FREQUENCY OF ABDOMINAL OBESITY AND ITS ASSOCIATION WITH DIABETES MELLITUS AMONG PEOPLE OF PESHAWAR.

PubMed

Khan, Attaullah; Faheem, Muhammad; Shah, Syed Tahir; Hadi, Abdul; Rafiullah; Ahmad, Salman; Gul, Adnan Mahmood; Shah, Sayyad Farhat Abbas; Jan, Hikmatullah; Hafizullah, Mohammad

2015-01-01

Increased body weight is a major risk factor for the metabolic syndrome which is a cluster of coronary heart disease risk factors, like: hypertension, diabetes mellitus and dyslipidaemia. This study was conducted to determine the frequency of abdominal obesity and diabetes mellitus in the population of Peshawar and association between them. This was a cross sectional study, performed by the Cardiology Department, Lady Reading Hospital Peshawar, in the population of Peshawar. All participants were interviewed in detail regarding known risk factors for coronary artery disease. Waist circumference (≥102 cm in male and ≥88 cm in females) was used as the surrogate marker for abdominal obesity in already diagnosed patients of type-2 diabetes mellitus. A total of 2548 individuals were included, 71.1% were male. Mean age was 37.94±12.59 years. Mean waist circumference was 90.25±13.45cm in males and 90.52±12.52cm in females. Diabetes was present in 4.4% of the participants and abdominal obesity in 56.6% Among the male, abdominal obesity was present in 39.4% and diabetes in 2.9%. Out of 39.4% males with abdominal obesity, 2% were diabetic. Out of 38.6% males with no abdominal obesity, 0.9% was diabetic. Amongst the total 559 (21.1%) female subjects, 17.2% were having abdominal obesity and 1.4% was diabetics. Among 123 (4.8%) females with no abdominal obesity, 0.1% was diabetic. A positive association was established between abdominal obesity and diabetes mellitus with a significant p-valve (<0.05). Abdominal obesity is more common in the local population of Peshawar and associated with type-2 diabetes mellitus.

Left ventricular function impairment in patients with normal-weight obesity: contribution of abdominal fat deposition, profibrotic state, reduced insulin sensitivity, and proinflammatory activation.

PubMed

Kosmala, Wojciech; Jedrzejuk, Diana; Derzhko, Roksolana; Przewlocka-Kosmala, Monika; Mysiak, Andrzej; Bednarek-Tupikowska, Grazyna

2012-05-01

Obesity predisposes to left ventricular (LV) dysfunction and heart failure; however, the risk of these complications has not been assessed in patients with a normal body mass index (BMI) but increased body fat content (normal-weight obesity, NWO). We hypothesized that LV performance in NWO may be impaired and sought to investigate potential contributors to cardiac functional abnormalities. One hundred sixty-eight subjects (age, 38±7 years) with BMI <25kg/m(2) and no history of any disease affecting the myocardium were classified on the basis of body fat content into 2 groups: with NWO and without NWO. Echocardiographic indices of LV systolic and diastolic function, including myocardial velocities and deformation, serological fibrosis markers, indicators of proinflammatory activation, and metabolic control, were evaluated. Subjects with NWO demonstrated impaired LV systolic and diastolic function, increased fibrosis intensity (assessed by procollagen type I carboxy-terminal propeptide [PICP]), impaired insulin sensitivity, and increased proinflammatory activation as compared with individuals with normal body fat. The independent correlates of LV systolic and diastolic function variables were as follows: for strain, IL-18 (β=-0.17, P<0.006), C-reactive protein (β=-0.20, P<0.002) and abdominal fat deposit (β=-0.20, P<0.003); for tissue S velocity, PICP (β=-0.21, P<0.002) and abdominal fat deposit (β=-0.43, P<0.0001); for tissue E velocity, abdominal fat deposit (β=-0.30, P<0.0001), PICP (β=-0.31, P<0.0001) and homeostasis model assessment of insulin resistance index (HOMA IR; β=-0.20, P<0.002); and for E/e'-PICP, IL-18 (both β=0.18, P<0.01) and HOMA IR (β=0.16, P<0.04). In patients with NWO, subclinical disturbances of LV function are independently associated with the extent of abdominal fat deposit, profibrotic state (as reflected by circulating PICP), reduced insulin sensitivity, and proinflammatory activation.

Prevalence of overweight, obesity, abdominal obesity and obesity-related risk factors in southern China.

PubMed

Hu, Lihua; Huang, Xiao; You, Chunjiao; Li, Juxiang; Hong, Kui; Li, Ping; Wu, Yanqing; Wu, Qinhua; Wang, Zengwu; Gao, Runlin; Bao, Huihui; Cheng, Xiaoshu

2017-01-01

The purpose of this study is to assess the prevalence of overweight/obesity, abdominal obesity and obesity-related risk factors in southern China. A cross-sectional survey of 15,364 participants aged 15 years and older was conducted from November 2013 to August 2014 in Jiangxi Province, China, using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), body fat percentage (BFP) and visceral adipose index (VAI). Multivariate logistic regression analysis was performed to evaluate the risk factors for overweight/obesity and abdominal obesity. The prevalence of overweight was 25.8% (25.9% in males and 25.7% in females), while that of obesity was 7.9% (8.4% in males and 7.6% in females). The prevalence of abdominal obesity was 10.2% (8.6% in males and 11.3% in females). The prevalence of overweight/obesity was 37.1% in urban residents and 30.2% in rural residents, and this difference was significant (P < 0.001). Urban residents had a significantly higher prevalence of abdominal obesity than rural residents (11.6% vs 8.7%, P < 0.001). Among the participants with an underweight/normal body mass index (BMI), 1.3% still had abdominal obesity, 16.1% had a high BFP and 1.0% had a high VAI. Moreover, among obese participants, 9.7% had a low /normal WC, 0.8% had a normal BFP and 15.9% had a normal VAI. Meanwhile, the partial correlation analysis indicated that the correlation coefficients between VAI and BMI, VAI and WC, and BMI and WC were 0.700, 0.666, and 0.721, respectively. A multivariate logistic regression analysis indicated that being female and having a high BFP and a high VAI were significantly associated with an increased risk of overweight/obesity and abdominal obesity. In addition, living in an urban area and older age correlated with overweight/obesity. This study revealed that obesity and abdominal obesity, which differed by gender and age, are epidemic in southern China. Moreover, there

Prevalence of overweight, obesity, abdominal obesity and obesity-related risk factors in southern China

PubMed Central

Hu, Lihua; Huang, Xiao; You, Chunjiao; Li, Juxiang; Hong, Kui; Li, Ping; Wu, Yanqing; Wu, Qinhua; Wang, Zengwu; Gao, Runlin; Bao, Huihui

2017-01-01

Objectives The purpose of this study is to assess the prevalence of overweight/obesity, abdominal obesity and obesity-related risk factors in southern China. Methods A cross-sectional survey of 15,364 participants aged 15 years and older was conducted from November 2013 to August 2014 in Jiangxi Province, China, using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), body fat percentage (BFP) and visceral adipose index (VAI). Multivariate logistic regression analysis was performed to evaluate the risk factors for overweight/obesity and abdominal obesity. Results The prevalence of overweight was 25.8% (25.9% in males and 25.7% in females), while that of obesity was 7.9% (8.4% in males and 7.6% in females). The prevalence of abdominal obesity was 10.2% (8.6% in males and 11.3% in females). The prevalence of overweight/obesity was 37.1% in urban residents and 30.2% in rural residents, and this difference was significant (P < 0.001). Urban residents had a significantly higher prevalence of abdominal obesity than rural residents (11.6% vs 8.7%, P < 0.001). Among the participants with an underweight/normal body mass index (BMI), 1.3% still had abdominal obesity, 16.1% had a high BFP and 1.0% had a high VAI. Moreover, among obese participants, 9.7% had a low /normal WC, 0.8% had a normal BFP and 15.9% had a normal VAI. Meanwhile, the partial correlation analysis indicated that the correlation coefficients between VAI and BMI, VAI and WC, and BMI and WC were 0.700, 0.666, and 0.721, respectively. A multivariate logistic regression analysis indicated that being female and having a high BFP and a high VAI were significantly associated with an increased risk of overweight/obesity and abdominal obesity. In addition, living in an urban area and older age correlated with overweight/obesity. Conclusion This study revealed that obesity and abdominal obesity, which differed by gender and age, are

[Excess weight and abdominal obesity in Galician children and adolescents].

