, R.A.R.; Hussain, A.

    2015-01-01

    Introduction We present a case on conservative management of salvaging the mesh in an immunocompromised morbidly obese patient, who developed a synergistic gangrene infection following a primary open mesh repair of an incisional hernia. Presentation of case Our patient presented with a surgical wound infection, comorbidities were Chronic Lymphoblastic Leukemia (CLL), Body Mass Index (BMI) of 50, hypertension and diet controlled type-2 diabetes. In surgery, wide necrotic wound debridement, early and repetitive wound drainages with the use of a large pore polypropylene mesh and a detailed surgical follow up was required. High dose intravenous broad-spectrum antibiotic treatment and Negative Pressure Wound Therapy (NPWT) was administrated in combination with adopting a multidisciplinary approach was key to our success. Discussion Stoppa Re et al. complied a series of 360 ventral hernia mesh repairs reporting an infection rate of 12% that were managed conservatively. However, our selective case is unique within current literature, being the first to illustrate mesh salvage in a morbid obese patient with CLL. Recent modifications in mesh morphology, such as lower density, wide pores, and lighter weight has led to considerable improvements regarding infection avoidance. Conclusion This case has demonstrated how a planned multidisciplinary action can produce prosperous results in a severely obese immunocompromised patient with an SSI, following an incisional hernia repair. PMID:26322822

  7. Treatment of dyslipidemia

    PubMed Central

    Byrnes, Allison

    2014-01-01

    Atherosclerotic cardiovascular disease (including coronary heart disease, stroke and peripheral arterial disease) is the leading cause of death globally. Abnormal blood lipids (dyslipidemia), smoking, and high blood pressure are responsible for more than 75% of cases. Aggressive low-density lipoprotein (LDL)-cholesterol lowering therapy, particularly statins, appear to be the most effective of the therapeutic approaches, but even with their use, cardiovascular disease event rates remain relatively high, underpinning the quest for novel treatments. In this review we discuss recent advances in the field and what remains to be done to reduce this rate further. In particular, in addition to development and investigation of new LDL-cholesterol lowering therapies, there has been a major focus on treatments to favorably influence high-density lipoprotein (HDL)-cholesterol and triglyceride concentrations. However, to this time, approaches to the latter have been somewhat disappointing, but they may have particular benefits in people with diabetes. As atherosclerosis is a largely preventable process, which is driven particularly by behavioral and lifestyle factors, attention to other modifiable risk factors is imperative. PMID:24669298

  8. Sensitivity and Specificity Improvement in Abdominal Obesity Diagnosis Using Cluster Analysis during Waist Circumference Cut-Off Point Selection

    PubMed Central

    Bermúdez, Valmore; Añez, Roberto; Toledo, Alexandra; Bello, Luis; Apruzzese, Vanessa; González, Robys; Chacín, Maricarmen; Cabrera, Mayela; Cano, Clímaco; Velasco, Manuel; López-Miranda, José

    2015-01-01

    Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes during the construction of ROC curves for waist circumference (WC) cutpoint selection. Materials and Methods. A total of 1,902 subjects of both genders were selected from the Maracaibo City Metabolic Syndrome Prevalence Study database. Two-Step Cluster Analysis (TSCA) was applied to select metabolically healthy and sick men and women. ROC curves were constructed to determine WC cutoff points by gender. Results. Through TSCA, metabolic phenotype predictive variables were selected: HOMA2-IR and HOMA2-βcell for women and HOMA2-IR, HOMA2-βcell, and TAG for men. Subjects were classified as healthy normal weight, metabolically obese normal weight, healthy and metabolically disturbed overweight, and healthy and metabolically disturbed obese. Final WC cutpoints were 91.50 cm for women (93.4% sensitivity, 93.7% specificity) and 98.15 cm for men (96% sensitivity, 99.5% specificity). Conclusions. TSCA in the selection of the groups used in ROC curves construction proved to be an important tool, aiding in the detection of MOWN and MHO which cannot be identified with WC alone. The resulting WC cutpoints were <91.00 cm for women and <98.00 cm for men. Furthermore, anthropometry is insufficient to determine healthiness, and, biochemical analysis is needed to properly filter subjects during classification. PMID:25945356

  9. Anti-Obesity Activity of the Marine Carotenoid Fucoxanthin

    PubMed Central

    Gammone, Maria Alessandra; D’Orazio, Nicolantonio

    2015-01-01

    Nowadays the global tendency towards physical activity reduction and an augmented dietary intake of fats, sugars and calories is leading to a growing propagation of overweight, obesity and lifestyle-related diseases, such diabetes, hypertension, dyslipidemia and metabolic syndrome. In particular, obesity, characterized as a state of low-level inflammation, is a powerful determinant both in the development of insulin resistance and in the progression to type 2 diabetes. A few molecular targets offer hope for anti-obesity therapeutics. One of the keys to success could be the induction of uncoupling protein 1 (UCP1) in abdominal white adipose tissue (WAT) and the regulation of cytokine secretions from both abdominal adipose cells and macrophage cells infiltrated into adipose tissue. Anti-obesity effects of fucoxanthin, a characteristic carotenoid, exactly belonging to xanthophylls, have been reported. Nutrigenomic studies reveal that fucoxanthin induces UCP1 in abdominal WAT mitochondria, leading to the oxidation of fatty acids and heat production in WAT. Fucoxanthin improves insulin resistance and decreases blood glucose levels through the regulation of cytokine secretions from WAT. The key structure of anti-obesity effect is suggested to be the carotenoid end of the polyene chromophore, which contains an allenic bond and two hydroxyl groups. Fucoxanthin, which can be isolated from edible brown seaweeds, recently displayed its many physiological functions and biological properties. We reviewed recent studies and this article aims to explain essential background of fucoxanthin, focusing on its promising potential anti-obesity effects. In this respect, fucoxanthin can be developed into promising marine drugs and nutritional products, in order to become a helpful functional food. PMID:25871295

  10. Dyslipidemia in patients with nonalcoholic fatty liver disease.

    PubMed

    Chatrath, Hemant; Vuppalanchi, Raj; Chalasani, Naga

    2012-02-01

    Patients with nonalcoholic fatty liver disease (NAFLD) often have dyslipidemia along with other features of metabolic syndrome such as obesity, diabetes mellitus, and hypertension. The dyslipidemia in NAFLD is characterized by increased serum triglycerides, increased small, dense low-density lipoprotein (LDL nontype A) particles, and low high-density lipoprotein (HDL) cholesterol. The pathogenesis of dyslipidemia in NAFLD is not well understood, but it is likely related to hepatic overproduction of the very low-density lipoprotein particles and dysregulated clearance of lipoproteins from the circulation. There is unequivocal evidence that cardiovascular disease is the most common cause of mortality in patients with NAFLD. Aggressive treatment of dyslipidemia plays a critical role in the overall management of patients with NAFLD. Statins are the first-line agents to treat high cholesterol and their dosage should be adjusted based on achieving therapeutic targets and tolerability. Although all statins appear to be effective in improving cholesterol levels in patients with NAFLD, there is more experience with atorvastatin in patients with NAFLD; furthermore, it is the only statin to date to show a reduced cardiovascular morbidity in patients with NAFLD. The risk for serious liver injury from statins is quite rare and patients with NAFLD are not at increased risk for statin hepatotoxicity. Omega-3 fatty acids are perhaps the first choice to treat hypertriglyceridemia because of their safety, tolerability, and efficacy in improving serum triglycerides, as well as their potential to improve liver disease. PMID:22418885

  11. Prevalence of Dyslipidemia in Children with Congenital Heart Disease

    PubMed Central

    Fuenmayor, Gabriela; Redondo, Ana Carolina Costa; Shiraishi, Karen Saori; Souza, Rogerio; Elias, Patrícia Figueiredo; Jatene, Ieda Biscegli

    2013-01-01

    Dyslipidemia is one of the main risk factors associated with cardiovascular diseases. Few data on the impacts of congenital heart diseases are available with regard to the prevalence of dyslipidemia in children. Our study evaluated the lipid profile in children with congenital heart disease at a referral center. From January 2011 to July 2012, 52 pediatric patients had their lipid, metabolic and clinical profiles traced. The mean age was 10.4 ± 2.8 years and male/female rate of 1.38:1. Our population had 53.8% patients with high levels of total cholesterol and 13.4% (CI 95 %, from 6.6 to 25.2%) of them also presenting LDL levels ≥ 130 mg/dL, which characterizes dyslipidemia. The group of dyslipidemic patients presented only two obese individuals. Our data show that the presence of congenital heart disease does not lead to higher risk associated with the prevalence of dyslipidemia. Therefore, the screening of this specific population should follow the regular pediatric guidelines, which are also independent of the nutritional status of the children tested. PMID:24061754

  12. Dyslipidemia in type 2 diabetes.

    PubMed

    Krauss, Ronald M; Siri, Patty W

    2004-07-01

    Type 2 diabetes mellitus is associated with a cluster of lipid abnormalities:elevated plasma triglycerides, reduced high-density lipoprotein cholesterol, and smaller and denser low-density lipoproteins,which have been associated with an increased risk of cardiovascular disease. Insulin resistance may contribute to dyslipidemia associated with type 2 diabetes by increasing hepatic secretion of large,triglyceride-rich very low-density lipoprotein particles and by impairing the clearance of lipoprotein particles from plasma. Lifestyle interventions may be effective in improving the diabetic dyslipidemia syndrome. For patients who do not respond to lifestyle changes, pharmacologic therapies (lipid-lowering medications and anti-diabetic agents) are available. Clinical trials demonstrate that the use of such pharmaceutics to treat diabetic dyslipidemia concomitantly reduces the risk of coronary artery disease.

  13. Association between Abdominal Fat (DXA) and Its Subcomponents (CT Scan) before and after Weight Loss in Obese Postmenopausal Women: A MONET Study.

    PubMed

    Doyon, Caroline Y; Brochu, Martin; Messier, Virginie; Lavoie, Marie-Ève; Faraj, May; Doucet, Eric; Rabasa-Lhoret, Rémi; Dionne, Isabelle J

    2011-01-01

    Introduction. Subcutaneous fat (ScF) and visceral fat (VF) measurements using CT scan are expensive and may imply significant radiation doses. Cross-sectional studies using CT scan showed that ScF and VF are significantly correlated with abdominal fat measured by DXA (AF-DXA). The association has not been studied after a weight loss. Objective. To determine (1) the associations between AF-DXA and ScF and VF before and after weight loss and (2) the associations between their changes. Methods. 137 overweight/obese postmenopausal women were divided in two groups (1-caloric restriction or 2-caloric restriction + resistance training). AF was assessed using DXA and CT scan. Results. Correlations between AF-DXA and ScF (before: r = 0.87, after; r = 0.87; P < .01) and, AF-DXA and VF (before: r = 0.61, after; r = 0.69; P < .01) are not different before and after the weight loss. Correlations between delta AF-DXA and delta ScF (r = 0.72; P < .01) or delta VF (r = 0.51; P < .01) were found. Conclusion. The use of AF-DXA as a surrogate for VF after weight loss is questionable, but may be interesting for ScF.

  14. Nonalcoholic Fatty Liver Disease: Dyslipidemia, Risk for Cardiovascular Complications, and Treatment Strategy

    PubMed Central

    Zhang, Qing-Qing; Lu, Lun-Gen

    2015-01-01

    Studies have shown that nonalcoholic fatty liver disease (NAFLD) is strongly associated with several metabolic disorders and diseases, such as obesity, type 2 diabetes mellitus, and dyslipidemia. In NAFLD, dyslipidemia is manifested as increased serum triglyceride and low-density lipoprotein cholesterol levels and decreased high-density lipoprotein cholesterol levels, all of which are key risk factors for cardiovascular disease (CVD). CVD is a leading cause of mortality in NAFLD patients. Thus, implementation of an aggressive therapeutic strategy for dyslipidemia with hypolipidemic agents may mitigate the risk for CVD among NAFLD patients. Here, we provide a current review of literature regarding NAFLD, with particular emphasis on dyslipidemia and available treatment options. PMID:26357637

  15. Effects of auricular acupressure on weight reduction and abdominal obesity in Asian young adults: a randomized controlled trial.

    PubMed

    Hsieh, Ching Hsiu; Su, Tsann-Jnn; Fang, Yu-Wen; Chou, Pei-Hsuan

    2011-01-01

    The current study was designed to test the efficacy of auricular acupressure on weight reduction and changes of waist circumference and waist-to-hip ratio. This study used a randomized design with one control group and one experimental group consisting of Asian young adults with a waist circumference ≥80 cm in the females and ≥90cm in the males. At completion of eight weeks of auricular therapy, the total sample size was 55 young adults who ranged in age from 18 to 20 years old. Each participant was treated weekly for ear acupressure in ten-minute sessions. Sessions continued for eight weeks wherein the control group received acupressure only while the experimental group received acupressure with the Japanese Magnetic Pearl on the ear acupoints. While both the control and treatment groups showed significant reduction (p ≤ 0.05) to body weight and waist circumference after eight weeks of treatment, only the group treated with Japanese Magnetic Pearls showed decreased waist to hip ratio. Thus, auricular acupressure may be a beneficial addition to weight loss programs for young adults. Auricular acupressure is thus a reasonable option in the treatment of overweight and obesity in young adults. PMID:21598412

  16. Accumulation of triglyceride-rich lipoprotein in subjects with abdominal obesity: the biguanides and the prevention of the risk of obesity (BIGPRO) 1 study.

    PubMed

    Bard, J M; Charles, M A; Juhan-Vague, I; Vague, P; André, P; Safar, M; Fruchart, J C; Eschwege, E

    2001-03-01

    The present study represents a new insight into the Biguanides and the Prevention of the Risk of Obesity (BIGPRO) 1 study population at inclusion. This population, selected basically on the basis of a high waist-to-hip ratio (>/=0.95 for men and >/=0.80 for women), is supposed to represent a group of patients with insulin resistance. The present study was undergone to establish whether apolipoprotein C-III (apoC-III) and apolipoprotein E (apoE) associated with apo B (apoC-III LpB and apoE LpB, respectively), considered to be markers of remnant accumulation, play a role in the hypertriglyceridemia associated with insulin resistance and whether they are related to other biological abnormalities frequently observed in this syndrome. In this population, the concentration of the markers of remnant accumulation increases with triglyceride levels. Therefore, correlation studies were realized to assess the relative effect of insulin and the markers of remnant accumulation on triglyceride plasma level. As a first attempt, a simple correlation analysis revealed that insulin is positively related to the markers of remnant accumulation only in hypertriglyceridemic patients (triglycerides >/=1.7 mmol/L). To assess the independent contribution of these markers, insulin, and other parameters related to the plasma triglyceride concentration, a stepwise multiple regression analysis was run. Results revealed that insulin and the markers of remnant accumulation (specifically, apoE LpB) are independent contributors to the plasma triglyceride concentration. Markers of the endothelial damage, plasminogen activator inhibitor-1, tissue plasminogen activator, and von Willebrand factor, which are often increased in the case of insulin resistance, were tested for their correlation with the markers of remnant accumulation. Plasminogen activator inhibitor-1 is positively correlated with these markers only in hypertriglyceridemic male subjects. It is concluded that increased insulin levels

  17. Renal function following long-term weight loss in individuals with abdominal obesity on a very-low-carbohydrate diet vs high-carbohydrate diet.

    PubMed

    Brinkworth, Grant D; Buckley, Jonathan D; Noakes, Manny; Clifton, Peter M

    2010-04-01

    A frequently cited concern of very-low-carbohydrate diets is the potential for increased risk of renal disease associated with a higher protein intake. However, to date, no well-controlled randomized studies have evaluated the long-term effects of very-low-carbohydrate diets on renal function. To study this issue, renal function was assessed in 68 men and women with abdominal obesity (age 51.5+/-7.7 years, body mass index [calculated as kg/m(2)] 33.6+/-4.0) without preexisting renal dysfunction who were randomized to consume either an energy-restricted ( approximately 1,433 to 1,672 kcal/day), planned isocaloric very-low-carbohydrate (4% total energy as carbohydrate [14 g], 35% protein [124 g], 61% fat [99 g]), or high-carbohydrate diet (46% total energy as carbohydrate [162 g], 24% protein [85 g], 30% fat [49 g]) for 1 year. Body weight, serum creatinine, estimated glomerular filtration rate and urinary albumin excretion were assessed before and after 1 year (April 2006-July 2007). Repeated measures analysis of variance was conducted. Weight loss was similar in both groups (very-low-carbohydrate: -14.5+/-9.7 kg, high-carbohydrate: -11.6+/-7.3 kg; P=0.16). By 1 year, there were no changes in either group in serum creatinine levels (very-low-carbohydrate: 72.4+/-15.1 to 71.3+/-13.8 mumol/L, high-carbohydrate: 78.0+/-16.0 to 77.2+/-13.2 mumol/L; P=0.93 time x diet effect) or estimated glomerular filtration rate (very-low-carbohydrate: 90.0+/-17.0 to 91.2+/-17.8 mL/min/1.73 m(2), high-carbohydrate: 83.8+/-13.8 to 83.6+/-11.8 mL/min/1.73 m(2); P=0.53 time x diet effect). All but one participant was classified as having normoalbuminuria at baseline, and for these participants, urinary albumin excretion values remained in the normoalbuminuria range at 1 year. One participant in high-carbohydrate had microalbuminuria (41.8 microg/min) at baseline, which decreased to a value of 3.1 microg/min (classified as normoalbuminuria) at 1 year. This study provides preliminary

  18. EFFECT OF PROTEIN SOURCE DURING WEIGHT LOSS ON BODY COMPOSITION, CARDIOMETABOLIC RISK AND PHYSICAL PERFORMANCE IN ABDOMINALLY OBESE, OLDER ADULTS: A PILOT FEEDING STUDY

    PubMed Central

    BEAVERS, K.M.; GORDON, M.M.; EASTER, L.; BEAVERS, D.P.; HAIRSTON, K.G.; NICKLAS, B.J.; VITOLINS, M.Z.

    2016-01-01

    Objectives The purpose of this pilot study was to begin to examine the effect of dietary protein source (soy protein versus non-soy protein) during weight loss on body composition, and cardiometabolic and functional decline risk factors in older, abdominally obese adults. Design Two-arm, single-blind, randomized, controlled trial. Setting Wake Forest School of Medicine, Winston-Salem NC 27157, USA. Participants 25 older (68.4±5.5 years, 88% female), abdominally obese (BMI: 35.1±4.3 kg/m2; WC: 101.4±13.1 cm) men and women were randomized to participate in the study. Intervention A 12-week weight loss intervention, with participants randomized to consume soy protein-based meal replacements (S; n=12) or non-soy protein-based meal replacements (NS; n=12), in addition to prepared meals, and all participants targeted to receive an individualized caloric deficit of 500 kcal/day. Measurements Body weight and composition (assessed via DXA and CT), conventional biomarkers of cardiometabolic risk, and physical performance measures were assessed pre- and post-intervention. Additional endpoints of feasibility (accrual, participation, retention, compliance, and safety) are reported. Results A total of 24 participants (87% female) completed the study (96% retention) and lost an average of 7.8±3.0 kg over the 12-week period, with no difference seen between groups (p=0.83). Although nearly all measures of global and regional body composition were significantly reduced following the 12-week intervention, differences were not observed between groups. Among cardiometabolic risk factors and physical performance measures, only diastolic blood pressure was significantly lower in the NS group compared to the S group (66.7±2.7 mmHg vs 73.5±2.7 mmHg, respectively; p=0.04). Interestingly, in groups combined, despite significant reductions in body weight and lean mass, no significant changes in 400-meter walk time (+5.3±43.4 s), short physical performance battery score (+0.1±1

  19. Sex Differences in Somatotrope Dependency on Leptin Receptors in Young Mice: Ablation of LEPR Causes Severe Growth Hormone Deficiency and Abdominal Obesity in Males.

    PubMed

    Allensworth-James, Melody L; Odle, Angela; Haney, Anessa; Childs, Gwen

    2015-09-01

    Leptin receptor (LEPR) signaling controls appetite and energy expenditure. Somatotrope-specific deletion of the LEPRb signaling isoform causes GH deficiency and obesity. The present study selectively ablated Lepr exon 1 in somatotropes, which removes the signal peptide, causing the loss of all isoforms of LEPR. Excision of Lepr exon 1 was restricted to the pituitary, and mutant somatotropes failed to respond to leptin. Young (2-3 mo) males showed a severe 84% reduction in serum GH levels and more than 60% reduction in immunolabeled GH cells compared with 41%-42% reductions in GH and GH cells in mutant females. Mutant males (35 d) and females (45 d) weighed less than controls and males had lower lean body mass. Image analysis of adipose tissue by magnetic resonance imaging showed that young males had a 2-fold increase in abdominal fat mass and increased adipose tissue density. Young females had only an overall increase in adipose tissue. Both males and females showed lower energy expenditure and higher respiratory quotient, indicating preferential carbohydrate burning. Young mutant males slept less and were more restless during the dark phase, whereas the opposite was true of females. The effects of a Cre-bearing sire on his non-Cre-recombinase bearing progeny are seen by increased respiratory quotient and reduced litter sizes. These studies elucidate clear sex differences in the extent to which somatotropes are dependent on all isoforms of LEPR. These results, which were not seen with the ablation of Lepr exon 17, highlight the severe consequences of ablation of LEPR in male somatotropes. PMID:26168341

  20. Effects of Obesity and Metabolic Syndrome on Steroidogenesis and Folliculogenesis in the Female Ossabaw Mini-Pig

    PubMed Central

    Newell-Fugate, Annie E.; Taibl, Jessica N.; Alloosh, Mouhamad; Sturek, Michael; Bahr, Janice M.; Nowak, Romana A.; Krisher, Rebecca L.

    2015-01-01

    The discrete effects of obesity on infertility in females remain undefined to date. To investigate obesity-induced ovarian dysfunction, we characterized metabolic parameters, steroidogenesis, and folliculogenesis in obese and lean female Ossabaw mini-pigs. Nineteen nulliparous, sexually mature female Ossabaw pigs were fed a high fat/cholesterol/fructose diet (n=10) or a control diet (n=9) for eight months. After a three-month diet-induction period, pigs remained on their respective diets and had ovarian ultrasound and blood collection conducted during a five-month study period after which ovaries were collected for histology, cell culture, and gene transcript level analysis. Blood was assayed for steroid and protein hormones. Obese pigs developed abdominal obesity and metabolic syndrome, including hyperglycemia, hypertension, insulin resistance and dyslipidemia. Obese pigs had elongated estrous cycles and hyperandrogenemia with decreased LH, increased FSH and luteal phase progesterone, and increased numbers of medium, ovulatory, and cystic follicles. Theca cells of obese, compared to control, pigs displayed androstenedione hypersecretion in response to in vitro treatment with LH, and up-regulated 3-beta-hydroxysteroid dehydrogenase 1 and 17-beta-hydroxysteroid dehydrogenase 4 transcript levels in response to in vitro treatment with LH or LH + insulin. Granulosa cells of obese pigs had increased 3-beta-hydroxysteroid dehydrogenase 1 transcript levels. In summary, obese Ossabaw pigs have increased transcript levels and function of ovarian enzymes in the delta 4 steroidogenic pathway. Alterations in LH, FSH, and progesterone, coupled with theca cell dysfunction, contribute to the hyperandrogenemia and disrupted folliculogenesis patterns observed in obese pigs. The obese Ossabaw mini-pig is a useful animal model in which to study the effects of obesity and metabolic syndrome on ovarian function and steroidogenesis. Ultimately, this animal model may be useful toward the

  1. Cross-Sectional Assessment of Nut Consumption and Obesity, Metabolic Syndrome and Other Cardiometabolic Risk Factors: The PREDIMED Study

    PubMed Central

    Ibarrola-Jurado, Núria; Bulló, Mònica; Guasch-Ferré, Marta; Ros, Emilio; Martínez-González, Miguel A.; Corella, Dolores; Fiol, Miquel; Wärnberg, Julia; Estruch, Ramón; Román, Pilar; Arós, Fernando; Vinyoles, Ernest; Serra-Majem, Lluis; Pintó, Xavier; Covas, María-Isabel; Basora, Josep; Salas-Salvadó, Jordi

    2013-01-01

    Introduction Prospective studies have consistently suggested that nut consumption is inversely related to fatal and non-fatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors. Objective To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS), type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk. Materials and Methods Cross-sectional study of 7,210 men and women (mean age, 67 y) recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia) by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as <1, 1–3, and >3 servings/wk. Control of confounding was done with multivariate logistic regression. Results Compared to participants consuming <1 serving/wk of nuts, those consuming >3 servings/wk had lower adjusted odds ratios (OR) for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend <0.001), MetS (0.74, 0.65 to 0.85; P-trend<0.001), and diabetes (0.87, 0.78 to 0.99; P-trend = 0.043). Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend<0.001). No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose. Conclusions Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk. PMID:23460844

  2. Sex Differences in Associations Among Obesity, Metabolic Abnormalities, and Chronic Kidney Disease in Japanese Men and Women

    PubMed Central

    Sakurai, Masaru; Kobayashi, Junji; Takeda, Yasuo; Nagasawa, Shin-Ya; Yamakawa, Junichi; Moriya, Junji; Mabuchi, Hiroshi; Nakagawa, Hideaki

    2016-01-01

    Aims The present study aimed to investigate relationships among abdominal obesity, metabolic abnormalities, and the prevalence of chronic kidney disease (CKD) in relatively lean Japanese men and women. Participants and methods The participants included 8133 men and 15 934 women between 40 and 75 years of age recruited from the government health check-up center in Kanazawa City, Japan. The prevalence of abdominal obesity, high blood pressure, dyslipidemia, and high fasting plasma glucose levels were assessed according to the Japanese criteria for metabolic syndrome. The estimated glomerular filtration rate (eGFR) was calculated using the modified Modification of Diet in Renal Disease equation for the Japanese population, and participants with an eGFR <60 mL/min/1.73 m2 and/or proteinuria were diagnosed with CKD. Results Overall, 23% of males and 14% of females met criteria for CKD. Having more numerous complicated metabolic abnormalities was significantly associated with a higher odds ratio (OR) of CKD for men and women, irrespective of abdominal obesity. However, there was a sex difference in the OR of CKD for obese participants without metabolic abnormalities, such that abdominal obesity without metabolic abnormalities was significantly associated with a higher OR for men (multivariate-adjusted OR 1.63; 95% confidence interval [CI], 1.16–2.28) but not for women (OR 1.01; 95% CI, 0.71–1.44). Conclusions The present findings demonstrated that obesity without metabolic abnormalities was associated with a higher risk of CKD in men but not women in a relatively lean Japanese population. PMID:27087606

  3. Dual Peroxisome Proliferator–Activated Receptor α/δ Agonist GFT505 Improves Hepatic and Peripheral Insulin Sensitivity in Abdominally Obese Subjects

    PubMed Central

    Cariou, Bertrand; Hanf, Rémy; Lambert-Porcheron, Stéphanie; Zaïr, Yassine; Sauvinet, Valérie; Noël, Benoit; Flet, Laurent; Vidal, Hubert; Staels, Bart; Laville, Martine

    2013-01-01

    OBJECTIVE The development of new insulin sensitizers is an unmet need for the treatment of type 2 diabetes. We investigated the effect of GFT505, a dual peroxisome proliferator–activated receptor (PPAR)-α/δ agonist, on peripheral and hepatic insulin sensitivity. RESEARCH DESIGN AND METHODS Twenty-two abdominally obese insulin-resistant males (homeostasis model assessment of insulin resistance >3) were randomly assigned in a randomized crossover study to subsequent 8-week treatment periods with GFT505 (80 mg/day) or placebo, followed by a two-step hyperinsulinemic-euglycemic insulin clamp with a glucose tracer to calculate endogenous glucose production (EGP). The primary end point was the improvement in glucose infusion rate (GIR). Gene expression analysis was performed on skeletal muscle biopsy specimens. RESULTS GFT505 improved peripheral insulin sensitivity, with a 21% (P = 0.048) increase of the GIR at the second insulin infusion period. GFT505 also enhanced hepatic insulin sensitivity, with a 44% (P = 0.006) increase of insulin suppression of EGP at the first insulin infusion period. Insulin-suppressed plasma free fatty acid concentrations were significantly reduced on GFT505 treatment (0.21 ± 0.07 vs. 0.27 ± 0.11 mmol/L; P = 0.006). Neither PPARα nor PPARδ target genes were induced in skeletal muscle, suggesting a liver-targeted action of GFT505. GFT505 significantly reduced fasting plasma triglycerides (−21%; P = 0.003) and LDL cholesterol (−13%; P = 0.0006), as well as liver enzyme concentrations (γ-glutamyltranspeptidase: −30.4%, P = 0.003; alanine aminotransferase: −20.5%, P = 0.004). There was no safety concern or any indication of PPARγ activation with GFT505. CONCLUSIONS The dual PPARα/δ agonist GFT505 is a liver-targeted insulin-sensitizer that is a promising drug candidate for the treatment of type 2 diabetes and nonalcoholic fatty liver disease. PMID:23715754

  4. From obesity to diabetes.

    PubMed

    Keller, U

    2006-07-01

    The prevalence of obesity has been increasing dramatically in the last decades in the whole world, not only in industrialized countries but also in developing areas. A major complication of obesity is insulin resistance and type 2 diabetes. Diabetes is also rapidly increasing world-wide--reaching a prevalence in adults of approx. 5-6% in Central Europe and in the US, and more than 50% in specific, genetically prone populations. This article reviews pathogenetic mechanisms linking obesity and type 2 diabetes. Emphasis is placed on the observation that excessive amounts of adipocytes are associated with an impairment of insulin sensitivity, a key feature of the "metabolic syndrome". This is a cluster of metabolic abnormalities such as type 2 diabetes, hypertension and dyslipidemia; all of them are enhanced by the presence of visceral (abdominal) obesity and all contribute to the increased cardiovascular risk observed in these patients. Besides release of free fatty acids, adipocytes secrete substances that contribute to peripheral insulin resistance, including adiponectin, resistin, TNF-alpha and interleukin 6. Increased turnover of free fatty acids interferes with intracellular metabolism of glucose in the muscle, and they exert lipotoxic effect on pancreatic beta-cells. The pre-receptor metabolism of cortisol is enhanced in visceral adipose tissue by activation of 11 beta-hydroxysteroid dehydrogenase type 1. A new class of anti-diabetic drugs (thiazolidinediones, or glitazones) bind to peroxisome proliferator activated receptor (PPAR-gamma) and lower thereby plasma free fatty acids and cytokine production in adipocytes, in addition to a decrease of resistin and an increase in adiponectin observed in animals, resulting in an overall increase in insulin sensitivity and in an improvement of glucose homeostasis. However, the first step to avoid insulin resistance and prevent the development of diabetes should be a reduction in body weight in overweight subjects, and an

  5. [Very low calorie diets in clinical management of morbid obesity].

    PubMed

    Vilchez López, Francisco Javier; Campos Martín, Cristina; Amaya García, María José; Sánchez Vera, Pilar; Pereira Cunill, José Luis

    2013-01-01

    Morbid obesity and its complications are an increasingly prevalent problem. Very low calorie diets (VLCD), providing between 450 and 800 kcal per day, are an option increasingly used. After proper patient selection, VLCD can result in significant weight loss in 8-16 weeks, contributing to improve control of chronic complications such as diabetes, hypertension, dyslipidemia (except for initial elevation of HDL cholesterol) and apnea-hypopnea syndrome. VLDC are increasingly used prior to bariatric surgery, showing a decrease in hepatic steatosis and visceral abdominal fat. Although the results of the different studies are controversial, preoperative use of VLDC may decrease the rate of perioperative complications, operative time and hospital length of stay. a drastic decrease in intake occurs after bariatric surgery, with risk of protein deficiency, which should be frequently corrected with supplementation by protein modules. Side effects such as cholelithiasis, hyperuricemia and bone loss among others should be monitored in patients undergoing this type of diet.

  6. Mechanisms of adverse cardiometabolic consequences of obesity.

    PubMed

    Diaz-Melean, Carlos M; Somers, Virend K; Rodriguez-Escudero, Juan Pablo; Singh, Prachi; Sochor, Ondrej; Llano, Ernesto Manuel; Lopez-Jimenez, Francisco

    2013-11-01

    Obesity is an epidemic that threatens the health of millions of people worldwide and is a major risk factor for cardiovascular diseases, hypertension, diabetes, and dyslipidemia. There are multiple and complex mechanisms to explain how obesity can cause cardiovascular disease. In recent years, studies have shown some limitations in the way we currently define obesity and assess adiposity. This review focuses on the mechanisms involved in the cardiometabolic consequences of obesity and on the relationship between obesity and cardiovascular comorbidities, and provides a brief review of the latest studies focused on normal weight obesity and the obesity paradox. PMID:24048571

  7. Hypertriglyceridemia: management of atherogenic dyslipidemia.

    PubMed

    Bersot, Thomas; Haffner, Steven; Harris, William S; Kellick, Kenneth A; Morris, Charlene M

    2006-07-01

    Elevated triglycerides are now considered an independent risk factor for coronary heart disease and continue to be a major risk for acute pancreatitis, especially when levels exceed 1000 mg/dL (SOR: B). Elevated triglycerides are a component of atherogenic dyslipidemia and often signal the presence of other conditions (eg, metabolic syndrome, type 2 diabetes mellitus) associated with an increased cardiovascular risk (SOR: A). When evaluating a patient with elevated triglycerides, it is important to be cognizant of all atherogenic lipoproteins to more accurately determine the risk of coronary heart disease (SOR: C). Patients with hypertriglyceridemia should first achieve their low-density lipoprotein cholesterol goal, followed by their non-high-density lipoprotein cholesterol goal (SOR: C). Fibrates, niacin, and omega-3 acid ethyl esters are highly effective at reducing triglycerides, while statins are considered moderately efficacious (SOR: A). PMID:16822443

  8. Major gender differences in the lipolytic capacity of abdominal subcutaneous fat cells in obesity observed before and after long-term weight reduction.

    PubMed

    Löfgren, Patrik; Hoffstedt, Johan; Rydén, Mikael; Thörne, Anders; Holm, Cecilia; Wahrenberg, Hans; Arner, Peter

    2002-02-01

    The influence of obesity on the lipolytic capacity of isolated sc fat cells was studied prospectively in 13 women and 10 men, all obese, but otherwise healthy, before and 2 and 3 yr after weight reduction by bariatric surgery. Nonobese subjects (25 women and 17 men) without a family history of obesity served as the control group. Lipolytic capacity was determined after stimulation at different steps of the lipolytic cascade with noradrenaline, isoprenaline, forskolin, and (Bu)(2)AMP. Bariatric surgery was followed by a marked and similar reduction of body mass index and fat cell volume (approximately 40%) in both genders. Before weight loss, lipolytic capacity per cell was elevated in obese women and decreased to normal levels after weight reduction at 2 and 3 yr. However, lipolytic capacity per fat cell surface area was not changed in obese women. In obese men, lipolytic capacity per cell was almost the same as in lean men and was not influenced by weight reduction. Lipolytic capacity was related to fat cell size in women (P = 0.0008; r = 0.58), but not in men (P = 0.67; r = 0.086). The protein content of hormone-sensitive lipase, which determines lipolytic capacity, was significantly lower in obese men and women and increased slightly after weight reduction in men only. Thus, in women, but not in men, the adipocyte lipolytic capacity is influenced by obesity and weight reduction, probably due to changes in fat cell size. These gender differences are not related to the amount of hormone-sensitive lipase protein in adipocytes. PMID:11836318

  9. Management of the Metabolic Syndrome and the Obese Patient with Metabolic Disturbances: South Asian Perspective.

    PubMed

    Misra, Anoop; Bhardwaj, Swati

    2015-01-01

    There is an increased prevalence of obesity and the metabolic syndrome (MS) among South Asians. The phenotypes of obesity and body fat distribution are different in South Asians; they have high body fat, intra-abdominal and subcutaneous fat and fatty liver at a lower body mass index compared to white Caucasians; this has led to the frequent occurrence of morbidities related to a higher magnitude of adiposity [e.g. type 2 diabetes mellitus (T2DM), hypertension (HTN) and dyslipidemia]. The increasing prevalence of obesity and related diseases in the South Asian population requires aggressive lifestyle management including diet, physical activity and, sometimes, drugs. For therapeutic interventions, several drugs can be used either as mono- or combination therapy. Drugs like orlistat, which is used for the management of obesity, also reduce the risk of T2DM. Similarly, HMG CoA reductase inhibitors decrease low-density-lipoprotein cholesterol levels and reduce the risk of cardiovascular diseases. However, some drugs used for the treatment of HTN (e.g. β-blockers) may increase the risk of hyperglycemia and therefore need to be used with caution. Finally, to prevent obesity, MS and T2DM among South Asians, it is particularly important to effectively implement and strengthen population-based primary prevention strategies.

  10. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  11. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  12. Treating dyslipidemias: is inflammation the missing link?

    PubMed

    Papoutsidakis, Nikolaos; Deftereos, Spyridon; Giannopoulos, Georgios; Panagopoulou, Vasiliki; Manolis, Antonis S; Bouras, Georgios

    2014-01-01

    Low-grade chronic inflammation is now being held as an important process in the development of atherosclerosis, with new links between dyslipidemia and inflammation being constantly found. While most studies aim to discover inflammatory pathways leading from dyslipidemia to atherogenesis, there is evidence that inflammation can also act in reverse, altering lipid metabolism in unfavorable ways, possibly creating a vicious cycle of inflammationdyslipidemia- inflammation. This is highly relevant for the search of novel therapeutic targets. In this review, after a brief account of the inflammatory mechanisms leading from dyslipidemia to atherogenesis, we focus on what is currently known about the ways inflammation can impair lipid metabolism and whether anti-inflammatory therapies could have a role in dyslipidemia management.

  13. The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity

    PubMed Central

    Speyer, Helene; Christian Brix Nørgaard, Hans; Birk, Merete; Karlsen, Mette; Storch Jakobsen, Ane; Pedersen, Kamilla; Hjorthøj, Carsten; Pisinger, Charlotta; Gluud, Christian; Mors, Ole; Krogh, Jesper; Nordentoft, Merete

    2016-01-01

    Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. CHANGE was a randomized, parallel‐group, superiority, multi‐centre trial with blinded outcome assessment, testing the efficacy of an intervention aimed to improve cardiovascular risk profile and hereby potentially reduce mortality. A total of 428 patients with schizophrenia spectrum disorders and abdominal obesity were recruited and centrally randomized 1:1:1 to 12 months of lifestyle coaching plus care coordination plus treatment as usual (N=138), or care coordination plus treatment as usual (N=142), or treatment as usual alone (N=148). The primary outcome was 10‐year risk of cardiovascular disease assessed post‐treatment and standardized to age 60. At follow‐up, the mean 10‐year risk of cardiovascular disease was 8.4 ± 6.7% in the group receiving lifestyle coaching, 8.5 ± 7.5% in the care coordination group, and 8.0 ± 6.5% in the treatment as usual group (p=0.41). We found no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, physical activity, weight, diet and smoking. In conclusion, the CHANGE trial did not support superiority of individual lifestyle coaching or care coordination compared to treatment as usual in reducing cardiovascular risk in patients with schizophrenia spectrum disorders and abdominal obesity. PMID:27265706

  14. The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity.

    PubMed

    Speyer, Helene; Christian Brix Nørgaard, Hans; Birk, Merete; Karlsen, Mette; Storch Jakobsen, Ane; Pedersen, Kamilla; Hjorthøj, Carsten; Pisinger, Charlotta; Gluud, Christian; Mors, Ole; Krogh, Jesper; Nordentoft, Merete

    2016-06-01

    Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. CHANGE was a randomized, parallel-group, superiority, multi-centre trial with blinded outcome assessment, testing the efficacy of an intervention aimed to improve cardiovascular risk profile and hereby potentially reduce mortality. A total of 428 patients with schizophrenia spectrum disorders and abdominal obesity were recruited and centrally randomized 1:1:1 to 12 months of lifestyle coaching plus care coordination plus treatment as usual (N=138), or care coordination plus treatment as usual (N=142), or treatment as usual alone (N=148). The primary outcome was 10-year risk of cardiovascular disease assessed post-treatment and standardized to age 60. At follow-up, the mean 10-year risk of cardiovascular disease was 8.4 ± 6.7% in the group receiving lifestyle coaching, 8.5 ± 7.5% in the care coordination group, and 8.0 ± 6.5% in the treatment as usual group (p=0.41). We found no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, physical activity, weight, diet and smoking. In conclusion, the CHANGE trial did not support superiority of individual lifestyle coaching or care coordination compared to treatment as usual in reducing cardiovascular risk in patients with schizophrenia spectrum disorders and abdominal obesity.

  15. The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity.

    PubMed

    Speyer, Helene; Christian Brix Nørgaard, Hans; Birk, Merete; Karlsen, Mette; Storch Jakobsen, Ane; Pedersen, Kamilla; Hjorthøj, Carsten; Pisinger, Charlotta; Gluud, Christian; Mors, Ole; Krogh, Jesper; Nordentoft, Merete

    2016-06-01

    Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. CHANGE was a randomized, parallel-group, superiority, multi-centre trial with blinded outcome assessment, testing the efficacy of an intervention aimed to improve cardiovascular risk profile and hereby potentially reduce mortality. A total of 428 patients with schizophrenia spectrum disorders and abdominal obesity were recruited and centrally randomized 1:1:1 to 12 months of lifestyle coaching plus care coordination plus treatment as usual (N=138), or care coordination plus treatment as usual (N=142), or treatment as usual alone (N=148). The primary outcome was 10-year risk of cardiovascular disease assessed post-treatment and standardized to age 60. At follow-up, the mean 10-year risk of cardiovascular disease was 8.4 ± 6.7% in the group receiving lifestyle coaching, 8.5 ± 7.5% in the care coordination group, and 8.0 ± 6.5% in the treatment as usual group (p=0.41). We found no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, physical activity, weight, diet and smoking. In conclusion, the CHANGE trial did not support superiority of individual lifestyle coaching or care coordination compared to treatment as usual in reducing cardiovascular risk in patients with schizophrenia spectrum disorders and abdominal obesity. PMID:27265706

  16. Social stress, visceral obesity, and coronary artery atherosclerosis: product of a primate adaptation.

    PubMed

    Shively, Carol A; Register, Thomas C; Clarkson, Thomas B

    2009-09-01

    Abdominal obesity is prevalent and often accompanied by an array of metabolic perturbations including elevated blood pressure, dyslipidemia, impaired glucose tolerance or insulin resistance, a prothrombotic state, and a proinflammatory state, together referred to as the metabolic syndrome. The metabolic syndrome greatly increases coronary heart disease (CHD) risk. Social stress also increases CHD although the mechanisms through which this occurs are not completely understood. Chronic stress may result in sustained glucocorticoid production, which is thought to promote visceral obesity. Thus, one hypothesis is that social stress may cause visceral fat deposition and the metabolic syndrome, which, in turn increases CHD. CHD is caused by coronary artery atherosclerosis (CAA) and its sequelae. Cynomolgus monkeys (Macaca fascicularis) are a well-established models of CAA. Social subordination may be stressful to cynomolgus monkeys and result in hypercortisolemia and exacerbated CAA in females. Herein is reviewed a body of literature which suggests that social stress increases visceral fat deposition in cynomolgus monkeys, that subordinate females are more likely than dominants to have visceral obesity, that females with visceral obesity have behavioral and physiological characteristics consistent with a stressed state, and that females with high ratios of visceral to subcutaneous abdominal fat develop more CAA. While these relationships have been most extensively studied in cynomolgus macaques, obesity-related metabolic disturbances are also observed in other primate species. Taken together, these observations support the view that the current obesity epidemic is the result of a primate adaptation involving the coevolution with encephalization of elaborate physiological systems to protect against starvation and defend stored body fat in order to feed a large and metabolically demanding brain. Social stress may be engaging these same physiological systems, increasing the

  17. The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease.

    PubMed

    Kim, Tae Nyun; Choi, Kyung Mook

    2015-07-01

    The important changes in body composition associated with aging are a decline in skeletal muscle mass and an increase in body fat. Body fat distribution also changes with age; subcutaneous fat decreases and visceral abdominal fat increase, which contributes to numerous cardiometabolic diseases (CMDs) such as type 2 diabetes, dyslipidemia, and cardiovascular disease (CVD). Sarcopenia often accompanied by an increase in body fat and vice versa, a scenario termed sarcopenic obesity (SO), which might lead to the cumulative risk of both sarcopenia and obesity. However, there is still no consensus regarding the definition and consequences of SO. The lack of a unified definition for SO might contribute to inconsistent findings about the association of SO with CMD. Complex etiologies are associated with development of SO. A vicious cycle between the loss of muscle and the accumulation of ectopic fat might be associated with CMD via an intricate interplay of factors including proinflammatory cytokines, oxidative stress, mitochondrial dysfunction, insulin resistance, dietary energy, physical activity, mitochondrial dysfunction, and other factors that have yet to be identified. Moreover, recent epidemiological studies suggest that SO is related to CVD and mortality. This review focuses on the current literature with regard to the association between sarcopenia, dynapenia, and obesity, as well as their implications for CMD. The ultimate goal of this Prospects is to encourage conduct of well-designed future studies that elucidate the relationship among sarcopenia, SO, and CMD.

  18. Pharmacotherapy of mixed dyslipidemia in the metabolic syndrome.

    PubMed

    Nakajima, Kei

    2010-05-01

    People with metabolic syndrome (MetS) are at increased risk of type 2 diabetes and cardiovascular diseases, and often have increased triglyceride, reduced high-density lipoprotein cholesterol (HDL-C) and sometimes moderately increased low-density lipoprotein cholesterol (LDL-C) levels. Lifestyle intervention is critical for treating MetS, while pharmacotherapy of dyslipidemia in MetS remains controversial. Considering the specific lipid profile in MetS, fibrates are typically used as first-line treatment. Nevertheless, first-line therapy should be directed towards LDL-C, even in people with MetS, because of the evidence that lowering LDL-C has cardioprotective effects. Non-HDL-C is considered to be an alternative treatment target for people with moderately or severely elevated triglyceride (> or =200mg/dl). Statins improve lipid profiles principally by lowering LDL-C and may exert anti-inflammatory and anti-atherothrombogenic effects, which ameliorate the fundamental pathophysiology of MetS. Fibrates also have pleiotropic effects that improve cardiometabolic risk factors, including insulin resistance, although they do not have clear cardioprotective effects. Omega-3 fatty acids, niacin, pioglitazone and anti-obesity drugs are also candidates for the treatment of dyslipidemia and other complications in MetS. Another question is whether statins in combination with fibrates or other lipid-lowering drugs has greater cardioprotective properties than monotherapy. In this article, we discuss several issues in the pharmacotherapy of MetS. PMID:20156152

  19. Effects of Insulin-Like Growth Factor (IGF)-I/IGF-Binding Protein-3 Treatment on Glucose Metabolism and Fat Distribution in Human Immunodeficiency Virus-Infected Patients with Abdominal Obesity and Insulin Resistance

    PubMed Central

    Rao, Madhu N.; Mulligan, Kathleen; Tai, Viva; Wen, Michael J.; Dyachenko, Artem; Weinberg, Melissa; Li, Xiaojuan; Lang, Thomas; Grunfeld, Carl; Schwarz, Jean-Marc; Schambelan, Morris

    2010-01-01

    Context: HIV-infected patients on antiretroviral therapy are at increased risk for excess visceral adiposity and insulin resistance. Treatment with GH decreases visceral adiposity but worsens glucose metabolism. IGF-I, which mediates many of the effects of GH, improves insulin sensitivity in HIV-negative individuals. Objective: Our objective was to determine whether IGF-I, complexed to its major binding protein, IGF-binding protein-3 (IGFBP-3), improves glucose metabolism and alters body fat distribution in HIV-infected patients with abdominal obesity and insulin resistance. Methods: We conducted a pilot, open-label study in 13 HIV-infected men with excess abdominal adiposity and insulin resistance to assess the effect of 3 months of treatment with IGF-I/IGFBP-3 on glucose metabolism and fat distribution. Glucose metabolism was assessed by oral glucose tolerance test and hyperinsulinemic-euglycemic clamp. Endogenous glucose production (EGP), gluconeogenesis, whole-body lipolysis, and de novo lipogenesis (DNL) were measured with stable isotope infusions. Body composition was assessed by dual-energy x-ray absorptiometry and abdominal computed tomography scan. Results: Glucose tolerance improved and insulin-mediated glucose uptake increased significantly during treatment. EGP increased under fasting conditions, and suppression of EGP by insulin was blunted. Fasting triglycerides decreased significantly in association with a decrease in hepatic DNL. Lean body mass increased and total body fat decreased, whereas visceral adipose tissue did not change. Conclusions: Treatment with IGF-I/IGFBP-3 improved whole-body glucose uptake and glucose tolerance, while increasing hepatic glucose production. Fasting triglycerides improved, reflecting decreased DNL, and visceral adiposity was unchanged. PMID:20610601

  20. Education is associated with lower levels of abdominal obesity in women with a non-agricultural occupation: an interaction study using China’s four provinces survey

    PubMed Central

    2013-01-01

    Background The prevalence of obesity is increasing rapidly in low- and middle-income countries (LMICs) as their populations become exposed to obesogenic environments. The transition from an agrarian to an industrial and service-based economy results in important lifestyle changes. Yet different socioeconomic groups may experience and respond to these changes differently. Investigating the socioeconomic distribution of obesity in LMICs is key to understanding the causes of obesity but the field is limited by the scarcity of data and a uni-dimensional approach to socioeconomic status (SES). This study splits socioeconomic status into two dimensions to investigate how educated women may have lower levels of obesity in a context where labour market opportunities have shifted away from agriculture to other forms of employment. Methods The Four Provinces Study in China 2008/09 is a household-based community survey of 4,314 people aged ≥60  years (2,465 women). It was used to investigate an interaction between education (none/any) and occupation (agricultural/non-agricultural) on high-risk central obesity defined as a waist circumference ≥80 cm. An interaction term between education and occupation was incorporated in a multivariate logistic regression model, and the estimates adjusted for age, parity, urban/rural residence and health behaviours (smoking, alcohol, meat and fruit & vegetable consumption). Complete case analyses were undertaken and results confirmed using multiple imputation to impute missing data. Results An interaction between occupation and education was present (P = 0.02). In the group with no education, the odds of central obesity in the sedentary occupation group were more than double those of the agricultural occupation group even after taking age group and parity into account (OR; 95%CI: 2.21; 1.52, 3.21), while in the group with any education there was no evidence of such a relationship (OR; 95%CI: 1.25; 0.92, 1.70). Health behaviours

  1. Consumption of total fiber and types of fiber are associated with a lower prevalence of obesity and abdominal adiposity in US adults. NHANES 1999-2006.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In this cross-sectional study, an inverse association was found between intakes of total dietary fiber and five types of fiber with Body Mass Index, waist circumference, and percent obese, and with increased waist circumference. Intake of vegetable fiber was not associated with any of the weight mea...

  2. Dietary supplementation of Chardonnay grape seed flour reduces plasma cholesterol concentration, hepatic steatosis, and abdominal fat content in high-fat diet-induced obese hamsters

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The mechanisms for the hypocholesterolemic and anti-obesity effects of grape seed flours derived from white and red winemaking processing were investigated. Male Golden Syrian hamsters were fed high-fat (HF) diets supplemented with 10% partially defatted grape seed flours from Chardonnay (ChrSd), Ca...

  3. Assessing the Causality Factors in the Association between (Abdominal) Obesity and Physical Activity among the Newfoundland Population—A Mendelian Randomization Analysis

    PubMed Central

    Barning, Frank; Abarin, Taraneh

    2016-01-01

    A total of 1,263 adults from Newfoundland and Labrador were studied in the research. Body mass index (BMI) and percent trunk fat (PTF) were analyzed as biomarkers for obesity. The Mendelian randomization (MR) approach with two single-nucleotide polymorphisms in the fat-mass and obesity (FTO) gene as instruments was employed to assess the causal effect. In both genders, increasing physical activity significantly reduced BMI and PTF when adjusted for age and the FTO gene. The effect of physical activity was stronger on PTF than BMI. Direct observational analyses showed significant increase in BMI/PTF when physical activity decreased. A similar association in MR analyses was not significant. The association between physical activity and BMI/PTF could be due to reversed causality or common confounding factors. Our study provides insights into the causal contributions of obesity to physical activity in adults. Health intervention strategies to increase physical activity among adults should include some other plans such as improving diet for reducing obesity. PMID:27478388

  4. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  5. Childhood obesity and cardiovascular dysfunction.

    PubMed

    Cote, Anita T; Harris, Kevin C; Panagiotopoulos, Constadina; Sandor, George G S; Devlin, Angela M

    2013-10-01

    Obesity-related cardiovascular disease in children is becoming more prevalent in conjunction with the rise in childhood obesity. Children with obesity are predisposed to an increased risk of cardiovascular morbidity and mortality in adulthood. Importantly, research in children with obesity over the last decade has demonstrated that children may exhibit early signs of cardiovascular dysfunction as a result of their excess adiposity, often independent of other obesity-related comorbidities such as dyslipidemia and insulin resistance. The clinical evidence is accumulating to suggest that the cardiovascular damage, once observed only in adults, is also occurring in obese children. The objective of this review is to provide a synopsis of the current research on cardiovascular abnormalities in children with obesity and highlight the importance and need for early detection and prevention programs to mitigate this potentially serious health problem.

  6. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  7. Dietary n-3 polyunsaturated fatty acids modify fatty acid composition in hepatic and abdominal adipose tissue of sucrose-induced obese rats.

    PubMed

    Alexander-Aguilera, Alfonso; Berruezo, Silvia; Hernández-Diaz, Guillermo; Angulo, Ofelia; Oliart-Ros, Rosamaria

    2011-12-01

    The fatty acid profile of hepatocytes and adipocytes is determined by the composition of the dietary lipids. It remains unclear which fatty acid components contribute to the development or reduction of insulin resistance. The present work examined the fatty acid composition of both tissues in sucrose-induced obese rats receiving fish oil to determine whether the effect of dietary (n-3) polyunsaturated fatty acids (PUFAs) on the reversion of metabolic syndrome in these rats is associated to changes in the fatty acid composition of hepatocyte and adipocyte membrane lipids. Animals with metabolic syndrome were divided into a corn-canola oil diet group and a fish oil diet group, and tissues fatty acids composition were analyzed after 6 weeks of dietary treatment. Fatty acid profiles of the total membrane lipids were modified by the fatty acid composition of the diets fed to rats. N-3 PUFAs levels in animals receiving the fish oil diet plus sucrose in drinking water were significantly higher than in animals under corn-canola oil diets. It is concluded that in sucrose-induced obese rats, consumption of dietary fish oil had beneficial effects on the metabolic syndrome and that such effects would be conditioned by the changes in the n-3 PUFAs composition in hepatic and adipose tissues because they alter membrane properties and modify the type of substrates available for the production of active lipid metabolites acting on insulin resistance and obesity. PMID:21695545

  8. Impact of obesity on the pathogenesis and prognosis of coronary heart disease.

    PubMed

    Todd Miller, M; Lavie, Carl J; White, Christopher J

    2008-01-01

    Obesity has a significant adverse effect on coronary heart disease (CHD) risk factors, including hypertension, dyslipidemia, and the metabolic syndrome/diabetes. Obesity is an independent risk factor for CHD events; however, obese patients with CHD generally have a more favorable prognosis, with the worst prognosis associated with either underweight or morbidly obese patients. In this manuscript, the authors review the impact of obesity on overall CHD risk as well as the prognosis of obese patients with established CHD.

  9. Management of inherited atherogenic dyslipidemias in children.

    PubMed

    Guardamagna, Ornella; Cagliero, Paola; Abello, Francesca

    2013-04-01

    In order to prevent cardiovascular disease, the treatment of inherited dyslipidemias in childhood represents an emerging topic capturing scientists' consideration. A body of findings emerged in the last decade for diagnosis and therapy, and results were recently summarized to introduce new guidelines by the American Academy of Pediatrics and National Institute for Health and Clinical Excellence. It is well known and generally shared the need to detect affected children precociously, when the family history address to genetic dyslipidemia and when familial premature cardiovascular disease occurs. A spectrum of disorders involving lipoproteins could be recognized by specific biochemical and genetic markers. A defined diagnosis represents the starting point to establish a correct treatment and follow-up program. This review represents a literature synthesis of the main cornerstones and criticisms concerning the screening program and management of atherogenic inherited dyslipidemias in children and adolescents.

  10. [New European clinical guidelines on dyslipidemias].

    PubMed

    Matikainen, Niina; Taskinen, Marja-Riitta

    2012-01-01

    In the new European clinical guidelines on dyslipidemias, screening of the risk for cardiovascular diseace is recommended by using lipid assays for all patients who are at high risk due to their clinical characteristics, and for men over 40 years of age and women of over 50 years of age. The starting point in the guidelines is an assessment of individual total risk based on traditional risk factors, i.e. LDL cholesterol level, blood pressure, smoking and age. With respect of dyslipidemia, the effect of HDL cholesterol and triglyceride levels on the total risk is recommended to complement the information provided by the LDL cholesterol level.

  11. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  12. Adolescent women and obesity.

    PubMed

    In-Iw, Supinya; Biro, Frank M

    2011-04-01

    The proportion of child and adolescent obesity in the United States has dramatically increased over the past few decades, challenging public health strategies and medical needs of the individual. The medical consequences of obesity include metabolic syndrome, polycystic ovary syndrome, and cardiovascular disease. There is no definite diagnostic criterion of metabolic syndrome in children and adolescents; commonly noted features are central adiposity, insulin resistance, dyslipidemia, and hypertension. To prevent negative health outcomes and early recognition for those at risk for overweight and obesity, healthcare providers should screen BMI in children and adolescents at least annually, as well as provide anticipatory guidance to all families during health maintenance visit. This review will address the epidemiology and consequences of obesity in children and adults, and issues for health care providers and public health officials to consider. These issues include increasing physical activity, decreasing sedentary activities, and promoting healthy eating behaviors.

  13. The effect of obesity and tobacco smoke exposure on inflammatory mediators and matrix metalloproteinases in rat model.

    PubMed

    Esquivel, Ana Laura; Pérez-Ramos, J; Cisneros, J; Herrera, I; Rivera-Rosales, R; Montaño, M; Ramos, C

    2014-12-01

    Obesity is characterized by hypertrophy of adipose tissue and chronic obstructive pulmonary disease (COPD) by lung damage; both diseases are associated with systemic low-grade inflammation. There are no animal models combining obesity and COPD; therefore, these diseases were induced simultaneously in rats to analyze their effects on the expression of inflammatory mediators and enzymes involved in lung tissue remodeling. Obesity was induced with sucrose (30%) for 4 months concomitant with tobacco smoke exposure (20 cigarettes/day, 5 days/wk) for the last 2 months. Were evaluated: body weight, abdominal fat, dyslipidemia, glucose tolerance test (GTT), histology, inflammatory mediators with qPCR and enzyme-linked immunosorbent assay, matrix metalloproteinases (MMP-2), MMP-9, MMP-12, TIMP-1 and TIMP-2 through qRT-PCR, and MMP-2 and MMP-9 by gelatin zymography. The rats on a sucrose diet exhibited increased body weight, abdominal fat, triglycerides, GTT, and plasma levels of insulin, adiponectin, leptin, resistin, IL-6, IL-1β, tumor necrosis factor-α (TNF-α) and IFN-γ, upregulated lung IL-6, IL-1β, TNF-α and IFN-γ, showing hyperplastic bronchial and alveolar epithelium. The animals exposed to sucrose and tobacco smoke exhibited decreased body weight, abdominal fat and plasma levels of leptin, resistin, IL-1β and IFN-γ, reducing inflammation but showing emphysematous lesions. Expression of gelatinases and MMP-12 augmented in the rats exposed to tobacco smoke alone or combined with sucrose. Zymography showed prominent gelatinases activity in all the experimental groups. These results suggest that simultaneous exposure to sucrose and tobacco smoke decreases inflammation but results in emphysematous lesions similar to those observed with tobacco smoke exposure, suggesting that obesity does not confer any protective effect against lung damage.

  14. A randomized, double blind, cross-over, placebo-controlled clinical trial to assess the effects of Candesartan on the insulin sensitivity on non diabetic, non hypertense subjects with dysglyce mia and abdominal obesity. "ARAMIA"

    PubMed Central

    López-Jaramillo, Patricio; Pradilla, Lina P; Lahera, Vicente; Sieger, Federico A Silva; Rueda-Clausen, Christian F; Márquez, Gustavo A

    2006-01-01

    Candesartan, could improve the HOMA index, the response to the oral glucose tolerance test and reduce the plasma levels of adipoquines, oxidative stress and prothrombotic markers, in non diabetic, non hypertense subjects with dysglycemia and abdominal obesity, recruited from a population at high risk of developing insulin resistance. These effects are independent of the changes in arterial blood pressure. Trial registration: NCT00319202 PMID:16959033

  15. Gastrointestinal Morbidity in Obesity

    PubMed Central

    Acosta, Andres; Camilleri, Michael

    2014-01-01

    Obesity is a complex disease that results from increased energy intake and decreased energy expenditure. The gastrointestinal system plays a key role in the pathogenesis of obesity and facilitates caloric imbalance. Changes in gastrointestinal hormones and the inhibition of mechanisms that curtail caloric intake result in weight gain. It is not clear if the gastrointestinal role in obesity is a cause or an effect of this disease. Obesity is often associated with type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). Obesity is also associated with gastrointestinal disorders, which are more frequent and present earlier than T2DM and CVD. Diseases such as gastro-esophageal reflux disease, cholelithiasis or non-alcoholic steatohepatitis are directly related to body weight and abdominal adiposity. Our objective is to assess the role of each gastrointestinal organ in obesity and the gastrointestinal morbidity resulting in those organs from effects of obesity. PMID:24602085

  16. Obesity drug therapy.

    PubMed

    Baretić, M

    2013-09-01

    Obesity is a chronic disease, and it requires chronic therapy. Hypertension, dyslipidemia, diabetes and cardiovascular diseases are leading causes of mortality in the modern world. All of them are strongly linked to obesity. While treating obesity, those conditions are also managed. Obese patients should always be treated through lifestyle interventions, though the results of such interventions are modest. Pharmacotherapy is a second step in the treatment of obesity, approved only when weight loss targets were not reached through lifestyle intervention. During the history of antiobesity drugs, many of them were withdrawn because of their side effects. Various guidelines recommend prescribing drug therapy for obesity through consideration of the potential benefits and limitations. Orlistat deactivates intestinal lipase and inhibits intestinal fat lipolysis. It is actually the only drug on the European market approved for the treatment of obesity. Orlistat therapy reduces weight to a modest extent, but it reduces the incidence of diabetes beyond the result achieved with lifestyle changes. Recently, some effective antiobesity drugs like sibutramine and rimonabant have been removed from the market due to their side effects. The new combination of topimarate and fentermine is approved in the US but not in Europe. The cost effectiveness of long-term pharmacotherapy of obesity is still an unresolved question. PMID:24126545

  17. Obesity and kidney protection

    PubMed Central

    Chandra, Aravind; Biersmith, Michael; Tolouian, Ramin

    2014-01-01

    Context: Obesity, both directly and indirectly, increases the risk for a variety of disease conditions including diabetes, hypertension, liver disease, and certain cancers, which in turn, decreases the overall lifespan in both men and women. Though the cardiovascular risks of obesity are widely acknowledged, less often identified is the relationship between obesity and renal function. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Results: The concept of the “Metabolic Syndrome“ helps us to understand this close link between obesity, diabetes, hypertension, and renal dysfunction. An elevated body mass index has shown to be one of the major determinants of glomerular hyperfiltration that lead to the development of chronic kidney disease. Interestingly, weight loss can lead to attenuation of hyperfiltration in severely obese patients suggesting a possible therapeutic option to combat obesity-related hyperfiltration. Conclusions: Various treatment strategies had been suggested to decrease impact of obesity on kidneys. These are blood pressure controling, inhibition of the renin-angiotensinaldosterone axis, improving glycemic control, improving dyslipidemia, improving protein uriaand lifestyle modifications. Regardless of the numerous pharmacotherapies, the focus should be on the root cause: obesity. PMID:25093156

  18. Mechanisms of Chronic State of Inflammation as Mediators That Link Obese Adipose Tissue and Metabolic Syndrome

    PubMed Central

    Fuentes, Eduardo; Fuentes, Francisco; Badimon, Lina; Palomo, Iván

    2013-01-01

    The metabolic syndrome is a cluster of cardiometabolic alterations that include the presence of arterial hypertension, insulin resistance, dyslipidemia, and abdominal obesity. Obesity is associated with a chronic inflammatory response, characterized by abnormal adipokine production, and the activation of proinflammatory signalling pathways resulting in the induction of several biological markers of inflammation. Macrophage and lymphocyte infiltration in adipose tissue may contribute to the pathogenesis of obesity-mediated metabolic disorders. Adiponectin can either act directly on macrophages to shift polarization and/or prime human monocytes into alternative M2-macrophages with anti-inflammatory properties. Meanwhile, the chronic inflammation in adipose tissue is regulated by a series of transcription factors, mainly PPARs and C/EBPs, that in conjunction regulate the expression of hundreds of proteins that participate in the metabolism and storage of lipids and, as such, the secretion by adipocytes. Therefore, the management of the metabolic syndrome requires the development of new therapeutic strategies aimed to alter the main genetic pathways involved in the regulation of adipose tissue metabolism. PMID:23843680

  19. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  20. Development of Antisense Drugs for Dyslipidemia.

    PubMed

    Yamamoto, Tsuyoshi; Wada, Fumito; Harada-Shiba, Mariko

    2016-09-01

    Abnormal elevation of low-density lipoprotein (LDL) and triglyceride-rich lipoproteins in plasma as well as dysfunction of anti-atherogenic high-density lipoprotein (HDL) have both been recognized as essential components of the pathogenesis of atherosclerosis and are classified as dyslipidemia. This review describes the arc of development of antisense oligonucleotides for the treatment of dyslipidemia. Chemically-armed antisense candidates can act on various kinds of transcripts, including mRNA and miRNA, via several different endogenous antisense mechanisms, and have exhibited potent systemic anti-dyslipidemic effects. Here, we present specific cutting-edge technologies have recently been brought into antisense strategies, and describe how they have improved the potency of antisense drugs in regard to pharmacokinetics and pharmacodynamics. In addition, we discuss perspectives for the use of armed antisense oligonucleotides as new clinical options for dyslipidemia, in the light of outcomes of recent clinical trials and safety concerns indicated by several clinical and preclinical studies. PMID:27466159

  1. Effect of Abdominoplasty in the Lipid Profile of Patients with Dyslipidemia

    PubMed Central

    Ramos-Gallardo, Guillermo; Pérez Verdin, Ana; Fuentes, Miguel; Godínez Gutiérrez, Sergio; Ambriz-Plascencia, Ana Rosa; González-García, Ignacio; Gómez-Fonseca, Sonia Mericia; Madrigal, Rosalio; González-Reynoso, Luis Iván; Figueroa, Sandra; Toscano Igartua, Xavier; Jiménez Gutierrez, Déctor Francisco

    2013-01-01

    Introduction. Dyslipidemia like other chronic degenerative diseases is pandemic in Latin America and around the world. A lot of patients asking for body contouring surgery can be sick without knowing it. Objective. Observe the lipid profile of patients with dyslipidemia, before and three months after an abdominoplasty. Methods. Patients candidate to an abdominoplasty without morbid obesity were followed before and three months after the surgery. We compared the lipid profile, glucose, insulin, and HOMA (cardiovascular risk marker) before and three months after the surgery. We used Student's t test to compare the results. A P value less than 0.05 was considered as significant. Results. Twenty-six patients were observed before and after the surgery. At the third month, we found only statistical differences in LDL and triglyceride values (P 0.04 and P 0.03). The rest of metabolic values did not reach statistical significance. Conclusion. In this group of patients with dyslipidemia, at the third month, only LDL and triglyceride values reached statistical significances. There is no significant change in glucose, insulin, HOMA, cholesterol, VLDL, or HDL. PMID:23956856

  2. The relationship between obesity and coronary artery disease.

    PubMed

    Jahangir, Eiman; De Schutter, Alban; Lavie, Carl J

    2014-10-01

    Obesity continues to be a growing issue in the United States, with an estimated prevalence of 72 million people. There are major health implications associated with obesity, including its relationship with hypertension, diabetes mellitus type 2, metabolic syndrome, and dyslipidemia, all independent risk factors for coronary artery disease (CAD). Despite the increased risk of developing CAD, in recent years an "obesity paradox" has been described in which moderately obese individuals with established cardiovascular disease, including CAD, appear to have mortality similar to their normal-weight counterparts. This review examines the relationship between obesity and CAD, including the increased risk of hypertension, diabetes mellitus, metabolic syndrome, and dyslipidemia, along with a discussion of the obesity paradox and the benefits of weight reduction.

  3. [Neuroendocrine disturbances in obesity].

    PubMed

    Isidro, M L; Alvarez, P; Martínez, T; Cordido, F

    2004-01-01

    Obesity is associated with different disturbances in endocrine function. Both spontaneous growth hormone (GH) secretion and its response to several stimuli have shown to be reduced in obese patients. The GH responses to GH-releasing hormone and other challenges by pyridostigmine suggest that the reduction in GH secretion is related to an increased somatostatinergic tone. Other experiments point to a down-regulation of somatostatin receptors in the somatotroph cell. Ghrelin administration is followed by a massive GH release, but the possibility that ghrelin or GHRH deficiency are the cause of GH deficiency in obesity is unlikely. The increase in free fatty acids in obesity might be related to GH reduction, since acipimox administration is able to reverse GH secretion. In women, abdominal obesity is associated with hyperandrogenism and low sex hormone-binding globulin levels. Obese men have low testosterone and gonadotrophin concentrations, specially in cases of morbid obesity. An increase in hypothalamic-pituitary-adrenal axis activity and some resistance to dexamethasone suppression have been described in abdominal obesity. This effect may be due to neuroendocrine alterations related to a genetic origin. Adrenal hyperfunction may favour cardiovascular and metabolic complications. There are no disturbances in thyroid function. Sometimes a reduction in prolactin response to several stimuli has been reported. This effect may be due to hyperinsulinaemia or to disturbances in the dopaminergic tone.

  4. Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia

    PubMed Central

    2015-01-01

    Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dose-dependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate. PMID:26566492

  5. Dyslipidemias in the prevention of cardiovascular disease: risks and causality.

    PubMed

    Graham, Ian; Cooney, Marie-Therese; Bradley, David; Dudina, Alexandra; Reiner, Zeljko

    2012-12-01

    Atherosclerotic cardiovascular disease is now the major global cause of death, despite reductions in CVD deaths in developed societies. Dyslipidemias are a major contributor, but the mass occurrence of CVD relates to the combined effects of hyperlipidemia, hypertension, and smoking. Total blood cholesterol and LDL-cholesterol relate to CVD risk in an independent and graded manner and fulfill the criteria for causality. Therapeutic reduction of these lipid fractions is associated with improved outcomes. There is good evidence that HDL-cholesterol, triglycerides, and Lp(a) relate to CVD although the evidence for a causal relationship is weaker. The HDL association with CVD is largely independent of other risk factors whereas triglycerides may be more important as signaling a need to look intensively for other measures of risk such as central obesity, hypertension, low HDL-cholesterol, and glucose intolerance. Lp(a) is an inherited risk marker. The benefit of lowering it is uncertain, but it may be that its impact on risk is attenuated if LDL-cholesterol is low.

  6. Managing dyslipidemia in HIV/AIDS patients: challenges and solutions

    PubMed Central

    Husain, Nazik Elmalaika OS; Ahmed, Mohamed H

    2015-01-01

    Human immunodeficiency virus (HIV) is a chronic disease associated with dyslipidemia and insulin resistance. In addition, the administration of combination antiretroviral therapy is associated with an increase in the incidence of metabolic risk factors (insulin resistance, lipoatrophy, dyslipidemia, and abnormalities of fat distribution in HIV patients). HIV dyslipidemia is a common problem, and associated with an increase in incidence of cardiovascular disease. Further challenges in the management of HIV dyslipidemia are the presence of diabetes and metabolic syndrome, nonalcoholic fatty liver disease, hypothyroidism, chronic kidney disease, the risk of diabetes associated with statin administration, age and ethnicity, and early menopause in females. Dyslipidemia in patients with HIV is different from the normal population, due to the fact that HIV increases insulin resistance and HIV treatment not only may induce dyslipidemia but also may interact with lipid-lowering medication. The use of all statins (apart from simvastatin and lovastatin) is safe and effective in HIV dyslipidemia, and the addition of ezetimibe, fenofibrate, fish oil, and niacin can be used in statin-unresponsive HIV dyslipidemia. The management of dyslipidemia and cardiovascular disease risks associated with HIV is complex, and a certain number of patients may require management in specialist clinics run by specialist physicians in lipid disorders. Future research is needed to address best strategies in the management of hyperlipidemia with HIV infection. PMID:25565897

  7. Metabolically healthy obesity--does it exist?

    PubMed

    Boonchaya-anant, Patchaya; Apovian, Caroline M

    2014-10-01

    The prevalence of obesity has been increasing worldwide over the past 30 years and is a major public health concern. Obesity is known to be associated with metabolic disturbances including insulin resistance and inflammation; however, there is a subset of obese subjects who have normal metabolic profiles, and they have been identified as the metabolically healthy obese (MHO). Several studies have described MHO as obese individuals who have high levels of insulin sensitivity and the absence of diabetes, dyslipidemia, or hypertension. The prevalence of MHO varies from 20 to 30% among obese individuals. This review will discuss the MHO phenotype; the differences between MHO and metabolically unhealthy obese (MUO) individuals; and the possible underlying mechanisms including adipocyte differentiation, immune regulation, and cellular energy metabolism. PMID:25092577

  8. [Prevalence of no alcohol fatty liver disease (NAFLD) in a population of obese children in Valencia, Venezuela].

    PubMed

    Pontiles de Sánchez, Milagros; Morón de Salim, Alba; Rodríguez de Perdomo, Henny; Perdomo Oramas, Germán

    2014-06-01

    No Alcoholic Fatty Liver Disease (NAFLD) is characterized by an abnormal accumulation of fat in hepatocytes, without alcohol, where overweight and obesity are determinants. Ecosonografia evaluated the prevalence of fatty liver in obese pediatric patients and its relation to nutritional assessment. The sample consisted of 85 children (51 females, 34 males), age 3-17. The abdominal ecosonography, BMI, waist circumference were performed; Godard Test for physical activity, history of diabetes, dyslipidemia, obesity and cardiovascular disease were questioned. Lipid profile, glucose and insulin resistance were determined. Data analyzed from descriptive and comparative tables. We obtained: mean age 9.8 ± 2.7 females and males 9.6 ± 2.7 years. The ecosonography indicated 50% and 50% fatty liver-pancreas fatty liver in children aged 3-6 years; 7-11 years 39.7% fatty liver-pancreas; 12-17yrs 31.6% fatty liver-pancreas (p > 0.05); BMI > 26 kg/m2 42.9% fatty liver-pancreas; 21 to 25 kg/m2 44.7% fatty liver; 15 to 20 kg/m2 60%fatty liver-pancreas (p> 0.05). 97.6% with high CC; 68.2% with inadequate physical activity; high frequency of history of chronic non-communicable diseases. We concluded that this population had predominantly fatty liver fatty replacement of the pancreas (HG-RGP) in the groups with higher BMI, CC and high male unrelated insulin resistance, altered lipid profile and diagnosis HG. We inferred that the anthropometric assessment of waist circumference and abdominal ecosonography indicate the presence of visceral obesity, a condition that predisposes to hepatic steatosis, pancreas and/or liver-pancreas.

  9. Effects of a multicomponent wellness intervention on dyslipidemia among overweight adolescents

    PubMed Central

    Hardy, Olga T.; Wiecha, Jean; Kim, Albert; Salas, Carlos; Briceno, Rayna; Moody, Kwesi; Becker, Joan; Glazer, Greer; Ciccarelli, Carol; Shi, Ling; Hayman, Laura L.

    2013-01-01

    Behavioral changes are the first line of treatment for dyslipidemia in adolescents, but outcome data on the effectiveness of this approach are inconsistent. This study aims to assess the effect of a 13-week multicomponent wellness intervention program, which included weekly nutrition classes and structured cardiovascular, flexibility, and strength training on dyslipidemia in nine overweight/obese [body mass index (BMI) ≥85th percentile] and nine lean (BMI <85th percentile) adolescents. Clinical measurements and lipid profile assessment were performed before and after the intervention. At the completion of the study, the overweight/obese adolescents demonstrated a 15% increase in high-density lipoprotein cholesterol (HDL-C) levels (mean, 47±8 vs. 54±5 mg/dL), whereas there was no improvement in BMI or other measurements. The participants in the lean group showed no change in their anthropometric and serum parameters. A multicomponent wellness intervention resulted in a significant increase of cardioprotective HDL-C levels, which have been associated with coronary health in adulthood. PMID:22570954

  10. Obesity, insulin resistance and comorbidities – Mechanisms of association

    PubMed Central

    Castro, Ana Valeria B.; Kolka, Cathryn M.; Kim, Stella P.; Bergman, Richard N.

    2015-01-01

    Overall excess of fat, usually defined by the body mass index, is associated with metabolic (e.g. glucose intolerance, type 2 diabetes mellitus (T2DM), dyslipidemia) and non-metabolic disorders (e.g. neoplasias, polycystic ovary syndrome, non-alcoholic fat liver disease, glomerulopathy, bone fragility etc.). However, more than its total amount, the distribution of adipose tissue throughout the body is a better predictor of the risk to the development of those disorders. Fat accumulation in the abdominal area and in non-adipose tissue (ectopic fat), for example, is associated with increased risk to develop metabolic and non-metabolic derangements. On the other hand, observations suggest that individuals who present peripheral adiposity, characterized by large hip and thigh circumferences, have better glucose tolerance, reduced incidence of T2DM and of metabolic syndrome. Insulin resistance (IR) is one of the main culprits in the association between obesity, particularly visceral, and metabolic as well as non-metabolic diseases. In this review we will highlight the current pathophysiological and molecular mechanisms possibly involved in the link between increased VAT, ectopic fat, IR and comorbidities. We will also provide some insights in the identification of these abnormalities. PMID:25211442

  11. [Dyslipidemia management in children and adolescents: recommendations of the Nutrition Branch of the Chilean Society of Pediatrics].

    PubMed

    Barja Y, Salesa; Cordero B, María Luisa; Baeza L, Cecilia; Hodgson B, María Isabel

    2014-06-01

    The prevalence of dyslipidemia has dramatically increased in children and adolescents, and many of these cases are associated with increased obesity. As this condition represents cardiovascular risk in the future, the bases of its treatment should be widely known. In the vast majority of patients, there will be lifestyle changes, specific diet and increased physical activity, usually all of these resulting in a favorable response. Only a minority will require drug treatment, which must be prescribed by a specialist in the context of a comprehensive cardiovascular risk assessment, including the patient and his family. The prevention of cardiovascular risk factors should be performed by all members of the health team. This article presents the recommendations of the Nutrition specialists of the Chilean Society of Pediatrics for screening, diagnosis and treatment of dyslipidemia in childhood.