PubMed

Pérez-Ríos, Mónica; Santiago-Pérez, María Isolina; Leis, Rosaura; Martínez, Ana; Malvar, Alberto; Hervada, Xurxo; Suanzes, Jorge

2017-12-06

The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6-15-years-old in the school year 2013-2014. Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15 years-old. The prevalence of underweight, overweight, and obese children (Cole's cut-off criteria) and abdominal obesity (Taylor's cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. A total of 7,438 students were weighed and measured in 137 schools. The prevalence of overweight and obese individuals was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of the premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Stress, abdominal obesity and intrarenal resistive index in essential hypertension.

PubMed

Trovato, G M; Pace, P; Martines, G F; Trovato, F M; Pirri, C; Catalano, D

2012-07-01

Although it is commonly believed that a strong causal link exists between psychological stress and hypertension, as well with other factors, such as obesity, just what kind of empirical evidence supports this assumption is still controversial. The aim of the study is to investigate if perceived stress have any interference with intrarenal resistance and hence with mechanisms related to Essential Hypertension (EH) and if Anxiety, Depression, Self efficacy and Illness Perception can account for perceived stress. Obesity, insulin resistance (HOMA), Doppler Renal Resistive Index (RRI) and glomerular filtration rate (GFR) are studied along with Psychological Stress Measure (PSM), Illness Perception Questionnaire (IPQ-R), Generalized Self-Efficacy scale (GSE) and Hospital Anxiety and Depression Scale (HADS) in 119 hypertensive patients referred for stable lasting EH, and 150 normal controls. Lower salt/lower calories Mediterranean diet, physical activity increase and smoking withdrawal counseling were provided. By Odds Ratios, higher risk of EH is associated with greater perceived stress, older age, lower GFR, obesity, greater RRI and insulin resistance. By Multiple Linear Regression the most significant variable that accounts for higher RRI are abdominal obesity and arterial pulse pressure; the only significant independent psychological variable that accounts for abdominal obesity are PSM and identity IPQ subscale. Self-Efficacy anxiety and Illness perception subscales (IPQr), accounts significantly for 62.0% of the variance to PSM, with possible effects on RRI and on the pathophysiological hypertension cascade. Worst identity and treatment control perceptions of EH, and a lower self-efficacy are the main psychological factors accounting for a greater stress. Interventions aimed to reduce perceived stress can be warranted in EH.

Effect of rimonabant on progression of atherosclerosis in patients with abdominal obesity and coronary artery disease: the STRADIVARIUS randomized controlled trial.

PubMed

Nissen, Steven E; Nicholls, Stephen J; Wolski, Kathy; Rodés-Cabau, Josep; Cannon, Christopher P; Deanfield, John E; Després, Jean-Pierre; Kastelein, John J P; Steinhubl, Steven R; Kapadia, Samir; Yasin, Muhammad; Ruzyllo, Witold; Gaudin, Christophe; Job, Bernard; Hu, Bo; Bhatt, Deepak L; Lincoff, A Michael; Tuzcu, E Murat

2008-04-02

Abdominal obesity is associated with metabolic abnormalities and increased risk of atherosclerotic cardiovascular disease. However, no obesity management strategy has demonstrated the ability to slow progression of coronary disease. To determine whether weight loss and metabolic effects of the selective cannabinoid type 1 receptor antagonist rimonabant reduces progression of coronary disease in patients with abdominal obesity and the metabolic syndrome. Randomized, double-blinded, placebo-controlled, 2-group, parallel-group trial (enrollment December 2004-December 2005) comparing rimonabant with placebo in 839 patients at 112 centers in North America, Europe, and Australia. Patients received dietary counseling, were randomized to receive rimonabant (20 mg daily) or matching placebo, and underwent coronary intravascular ultrasonography at baseline (n = 839) and study completion (n = 676). The primary efficacy parameter was change in percent atheroma volume (PAV); the secondary efficacy parameter was change in normalized total atheroma volume (TAV). In the rimonabant vs placebo groups, PAV (95% confidence interval [CI]) increased 0.25% (-0.04% to 0.54%) vs 0.51% (0.22% to 0.80%) (P = .22), respectively, and TAV decreased 2.2 mm3 (-4.09 to -0.24) vs an increase of 0.88 mm3 (-1.03 to 2.79) (P = .03). In the rimonabant vs placebo groups, imputing results based on baseline characteristics for patients not completing the trial, PAV increased 0.25% (-0.04% to 0.55%) vs 0.57% (0.29% to 0.84%) (P = .13), and TAV decreased 1.95 mm3 (-3.8 to -0.10) vs an increase of 1.19 mm3 (-0.73 to 3.12) (P = .02). Rimonabant-treated patients had a larger reduction in body weight (4.3 kg [-5.1 to -3.5] vs 0.5 kg [-1.3 to 0.3]) and greater decrease in waist circumference (4.5 cm [-5.4 to -3.7] vs 1.0 cm [-1.9 to -0.2]) (P < .001 for both comparisons). In the rimonabant vs placebo groups, high-density lipoprotein cholesterol levels increased 5.8 mg/dL (4.9 to 6.8) (22.4%) vs 1.8 mg/dL (0.9 to

Prevalence of overweight, obesity, abdominal-obesity and short stature of adult population of Rosario, Argentina.

PubMed

Zapata, María Elisa; Bibiloni, María Del Mar; Tur, Josep A

2016-09-20

The aim of this work was to assess the prevalence of overweight, obesity, abdominal-obesity and short stature among Rosario (Argentina) adult population. A cross-sectional nutritional survey was carried out in Rosario (2012-2013). A random sample (n = 1194) of adult population (18-70 years old) was interviewed. Anthropometric measurements and a general questionnaire incorporating questions related to socio-demographic and lifestyle characteristics, education level and physical activity were used. The current study detected a high prevalence of overweight and obesity among adult population in Rosario. The prevalence of overweight was 32.7% (43.9% in men and 27.6% in women, p < 0.001), of obesity was 23.5% (21.6% in men and 24.3% in women), and of abdominal obesity was 57.5% (63.5% in men vs.54.8% in women, p < 0.005). Multivariate analysis showed that the prevalence of overweight/obesity and abdominal obesity increased according the age and abdominal obesity decreased with high physical activity in men. In women prevalence of overweight/obesity, and abdominal obesity increased with age, marital status (married or coupled), presence of at least one child at home and low educational level. The prevalence of short stature was higher in women (16.4% vs. 8.4%, p < 0.001) and was related with age, overweight and abdominal obesity.

[Abdominal ultrasound and magnetic resonance imaging: a comparative study on the non-alcoholic fatty liver disease diagnosis in morbidly obese patients].

PubMed

Chaves, Gabriela Villaça; Pereira, Sílvia Elaine; Saboya, Carlos José; Cortes, Caroline; Ramalho, Rejane

2009-01-01

To evaluate the concordance between abdominal ultrasound and an MRI (Magnetic Resonance Imaging) in the diagnosis of non-alcoholic fatty liver disease (NAFLD), and concordance of these two methods with the histopathological exam. The population studied was comprised of 145 patients with morbid obesity (BMI > or = 40 Kg/m(2)), of both genders. NAFLD diagnosis was performed by MRI and Ultrasound. Liver biopsy was performed in a sub-sample (n=40). To evaluate the concordance of these two methods, the kappa coefficient was used. Concordance between both methods (MRI and Ultrasound) was poor and not significant (Kappa adjusted= 0.27; CI 95%= 0.07-0.39.) Nevertheless a slight concordance was found between diagnosis of NAFLD by ultrasound and the hepatic biopsy, with 83.,3% of concordant results and Kappa adjusted= 0.67.Results of an MRI and the histopathological exam were compared and results showed 53.6% of concordant results and kappa adjusted= 0.07. The concordance found in the diagnosis performed using the ultrasound method and the hepatic biopsy, shows a need to implement and perform more research on the use of ultrasound to validate and reconsider these methods. This would minimize the need to perform biopsies to detect and diagnose such disease.

[BO's abdominal acupuncture for obese type-2 diabetes mellitus].

PubMed

Yang, Yuan; Liu, Yunxia

2015-04-01

To observe the clinical efficacy of BO's abdominal acupuncture for obese type-2 diabetes mellitus (T2DM). Sixty patients of obese T2DM were randomly divided into an acupuncture group and a medication group, 30 cases in each one. Patients in the medication group were treated with basic treatment combined with oral administration of regular antidiabetics, three weeks as one session. Patients in the acupuncture group, based on the medication group, were treated with abdominal acupuncture at Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanguan (CV 4)], Fusiguan [Huaroumen (ST 24), Wailing (TE 5)], Tianshu (ST 25), Daheng (SP 15), Qixue (KI 13), etc.; the treatment was given three times per week, 3 weeks as one session. The systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, waist circumference (WC), hip circumference, body mass index (BI) were observed before and after treatment in the two groups, and fasting plasma glucose (FPG), fasting insulin (FINS), 2-hours postprandial blood glucose by oral glucose tolerance test (OGTT) and insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), HOMA-IR of insulin resistance index were calculated and adverge events were recorded. Compared before the treatment, SBP, WC, body weight, BMI, FPG, OG-TT2hBG, FINS, GTT2h insulin, HOMA-IR, TC and LDL-C in the acupuncture group were all significantly reduced (all P <0. 05), while FPG, OGTT2H insulin and TG were increased in the medication group (all P<0. 05)'. The differences of reducing SBP, WC, FPG, OGTT2H insulin, HOMA-IR, TC, TG and LDL-C were statistically significant between the two groups (all P<0. 05). The total effective rate was 93. 3% (28/30) in the acupuncture group, which was significantly superior to 23. 3% (7/30) in the medication group (P<0. 01). BO's abdominal acupuncture has obvious clinical efficacy for obese type-2 diabetes mellitus

Abdominal obesity and the metabolic syndrome: a surgeon's perspective.

PubMed

Mathieu, Patrick

2008-09-01

Over the past decade, a major shift in the clinical risk factors in the population undergoing a cardiac surgery has been observed. In the general population, an increasing prevalence of obesity has largely contributed to the development of cardiovascular disorders. Obesity is a heterogeneous condition in which body fat distribution largely determines metabolic perturbations. Consequently, individuals characterized by increased abdominal fat deposition and the so-called metabolic syndrome (MetS) have a higher risk of developing coronary artery disease. Recent studies have also emphasized that visceral obesity is a strong risk factor for the development of heart valve diseases. In fact, individuals characterized by visceral obesity and its metabolic consequences, such as the small dense low-density lipoprotein phenotype, have a faster progression rate of aortic stenosis, which is related to increased valvular inflammation. Furthermore, the degenerative process of implanted bioprostheses is increased in subjects with the MetS and/or diabetes, suggesting that a process akin to atherosclerosis could be involved in the failure of bioprostheses. In addition to being an important risk factor for the development of cardiovascular disorders, the MetS is increasing the operative mortality risk following coronary artery bypass graft surgery. Thus, recent evidence supports visceral obesity as a global risk factor that is affecting the development of many heart disorders, and that is also impacting negatively on the results of patients undergoing surgical treatment for cardiovascular diseases. In the present paper, recent concepts surrounding the MetS and its implications in various cardiovascular disorders are reviewed along with the clinical implications.

Effects of the new dual PPAR α/δ agonist GFT505 on lipid and glucose homeostasis in abdominally obese patients with combined dyslipidemia or impaired glucose metabolism.

PubMed

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

2011-09-01

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. 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. 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. GFT505 may be considered a new drug candidate for the treatment of lipid and glucose disorders associated with the metabolic syndrome.

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

Yogurt consumption and abdominal obesity reversion in the PREDIMED study.

PubMed

Santiago, S; Sayón-Orea, C; Babio, N; Ruiz-Canela, M; Martí, A; Corella, D; Estruch, R; Fitó, M; Aros, F; Ros, E; Gómez-García, E; Fiol, M; Lapetra, J; Serra-Majem, Ll; Becerra-Tomás, N; Salas-Salvadó, J; Pinto, X; Schröder, H; Martínez, J A

2016-06-01

Evidence on the association yogurt consumption and obesity is not conclusive. The aim of this study was to prospectively evaluate the association between yogurt consumption, reversion of abdominal obesity status and waist circumference change in elderly. 4545 individuals at high cardiovascular risk were prospectively followed. Total, whole-fat and low-fat yogurt consumption were assessed using food frequency questionnaires. Generalized estimating equations were used to analyze the association between yogurt consumption and waist circumference change (measured at baseline and yearly during the follow-up). Logistic regression models were used to evaluate the odds ratios (ORs) and 95% CIs of the reversion rate of abdominal obesity for each quintile of yogurt consumption compared with the lowest quintile. After multivariable adjustment, the average yearly waist circumference change in the quintiles of whole-fat yogurt consumption was: Q1: 0.00, Q2: 0.00 (-0.23 to 0.23), Q3: -0.15 (-0.42 to 0.13), Q4: 0.10 (-0.21 to 0.42), and Q5: -0.23 (-0.46 to -0.00) cm; p for trend = 0.05. The ORs for the reversion of abdominal obesity for whole-fat yogurt consumption were Q1: 1.00, Q2: 1.40 (1.04-1.90), Q3: 1.33 (0.94-1.89), Q4: 1.21 (0.83-1.77), and Q5: 1.43 (1.06-1.93); p for trend = 0.26. Total yogurt consumption was not significantly associated with reversion of abdominal obesity status and a lower waist circumference. However, consumption of whole-fat yogurt was associated with changes in waist circumference and higher probability for reversion of abdominal obesity. Therefore, it seems that whole-fat yogurt has more beneficial effects in management of abdominal obesity in elderly population at high cardiovascular risk. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All

Abdominal obesity and metabolic syndrome: exercise as medicine?

PubMed

Paley, Carole A; Johnson, Mark I

2018-01-01

Metabolic syndrome is defined as a cluster of at least three out of five clinical risk factors: abdominal (visceral) obesity, hypertension, elevated serum triglycerides, low serum high-density lipoprotein (HDL) and insulin resistance. It is estimated to affect over 20% of the global adult population. Abdominal (visceral) obesity is thought to be the predominant risk factor for metabolic syndrome and as predictions estimate that 50% of adults will be classified as obese by 2030 it is likely that metabolic syndrome will be a significant problem for health services and a drain on health economies.Evidence shows that regular and consistent exercise reduces abdominal obesity and results in favourable changes in body composition. It has therefore been suggested that exercise is a medicine in its own right and should be prescribed as such. This review provides a summary of the current evidence on the pathophysiology of dysfunctional adipose tissue (adiposopathy). It describes the relationship of adiposopathy to metabolic syndrome and how exercise may mediate these processes, and evaluates current evidence on the clinical efficacy of exercise in the management of abdominal obesity. The review also discusses the type and dose of exercise needed for optimal improvements in health status in relation to the available evidence and considers the difficulty in achieving adherence to exercise programmes. There is moderate evidence supporting the use of programmes of exercise to reverse metabolic syndrome although at present the optimal dose and type of exercise is unknown. The main challenge for health care professionals is how to motivate individuals to participate and adherence to programmes of exercise used prophylactically and as a treatment for metabolic syndrome.

Prevalence of Overweight, Obesity, and Abdominal Obesity among Urban Saudi Adolescents: Gender and Regional Variations

PubMed Central

Abahussain, Nada A.; Al-Sobayel, Hana I.; Qahwaji, Dina M.; Alsulaiman, Nouf A.; Musaiger, Abdulrahman O.

2014-01-01

ABSTRACT The nutrition transition with associated lifestyle-related non-communicable diseases has rapidly reached many developing countries, including Saudi Arabia. Therefore, the objective of this study was to examine the prevalence of overweight, obesity, and abdominal obesity among Saudi adolescents. This school-based multicentre cross-sectional study was conducted during 2009-2010 in three major cities in Saudi Arabia: Al-Khobar, Jeddah, and Riyadh. Participants included 2,908 students of secondary schools (1,401 males and 1,507 females) aged 14 to 19 years, randomly selected using a multistage stratified cluster-sampling technique. Weight, height, and waist-circumference were measured; prevalence of overweight and obesity was determined using age- and sex-specific BMI cutoff reference standards of the International Obesity Task Force (IOTF). Abdominal obesity was determined using waist-to-height ratio (WHtR) cutoffs (above 0.5). The prevalence of overweight was 19.5% in males and 20.8% in females while that of obesity was 24.1% in males and 14% in females. The prevalence of abdominal obesity in males and females was 35.9% and 30.3% respectively. Higher prevalence of obesity was observed among adolescents in private schools. Across all ages, overweight and obesity ranged from 39.9% to 45.6% in males and from 30.4% to 38.7% in females. ANCOVA, controlling for age, showed significant interaction effects (city by gender). It is concluded that the proportions of overweight, obesity, and abdominal obesity, observed among Saudi adolescents were remarkably high. Such high prevalence of overweight and obesity is a major public-health concern. PMID:25895197

Dietary patterns and their associations with general obesity and abdominal obesity among young Chinese women.