  12. Synergic insulin sensitizing effect of rimonabant and BGP-15 in Zucker-obese rats.

    PubMed

    Literati-Nagy, Zsuzsanna; Tory, Kálmán; Literáti-Nagy, Botond; Bajza, Agnes; Vígh, László; Vígh, László; Mandl, József; Szilvássy, Zoltán

    2013-07-01

    Abdominal obesity is referred for as a common pathogenic root of multiple risk factors, which include insulin resistance, dyslipidemia, hypertension, and a pro-atherogenic and pro-inflammatory state. Irrespective of its psychiatric side effects, rimonabant through blocking cannabinoid-1 receptor (CB1R) induces an increase in whole body insulin sensitivity. The aim of this work was to study the effect of selected doses of another insulin sensitizer compound BGP-15, and rimonabant on insulin resistance in Zucker obese rats with a promise of inducing insulin sensitization together at lower doses than would have been expected by rimonabant alone. We found that BGP-15 potentiates the insulin sensitizing effect of rimonabant. The combination at doses, which do not induce insulin sensitization by themselves, improved insulin signaling. Furthermore our results suggest that capsaicin-induced signal may play a role in insulin sensitizing effect of both molecules. Our data might indicate that a lower dose of rimonabant in the treatment of insulin resistance and type 2 diabetes is sufficient to administer, thus a lower incidence of the unfavorable psychiatric side effects of rimonabant are to be expected.

  13. [Treatment of older patients with dyslipidemia].

    PubMed

    González, David Fierro

    2014-05-01

    Elderly persons represent a growing percentage of the total population, and this tendency will become stronger in the coming years. To date, the little evidence available on primary and secondary prevention indicates that this population has high cholesterol levels, that few are under treatment, and that the degree of control requires improvement. Current guidelines recommend that treatment targets in older persons should be the same as those in younger patients. Nevertheless, it is important to remember certain characteristics in older persons, such as biological and metabolic changes or the higher incidence of atherogenic dyslipidemia, which will affect them. Moreover, quality of life and maintaining independence rather than mere survival are especially important in older individuals, as demonstrated by various surveys. Consequently, pravastatin -the most widely studied statin- seems to be the statin of choice for the control of triglycerides and residual risk, although fenofibrate is also useful.

  14. [Treatment of older patients with dyslipidemia].

    PubMed

    González, David Fierro

    2014-05-01

    Elderly persons represent a growing percentage of the total population, and this tendency will become stronger in the coming years. To date, the little evidence available on primary and secondary prevention indicates that this population has high cholesterol levels, that few are under treatment, and that the degree of control requires improvement. Current guidelines recommend that treatment targets in older persons should be the same as those in younger patients. Nevertheless, it is important to remember certain characteristics in older persons, such as biological and metabolic changes or the higher incidence of atherogenic dyslipidemia, which will affect them. Moreover, quality of life and maintaining independence rather than mere survival are especially important in older individuals, as demonstrated by various surveys. Consequently, pravastatin -the most widely studied statin- seems to be the statin of choice for the control of triglycerides and residual risk, although fenofibrate is also useful. PMID:25263639

  15. The burden and management of dyslipidemia: practical issues.

    PubMed

    Schultz, Alyssa B; Chen, Chin-Yu; Burton, Wayne N; Edington, Dee W

    2012-10-01

    The objective of this study is to describe briefly the burden of dyslipidemia, and to discuss and present strategies for health professionals to improve dyslipidemia management, based on a review of selected literature focusing on interventions for dyslipidemia treatment adherence. Despite the availability of effective lifestyle and pharmaceutical therapies for dyslipidemias, they continue to present a significant economic burden in the United States. Adherence to evidence-based guidelines for the treatment of dyslipidemias is unsatisfactory. The reasons for medication nonadherence are complex and specific to each patient. The lack of progress in achieving optimal lipid targets is caused by many factors: patient (medication adherence, cost of medication, literacy), medication (adverse effects, complexity of regimen), provider (lack of adherence to evidence-based practice guidelines, poor communication), and the US healthcare system (being focused on acute care rather than prevention, lack of continuity of care, general lack of use of an electronic health record). Combined interventions that target each part of the system have been effective in improving treatment adherence and achieving lipid goals. Patients, providers, pharmacists, and employers all play a role in management of dyslipidemia. No single approach will solve the complex issue of improving dyslipidemia management. The required lifestyle changes are known and effective medications are available. The challenge is for all interested parties-including nurses, nurse practitioners, doctors, pharmacists, other health care professionals, employers, and health plans-to help patients achieve behavioral changes.

  16. [Guidelines for the management of dyslipidemia].

    PubMed

    Díaz Rodríguez, Ángel

    2014-09-01

    The AHA/ACC 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) in adults contains major differences with the previous ESC/EAS 2011 guidelines and the remaining international guidelines, which has generated major controversies. The AHA/ACC document has developed a new model for estimating cardiovascular risk for primary prevention which is not comparable with the SCORE recommended in the European guidelines. This guideline does not establish a fixed target for low-density lipoprotein cholesterol (LDLc). Instead, it identifies 4 major statin benefit groups at risk for the development ASCVD, who should receive low-, moderate-, and high-intensity statin therapy to reduce LCLc. In contrast, the European guidelines maintain LDLc as the main treatment target and non-high-density lipoprotein cholesterol as a secondary treatment target. The document recommends calculating cardiovascular risk for the overall treatment of patients with dyslipidemia according to 4 risk levels (low, moderate, high, and very high), establishes LDLc treatment targets, and recommends a statin-based therapeutic strategy and other, lipid-lowering strategies, aimed at achieving these targets. The American guidelines cannot be extrapolated to the European population. Target-based treatment, as recommended in the EAS/ESC guidelines, is the best strategy for Europe. In Spain, the Primary Care Guidelines of the Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of Primary Care Physicians (SEMERGEN) are based on the European recommendations. Finally, the Spanish Society of Arteriosclerosis (SEA), SEMERGEN, semFYC and the Spanish Society of General Medicine (SEMG) are reaching a consensus on the approach and management of patients with atherogenic dyslipidemia in primary care.

  17. Exome Sequencing in Suspected Monogenic Dyslipidemias

    PubMed Central

    Stitziel, Nathan O.; Peloso, Gina M.; Abifadel, Marianne; Cefalu, Angelo B.; Fouchier, Sigrid; Motazacker, M. Mahdi; Tada, Hayato; Larach, Daniel B.; Awan, Zuhier; Haller, Jorge F.; Pullinger, Clive R.; Varret, Mathilde; Rabès, Jean-Pierre; Noto, Davide; Tarugi, Patrizia; Kawashiri, Masa-aki; Nohara, Atsushi; Yamagishi, Masakazu; Risman, Marjorie; Deo, Rahul; Ruel, Isabelle; Shendure, Jay; Nickerson, Deborah A.; Wilson, James G.; Rich, Stephen S.; Gupta, Namrata; Farlow, Deborah N.; Neale, Benjamin M.; Daly, Mark J.; Kane, John P.; Freeman, Mason W.; Genest, Jacques; Rader, Daniel J.; Mabuchi, Hiroshi; Kastelein, John J.P.; Hovingh, G. Kees; Averna, Maurizio R.; Gabriel, Stacey; Boileau, Catherine; Kathiresan, Sekar

    2015-01-01

    Background Exome sequencing is a promising tool for gene mapping in Mendelian disorders. We utilized this technique in an attempt to identify novel genes underlying monogenic dyslipidemias. Methods and Results We performed exome sequencing on 213 selected family members from 41 kindreds with suspected Mendelian inheritance of extreme levels of low-density lipoprotein (LDL) cholesterol (after candidate gene sequencing excluded known genetic causes for high LDL cholesterol families) or high-density lipoprotein (HDL) cholesterol. We used standard analytic approaches to identify candidate variants and also assigned a polygenic score to each individual in order to account for their burden of common genetic variants known to influence lipid levels. In nine families, we identified likely pathogenic variants in known lipid genes (ABCA1, APOB, APOE, LDLR, LIPA, and PCSK9); however, we were unable to identify obvious genetic etiologies in the remaining 32 families despite follow-up analyses. We identified three factors that limited novel gene discovery: (1) imperfect sequencing coverage across the exome hid potentially causal variants; (2) large numbers of shared rare alleles within families obfuscated causal variant identification; and (3) individuals from 15% of families carried a significant burden of common lipid-related alleles, suggesting complex inheritance can masquerade as monogenic disease. Conclusions We identified the genetic basis of disease in nine of 41 families; however, none of these represented novel gene discoveries. Our results highlight the promise and limitations of exome sequencing as a discovery technique in suspected monogenic dyslipidemias. Considering the confounders identified may inform the design of future exome sequencing studies. PMID:25632026

  18. Dyslipidemia and H pylori in gastric xanthomatosis

    PubMed Central

    Yi, Sun Young

    2007-01-01

    AIM: To investigate the relationship among gastric xanthomatosis (GX), H pylori, dyslipidemia, and gastritis in Korea, a well-known H pylori endemic area. METHODS: A total of 771 patients who had undergone gastroduodenoscopy by one endoscopist were included in this study. Among them, 54 patients with GX were assessed for H pylori infection and their endoscopic characteristics and serum lipid profiles. The findings were compared with 54 age- and sex-matched control subjects without GX. RESULTS: The prevalence of GX was 7% (54/771) with no sex difference. GX was mainly single (64.8%) and located in the antrum (53.7%). The mean diameter was 7 ± 3 mm. Mean body mass index (BMI) of patients with GX was 23.1 ± 2.8 and no one was above 30. Compared with the controls, lipid profiles of GX group showed significantly lower HDL-cholesterol (48.8 ± 12.3 vs 62.9 ± 40.5, P = 0.028) and higher LDL-cholesterol (112.9 ± 29.9 vs 95.9 ± 22.4, P = 0.032). The level of total serum cholesterol, triglyceride and the existence of dyslipoproteinemia were not related to the presence of GX. However, GX showed a close relationship with endoscopically determined atrophic gastritis and histologic severity (24/53, 44.4% vs 8/54, 14.8%, P = 0.0082). H pylori infection and bile reflux gastritis were not significantly related with GX. CONCLUSION: The prevalence of GX is 7% and it may be an increasing entity in Korea. Moreover, dyslipidemia and atrophic gastritis are found to be related to GX, but H pylori infection is not. PMID:17729413

  19. Abdominal cerebrospinal fluid pseudocysts.

    PubMed

    Erşahin, Y; Mutluer, S; Tekeli, G

    1996-12-01

    Abdominal cerebrospinal fluid pseudocyst in an infrequent complication of ventriculoperitoneal (VP) shunts. We reviewed ten patients with abdominal pseudocyst. There were five girls and five boys, aged between 4 months and 14 years. The number of shunt procedures prior to the presentation varied between one and five. Only one patient had had a previous shunt infection. No patients had undergone prior abdominal surgery other than VP shunting. The time from the last shunting procedure to the development of abdominal pseudocyst ranged from 3 weeks to 5 years. Presenting symptoms and signs were mainly related to abdominal complaints in all patients. Three patients also had signs of shunt malfunction. The diagnosis was made by ultrasound in all patients. Shunt infection was determined in six patients. Repositioning if the peritoneal catheter seemed to have a higher rate of recurrence. The diagnosis of abdominal pseudocyst should be considered in VP-shunted patients presenting with abdominal complaints.

  20. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  1. Comparison of the relationships of alcoholic and nonalcoholic fatty liver with hypertension, diabetes mellitus, and dyslipidemia

    PubMed Central

    Toshikuni, Nobuyuki; Fukumura, Atsushi; Hayashi, Nobuhiko; Nomura, Tomoe; Tsuchishima, Mutsumi; Arisawa, Tomiyasu; Tsutsumi, Mikihiro

    2013-01-01

    We compared the relationships of alcoholic fatty liver and nonalcoholic fatty liver with hypertension, diabetes mellitus, and dyslipidemia. Using a nationwide Japanese survey, we collected data on subjects with biopsy-proven alcoholic fatty liver or nonalcoholic fatty liver. Multiple logistic regression analysis was performed to determine whether alcoholic fatty liver and nonalcoholic fatty liver are associated factors for these diseases. Data on 191 subjects (65, alcoholic fatty liver; 126, nonalcoholic fatty liver) were analyzed. Alcoholic fatty liver (odds ratio, 2.54; 95% confidence interval, 1.06–6.32; p = 0.040), age ≥55 years, and body mass index ≥25 kg/m2 were correlated with hypertension, whereas nonalcoholic fatty liver (odds ratio, 2.32; 95% confidence interval, 1.08–5.20; p = 0.035) and serum γ-glutamyl transpeptidase levels ≥75 IU/l were correlated with dyslipidemia. Furthermore, we found that there were biological interactions between alcoholic fatty liver and body mass index ≥25 kg/m2 in ≥55-year-old subjects (attributable proportion due to interaction, 0.68; 95% confidence interval, 0.19–1.17), as well as between alcoholic fatty liver and age ≥55 years in subjects with body mass index ≥25 kg/m2 (attributable proportion due to interaction, 0.71; 95% confidence interval, 0.24–1.18). Alcoholic fatty liver was more strongly associated with hypertension than nonalcoholic fatty liver and nonalcoholic fatty liver was more strongly associated with dyslipidemia than alcoholic fatty liver. Moreover, alcoholic fatty liver, obesity, and older age may interact to influence hypertension status. PMID:23341703

  2. Fibrates are an essential part of modern anti-dyslipidemic arsenal: spotlight on atherogenic dyslipidemia and residual risk reduction.

    PubMed

    Tenenbaum, Alexander; Fisman, Enrique Z

    2012-10-11

    Currently the world faces epidemic of several closely related conditions: obesity, metabolic syndrome and type 2 diabetes (T2DM). The lipid profile of these patients and those with metabolic syndrome is characterized by the concurrent presence of qualitative as well as quantitative lipoprotein abnormalities: low levels of HDL, increased triglycerides, and prevalence of LDL particles that are smaller and denser than normal. This lipid phenotype has been defined as atherogenic dyslipidemia. Overwhelming evidences demonstrate that all components of the atherogenic dyslipidemia are important risk-factors for cardiovascular diseases. Optimal reduction of cardiovascular risk through comprehensive management of atherogenic dyslipidemias basically depends of the presence of efficacious lipid-modulating agents (beyond statin-based reduction of LDL-C). The most important class of medications which can be effectively used nowadays to combat atherogenic dyslipidemias is the fibrates. From a clinical point of view, in all available 5 randomized control trials beneficial effects of major fibrates (gemfibrozil, fenofibrate, bezafibrate) were clearly demonstrated and were highly significant in patients with atherogenic dyslipidemia. In these circumstances, the main determinant of the overall results of the trial is mainly dependent of the number of the included appropriate patients with atherogenic dyslipidemia. In a meta-analysis of dyslipidemic subgroups totaling 4726 patients a significant 35% relative risk reduction in cardiovascular events was observed compared with a non significant 6% reduction in those without dyslipidemia. However, different fibrates may have a somewhat different spectrum of effects. Currently only fenofibrate was investigated and proved to be effective in reducing microvascular complications of diabetes. Bezafibrate reduced the severity of intermittent claudication. Cardinal differences between bezafibrate and other fibrates are related to the effects on

  3. Post-transplant dyslipidemia: Mechanisms, diagnosis and management

    PubMed Central

    Agarwal, Arnav; Prasad, G V Ramesh

    2016-01-01

    Post-transplant dyslipidemia is highly prevalent and presents unique management challenges to the clinician. The two major outcomes to consider with post-transplant therapies for dyslipidemia are preserving or improving allograft function, and reducing cardiovascular risk. Although there are other cardiovascular risk factors such as graft dysfunction, hypertension, and diabetes, attention to dyslipidemia is warranted because interventions for dyslipidemia have an impact on reducing cardiac events in clinical trials specific to the transplant population. Dyslipidemia is not synonymous with hyperlipidemia. Numerous mechanisms exist for the occurrence of post-transplant dyslipidemia, including those mediated by immunosuppressive drug therapy. Statin therapy has received the most attention in all solid organ transplant recipient populations, although the effect of proper dietary advice and adjuvant pharmacological and non-pharmacological agents should not be dismissed. At all stages of treatment appropriate monitoring strategies for side effects should be implemented so that the benefits from these therapies can be achieved. Clinicians have a choice when there is a conflict between various transplant society and lipid society guidelines for therapy and targets. PMID:27011910

  4. The treatment of dyslipidemia--what's left in the pipeline?

    PubMed

    Rau, Oliver; Zettl, Heiko; Popescu, Laura; Steinhilber, Dieter; Schubert-Zsilavecz, Manfred

    2008-02-01

    Dyslipidemia is a pathological alteration of serum lipid levels. The most common forms are either elevations of triglycerides or low density lipoprotein cholesterol associated with a reduction of high density lipoprotein cholesterol. Most frequently both forms of lipid disorders are combined. Elevations of free fatty acid blood levels are commonly not subsumed under the term dyslipidemia. However, free fatty acids should also be considered, as they are frequently associated with dyslipidemia and represent a risk factor for cardiovascular diseases. Dyslipidemias are among the major etiologic factors for arterial occlusive diseases. Resulting in fatal implications such as stroke and coronary heart disease, dyslipidemias contribute to the most prevalent causes of death. Lowering of low density lipoprotein and raising of high density lipoprotein cholesterol levels have been shown in both epidemiologic and intervention studies to decrease mortality. Established treatments of dyslipidemias are statins and fibrates. However, recent research has established some new potential therapeutic targets which are currently investigated in clinical trials. New therapeutic approaches include subtype selective, dual, and pan-agonists of the peroxisome proliferator activated receptor, inhibitors of the cholesterol ester transfer protein, Acyl-CoA-cholesterol-acyltransferase, squalene synthase, microsomal triglycerid-transfer-protein, and cholesterol absorption. Clinical implications of new drugs under investigation are discussed in this review. PMID:17963209

  5. Visceral and not subcutaneous abdominal adiposity reduction drives the benefits of a 1-year lifestyle modification program.

    PubMed

    Borel, Anne-Laure; Nazare, Julie-Anne; Smith, Jessica; Alméras, Natalie; Tremblay, Angelo; Bergeron, Jean; Poirier, Paul; Després, Jean-Pierre

    2012-06-01

    Excess visceral adipose tissue (VAT) is associated with an increased cardiometabolic risk. The study examined whether changes in cardiometabolic risk markers after a 1-year lifestyle intervention in viscerally obese men were associated with changes in VAT or with changes in subcutaneous abdominal adipose tissue (SAT). The relative contributions of changes in global adiposity vs. changes in cardiorespiratory fitness to changes in VAT were also quantified. One hundred and forty four men were selected on the basis of an increased waist circumference (≥ 90 cm) associated with dyslipidemia (triglycerides ≥ 1.69 and/or high-density lipoprotein (HDL)-cholesterol <1.03 mmol/l); 117 men completed the 1-year intervention which consisted in a healthy eating, physical activity/exercise program. Body weight, body composition, and fat distribution were assessed by anthropometry and dual-energy X-ray absorptiometry (DEXA)/computed tomography. Cardiorespiratory fitness, plasma adipokine/inflammatory markers, fasting lipoprotein-lipid profile, and oral glucose tolerance test (OGTT) were assessed. VAT volume decreased by 26%, cardiorespiratory fitness improved by 20% (P < 0.0001) after 1 year. Plasma adipokine/inflammatory markers, lipids/lipoproteins, and glucose homeostasis were improved. One-year changes in triglyceride (r = 0.29), apolipoprotein B (r = 0.21), 120-min OGTT-glucose (r = 0.27), and fasting insulin (r = 0.27) levels correlated with changes in VAT (all P < 0.05) after adjustment for changes in SAT. Using a multilinear regression model, VAT reduction was independently associated with SAT reduction and with improvement in cardiorespiratory fitness (R(2) = 0.58, P < 0.0001). Therefore, this healthy eating-physical activity/exercise program improved the cardiometabolic risk profile of viscerally obese men in relation to the reduction of VAT. Furthermore, the reduction in VAT was independently related to the reduction in global adiposity and to the improvement in

  6. Obesity and heart failure.

    PubMed

    De Pergola, Giovanni; Nardecchia, Adele; Giagulli, Vito Angelo; Triggiani, Vincenzo; Guastamacchia, Edoardo; Minischetti, Manuela Castiglione; Silvestris, Franco

    2013-03-01

    Epidemiological studies have recently shown that obesity, and abdominal obesity in particular, is an independent risk factor for the development of heart failure (HF). Higher cardiac oxidative stress is the early stage of heart dysfunction due to obesity, and it is the result of insulin resistance, altered fatty acid and glucose metabolism, and impaired mitochondrial biogenesis. Extense myocyte hypertrophy and myocardial fibrosis are early microscopic changes in patients with HF, whereas circumferential strain during the left ventricular (LV) systole, LV increase in both chamber size and wall thickness (LV hypertrophy), and LV dilatation are the early macroscopic and functional alterations in obese developing heart failure. LV hypertrophy leads to diastolic dysfunction and subendocardial ischemia in obesity, and pericardial fat has been shown to be significantly associated with LV diastolic dysfunction. Evolving abnormalities of diastolic dysfunction may include progressive hypertrophy and systolic dysfunction, and various degrees of eccentric and/or concentric LV hypertrophy may be present with time. Once HF is established, overweight and obese have a better prognosis than do their lean counterparts with the same level of cardiovascular disease, and this phenomenon is called "obesity paradox". It is mainly due to lower muscle protein degradation, brain natriuretic peptide circulating levels and cardio-respiratory fitness than normal weight patients with HF.

  7. Obesity and psoriasis: inflammatory nature of obesity, relationship between psoriasis and obesity, and therapeutic implications.

    PubMed

    Carrascosa, J M; Rocamora, V; Fernandez-Torres, R M; Jimenez-Puya, R; Moreno, J C; Coll-Puigserver, N; Fonseca, E

    2014-01-01

    Obesity, particularly abdominal obesity, is currently considered a chronic low-grade inflammatory condition that plays an active role in the development of the pathophysiologic phenomena responsible for metabolic syndrome and cardiovascular disease through the secretion of proinflammatory adipokines and cytokines. In recent years clear genetic, pathogenic, and epidemiologic links have been established between psoriasis and obesity, with important implications for health. The relationship between the 2 conditions is probably bidirectional, with obesity predisposing to psoriasis and psoriasis favoring obesity. Obesity also has important implications in the treatment of psoriasis, such as a greater risk of adverse effects with conventional systemic drugs and reduced efficacy and/or increased cost with biologic agents, for which dosage should be adjusted to the patient's weight.

  8. Obesity and psoriasis: inflammatory nature of obesity, relationship between psoriasis and obesity, and therapeutic implications.

    PubMed

    Carrascosa, J M; Rocamora, V; Fernandez-Torres, R M; Jimenez-Puya, R; Moreno, J C; Coll-Puigserver, N; Fonseca, E

    2014-01-01

    Obesity, particularly abdominal obesity, is currently considered a chronic low-grade inflammatory condition that plays an active role in the development of the pathophysiologic phenomena responsible for metabolic syndrome and cardiovascular disease through the secretion of proinflammatory adipokines and cytokines. In recent years clear genetic, pathogenic, and epidemiologic links have been established between psoriasis and obesity, with important implications for health. The relationship between the 2 conditions is probably bidirectional, with obesity predisposing to psoriasis and psoriasis favoring obesity. Obesity also has important implications in the treatment of psoriasis, such as a greater risk of adverse effects with conventional systemic drugs and reduced efficacy and/or increased cost with biologic agents, for which dosage should be adjusted to the patient's weight. PMID:23177976

  9. Insulin resistance uncoupled from dyslipidemia due to C-terminal PIK3R1 mutations

    PubMed Central

    Huang-Doran, Isabel; Tomlinson, Patsy; Payne, Felicity; Gast, Alexandra; Sleigh, Alison; Bottomley, William; Harris, Julie; Daly, Allan; Rocha, Nuno; Rudge, Simon; Clark, Jonathan; Kwok, Albert; Romeo, Stefano; McCann, Emma; Müksch, Barbara; Dattani, Mehul; Zucchini, Stefano; Wakelam, Michael; Foukas, Lazaros C.; Savage, David B.; Murphy, Rinki; O’Rahilly, Stephen; Semple, Robert K.

    2016-01-01

    Obesity-related insulin resistance is associated with fatty liver, dyslipidemia, and low plasma adiponectin. Insulin resistance due to insulin receptor (INSR) dysfunction is associated with none of these, but when due to dysfunction of the downstream kinase AKT2 phenocopies obesity-related insulin resistance. We report 5 patients with SHORT syndrome and C-terminal mutations in PIK3R1, encoding the p85α/p55α/p50α subunits of PI3K, which act between INSR and AKT in insulin signaling. Four of 5 patients had extreme insulin resistance without dyslipidemia or hepatic steatosis. In 3 of these 4, plasma adiponectin was preserved, as in insulin receptor dysfunction. The fourth patient and her healthy mother had low plasma adiponectin associated with a potentially novel mutation, p.Asp231Ala, in adiponectin itself. Cells studied from one patient with the p.Tyr657X PIK3R1 mutation expressed abundant truncated PIK3R1 products and showed severely reduced insulin-stimulated association of mutant but not WT p85α with IRS1, but normal downstream signaling. In 3T3-L1 preadipocytes, mutant p85α overexpression attenuated insulin-induced AKT phosphorylation and adipocyte differentiation. Thus, PIK3R1 C-terminal mutations impair insulin signaling only in some cellular contexts and produce a subphenotype of insulin resistance resembling INSR dysfunction but unlike AKT2 dysfunction, implicating PI3K in the pathogenesis of key components of the metabolic syndrome. PMID:27766312

  10. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  11. New Drugs for Treating Dyslipidemia: Beyond Statins

    PubMed Central

    Ahn, Chang Ho

    2015-01-01

    Statins have been shown to be very effective and safe in numerous randomized clinical trials, and became the implacable first-line treatment against atherogenic dyslipidemia. However, even with optimal statin treatment, 60% to 80% of residual cardiovascular risk still exists. The patients with familial hypercholesterolemia which results in extremely high level of low density lipoprotein cholesterol (LDL-C) level and the patients who are intolerant or unresponsive to statins are the other hurdles of statin treatment. Recently, new classes of lipid-lowering drugs have been developed and some of them are available for the clinical practice. The pro-protein convertase subtilisin/kexintype 9 (PCSK9) inhibitor increases the expression of low density lipoprotein (LDL) receptor in hepatocytes by enhancing LDL receptor recycling. The microsomal triglyceride transport protein (MTP) inhibitor and antisense oligonucleotide against apolipoprotein B (ApoB) reduce the ApoB containing lipoprotein by blocking the hepatic very low density lipoprotein synthesis pathway. The apolipoprotein A1 (ApoA1) mimetics pursuing the beneficial effect of high density lipoprotein cholesterol and can reverse the course of atherosclerosis. ApoA1 mimetics had many controversial clinical data and need more validation in humans. The PCSK9 inhibitor recently showed promising results of significant LDL-C lowering in familial hypercholesterolemia (FH) patients from the long-term phase III trials. The MTP inhibitor and antisesnse oligonucleotide against ApoB were approved for the treatment of homozygous FH but still needs more consolidated evidences about hepatic safety such as hepatosteatosis. We would discuss the benefits and concerns of these new lipid-lowering drugs anticipating additional benefits beyond statin treatment. PMID:25922802

  12. [Abdominal compartment syndrome].

    PubMed

    Pottecher, T; Segura, P; Launoy, A

    2001-04-01

    French physicians dealing with abdominal emergencies are not very familiar with the abdominal compartment syndrome (ACS). Increased abdominal pressure has deleterious consequences on local (intestine, liver, kidney) circulation, leading to death in the absence of correct treatment. Abdominal trauma and ruptured aortic aneurism are the main causes of ACS. Clinical presentation may be misleading: respiratory failure, oliguria or circulatory symptoms are often predominant. Abdominal palpation is inefficient for evaluating intra-abdominal pressure (IAP); only measurement of cystic pressure allows precise evaluation of IAP. Abdominal decompression is the treatment of choice. It must be performed as soon as IAP exceeds 25 mmHg. The procedure may be risky with a high incidence of severe complications when ischaemic territories are reperfused. Recent data underline the importance of compensation of hypovolemia before decompression. Abdominal closure may necessitate various techniques (aponevrotomy, Bogota bags, etc.). At any rate, IAP must remain low at the end of the procedure. In case of suspicion of ACS, early measurement of IAP is mandatory. If pressure is over 25 mmHg, a decompressive procedure must be initiated. PMID:11340703

  13. Trans fatty acids adversely affect blood lipids but not intra-abdominal and liver fat deposition - a randomized trial in overweight postmenopausal women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Intake of industrially produced trans fatty acids (TFA) is, according to observational studies, associated with an increased risk of cardiovascular disease, but the causal mechanisms have not been fully elucidated. Besides inducing dyslipidemia, TFA intake is suspected of promoting abdominal and liv...

  14. [Semeiotics of abdominal tuberculosis].

    PubMed

    Guseĭnov, G K; Ramazanova, A M; Guseĭnov, A G

    1984-01-01

    Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy.

  15. Obesity and hypertriglyceridemia produce cognitive impairment.

    PubMed

    Farr, Susan A; Yamada, Kelvin A; Butterfield, D Allan; Abdul, H Mohammad; Xu, Lin; Miller, Nicole E; Banks, William A; Morley, John E

    2008-05-01

    Obesity is associated with cognitive impairments. Long-term mechanisms for this association include consequences of hyperglycemia, dyslipidemia, or other factors comprising metabolic syndrome X. We found that hypertriglyceridemia, the main dyslipidemia of metabolic syndrome X, is in part responsible for the leptin resistance seen in obesity. Here we determined whether triglycerides have an immediate and direct effect on cognition. Obese mice showed impaired acquisition in three different cognitive paradigms: the active avoidance T-maze, the Morris water maze, and a food reward lever press. These impairments were not attributable to differences in foot shock sensitivity, swim speed, swimming distance, or voluntary milk consumption. Impaired cognition in obese mice was improved by selectively lowering triglycerides with gemfibrozil. Injection into the brain of the triglyceride triolein, but not of the free fatty acid palmitate, impaired acquisition in normal body weight mice. Triolein or milk (97% of fats are triglycerides), but not skim milk (no triglycerides), impaired maintenance of the N-methyl-d-aspartate component of the hippocampal long-term synaptic potential. Measures of oxidative stress in whole brain were reduced by gemfibrozil. We conclude that triglycerides mediate cognitive impairment as seen in obesity, possibly by impairing maintenance of the N-methyl-d-aspartate component of hippocampal long-term potentiation, and that lowering triglycerides can reverse the cognitive impairment and improve oxidative stress in the brain.

  16. New Frontiers in the Treatment of Diabetic Dyslipidemia

    PubMed Central

    Wang, Shu-Yi; Hsieh, Ming-Chia; Tu, Shih-Te; Chuang, Chieh-Sen

    2013-01-01

    Dyslipidemia is a major risk factor for cardiovascular complications in people with diabetes. Lowering low-density lipoprotein cholesterol (LDL-C) levels is effective in the primary and secondary prevention of diabetic vascular complications. However, LDL-C levels do not reflect all aspects of diabetic dyslipidemia, which is characterized by hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C). Statins, nicotinic acid, and fibrates play a role in treating diabetic dyslipidemia. Atherosclerosis is a major disorder of the blood vessel wall in patients with diabetes. A number of antihyperlipidemic agents may be beneficial and exhibit effects at the actual site of vascular disease and not only on plasma lipoprotein concentrations. Several novel therapeutic compounds are currently being developed. These include additional therapeutics for LDL-C, triglycerides, HDL-C, and modulators of inflammation that can be used as possible synergic agents for the treatment of atherosclerosis and irregularities in plasma lipoprotein concentrations. PMID:24380093

  17. Chinese Herbal Medicine on Dyslipidemia: Progress and Perspective

    PubMed Central

    Guo, Ming; Liu, Yue; Gao, Zhu-Ye; Shi, Da-zhuo

    2014-01-01

    Dyslipidemia is an independent risk factor of cardiovascular diseases. The statins are a milestone in the primary and second prevention of cardiovascular diseases and significantly improved its prognosis. Along with the long-term treatment with statins in combination with other hypolipidemic drugs or alone, its safety has attracted a particular attention in clinic, such as the elevation of transaminase and rhabdomyolysis, which have raised an idea of developing the other types of lipid-lowering agents from botanic materials. Traditional Chinese medicine (TCM) has been used in clinical practice for more than 2000 years in China and showed some beneficial effects for human health and many diseases. Recently, many studies demonstrated a favorable effect of TCM for treating dyslipidemia; however, its mechanism remains unclear or totally unknown. The progress and perspective of studies on dyslipidemia with single Chinese herb and its monomers or effective extracts during the past 10 years are discussed in the present review. PMID:24688589

  18. Genetic polymorphisms as a risk factor for dyslipidemia in children.

    PubMed

    Santos, Izabela R; Fernandes, Ana Paula; Sousa, Marinez O; Ferreira, Cláudia N; Gomes, Karina B

    2013-06-01

    Dyslipidemia is an important etiological factor for development of cardiovascular disease, which is the leading cause of deaths in adults. Given the growing global epidemic of dyslipidemia, lipoprotein metabolism disorders have become an important health problem not only in adulthood, but have also emerged as an increasingly risk factor in childhood. Although several genome-wide association studies in multiple large population-based cohorts of adults and meta-analyses have identified susceptibility genes or loci, especially in lipid-related traits, it is of great importance to evaluate genetic predisposition at an early age. Recent findings suggest that the identification of polymorphisms in the metabolism of lipids in childhood may help fight subclinical atherosclerosis and its progression to cardiovascular complications in adulthood. Therefore, the aim of this study was to review genetic polymorphisms as risk factors associated with dyslipidemia in children and adolescents. PMID:27625842

  19. Genetic polymorphisms as a risk factor for dyslipidemia in children

    PubMed Central

    Santos, Izabela R.; Fernandes, Ana Paula; Sousa, Marinez O.; Ferreira, Cláudia N.; Gomes, Karina B.

    2013-01-01

    Dyslipidemia is an important etiological factor for development of cardiovascular disease, which is the leading cause of deaths in adults. Given the growing global epidemic of dyslipidemia, lipoprotein metabolism disorders have become an important health problem not only in adulthood, but have also emerged as an increasingly risk factor in childhood. Although several genome-wide association studies in multiple large population-based cohorts of adults and meta-analyses have identified susceptibility genes or loci, especially in lipid-related traits, it is of great importance to evaluate genetic predisposition at an early age. Recent findings suggest that the identification of polymorphisms in the metabolism of lipids in childhood may help fight subclinical atherosclerosis and its progression to cardiovascular complications in adulthood. Therefore, the aim of this study was to review genetic polymorphisms as risk factors associated with dyslipidemia in children and adolescents. PMID:27625842

  20. ERICA: prevalence of dyslipidemia in Brazilian adolescents.

    PubMed

    Faria Neto, José Rocha; Bento, Vivian Freitas Rezende; Baena, Cristina Pellegrino; Olandoski, Marcia; Gonçalves, Luis Gonzaga de Oliveira; Abreu, Gabriela de Azevedo; Kuschnir, Maria Cristina Caetano; Bloch, Katia Vergetti

    2016-02-01

    OBJECTIVE To determine the distribution of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in Brazilian adolescents, as well as the prevalence of altered levels of such parameters. METHODS Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were used. This is a country-wide, school-based cross-sectional study that evaluated 12 to 17-year old adolescents living in cities with over 100,000 inhabitants. The average and distribution of plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were evaluated. Dyslipidemia was determined by levels of total cholesterol ≥ 170 mg/dl, LDL cholesterol ≥ 130 mg/dl, HDL cholesterol < 45 mg/dL, or triglycerides ≥ 130 mg/dl. The data were analyzed by gender, age, and regions in Brazil. RESULTS We evaluated 38,069 adolescents - 59.9% of females, and 54.2% between 15 and 17 years. The average values found were: total cholesterol = 148.1 mg/dl (95%CI 147.1-149.1), HDL cholesterol = 47.3 mg/dl (95%CI 46.7-47.9), LDL cholesterol = 85.3 mg/dl (95%CI 84.5-86.1), and triglycerides = 77.8 mg/dl (95%CI 76.5-79.2). The female adolescents had higher average levels of total cholesterol, LDL cholesterol, and HDL cholesterol, without differences in the levels of triglycerides. We did not observe any significant differences between the average values among 12 to 14 and 15- to 17-year old adolescents. The most prevalent lipid alterations were low HDL cholesterol (46.8% [95%CI 44.8-48.9]), hypercholesterolemia (20.1% [95%CI 19.0-21.3]), and hypertriglyceridemia (7.8% [95%CI 7.1-8.6]). High LDL cholesterol was found in 3.5% (95%CI 3.2-4.0) of the adolescents. Prevalence of low HDL cholesterol was higher in Brazil's North and Northeast regions. CONCLUSIONS A significant proportion of Brazilian adolescents has alterations in their plasma lipids. The high prevalence of low HDL cholesterol and hypertriglyceridemia, especially in Brazil's North and Northeast regions, must be

  1. ERICA: prevalence of dyslipidemia in Brazilian adolescents

    PubMed Central

    Faria, José Rocha; Bento, Vivian Freitas Rezende; Baena, Cristina Pellegrino; Olandoski, Marcia; Gonçalves, Luis Gonzaga de Oliveira; Abreu, Gabriela de Azevedo; Kuschnir, Maria Cristina Caetano; Bloch, Katia Vergetti

    2016-01-01

    ABSTRACT OBJECTIVE To determine the distribution of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in Brazilian adolescents, as well as the prevalence of altered levels of such parameters. METHODS Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were used. This is a country-wide, school-based cross-sectional study that evaluated 12 to 17-year old adolescents living in cities with over 100,000 inhabitants. The average and distribution of plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were evaluated. Dyslipidemia was determined by levels of total cholesterol ≥ 170 mg/dl, LDL cholesterol ≥ 130 mg/dl, HDL cholesterol < 45 mg/dL, or triglycerides ≥ 130 mg/dl. The data were analyzed by gender, age, and regions in Brazil. RESULTS We evaluated 38,069 adolescents – 59.9% of females, and 54.2% between 15 and 17 years. The average values found were: total cholesterol = 148.1 mg/dl (95%CI 147.1-149.1), HDL cholesterol = 47.3 mg/dl (95%CI 46.7-47.9), LDL cholesterol = 85.3 mg/dl (95%CI 84.5-86.1), and triglycerides = 77.8 mg/dl (95%CI 76.5-79.2). The female adolescents had higher average levels of total cholesterol, LDL cholesterol, and HDL cholesterol, without differences in the levels of triglycerides. We did not observe any significant differences between the average values among 12 to 14 and 15- to 17-year old adolescents. The most prevalent lipid alterations were low HDL cholesterol (46.8% [95%CI 44.8-48.9]), hypercholesterolemia (20.1% [95%CI 19.0-21.3]), and hypertriglyceridemia (7.8% [95%CI 7.1-8.6]). High LDL cholesterol was found in 3.5% (95%CI 3.2-4.0) of the adolescents. Prevalence of low HDL cholesterol was higher in Brazil’s North and Northeast regions. CONCLUSIONS A significant proportion of Brazilian adolescents has alterations in their plasma lipids. The high prevalence of low HDL cholesterol and hypertriglyceridemia, especially in Brazil’s North and Northeast regions

  2. Dyslipidemia, kidney disease, and cardiovascular disease in diabetic patients.

    PubMed

    Chen, Szu-chi; Tseng, Chin-Hsiao

    2013-01-01

    This article reviews the relationship between dyslipidemia, chronic kidney disease, and cardiovascular diseases in patients with diabetes. Diabetes mellitus is associated with complications in the cardiovascular and renal system, and is increasing in prevalence worldwide. Modification of the multifactorial risk factors, in particular dyslipidemia, has been suggested to reduce the rates of diabetes-related complications. Dyslipidemia in diabetes is a condition that includes hypertriglyceridemia, low high-density lipoprotein levels, and increased small and dense low-density lipoprotein particles. This condition is associated with higher cardiovascular risk and mortality in diabetic patients. Current treatment guidelines focus on lowering the low-density lipoprotein cholesterol level; multiple trials have confirmed the cardiovascular benefits of treatment with statins. Chronic kidney disease also contributes to dyslipidemia, and dyslipidemia in turn is related to the occurrence and progression of diabetic nephropathy. Different patterns of dyslipidemia are associated with different stages of diabetic nephropathy. Some trials have shown that treatment with statins not only decreased the risk of cardiovascular events, but also delayed the progression of diabetic nephropathy. However, studies using statins as the sole treatment of hyperlipidemia in patients on dialysis have not shown benefits with respect to cardiovascular risk. Diabetic patients with nephropathy have a higher risk of cardiovascular events than those without nephropathy. The degree of albuminuria and the reduction in estimated glomerular filtration rate are also correlated with the risk of cardiovascular events. Treatment with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to reduce albuminuria in diabetic patients has been shown to decrease the risk of cardiovascular morbidity and mortality. PMID:24380085

  3. Overweight and Obesity in Children and Adolescents

    PubMed Central

    Koyuncuoğlu Güngör, Neslihan

    2014-01-01

    Obesity among children, adolescents and adults has emerged as one of the most serious public health concerns in the 21st century. The worldwide prevalence of childhood obesity has increased remarkably over the past 3 decades. The growing prevalence of childhood obesity has also led to appearance of obesity-related comorbid disease entities at an early age. Childhood obesity can adversely affect nearly every organ system and often causes serious consequences, including hypertension, dyslipidemia, insulin resistance, dysglycemia, fatty liver disease and psychosocial complications. It is also a major contributor to increasing healthcare expenditures. For all these reasons, it is important to prevent childhood obesity as well as to identify overweight and obese children at an early stage so they can begin treatment and attain and maintain a healthy weight. At present, pharmacotherapy options for treatment of pediatric obesity are very limited. Therefore, establishing a comprehensive management program that emphasizes appropriate nutrition, exercise and behavioral modification is crucial. The physician’s role should expand beyond the clinical setting to the community to serve as a role model and to advocate for prevention and early treatment of obesity. PMID:25241606

  4. Overweight and obesity in children and adolescents.

    PubMed

    Güngör, Neslihan Koyuncuoğlu

    2014-09-01

    Obesity among children, adolescents and adults has emerged as one of the most serious public health concerns in the 21st century. The worldwide prevalence of childhood obesity has increased remarkably over the past 3 decades. The growing prevalence of childhood obesity has also led to appearance of obesity-related comorbid disease entities at an early age. Childhood obesity can adversely affect nearly every organ system and often causes serious consequences, including hypertension, dyslipidemia, insulin resistance, dysglycemia, fatty liver disease and psychosocial complications. It is also a major contributor to increasing healthcare expenditures. For all these reasons, it is important to prevent childhood obesity as well as to identify overweight and obese children at an early stage so they can begin treatment and attain and maintain a healthy weight. At present, pharmacotherapy options for treatment of pediatric obesity are very limited. Therefore, establishing a comprehensive management program that emphasizes appropriate nutrition, exercise and behavioral modification is crucial. The physician's role should expand beyond the clinical setting to the community to serve as a role model and to advocate for prevention and early treatment of obesity. PMID:25241606

  5. Adiposity significantly modifies genetic risk for dyslipidemia.

    PubMed

    Cole, Christopher B; Nikpay, Majid; Lau, Paulina; Stewart, Alexandre F R; Davies, Robert W; Wells, George A; Dent, Robert; McPherson, Ruth

    2014-11-01

    Recent genome-wide association studies have identified multiple loci robustly associated with plasma lipids, which also contribute to extreme lipid phenotypes. However, these common genetic variants explain <12% of variation in lipid traits. Adiposity is also an important determinant of plasma lipoproteins, particularly plasma TGs and HDL cholesterol (HDLc) concentrations. Thus, interactions between genes and clinical phenotypes may contribute to this unexplained heritability. We have applied a weighted genetic risk score (GRS) for both plasma TGs and HDLc in two large cohorts at the extremes of BMI. Both BMI and GRS were strongly associated with these lipid traits. A significant interaction between obese/lean status and GRS was noted for each of TG (P(Interaction) = 2.87 × 10(-4)) and HDLc (P(Interaction) = 1.05 × 10(-3)). These interactions were largely driven by SNPs tagging APOA5, glucokinase receptor (GCKR), and LPL for TG, and cholesteryl ester transfer protein (CETP), GalNAc-transferase (GALNT2), endothelial lipase (LIPG), and phospholipid transfer protein (PLTP) for HDLc. In contrast, the GRSLDL cholesterol × adiposity interaction was not significant. Sexual dimorphism was evident for the GRSHDL on HDLc in obese (P(Interaction) = 0.016) but not lean subjects. SNP by BMI interactions may provide biological insight into specific genetic associations and missing heritability. PMID:25225679

  6. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  7. Medical management of obesity: an update.

    PubMed

    Karam, J G; El-Sayegh, S; Nessim, F; Farag, A; McFarlane, S I

    2007-09-01

    Obesity is rapidly growing global epidemic with monumental impact on health and economics. It is associated with multiple adverse health consequences including hypertension, diabetes, dyslipidemia, coronary heart disease, heart failure and stroke to name a few. It is also associated with premature death. The economic impact of obesity is also striking and represents up to 6% of the total healthcare expenditure worldwide. Therefore, effective therapeutic strategies are desperately needed to curb the rising epidemic of obesity. In this review, we present the underlying cause of obesity, together with pathophysologic insights necessary for the practicing physician as basis for the medical therapeutic options available, that are presented in more details. We also discuss promising therapeutic agents that are under different stages of development.

  8. Management of dyslipidemia in patients with human immunodeficiency virus.

    PubMed

    Shalit, Peter

    2014-01-01

    Dyslipidemias are more common in the patient population with human immunodeficiency virus (HIV). Combination antiretroviral therapy (ART) has dramatically reduced HIV-associated morbidity and mortality and has transformed HIV disease into a chronic, manageable condition. As a result, non-AIDS-related illnesses, including cardiovascular diseases, are now the leading causes of death in the HIV-infected population. Optimizing fasting lipid parameters plays an important role in reducing cardiovascular risk in this population. This review focuses on the management of dyslipidemia in HIV-infected individuals treated with combination ART.

  9. [Dyslipidemia management with medical nutrition therapy: current status and perspectives].

    PubMed

    Sucato, Vincenzo; Triolo, Oreste Fabio; Bronte, Enrico; Trovato, Rosaria Linda; Tona, Giuseppe Riccardo; Novo, Salvatore

    2013-09-01

    In Italy, patients with dyslipidemia account for 15-20% of the adult population with major healthcare and socio-economic impact. According to the ESC/EAS guidelines for the management of dyslipidemias, desirable cholesterol and triglyceride levels can be achieved with a synergy between drug treatment and adequate diet therapy. However, what diets should be adopted? In this review article, different types of dietary treatments are compared, with a special focus on diet education. The new scientific frontier of nutrigenetics is also discussed.

  10. Obesity. Part I--Pathogenesis.

    PubMed Central

    Bray, G A; Gray, D S

    1988-01-01

    Obesity--defined by a body mass index above 30 kg per m2--is a major problem for affluent nations. Its prevalence is higher in North America than in Europe--between 9% and 12% of the population. Reduced energy expenditure from exercise or metabolism or both may be an important contributory factor in the development of obesity because of a failure to reduce food intake sufficiently to maintain energy balance. A high ratio of abdominal circumference relative to gluteal circumference carries a twofold or greater risk of heart attack, stroke, hypertension, diabetes mellitus, gallbladder disease, and death. The effect of increased quantities of abdominal fat is greater than that of a similar increase in total body fat on the risks of ill health associated with obesity. Genetic factors appear to contribute about 25% to its etiology. Images PMID:3067447

  11. Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women

    PubMed Central

    We, Ji-Sun; Han, Kyungdo; Kwon, Hyuk-Sang; Kil, Kicheol

    2016-01-01

    Abstract The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth. We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m2, nongeneral obesity; BMI ≤25 kg/m2, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders. The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors. Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics. PMID:27175656

  12. Adiposopathy, "sick fat," Ockham's razor, and resolution of the obesity paradox.

    PubMed

    Bays, Harold

    2014-05-01

    Among lean populations, cardiovascular disease (CVD) is rare. Among those with increased adiposity, CVD is the commonest cause of worldwide death. The "obesity paradox" describes seemingly contrary relationships between body fat and health/ill-health. Multiple obesity paradoxes exist, and include the anatomic obesity paradox, physiologic obesity paradox, demographic obesity paradox, therapeutic obesity paradox, cardiovascular event/procedure obesity paradox, and obesity treatment paradox. Adiposopathy ("sick fat") is defined as adipocyte/adipose tissue dysfunction caused by positive caloric balance and sedentary lifestyle in genetically and environmentally susceptible individuals. Adiposopathy contributes to the commonest metabolic disorders encountered in clinical practice (high glucose levels, high blood pressure, dyslipidemia, etc.), all major CVD risk factors. Ockham's razor is a principle of parsimony which postulates that among competing theories, the hypothesis with the fewest assumptions is the one best selected. Ockham's razor supports adiposopathy as the primary cause of most cases of adiposity-related metabolic diseases, which in turn helps resolve the obesity paradox.

  13. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  14. Angiotensin II and 1-7 during aging in Metabolic Syndrome rats. Expression of AT1, AT2 and Mas receptors in abdominal white adipose tissue.

    PubMed

    Rubio-Ruíz, M E; Del Valle-Mondragón, L; Castrejón-Tellez, V; Carreón-Torres, E; Díaz-Díaz, E; Guarner-Lans, V

    2014-07-01

    Renin-Angiotensin System (RAS) plays an important role in the development of Metabolic Syndrome (MS) and in aging. Angiotensin 1-7 (Ang 1-7) has opposite effects to Ang II. All of the components of RAS are expressed locally in adipose tissue and there is over-activation of adipose RAS in obesity and hypertension. We determined serum and abdominal adipose tissue Ang II and Ang 1-7 in control and MS rats during aging and the expression of AT1, AT2 and Mas in white adipose tissue. MS was induced by sucrose ingestion during 6, 12 and 18 months. During aging, an increase in body weight, abdominal fat and dyslipidemia were found but increases in aging MS rats were higher. Control and MS concentrations of serum Ang II from 6-month old rats were similar. Aging did not modify Ang II seric concentration in control rats but decreased it in MS rats. Ang II levels increased in WAT from both groups of rats. Serum and adipose tissue Ang 1-7 increased during aging in MS rats. Western blot analysis revealed that AT1 expression increased in the control group during aging while AT2 and Mas remained unchanged. In MS rats, AT1 and AT2 expression decreased significantly in aged rats. The high concentration of Ang 1-7 and adiponectin in old MS rats might be associated to an increased expression of PPAR-γ. PPAR-γ was increased in adipose tissue from MS rats. It decreased with aging in control rats and showed no changes during aging in MS rats. Ang 1-7/Mas axis was the predominant pathway in WAT from old MS animals and could represent a potential target for therapeutical strategies in the treatment of MS during aging.

  15. Vascular Risks and Management of Obesity in Children and Adolescents

    PubMed Central

    Jolliffe, Courtney J; Janssen, Ian

    2006-01-01

    Childhood obesity has reached epidemic proportions in many countries. Pediatric obesity is associated with the development of cardiovascular (CV) risk factors including type 2 diabetes, hypertension, dyslipidemia, and the metabolic syndrome. It is also associated with an increased risk of CV disease (CVD) in adulthood. Moreover, obesity and CVD risk factors in obese youth tend to track into adulthood, further increasing the risk of adult CVD. Consequently, the treatment and prevention of childhood overweight and obesity has become a public health priority. Proper nutrition and increased physical activity are the main focus of these efforts; however, few studies have shown positive results. Treatment options for obesity in youth also include pharmacotherapy and surgery. While pharmacotherapy appears promising, additional evidence is needed, especially with respect to the long-term impact, before it becomes a widespread treatment option in the pediatric population. PMID:17319462

  16. [Consensus document on the treatment of dyslipidemia in diabetes].

    PubMed

    Hormigo-Pozo, A; Mancera-Romero, J; Perez-Unanua, M P; Alonso-Fernandez, M; Lopez-Simarro, F; Mediavilla-Bravo, J J

    2015-03-01

    People with type 2 diabetes mellitus have a 2 to 4 times higher risk of developing cardiovascular diseases when compared to general population of similar age and sex. This risk remains after adjustment of other traditional cardiovascular risk factors. The dyslipidemia associated with type 2 diabetes mellitus is present in up to 60% of people with diabetes and contributes greatly to increased cardiovascular, morbidity and mortality risk in these patients. Diabetic dyslipidemia is a disorder of lipid metabolism characterized by an excess of triglycerides, a decrease in HDL-cholesterol and altered lipoprotein composition, consisting mainly in an excess of small, dense LDL particles. Multiple clinical trials have demonstrated the benefits of drug treatment of dyslipidemia (mainly statins) to prevent cardiovascular events and mortality in people with diabetes, both in primary and secondary prevention. This consensus document, developed by general practitioners, members of the Diabetes Group of the Spanish Society of Primary Care Physicians (SEMERGEN), aims to assist in the management of patients with diabetes and dyslipidemia in accordance with the most recent recommendations.

  17. Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management.

    PubMed

    Griffith, Michelle L; Savani, Bipin N; Boord, Jeffrey B

    2010-08-26

    Currently, approximately 15,000 to 20,000 patients undergo allogeneic hematopoietic stem cell transplantation (HSCT) annually throughout the world, with the number of long-term survivors increasing rapidly. In long-term follow-up after transplantation, the focus of care moves beyond cure of the original disease to the identification and treatment of late effects after HSCT. One of the more serious complications is therapy-related cardiovascular disease. Long-term survivors after HSCT probably have an increased risk of premature cardiovascular events. Cardiovascular complications related to dyslipidemia and other risk factors account for a significant proportion of late nonrelapse morbidity and mortality. This review addresses the risk and causes of dyslipidemia and impact on cardiovascular complications after HSCT. Immunosuppressive therapy, chronic graft-versus-host disease, and other long-term complications influence the management of dyslipidemia. There are currently no established guidelines for evaluation and management of dyslipidemia in HSCT patients; in this review, we have summarized our suggested approach in the HSCT population.

  18. Dyslipidemia in HIV-infected individuals: from pharmacogenetics to pharmacogenomics.

    PubMed

    Tarr, Philip E; Rotger, Margalida; Telenti, Amalio

    2010-04-01

    HIV-infected individuals may have accelerated atherogenesis and an increased risk for premature coronary artery disease. Dyslipidemia represents a key pro-atherogenic mechanism. In HIV-infected patients, dyslipidemia is typically attributed to the adverse effects of antiretroviral therapy. Nine recent genome-wide association studies have afforded a comprehensive, unbiased inventory of common SNPs at 36 genetic loci that are reproducibly associated with dyslipidemia in the general population. Genome-wide association study-validated SNPs have now been demonstrated to contribute to dyslipidemia in the setting of HIV infection and antiretroviral therapy. In a Swiss HIV-infected study population, a similar proportion of serum lipid variability was explained by antiretroviral therapy and by genetic background. In the individual patient, both antiretroviral therapy and the cumulative effect of SNPs contribute to the risk of high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol and hypertriglyceridemia. Genetic variants presumably contribute to additional major metabolic complications in HIV-infected individuals, including diabetes mellitus and coronary artery disease. In an effort to explain an increasing proportion of the heritability of complex metabolic traits, ongoing large-scale gene resequencing studies are focusing on the effects of rare SNPs and structural genetic variants.

  19. Metabolic disturbances connecting obesity and depression

    PubMed Central

    Hryhorczuk, Cecile; Sharma, Sandeep; Fulton, Stephanie E.

    2013-01-01

    Obesity markedly increases the odds of developing depression. Depressed mood not only impairs motivation, quality of life and overall functioning but also increases the risks of obesity complications. Abdominal obesity is a better predictor of depression and anxiety risk than overall adipose mass. A growing amount of research suggests that metabolic abnormalities stemming from central obesity that lead to metabolic disease may also be responsible for the increased incidence of depression in obesity. As reviewed here, a higher mass of dysfunctional adipose tissue is associated with several metabolic disturbances that are either directly or indirectly implicated in the control of emotions and mood. To better comprehend the development of depression in obesity, this review pulls together select findings addressing the link between adiposity, diet and negative emotional states and discusses the evidence that alterations in glucocorticoids, adipose-derived hormones, insulin and inflammatory signaling that are characteristic of central obesity may be involved. PMID:24109426

  20. A comparative clinical study of Asanadi Ghanavati and Gomutra Haritaki in Kapha Medo Margavarana (dyslipidemia)

    PubMed Central

    Joshi, Shivam G.; Chandola, Hari Mohan; Dave, Alankruta R.

    2014-01-01

    Background: Dyslipidemia is a disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency and it can be understood in the parlance of the closest conditions in Ayurveda, viz. Kapha Medo Margavarana (dyslipidemia), Atisthaulya (obesity) or Meda Roga and Prameha. Asanadi Ghanavati (AG) is a modified presentation of Asanadi Gana drugs referred in Ashtanga Hridaya and Gomutra Haritaki (GH) is described in Charaka Samhita under Shotha Chikitsa and Ashtanga Hridaya in Arsha Chikitsa. Aim: To evaluate and compare the clinical effect of AG and GH in Kapha Medo Margavarana. Materials and Methods: Patients with the high lipid profile were selected and randomly divided into two groups. In Group A (n = 30), patients were administered with tablet of AG 1 g (500 mg each) thrice a day for 8 weeks and in Group B (n = 30), tablet of GH in similar dose and duration. Effect of therapy was assessed by body circumference, Body Mass Index (BMI), cardinal symptoms like Anga-Gaurava, Bharavriddhi, etc., and lipid profile parameters. Result: AG decreased the serum cholesterol by 7.12%, Serum Triglyceride (S. TG) by 7.72%, Serum Low Density Lipoprotein (S. LDL) by 11.68%, Serum Very Low Density Lipoprotein (S. VLDL) by 7.73%, and had increased Serum High Density Lipoprotein (S. HDL) by 9.52%, with moderate improvement in 14.81% and mild improvement in 70.37% of patients. The GH decreased the serum cholesterol by 6.31%, S. TG by 9.61%, S. LDL by 12.55%, serum VLDL by 8.99%, and increased S. HDL by 10.52% with moderate improvement in 3.70%, and mild improvement in 74.07% patients. Conclusion: AG and GH are suggested to be used in Kleda Bahul Samprapti Janya Vyadhi and Ama Bahul Samprapti Janya Vyadhi respectively. PMID:25558160

  1. Impact of Obesity on Cardiopulmonary Disease.

    PubMed

    Chandler, Marjorie L

    2016-09-01

    Although there are known detrimental effects of obesity on the heart and lungs, few data exist showing obesity as risk factor for cardiopulmonary disorders in dogs and cats. It is probable that increased abdominal fat is detrimental as it is in humans, and there is evidence of negative effects of increased intrathoracic fat. As well as physical effects of fat, increased inflammatory mediators and neurohormonal effects of obesity likely contribute to cardiopulmonary disorders. Weight loss in overweight individuals improves cardiac parameters and exercise tolerance. Obesity in patients with obstructive airway disorders is recognized to increase disease severity. PMID:27264052

  2. What is Obesity Doing to Your Gut?

    PubMed

    Lee, Yeong Yeh

    2015-01-01

    Obesity is a fast-emerging epidemic in the Asia-Pacific region, with numbers paralleling the rising global prevalence within the past 30 years. The landscape of gut diseases in Asia has been drastically changed by obesity. In addition to more non-specific abdominal symptoms, obesity is the cause of gastro-oesophageal reflux disease, various gastrointestinal cancers (colorectal cancer, hepatocellular carcinoma, oesophageal adenocarcinoma, gastric cardia adenocarcinoma, pancreatic cancer and gallbladder cancer) and non-alcoholic fatty liver disease. Abnormal cross-talk between the gut microbiome and the obese host seems to play a central role in the pathogenesis, but more studies are needed. PMID:25892944

  3. [Pharmacological therapy of obesity].

    PubMed

    Pagotto, Uberto; Vanuzzo, Diego; Vicennati, Valentina; Pasquali, Renato

    2008-04-01

    Obesity is reaching epidemic proportions worldwide and it is correlated with various comorbidities, among which the most relevant are diabetes mellitus, arterial hypertension, and cardiovascular diseases. Obesity management is a modern challenge because of the rapid evolution of unfavorable lifestyles and unfortunately there are no effective treatments applicable to the large majority of obese/overweight people. The current medical attitude is to treat the complications of obesity (e.g. dyslipidemia, hypertension, diabetes, and cardiovascular diseases). However, the potential of treating obesity is enormous, bearing in mind that a volitional weight loss of 10 kg is associated with important risk factor improvement: blood pressure -10 mmHg, total cholesterol -10%, LDL cholesterol -15%, triglycerides -30%, fasting glucose -50%, HDL cholesterol +8%. Drug treatment for obesity is an evolving branch of pharmacology, burdened by severe side effects and consequences of the early drugs, withdrawn from the market, and challenged by the lack of long-term data on the effect of medications on obesity-related morbidity and mortality, first of all cardiovascular diseases. In Europe three antiobesity drugs are currently licensed: sibutramine, orlistat, and rimonabant; important trials with clinical endpoints are ongoing for sibutramine and rimonabant. While waiting for their results, it is convenient to evaluate these drugs for their effects on body weight and cardiometabolic risk factors. Sibutramine is a centrally acting serotonin/noradrenaline reuptake inhibitor that mainly increases satiety. At the level of brown adipose tissue, sibutramine can also facilitate energy expenditure by increasing thermogenesis. The long-term studies (five) documented a mean differential weight reduction of 4.45 kg for sibutramine vs placebo. Considering the principal studies, attrition rate was 43%. This drug not only reduces body weight and waist circumference, but it decreases triglycerides and

  4. Gastrointestinal Symptoms in Morbid Obesity

    PubMed Central

    Huseini, Mustafa; Wood, G. Craig; Seiler, Jamie; Argyropoulos, George; Irving, Brian A.; Gerhard, Glenn S.; Benotti, Peter; Still, Christopher; Rolston, David D. K.

    2014-01-01

    Background: Several reports have shown an increased prevalence of gastrointestinal (GI) symptoms in obese subjects in community-based studies. To better understand the role of the GI tract in obesity, and because there are limited clinic-based studies, we documented the prevalence of upper and lower GI symptoms in morbidly obese individuals in a clinic setting. Objective: The aim of our study was to compare the prevalence of GI symptoms in morbidly obese individuals in a weight management clinic with non-obese individuals with similar comorbidities as morbidly obese individuals in an Internal Medicine clinic. Methods: Class II and III obese patients BMI >35 kg/m2 (N = 114) and 182 non-obese patients (BMI <25 kg/m2) completed the GI symptoms survey between August 2011 and April 2012 were included in this study. The survey included 24 items pertaining to upper and lower GI symptoms. The participants rated the frequency of symptoms as absent (never, rarely) or present (occasionally, frequently). The symptoms were clustered into five categories: oral symptoms, dysphagia, gastroesophageal reflux, abdominal pain, and bowel habits. Responses to each symptom cluster were compared between obese group and normal weight groups using logistic regression. Results: Of the 24 items, 18 had a higher frequency in the obese group (p < 0.005 for each). After adjusting for age and gender, the obese patients were more likely to have upper GI symptoms: any oral symptom (OR = 2.3, p = 0.0013), dysphagia (OR 2.9, p = 0.0006), and any gastroesophageal reflux (OR 3.8, p < 0.0001). Similarly, the obese patients were more likely to have lower GI symptoms: any abdominal pain (OR = 1.7, p = 0.042) and altered bowel habits (OR = 2.8, p < 0.0001). Conclusion: These observations suggest a statistically significant increase in frequency of both upper and lower GI symptoms in morbidly obese patients when compared to non-obese subjects. PMID:25593922

  5. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  6. [Abdominal actinomycosis: four cases].

    PubMed

    Ghannouchi Jaafoura, N; Kaabia, N; Khalifa, M; Ben Jazia, I; Hachfi, W; Braham, A; Letaief, A; Bahri, F

    2008-12-01

    The abdominal actinomycosis (AA) is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic Gram positive bacteria, Actinomyces israelii. Abdominal actinomycosis is responsible for pseudotumoral syndrome often leading, to a large and mutilating surgery whereas a prolonged treatment by antibiotics would have permitted to cure the disease. The diagnosis is obtained generally from anatomopathologic exam. We report four cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis was only made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had a relapse of the infectious process. These four observations confirm the diagnostic and therapeutic difficulties previously reported by other authors.

  7. Metabolic syndrome, dyslipidemia, hypertension and type 2 diabetes in youth: from diagnosis to treatment

    PubMed Central

    2010-01-01

    Overweight and obesity in youth is a worldwide public health problem. Overweight and obesity in childhood and adolescents have a substantial effect upon many systems, resulting in clinical conditions such as metabolic syndrome, early atherosclerosis, dyslipidemia, hypertension and type 2 diabetes (T2D). Obesity and the type of body fat distribution are still the core aspects of insulin resistance and seem to be the physiopathologic links common to metabolic syndrome, cardiovascular disease and T2D. The earlier the appearance of the clustering of risk factors and the higher the time of exposure, the greater will be the chance of developing coronary disease with a more severe endpoint. The age when the event may occur seems to be related to the presence and aggregation of risk factors throughout life. The treatment in this age-group is non pharmacological and aims at promoting changes in lifestyle. However, pharmacological treatments are indicated in special situations. The major goals in dietary treatments are not only limited to weight loss, but also to an improvement in the quality of life. Modification of risk factors associated to comorbidities, personal satisfaction of the child or adolescent and trying to establish healthy life habits from an early age are also important. There is a continuous debate on the best possible exercise to do, for children or adolescents, in order to lose weight. The prescription of physical activity to children and adolescents requires extensive integrated work among multidisciplinary teams, patients and their families, in order to reach therapeutic success. The most important conclusion drawn from this symposium was that if the growing prevalence of overweight and obesity continues at this pace, the result will be a population of children and adolescents with metabolic syndrome. This would lead to high mortality rates in young adults, changing the current increasing trend of worldwide longevity. Government actions and a better

  8. Metabolic syndrome, dyslipidemia, hypertension and type 2 diabetes in youth: from diagnosis to treatment.

    PubMed

    Halpern, Alfredo; Mancini, Marcio C; Magalhães, Maria Eliane C; Fisberg, Mauro; Radominski, Rosana; Bertolami, Marcelo C; Bertolami, Adriana; de Melo, Maria Edna; Zanella, Maria Teresa; Queiroz, Marcia S; Nery, Marcia

    2010-08-18

    Overweight and obesity in youth is a worldwide public health problem. Overweight and obesity in childhood and adolescents have a substantial effect upon many systems, resulting in clinical conditions such as metabolic syndrome, early atherosclerosis, dyslipidemia, hypertension and type 2 diabetes (T2D). Obesity and the type of body fat distribution are still the core aspects of insulin resistance and seem to be the physiopathologic links common to metabolic syndrome, cardiovascular disease and T2D. The earlier the appearance of the clustering of risk factors and the higher the time of exposure, the greater will be the chance of developing coronary disease with a more severe endpoint. The age when the event may occur seems to be related to the presence and aggregation of risk factors throughout life.The treatment in this age-group is non pharmacological and aims at promoting changes in lifestyle. However, pharmacological treatments are indicated in special situations.The major goals in dietary treatments are not only limited to weight loss, but also to an improvement in the quality of life. Modification of risk factors associated to comorbidities, personal satisfaction of the child or adolescent and trying to establish healthy life habits from an early age are also important. There is a continuous debate on the best possible exercise to do, for children or adolescents, in order to lose weight. The prescription of physical activity to children and adolescents requires extensive integrated work among multidisciplinary teams, patients and their families, in order to reach therapeutic success.The most important conclusion drawn from this symposium was that if the growing prevalence of overweight and obesity continues at this pace, the result will be a population of children and adolescents with metabolic syndrome. This would lead to high mortality rates in young adults, changing the current increasing trend of worldwide longevity. Government actions and a better

  9. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  10. Obesity, regional fat distribution, and syndrome X in obese black versus white adolescents: race differential in diabetogenic and atherogenic risk factors.

    PubMed

    Bacha, Fida; Saad, Rola; Gungor, Neslihan; Janosky, Janine; Arslanian, Silva A

    2003-06-01

    The incidence of type 2 diabetes mellitus in children is increasing with the increasing prevalence of obesity, particularly in African-American children. We hypothesized that African-American obese adolescents are more insulin resistant than their white peers, but have lower insulin secretion, thus increasing their risk of type 2 diabetes mellitus. The present study investigated insulin sensitivity and secretion, visceral adiposity (VAT), and cardiovascular disease (CVD) risk profile in black obese adolescents (BOA) vs. white obese adolescents (WOA). Twenty-four BOA and 26 WOA underwent a hyperinsulinemic-euglycemic clamp to assess insulin sensitivity, a hyperglycemic clamp to determine insulin secretion, dual energy x-ray absorptiometry for body composition and computed tomography scan at L4-L5 to measure VAT and sc abdominal adipose tissue. Fasting lipid and automated blood pressure measurements were obtained. The WOA and BOA groups were divided into low VAT and high VAT groups. BOA compared with WOA of similar body mass index and percent body fat had less visceral adiposity, lower hepatic glucose production, and lower lipid levels. Visceral adiposity was associated with lower insulin sensitivity in both groups [low vs. high VAT; BOA, 2.9 +/- 0.4 vs. 1.7 +/- 0.2 micromol/kg x min per pmol/liter (P = 0.016); WOA, 2.6 +/- 0.5 vs. 1.5 +/- 0.1 (P = 0.032)]. However, this was compensated by higher insulin secretion in whites (low VAT, 934.8 +/- 121.8; high VAT, 1590.6 +/- 232.8 pmol/liter; P = 0.037), but not in blacks (low VAT, 1398.9 +/- 214.0; high VAT, 1423.7 +/- 108.7 pmol/liter). Glucose disposition index (insulin sensitivity x first phase insulin) was lower in high VAT vs. low VAT BOA, but not in WOA. In each racial group, high VAT groups had elevation of systolic and diastolic blood pressure, but dyslipidemia was worse in WOA with high VAT. In conclusion, a given level of body mass index confers different metabolic risks for WOA vs. BOA. Although differences

  11. [Obesity, bariatric surgery and future fertility].

    PubMed

    Tsur, Abraham; Machtinger, Ronit; Segal-Lieberman, Gabriella; Orvieto, R

    2014-08-01

    Obesity is an increasingly widespread health problem. In addition to comorbidities such as diabetes, hypertension, dyslipidemia and cardiovascular disease, obesity has a significant impact on reproductive life, including infertility, miscarriages and high prevalence of pregnancy complications. The present review describes the possible benefits of bariatric surgery regarding fertility and pregnancy outcome. It is well established that bariatric surgery leads to regular ovulatory cycles and improves spontaneous conception rates in obese women. While pregnancy after bariatric surgery is safe and associated with reduced pregnancy complications, pregnant women following bariatric surgery are still at high risk for preterm births and small dimensions of gestational age offsprings. The optimal interval that should be kept between surgery and subsequent pregnancy is controversial, with recent studies emphasizing the importance of nutritional balance rather than the time from surgery to conception as being the most important determinant. Strict peri-conceptional surveillance is mandatory in order to prevent nutritional deficiencies and for the early diagnosis of abnormal fetal growth.

  12. BR 08-3 MANAGEMENT OF DYSLIPIDEMIA IN HYPERTENSION.

    PubMed

    Muthusamy, V V

    2016-09-01

    Cardiovascular disease burden is increasing all over the world. The diagnosis of hypertension is considered when a person has persistently elevated BP (Systolic BP more than 140 mmHg and/or Diastolic BP more than 90 mmHg). Dyslipidemia denotes abnormal levels of lipids in the blood (Total Cholesterol >200 mg%, Low density lipoprotein (LDL) >100 mg%, Triglycerides (TGL) >150 mg% and High density lipoprotein (HDL) <40 mg in men and < 50 mg in women. Hypertension and Dyslipidemia constitute the important components of metabolic syndrome as per the definition of NCEP Guidelines-Adult Treatment Panel III (ATP III). The prevalence of the co-existence of hypertension and dyslipidemia is in the range of 15-31%. The co-existence of these two risk factors has more than the additive effect for endothelial dysfunction resulting in enhanced atherosclerosis leading to CVD. The term dyslipidemic hypertension (DH) was used in the context of familial DH. Non-familial forms of DH are more common than familial form. Some authors name this combination as Lipitension for easy understanding. Framingham Heart study shows that the majority of hypertension population have more than one risk factor predominantly atherogenic in nature. Dyslipidemia causes endothelial damage and loss of vasomotor activity. The damage may manifest as elevated BP. MRFIT study reveals that mild to moderate elevation of BP and Dyslipidemia can lead to multiplicative adverse impact on CVD. Framingham study results also reveal that moderately elevated BP and cholesterol had a similar risk.RAAS promotes atherogenesis. Angiotensin II promotes atherogenesis through stimulation AT1 receptor, which increases lipid uptake in cells, vasoconstriction and free radical production to foster both hypertension and atherosclerosis. Hypertension damages vascular endothelium through altered shear stress and oxidative stress resulting in increased synthesis of collagen and fibronectin, reduced nitric oxide-dependent vascular

  13. [New guidelines for screening and management of familial dyslipidemia].

    PubMed

    Brun, Nathalie; Aubert, Carole E; Nanchen, David; Rodondi, Nicolas

    2016-03-01

    Familial dyslipidemia, a frequent genetic cause of premature cardiovascular disease, is still underdiagnosed and undertreated. According to recent European studies, the prevalence of familial hypercholesterolemia is higher than previously suspected and reaches 1/200-300 persons, while familial combined hyperlipidemia affects 1-3% of the population. Screening is important, as familial dyslipidemia often leads to cardiovascular event before 60 years of age, and usual scores of risk are not appropriate for these patients. Screening is recommended in childhood in case of family history of premature cardiovascular disease or severe hyperlipidemia in first degree relatives. Lifestyle modifications, eviction of any additive cardiovascular risk factor and tailored drug therapy are the cornerstones of an optimal management. PMID:27089599

  14. BR 08-3 MANAGEMENT OF DYSLIPIDEMIA IN HYPERTENSION.

    PubMed

    Muthusamy, V V

    2016-09-01

    Cardiovascular disease burden is increasing all over the world. The diagnosis of hypertension is considered when a person has persistently elevated BP (Systolic BP more than 140 mmHg and/or Diastolic BP more than 90 mmHg). Dyslipidemia denotes abnormal levels of lipids in the blood (Total Cholesterol >200 mg%, Low density lipoprotein (LDL) >100 mg%, Triglycerides (TGL) >150 mg% and High density lipoprotein (HDL) <40 mg in men and < 50 mg in women. Hypertension and Dyslipidemia constitute the important components of metabolic syndrome as per the definition of NCEP Guidelines-Adult Treatment Panel III (ATP III). The prevalence of the co-existence of hypertension and dyslipidemia is in the range of 15-31%. The co-existence of these two risk factors has more than the additive effect for endothelial dysfunction resulting in enhanced atherosclerosis leading to CVD. The term dyslipidemic hypertension (DH) was used in the context of familial DH. Non-familial forms of DH are more common than familial form. Some authors name this combination as Lipitension for easy understanding. Framingham Heart study shows that the majority of hypertension population have more than one risk factor predominantly atherogenic in nature. Dyslipidemia causes endothelial damage and loss of vasomotor activity. The damage may manifest as elevated BP. MRFIT study reveals that mild to moderate elevation of BP and Dyslipidemia can lead to multiplicative adverse impact on CVD. Framingham study results also reveal that moderately elevated BP and cholesterol had a similar risk.RAAS promotes atherogenesis. Angiotensin II promotes atherogenesis through stimulation AT1 receptor, which increases lipid uptake in cells, vasoconstriction and free radical production to foster both hypertension and atherosclerosis. Hypertension damages vascular endothelium through altered shear stress and oxidative stress resulting in increased synthesis of collagen and fibronectin, reduced nitric oxide-dependent vascular

  15. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus

    PubMed Central

    Tangvarasittichai, Surapon

    2015-01-01

    Oxidative stress is increased in metabolic syndrome and type 2 diabetes mellitus (T2DM) and this appears to underlie the development of cardiovascular disease, T2DM and diabetic complications. Increased oxidative stress appears to be a deleterious factor leading to insulin resistance, dyslipidemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to T2DM. Chronic oxidative stress, hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant, have high oxidative energy requirements, decrease the gene expression of key β-cell genes and induce cell death. If β-cell functioning is impaired, it results in an under production of insulin, impairs glucose stimulated insulin secretion, fasting hyperglycemia and eventually the development of T2DM. PMID:25897356

  16. Low Urinary Iodine Concentrations Associated with Dyslipidemia in US Adults.

    PubMed

    Lee, Kyung Won; Shin, Dayeon; Song, Won O

    2016-03-01

    Iodine is an essential component of the thyroid hormone which plays crucial roles in healthy thyroid function and lipid metabolism. However, the association between iodine status and dyslipidemia has not been well established at a population level. We aimed to test the hypothesis that the odds of dyslipidemia including elevated total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and apolipoprotein B, and lowered high-density lipoprotein (HDL) cholesterol and HDL/LDL ratio are associated with urinary iodine concentration (UIC) in a population perspective. Data of 2495 US adults (≥20 years) in the National Health and Nutrition Examination Survey 2007-2012 were used in this study. Two subgroups (i.e., UIC below vs. above the 10th percentile) were compared of dyslipidemia as defined based on NCEP ATP III guidelines. The differences between the groups were tested statistically by chi-square test, simple linear regressions, and multiple logistic regressions. Serum lipid concentrations differed significantly between two iodine status groups when sociodemographic and lifestyle covariates were controlled (all, p < 0.05). Those with the lowest decile of UIC were more likely to be at risk for elevated total cholesterol (>200 mg/dL) (adjusted odds ratio (AOR) = 1.51, 95% confidence interval (CI): 1.03-2.23) and elevated LDL cholesterol (>130 mg/dL) (AOR = 1.58, 95% CI: 1.11-2.23) and lowered HDL/LDL ratio (<0.4) (AOR = 1.66, 95% CI: 1.18-2.33), compared to those with UIC above the 10th percentile. In US adults, low UIC was associated with increased odds for dyslipidemia. Findings of the present cross-sectional study with spot urine samples highlight the significant association between UIC and serum lipids at population level, but do not substantiate a causal relationship. Further investigations are warranted to elucidate the causal relationship among iodine intakes, iodine status, and serum lipid profiles. PMID:26999198

  17. Hyperinsulinemia and ectopic fat deposition develop in the face of hyperadiponectinemia in young obese rats

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The role of reduced adiponenctin signaling in childhood obesity is unclear. Weanling male Sprague-Dawley rats were overfed a high fat diet via total enteral nutrition. Excessive caloric intake led to increased weight and fat mass; dyslipidemia; ectopic fat deposition; and hyperinsulinemia (P less th...

  18. Comparison of effect of resveratrol and vanadium on diabetes related dyslipidemia and hyperglycemia in streptozotocin induced diabetic rats

    PubMed Central

    Mohamad Shahi, Majid; Haidari, Fatemeh; Shiri, Mohamad Reza

    2011-01-01

    Purpose: Resveratrol a natural polyphenolicstilbene derivative has wide variety of biological activities. There is also a large body of evidence demonstrating positive effect of resveratrol in treatment of various metabolic complications including metabolic syndrome, obesity, diabetes and dyslipidemia in adults. The purpose of this study was to investigate anti-hyperglycemic and anti-dyslipidemic effects of resveratrol. Methods: We used 40 diabetic streptozotocin Wistar rats. Rats were randomly divided into 5 treatment groups (n=8 in each) including normal control, normal treated with resveratrol, diabetic control, diabetic treated with vanadium , diabetic treated with resveratrol . Resveratrol (25 mg/kgbw) and vanadate (0.2 mg/kgbw) was orally gavaged for 40 days and blood samples were directly collected from heart. Results: Diabetic rats treated with resveratrol in comparison to control diabetic rats demonstrated a significant (p = 0.001) decline in serum glucose concentration, and high plasma concentrations of total cholesterol and LDL-c were reduced (p = 0.031, p = 0.004 respectively). Furthermore, body weight loss trend that observed in diabetic rats alleviated by resveratrol and vanadate. However triglyceride, VLDL-c and HDL-c levels did not changed significantly. Conclusion: In conclusion Resveratrol ameliorated dyslipidemia and hyperglycemia in diabetic rats. However further investigations in peculiar human studies are required. PMID:24312761

  19. Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea.