PubMed

Zhang, J G; Wang, Z H; Wang, H J; Du, W W; Su, C; Zhang, J; Jiang, H R; Zhai, F Y; Zhang, B

2015-09-01

Dietary patterns represent the combined effects of foods and efficaciously illustrate the impact of diet on health outcomes. This study identified the dietary patterns and determined their relationships with obesity among young Chinese women. In 2011, the China Health and Nutrition Survey included 2363 young women aged 18-44 years. Factor analysis of data from three consecutive 24-h dietary recalls identified the dietary patterns. Weight, height and waist circumstance (WC) were measured, and body mass index (BMI) was calculated. General obesity was defined as BMI ⩾28 kg/m(2) and abdominal obesity as WC ⩾85 cm. Four dietary patterns were identified: traditional south; traditional north; snack; and high protein. After adjusting for confounders and energy intake, women in the highest-score quintiles of the traditional south pattern were less likely to have general obesity (odds ratio (OR)=0.48; 95% confidence interval (CI) 0.29-0.78) and abdominal obesity (OR=0.64; 95% CI 0.46-0.90). Subjects in the highest-score quintiles of the traditional north pattern had significantly greater risk of general obesity (OR=2.28; 95% CI 1.38-3.74) and of abdominal obesity (OR=2.32; 95% CI 1.66-3.24). The traditional south pattern of rice as the major staple food with pork and vegetable dishes is associated with lower risk of general and abdominal obesity. The traditional north pattern of high intake of wheat, other cereals and tubers is positively associated with general and abdominal obesity. This provides important information for interventions and policies addressing obesity prevention among young Chinese women.

Trends in obesity and abdominal obesity in the older adult population of Spain (2000-2010).

PubMed

Gutiérrez-Fisac, Juan Luis; León-Muñoz, Luz M; Regidor, Enrique; Banegas, Josér; Rodríguez-Artalejo, Fernando

2013-01-01

This work examines the trend in obesity and abdominal obesity in the Spanish population aged 60 years and over during the first decade of the 21st century. We analyze data from a representative study of the Spanish population aged 60 years and older conducted in 2000-2001 and from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) conducted in 2008-2010. In men, the distribution of BMI did not vary in the period 2000-2010. In contrast, in women there was a reduction in both mean BMI--from 29.3 to 28.8 kg/m2--and the prevalence of obesity--from 40.8 to 36.3%. This decline was greatest in women aged 60-69 years. In men, no significant changes were observed in mean waist circumference (WC) or in the prevalence of abdominal obesity. In contrast, WC decreased by 3.6 cm and abdominal obesity prevalence by 12.7% in women. The decline was greatest in women aged 60-69 years, in whom mean WC decreased by 5.1 cm and abdominal obesity prevalence by 18.6%. These findings show that the frequency of obesity has begun to decline in Spanish women aged 60 and over. The causes of this decline are unclear.

Abdominal Pain in the Geriatric Patient.

PubMed

Magidson, Phillip D; Martinez, Joseph P

2016-08-01

With an aging population, emergency department clinicians can expect an increase in geriatric patients presenting with abdominal pain. Compared with younger patients, this patient population is less likely to present with classic symptoms, physical examination findings, and laboratory values of abdominal disease. However, the morbidity and mortality associated with elderly patients presenting with abdominal pathologic conditions are significant. For this reason, the clinician must be familiar with some subtle and not so subtle differences when caring for the geriatric patient with abdominal pain to ensure timely diagnosis and appropriate treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010.

PubMed

Ladabaum, Uri; Mannalithara, Ajitha; Myer, Parvathi A; Singh, Gurkirpal

2014-08-01

Obesity and abdominal obesity are associated independently with morbidity and mortality. Physical activity attenuates these risks. We examined trends in obesity, abdominal obesity, physical activity, and caloric intake in US adults from 1988 to 2010. Univariate and multivariate analyses were performed using National Health and Nutrition Examination Survey data. Average body mass index (BMI) increased by 0.37% (95% confidence interval [CI], 0.30-0.44) per year in both women and men. Average waist circumference increased by 0.37% (95% CI, 0.30-0.43) and 0.27% (95% CI, 0.22-0.32) per year in women and men, respectively. The prevalence of obesity and abdominal obesity increased substantially, as did the prevalence of abdominal obesity among overweight adults. Younger women experienced the greatest increases. The proportion of adults who reported no leisure-time physical activity increased from 19.1% (95% CI, 17.3-21.0) to 51.7% (95% CI, 48.9-54.5) in women, and from 11.4% (95% CI, 10.0-12.8) to 43.5% (95% CI, 40.7-46.3) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level but not caloric intake. The associated changes in adjusted BMIs were 8.3% (95% CI, 6.9-9.6) higher among women and 1.7% (95% CI, 0.68-2.8) higher among men with no leisure-time physical activity compared with those with an ideal level of leisure-time physical activity. Our analyses highlight important dimensions of the public health problem of obesity, including trends in younger women and in abdominal obesity, and lend support to the emphasis placed on physical activity by the Institute of Medicine. Copyright © 2014 Elsevier Inc. All rights reserved.

Obesity, Abdominal Obesity, Physical Activity, and Caloric Intake in U.S. Adults: 1988-2010

PubMed Central

Ladabaum, Uri; Mannalithara, Ajitha; Myer, Parvathi A.; Singh, Gurkirpal

2014-01-01

Background Obesity and abdominal obesity are independently associated with morbidity and mortality. Physical activity attenuates these risks. We examined trends in obesity, abdominal obesity, physical activity, and caloric intake in U.S. adults from 1988 to 2010. Methods Univariate and multivariate analyses were performed using National Health and Nutrition Examination Survey (NHANES) data. Results Average body-mass index (BMI) increased by 0.37% (95% CI, 0.30-0.44%) per year in both women and men. Average waist circumference increased by 0.37% (95% CI, 0.30-0.43%) and 0.27% (95% CI, 0.22-0.32%) per year in women and men, respectively. The prevalence of obesity and abdominal obesity increased substantially, as did the prevalence of abdominal obesity among overweight adults. Younger women experienced the greatest increases. The proportion of adults who reported no leisure-time physical activity increased from 19.1% (95% CI, 17.3-21.0%) to 51.7% (95% CI, 48.9-54.5%) in women, and from 11.4% (95% CI, 10.0-12.8%) to 43.5% (95% CI, 40.7-46.3%) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level, but not caloric intake. The associated changes in adjusted BMIs were 8.3% (95% CI, 6.9-9.6%) higher among women and 1.7% (95% CI, 0.68-2.8%) higher among men with no leisure-time physical activity compared to those with an ideal level of leisure-time physical activity. Conclusions Our analyses highlight important dimensions of the public health problem of obesity, including trends in younger women and in abdominal obesity, and lend support to the emphasis placed on physical activity by the Institute of Medicine. PMID:24631411

Prevalence of abdominal obesity among Chinese adults in 2011.

PubMed

Du, Pei; Wang, Hui-Jun; Zhang, Bing; Qi, Su-Fen; Mi, Ying-Jun; Liu, Dian-Wu; Tian, Qing-Bao

2017-06-01

The prevalence of abdominal obesity is increasing dramatically worldwide. This study aimed to estimate the current prevalence of abdominal obesity from the 2011 China Health and Nutrition Survey (CHNS) and compare the data with other countries. Waist circumference (WC) of 12,326 Chinese adults (aged 20 years or older) from the 2011 CHNS were analyzed by age group and region. Abdominal obesity was defined as a WC ≥90 cm for men and WC ≥80 cm for women based on World Health Organization (WHO) recommendations for Asians. In 2011, the age-adjusted mean WC was 85.9 cm (95% confidence interval [CI], 85.6-86.2 cm) for men and 80.7 cm (95% CI, 80.4-80.9 cm) for women. Based on the WHO recommendations, the age-adjusted prevalence of abdominal obesity was 44.0% (95% CI, 43.1%-44.8%) overall, 35.3% (95% CI, 34.1%-36.6%) in men, and 51.7% (95% CI, 50.5%-52.9%) in women. Moreover, the age-adjusted prevalence was 44.0% (95% CI, 42.7%-45.2%) in rural populations, 42.5% (95% CI, 40.7%-44.2%) in urban populations, and 45.2% (95% CI, 43.5%-46.9%) in megacity populations. The prevalence in China (35.3% for men and 51.7% for women) was lower than in Japan (50.8% for men) and the United States (43.5% for men and 64.7% for women). Similar results were observed when applying the criteria suggested by the Working Group on Obesity in China. In 2011, the age-adjusted prevalence of abdominal obesity in China was 35.3% in men and 51.7% in women. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Normal Weight but Low Muscle Mass and Abdominally Obese: Implications for the Cardiometabolic Risk Profile in Chronic Obstructive Pulmonary Disease.