    PubMed

    We, Ji-Sun; Han, Kyungdo; Kwon, Hyuk-Sang; Kil, Kicheol

    2016-05-01

    The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics. PMID:27175656

  20. Dyslipidemia in type 2 diabetes: prevalence, pathophysiology, and management.

    PubMed

    Chehade, Joe M; Gladysz, Margaret; Mooradian, Arshag D

    2013-03-01

    Dyslipidemia is one of the key risk factors for cardiovascular disease (CVD) in diabetes mellitus. Despite the mounting clinical trial data, the management of dyslipidemia other than lowering the low density lipoprotein cholesterol (LDL-c) continues to be controversial. The characteristic features of diabetic dyslipidemia are high plasma triglyceride concentration, reduced high density lipoprotein cholesterol (HDL-c) concentration, and increased concentration of small dense LDL particles. These changes are caused by increased free fatty acid flux secondary to insulin resistance and aggravated by increased inflammatory adipokines. The availability of several lipid-lowering drugs and nutritional supplements offers novel and effective options for achieving target lipid levels in people with diabetes. While initiation of drug therapy based on differences in the lipid profile is an option, most practice guidelines recommend statins as first-line therapy. Although the evidence for clinical utility of combination of statins with fibrates or nicotinic acid in reducing cardiovascular events remains inconclusive, the preponderance of evidence suggests that a subgroup who have high triglycerides and low HDL-c levels may benefit from combination therapy of statins and fibrates. The goal of therapy is to achieve at least 30-40 % reduction in LDL-c levels. Preferably the LDL-c should be less than 100 mg/dL in low-risk people and less than 70 mg/dL in those at high risk, including people with established CVD.

  1. Clinical management considerations for dyslipidemia in HIV-infected individuals.

    PubMed

    Kirchner, Jeffrey T

    2012-01-01

    Dyslipidemia is common in patients with human immunodeficiency virus (HIV) and may result in significant morbidity, including coronary heart disease (CHD). Treatment of dyslipidemia in these patients is generally based on the National Cholesterol Education Program Adult Treatment Panel III goals for individuals without HIV. For individuals with ≥ 2 cardiovascular risk factors, the risk of CHD should be evaluated using the Framingham risk calculator and managed accordingly. Switching to an antiretroviral regimen with a favorable lipid profile should be considered before pharmacologic management if virologic suppression can be maintained. Statins are the first-choice therapy for elevated low-density lipoprotein cholesterol, but in HIV-infected individuals, special consideration must be given to drug-drug interactions, specifically those between protease inhibitors and statins. Management of dyslipidemia in HIV-infected individuals is a challenging but important aspect of chronic disease management. Additional research, specifically related to the role of chronic inflammation, is needed to better define the relationship between HIV infection and cardiovascular disease.

  2. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  3. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  4. [Obesity--significant risk factor for erectile dysfunction in men].

    PubMed

    Skrypnik, Damian; Bogdański, Paweł; Musialik, Katarzyna

    2014-02-01

    The obesity affects around 312 million people over the world. In The United States it causes more than 300 000 deaths per year. It leads to many complications, such as ischemic heart disease, hypertension, dyslipidemia, atherosclerosis and abnormal carbohydrate metabolism. It was proven recently that obesity is also an independent risk factor for erectile dysfunction in men. 79% of men presenting erectile disorders have BMI of 25 kg/m2 or greater. BMI in the range 25-30 kg/m2 is associated with 1,5 times, and in the range of over 30 kg/m2 with 3 times greater risk of sexual dysfunction. The occurrence of erectile dysfunction in patients with obesity is caused by a number of complications which are characteristic for an excessive amount of fat tissue, in example: cardiovascular diseases, diabetes or dyslipidemia. In the United States diabetes and obesity are responsible for 8 million cases of erectile dysfunction. Scientific evidence indicates that excessive body weight should be considered as an independent risk factor for erectile dysfunction. This risk increases with increasing BMI. Erectile disorders correlate with the occurrence of obesity at any time during the patient's life. Obesity leads to erectile dysfunction in a considerably greater extent than aging. Mechanisms responsible for the independent influence of obesity on the erectile dysfunction are: hormonal imbalance, endothelial dysfunction, insulin resistance, psychological factors and physical inactivity. The basis for erectile dysfunction treatment in obesity is body weight loss. Erectile disorders in obese men are significantly more frequent than in general population. Obesity is beyond any doubts an independent risk factor of erectile dysfunction.

  5. Obesity Epidemiology

    PubMed Central

    Haidar, Yarah M.; Cosman, Bard C.

    2011-01-01

    Obesity has progressed in a few decades from a public health footnote in developed countries to a top-priority international issue. Because obesity implies increased morbidity and mortality from chronic, debilitating disorders, it is a major burden on individuals and health systems in both developing and developed countries. Obesity is a complex disorder unequally affecting all age groups and socioeconomic classes. Of special concern is increasing childhood obesity. This review presents the extent of the obesity epidemic and its impact worldwide by way of introduction to a discussion of colon and rectal surgery in the obese patient. PMID:23204935

  6. Relationship between bread and obesity.

    PubMed

    Serra-Majem, Luis; Bautista-Castaño, Inmaculada

    2015-04-01

    Some studies have indicated that promoting the Mediterranean diet pattern as a model of healthy eating may help to prevent weight gain and the development of overweight/obesity. Bread consumption, which has been part of the traditional Mediterranean diet, has continued to decline in Spain and in the rest of the world, because the opinion of the general public is that bread fattens. The present study was conducted to assess whether or not eating patterns that include bread are associated with obesity and excess abdominal adiposity, both in the population at large or in subjects undergoing obesity management. The results of the present review indicate that reducing white bread, but not whole-grain bread, consumption within a Mediterranean-style food pattern setting is associated with lower gains in weight and abdominal fat. It appears that the different composition between whole-grain bread and white bread varies in its effect on body weight and abdominal fat. However, the term 'whole-grain bread' needs to be defined for use in epidemiological studies. Finally, additional studies employing traditional ways of bread production should analyse this effect on body-weight and metabolic regulation.

  7. Lifestyle changes in the management of adulthood and childhood obesity.

    PubMed

    Orio, Francesco; Tafuri, Domenico; Ascione, Antonio; Marciano, Francesca; Savastano, Silvia; Colarieti, Giorgio; Orio, Marcello; Colao, Annamaria; Palomba, Stefano; Muscogiuri, Giovanna

    2016-12-01

    Adulthood and childhood obesity is rapidly becoming an epidemic problem and it has a short and long-term impact on health. Short-term consequences are mostly represented by psychological effects; in fact obese children have more chances to develop psychological or psychiatric problems than non-obese children. The main long-term effect is represented by the fact that childhood obesity continues into adulthood obesity and this results in negative effects in young adult life, since obesity increases the risk to develop morbidity and premature mortality. The obesity-related diseases are mostly represented by hypertension, type 2 diabetes, dyslipidemia, cardiovascular diseases. Medical treatment should be discouraged in childhood because of the side effects and it should be only reserved for obese children with related medical complications. Lifestyle changes should be encouraged in both adulthood and childhood obesity. This review focuses on the management of obesity both in adulthood and in childhood, paying particular attention to lifestyle changes that should be recommended.

  8. Lifestyle changes in the management of adulthood and childhood obesity.

    PubMed

    Orio, Francesco; Tafuri, Domenico; Ascione, Antonio; Marciano, Francesca; Savastano, Silvia; Colarieti, Giorgio; Orio, Marcello; Colao, Annamaria; Palomba, Stefano; Muscogiuri, Giovanna

    2016-12-01

    Adulthood and childhood obesity is rapidly becoming an epidemic problem and it has a short and long-term impact on health. Short-term consequences are mostly represented by psychological effects; in fact obese children have more chances to develop psychological or psychiatric problems than non-obese children. The main long-term effect is represented by the fact that childhood obesity continues into adulthood obesity and this results in negative effects in young adult life, since obesity increases the risk to develop morbidity and premature mortality. The obesity-related diseases are mostly represented by hypertension, type 2 diabetes, dyslipidemia, cardiovascular diseases. Medical treatment should be discouraged in childhood because of the side effects and it should be only reserved for obese children with related medical complications. Lifestyle changes should be encouraged in both adulthood and childhood obesity. This review focuses on the management of obesity both in adulthood and in childhood, paying particular attention to lifestyle changes that should be recommended. PMID:27600645

  9. Acute Abdominal Pain in the Bariatric Surgery Patient.

    PubMed

    Lewis, Kyle D; Takenaka, Katrin Y; Luber, Samuel D

    2016-05-01

    Obesity is present in epidemic proportions in the United States, and bariatric surgery has become more common. Thus, emergency physicians will undoubtedly encounter many patients who have undergone one of these procedures. Knowledge of the anatomic changes specific to these procedures aids the clinician in understanding potential complications and devising an organized differential diagnosis. This article reviews common bariatric surgery procedures, their complications, and the approach to acute abdominal pain in these patients. PMID:27133251

  10. Lifestyle habits and obesity progression in overweight and obese American young adults: Lessons for promoting cardiometabolic health.

    PubMed

    Cha, EunSeok; Akazawa, Margeaux K; Kim, Kevin H; Dawkins, Colleen R; Lerner, Hannah M; Umpierrez, Guillermo; Dunbar, Sandra B

    2015-12-01

    Obesity among young adults is a growing problem in the United States and is related to unhealthy lifestyle habits, such as high caloric intake and inadequate exercise. Accurate assessment of lifestyle habits across obesity stages is important for informing age-specific intervention strategies to prevent and reduce obesity progression. Using a modified version of the Edmonton Obesity Staging System (mEOSS), a new scale for defining obesity risk and predicting obesity morbidity and mortality, this cross-sectional study assessed the prevalence of overweight/obese conditions in 105 young adults and compared their lifestyle habits across the mEOSS stages. Descriptive statistics, chi-square tests, and one-way analyses of variance were performed. Eighty percent of participants (n = 83) fell into the mEOSS-2 group and had obesity-related chronic disorders, such as diabetes, hypertension, and/or dyslipidemia. There were significant differences in dietary quality and patterns across the mEOSS stages. Findings highlighted the significance of prevention and early treatment for overweight and obese young adults to prevent and cease obesity progression.

  11. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  12. Is there a paradox in obesity?

    PubMed

    Goyal, Akankasha; Nimmakayala, Kameswara Rao; Zonszein, Joel

    2014-01-01

    In an industrialized society, the increase in obesity incidence has led to an increase in premature morbidity and mortality rates. There is a relationship between body mass index (BMI) and the increased incidence of hypertension, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease, an increase in mortality. However, obese individuals with these conditions may have better outcomes than their lean counterparts, thus the term "obesity paradox." Most studies supporting this paradox are cross-sectional and do not take into account the quantity or type of adiposity, the disease severity, and comorbidities. Although BMI is an indicator of the amount of body fat, it does not differentiate between adiposity types. Adipocytes that are highly functional have good fuel storage capacity are different from adipocytes found in visceral obesity, which are poorly functioning, laden with macrophages, and causing low-grade inflammation. Individuals with high BMI may be physically fit and have a lower mortality risk when compared with individuals with a lower BMI and poorly functioning adiposity. We review the complexity of adipose tissue and its location, function, metabolic implications, and role in cardiovascular morbidity and mortality. The terminology "obesity paradox" may reflect a lack of understanding of the complex pathophysiology of obesity and the association between adiposity and cardiovascular disease. PMID:24896249

  13. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  14. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  15. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  16. Childhood Obesity

    ERIC Educational Resources Information Center

    Yuca, Sevil Ari, Ed.

    2012-01-01

    This book aims to provide readers with a general as well as an advanced overview of the key trends in childhood obesity. Obesity is an illness that occurs due to a combination of genetic, environmental, psychosocial, metabolic and hormonal factors. The prevalence of obesity has shown a great rise both in adults and children in the last 30 years.…

  17. Obesity management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rates of obesity in the United States have increased dramatically over the past 30 years. Approximately 35% of children and 66% of adults are currently considered overweight or obese. Although obesity is seen in all ethnicities and economic classes, ethnic minorities and those of lower socioeconomic...

  18. Expression of ceramide-metabolising enzymes in subcutaneous and intra-abdominal human adipose tissue

    PubMed Central

    2012-01-01

    Background Inflammation and increased ceramide concentrations characterise adipose tissue of obese women with high liver fat content compared to equally obese women with normal liver fat content. The present study characterises enzymes involved in ceramide metabolism in subcutaneous and intra-abdominal adipose tissue. Methods Pathways leading to increased ceramide concentrations in inflamed versus non-inflamed adipose tissue were investigated by quantifying expression levels of key enzymes involved in ceramide metabolism. Sphingomyelinases (sphingomyelin phosphodiesterases SMPD1-3) were investigated further using immunohistochemistry to establish their location within adipose tissue, and their mRNA expression levels were determined in subcutaneous and intra-abdominal adipose tissue from both non-obese and obese subject. Results Gene expression levels of sphingomyelinases, enzymes that hydrolyse sphingomyelin to ceramide, rather than enzymes involved in de novo ceramide synthesis, were higher in inflamed compared to non-inflamed adipose tissue of obese women (with high and normal liver fat contents respectively). Sphingomyelinases were localised to both macrophages and adipocytes, but also to blood vessels and to extracellular regions surrounding vessels within adipose tissue. Expression levels of SMPD3 mRNA correlated significantly with concentrations of different ceramides and sphingomyelins. In both non-obese and obese subjects SMPD3 mRNA levels were higher in the more inflamed intra-abdominal compared to the subcutaneous adipose tissue depot. Conclusions Generation of ceramides within adipose tissue as a result of sphingomyelinase action may contribute to inflammation in human adipose tissue. PMID:22974251

  19. Childhood obesity.

    PubMed

    Dean, Erin

    2016-08-31

    Essential facts Nearly one third of children aged 2-15 in England are overweight or obese. Younger generations are becoming obese at earlier ages and staying so for longer. Reducing obesity levels is a major public health challenge as the condition doubles the risk of dying prematurely. Obese adults are more likely to develop health conditions such as heart disease, type 2 diabetes and depression. Treating conditions related to obesity is a major financial burden on the NHS, costing more than £5 billion a year. PMID:27577286

  20. Association analysis of dyslipidemia-related genes in diabetic nephropathy.

    PubMed

    McKay, Gareth J; Savage, David A; Patterson, Christopher C; Lewis, Gareth; McKnight, Amy Jayne; Maxwell, Alexander P

    2013-01-01

    Type 1 diabetes (T1D) increases risk of the development of microvascular complications and cardiovascular disease (CVD). Dyslipidemia is a common risk factor in the pathogenesis of both CVD and diabetic nephropathy (DN), with CVD identified as the primary cause of death in patients with DN. In light of this commonality, we assessed single nucleotide polymorphisms (SNPs) in thirty-seven key genetic loci previously associated with dyslipidemia in a T1D cohort using a case-control design. SNPs (n = 53) were genotyped using Sequenom in 1467 individuals with T1D (718 cases with proteinuric nephropathy and 749 controls without nephropathy i.e. normal albumin excretion). Cases and controls were white and recruited from the UK and Ireland. Association analyses were performed using PLINK to compare allele frequencies in cases and controls. In a sensitivity analysis, samples from control individuals with reduced renal function (estimated glomerular filtration rate<60 ml/min/1.73 m(2)) were excluded. Correction for multiple testing was performed by permutation testing. A total of 1394 samples passed quality control filters. Following regression analysis adjusted by collection center, gender, duration of diabetes, and average HbA1c, two SNPs were significantly associated with DN. rs4420638 in the APOC1 region (odds ratio [OR] = 1.51; confidence intervals [CI]: 1.19-1.91; P = 0.001) and rs1532624 in CETP (OR = 0.82; CI: 0.69-0.99; P = 0.034); rs4420638 was also significantly associated in a sensitivity analysis (P = 0.016) together with rs7679 (P = 0.027). However, no association was significant following correction for multiple testing. Subgroup analysis of end-stage renal disease status failed to reveal any association. Our results suggest common variants associated with dyslipidemia are not strongly associated with DN in T1D among white individuals. Our findings, cannot entirely exclude these key genes which are central to the process of dyslipidemia, from involvement in DN

  1. [Therapeutic Strategies. Cardiovascular risk and dyslipidemia in elderly and women].

    PubMed

    Morales, Clotilde; Royuela, Meritxell

    2013-01-01

    The management of cardiovascular risk and dyslipidemia are justified in guidelines. In the elderly, when they are in primary prevention, recommendations are controversial, even if there is evidence in reducing morbidity. In secondary prevention, between 65 and 85 years, there is enough evidence to recommend statins. The decision to start or to continue further treatment must be complemented by comprehensive assessment of the risk-benefit factor. In elderly patients we have to support in decision-making, we take clinical judgment and not just the age criteria. In women the risk is underestimated and may be untreated. The recomendations are the same as in men. During pregnancy there are particular recommendations.

  2. Sagittal Abdominal Diameter and Visceral Adiposity

    PubMed Central

    Kahn, Henry S.; Gasevic, Danijela; Liang, Zhe; Frediani, Jennifer K.; Torres, William E.; Ziegler, Thomas R.; Phillips, Lawrence S.; Lin, Edward

    2013-01-01

    Background In the context of increasing obesity prevalence, the relationship between large visceral adipose tissue (VAT) volumes and type 2 diabetes mellitus (T2DM) is unclear. In a clinical sample of severely obese women (mean body mass index [BMI], 46 kg/m2) with fasting normoglycemia (n=40) or dysglycemia (impaired fasting glucose+diabetes; n=20), we sought to determine the usefulness of anthropometric correlates of VAT and associations with dysglycemia. Methods VAT volume was estimated using multi-slice computer tomography; anthropometric surrogates included sagittal abdominal diameter (SAD), waist circumference (WC) and BMI. Insulin sensitivity (Si), and beta-cell dysfunction, measured by insulin secretion (AIRg) and the disposition index (DI), were determined by frequently sampled intravenous glucose tolerance test. Results Compared to fasting normoglycemic women, individuals with dysglycemia had greater VAT (P<0.001) and SAD (P=0.04), but BMI, total adiposity and Si were similar. VAT was inversely associated with AIRg and DI after controlling for ancestry, Si, and total adiposity (standardized beta, −0.32 and −0.34, both P<0.05). In addition, SAD (beta=0.41, P=0.02) was found to be a better estimate of VAT volume than WC (beta=0.32, P=0.08) after controlling for covariates. Receiver operating characteristic analysis showed that VAT volume, followed by SAD, outperformed WC and BMI in identifying dysglycemic participants. Conclusions Increasing VAT is associated with beta-cell dysfunction and dysglycemia in very obese women. In the presence of severe obesity, SAD is a simple surrogate of VAT, and an indicator of glucose dysregulation. PMID:23408092

  3. OBESITY-INDUCED HYPERTENSION: INTERACTION OF NEUROHUMORAL AND RENAL MECHANISMS

    PubMed Central

    Hall, John E.; do Carmo, Jussara M.; da Silva, Alexandre A.; Wang, Zhen; Hall, Michael E.

    2015-01-01

    Excess weight gain, especially when associated with increased visceral adiposity, is a major cause of hypertension, accounting for 65–75% of the risk for human primary (essential) hypertension. Increased renal tubular sodium reabsorption impairs pressure natriuresis and plays an important role in initiating obesity hypertension. The mediators of abnormal kidney function and increased blood pressure during development of obesity hypertension include 1) physical compression of the kidneys by fat in and around the kidneys, 2) activation of the renin-angiotensin-aldosterone system (RAAS), and 3) increased sympathetic nervous system (SNS) activity. Activation of the RAAS system is likely due, in part, to renal compression as well as SNS activation. However, obesity also causes mineralocorticoid receptor activation independent of aldosterone or angiotensin II. The mechanisms for SNS activation in obesity have not been fully elucidated but appear to require leptin and activation of the brain melanocortin system. With prolonged obesity and development of target organ injury, especially renal injury, obesity-associated hypertension becomes more difficult to control, often requiring multiple antihypertensive drugs and treatment of other risk factors, including dyslipidemia, insulin resistance and diabetes, and inflammation. Unless effective anti-obesity drugs are developed, the impact of obesity on hypertension and related cardiovascular, renal and metabolic disorders is likely to become even more important in the future as the prevalence of obesity continues to increase. PMID:25767285

  4. Prevalence, Distributions and Determinants of Obesity and Central Obesity in the Southern Cone of America

    PubMed Central

    Bazzano, Lydia; Rubinstein, Adolfo; Calandrelli, Matias; Chen, Chung-Shiuan; Elorriaga, Natalia; Gutierrez, Laura; Manfredi, Jose A.; Seron, Pamela; Mores, Nora; Poggio, Rosana; Ponzo, Jacqueline; Olivera, Hector; He, Jiang; Irazola, Vilma E.

    2016-01-01

    Background Obesity is a major determinant of cardiovascular disease in South America. However, population-based data are limited. Methods A total of 7,524 women and men, aged 35 to 74 years old, were randomly selected from 4 cities in the Southern Cone of Latin America between February 2010 and December 2011. Obesity clinical measurements and cardiovascular risk factors were measured using standard methodology. Results The prevalence of obesity and central obesity were 35.7% and 52.9%, respectively. The prevalence of obesity and central obesity were higher in women, and even higher in women with lower education compared with women with higher education. In men and women obesity was associated with a higher prevalence of diabetes, odds ratio (OR) 2.38 (95% Confidence Interval [CI]: 1.86 to 3.05) and 3.01 (95%CI 2.42 to 3.74) respectively, hypertension (OR 2.79 (95%CI 2.32 to 3.36) and 2.40 (95%CI 2.05 to 2.80) respectively, dyslipidemia (OR 1.83 (95%CI 1.50 to 2.24) and 1.69 (95%CI 1.45 to 1.98), respectively, low physical activity (OR 1.38(95%CI 1.14 to 1.68) and 1.38 (95%CI 1.18 to 1.62) respectively and a lower prevalence of smoking (OR, 0.65 (95%CI 0.53 to 0.80) and 0.58(95%CI 0.48 to 0.70) respectively. Conclusions Obesity and central obesity are highly prevalent in the general population in the Southern Cone of Latin America and are strongly associated with cardiovascular risk factor prevalence. These data suggest that efforts toward prevention, treatment, and control of obesity should be a public health priority in the Southern Cone of Latin America. PMID:27741247

  5. How Well Can We Control Dyslipidemias Through Lifestyle Modifications?

    PubMed

    Riccardi, Gabriele; Vaccaro, Olga; Costabile, Giuseppina; Rivellese, Angela A

    2016-07-01

    The role for lifestyle modifications to correct dyslipidemia(s) is reviewed. Dietary composition is crucial. Replacing saturated fat with MUFA or n-6 PUFA lowers plasma low-density lipoproteins (LDL) cholesterol and ameliorates the LDL/HDL ratio. Replacing saturated fat with carbohydrates has diverging effects due to the heterogeneity of carbohydrate foods. Diets rich in refined carbohydrates increase fasting and postprandial triglycerides, whereas the consumption of fiber-rich, low GI foods lowers LDL cholesterol with no detrimental effects on triglycerides. The role of polyphenols is debated: available evidence suggests a lowering effect of polyphenol-rich foods on postprandial triglycerides. As for functional foods, health claims on a cholesterol lowering effect of psyllium, beta-glucans and phytosterols are accepted by regulatory agencies. The importance of alcohol intake, weight reduction, and physical activity is discussed. In conclusion, there is evidence that lifestyle affects plasma lipid. A multifactorial approach including multiple changes with additive effects is the best option. This may also ensure feasibility and durability. The traditional Mediterranean way of life can represent a useful model.

  6. Cardiovascular risk and dyslipidemia management in HIV-infected patients.

    PubMed

    Stein, James H

    2012-01-01

    HIV infection and antiretroviral therapy each appear to increase cardiovascular disease risk. Increased risk may be attributable to the inflammatory effects of HIV infection and dyslipidemia associated with some antiretroviral agents. The prevalence of cardiovascular disease is increasing as patients live longer, age, and acquire traditional coronary heart disease (CHD) risk factors. In general, any additional cardiovascular risk posed by HIV infection or antiretroviral therapy is of potential concern for patients who are already at moderate or high risk for CHD. Long-term and well-designed studies are needed to more accurately ascertain to what degree HIV infection and antiretroviral therapy affect long-term cardiovascular disease risk. Management of dyslipidemia to reduce CHD risk in HIV-infected patients is much the same as in the general population, with the cornerstone consisting of statin therapy and lifestyle interventions. Smoking cessation is a major step in reducing CHD risk in those who smoke. This article summarizes a presentation by James H. Stein, MD, at the IAS-USA live continuing medical education activity held in New York City in March 2012.

  7. Pediatric obesity: Causes, symptoms, prevention and treatment

    PubMed Central

    XU, SHUMEI; XUE, YING

    2016-01-01

    Pediatric or childhood obesity is the most prevalent nutritional disorder among children and adolescents worldwide. Approximately 43 million individuals are obese, 21–24% children and adolescents are overweight, and 16–18% of individuals have abdominal obesity. The prevalence of obesity is highest among specific ethnic groups. Obesity increases the risk of heart diseases in children and adults. Childhood obesity predisposes the individual to insulin resistance and type 2 diabetes, hypertension, hyperlipidemia, liver and kidney diseases and causes reproductive dysfunction in adults. Obesity in children is a major health concern of the developed world. The National Health and Nutrition Examination Survey has reported that the prevalence of obesity is on the increase in all the pediatric age groups, in males and females, and in various ethnic and racial groups. Factors, such as eating habits, genetics, environment, metabolism, and lifestyle play an important role in the development of obesity. Over 90% of obesity cases are idiopathic and less than 10% are associated with genetic and hormonal causes. Obesity occurs when the body consumes more calories than it burns, through overeating and underexercising. The symptoms of obesity include breathing disorders, sleep apnea, chronic obstructive pulmonary disease, certain types of cancer such as prostate, bowel, breast and uterine, coronary heart disease, diabetes (type 2 in children), depression, liver and gallbladder problems, gastro-esophageal reflux disease, high blood pressure, high cholesterol, stroke, and joint diseases such as osteoarthritis, pain in knees and lower back. Environmental, behavioral such as consumption of convenience foods, genetic, and family factors contribute to pediatric obesity. Obesity can be countered through lower calorie consumption, weight loss and diet programs, as well as increased physical activity. A number of endogenous molecules including leptin, hypothalamic melanocortin 4 receptor

  8. The supplementation of Korean mistletoe water extracts reduces hot flushes, dyslipidemia, hepatic steatosis, and muscle loss in ovariectomized rats

    PubMed Central

    Kim, Min Jung; Park, Jong-Heum; Kwon, Dae Young; Yang, Hye Jeong; Kim, Da Sol; Kang, Suna; Shin, Bae Keun; Moon, Na Rang; Song, Beom-Seok; Kim, Jae-Hun

    2015-01-01

    Since Korean mistletoe (Viscum album) has been used for alleviating metabolic diseases, it may also prevent the impairment of energy, glucose, lipid, and bone metabolisms in an estrogen-deficient animal model. We determined that long-term consumption of Korean mistletoe water extract (KME) can alleviate menopausal symptoms such as hot flush, increased abdominal fat mass, dyslipidemia, hyperglycemia, and decreased bone mineral density in ovariectomized (OVX) rats fed a high-fat diet, and explored the mechanisms of the effects. OVX rats were divided into four groups and fed high-fat diets supplemented with either 0.6% dextrin (control), 0.2% lyophilized KME + 0.4% dextrin (KME-L), or 0.6% lyophilized KME (KME-H). Sham rats were fed with the high-fat diets with 0.6% dextrin as a normal-control without estrogen deficiency. After eight weeks, OVX rats exhibited impaired energy, glucose and lipid metabolism, and decreased uterine and bone masses. KME-L did not alleviate energy dysfunction. However, KME-H lowered serum levels of total-, LDL-cholesterol, and triglycerides and elevated serum HDL-cholesterol levels in OVX rats with dyslipidemia, to similar levels as normal-control rats. Furthermore, KME-H improved HOMA-IR, an indicator of insulin resistance, in OVX rats. Surprisingly, KME-H fed rats had greater lean mass in the abdomen and leg without differences in fat mass but neither dosage of KME altered bone mineral density in the lumbar spine and femur. The increased lean mass was related to greater phosphorylation of mTOR and eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1) in the quadriceps muscles. Hepatic triglyceride contents were lowered with KME-H in OVX rats by increasing carnitine palmitoyltransferase-1 (CPT-1) expression and decreasing fatty acid synthase (FAS) and sterol regulatory element-binding protein-1c (SREBP-1c) expression. In conclusion, KME may be useful for preventing some menopausal symptoms such as hot flushes, dyslipidemia

  9. Leaking mycotic abdominal aortic aneurysm.

    PubMed

    Sing, T M; Young, N; O'Rourke, I C; Tomlinson, P

    1994-11-01

    A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes. PMID:7993259

  10. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  11. Abdominal body composition differences in NFL football players.

    PubMed

    Bosch, Tyler A; Burruss, T Pepper; Weir, Nate L; Fielding, Kurt A; Engel, Bryan E; Weston, Todd D; Dengel, Donald R

    2014-12-01

    The purpose of this study was to examine visceral fat mass as well as other measures abdominal body composition in National Football League (NFL) players before the start of the season. Three hundred and seventy NFL football players were measured before the start of the season using dual-energy x-ray absorptiometry. Regional fat and lean mass was measured for each player. Players were categorized into 3 groups based on positions that mirror each other: linemen; linebackers/tight ends/running backs and wide receivers/defensive backs. Significant differences were observed between the position groups for both lean and fat regional measurements. However, the magnitude of difference was much greater for fat measures than lean measures. Additionally, a threshold was observed (∼114 kg) at which there is a greater increase in fat accumulation than lean mass accumulation. The increase in fat accumulation is distributed to the abdominal region where thresholds were observed for subcutaneous abdominal fat accumulation (12.1% body fat) and visceral abdominal fat accumulation (20.1% body fat), which likely explains the regional fat differences between groups. The results of this study suggest that as players get larger, there is more total fat than total lean mass accumulation and more fat is distributed to the abdominal region. This is of importance as increased fat mass may be detrimental to performance at certain positions. The thresholds observed for increased abdominal fat accumulation should be monitored closely given recent research observed that abdominal obesity predicts lower extremity injury risk and visceral adipose tissue's established association with cardiometabolic risk.

  12. Effects of different types of contraction in abdominal bracing on the asymmetry of left and right abdominal muscles.

    PubMed

    Park, Sung-Hyun; Song, Min-Young; Park, Hyeon-Ji; Park, Ji-Hyun; Bae, Hyun-Young; Lim, Da-Som

    2014-12-01

    [Purpose] The purpose of this study was to investigate the effective strength levels of abdominal muscle contraction using the bracing contraction method. [Subjects] The experiment was conducted with 31 healthy male (M=15) and female (F=16) adults attending D University in Busan; all participants had less than obesity level BMI (BMI<30). [Methods] Bracing contraction was performed by the subjects in the hook-lying position at maximum and minimum pressure levels, five times each, using a Pressure Biofeedback Unit (PBU), and the mean measurement value was calculated. The maximum pressure level was set at 100% and the half maximum pressure level was set at 50%. Each subject's left and right abdominal muscle thicknesses were then measured by ultrasound imaging in each state: at rest, 100% contraction, and 50% contraction. [Results] No significant differences were found between the left and right sides of the transversus abdominis (TrA) at rest, 50%, or 100% contraction. The external oblique abdominis (EO) and internal oblique abdominis (IO) showed no significant difference at rest or at the 50% contraction. However, a significant difference was noted at 100% contraction for the EO and IO. [Conclusion] Application of abdominal contraction using bracing can achieve symmetry in the left and right abdominal muscles at less than the maximum contractile strength. The occurrence of asymmetry in the left and right abdominal muscles at the maximum contractile strength suggests that the most suitable contractile strength in this exercise is less than the maximum contractile strength. PMID:25540478

  13. Obesity vaccines.

    PubMed

    Monteiro, Mariana P

    2014-01-01

    Obesity is one of the largest and fastest growing public health problems in the world. Last century social changes have set an obesogenic milieu that calls for micro and macro environment interventions for disease prevention, while treatment is mandatory for individuals already obese. The cornerstone of overweight and obesity treatment is diet and physical exercise. However, many patients find lifestyle modifications difficult to comply and prone to failure in the long-term; therefore many patients consider anti-obesity drugs an important adjuvant if not a better alternative to behavioral approach or obesity surgery. Since the pharmacological options for obesity treatment remain quite limited, this is an exciting research area, with new treatment targets and strategies on the horizon. This review discusses the development of innovative therapeutic agents, focusing in energy homeostasis regulation and the use of molecular vaccines, targeting hormones such as somatostatin, GIP and ghrelin, to reduce body weight.

  14. Obesity, growth hormone and exercise.

    PubMed

    Thomas, Gwendolyn A; Kraemer, William J; Comstock, Brett A; Dunn-Lewis, Courtenay; Maresh, Carl M; Volek, Jeff S

    2013-09-01

    Growth hormone (GH) is regulated, suppressed and stimulated by numerous physiological stimuli. However, it is believed that obesity disrupts the physiological and pathological factors that regulate, suppress or stimulate GH release. Pulsatile GH has been potently stimulated in healthy subjects by both aerobic and resistance exercise of the right intensity and duration. GH modulates fuel metabolism, reduces total fat mass and abdominal fat mass, and could be a potent stimulus of lipolysis when administered to obese individuals exogenously. Only pulsatile GH has been shown to augment adipose tissue lipolysis and, therefore, increasing pulsatile GH response may be a therapeutic target. This review discusses the factors that cause secretion of GH, how obesity may alter GH secretion and how both aerobic and resistance exercise stimulates GH, as well as how exercise of a specific intensity may be used as a stimulus for GH release in individuals who are obese. Only five prior studies have investigated exercise as a stimulus of endogenous GH in individuals who are obese. Based on prior literature, resistance exercise may provide a therapeutic target for releasing endogenous GH in individuals who are obese if specific exercise programme variables are utilized. Biological activity of GH indicates that this may be an important precursor to beneficial changes in body fat and lean tissue mass in obese individuals. However, additional research is needed including what molecular GH variants are acutely released and involved at target tissues as a result of different exercise stimuli and what specific exercise programme variables may serve to stimulate GH in individuals who are obese.

  15. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  16. Glucose transporter-8 (GLUT8) mediates glucose intolerance and dyslipidemia in high-fructose diet-fed male mice.

    PubMed

    DeBosch, Brian J; Chen, Zhouji; Finck, Brian N; Chi, Maggie; Moley, Kelle H

    2013-11-01

    Members of the glucose transporter (GLUT) family of membrane-spanning hexose transporters are subjects of intensive investigation for their potential as modifiable targets to treat or prevent obesity, metabolic syndrome, and type 2 diabetes mellitus. Mounting evidence suggests that the ubiquitously expressed class III dual-specificity glucose and fructose transporter, GLUT8, has important metabolic homeostatic functions. We therefore tested the hypothesis that GLUT8 mediates the deleterious metabolic effects of chronic high-fructose diet exposure. Here we demonstrate resistance to high-fructose diet-induced glucose intolerance and dyslipidemia concomitant with enhanced oxygen consumption and thermogenesis in GLUT8-deficient male mice. Independent of diet, significantly lower systolic blood pressure both at baseline and after high-fructose diet feeding was also observed by tail-cuff plethysmography in GLUT8-deficient mice vs wild-type controls. Resistance to fructose-induced metabolic dysregulation occurred in the context of enhanced hepatic peroxisome proliferator antigen receptor-γ (PPARγ) protein abundance, whereas in vivo hepatic adenoviral GLUT8 overexpression suppressed hepatic PPARγ expression. Taken together, these findings suggest that GLUT8 blockade prevents fructose-induced metabolic dysregulation, potentially by enhancing hepatic fatty acid metabolism through PPARγ and its downstream targets. We thus establish GLUT8 as a promising target in the prevention of diet-induced obesity, metabolic syndrome, and type 2 diabetes mellitus in males.

  17. Acetyl-CoA carboxylase inhibition by ND-630 reduces hepatic steatosis, improves insulin sensitivity, and modulates dyslipidemia in rats

    PubMed Central

    Harriman, Geraldine; Greenwood, Jeremy; Bhat, Sathesh; Huang, Xinyi; Wang, Ruiying; Paul, Debamita; Tong, Liang; Saha, Asish K.; Westlin, William F.; Kapeller, Rosana; Harwood, H. James

    2016-01-01

    Simultaneous inhibition of the acetyl-CoA carboxylase (ACC) isozymes ACC1 and ACC2 results in concomitant inhibition of fatty acid synthesis and stimulation of fatty acid oxidation and may favorably affect the morbidity and mortality associated with obesity, diabetes, and fatty liver disease. Using structure-based drug design, we have identified a series of potent allosteric protein–protein interaction inhibitors, exemplified by ND-630, that interact within the ACC phosphopeptide acceptor and dimerization site to prevent dimerization and inhibit the enzymatic activity of both ACC isozymes, reduce fatty acid synthesis and stimulate fatty acid oxidation in cultured cells and in animals, and exhibit favorable drug-like properties. When administered chronically to rats with diet-induced obesity, ND-630 reduces hepatic steatosis, improves insulin sensitivity, reduces weight gain without affecting food intake, and favorably affects dyslipidemia. When administered chronically to Zucker diabetic fatty rats, ND-630 reduces hepatic steatosis, improves glucose-stimulated insulin secretion, and reduces hemoglobin A1c (0.9% reduction). Together, these data suggest that ACC inhibition by representatives of this series may be useful in treating a variety of metabolic disorders, including metabolic syndrome, type 2 diabetes mellitus, and fatty liver disease. PMID:26976583

  18. Exercise in aging: its important role in mortality, obesity and insulin resistance

    PubMed Central

    Ryan, Alice S

    2011-01-01

    The prevalence of overweight and obesity has increased dramatically over the last several decades. Obesity and physical inactivity increase the risk for cardiovascular disease, Type 2 diabetes mellitus, hypertension, dyslipidemia and certain cancers. Obesity and low levels of physical fitness are also associated with increased risk of all-cause and cardiovascular mortality. Central and total obesity, insulin resistance and inactivity increase with age. Exercise training and increased fitness promote positive changes in body composition and improve insulin sensitivity. This article will describe the effects of exercise training, both aerobic and resistive, on body composition and obesity as well as review studies investigating the effects of exercise training on glucose metabolism and insulin sensitivity in older adults. Adopting a physically active lifestyle should be emphasized in overweight and obese individuals with insulin resistance to reduce the risk for cardiovascular events in the aging population. PMID:21359160

  19. The Role of Psychobiological and Neuroendocrine Mechanisms in Appetite Regulation and Obesity

    PubMed Central

    Paspala, Ioanna; Katsiki, Niki; Kapoukranidou, Dorothea; Mikhailidis, Dimitri P; Tsiligiroglou-Fachantidou, Anna

    2012-01-01

    Obesity is a multifactorial disease. Among its causes are physical inactivity and overeating. In addition, other factors may play an important role in the development of overweight/obesity. For example, certain hormones including leptin, insulin and ghrelin, may influence appetite and consequently body weight. Obesity frequently co-exists with metabolic disorders including dyslipidemia, hypertension and insulin resistance, thus constituting the metabolic syndrome which is characterized by increased cardiovascular risk. Lack of comprehensive knowledge on obesity-related issues makes both prevention and treatment difficult. This review considers the psychobiological and neuroendocrine mechanisms of appetite and food intake. Whether these factors, in terms of obesity prevention and treatment, will prove to be relevant in clinical practice (including reducing the cardiovas-cular risk associated with obesity) remains to be established. PMID:23346258

  20. Oxidized LDL receptor 1 (OLR1) as a possible link between obesity, dyslipidemia and cancer.

    PubMed

    Khaidakov, Magomed; Mitra, Sona; Kang, Bum-Yong; Wang, Xianwei; Kadlubar, Susan; Novelli, Giuseppe; Raj, Vinay; Winters, Maria; Carter, Weleetka C; Mehta, Jawahar L

    2011-01-01

    Recent studies have linked expression of lectin-like ox-LDL receptor 1 (OLR1) to tumorigenesis. We analyzed microarray data from Olr1 knockout (KO) and wild type (WT) mice for genes involved in cellular transformation and evaluated effects of OLR1 over-expression in normal mammary epithelial cells (MCF10A) and breast cancer cells (HCC1143) in terms of gene expression, migration, adhesion and transendothelial migration. Twenty-six out of 238 genes were inhibited in tissues of OLR1 KO mice; the vast majority of OLR1 sensitive genes contained NF-κB binding sites in their promoters. Further studies revealed broad inhibition of NF-kB target genes outside of the transformation-associated gene pool, with enrichment themes of defense response, immune response, apoptosis, proliferation, and wound healing. Transcriptome of Olr1 KO mice also revealed inhibition of de novo lipogenesis, rate-limiting enzymes fatty acid synthase (Fasn), stearoyl-CoA desaturase (Scd1) and ELOVL family member 6 (Elovl6), as well as lipolytic phospholipase A2 group IVB (Pla2g4b). In studies comparing MCF10A and HCC1143, the latter displayed 60% higher OLR1 expression. Forced over-expression of OLR1 resulted in upregulation of NF-κB (p65) and its target pro-oncogenes involved in inhibition of apoptosis (BCL2, BCL2A1, TNFAIP3) and regulation of cell cycle (CCND2) in both cell lines. Basal expression of FASN, SCD1 and PLA2G4B, as well as lipogenesis transcription factors PPARA, SREBF2 and CREM, was higher in HCC1143 cells. Over-expression of OLR1 in HCC1143 cells also enhanced cell migration, without affecting their adherence to TNFα-activated endothelium or transendothelial migration. On the other hand, OLR1 neutralizing antibody inhibited both adhesion and transmigration of untreated HCC1143 cells. We conclude that OLR1 may act as an oncogene by activation of NF-kB target genes responsible for proliferation, migration and inhibition of apoptosis and de novo lipogenesis genes.