PubMed

Beijers, Rosanne J H C G; van de Bool, Coby; van den Borst, Bram; Franssen, Frits M E; Wouters, Emiel F M; Schols, Annemie M W J

2017-06-01

It is well established that low muscle mass affects physical performance in chronic obstructive pulmonary disease (COPD). We hypothesize that combined low muscle mass and abdominal obesity may also adversely influence the cardiometabolic risk profile in COPD, even in those with normal weight. The cardiometabolic risk profile and the responsiveness to 4 months high-intensity exercise training was assessed in normal-weight patients with COPD with low muscle mass stratified by abdominal obesity. This is a cross-sectional study including 81 clinically stable patients with COPD (age 62.5 ± 8.2 years; 50.6% males; forced expiratory volume in 1 second 55.1 ± 19.5 percentage predicted) with fat-free mass index <25th percentile eligible for outpatient pulmonary rehabilitation. Body composition, blood biomarkers, blood pressure, physical activity level, dietary intake, and physical performance were assessed at baseline and in a subgroup after 4 months of exercise training. Mean body mass index was 22.7 ± 2.7 kg/m 2 , and 75% of patients had abdominal obesity. Abdominally obese patients had higher glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), branched chain amino acids and a higher prevalence of metabolic syndrome compared with those without abdominal obesity. Exercise training improved cycling endurance time and quadriceps strength, but did not yield a clinically meaningful improvement of the cardiometabolic risk profile. Triglycerides showed a significant decrease, while the HOMA-IR increased. Abdominal obesity is highly prevalent in normal-weight patients with COPD with low muscle mass who showed an increased cardiometabolic risk compared with patients without abdominal obesity. This cardiometabolic risk profile was not altered after 4 months of exercise training. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Abdominal Pain After Roux-En-Y Gastric Bypass for Morbid Obesity.

PubMed

Mala, Tom; Høgestøl, Ingvild

2018-05-01

Roux-en-Y gastric bypass is widely used as treatment of morbid obesity. Weight loss, effects on obesity-related co-morbidities and quality of life are well documented post Roux-en-Y gastric bypass. Other outcome measures are less well studied. This review explores aspects of prevalence, diagnostic evaluations, etiology, and treatment of abdominal pain specific to Roux-en-Y gastric bypass. The review is based on PubMed searches and clinical experience with Roux-en-Y gastric bypass. Symptoms in the early postoperative phase (<30 days) were not included. Based on limited evidence, up to about 30% of the patients may perceive recurrent abdominal pain post Roux-en-Y gastric bypass in the long term. A substantial subset of patients will need health-care evaluation for acute abdominal pain and hospital admission. The etiology of abdominal pain is heterogeneous and includes gallstone-related disease, intestinal obstruction, anastomotic ulcerations and strictures, intestinal dysmotility, dysfunctional eating, and food intolerance. Surgical treatment and guidance on diet and eating habits may allow symptom relief. The cause of pain remains undefined for a subset of patients. Impact of abdominal pain post Roux-en-Y gastric bypass on the perception of well-being, quality of life, and patient satisfaction with the procedure needs to be further evaluated and may be influenced by complex interactions between new symptoms post Roux-en-Y gastric bypass and relief of pre-existing symptoms. Abdominal pain should be part of follow-up consultations post Roux-en-Y gastric bypass. Future studies should focus on combined evaluations before and after surgery to enlighten potential casual relationships between abdominal pain and Roux-en-Y gastric bypass.

Abdominal obesity and all-cause and cardiovascular mortality in end-stage renal disease.

PubMed

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

2009-04-14

The aim of this study was to investigate the predictive value for all-cause and cardiovascular (CV) death of anthropometric measurements of abdominal obesity in patients with end-stage renal disease (ESRD). Surrogate measures of abdominal obesity and segmental fat distribution (waist circumference and waist/hip ratio [WHR]) are stronger predictors of all-cause and CV death than body mass index (BMI) in the general population, but the issue has never been investigated in patients with ESRD. We performed a prospective cohort study in 537 patients with ESRD (age 63 +/- 15 years). In BMI-adjusted Cox models, waist circumference was a direct predictor of all-cause and CV mortality (p < 0.001), whereas BMI showed an inverse relationship (p < 0.001) with these outcomes. The incidence rates of overall and CV death were maximal in patients with relatively lower BMI scores (below the median) and higher waist circumferences (at least the median) and minimal in patients with higher BMI scores (at least the median) and small waist circumferences (below the median). The prognostic power of waist circumference for all-cause (hazard ratio [HR] [10-cm increase]: 1.23; 95% confidence interval [CI]: 1.02 to 1.47; p = 0.03) and CV mortality (HR: 1.37; 95% CI: 1.09 to 1.73; p = 0.006) remained significant after adjustment for CV comorbidities and traditional and emerging risk factors. WHR was found to be related to all-cause (p = 0.009) and CV mortality (p = 0.07). Abdominal obesity underlies a high risk of all-cause and CV mortality in patients with ESRD. Redefinition of nutritional status by combining the metrics of abdominal obesity and BMI may refine prognosis in the ESRD population.

[Abdominal obesity and coronary heart disease. Pathophysiology and clinical significance].

PubMed

Hauner, H

1995-02-01

The relationship between overweight and cardiovascular disease was a matter of debate for many years. Recent studies have demonstrated that obesity defined as body mass index of 30 kg/m2 or higher is associated with an exponential increase of cardiovascular complications. This effect is largely mediated by the induction of established risk factors such as dyslipidemia, hypertension and type 2 diabetes mellitus. Recently, there is growing evidence that the occurrence of most complications of obesity depends not only on the degree of overweight but also on the pattern of body fat distribution. Many data suggest that the anatomical localization of body fat is more important for the risk of developing complications than the adipose tissue mass per se. An abdominal, upper-body type of fat distribution, which can be easily determined by the measurement of waist and hip circumferences (waist/hip ratio = WHR), is also a confirmed risk factor for metabolic disturbances, hypertension and atherosclerosis, independent of body weight. However, the clinical appearance of these disturbances is frequently associated with the development of obesity. This network of metabolic disorders and their vascular complications is termed "metabolic syndrome" or "syndrome X" (Table 2). Abdominal obesity is now known to be closely associated with the metabolic syndrome and is regarded to represent its readily recognizable phenotypic feature. The components of the metabolic syndrome are characterized by varying forms and degrees of insulin resistance. It is assumed that insulin resistance, defined as diminished biological response to the action of insulin, represents the primary defect or at least the common pathogenetic link between these disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal obesity and circulating metabolites: A twin study approach.

PubMed

Bogl, Leonie H; Kaye, Sanna M; Rämö, Joel T; Kangas, Antti J; Soininen, Pasi; Hakkarainen, Antti; Lundbom, Jesper; Lundbom, Nina; Ortega-Alonso, Alfredo; Rissanen, Aila; Ala-Korpela, Mika; Kaprio, Jaakko; Pietiläinen, Kirsi H

2016-03-01

To investigate how obesity, insulin resistance and low-grade inflammation link to circulating metabolites, and whether the connections are due to genetic or environmental factors. Circulating serum metabolites were determined by proton NMR spectroscopy. Data from 1368 (531 monozygotic (MZ) and 837 dizygotic (DZ)) twins were used for bivariate twin modeling to derive the genetic (rg) and environmental (re) correlations between waist circumference (WC) and serum metabolites. Detailed examination of the associations between fat distribution (DEXA) and metabolic health (HOMA-IR, CRP) was performed among 286 twins including 33 BMI-discordant MZ pairs (intrapair BMI difference ≥3 kg/m(2)). Fat, especially in the abdominal area (i.e. WC, android fat % and android to gynoid fat ratio), together with HOMA-IR and CRP correlated significantly with an atherogenic lipoprotein profile, higher levels of branched-chain (BCAA) and aromatic amino acids, higher levels of glycoprotein, and a more saturated fatty acid profile. In contrast, a higher proportion of gynoid to total fat associated with a favorable metabolite profile. There was a significant genetic overlap between WC and several metabolites, most strongly with phenylalanine (rg=0.40), glycoprotein (rg=0.37), serum triglycerides (rg=0.36), BCAAs (rg=0.30-0.40), HDL particle diameter (rg=-0.33) and HDL cholesterol (rg=-0.30). The effect of acquired obesity within the discordant MZ pairs was particularly strong for atherogenic lipoproteins. A wide range of unfavorable alterations in the serum metabolome was associated with abdominal obesity, insulin resistance and low-grade inflammation. Twin modeling and obesity-discordant twin analysis suggest that these associations are partly explained by shared genes but also reflect mechanisms independent of genetic liability. Copyright © 2015 Elsevier Inc. All rights reserved.