  1. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  2. Cardiovascular Risk Factors in Obese Children and Adolescents.

    PubMed

    Rumińska, Małgorzata; Majcher, Anna; Pyrzak, Beata; Czerwonogrodzka-Senczyna, Aneta; Brzewski, Michał; Demkow, Urszula

    2016-01-01

    The aim of the study was to analyze cardiometabolic risk factors andcarotid intima-media thickness (IMT) in obese children. We studied 122 obese children fulfilling the criteria of the International Obesity Task Force and 58 non-obese children. Anthropometric parameters, blood pressure, lipid profile, C-reactive protein, and adiponectin were assessed in all children. Glucose and insulin during the oral glucose tolerance test were assessed in obese children. The IMT was determined using ultrasound B-mode imaging in 81 obese and 32 non-obese children. We found that obese children had significantly higher levels of lipid andother non-lipid atherogenic indicators, but lower levels of adiponectin compared with non-obese children. The difference in the mean carotid IMT was insignificant in the two groups. Taking the combined groups, the level of adiponectin correlated negatively with body mass index and lipid atherogenic indicators. The IMT strongly correlated with systolic blood pressure in obese children. In the children fulfilling the criteria of metabolic syndrome, 17 out of the 84 obese children older than 10 years of age, IMT was greater than in those who did not fulfil these criteria. We conclude that the coexistence of abdominal obesity with abnormal lipid profile and hypertension leads to the early development of atherosclerosis accompanied by increased carotid intima-media thickness. Obesity initiates the atherosclerotic processes in early childhood. PMID:26453070

  3. [The abdominal drop flap].

    PubMed

    Bodin, F; Liverneaux, P; Seigle-Murandi, F; Facca, S; Bruant-Rodier, C; Dissaux, C; Chaput, B

    2015-08-01

    The skin between the mastectomy scar and the future infra-mammary fold may be managed in different ways in delayed breast reconstruction using a DIEP (deep inferior epigastric perforator). Conserving this skin and positioning the flap skin paddle in the middle of the breast usually highlights skin color disparity because of two visible transition zones. Resection of the entire skin under the scar may be more aesthetic but limits direct closure possibility in case of flap failure. In order to benefit from both aesthetic result and safe surgical method, we propose the abdominal drop flap. The inferior thoracic skin flap is detached from the thoracic wall beyond the future infra-mammary fold, preserved and pushed under the breast.

  4. Obesity in CKD--what should nephrologists know?

    PubMed

    Stenvinkel, Peter; Zoccali, Carmine; Ikizler, T Alp

    2013-11-01

    Obesity, the epidemic of the 21st century, carries a markedly increased risk for comorbid complications, such as type 2 diabetes, cancer, hypertension, dyslipidemia, cardiovascular disease, and sleep apnea. In addition, obesity increases the risk for CKD and its progression to ESRD. Paradoxically, even morbid obesity associates with better outcomes in studies of ESRD patients on maintenance dialysis. Because the number of obese CKD and maintenance dialysis patients is projected to increase markedly in developed as well as low- and middle-income countries, obesity is a rapidly emerging problem for the international renal community. Targeting the obesity epidemic represents an unprecedented opportunity for health officials to ameliorate the current worldwide increase in CKD prevalence. Nephrologists need more information about assessing and managing obesity in the setting of CKD. Specifically, more precise estimation of regional fat distribution and the amount of muscle mass should be introduced into regular clinical practice to complement more commonly used practical markers, such as body mass index. Studies examining the effects of obesity on kidney disease progression and other clinical outcomes along with weight management strategies are much needed in this orphan area of research.

  5. Obesity in CKD—What Should Nephrologists Know?

    PubMed Central

    Zoccali, Carmine; Ikizler, T. Alp

    2013-01-01

    Obesity, the epidemic of the 21st century, carries a markedly increased risk for comorbid complications, such as type 2 diabetes, cancer, hypertension, dyslipidemia, cardiovascular disease, and sleep apnea. In addition, obesity increases the risk for CKD and its progression to ESRD. Paradoxically, even morbid obesity associates with better outcomes in studies of ESRD patients on maintenance dialysis. Because the number of obese CKD and maintenance dialysis patients is projected to increase markedly in developed as well as low- and middle-income countries, obesity is a rapidly emerging problem for the international renal community. Targeting the obesity epidemic represents an unprecedented opportunity for health officials to ameliorate the current worldwide increase in CKD prevalence. Nephrologists need more information about assessing and managing obesity in the setting of CKD. Specifically, more precise estimation of regional fat distribution and the amount of muscle mass should be introduced into regular clinical practice to complement more commonly used practical markers, such as body mass index. Studies examining the effects of obesity on kidney disease progression and other clinical outcomes along with weight management strategies are much needed in this orphan area of research. PMID:24115475

  6. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms.

    PubMed

    Hall, John E; do Carmo, Jussara M; da Silva, Alexandre A; Wang, Zhen; Hall, Michael E

    2015-03-13

    Excess weight gain, especially when associated with increased visceral adiposity, is a major cause of hypertension, accounting for 65% to 75% of the risk for human primary (essential) hypertension. Increased renal tubular sodium reabsorption impairs pressure natriuresis and plays an important role in initiating obesity hypertension. The mediators of abnormal kidney function and increased blood pressure during development of obesity hypertension include (1) physical compression of the kidneys by fat in and around the kidneys, (2) activation of the renin-angiotensin-aldosterone system, and (3) increased sympathetic nervous system activity. Activation of the renin-angiotensin-aldosterone system is likely due, in part, to renal compression, as well as sympathetic nervous system activation. However, obesity also causes mineralocorticoid receptor activation independent of aldosterone or angiotensin II. The mechanisms for sympathetic nervous system activation in obesity have not been fully elucidated but may require leptin and activation of the brain melanocortin system. With prolonged obesity and development of target organ injury, especially renal injury, obesity-associated hypertension becomes more difficult to control, often requiring multiple antihypertensive drugs and treatment of other risk factors, including dyslipidemia, insulin resistance and diabetes mellitus, and inflammation. Unless effective antiobesity drugs are developed, the effect of obesity on hypertension and related cardiovascular, renal and metabolic disorders is likely to become even more important in the future as the prevalence of obesity continues to increase.

  7. MACRONUTRIENT INTAKE IS CORRELATED WITH DYSLIPIDEMIA AND LOW-GRADE INFLAMMATION IN CHILDHOOD OBESITY BUT MOSTLY IN MALE OBESE.

    PubMed

    Antunes, Barbara de Moura Mello; Monteiro, Paula Alves; Silveira, Loreana Sanches; Brunholi, Claudia de Carvalho; Lira, Fábio Santos; Freitas Júnior, Ismael Forte

    2015-09-01

    Introducción y objetivo: la hipoxia causada por la hipertrofia de las células adiposas en la obesidad desencadena macrófagos de reclutamiento y la producción de citoquinas. Además, el alto consumo de ácidos grasos saturados (AGS) y las comidas con alto índice glucémico pueden contribuir al estrés oxidativo y la inflamación crónica de bajo grado por los aumentos de activación de NF-kB. Por lo tanto, el objetivo del estudio fue analizar la contribución de la ingesta de macronutrientes en el perfil metabólico e inflamatorio, por niveles de lipoproteínas, resistencia a la insulina, citoquinas anti y pro inflamatorias, en adolescentes obesos según el género. Métodos: la muestra estaba compuesta por 37 adolescentes, de ambos géneros, identificados como obesos según el índice de masa corporal (IMC). La composición corporal se evaluó mediante absorciometría de energía dual de rayos X (DEXA) y medidas de adiposidad intraabdominal (IAAT) y del tejido adiposo subcutáneo (SAT) se realizaron mediante ecografía. Los análisis bioquímicos se realizaron mediante la medición de citoquinas; los ácidos grasos y la insulina se realizaron por la técnica de ELISA. La estimación del consumo de macronutrientes fue llevado a cabo durante tres días mediante el registro de alimentos con respecto a la ingesta total. La significación estadística se estableció en el valor p.

  8. Evidence in Obese Children: Contribution of Hyperlipidemia, Obesity-Inflammation, and Insulin Sensitivity

    PubMed Central

    Chang, Chi-Jen; Jian, Deng-Yuan; Lin, Ming-Wei; Zhao, Jun-Zhi; Ho, Low-Tone; Juan, Chi-Chang

    2015-01-01

    Background Evidence shows a high incidence of insulin resistance, inflammation and dyslipidemia in adult obesity. The aim of this study was to assess the relevance of inflammatory markers, circulating lipids, and insulin sensitivity in overweight/obese children. Methods We enrolled 45 male children (aged 6 to 13 years, lean control = 16, obese = 19, overweight = 10) in this study. The plasma total cholesterol, HDL cholesterol, triglyceride, glucose and insulin levels, the circulating levels of inflammatory factors, such as TNF-α, IL-6, and MCP-1, and the high-sensitive CRP level were determined using quantitative colorimetric sandwich ELISA kits. Results Compared with the lean control subjects, the obese subjects had obvious insulin resistance, abnormal lipid profiles, and low-grade inflammation. The overweight subjects only exhibited significant insulin resistance and low-grade inflammation. Both TNF-α and leptin levels were higher in the overweight/obese subjects. A concurrent correlation analysis showed that body mass index (BMI) percentile and fasting insulin were positively correlated with insulin resistance, lipid profiles, and inflammatory markers but negatively correlated with adiponectin. A factor analysis identified three domains that explained 74.08% of the total variance among the obese children (factor 1: lipid, 46.05%; factor 2: obesity-inflammation, 15.38%; factor 3: insulin sensitivity domains, 12.65%). Conclusions Our findings suggest that lipid, obesity-inflammation, and insulin sensitivity domains predominantly exist among obese children. These factors might be applied to predict the outcomes of cardiovascular diseases in the future. PMID:26011530

  9. [Fifth Jesús Culebras Lecture; Tree nuts: effects on health, obesity and metabolic syndrome].

    PubMed

    Salas-Salvadó, Jordi

    2014-11-30

    Several epidemiological studies have shown that consumption of tree nuts is associated with lower cardiovascular risk, specific cause of mortality and total mortality. Clinical feeding trials have demonstrated that tree nuts protect from cardiovascular disease risk through different mechanisms: regulating inflammatory processes, oxidative stress and endothelial function, thereby improving various cardiovascular risk factors. In the context of meals high in carbohydrates, tree nuts reduce the postprandial glucose peaks, improving insulin resistance. Frequent consumption of nuts has been associated with a lower risk of diabetes in women, but the effect was not yet elucidated in men. Although tree nuts are energetically dense and they are high in fat, nut consumption does not imply appreciable weight gain nor has been associated with a higher risk of abdominal obesity. Tree nut consumption reduces LDL cholesterol levels, but its effects on atherogenic dyslipidemia associated to metabolic syndrome (MetS) are less clear. The effect of consumption of nuts on LDL cholesterol in subjects with MetS neither has been well established, but it seems that in these patients could lower plasma triglyceride levels. Some studies suggest an inverse association between tree nut consumption and blood pressure or endothelial function, especially in non-diabetic individuals. Nut consumption was inversely related to the prevalence and incidence of MetS. Including tree nuts in the context of a healthy dietary pattern way increase the health benefits. It has been observed a lower prevalence of MetS and a lower incidence of diabetes in people who adhered to a Mediterranean diet supplemented with nuts. Future nutrition intervention studies are needed on large samples of subjects and long follow-up to affirm that tree nut consumption has beneficial effects on the prevention and treatment of MetS.

  10. Socio-Urban Spatial Patterns Associated with Dyslipidemia among Schoolchildren in the City of San Luis Potosi, Mexico.

    PubMed

    Aradillas-García, Celia; Palos-Lucio, Gabriela; Padrón-Salas, Aldanely

    2016-02-01

    The places where a child lives and attends to school are both major environmental and social determinants of its present and future health status. Noncommunicable diseases (NCDs) and some of their risk factors among child and adolescent populations are obesity and dyslipidemia, so finding the patterns of distribution of these risk factors by gender, type of school, area, and margination level is important to do health intervention focusing in their necessities to prevent diseases at younger ages. Because of that, a cross-sectional study was performed among elementary and junior high school students from public and private schools in six of the seven areas of the metropolitan zone of San Luis Potosi, Mexico. Biochemical dyslipidemia indicators (triglycerides, total cholesterol, and high-density lipoprotein) and anthropometric data (weight and height) were obtained. Seventeen public schools and five private schools with a total of 383 students were included. More than half of the studied population (53.0%) had elevated triglyceride levels. A total of 330 students (86.2%) had normal levels of total cholesterol with a mean value of 141.7 mg/dl, and 202 schoolchildren (52.8%) had lower than acceptable levels of high-density lipoprotein (HDL) with a mean value of 43.9 mg/dl. There were differences in the levels of high-density protein between the areas and the type of school where they had been studied. Finally, a total of 150 students (39.4%) had at least one altered lipid value and 103 participants (26.9%) had two altered values. Several students, despite their young age, showed a high prevalence of risk factors, so it is important to design programs according to their necessities.

  11. Lipid profile and high-sensitivity C-reactive protein levels in obese and non-obese subjects undergoing non-surgical periodontal therapy.

    PubMed

    Zuza, Elizangela P; Barroso, Eliane M; Fabricio, Mariana; Carrareto, Ana Luiza V; Toledo, Benedicto E C; R Pires, Juliana

    2016-01-01

    Periodontal treatment may improve the metabolic control of dyslipidemia. The aim of this study was to evaluate the lipid profile and high-sensitivity C-reactive protein (hs-CRP) levels in obese and non-obese patients undergoing periodontal therapy. Patients with generalized chronic periodontitis were divided into obese (n = 28) and non-obese groups (n = 26). The periodontal parameters (visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing), anthropometric measurements (body mass index, waist circumference, and body fat), and serum analyses (triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, fasting glucose, glycated hemoglobin, and hs-CRP) were measured at baseline and 90 days after periodontal treatment. The results showed that the obese subjects presented alterations in triglycerides, total cholesterol, low-density lipoprotein, and hs-CRP at baseline when compared with non-obese patients (P < 0.05). Periodontal treatment could improve the periodontal parameters in both groups similarly (P > 0.05). Obese subjects showed a significant decrease in the levels of triglycerides, total cholesterol, low-density lipoprotein, and hs-CRP post-therapy (P < 0.05), while non-obese patients showed improvement only in hs-CRP (P < 0.05). In conclusion, periodontal treatment could improve the periodontal parameters and circulating hs-CRP in obese and non-obese subjects. Lipid profile was modified only in obese patients post-therapy. (J Oral Sci 58, 423-430, 2016). PMID:27665983

  12. [Therapeutic Strategies. Cardiovascular risk and dyslipidemia in elderly and women].

    PubMed

    Morales, Clotilde; Royuela, Meritxell

    2013-01-01

    The management of cardiovascular risk and dyslipidemia are justified in guidelines. In the elderly, when they are in primary prevention, recommendations are controversial, even if there is evidence in reducing morbidity. In secondary prevention, between 65 and 85 years, there is enough evidence to recommend statins. The decision to start or to continue further treatment must be complemented by comprehensive assessment of the risk-benefit factor. In elderly patients we have to support in decision-making, we take clinical judgment and not just the age criteria. In women the risk is underestimated and may be untreated. The recomendations are the same as in men. During pregnancy there are particular recommendations. PMID:23786854

  13. Dyslipidemia and its association with meibomian gland dysfunction.

    PubMed

    Braich, Puneet S; Howard, Mary K; Singh, Jorawer S

    2016-08-01

    Abnormal serum lipid levels significantly increase the risk for cardiovascular disease. Furthermore, abnormal compositions of cholesterol in glandular secretions have been hypothesized as an etiology for meibomian gland dysfunction, yet this relationship has not been well studied in clinical settings. The primary purpose of this study was to determine if there is an association between dyslipidemia and meibomian gland dysfunction (MGD). The secondary purpose was to identify the factors, if any, that play a role in this association. A case-control study was performed between October 2013 and February 2015 which recruited 109 patients with MGD and 115 control patients without MGD. All participants were of Indian descent and had no history of dyslipidemia. Basic demographic information was collected as well as fasting levels of serum glucose, creatinine, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). To calculate differences between groups, Z test or Student t test were used. A stepwise logistic regression model was used to calculate the estimates of odds ratios (ORs), where MGD was the dependent variable, making the independent variables consist of sex, age, body mass index (BMI), triglycerides ≥150 mg/dL, total cholesterol ≥200 mg/dL, LDL ≥130 mg/dL, or HDL ≤40 mg/dL, serum glucose, and serum creatinine. Dyslipidemia, defined by either a fasting total cholesterol level of ≥ 200 mg/dL, triglycerides ≥150 mg/dL, LDL ≥130 mg/dL, or HDL ≤40 mg/dL, was detected in 70 cases (64 %) and 21 controls (18 %), P < 0.001. Mean levels of triglycerides, total cholesterol, LDL, and HDL were 98.5 ± 42.1, 203.1 ± 13.2, 126.1 ± 10.2, and 53.3 ± 4.2 mg/dL, respectively, in cases and 82.3 ± 36.5, 156.6 ± 14.5, 92.2 ± 12.4, 45.8 ± 2.6 mg/dL, respectively, in controls. All differences were statistically significant (P < 0.05). MGD was significantly associated with age >65

  14. [Clinical practice guideline. Diagnosis and treatment of dyslipidemia.

    PubMed

    Canalizo-Miranda, Elvia; Favela-Pérez, Eddie Alberto; Salas-Anaya, Javier Alejandro; Gómez-Díaz, Rita; Jara-Espino, Ricardo; Del Pilar Torres-Arreola, Laura; Viniegra-Osorio, Arturo

    2013-01-01

    Non-communicable diseases are a public health problem in México. Coronary heart disease and diabetes mellitus are the first and second cause of death in the country, followed by thrombotic cerebrovascular events. Cardiovascular diseases are the leading cause of death; one primary risk factor is hypercholesterolemia. The detection and treatment of lipid abnormalities is the key to the prevention and management of chronic non-communicable diseases. Two nationally representative surveys have shown that lipid abnormalities are the most common risk factors in Mexican adults. The purpose of this guide is to provide a basis for identifying dyslipidemia in a timely manner, and to systematize the criteria for diagnosis and treatment in the first and second level of care.

  15. Dyslipidemia and its association with meibomian gland dysfunction.

    PubMed

    Braich, Puneet S; Howard, Mary K; Singh, Jorawer S

    2016-08-01

    Abnormal serum lipid levels significantly increase the risk for cardiovascular disease. Furthermore, abnormal compositions of cholesterol in glandular secretions have been hypothesized as an etiology for meibomian gland dysfunction, yet this relationship has not been well studied in clinical settings. The primary purpose of this study was to determine if there is an association between dyslipidemia and meibomian gland dysfunction (MGD). The secondary purpose was to identify the factors, if any, that play a role in this association. A case-control study was performed between October 2013 and February 2015 which recruited 109 patients with MGD and 115 control patients without MGD. All participants were of Indian descent and had no history of dyslipidemia. Basic demographic information was collected as well as fasting levels of serum glucose, creatinine, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). To calculate differences between groups, Z test or Student t test were used. A stepwise logistic regression model was used to calculate the estimates of odds ratios (ORs), where MGD was the dependent variable, making the independent variables consist of sex, age, body mass index (BMI), triglycerides ≥150 mg/dL, total cholesterol ≥200 mg/dL, LDL ≥130 mg/dL, or HDL ≤40 mg/dL, serum glucose, and serum creatinine. Dyslipidemia, defined by either a fasting total cholesterol level of ≥ 200 mg/dL, triglycerides ≥150 mg/dL, LDL ≥130 mg/dL, or HDL ≤40 mg/dL, was detected in 70 cases (64 %) and 21 controls (18 %), P < 0.001. Mean levels of triglycerides, total cholesterol, LDL, and HDL were 98.5 ± 42.1, 203.1 ± 13.2, 126.1 ± 10.2, and 53.3 ± 4.2 mg/dL, respectively, in cases and 82.3 ± 36.5, 156.6 ± 14.5, 92.2 ± 12.4, 45.8 ± 2.6 mg/dL, respectively, in controls. All differences were statistically significant (P < 0.05). MGD was significantly associated with age >65

  16. [Clinical practice guideline. Diagnosis and treatment of dyslipidemia.

    PubMed

    Canalizo-Miranda, Elvia; Favela-Pérez, Eddie Alberto; Salas-Anaya, Javier Alejandro; Gómez-Díaz, Rita; Jara-Espino, Ricardo; Del Pilar Torres-Arreola, Laura; Viniegra-Osorio, Arturo

    2013-01-01

    Non-communicable diseases are a public health problem in México. Coronary heart disease and diabetes mellitus are the first and second cause of death in the country, followed by thrombotic cerebrovascular events. Cardiovascular diseases are the leading cause of death; one primary risk factor is hypercholesterolemia. The detection and treatment of lipid abnormalities is the key to the prevention and management of chronic non-communicable diseases. Two nationally representative surveys have shown that lipid abnormalities are the most common risk factors in Mexican adults. The purpose of this guide is to provide a basis for identifying dyslipidemia in a timely manner, and to systematize the criteria for diagnosis and treatment in the first and second level of care. PMID:24290026

  17. Childhood obesity.

    PubMed

    Strauss, R

    1999-01-01

    Approximately 10% of children are obese. Twin and adoption studies demonstrate a large genetic component to obesity, especially in adults. However, the increasing prevalence of obesity over the last 20 years can only be explained by environmental factors. In most obese individuals, no measurable differences in metabolism can be detected. Few children engage in regular physical activity. Obese children and adults uniformly underreport the amount of food they eat. Obesity is particularly related to increased consumption of high-fat foods. BMI is a quick and easy way to screen for childhood obesity. Treating childhood obesity relies on positive family support and lifestyle changes involving the whole family. Food preferences are influenced early by parental eating habits, and when developed in childhood, they tend to remain fairly constant into adulthood. Children learn to be active or inactive from their parents. In addition, physical activity (or more commonly, physical inactivity) habits that are established in childhood tend to persist into adulthood. Weight loss is usually followed by changes in appetite and metabolism, predisposing individuals to regain their weight. However, when the right family dynamics exist--a motivated child with supportive parents--long-term success is possible.

  18. Development of Job Standards for Clinical Nutrition Therapy for Dyslipidemia Patients

    PubMed Central

    Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A

    2015-01-01

    Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals. PMID:25954728

  19. Medications not intended for treatment of dyslipidemias and with a variable effect on lipids.

    PubMed

    Whayne, Thomas F; Mukherjee, Debabrata

    2014-01-01

    Many therapeutically active medications have significant side effects, some of which can compromise the intended therapeutic goal. The development of plasma lipid abnormalities or a dyslipidemia as the result of a medication intended for an unrelated effect has been reported. Human immunodeficiency virus (HIV) infection can cause dyslipidemia as can the medications used to treat this infection. Such dyslipidemia can be a significant problem made more relevant by the already increased risk of cardiovascular (CV) disease faced by these patients. Some hypoglycemic medications used to treat diabetes can also be associated with dyslipidemia, most notably rosiglitazone. Antihypertensive medications are intended to decrease CV risk but are not free of dyslipidemia problems with thiazides able to cause hypertriglyceridemia and older beta-blockers without an alpha-blocking effect associated with moderate plasma lipid abnormalities and altered glucose metabolism. Estrogen administered orally can be associated with a severe hypertriglyceridemia. Currently-used antipsychotic medications have a significant association with hypertriglyceridemia. Clinicians must be aware of the dyslipidemias caused by these medications and know how to manage them, even treating a secondary dyslipidemia with another medication as in the case of HIV infection rather than trying to switch treatment of the infection in many cases. Mention is also made of lipid lowering effects of medications intended for other purposes (e.g. angiotensin receptor blockers and orlistat).

  20. Development of job standards for clinical nutrition therapy for dyslipidemia patients.

    PubMed

    Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A; Sohn, Cheong-Min

    2015-04-01

    Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.

  1. Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce cardiovascular risk.

    PubMed

    Chapman, M John; Redfern, Jan S; McGovern, Mark E; Giral, Philippe

    2010-06-01

    Although statin therapy represents a cornerstone of cardiovascular disease (CVD) prevention, a major residual CVD risk (60-70% of total relative risk) remains, attributable to both modifiable and non-modifiable risk factors. Among the former, low levels of HDL-C together with elevated triglyceride (TG)-rich lipoproteins and their remnants represent major therapeutic targets. The current pandemic of obesity, metabolic syndrome, and type 2 diabetes is intimately associated with an atherogenic dyslipidemic phenotype featuring low HDL-C combined with elevated TG-rich lipoproteins and small dense LDL. In this context, there is renewed interest in pharmacotherapeutic strategies involving niacin and fibrates in monotherapy and in association with statins. This comprehensive, critical review of available data in dyslipidemic subjects indicates that niacin is more efficacious in raising HDL-C than fibrates, whereas niacin and fibrates reduce TG-rich lipoproteins and LDL comparably. Niacin is distinguished by its unique capacity to effectively lower Lp(a) levels. Several studies have demonstrated anti-atherosclerotic action for both niacin and fibrates. In contrast with statin therapy, the clinical benefit of fibrates appears limited to reduction of nonfatal myocardial infarction, whereas niacin (frequently associated with statins and/or other agents) exerts benefit across a wider range of cardiovascular endpoints in studies involving limited patient numbers. Clearly the future treatment of atherogenic dyslipidemias involving the lipid triad, as exemplified by the occurrence of the mixed dyslipidemic phenotype in metabolic syndrome, type 2 diabetes, renal, and auto-immune diseases, requires integrated pharmacotherapy targeted not only to proatherogenic particles, notably VLDL, IDL, LDL, and Lp(a), but also to atheroprotective HDL.

  2. The Contribution of GWAS Loci in Familial Dyslipidemias

    PubMed Central

    Söderlund, Sanni; Surakka, Ida; Matikainen, Niina; Pirinen, Matti; Pajukanta, Päivi; Service, Susan K.; Laurila, Pirkka-Pekka; Ehnholm, Christian; Salomaa, Veikko; Wilson, Richard K.; Palotie, Aarno; Freimer, Nelson B.; Taskinen, Marja-Riitta; Ripatti, Samuli

    2016-01-01

    Familial combined hyperlipidemia (FCH) is a complex and common familial dyslipidemia characterized by elevated total cholesterol and/or triglyceride levels with over five-fold risk of coronary heart disease. The genetic architecture and contribution of rare Mendelian and common variants to FCH susceptibility is unknown. In 53 Finnish FCH families, we genotyped and imputed nine million variants in 715 family members with DNA available. We studied the enrichment of variants previously implicated with monogenic dyslipidemias and/or lipid levels in the general population by comparing allele frequencies between the FCH families and population samples. We also constructed weighted polygenic scores using 212 lipid-associated SNPs and estimated the relative contributions of Mendelian variants and polygenic scores to the risk of FCH in the families. We identified, across the whole allele frequency spectrum, an enrichment of variants known to elevate, and a deficiency of variants known to lower LDL-C and/or TG levels among both probands and affected FCH individuals. The score based on TG associated SNPs was particularly high among affected individuals compared to non-affected family members. Out of 234 affected FCH individuals across the families, seven (3%) carried Mendelian variants and 83 (35%) showed high accumulation of either known LDL-C or TG elevating variants by having either polygenic score over the 90th percentile in the population. The positive predictive value of high score was much higher for affected FCH individuals than for similar sporadic cases in the population. FCH is highly polygenic, supporting the hypothesis that variants across the whole allele frequency spectrum contribute to this complex familial trait. Polygenic SNP panels improve identification of individuals affected with FCH, but their clinical utility remains to be defined. PMID:27227539

  3. The Contribution of GWAS Loci in Familial Dyslipidemias.

    PubMed

    Ripatti, Pietari; Rämö, Joel T; Söderlund, Sanni; Surakka, Ida; Matikainen, Niina; Pirinen, Matti; Pajukanta, Päivi; Sarin, Antti-Pekka; Service, Susan K; Laurila, Pirkka-Pekka; Ehnholm, Christian; Salomaa, Veikko; Wilson, Richard K; Palotie, Aarno; Freimer, Nelson B; Taskinen, Marja-Riitta; Ripatti, Samuli

    2016-05-01

    Familial combined hyperlipidemia (FCH) is a complex and common familial dyslipidemia characterized by elevated total cholesterol and/or triglyceride levels with over five-fold risk of coronary heart disease. The genetic architecture and contribution of rare Mendelian and common variants to FCH susceptibility is unknown. In 53 Finnish FCH families, we genotyped and imputed nine million variants in 715 family members with DNA available. We studied the enrichment of variants previously implicated with monogenic dyslipidemias and/or lipid levels in the general population by comparing allele frequencies between the FCH families and population samples. We also constructed weighted polygenic scores using 212 lipid-associated SNPs and estimated the relative contributions of Mendelian variants and polygenic scores to the risk of FCH in the families. We identified, across the whole allele frequency spectrum, an enrichment of variants known to elevate, and a deficiency of variants known to lower LDL-C and/or TG levels among both probands and affected FCH individuals. The score based on TG associated SNPs was particularly high among affected individuals compared to non-affected family members. Out of 234 affected FCH individuals across the families, seven (3%) carried Mendelian variants and 83 (35%) showed high accumulation of either known LDL-C or TG elevating variants by having either polygenic score over the 90th percentile in the population. The positive predictive value of high score was much higher for affected FCH individuals than for similar sporadic cases in the population. FCH is highly polygenic, supporting the hypothesis that variants across the whole allele frequency spectrum contribute to this complex familial trait. Polygenic SNP panels improve identification of individuals affected with FCH, but their clinical utility remains to be defined.

  4. An In-depth Study of Abdominal Injuries Sustained by Car Occupants in Frontal Crashes

    PubMed Central

    Frampton, Richard; Lenard, James; Compigne, Sabine

    2012-01-01

    Currently, neither abdominal injury risk nor rear seat passenger safety is assessed in European frontal crash testing. The objective of this study was to provide real world in-depth analysis of the factors related to abdominal injury for belted front and rear seat occupants in frontal crashes. Rear occupants were significantly more at risk of AIS 2+ and 3+ abdominal injury, followed by front seat passengers and then drivers. This was still the case even after controlling for occupant age. Increasing age was separately identified as a factor related to increased abdominal injury risk in all seating positions. One exception to this trend concerned rear seated 15 to 19 year olds who sustained moderate to serious abdominal injury at almost the same rate as rear occupants aged 65+.No strong association was seen between AIS 2+ abdominal injury rates and gender. The majority of occupant body mass indices ranged from underweight to obese. Across that range, the AIS 2+ abdominal injury rates were very similar but a small number of very obese and extremely obese occupants outside of the range did exhibit noticeably higher rates. An analysis of variance in the rate of AIS 2+ abdominal injury with different restraint systems showed that simple belt systems, as used by most rear seat passengers, were the least protective. Increasing sophistication of the restraint system was related to lower rates of injury. The ANOVA also confirmed occupant age and crash severity as highly associated with abdominal injury risk. The most frequently injured abdominal organs for front seat occupants were the liver and spleen. Abdominal injury patterns for rear seat passengers were very different. While they also sustained significant injuries to solid organs, their rates of injury to the hollow organs (jejunum-ileum, mesentary, colon) were far higher even though the rate of fracture of two or more ribs did not differ significantly between seat positions. These results have implications for the

  5. [[Role of dyslipidemia in pathogenesis of vascular events among Arctic Circle population].

    PubMed

    Maslov, L N; Vychuzhanova, E A; Gorbunov, A S; Tsibul'nikov, S Iu

    2014-01-01

    Habitation within the polar circle increases cardiovascular mortality rate and particularly increases mortality as a result of coronary events. The main reason of elevation of mortality from these diseases is a dyslipidemia which developed more among alien population residing long time in Far North. Dyslipidemia is less found among aboriginal population of Arctic Circle keeping traditional way of life and respectively it is low rate of mortality from coronary heart disease. The data showed that low rate of dyslipidemia among aboriginal population of North regions depends on fish consumption which is high content of Ω3-polyunsaturated fatty acids.

  6. Vascular Disease in Young Indians (20-40 years): Role of Dyslipidemia

    PubMed Central

    Deb, Pradeep Kumar; Shrivastava, Sameer; Rao, Maddury Srinivas; Mohan, Jagdish Chander; Kumar, Arramraju Sreenivas

    2016-01-01

    Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Atherosclerosis begins early in life as suggested by “fatty streaks” observed in coronaries of healthy organ donors aged 20-29 years. Premature occurrence of coronary heart disease (CHD) in Indians, increases the risk for young individuals. Management of Dyslipidemia in the young Indian poses several challenges. In this article we provide in-depth review of prevalence, guidelines’ perspective and expert comments on management of Dyslipidemia in the young (20-40 years) Indian.

  7. Vascular Disease in Young Indians (20-40 years): Role of Dyslipidemia

    PubMed Central

    Deb, Pradeep Kumar; Shrivastava, Sameer; Rao, Maddury Srinivas; Mohan, Jagdish Chander; Kumar, Arramraju Sreenivas

    2016-01-01

    Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Atherosclerosis begins early in life as suggested by “fatty streaks” observed in coronaries of healthy organ donors aged 20-29 years. Premature occurrence of coronary heart disease (CHD) in Indians, increases the risk for young individuals. Management of Dyslipidemia in the young Indian poses several challenges. In this article we provide in-depth review of prevalence, guidelines’ perspective and expert comments on management of Dyslipidemia in the young (20-40 years) Indian. PMID:27630892

  8. Vascular Disease in Young Indians (20-40 years): Role of Dyslipidemia.

    PubMed

    Dalal, Jamshed; Deb, Pradeep Kumar; Shrivastava, Sameer; Rao, Maddury Srinivas; Mohan, Jagdish Chander; Kumar, Arramraju Sreenivas

    2016-07-01

    Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Atherosclerosis begins early in life as suggested by "fatty streaks" observed in coronaries of healthy organ donors aged 20-29 years. Premature occurrence of coronary heart disease (CHD) in Indians, increases the risk for young individuals. Management of Dyslipidemia in the young Indian poses several challenges. In this article we provide in-depth review of prevalence, guidelines' perspective and expert comments on management of Dyslipidemia in the young (20-40 years) Indian. PMID:27630892

  9. Transgenic mice with muscle-specific insulin resistance develop increased adiposity, impaired glucose tolerance, and dyslipidemia.

    PubMed

    Moller, D E; Chang, P Y; Yaspelkis, B B; Flier, J S; Wallberg-Henriksson, H; Ivy, J L

    1996-06-01

    -specific insulin resistance can contribute to the development of obesity; and 3) a "pure" defect in insulin-mediated muscle glucose disposal is sufficient to result in impaired glucose tolerance and other features of the insulin resistance syndrome, including hyperinsulinemia and dyslipidemia.

  10. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  11. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  12. [Prevention and treatment of obesity in children].

    PubMed

    Togashi, Kenji; Iguchi, Kosei; Masuda, Hidenari

    2013-02-01

    The prevalence of childhood obesity and its comorbidities is high in Japan. Increasing prevalence of obesity among children emphasizes the importance of focusing on primary prevention to avoid health complications later in life. We emphasize the prevention of obesity by recommending breast-feeding of infants for at least 6 months and advocating that schools provide for 60 min of moderate to vigorous daily exercise in all grades. Treatment interventions include behavioral therapy, reduction in sedentary behavior, and dietary and exercise education. After dietary treatment combined with exercise treatment, the areas of subcutaneous and visceral fat decreased significantly. These data suggest that dietary treatment combined with exercise treatment in obese children normalizes the distribution of abdominal fat and reduces the risk factors for chronic disease.

  13. The impact of obesity towards prostate diseases

    PubMed Central

    Parikesit, Dyandra; Mochtar, Chaidir Arief; Umbas, Rainy; Hamid, Agus Rizal Ardy Hariandy

    2015-01-01

    Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and prostate cancer (PCa). Obesity causes several mechanisms including increased intra-abdominal pressure, altered endocrine status, increased sympathetic nervous activity, increased inflammation process, and oxidative stress, all of which are favorable in the development of BPH. In PCa, there are several different mechanisms, such as decreased serum testosterone, peripheral aromatization of androgens, insulin resistance, and altered adipokine secretion caused by inflammation, which may precipitate the development of and even cause high-grade PCa. The role of obesity in prostatitis still remains unclear. A greater understanding of the pathogenesis of prostate disease and adiposity could allow the development of new therapeutic markers, prognostic indicators, and drug targets. This review was made to help better understanding of the association between central obesity and prostate diseases, such as prostatitis, BPH, and PCa. PMID:27014656

  14. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  15. Abdominal wall fat index in neonates: correlation with birth size.

    PubMed

    Alves, J G; Silva, E; Didier, R; Bandeira, M; Bandeira, F

    2010-06-01

    Low birth weight is associated with obesity in later life and a more central fat distribution has a positive correlation with cardiovascular disease. However, the correlation between visceral adiposity in newborns and birth size is unknown. We measured the visceral adiposity in 118 newborns using the abdominal wall fat index (AFI), ratio between the maximum thickness of preperitoneal and the minimum thickness of subcutaneous fat evaluated by ultrasound. There was a weak negative correlation between AFI and birth weight (r = -0.197; P = 0.033) but not with birth length (r = -0.118; P = 0.201), body mass index (r = -0.138; P = 0.176) and abdominal circumference (r = 0.063; P = 0.497). In conclusion, we suggest that AFI is a useful parameter for evaluating the fat distribution in newborns and that visceral adiposity has a weak negative correlation with birth weight.