[Corticotropic axis and chronic stress in abdominal obesity and metabolic syndrome].

PubMed

Boullu-Ciocca, S; Verger, P; Bocquier, A; Oliver, C

2005-12-03

Several indicators of corticotropic axis hyperactivity have been observed in common abdominal obesity, which is clinically similar to the obesity found in Cushing's syndrome. Corticotropic axis hyperactivity may be involved in the development and metabolic and cardiovascular complications of abdominal obesity. Several mechanisms may be responsible for this hormonal dysregulation: genetic, lifestyle, and nutritional factors, and chronic stress. We note the necessity of methodologically-impeccable clinical studies for an objective evaluation of the role of stress in obesity.

Effect of abdominal resistance exercise on abdominal subcutaneous fat of obese women: a randomized controlled trial using ultrasound imaging assessments.

PubMed

Kordi, Ramin; Dehghani, Saeed; Noormohammadpour, Pardis; Rostami, Mohsen; Mansournia, Mohammad Ali

2015-01-01

The aim of this study was to compare the effect of diet and an abdominal resistance training program to diet alone on abdominal subcutaneous fat thickness and waist circumference of overweight and obese women. This randomized clinical trial included 40 overweight and obese women randomly divided into 2 groups: diet only and diet combined with 12 weeks of abdominal resistance training. Waist and hip circumferences and abdominal skin folds of the subjects were measured at the beginning and 12 weeks after the interventions. In addition, abdominal subcutaneous fat thickness of the subjects was measured using ultrasonography. Percentage body fat and lean body mass of all the subjects were also measured using a bioelectric impedance device. After 12 weeks of intervention, the weight of participants in both groups decreased; but the difference between the 2 groups was not significant (P = .45). Similarly, other variables including abdominal subcutaneous fat, waist circumference, hip circumference, body mass index, body fat percentage, and skin fold thickness were reduced in both groups; but there were no significant differences between the groups. This study found that abdominal resistance training besides diet did not reduce abdominal subcutaneous fat thickness compared to diet alone in overweight or obese women. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Predictors of urinary incontinence between abdominal obesity and non-obese male adults.

PubMed

Li, Dongmei; Xu, Yi; Nie, Qingbin; Li, Yan; Mao, Gengsheng

2017-09-01

To investigate factors that may be associated with urinary incontinence (UI) in abdominal obese and non-obese adult males. Data were analyzed for 2671 men (≥40 years of age) who participated in the National Health and Nutrition Examination Survey (2005-2008). We define abdominal obesity as a waist circumference >102 cm. Men with Incontinence Severity Index ≥3 were defined as having UI. Logistic regression analyses were used to identify factors associated with stress and urge UI. Multivariate analysis found that in abdominal obese men, stress UI was associated with enlarged prostate (odds ratio [OR] = 2.20, 95% confidence interval [CI]: 1.16-4.16), chronic respiratory tract disease (OR = 2.78, 95% CI: 1.55-4.97), and major depression (OR = 4.79, 95% CI: 1.79-12.84). In non-obese men, arthritis was associated with stress UI (odds ratio = 3.37, 95% CI: 1.06-10.73). Urge UI in abdominally obese men was associated with age ≥65 years (OR = 1.67, 95% CI: 1.05-2.67), being non-Hispanic black (OR = 1.63, 95% CI: 1.06-2.52), and with enlarged prostate (OR = 2.30, 95% CI: 1.54-3.40), arthritis (OR = 1.39, 95% CI: 1.03-1.88), and major depression (OR = 2.96, 95% CI: 1.89-4.64). Urge UI in non-obese men was associated with current smoking (OR = 1.79, 95% CI: 1.01-3.17), major depression (OR = 2.60, 95% CI: 1.33-5.09) and vitamin D deficiency (OR = 1.61, 95% CI: 1.01-2.59). Factors associated with urinary incontinence varied with abdominal obesity status and type of UI. The findings identify important contributors to urinary incontinence that clinicians should consider to help manage and effectively treat the condition.

Effect of Gender on the Total Abdominal Fat, Intra-Abdominal Adipose Tissue and Abdominal Sub-Cutaneous Adipose Tissue among Indian Hypertensive Patients.

PubMed

Sahoo, Jaya Prakash; Kumari, Savita; Jain, Sanjay

2016-04-01

Abdominal obesity is a better marker of adverse metabolic profile than generalized obesity in hypertensive subjects. Further, gender has effect on adiposity and its distribution. Effect of gender on obesity and the distribution of fat in different sub-compartments of abdomen among Indian hypertensive subjects. This observational study included 278 adult subjects (Males-149 & Females-129) with essential hypertension from a tertiary care centre in north India over one year. A detailed history taking and physical examination including anthropometry were performed in all patients. Total Abdominal Fat (TAF) and abdominal adipose tissue sub-compartments like Intra-Abdominal Adipose Tissue (IAAT) and Sub-Cutaneous Adipose Tissue (SCAT) were measured using the predictive equations developed for Asian Indians. Female hypertensive subjects had higher Body Mass Index (BMI) with more overweight (BMI ≥ 23kg/m(2)), and obesity (BMI≥ 25 kg/m(2)). Additionally, they had higher prevalence of central obesity based on both Waist Circumference (WC) criteria (WC≥ 90 cm in males and WC≥ 80 cm in females) and TAF criteria {≥245.6 cm(2) (males) and ≥203.46 cm(2) (females)} than male patients. But there was no difference in the prevalence of central obesity based on Waist Hip Ratio (WHR) criteria (WHR ≥0.90 in males and WHR ≥ 0.85 in females) between two genders. High TAF & IAAT were present in more females although there was no difference in the distribution of high SCAT between two genders. Female hypertensive subjects were more obese with higher abnormal TAF & IAAT compared to male patients. However, there was no difference in the distribution of high SCAT among them.

Pseudotumors after primary abdominal lipectomy as a new sequela in patients with abdominal apron.

PubMed

Dragu, Adrian; Bach, Alexander D; Polykandriotis, Elias; Kneser, Ulrich; Horch, Raymund E

2009-11-01

Malnutrition and overweight is a common problem in modern societies. Primary abdominal lipectomy is a standard surgical tool in patients with these problems. However, unknown secondary problems result from recent advances in obesity surgery. Plication of the anterior musculoaponeurotic wall is a widely and commonly used operative technique during abdominoplasty. Many different plication techniques have been published. So far no common standard and long-term effectiveness is proven. In addition, there is no sufficient literature dealing with the postoperative risks of plication of the musculoaponeurotic wall. Four patients with development of pseudotumors were reviewed. All four patients received 12 months in advance a primary abdominal lipectomy including a vertical plication of the musculoaponeurotic wall. All four patients were females with mean age of 61 years and mean body mass index (BMI) of 37 kg/m(2). All four patients had developed a pseudotumor of the abdomen as a long-term complication more than 12 months after primary abdominal lipectomy including a vertical plication of the anterior rectus sheath. One should be aware of the potential long-term risk of secondary postoperative hematoma formation, with or without partial necrosis of the anterior rectus sheath after vertical plication of the anterior musculoaponeurotic wall. Viewed clinically and radiologically, such sequelas may appear as pseudotumor like masses and require immediate revision.

Skeletal muscle ceramide species in men with abdominal obesity.

PubMed

de la Maza, M P; Rodriguez, J M; Hirsch, S; Leiva, L; Barrera, G; Bunout, D

2015-04-01

Obesity is a risk factor for diabetes and its consequences, including accelerated ageing and mortality. The underlying factor could be accumulation of certain lipid moieties, such as ceramides (CER) and diacylgycerol (DAG) within muscle tissue, which are known to promote insulin resistance (IR), induce inflammation and oxidative injury, ultimately altering muscle function. First, to study the relationship between body composition and age (independent variables) with skeletal muscle accumulation of lipid species, oxidative injury and strength. Second, to analyze the relationship between muscle tissue metabolites and insulin resistance, inflammation and lymphocyte telomere length, the latter as an indicator of ageing. The sample included 56 healthy sedentary males, scheduled for inguinal hernia surgery, aged 27 to 80 y. Each individual was subject to anthropometric measurements, body composition assessment through radiologic densitometry (DEXA), measurement of handgrip and quadriceps strength, serum biochemical parameters (lipoproteins, creatinine, high sensitivity C reactive protein [hsCRP], fasting and post glucose insulin and glucose concentrations for calculation of IR through the Matsuda and HOMA-IR indexes), and extraction of peripheral leukocytes for measurement of telomere length. During the surgical procedure, a sample of muscle tissue was obtained (anterior abdominal oblique) in order to measure CER and DAG (and sub species according to chain length and saturation) by mass spectrometry, 4 hydroxy-2-nonenal adducts (4-HNE) using electron microscopy immunohistochemistry, and carboxymethyl-lisine (CML) by immunohistochemistry, the latter as indicators of oxidative stress (OS). Body mass index (BMI) of twenty six individuals was > 25 k/m2, while BMI of 7 was > 30 k/m2. Overweight/obese individuals, did not exhibit differences in skeletal muscle lipid metabolites, however total CER and specific long chain CER sub-species (20 and 22 carbon) increased

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

Abdominal obesity is associated with heart disease in dogs

PubMed Central

2014-01-01

Background The relationship between overall obesity and fat distribution in dogs and the development of heart disease is unclear. In the present study we evaluated the association between overall obesity and fat distribution and clinical heart disease by morphometric and computed tomography (CT)-based measurements. Body condition score (BCS), modified body mass index (MBMI, kg/m2), waist-to-hock-to-stifle distance ratio (WHSDR), waist-to-ilium wing distance ratio (WIWDR), and waist-to-truncal length ratio (WTLR) were compared between dogs with (n = 44) and without (n = 43) heart disease using receiver operating characteristic (ROC) analysis. Intra-abdominal fat (IAF) and subcutaneous fat (SQF) were measured in dogs with (n = 8) and without (n = 9) heart disease at the center of the fourth and fifth lumbar vertebrae by CT. Results BCS was similar between heart disease and healthy groups (3.6 ± 0.2 vs. 3.3 ± 0.1, P = 0.126). The following morphometric measurements were greater in the heart disease group compared with healthy canines: MBMI (65.0 ± 4.5 vs. 52.5 ± 3.7 kg/m2, respectively, P = 0.035); WIWDR (4.1 ± 0.1 vs. 3.1 ± 0.1, P < 0.01); and WTLR (1.25 ± 0.04 vs. 1.05 ± 0.04, P < 0.01). However, there was no significant difference in WHSDR (3.6 ± 0.1 vs. 3.7 ± 0.2, P = 0.875). Interestingly, IAF was significantly increased in dogs with heart disease compared with healthy dogs (23.5 ± 1.5% vs. 19.4 ± 1.2%, P = 0.039) whereas SQF was similar between two groups (35.5 ± 2.7% vs. 38.6 ± 3.5%, P = 0.496). Of the five morphometric indices studied, WIWDR and WTLR provided acceptable discrimination for diagnosing heart disease in dogs, with areas under the ROC curve of 0.778 (95% confidence interval [CI]:0.683-0.874) and 0.727 (95% CI:0.619-0.835), respectively. Conclusions Our data indicate that abdominal obesity, rather than overall obesity, is associated

Abdominal obesity is associated with heart disease in dogs.

PubMed

Thengchaisri, Naris; Theerapun, Wutthiwong; Kaewmokul, Santi; Sastravaha, Amornrate

2014-06-13

The relationship between overall obesity and fat distribution in dogs and the development of heart disease is unclear. In the present study we evaluated the association between overall obesity and fat distribution and clinical heart disease by morphometric and computed tomography (CT)-based measurements. Body condition score (BCS), modified body mass index (MBMI, kg/m2), waist-to-hock-to-stifle distance ratio (WHSDR), waist-to-ilium wing distance ratio (WIWDR), and waist-to-truncal length ratio (WTLR) were compared between dogs with (n = 44) and without (n = 43) heart disease using receiver operating characteristic (ROC) analysis. Intra-abdominal fat (IAF) and subcutaneous fat (SQF) were measured in dogs with (n = 8) and without (n = 9) heart disease at the center of the fourth and fifth lumbar vertebrae by CT. BCS was similar between heart disease and healthy groups (3.6 ± 0.2 vs. 3.3 ± 0.1, P = 0.126). The following morphometric measurements were greater in the heart disease group compared with healthy canines: MBMI (65.0 ± 4.5 vs. 52.5 ± 3.7 kg/m2, respectively, P = 0.035); WIWDR (4.1 ± 0.1 vs. 3.1 ± 0.1, P < 0.01); and WTLR (1.25 ± 0.04 vs. 1.05 ± 0.04, P < 0.01). However, there was no significant difference in WHSDR (3.6 ± 0.1 vs. 3.7 ± 0.2, P = 0.875). Interestingly, IAF was significantly increased in dogs with heart disease compared with healthy dogs (23.5 ± 1.5% vs. 19.4 ± 1.2%, P = 0.039) whereas SQF was similar between two groups (35.5 ± 2.7% vs. 38.6 ± 3.5%, P = 0.496). Of the five morphometric indices studied, WIWDR and WTLR provided acceptable discrimination for diagnosing heart disease in dogs, with areas under the ROC curve of 0.778 (95% confidence interval [CI]:0.683-0.874) and 0.727 (95% CI:0.619-0.835), respectively. Our data indicate that abdominal obesity, rather than overall obesity, is associated with heart disease in dogs

The prevalence of abdominal obesity is remarkable for underweight and normal weight adolescent girls

PubMed

Acar Tek, Nilüfer; Şanlıer, Nevin; Türközü, Duygu

2017-08-23

Background/aim: Obesity is a global public health challenge. This study was carried out in order to determine the prevalence of obesity and abdominal obesity in Turkish adolescent girls. Materials and methods: A cross-sectional study was conducted in a total of 1111 adolescent girls aged 12?18 years. The subjects were classified into four groups: underweight, normal, overweight, and obese. Abdominal obesity was defined according to waist circumference (WC) ≥ 90th percentile for Turkish adolescent population references (12-17 years) and waist-to-height ratio (WHtR) ≥ 0.5. Results: The prevalence of underweight was 17.4%, normal weight 68.5%, overweight 12.1%, and obese 2.0%. A total of 16.9% subjects were abdominal obese based on WC and 10.4% based on WHtR. When the four groups were evaluated in terms of abdominal obesity status, prevalence was 6.4% and 2.6% in the underweight, 14.6% and 5.8% in the normal, 60.0% and 37.3% in the overweight, and 88.8% and 77.3% in the obese groups according to WC and WHtR, respectively. Both WC (r: 0.332) and WHtR (r: 0.156) were positively correlated with age (P < 0.05). Conclusion: The prevalence of abdominal obesity was found at high levels for overweight and obese adolescents. It should be emphasized that abdominal obesity is a condition that should be considered for underweight and normal adolescents as well. Therefore, abdominal obesity should be regularly assessed for nonobese adolescents to prevent cardiovascular risks, metabolic syndrome, and other related disease.

Abdominal obesity and mortality risk among men in nineteenth-century North America.

PubMed

Kahn, H S; Williamson, D F

1994-10-01

The health consequences of an adverse body-fat distribution (e.g., android, upper-body, visceral) have only recently concerned the medical community. Ninety years ago, however, actuarial study demonstrated the relationship of body-fat distribution to the mortality experience of insured, North American men. Thirty-four insurance companies pooled their data on males issued life policies between 1870 and 1899. Special classes of risk were defined by weight for height at baseline or by the observation that abdominal girth exceeded the girth of the expanded chest (abdominal obesity). The mortality experience of each risk class was compared to an age-stratified, actuarial table of the period. We present new analyses of these historical data relating specifically to the mortality impact of abdominal obesity. Among 163,567 overweight men, the prevalence of abdominal obesity increased with age and with degree of overweight. Among moderately overweight men, those with abdominal obesity experienced 133% of the expected mortality rate compared to 112% of the expected mortality for those who were not abdominally obese. Severely overweight men with abdominal obesity experienced 152% of the expected mortality compared to 135% of the expected mortality for severely overweight men who were not abdominally obese. We believe this nineteenth-century, acturial study of waist and chest girths was the first demonstration that body-fat distribution can influence longevity. These early actuarial findings, taken with more recent reports, establish that abdominal enlargement, but not necessarily an 'upper-body' fat distribution, constitutes a major health hazard. Future research must establish which abdominal-obesity index best predicts disease outcomes.