  16. Fully automated adipose tissue measurement on abdominal CT

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Sussman, Daniel L.; Summers, Ronald M.

    2011-03-01

    Obesity has become widespread in America and has been associated as a risk factor for many illnesses. Adipose tissue (AT) content, especially visceral AT (VAT), is an important indicator for risks of many disorders, including heart disease and diabetes. Measuring adipose tissue (AT) with traditional means is often unreliable and inaccurate. CT provides a means to measure AT accurately and consistently. We present a fully automated method to segment and measure abdominal AT in CT. Our method integrates image preprocessing which attempts to correct for image artifacts and inhomogeneities. We use fuzzy cmeans to cluster AT regions and active contour models to separate subcutaneous and visceral AT. We tested our method on 50 abdominal CT scans and evaluated the correlations between several measurements.

  17. Obesity versus osteoarthritis: beyond the mechanical overload

    PubMed Central

    Sartori-Cintra, Angélica Rossi; Aikawa, Priscila; Cintra, Dennys Esper Correa

    2014-01-01

    Obesity is currently considered a major public health problem in the world, already reaching epidemic characteristics, according to the World Health Organization. Excess weight is the major risk factor associated with various diseases, such as type 2 diabetes mellitus, hypertension, dyslipidemia and osteometabolic diseases, including osteoporosis and osteoarthritis. Osteoarthritis is the most prevalent rheumatic disease and the leading cause of physical disability and reduced quality of life of the population over 65 years. It mainly involves the joints that bear weight - knees and hips. However, along with the cases of obesity, its prevalence is increasing, and even in other joints, such as hands. Thus, it is assumed that the influence of obesity on the development of OA is beyond mechanical overload. The purpose of this review was to correlate the possible mechanisms underlying the genesis and development of these two diseases. Increased fat mass is directly proportional to excessive consumption of saturated fatty acids, responsible for systemic low-grade inflammation condition and insulin and leptin resistance. At high levels, leptin assumes inflammatory characteristics and acts in the articular cartilage, triggering the inflammatory process and changing homeostasis this tissue with consequent degeneration. We conclude that obesity is a risk factor for osteoarthritis and that physical activity and changes in diet composition can reverse the inflammatory and leptin resistance, reducing progression or preventing the onset of osteoarthritis. PMID:25184806

  18. Childhood obesity: Determinants, evaluation, and prevention.

    PubMed

    Raychaudhuri, Moutusi; Sanyal, Debmalya

    2012-12-01

    Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child's food environment at home and parental obesity are strong determinants. Urban poor in developed countries and urban rich in developing countries are both at risk. In developing countries, a number of beliefs passed down over generations are other important determinants. Evaluation includes assessing the child's lifestyle, excluding weight-promoting medication history; poor linear growth needs endocrine evaluation; genetic syndromes should be considered if there are clinical pointers. Overweight children should be evaluated for hypertension, dyslipidemia, T2DM, and NAFLD. Therapeutic lifestyle changes targeting food habits and physical activity through parental participation and social support are the cornerstones of preventing childhood obesity. Active travel and play by making the built environment more accessible, ban on 'junk' food advertising, and effective health education through active participation of clinicians, school systems, and the media will go a long way in reversing anticipated trends in childhood obesity. PMID:23565376

  19. Childhood obesity: Determinants, evaluation, and prevention

    PubMed Central

    Raychaudhuri, Moutusi; Sanyal, Debmalya

    2012-01-01

    Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child's food environment at home and parental obesity are strong determinants. Urban poor in developed countries and urban rich in developing countries are both at risk. In developing countries, a number of beliefs passed down over generations are other important determinants. Evaluation includes assessing the child's lifestyle, excluding weight-promoting medication history; poor linear growth needs endocrine evaluation; genetic syndromes should be considered if there are clinical pointers. Overweight children should be evaluated for hypertension, dyslipidemia, T2DM, and NAFLD. Therapeutic lifestyle changes targeting food habits and physical activity through parental participation and social support are the cornerstones of preventing childhood obesity. Active travel and play by making the built environment more accessible, ban on ‘junk’ food advertising, and effective health education through active participation of clinicians, school systems, and the media will go a long way in reversing anticipated trends in childhood obesity. PMID:23565376

  20. Drug treatment of obesity in cardiovascular disease.

    PubMed

    Charakida, Marietta; Finer, Nicholas

    2012-04-01

    Obesity is a significant health problem worldwide and is associated with a number of co-morbidities including type 2 diabetes mellitus, hypertension, dyslipidemia, obstructive sleep apnea, and cardiovascular disease. A number of different pathophysiologic mechanisms including increased inflammation, oxidative stress, and insulin resistance have been associated with initiation and progression of atherosclerotic disease in obese individuals. Lifestyle modifications have provided modest results in weight reduction and the focus of interest has now shifted towards drug development to treat severely obese individuals with a body mass index (BMI) >30 kg/m(2) or those with a BMI >27 kg/m(2) who have additional co-morbidities. Different regimens focusing on dietary absorption or acting centrally to control hunger and food intake have been developed. However, their weight loss effect is, in most cases, modest and this effect is lost once the medication is discontinued. In addition, long-term use of these drugs is limited by significant side effects and lack of long-term safety and efficacy data. Orlistat is the only US FDA-approved medication for long-term use. A number of new medications are currently under investigation in phase III trials with promising preliminary results. This review comments on available anti-obesity pharmacologic regimens, their weight-loss benefit, and their impact on cardiovascular risk factors. PMID:22292446

  1. Childhood obesity: Determinants, evaluation, and prevention.

    PubMed

    Raychaudhuri, Moutusi; Sanyal, Debmalya

    2012-12-01

    Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child's food environment at home and parental obesity are strong determinants. Urban poor in developed countries and urban rich in developing countries are both at risk. In developing countries, a number of beliefs passed down over generations are other important determinants. Evaluation includes assessing the child's lifestyle, excluding weight-promoting medication history; poor linear growth needs endocrine evaluation; genetic syndromes should be considered if there are clinical pointers. Overweight children should be evaluated for hypertension, dyslipidemia, T2DM, and NAFLD. Therapeutic lifestyle changes targeting food habits and physical activity through parental participation and social support are the cornerstones of preventing childhood obesity. Active travel and play by making the built environment more accessible, ban on 'junk' food advertising, and effective health education through active participation of clinicians, school systems, and the media will go a long way in reversing anticipated trends in childhood obesity.

  2. Relation between Delayed Superfluous Insulin Secretion during An Oral Glucose Tolerance Test and Metabolic Disorders in Obese Japanese Children.

    PubMed

    Sato, Hidetoshi; Kikuchi, Toru; Harada, Waka; Yoshida, Hiroshi; Ito, Sueshi; Uchiyama, Makoto

    2011-04-01

    The aim of this study was to clarify the relation between postprandial hyperinsulinemia and metabolic disorders in obese children. Twenty-eight obese Japanese children (8.8-16.2 yr) were divided into four groups: without impaired liver function and dyslipidemia (Group A), with impaired liver function (Group B), with dyslipidemia (Group C), and with impaired liver function and dyslipidemia (Group D). The levels of PG, serum immunoreactive insulin (IRI) and serum C-peptide (CPR) were measured during an oral glucose tolerance test (OGTT). The subjects had delayed superfluous insulin and CPR secretion during the OGTT compared with healthy references. In regard to the insulin secretion pattern, Group A's response peaked at 60 min and then decreased gradually until 120 min, Group B's response peaked at 60 min, remained at the peak until 120 min and then decreased gradually until 180 min, Group C's response peaked at 120 min and then decreased gradually until 180 min, and Group D's response peaked at 120 min and remained at the peak until 180 min. These results suggest that delayed superfluous insulin secretion during an OGTT is related to metabolic disorders in obese Japanese children and that these patients will experience a vicious cycle of postprandial hyperinsulinemia and metabolic disorders. It is important to prevent healthy children from becoming obese and to improve management of childhood obesity.

  3. Intra-abdominal hypertension and abdominal compartment syndrome in pancreatitis, paediatrics, and trauma.

    PubMed

    De Waele, Jan J; Ejike, Janeth C; Leppäniemi, Ari; De Keulenaer, Bart L; De Laet, Inneke; Kirkpatrick, Andrew W; Roberts, Derek J; Kimball, Edward; Ivatury, Rao; Malbrain, Manu L N G

    2015-01-01

    Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction among patients with trauma and sepsis. However, the impact of increased intra-abdominal pressure (IAP) among pediatric, pregnant, non-septic medical patients, and those with severe acute pancreatitis (SAP), obesity, and burns has been studied less extensively. The aim of this review is to outline the pathophysiologic implications and treatment options for IAH and abdominal compartment syndrome (ACS) for the above patient populations. We searched MEDLINE and PubMed to identify relevant studies. There is an increasing awareness of IAH in general medicine. The incidence of IAH and, to a lesser extent, ACS is high among patients with SAP. IAH should always be suspected and IAP measured routinely. In children, normal IAP in mechanically ventilated patients is approximately 7 ± 3 mm Hg. As an IAP of 10-15 mm Hg has been associated with organ damage in children, an IAP greater than 10 mm Hg should be considered IAH in these patients. Moreover, as ACS may occur in children at an IAP lower than 20 mm Hg, any elevation in IAP higher than 10 mm Hg associated with new organ dysfunction should be considered ACS in children until proven otherwise. Monitor IAP trends and be aware that specific interventions may need to be instituted at lower IAP than the current ACS definitions accommodate. Finally, IAH and ACS can occur both in abdominal trauma and extra-abdominal trauma patients. Early mechanical hemorrhage control and the avoidance of excessive fluid resuscitation are key elements in preventing IAH in trauma patients. IAH and ACS have been associated with many conditions beyond the general ICU patient. In adults and in children, the focus should be on the early recognition of IAH and the prevention of ACS. Patients at risk for IAH should be identified early during their treatment (with a low threshold to initiate IAP monitoring). Appropriate actions should be taken when IAP increases

  4. Biomarkers of the prothrombotic state in abdominal obesity.

    PubMed

    Montilla, Marcela; Santi, María José; Carrozas, María A; Ruiz, Félix A

    2014-10-04

    Introducción: La obesidad central está especialmente asociada con la enfermedad cardiovascular. No obstante, los mecanismos moleculares que la promueven no están completamente definidos y la estratificación del riesgo de los pacientes para la enfermedad cardiovascular sigue siendo un reto. Objetivo: Evaluar la asociación de la adiposidad central con marcadores hemostáticos coste-eficientes y con los factores de riesgo cardiovascular tradicionales en una cohorte de varones de mediana edad sin enfermedad cardiovascular clínica con objeto de mejorar la prevención y la intervención. Métodos: Estudiamos 307 varones de 45±7 años, a los que se realizó historia clínica, examen físico, mediciones antropométricas y determinaciones plasmáticas bioquímicas y de fibrinógeno, actividad protrombina, tiempo de tromboplastina parcial activada, recuento de plaquetas y volumen plaquetario medio. Resultados: Los valores de actividad protrombina fueron significativamente más elevados en pacientes con obesidad central (103 ± 16 % vs 111 ± 17 %, p.

  5. Obesity and the metabolic syndrome in pediatric psoriasis.

    PubMed

    Gutmark-Little, Iris; Shah, Kara N

    2015-01-01

    Psoriasis is a common, chronic inflammatory dermatosis that often has its onset during childhood. There is increasing evidence that psoriasis in adults is associated with obesity, the metabolic syndrome, and associated comorbidities, including insulin resistance/type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease. This association is postulated to arise, at least in part, as a result of a systemic proinflammatory state that is mediated by adipose tissue. Several recent observational studies suggest that children and adolescents with psoriasis may be at increased risk of being overweight and obese as well as having an increased risk for features of the metabolic syndrome. Such an association raises concern with regards to the long-term health implications for children and adolescents with psoriasis and suggests that better awareness, evaluation, and management of overweight and obese patients and associated metabolic disease are warranted in this population. PMID:25889131

  6. Prevalence and Determinants of Metabolic Health in Subjects with Obesity in Chinese Population

    PubMed Central

    Zheng, Ruizhi; Yang, Min; Bao, Yuqian; Li, Hong; Shan, Zhongyan; Zhang, Bo; Liu, Juan; Lv, Qinguo; Wu, Ou; Zhu, Yimin; Lai, Maode

    2015-01-01

    Background: The study was to investigate the prevalence of metabolic health in subjects with obesity in the Chinese population and to identify the determinants related to metabolic abnormality in obese individuals. Methods: 5013 subjects were recruited from seven provincial capitals in China. The obesity and metabolic status were classified based on body mass index (BMI) and the number of abnormalities in common components of metabolic syndrome. Results: 27.9% of individuals with obesity were metabolically healthy. The prevalence of the metabolically healthy obese (MHO) phenotype was significantly decreased with age in women (p trend < 0.001), but not significantly in men (p trend = 0.349). Central obesity (odds ratio [OR] = 4.07, 95% confidence interval [CI] = 1.93–8.59), longer sedentary time (OR = 1.97, 95%CI = 1.27–3.06), and with a family history of obesity related diseases (hypertension, diabetes, dyslipidemia) (OR = 1.85, 95%CI = 1.26–2.71) were significantly associated with having metabolic abnormality in obese individuals. Higher levels of physical activity and more fruit/vegetable intake had decreased ORs of 0.67 (95%CI = 0.45–0.98) and 0.44 (95%CI = 0.28–0.70), respectively. Conclusion: 27.9% of obese participants are in metabolic health. Central obesity, physical activity, sedentary time, fruits/vegetables intake and family history of diseases are the determinants associated with metabolic status in obesity. PMID:26516886

  7. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1 - executive summary.

    PubMed

    Jacobson, Terry A; Ito, Matthew K; Maki, Kevin C; Orringer, Carl E; Bays, Harold E; Jones, Peter H; McKenney, James M; Grundy, Scott M; Gill, Edward A; Wild, Robert A; Wilson, Don P; Brown, W Virgil

    2014-01-01

    Various organizations and agencies have issued recommendations for the management of dyslipidemia. Although many commonalities exist among them, material differences are present as well. The leadership of the National Lipid Association (NLA) convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel and includes: (1) background and conceptual framework for formulation of the NLA Expert Panel recommendations; (2) screening and classification of lipoprotein lipid levels in adults; (3) targets for intervention in dyslipidemia management; (4) atherosclerotic cardiovascular disease risk assessment and treatment goals based on risk category; (5) atherogenic cholesterol-non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol-as the primary targets of therapy; and (6) lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia.

  8. [ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR].

    PubMed

    Maĭstrenko, D N; Generalov, M I; Tarazov, P G; Zherebtsov, F K; Osovskikh, V V; Ivanov, A S; Oleshchuk, A N; Granov, D A

    2015-01-01

    The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stent-grafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn't necessary to use a conversion to open surgery. The follow-up period consisted of 44,6?2,1 months. Control ultrasound and computer tomography studies hadn't revealed an increase of aneurism sack sizes or "eakages". A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stent-graft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group. PMID:26234059

  9. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  10. Cardiorespiratory fitness, obesity, and functional limitation in older adults.

    PubMed

    Bouchard, Danielle R; McGuire, K Ashlee; Davidson, Lance; Ross, Robert

    2011-10-01

    One hundred forty-six abdominally obese adults age 60-80 yr were studied to investigate the interaction between cardiorespiratory fitness (CRF) and obesity on functional limitation. Obesity was determined by fat mass (FM), CRF was determined by a maximal treadmill test, and functional limitation was based on 4 different tasks that are predictive of subsequent disability. Both FM (r = -.34, p ≤ .01) and CRF (r = .54, p ≤ .01) were independently associated with functional limitation in bivariate analysis.After further control for sex, age, and the interaction term (CRF × FM), FM was no longer independently associated with functional limitation (p = .10). Analyses were also based on sex-specific tertiles of FM and CRF. The referent group demonstrated significantly lower functional limitation than the low-CRF/low-FM and the low-CRF/high-FM groups (both p ≤ .05). These results highlight the value of recommending exercise for abdominally obese adults.

  11. Abdominal ultrasonography, 2nd Ed

    SciTech Connect

    Goldberg, B.B.

    1984-01-01

    This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy.

  12. Adrenal and gonadal function in obesity.

    PubMed

    Pasquali, R; Vicennati, V; Gambineri, A

    2002-11-01

    Obesity is associated with multiple alterations of the endocrine systems, including abnormal circulating blood hormone concentrations, due to changes in their pattern of secretion and/or metabolism, altered hormone transport, and/or action at the level of target tissues. There is evidence that alterations of endocrine systems regulating sex hormones and corticosteroids may play a crucial role in the development of obesity, particularly the abdominal phenotype. Obese women are characterized by a condition of sc"functional hyperandrogenism", whereas in males, obesity is associated with reduced T levels and decreased LH secretory pattern from the pituitary. In addition, in both sexes a dysregulation of the hypothalamic-pituitary-adrenal axis has been reported, including both neuroendocrine and peripheral alterations, finally leading to inappropriately higher than normal exposure to F of peripheral tissues, particularly the visceral adipose tissue. By these mechanisms, it can be hypothesized that both visceral fat enlargement and alterations of insulin action and associated metabolic disturbances may develop, therefore predisposing abdominally obese individuals to Type 2 diabetes and cardiovascular disease.

  13. Chewing the fat: genetic approaches to model dyslipidemia-induced diabetic neuropathy in mice.

    PubMed

    Guilford, B L; Wright, D E

    2013-10-01

    Emerging clinical evidence now suggests that dyslipidemia may be strongly linked with the development and progression of neuropathy in diabetic patients, and dyslipidemia is considered an important risk factor for the development of diabetic neuropathy. However, because of important species differences, current animal models fall short of accurately replicating human diabetic dyslipidemia. Rodents resist expansion in low-density lipoprotein cholesterol (LDL-C) and typically maintain or increase high-density lipoprotein cholesterol (HDL-C), despite prolonged high-fat feeding. Here, we discuss the findings of Hinder et al., in which they utilized novel genetic experimental approaches to develop a diabetic mouse model with human-like dyslipidemia. The authors created a mouse with an apolipoprotein E (ApoE) knockout in conjunction with a leptin receptor mutation. A triple mutant mouse with both ApoE and apolipoprotein B48 knockout and leptin deficiency was also created in an effort to generate a model of diabetic dyslipidemia that better mimics the human condition. The long-term goal of these studies is to develop more faithful models to address how hyperglycemia and hyperlipidemia may drive the development and progression of neuropathy. Hinder and colleagues were successful at creating a diabetic mouse model with severe hypertriglyceridemia, hypercholesterolemia, and a significant increase in the total cholesterol to HDL-C ratio. This work was successful in establishing a model of diabetic dyslipidemia that more closely emulates the poor lipid profile observed in human diabetic patients with neuropathy. This commentary will also review current models used to study the effects of dyslipidemia on diabetic neuropathy and highlight a proposed mechanism for the role of dyslipidemia in the pathogenesis of diabetic neuropathy.

  14. Cardiovascular and Renal Effects of Weight Reduction in Obesity and the Metabolic Syndrome

    PubMed Central

    Cohen, Jordana B.; Cohen, Debbie L.

    2015-01-01

    Obesity is a critical public health issue worldwide. Patients with obesity have markedly increased morbidity and mortality compared to the general population. The increased health risks of obesity in part are due to its close association with each of the other components of the metabolic syndrome, including hypertension, dyslipidemia, and insulin resistance. Accordingly, obese individuals are at particularly increased risk of cardiovascular disease and chronic kidney disease. Modest weight loss results in improvements in serum cholesterol levels, blood pressure, and glycemic profiles. Lifestyle interventions for weight loss have long been the mainstay of treatment in obesity. However, the existing literature demonstrates limited weight loss sustainability and inconsistent cardiovascular and renal benefits using these modalities. In addition to improvements in intermediate risk factors, surgical interventions provide a more lasting impact on long-term cardiovascular and renal outcomes, though carry higher short-term risks due to perioperative complications. PMID:25833456

  15. Cardiovascular and renal effects of weight reduction in obesity and the metabolic syndrome.

    PubMed

    Cohen, Jordana B; Cohen, Debbie L

    2015-05-01

    Obesity is a critical public health issue worldwide. Patients with obesity have markedly increased morbidity and mortality compared to the general population. The increased health risks of obesity in part are due to its close association with each of the other components of the metabolic syndrome, including hypertension, dyslipidemia, and insulin resistance. Accordingly, obese individuals are at particularly increased risk of cardiovascular disease and chronic kidney disease. Modest weight loss results in improvements in serum cholesterol levels, blood pressure, and glycemic profiles. Lifestyle interventions for weight loss have long been the mainstay of treatment in obesity. However, the existing literature demonstrates limited weight loss sustainability and inconsistent cardiovascular and renal benefits using these modalities. In addition to improvements in intermediate risk factors, surgical interventions provide a more lasting impact on long-term cardiovascular and renal outcomes, though carry higher short-term risks due to perioperative complications. PMID:25833456

  16. Maternal Obesity: Lifelong Metabolic Outcomes for Offspring from Poor Developmental Trajectories During the Perinatal Period.

    PubMed

    Zambrano, Elena; Ibáñez, Carlos; Martínez-Samayoa, Paola M; Lomas-Soria, Consuelo; Durand-Carbajal, Marta; Rodríguez-González, Guadalupe L

    2016-01-01

    The prevalence of obesity in women of reproductive age is increasing in developed and developing countries around the world. Human and animal studies indicate that maternal obesity adversely impacts both maternal health and offspring phenotype, predisposing them to chronic diseases later in life including obesity, dyslipidemia, type 2 diabetes mellitus, and hypertension. Several mechanisms act together to produce these adverse health effects including programming of hypothalamic appetite-regulating centers, increasing maternal, fetal and offspring glucocorticoid production, changes in maternal metabolism and increasing maternal oxidative stress. Effective interventions during human pregnancy are needed to prevent both maternal and offspring metabolic dysfunction due to maternal obesity. This review addresses the relationship between maternal obesity and its negative impact on offspring development and presents some maternal intervention studies that propose strategies to prevent adverse offspring metabolic outcomes.

  17. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  18. Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults

    PubMed Central

    Lee, Sung-Ho; Kim, Do Hoon; Kim, Yang-Hyun; Roh, Yong Kyun; Ju, Sang Yhun; Nam, Hyo-Yun; Nam, Ga-Eun; Choi, Jun-Seok; Lee, Jong-Eun; Sang, Jung-Eun; Han, Kyungdo; Park, Yong-Gyu

    2016-01-01

    Abstract This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06–2.21], 1.21 [1.02–1.45], and 1.78 [1.21–2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67–0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria. PMID:27100412

  19. LDLR C1725T Gene Polymorphism Frequency in Type 2 Diabetes Mellitus Patients With Dyslipidemia

    PubMed Central

    Eroglu, Zuhal; Harman, Ece; Vardarli, Egemen; Kayikcioglu, Meral; Vardarli, Asli Tetik

    2016-01-01

    Background Dyslipidemia has a substantial role in the development of cardiovascular diseases in patients with type 2 diabetes mellitus (T2DM). Determining the genetic profile of T2DM patients with dyslipidemia is important in order to reduce the risk of microvascular and macrovascular complications. Low-density lipoprotein receptor (LDLR) plays a critical role in plasma lipoprotein hemostasis. LDLR mutations/polymorphisms cause changes at the lipoprotein level. The objective of this study is to determine the frequency of LDLR (rs179989) polymorphisms in Turkish T2DM patients with dyslipidemia. Methods The study group consisted of 217 T2DM patients with dyslipidemia including 28 cases with myocardial infarction and 212 healthy controls. Genomic DNA was isolated from venous blood samples and genotype analysis was carried out on the LightCycler® 480 instrument. The χ2 test was used to compare genotype distributions. Results There were no significant differences in the frequency or allelic distribution of the LDLR C1725T (rs1799898) genotype between the type 2 diabetic dyslipidemia patients and the control group (P > 0.05). Conclusion LDLR C1725T polymorphism was not associated with lipid parameters, and dyslipidemia in T2DM patients. PMID:27738480

  20. The renin-angiotensin system: a target of and contributor to dyslipidemias, altered glucose homeostasis, and hypertension of the metabolic syndrome.

    PubMed

    Putnam, Kelly; Shoemaker, Robin; Yiannikouris, Frederique; Cassis, Lisa A

    2012-03-15

    The renin-angiotensin system (RAS) is an important therapeutic target in the treatment of hypertension. Obesity has emerged as a primary contributor to essential hypertension in the United States and clusters with other metabolic disorders (hyperglycemia, hypertension, high triglycerides, low HDL cholesterol) defined within the metabolic syndrome. In addition to hypertension, RAS blockade may also serve as an effective treatment strategy to control impaired glucose and insulin tolerance and dyslipidemias in patients with the metabolic syndrome. Hyperglycemia, insulin resistance, and/or specific cholesterol metabolites have been demonstrated to activate components required for the synthesis [angiotensinogen, renin, angiotensin-converting enzyme (ACE)], degradation (ACE2), or responsiveness (angiotensin II type 1 receptors, Mas receptors) to angiotensin peptides in cell types (e.g., pancreatic islet cells, adipocytes, macrophages) that mediate specific disorders of the metabolic syndrome. An activated local RAS in these cell types may contribute to dysregulated function by promoting oxidative stress, apoptosis, and inflammation. This review will discuss data demonstrating the regulation of components of the RAS by cholesterol and its metabolites, glucose, and/or insulin in cell types implicated in disorders of the metabolic syndrome. In addition, we discuss data supporting a role for an activated local RAS in dyslipidemias and glucose intolerance/insulin resistance and the development of hypertension in the metabolic syndrome. Identification of an activated RAS as a common thread contributing to several disorders of the metabolic syndrome makes the use of angiotensin receptor blockers and ACE inhibitors an intriguing and novel option for multisymptom treatment.

  1. Coronary events in obese hemodialysis patients before and after renal transplantation.

    PubMed

    De Lima, Jose Jayme G; Gowdak, Luis Henrique W; de Paula, Flavio J; Muela, Henrique Cotchi S; David-Neto, Elias; Bortolotto, Luiz A

    2015-11-01

    We examined the impact of obesity (BMI ≥30 kg/m(2) , n = 357) on prognosis in 1696 hemodialysis (HD) patients before and after renal transplantation (TX). End-points were coronary events, composite cardiovascular (CV) events, and death. Obese HD patients were older (55.9 ± 9.2 vs. 54.2 ± 11), had more diabetes (54% vs. 40%), dyslipidemia (49% vs. 30%), altered myocardial scan (38% vs. 31%), myocardial infarction (MI) (16% vs. 10%), coronary intervention (11% vs. 7%), higher total cholesterol (186 ± 52 vs. 169 ± 47), and triglycerides (219 ± 167 vs. 144 ± 91). Obese undergoing TX had more dyslipidemia (46% vs. 31%), angina (23% vs. 14%), MI (18% vs. 5%), increased total cholesterol (185 ± 56 vs. 172 ± 48), and triglycerides (237 ± 190 vs. 149 ± 100). Obesity was independently associated with coronary events (log-rank = 0.008, HR 2.55% CI 1.27-5.11) and death (log-rank 0.046, HR 1.52, % CI 1.007-2.30) in TX but not in HD. Obese HD patients had more risk factors and ischemic heart disease, but these characteristics did not interfere with prognosis. In TX patients, obesity predicts coronary events and death.

  2. Standardized anatomic space for abdominal fat quantification

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-03-01

    The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.

  3. Continuation of Gradual Weight Gain Necessary for the Onset of Puberty May Be Responsible for Obesity Later in Life

    PubMed Central

    Lehrer, Steven

    2016-01-01

    A continuation of the gradual weight gain necessary for the onset of puberty may be responsible for obesity later in life. Hypothetically, a group of brain nuclei form components of a single pubertal clock mechanism that drives pre-pubertal weight gain and governs the onset of puberty and fertility. No mechanism evolved to shut off pre-pubertal and pubertal weight and body fat gain after puberty. The weight gain continues unabated throughout life. A better understanding of the mechanism of puberty and pre-pubertal weight gain could provide new insights into obesity and diseases associated with obesity such as type 2 diabetes, dyslipidemia, hypertension, heart disease, depression, etc. PMID:26562472

  4. Acrolein Consumption Induces Systemic Dyslipidemia and Lipoprotein Modification

    PubMed Central

    Conklin, Daniel J.; Barski, Oleg A.; Lesgards, Jean-Francois; Juvan, Peter; Rezen, Tadeja; Rozman, Damjana; Prough, Russell A.; Vladykovskaya, Elena; Liu, SiQi; Srivastava, Sanjay; Bhatnagar, Aruni

    2010-01-01

    Aldehydes such as acrolein are ubiquitous pollutants present in automobile exhaust, cigarette, wood, and coal smoke. Such aldehydes are also constituents of several food substances and are present in drinking water, irrigation canals, and effluents from manufacturing plants. Oral intake represents the most significant source of exposure to acrolein and related aldehydes. To study the effects of short-term oral exposure to acrolein on lipoprotein levels and metabolism, adult mice were gavage fed 0.1 to 5 mg acrolein/kg bwt and changes in plasma lipoproteins were assessed. Changes in hepatic gene expression related to lipid metabolism and cytokines were examined by qRT-PCR analysis. Acrolein feeding did not affect body weight, BUN, plasma creatinine, electrolytes, cytokines or liver enzymes, but increased plasma cholesterol and triglycerides. Similar results were obtained with apoE-null mice. Plasma lipoproteins from acrolein-fed mice showed altered electrophoretic mobility on agarose gels. Chromatographic analysis revealed elevated VLDL cholesterol, phospholipids, and triglycerides levels with little change in LDL or HDL. NMR analysis indicated shifts from small to large VLDL and from large to medium-small LDL with no change in the size of HDL particles. Increased plasma VLDL was associated with a significant decrease in post-heparin plasma hepatic lipase activity and a decrease in hepatic expression of hepatic lipase. These observations suggest that oral exposure to acrolein could induce or exacerbate systemic dyslipidemia and thereby contribute to cardiovascular disease risk. PMID:20034506

  5. Acrolein consumption induces systemic dyslipidemia and lipoprotein modification

    SciTech Connect

    Conklin, Daniel J.; Barski, Oleg A.; Lesgards, Jean-Francois; Juvan, Peter; Rezen, Tadeja; Rozman, Damjana; Prough, Russell A.; Vladykovskaya, Elena; Liu, SiQi; Srivastava, Sanjay; Bhatnagar, Aruni

    2010-02-15

    Aldehydes such as acrolein are ubiquitous pollutants present in automobile exhaust, cigarette, wood, and coal smoke. Such aldehydes are also constituents of several food substances and are present in drinking water, irrigation canals, and effluents from manufacturing plants. Oral intake represents the most significant source of exposure to acrolein and related aldehydes. To study the effects of short-term oral exposure to acrolein on lipoprotein levels and metabolism, adult mice were gavage-fed 0.1 to 5 mg acrolein/kg bwt and changes in plasma lipoproteins were assessed. Changes in hepatic gene expression related to lipid metabolism and cytokines were examined by qRT-PCR analysis. Acrolein feeding did not affect body weight, blood urea nitrogen, plasma creatinine, electrolytes, cytokines or liver enzymes, but increased plasma cholesterol and triglycerides. Similar results were obtained with apoE-null mice. Plasma lipoproteins from acrolein-fed mice showed altered electrophoretic mobility on agarose gels. Chromatographic analysis revealed elevated VLDL cholesterol, phospholipids, and triglycerides levels with little change in LDL or HDL. NMR analysis indicated shifts from small to large VLDL and from large to medium-small LDL with no change in the size of HDL particles. Increased plasma VLDL was associated with a significant decrease in post-heparin plasma hepatic lipase activity and a decrease in hepatic expression of hepatic lipase. These observations suggest that oral exposure to acrolein could induce or exacerbate systemic dyslipidemia and thereby contribute to cardiovascular disease risk.

  6. Conservative management of abdominal injuries

    PubMed Central

    Okuş, Ahmet; Sevinç, Barış; Ay, Serden; Arslan, Kemal; Karahan, Ömer; Eryılmaz, Mehmet Ali

    2013-01-01

    Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results: The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring. PMID:25931868

  7. Bariatric surgery for pediatric extreme obesity: now or later?

    PubMed

    Inge, T H; Xanthakos, S A; Zeller, M H

    2007-01-01

    Obesity is a multifactorial disease of epidemic and global proportions that poses the most significant threat to the health of our younger generations. Those who are the most extremely affected bear the largest burden of health problems. In the US, extreme obesity affects approximately 9 million adults and 2 million children, and is associated with both immediate health problems and later health risk, including premature mortality. Present medical and behavioral interventions for extreme obesity in adults and children rarely result in the significant, durable weight loss necessary to improve health outcomes, prompting a search for more aggressive measures. Weight loss (bariatric) surgery has been advocated as an intervention for those with extreme obesity. In adults, bariatric surgery results in prolonged weight control and improvement in serious obesity comorbidities, namely type 2 diabetes, dyslipidemias, hypertension and obstructive sleep apnea syndrome. A surge in weight loss operations for adolescents has been observed recently, with a threefold increase in case volumes nationwide from 2000 to 2003. Current evidence suggests that after bariatric surgery, adolescents lose significant weight and serious obesity-related medical conditions and psychosocial status are improved. Thus it is reasonable to propose that bariatric surgery performed in the adolescent period may be more effective treatment for childhood-onset extreme obesity than delaying surgery for extremely obese youth until adulthood. This position has been echoed by a number of groups and an independent systematic review. Finally, it is conceivable that bariatric surgery performed in adulthood for childhood onset extreme obesity may not be as effective for comorbidity treatment as surgery performed earlier during adolescence. The purpose of this review is to examine the evidence, which supports early rather than later use of bariatric surgery in the treatment of extreme obesity, and to present this

  8. The use of body mass index for measurement of fat mass in children is highly dependant on abdominal fat.

    PubMed

    El Taguri, A; Dabbas-Tyan, M; Goulet, O; Ricour, C

    2009-01-01

    We examined the relationship between body fat and body mass index (BMI) in a multiethnic population of obese children. BMI z-scores were compared to DEXA measures of whole body composition and regional fat distribution. Fat mass index (FMI) was best predicted by the equation: 1/[(0.159- 0.013 x percentile of total abdominal fat)- (0.01 x BMI z-score)], where percentile of abdominal fat ranges from 1 to 5. Predicted FMI had high agreement with FMI measured by DEXA. There were no detectable differences in this relation between different ethnic groups. Both BMI and abdominal fat should be used as a proxy to determine adiposity.

  9. European Guidelines for Obesity Management in Adults.

    PubMed

    Yumuk, Volkan; Tsigos, Constantine; Fried, Martin; Schindler, Karin; Busetto, Luca; Micic, Dragan; Toplak, Hermann

    2015-01-01

    Obesity is a chronic metabolic disease characterised by an increase of body fat stores. It is a gateway to ill health, and it has become one of the leading causes of disability and death, affecting not only adults but also children and adolescents worldwide. In clinical practice, the body fatness is estimated by BMI, and the accumulation of intra-abdominal fat (marker for higher metabolic and cardiovascular disease risk) can be assessed by waist circumference. Complex interactions between biological, behavioural, social and environmental factors are involved in regulation of energy balance and fat stores. A comprehensive history, physical examination and laboratory assessment relevant to the patient's obesity should be obtained. Appropriate goals of weight management emphasise realistic weight loss to achieve a reduction in health risks and should include promotion of weight loss, maintenance and prevention of weight regain. Management of co-morbidities and improving quality of life of obese patients are also included in treatment aims. Balanced hypocaloric diets result in clinically meaningful weight loss regardless of which macronutrients they emphasise. Aerobic training is the optimal mode of exercise for reducing fat mass while a programme including resistance training is needed for increasing lean mass in middle-aged and overweight/obese individuals. Cognitive behavioural therapy directly addresses behaviours that require change for successful weight loss and weight loss maintenance. Pharmacotherapy can help patients to maintain compliance and ameliorate obesity-related health risks. Surgery is the most effective treatment for morbid obesity in terms of long-term weight loss. A comprehensive obesity management can only be accomplished by a multidisciplinary obesity management team. We conclude that physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment. Treatment should be based on

  10. Abdominal adiposity and cardiometabolic risk: do we have all the answers?

    PubMed

    Haffner, Steven M

    2007-09-01

    Overweight and obesity, particularly abdominal adiposity, increase the risk for type 2 diabetes mellitus and cardiovascular disease (CVD). Metabolic syndrome, a constellation of risk factors that includes elevated triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure, elevated fasting glucose, and abdominal obesity, predicts the development of CVD and diabetes to an even greater degree. Excess abdominal adipose tissue is associated with insulin resistance, the precursor to type 2 diabetes, and creates an atherogenic inflammatory milieu, characterized by high levels of C-reactive protein and other inflammatory markers (e.g., fibrinogen, plasminogen activator inhibitor-1, cytokines, and adhesion molecules). High levels of these biomarkers correlate with an increased incidence of diabetes and CVD. Recent evidence suggests that patients with nonalcoholic fatty liver disease have an increased incidence of obesity, metabolic syndrome, and insulin resistance and/or type 2 diabetes. Relatively small reductions in body weight may significantly reduce abdominal adipose tissue, reduce insulin resistance, lower triglycerides and low-density lipoprotein cholesterol, reduce inflammation, and decrease overall cardiometabolic risk. PMID:17720354

  11. Abdominal aortic grafting for spontaneous infrarenal abdominal aortic dissection.

    PubMed

    Iwasaki, Hiroto; Shibuya, Takashi; Shintani, Takashi; Uenaka, Hisazumi; Suehiro, Shigefumi; Satoh, Hisashi

    2010-02-01

    This case report concerns a 62-year-old woman with spontaneous infrarenal abdominal aortic dissection, which developed into claudication and rest pain in the lower extremity. Multi-row detector computed tomography showed the entry site of the abdominal aortic dissection at the second lumbar artery, while the reentry site was found intraoperatively at the median sacral artery, indicating that the false lumen had progressed and compressed the true lumen. A direct approach involving grafting appears to be an effective procedure for resolving mesenteric and lower extremity hypoperfusion due to aortic dissection with a dilated false channel, even during the acute period. PMID:19879731

  12. Association of Biomarkers of Inflammation with Dyslipidemia and Its Components among Mongolians in China

    PubMed Central

    Tang, Lingyan; Peng, Hao; Xu, Tian; Wang, Aili; Wang, Guiyan; Tong, Weijun; Zhang, Yonghong

    2014-01-01

    Objective This study aims to examine the association between inflammatory biomarkers and dyslipidemia and its components among Mongolians in China. Methods Data were obtained from 2544 Mongolians via standard questionnaires and blood samples in Inner Mongolia, China. High sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selectin (sE-selectin) as well as blood lipids were examined. Results Individuals with dyslipidemia had higher levels of hsCRP, sICAM-1 and sE-selectin than those without dyslipidemia (all P values<0.001). Compared to the lowest quartile of inflammatory biomarkers, individuals with the highest quartile were more likely to have dyslipidemia (odds ratio, 95% confidence interval: 3.215, 2.551–4.116 for hsCRP; 1.575, 1.253–1.980 for sICAM-1; 1.495, 1.193–1.873 for sE-selectin). Moreover, hsCRP was associated with all the components of dyslipidemia, whereas, sICAM-1 was not related to high density lipoprotein cholesterol (HDL-c) or triglycerides (TAG). Additionally, sE-selectin was just associated with TAG. Conclusion Our study indicated that elevated plasma levels of hsCRP, sICAM-1 and sE-selectin were positively and significantly associated with increased risk of dyslipidemia among Mongolians. However, the associations were not identical for different inflammatory biomarkers with the components of dyslipidemia. PMID:24558466

  13. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    PubMed

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta. PMID:26858185

  14. Ultrasonographic evaluation of visceral and subcutaneous abdominal fat tissue before and after bariatric surgery.

    PubMed

    Djurić-Stefanović, A; Vasin, D; Jovanović, S; Lazić, Lj; Kovac, J; Popović, I; Bajec, Dj; Saranović, Dj

    2013-01-01

    Visceral fat is considered a key factor in the development of metabolic syndrome and other pathological conditions and diseases associated with obesity. Therefore, analysis of the dynamics of reducing the amount of abdominal visceral fat is important for evaluating the therapeutic effects of different modalities of obesity treatment, including bariatric surgery. In 53 obese patients visceral and subcutaneous abdominal adipose tissue was measured by ultrasonography (US) before and after bariatric surgery, in the period of 1, 3, 6 months. At the same time, standard anthropometric parameters were assessed: body mass (m), BMI, waist circumference (WC), and hip circumference (HC). Five diameters of the visceral abdominal fat (VAF) were measured: IAFT (Intraabdominal Fat Thickness), LV (Lienal Vein), VF (Visceral Fat), MES sum (Mesenterial leafs) and Max PFT (Maximal Preperitoneal Fat Thickness), and three diameters of the subcutaneous abdominal adipose tissue (SCAF): Min SFT (Minimal Subcutaneous Fat), and MaxSFTa and MaxSFTb (Maximal Subcutaneous Fat Thickness a and b). Statistically significant decrease in all anthropometric parameters, except HC was registered 1, 3 and 6 months after the surgery. We registered the decline of almost all US diameters of abdominal adipose tissue in the follow-up period, but statistically significant decrease were found only in the diameters of visceral adipose tissue: IAFT after 1 and 3 months (p = 0.031 and p = 0.027); VF after 1 month (p = 0.031), LV after 6 months (p = 0.011), and MESsum after 3 and 6 months (p = 0.001 and p = 0.028), as well as MaxSFTb, at 1 month follow-up (p = 0.015). In the short-term follow-up period after the bariatric surgery, there was a significant decrease in body mass, BMI and WC, and ultrasonography revealed a significant reduction in the diameters of the visceral abdominal fat.

  15. Pathophysiological role of host microbiota in the development of obesity.

    PubMed

    Kobyliak, Nazarii; Virchenko, Oleksandr; Falalyeyeva, Tetyana

    2016-01-01

    Overweight and obesity increase the risk for a number of diseases, namely, cardiovascular diseases, type 2 diabetes, dyslipidemia, premature death, non-alcoholic fatty liver disease as well as different types of cancer. Approximately 1.7 billion people in the world suffer from being overweight, most notably in developed countries. Current research efforts have focused on host and environmental factors that may affect energy balance. It was hypothesized that a microbiota profile specific to an obese host with increased energy-yielding behavior may exist. Consequently, the gut microbiota is becoming of significant research interest in relation to obesity in an attempt to better understand the aetiology of obesity and to develop new methods of its prevention and treatment. Alteration of microbiota composition may stimulate development of obesity and other metabolic diseases via several mechanisms: increasing gut permeability with subsequent metabolic inflammation; increasing energy harvest from the diet; impairing short-chain fatty acids synthesis; and altering bile acids metabolism and FXR/TGR5 signaling. Prebiotics and probiotics have physiologic functions that contribute to the health of gut microbiota, maintenance of a healthy body weight and control of factors associated with obesity through their effects on mechanisms that control food intake, body weight, gut microbiota and inflammatory processes. PMID:27105827

  16. Pathophysiological role of host microbiota in the development of obesity.

    PubMed

    Kobyliak, Nazarii; Virchenko, Oleksandr; Falalyeyeva, Tetyana

    2016-04-23

    Overweight and obesity increase the risk for a number of diseases, namely, cardiovascular diseases, type 2 diabetes, dyslipidemia, premature death, non-alcoholic fatty liver disease as well as different types of cancer. Approximately 1.7 billion people in the world suffer from being overweight, most notably in developed countries. Current research efforts have focused on host and environmental factors that may affect energy balance. It was hypothesized that a microbiota profile specific to an obese host with increased energy-yielding behavior may exist. Consequently, the gut microbiota is becoming of significant research interest in relation to obesity in an attempt to better understand the aetiology of obesity and to develop new methods of its prevention and treatment. Alteration of microbiota composition may stimulate development of obesity and other metabolic diseases via several mechanisms: increasing gut permeability with subsequent metabolic inflammation; increasing energy harvest from the diet; impairing short-chain fatty acids synthesis; and altering bile acids metabolism and FXR/TGR5 signaling. Prebiotics and probiotics have physiologic functions that contribute to the health of gut microbiota, maintenance of a healthy body weight and control of factors associated with obesity through their effects on mechanisms that control food intake, body weight, gut microbiota and inflammatory processes.

  17. Abdominal actinomycosis mimicking acute appendicitis.

    PubMed

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  18. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  19. Similar Adiponectin Levels in Obese Normotensive and Obese Hypertensive Men and No Vasorelaxant Effect of Adiponectin on Human Arteries.

    PubMed

    Dreier, Rasmus; Asferg, Camilla; Berg, Jais O; Andersen, Ulrik B; Flyvbjerg, Allan; Frystyk, Jan; Linneberg, Allan; Jeppesen, Jørgen L; Edvinsson, Lars; Skovsted, Gry F

    2016-02-01

    Obesity is a strong risk factor for hypertension, but the mechanism linking obesity to hypertension is not fully elucidated. In obesity, circulating concentrations of adiponectin are decreased and hypoadiponectinaemia has in some but not all studies been associated with increased risk of hypertension. Due to this inconsistency, we decided to study adiponectin from two aspects in a cross-sectional in vivo study and in an experimental in vitro study. In the cross-sectional study, 103 men with body mass index (BMI) ≥ 30.0 kg/m(2) were studied; 63 had 24-hr ambulatory blood pressure (ABP) ≥ 130/80 mmHg (ObeseHT) and 40 had 24-hr ABP < 130/80 mmHg (ObeseNT). As controls, we studied 27 men with BMI between 20.0 and 24.9 kg/m(2) and 24-hr ABP < 130/80 mmHg (LeanNT). Serum concentrations of adiponectin and body composition using dual-energy X-ray absorptiometry scanning were determined. In vitro, the direct vasomotor response of adiponectin was tested on subcutaneous resistance arteries from human abdominal adipose tissue. The two obese groups had lower adiponectin concentrations compared with LeanNT (p < 0.01) [median (interquartile range)]: ObeseHT 6.5 (5.1-8.3) mg/L; ObeseNT 6.6 (5.2-7.8) mg/L; and LeanNT 9.4 (6.7-12.4) mg/L, with no significant difference in adiponectin concentrations (or body composition) between ObeseHT and ObeseNT (p = 0.67). In vitro, adiponectin did not have any direct vasodilatory effect and adiponectin did not affect angiotensin II-stimulated vasoconstriction. In conclusion, obese hypertensive men have similar serum concentrations of adiponectin as obese normotensive men. In combination with the in vitro data, these findings question a pathogenic role of adiponectin in human hypertension.

  20. Oral carnitine supplementation for dyslipidemia in chronic hemodialysis patients.

    PubMed

    Naini, Afsoon Emami; Sadeghi, Masoumeh; Mortazavi, Mojgan; Moghadasi, Mojdeh; Harandi, Asghar Amini

    2012-05-01

    Carnitine deficiency is a commonly observed problem in maintenance hemodialysis (MHD) patients, which results in altered metabolism of fatty acids and subsequently development of dyslipidemia. To evaluate the effect of oral L-carnitine (LC) supplementation on lipid profile of adult MHD patients, we studied 30 of them (19 males, 11 females) who received LC supplementation of 250 mg tablets three times a day for eight weeks. They were compared with 30 matched patients as a control group. Serum lipid profiles were compared before and after the intervention between the two groups. There was a significant decrease of the values of the lipid profile in the intervention group before and after carnitine supplementation including the mean values of total cholesterol (190 ± 36.8 vs. 177 ± 31.2 mg/dL), triglyceride (210 ± 64.7 vs. 190 ± 54.1 mg/dL) and LDL-cholesterol (117 ± 30.1 vs. 106 ± 26.3 mg/dL), while the values did not change siginificantly from base line in the control group. However, the difference for HDL-cholesterol in intervention group was not statistically significant. None of the patients dropped out of the study due to drug side effects. Oral LC supplementation (750 mg/day) is able to improve lipid profile in patients on MHD. Further long-term studies with adequate sample size are needed to define the population of patients who would benefit more from carnitine therapy and the optimal dose and the most efficient route for administration of the drug. PMID:22569432

  1. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

  2. Recurrent abdominal pain during childhood.

    PubMed Central

    Scott, R. B.

    1994-01-01

    Recurrent abdominal pain is a common presenting complaint among children. A thorough history and physical examination and limited laboratory investigation should enable a physician to make a positive diagnosis of "functional" recurrent abdominal pain in 90% to 95% of cases; an organic cause is identified in only 5% to 10%. The care and thoroughness of the history and physical examination establish the physician's credibility; explaining the clinical basis for the diagnosis and educating the child and parents on what is known about the condition reassures the parents. PMID:8199511

  3. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  4. Radiological management of abdominal abscess.

    PubMed Central

    Mac Erlean, D P; Gibney, R G

    1983-01-01

    Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure. PMID:6842496

  5. Lipoprotein lipase gene polymorphisms and risks of childhood obesity in Chinese preschool children.

    PubMed

    Wang, Li N; Yu, Qing; Xiong, Yan; Liu, Lin F; Zhang, Zhen; Zhang, Xue N; Cheng, Hao; Wang, Bei

    2011-10-01

    Childhood obesity is increasingly prevalent in the community and is related to many adult diseases. Lipoprotein lipase (LPL) plays a central role in dyslipidemia, and polymorphisms of the LPL gene may result in the disturbance in the lipid's metabolism. The aim of this study is to test the hypothesis that genetic variants of LPL and serum lipid levels are associated with the risk of childhood obesity. We genotyped +495T > G and PvuII T > C in an LPL gene and measured the serum lipid levels in a case-control study of 124 obese children and 346 frequency-matched normal controls in preschool Chinese children. The variant genotypes of LPL + 495GG and PvuII CC were associated with a significantly increased risk of childhood obesity [adjusted odds ratio (OR) = 2.39, 95% CI = 1.09-5.23 for +495 GG; adjusted OR = 2.00, 95% CI = 1.04-3.83 for PvuII CC], compared with their wild-type genotypes, respectively. In addition, compared with the lower serum level cut off by the control median, the higher level of serum triglyceride (TG) (>0.59 mmol/L) was associated with a 1.32-fold increased risk of childhood obesity, and the higher level of high density lipoprotein cholesterol (HDLC) (>1.14 mmol/L) was associated with a 36% decrease in risk of childhood obesity. Furthermore, the median levels of TG were higher in obese children carrying LPL +495TT/TG and PvuII TT/CT genotypes than those in controls, the HDLC levels were lower in obese children carrying LPL +495TG and PvuII CT/CC genotypes than those in controls. In conclusion, the LPL gene +495T > G and PvuII T > C polymorphisms may modulate the magnitude of dyslipidemia in Chinese early-onset obesity.

  6. Laparoscopic excision of intra-abdominal paragonimiasis.

    PubMed

    Kim, Jun-Young; Kang, Chang-Moo; Choi, Gi-Hong; Yang, Woo-Ick; Sim, Seo-Bo; Kwon, Ji-Eun; Kim, Kyung-Sik; Choi, Jin-Sub; Lee, Woo-Jung; Kim, Byong-Ro

    2007-12-01

    Lung fluke, Paragonimus westermani of Paragonimus species usually are accompanied by a persistent cough, hemoptysis, and chest pain. Extrapulmonary paragonimiasis caused by ectopic parasites in aberrant locations such as the abdominal wall, abdominal organs, and brain has been reported and the most commonly involved extrapulmonary organ is the brain. We present a case of 56-year-old male patient with intra-abdominal paragonimiasis who underwent laparoscopic excision of abdominal granuloma caused by parasite infection. An intra-abdominal mass associated with eosinophilia might be related to parasite infection. A laparoscopic approach is the most appropriate treatment modality in such benign abdominal pathology.

  7. Chronic stress, visceral obesity and gonadal dysfunction.

    PubMed

    Kyrou, Ioannis; Tsigos, Constantine

    2008-01-01

    Chronic stress represents a prolonged state of dyshomeostasis caused by intense and frequently imposed stressors. Obesity constitutes a chronic dysmetabolic state, leading progressively to a spectrum of metabolic complications, such as diabetes, dyslipidemia, hypertension and cardiovascular disease. Alpha growing body of evidence supports the existence of significant interactions between stress and obesity, with chronic stress promoting weight gain, and consequently excessive fat accumulation especially visceral, all these factors contributing to the development of a chronic stressful state. Maintaining body homeostasis is a prerequisite for normal reproductive function, which is vital for the survival of the species and an important process of natural selection. Under chronic stress, reproductive function is suspended and disrupted due to central and peripheral actions of hormones, adipokines and pro-inflammatory cytokines that inhibit the activity of the hypothalamic-pituitary gonadal (HPG) axis at various levels. Clinical and experimental data link both obesity and chronic stress to dysregulation of the gonadal axis, via independent and synergistic mechanisms, which may chronically lead to reproductive dysfunction and reduced fertility.

  8. Association of Oxidative Stress and Obesity with Insulin Resistance in Type 2 Diabetes Mellitus.

    PubMed

    Das, P; Biswas, S; Mukherjee, S; Bandyopadhyay, S K

    2016-01-01

    Oxidative stress occurs due to delicate imbalance between pro-oxidant and anti oxidant forces in our system. It has been found to be associated with many morbidities but its association with obesity and insulin resistance is still controversial. Here in our study we examined 167 patients of recent onset type 2 diabetes mellitus and 60 age sex matched non-diabetic control. Body Mass Index (BMI), abdominal circumference, fasting blood glucose, serum insulin and plasma Malondealdehyde (MDA, marker for oxidative stress) were measured in them. On the basis of BMI, subjects were divided into obese (BMI≥25) and non obese (BMI<25) groups. Insulin resistance scores were calculated by Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) method. Physical parameters (BMI, abdominal circumference) as well as levels of insulin and MDA were found to be significantly higher in subjects with diabetes than their non diabetic controls. The said parameters also showed significant difference in obese and non-obese sub groups. Insulin resistance score showed positive correlation with BMI, abdominal circumference, and plasma MDA, strength of association being highest with abdominal circumference. Plasma MDA was found to have positive correlation with physical parameters. Study concludes that, obesity mainly central type may predispose to insulin resistance and oxidative stress may be a crucial factor in its pathogenesis. Thus, oxidative stress may be the connecting link between obesity and type 2 diabetes mellitus, two on going global epidemics.

  9. Update on the clinical utility of fenofibrate in mixed dyslipidemias: mechanisms of action and rational prescribing

    PubMed Central

    Farnier, Michel

    2008-01-01

    Mixed dyslipidemia is a common lipid disorder characterized by the presence of an atherogenic lipoprotein phenotype due to abnormalities in various atherogenic and anti-atherogenic lipoproteins. Despite the link between the decrease of LDL-cholesterol by statin treatment and the prevention of cardiovascular disease, a high residual risk is observed in statin trials. This residual risk is partly explained by lipoprotein abnormalities other than LDL. Fenofibrate exerts a favorable effect on the atherogenic lipid profile of mixed dyslipidemia and can effectively reduce cardiovascular disease in patients with mixed dyslipidemia. Fenofibrate may offer important treatment alternatives as a second-line therapy in several circumstances: in combination with a statin for patients with mixed dyslipidemias not at goals on statin mono-therapy; in monotherapy for patients intolerant or with contraindication to statin therapy; and in combination with other drugs (ezetimibe, colesevelam) for patients with mixed dyslipidemias, known intolerance, or contraindication to statin and not at goals on fenofibrate monotherapy. However, the role of fenofibrate-statin therapy and of other therapies involving fenofibrate in cardiovascular risk reduction strategies remains to be established. PMID:19183747

  10. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies

    PubMed Central

    Hendrani, Aditya D; Adesiyun, Tolulope; Quispe, Renato; Jones, Steven R; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

    2016-01-01

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk. PMID:26981215

  11. LipidSeq: a next-generation clinical resequencing panel for monogenic dyslipidemias.

    PubMed

    Johansen, Christopher T; Dubé, Joseph B; Loyzer, Melissa N; MacDonald, Austin; Carter, David E; McIntyre, Adam D; Cao, Henian; Wang, Jian; Robinson, John F; Hegele, Robert A

    2014-04-01

    We report the design of a targeted resequencing panel for monogenic dyslipidemias, LipidSeq, for the purpose of replacing Sanger sequencing in the clinical detection of dyslipidemia-causing variants. We also evaluate the performance of the LipidSeq approach versus Sanger sequencing in 84 patients with a range of phenotypes including extreme blood lipid concentrations as well as additional dyslipidemias and related metabolic disorders. The panel performs well, with high concordance (95.2%) in samples with known mutations based on Sanger sequencing and a high detection rate (57.9%) of mutations likely to be causative for disease in samples not previously sequenced. Clinical implementation of LipidSeq has the potential to aid in the molecular diagnosis of patients with monogenic dyslipidemias with a high degree of speed and accuracy and at lower cost than either Sanger sequencing or whole exome sequencing. Furthermore, LipidSeq will help to provide a more focused picture of monogenic and polygenic contributors that underlie dyslipidemia while excluding the discovery of incidental pathogenic clinically actionable variants in nonmetabolism-related genes, such as oncogenes, that would otherwise be identified by a whole exome approach, thus minimizing potential ethical issues.

  12. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies.

    PubMed

    Hendrani, Aditya D; Adesiyun, Tolulope; Quispe, Renato; Jones, Steven R; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

    2016-02-26

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

  13. Socioeconomic Costs of Overweight and Obesity in Korean Adults

    PubMed Central

    Kang, Jae Heon; Cho, Young Gyu; Song, Hye Ryoung; Kim, Kyung A

    2011-01-01

    This study was conducted to estimate the socioeconomic costs of overweight and obesity in a sample of Korean adults aged 20 yr and older in 2005. The socioeconomic costs of overweight and obesity include direct costs (inpatient care, outpatient care and medication) and indirect costs (loss of productivity due to premature deaths and inpatient care, time costs, traffic costs and nursing fees). Hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, colon cancer and osteoarthritis were selected as obesity-related diseases. The population attributable fraction (PAF) of obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation (NHIC) cohort data and the 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Direct costs of overweight and obesity were estimated at approximately U$1,081 million equivalent (men: U$497 million, women: U$584 million) and indirect costs were estimated at approximately U$706 million (men: U$527 million, women: U$178 million). The estimated total socioeconomic costs of overweight and obesity were approximately U$1,787 million (men: U$1,081 million, women: U$706 million). These total costs represented about 0.22% of the gross domestic product (GDP) and 3.7% of the national health care expenditures in 2005. We found the socioeconomic costs of overweight and obesity in Korean adults aged 20 yr and older are substantial. In order to control the socioeconomic burden attributable to overweight and obesity, effective national strategies for prevention and management of obesity should be established and implemented. PMID:22147988

  14. Intraoperative arterial oxygenation in obese patients.

    PubMed Central

    Vaughan, R W; Wise, L

    1976-01-01

    Although obese patients have been shown to represent a particularly high risk group with respect to hypoxemia both pre and postoperatively, no data exist to delineate the intraoperative arterial oxygenation pattern of these patients. Furthermore, no one has studied the effects of a change in operative position or a subdiaphragmatic laparotomy pack on arterial oxygenation (PaO2). Sixty-four adults undergoing jejunoileal bypass for morbid exogenous obesity, with a mean weight of 142.0 +/- 31.4 kg and a mean age of 33.3 +/- 10.4 years, were studied. Twenty-five patients (Group I) were maintained in the supine position throughout the operative procedure, while the remaining 39 patients (Group II) were changed to a 15 degrees head down position 15 minutes after a control blood sample was taken. Four additional markedly obese patients were studied to determine the effect of an abdominal pack of PaO2 values. The following findings were demonstrated: 1) 40% oxygen did not uniformly produce adequate arterial oxygenation for intra-abdominal surgery in otherwise healthy obese patients; 2) placement of a subdiaphragmatic abdominal laparotomy pack without a change in operative position resulted in a consistent fall in PaO2 in each patient to less than 65 mm Hg even though 40% oxygen was being administered; and 3) a change from supine to a 15 degrees head down operative position resulted in a significant (P less than 0.001) reduction in mean PaO2 (73.0 +/- 26.3 mm Hg). Seventy-seven per cent of these patients demonstrated PaO2 values of less than 80 mm Hg on 40% oxygen. Because of these findings, serious consideration should be given to the routine use of the Trendelenberg position intraoperatively in obese patients. However, if one elects this posture, prudence would dictate careful monitoring and maintenance of arterial oxygenation. Certainly, in obese patients, the intraoperative combination of the head down position and a subdiaphragmatic laparotomy pack should be avoided

  15. Childhood obesity affects adult metabolic syndrome and diabetes.

    PubMed

    Liang, Yajun; Hou, Dongqing; Zhao, Xiaoyuan; Wang, Liang; Hu, Yuehua; Liu, Junting; Cheng, Hong; Yang, Ping; Shan, Xinying; Yan, Yinkun; Cruickshank, J Kennedy; Mi, Jie

    2015-09-01

    We seek to observe the association between childhood obesity by different measures and adult obesity, metabolic syndrome (MetS), and diabetes. Thousand two hundred and nine subjects from "Beijing Blood Pressure Cohort Study" were followed 22.9 ± 0.5 years in average from childhood to adulthood. We defined childhood obesity using body mass index (BMI) or left subscapular skinfold (LSSF), and adult obesity as BMI ≥ 28 kg/m(2). MetS was defined according to the joint statement of International Diabetes Federation and American Heart Association with modified waist circumference (≥ 90/85 cm for men/women). Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/L or blood glucose 2 h after oral glucose tolerance test ≥ 11.1 mmol/L or currently using blood glucose-lowering agents. Multiple linear and logistic regression models were used to assess the association. The incidence of adult obesity was 13.4, 60.0, 48.3, and 65.1 % for children without obesity, having obesity by BMI only, by LSSF only, and by both, respectively. Compared to children without obesity, children obese by LSSF only or by both had higher risk of diabetes. After controlling for adult obesity, childhood obesity predicted independently long-term risks of diabetes (odds ratio 2.8, 95 % confidence interval 1.2-6.3) or abdominal obesity (2.7, 1.6-4.7) other than MetS as a whole (1.2, 0.6-2.4). Childhood obesity predicts long-term risk of adult diabetes, and the effect is independent of adult obesity. LSSF is better than BMI in predicting adult diabetes.

  16. The db/db mouse, a model for diabetic dyslipidemia: molecular characterization and effects of Western diet feeding.

    PubMed

    Kobayashi, K; Forte, T M; Taniguchi, S; Ishida, B Y; Oka, K; Chan, L

    2000-01-01

    Diabetic dyslipidemia is a major factor contributing to the accelerated atherosclerosis in type 2 diabetes mellitus. Although several mouse models are available, the plasma lipoproteins in response to diet have not been fully characterized in these animals. In this study, we have characterized the plasma lipoproteins and related apolipoproteins, as well as the vascular lipases, in diabetes (db/db) mice and their nondiabetic controls (+/?) in the C57BL/KsJ strain. Within 6 weeks of age, db/db mice developed significant obesity, fasting hyperglycemia, and hyperinsulinemia. By FPLC analysis, db/db mice showed a prominent peak in the low-density lipoprotein (LDL) range that was absent in +/? mice, although high-density lipoprotein (HDL) was the predominant species in both groups of animals. Postheparin lipoprotein lipase (LPL) activity in db/db mice was 28% of the level in +/? mice. Upon feeding a human-like 0.15% (wt/wt) cholesterol and 21% (wt/wt) fat "Western" diet, db/db mice developed elevated plasma cholesterol, accompanied by an exaggerated apolipoprotein E (apoE) response compared with +/? mice. FPLC analysis showed that the marked hypercholesterolemic response in db/db mice was the result of a massive increase in the LDL region, which overshadowed a moderate increase in HDL. We next isolated lipoproteins by ultracentrifugation and characterized them by nondenaturing gradient gel electrophoresis. With regular chow, db/db mice had almost exclusively small dense LDL with a peak size at 21.4 nm, as compared with 26.6 nm in nondiabetic controls. On the Western diet, the small dense LDLs persisted but larger particles also appeared in db/db mice, whereas the size distribution in +/? mice was unchanged by the diet. Our results suggest that db/db mice fed a Western diet have a plasma lipoprotein phenotype that shows some similarities to that in patients with type 2 diabetes mellitus, and that db/db mice are a useful model to study the pathogenesis and treatment of

  17. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

  18. A perspective on the current strategies for the treatment of obesity.

    PubMed

    Joyal, Steven V

    2004-10-01

    The prevalence in obesity has increased dramatically over the past 30 years, more than double in the United States alone. Obesity is associated with an increased risk for type 2 diabetes mellitus, dyslipidemia, hypertension, biliary disease, obstructive sleep apnea, and certain types of cancer. The pathophysiology of obesity is complex, involving behavioral, environmental, and genetic factors. Current treatment options include behavior modification and lifestyle changes which incorporate weight-reducing diets and physical activity, FDA approved long-term anti-obesity pharmacological agents sibutramine and orlistat, non-FDA approved over-the-counter (OTC) supplements and nutriceuticals, and, when appropriate, bariatric surgery. Without adequate prevention and treatment of obesity, government agencies have suggested that the direct and indirect costs associated with obesity may overwhelm the healthcare system. This brief review explores the current data available on treatments for the obese patient including the relative merits of different types of macronutrient composition (e.g., low carbohydrate vs. high carbohydrate diets) of weight-reducing diets, the value of resistance/ strength training in physical activity programs designed for the obese patient, the safety and efficacy associated with OTC supplements and nutriceuticals for weight reduction (e.g., Ephedra, conjugated linoleic acid (CLA), Garcinia cambogia/ hydroxycitric acid (HCA), chromium, pyruvate), the safety and efficacy of FDA-approved long-term obesity treatments sibutramine and orlistat, and bariatric surgery. PMID:15544444

  19. Effects of fibre-enriched diets on tissue lipid profiles of MSG obese rats.

    PubMed

    Rotimi, O A; Olayiwola, I O; Ademuyiwa, O; Balogun, E A

    2012-11-01

    In order to investigate the influence of some fibre-enriched diets on tissue lipids in an animal model of obesity induced by the administration of monosodium glutamate (MSG), obese rats were fed diets containing 30% of Acha, Cassava, Maize and Plantain for five weeks and weight gain, feed intake and lee index were recorded. The lipid profiles of plasma, erythrocytes, kidney, heart and liver as well as hepatic 3-hydroxyl-3-methylglutaryl-CoA (HMG-CoA) reductase activity were measured. The diets significantly (p<0.05) reduced weight gain and lee index in the obese rats. Obesity-induced increase in plasma and erythrocytes lipid levels was significantly (p<0.05) reduced by these diets. MSG-induced obesity also resulted in a significant increase (p<0.05) in hepatic cholesterol level which was reduced by the diets. MSG-obesity was characterised by a significant (p<0.05) increase in cholesterol, triacylglycerol and phospholipids in kidney and this was reversed by the diets except Maize which did not reverse the increased cholesterol level. Only Acha reversed the obesity-induced increase in heart cholesterol and phospholipids. The increased activity of hepatic HMG-CoA reductase associated with obesity was also significantly (p<0.05) reduced by the diets. In conclusion, dyslipidemia associated with MSG-induced obesity could be attenuated by consumption of fibre-enriched diets. PMID:22898616

  20. Obesity patterns among women in a slum area in Brazil.

    PubMed

    Alves, Joao G; Falcão, Romero W; Pinto, Renato A; Correia, Jailson B

    2011-06-01

    High-energy diet and sedentary lifestyle fail to completely explain the epidemic of obesity in developing countries. In this cross-sectional survey, the prevalence and patterns of overweight/obesity were assessed among women in a slum in Brazil. Using anthropometric measurements, shorter form of the International Physical Activity Questionnaire (IPAQ), and a 24-hour diet recall questionnaire, data were collected from 632 women aged 20-60 years. The prevalence of overweight and obesity was 29% and 17% respectively. Physical inactivity was found in 17% of the women; 12% of them had short stature, and 44% had energy intake below the recommended dietary allowance. Results of multiple logistic regression showed that overweight/obesity differed significantly (p < 0.05) in the following aspects: abdominal circumference, energy intake, and short stature. A high prevalence of overweight/obesity was found in a very poor community associated with high-energy intake and short stature.

  1. Are conjugated linolenic acid isomers an alternative to conjugated linoleic acid isomers in obesity prevention?

    PubMed

    Miranda, Jonatan; Arias, Noemi; Fernández-Quintela, Alfredo; del Puy Portillo, María

    2014-04-01

    Despite its benefits, conjugated linoleic acid (CLA) may cause side effects after long-term administration. Because of this and the controversial efficacy of CLA in humans, alternative biomolecules that may be used as functional ingredients have been studied in recent years. Thus, conjugated linolenic acid (CLNA) has been reported to be a potential anti-obesity molecule which may have additional positive effects related to obesity. According to the results reported in obesity, CLNA needs to be given at higher doses than CLA to be effective. However, because of the few studies conducted so far, it is still difficult to reach clear conclusions about the potential use of these CLNAs in obesity and its related changes (insulin resistance, dyslipidemia, or inflammation).

  2. Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality

    PubMed Central

    LeRoith, Derek

    2015-01-01

    Obesity and type 2 diabetes are becoming increasingly prevalent worldwide, and both are associated with an increased incidence and mortality from many cancers. The metabolic abnormalities associated with type 2 diabetes develop many years before the onset of diabetes and, therefore, may be contributing to cancer risk before individuals are aware that they are at risk. Multiple factors potentially contribute to the progression of cancer in obesity and type 2 diabetes, including hyperinsulinemia and insulin-like growth factor I, hyperglycemia, dyslipidemia, adipokines and cytokines, and the gut microbiome. These metabolic changes may contribute directly or indirectly to cancer progression. Intentional weight loss may protect against cancer development, and therapies for diabetes may prove to be effective adjuvant agents in reducing cancer progression. In this review we discuss the current epidemiology, basic science, and clinical data that link obesity, diabetes, and cancer and how treating obesity and type 2 diabetes could also reduce cancer risk and improve outcomes. PMID:26084689

  3. Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality.

    PubMed

    Gallagher, Emily Jane; LeRoith, Derek

    2015-07-01

    Obesity and type 2 diabetes are becoming increasingly prevalent worldwide, and both are associated with an increased incidence and mortality from many cancers. The metabolic abnormalities associated with type 2 diabetes develop many years before the onset of diabetes and, therefore, may be contributing to cancer risk before individuals are aware that they are at risk. Multiple factors potentially contribute to the progression of cancer in obesity and type 2 diabetes, including hyperinsulinemia and insulin-like growth factor I, hyperglycemia, dyslipidemia, adipokines and cytokines, and the gut microbiome. These metabolic changes may contribute directly or indirectly to cancer progression. Intentional weight loss may protect against cancer development, and therapies for diabetes may prove to be effective adjuvant agents in reducing cancer progression. In this review we discuss the current epidemiology, basic science, and clinical data that link obesity, diabetes, and cancer and how treating obesity and type 2 diabetes could also reduce cancer risk and improve outcomes. PMID:26084689

  4. Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection.

    PubMed

    Rattan, Rishi; Allen, Casey J; Sawyer, Robert G; Mazuski, John; Duane, Therese M; Askari, Reza; Banton, Kaysie L; Claridge, Jeffrey A; Coimbra, Raul; Cuschieri, Joseph; Dellinger, E Patchen; Evans, Heather L; Guidry, Christopher A; Miller, Preston R; O'Neill, Patrick J; Rotstein, Ori D; West, Michaela A; Popovsky, Kimberley; Namias, Nicholas

    2016-09-01

    A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intra-abdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness.

  5. Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection.

    PubMed

    Rattan, Rishi; Allen, Casey J; Sawyer, Robert G; Mazuski, John; Duane, Therese M; Askari, Reza; Banton, Kaysie L; Claridge, Jeffrey A; Coimbra, Raul; Cuschieri, Joseph; Dellinger, E Patchen; Evans, Heather L; Guidry, Christopher A; Miller, Preston R; O'Neill, Patrick J; Rotstein, Ori D; West, Michaela A; Popovsky, Kimberley; Namias, Nicholas

    2016-09-01

    A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intra-abdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness. PMID:27670577

  6. Treatment options for dyslipidemia in chronic kidney disease and for protection from contrast-induced nephropathy.

    PubMed

    Athyros, Vasilios G; Tziomalos, Konstantinos; Karagiannis, Asterios

    2015-01-01

    Chronic kidney disease (CKD) is highly prevalent worldwide and represents a major cardiovascular risk factor. Dyslipidemia is present in most patients with CKD and further worsens CKD, creating a vicious cycle. The treatment of CKD-related dyslipidemia has been a controversial topic. The use of statins is recommended in all stages of CKD, but it appears to reduce cardiovascular and renal events only in the early CKD stages, up to stage 3. The use of atorvastatin has proven very beneficial; thus, the earliest we start statin treatment, the better for the patient. Atorvastatin and pitavastatin do not need dose adjustments at any level of renal function. Fibrates can be administered in mixed hyperlipidemia, combined with statins in early CKD stages. Omega-3 fatty acids are useful for treating hypertriglyceridemia in CKD. Antibodies against proprotein convertase subtilisin/kexin type 9 hold promise for a better control of dyslipidemia and a greater reduction of cardiovascular risk. PMID:26206619

  7. New insights into the pathophysiology of dyslipidemia in type 2 diabetes.

    PubMed

    Taskinen, Marja-Riitta; Borén, Jan

    2015-04-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality for patients with type 2 diabetes, despite recent significant advances in management strategies to lessen CVD risk factors. A major cause is the atherogenic dyslipidemia, which consists of elevated plasma concentrations of both fasting and postprandial triglyceride-rich lipoproteins (TRLs), small dense low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) cholesterol. The different components of diabetic dyslipidemia are not isolated abnormalities but closely linked to each other metabolically. The underlying disturbances are hepatic overproduction and delayed clearance of TRLs. Recent results have unequivocally shown that triglyceride-rich lipoproteins and their remnants are atherogenic. To develop novel strategies for the prevention and treatment of dyslipidaemia, it is essential to understand the pathophysiology of dyslipoproteinaemia in humans. Here, we review recent advances in our understanding of the pathophysiology of diabetic dyslipidemia.

  8. [Effect of jiang-zhi jian-fei yao on gastro-intestinal movement and adipose cell of abdominal wall].

    PubMed

    Jin, H M; Jiao, D H

    1994-04-01

    Jiang-Zhi Jian-Fei Yao (JZJFY), an obesity-reducing drug, its active principle is the refined Rhubarb, the mechanism of its obesity-reducing effect was studied. JZJFY was injected intragastrically. The results showed that there was no significant increased of body weight, but a reduction of food intake, prolongation of stomach evacuation time, acceleration of intestinal movement 6 days after medication in rats. Meanwhile the adipose cells in abdominal wall were varied in size, and with Sudan III stain the color of adipose cells was light. Authors suggest that the obesity-reducing effect of JZJFY was relevant to above-mentioned changes.

  9. A randomized trial of a community-based approach to dyslipidemia management

    PubMed Central

    Tsuyuki, Ross T.; Rosenthal, Meagen; Pearson, Glen J.

    2016-01-01

    Background: Dyslipidemia is an important risk factor for cardiovascular disease but is suboptimally managed. Pharmacists are accessible primary care professionals and with expanded scopes of practice (including prescribing), could identify and manage patients with dyslipidemia. We sought to evaluate the effect of pharmacist prescribing of dyslipidemia medications on the proportion of participants achieving target LDL-cholesterol (LDL-c) levels. Methods: We conducted a randomized controlled trial in 14 community pharmacies in Alberta, Canada. We enrolled adults with uncontrolled dyslipidemia as defined by the 2009 Canadian Dyslipidemia Guidelines. Intervention was pharmacist-directed dyslipidemia care, including assessment of cardiovascular risk, review of LDL-c, prescribing of medications, health behaviour interventions and follow-up every 6 weeks for 6 months. Usual care patients received their lipid results and a pamphlet on cardiovascular disease and usual care from their physician and pharmacist. Primary outcome was the proportion of participants achieving their target LDL-c (<2 mmol/L or ≥50% reduction) at 6 months between groups. Results: We enrolled 99 patients with a mean (SD) age of 63 (13) years, 49% male and baseline LDL-c of 3.37 mmol/L (0.98). Proportion of patients achieving LDL-c target was 43% intervention versus 18% control (p = 0.007). Adjusted odds of achieving target LDL-c were 3.3 times higher for the intervention group (p = 0.031), who also achieved greater reduction in LDL-c (1.12 mmol/L, SE = 0.112) versus control (0.42 mmol/L, SE = 0.109), for an adjusted mean difference of 0.546 mmol/L (SE = 0.157), p < 0.001. Conclusion: Pharmacist prescribing resulted in >3-fold more patients achieving target LDL-c levels. This could have major public health implications. PMID:27708674

  10. PPAR α and PPAR γ Polymorphisms as risk factors for Dyslipidemia in a Chinese han population

    PubMed Central

    2014-01-01

    Background The PPAR α and PPAR γ are the key messengers responsible for the translation of nutritional stimuli into changes for the expression of genes, particularly genes involved in lipid metabolism. However, the associations between PPAR α / γ polymorphisms and lipid serum levels in the general population were rarely studied, and the conclusions were conflicting. The objective was to investigate the associations of the PPAR α and PPAR γ polymorphisms with dyslipidemia. Methods 820 subjects were randomly selected from the Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province cohort populations. The logistic regression model was used to examine the association between these polymorphisms and dyslipidemia. SNPstats was used to explore the haplotype association analyses. Results In the codominant and log-additive models, rs1800206, rs1805192 and rs3856806 were all associated with dyslipidemia (P < 0.005). When the most common haplotype L-G (established by rs1800206, rs4253778) was treated as the reference group, the V-G haplotype was associated with dyslipidemia (P < 0.001), higher TC and TG levels (P < 0.01). Moreover, when compared to Pro-C haplotype (established by rs1805192, rs3856806), the Pro-T, Ala-C, Ala-T haplotypes were associated with dyslipidemia (p < 0.001). A-T haplotype was associated with higher TC levels, (p < 0.01), and the P-T, A-C, A-T haplotypes were associated with higher TG levels (p < 0.01). Conclusions PPAR α and PPAR γ polymorphisms and haplotypes may be the genetic risk factors for dyslipidemia. PMID:24460649

  11. Are there healthy obese?

    PubMed

    Griera Borrás, José Luis; Contreras Gilbert, José

    2014-01-01

    It is currently postulated that not all obese individuals have to be considered as pathological subjects. From 10% to 20% of obese people studied do not show the metabolic changes common in obese patients. The term "healthy obese" has been coined to refer to these patients and differentiate them from the larger and more common group of pathological obese subjects. However, the definition of "healthy obese" is not clear. Use of "healthy obese" as a synonym for obese without metabolic complications is risky. Clinical markers such as insulin resistance are used to identify this pathology. It is not clear that healthy obese subjects have lower morbidity and mortality than pathologically obese patients. According to some authors, healthy obese would represent an early stage in evolution towards pathological obesity. There is no agreement as to the need to treat healthy obese subjects.

  12. Are there healthy obese?

    PubMed

    Griera Borrás, José Luis; Contreras Gilbert, José

    2014-01-01

    It is currently postulated that not all obese individuals have to be considered as pathological subjects. From 10% to 20% of obese people studied do not show the metabolic changes common in obese patients. The term "healthy obese" has been coined to refer to these patients and differentiate them from the larger and more common group of pathological obese subjects. However, the definition of "healthy obese" is not clear. Use of "healthy obese" as a synonym for obese without metabolic complications is risky. Clinical markers such as insulin resistance are used to identify this pathology. It is not clear that healthy obese subjects have lower morbidity and mortality than pathologically obese patients. According to some authors, healthy obese would represent an early stage in evolution towards pathological obesity. There is no agreement as to the need to treat healthy obese subjects. PMID:24210176

  13. Abdomina