Evaluation of the levels of metalloproteinsase-2 in patients with abdominal aneurysm and abdominal hernias.

PubMed

Antoszewska, Magdalena

2013-05-01

Abdominal aortic aneurysms and abdominal hernias become an important health problems of our times. Abdominal aortic aneurysm and its rupture is one of the most dangerous fact in vascular surgery. There are some theories pointing to a multifactoral genesis of these kinds of diseases, all of them assume the attenuation of abdominal fascia and abdominal aortic wall. The density and continuity of these structures depend on collagen and elastic fibers structure. Reducing the strength of the fibers may be due to changes in the extracellular matrix (ECM) by the proteolytic enzymes-matrix metalloproteinases (MMPs) that degrade extracellular matrix proteins. These enzymes play an important role in the development of many disease: malignant tumors (colon, breast, lung, pancreas), cardiovascular disease (myocardial infarction, ischemia-reperfusion injury), connective tissue diseases (Ehler-Danlos Syndrome, Marfan's Syndrome), complications of diabetes (retinopathy, nephropathy). One of the most important is matrix metalloproteinase-2 (MMP-2). The aim of the study was an estimation of the MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia, and in patients with only abdominal aortic aneurysm. The study involved 88 patients aged 42 to 89 years, including 75 men and 13 women. Patients were divided into two groups: patients with abdominal aortic aneurysm and primary abdominal hernia (45 persons, representing 51.1% of all group) and patients with only abdominal aortic aneurysm (43 persons, representing 48,9% of all group). It was a statistically significant increase in MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia compared to patients with only abdominal aortic aneurysm. It was a statistically significant increase in the prevalence of POCHP in patients with only abdominal aortic aneurysm compared to patients with abdominal aortic aneurysm and primary abdominal hernia. Statistically significant

Assessment of image quality and low-contrast detectability in abdominal CT of obese patients: comparison of a novel integrated circuit with a conventional discrete circuit detector at different tube voltages.

PubMed

Euler, A; Heye, T; Kekelidze, M; Bongartz, G; Szucs-Farkas, Z; Sommer, C; Schmidt, B; Schindera, Sebastian T

2015-03-01

To compare image quality and low-contrast detectability of an integrated circuit (IC) detector in abdominal CT of obese patients with conventional detector technology at low tube voltages. A liver phantom with 45 lesions was placed in a water container to mimic an obese patient and examined on two different CT systems at 80, 100 and 120 kVp. The systems were equipped with either the IC or conventional detector. Image noise was measured, and the contrast-to-noise-ratio (CNR) was calculated. Low-contrast detectability was assessed independently by three radiologists. Radiation dose was estimated by the volume CT dose index (CTDIvol). The image noise was significantly lower, and the CNR was significantly higher with the IC detector at 80, 100 and 120 kVp, respectively (P = 0.023). The IC detector resulted in an increased lesion detection rate at 80 kVp (38.1 % vs. 17.2 %) and 100 kVp (57.0 % vs. 41.0 %). There was no difference in the detection rate between the IC detector at 100 kVp and the conventional detector at 120 kVp (57.0 % vs. 62.2 %). The CTDIvol at 80, 100 and 120 kVp measured 4.5-5.2, 7.3-7.9 and 9.8-10.2 mGy, respectively. The IC detector at 100 kVp resulted in similar low-contrast detectability compared to the conventional detector with a 120-kVp protocol at a radiation dose reduction of 37 %.

The effect of abdominal resistance training and energy restricted diet on lateral abdominal muscles thickness of overweight and obese women.

PubMed

Noormohammadpour, Pardis; Kordi, Ramin; Dehghani, Saeed; Rostami, Mohsen

2012-07-01

The role of transabdominal muscles (external oblique, internal oblique and transversus abdominis) on core stability has been shown previously. Energy restricted diet and abdominal resistance training are commonly used by overweight and obese people to reduce their weight. In this study we investigated the impact of 12 weeks concurrent energy restricted diet and abdominal resistance training on the thickness of the lateral abdominal muscles of 19 obese and overweight women employing ultrasonography in resting and drawing-in maneuvers. The results showed significant increase of the muscle thicknesses during drawing-in maneuver after 12 weeks intervention. Based on our findings, it can be concluded that 12 weeks concurrent abdominal resistance training and energy restricted diet in addition to weight loss lead to improvement of transabdominal muscles thickness in obese and overweight people. Considering the role of these muscles in core stability, using this therapeutic protocol in obese people, particularly in those who have weakness of these muscles might be helpful. Copyright © 2011 Elsevier Ltd. All rights reserved.

Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?

PubMed

Neto, Isaac José Felippe Corrêa; Pinto, Rodrigo Ambar; Jorge, José Marcio Neves; Santo, Marco Aurélio; Bustamante-Lopez, Leonardo Alfonso; Cecconello, Ivan; Nahas, Sérgio Carlos

2017-07-01

Factors associated with increased intra-abdominal pressure such as chronic cough, morbid obesity, and constipation may be related to pelvic floor dysfunction. In this study, we compared anorectal manometry values and clinical data of class II and III morbidly obese patients referred to bariatric surgery with that of non-obese patients. We performed a case-matched study between obese patients referred to bariatric surgery and non-obese patients without anorectal complaints. The groups were matched by age and gender. Men and nulliparous women with no history of abdominal or anorectal surgery were included in the study. Anorectal manometry was performed by the stationary technique, and clinical evaluation was based on validated questionnaires. Mean age was 44.8 ± 12.5 years (mean ± SD) in the obese group and 44.1 ± 11.8 years in the non-obese group (p = 0.829). In the obese group, 65.4% of patients had some degree of fecal incontinence. Mean squeeze pressure was significantly lower in obese than in non-obese patients (155.6 ± 64.1 vs. 210.1 ± 75.9 mmHg, p = 0.004), and there was no significant difference regarding mean rest pressure in obese patients compared to non-obese ones (63.7 ± 23.1 vs. 74.1 ± 21.8 mmHg, p = 0.051). There were no significant differences in anorectal manometry values between continent and incontinent obese patients. The prevalence of fecal incontinence among obese patients was high regardless of age, gender, and body mass index. Anal squeeze pressure was significantly lower in obese patients compared to non-obese controls.

Relationships of occupational and non-occupational physical activity to abdominal obesity.

PubMed

Steeves, J A; Bassett, D R; Thompson, D L; Fitzhugh, E C

2012-01-01

Physically active occupations may protect against the risk of abdominal obesity. This study assessed the interaction between non-occupational physical activity (NOA) (leisure-time, transport and domestic activity) and occupational activity (OA) in relation to abdominal obesity. A total of 3539 adults over the age of 20, with no work limitations, employed in one of the 17 occupations classified as low OA (LOA) or high OA (HOA) were identified in the 1999-2004 National Health and Nutrition Examination Survey. Waist circumference (WC) was used to categorize individuals into either non-obese or abdominally obese (WC>88 cm in women and >102 cm in men) categories. NOA was divided into three categories based upon physical activity guidelines: (1) no NOA; (2) insufficient NOA; and (3) sufficient NOA. Logistic regression was used to examine possible associations between NOA, OA and abdominal obesity. In those who are sedentary outside of work, a high-activity occupation reduces the odds risk ratio of being categorized with abdominal obesity to 0.37 in comparison with those who work in low-activity occupations. For people working in low-activity occupations, there was a clear association with activity outside of work and the odds risk ratio of being categorized with abdominal obesity. In these adults, a reduced odds ratio was found only among those who met the physical activity guidelines through NOA (odds ratio=0.55; 95% confidence interval (CI)=0.40-0.75). HOA is associated with a reduced risk of abdominal obesity. Thus, it is important to include OA in studies seeking to understand the association between physical activity and abdominal adiposity.

Gender, alexithymia and physical inactivity associated with abdominal obesity in type 1 diabetes mellitus: a cross sectional study at a secondary care hospital diabetes clinic.

PubMed

Melin, Eva O; Svensson, Ralph; Thunander, Maria; Hillman, Magnus; Thulesius, Hans O; Landin-Olsson, Mona

2017-01-01

Obesity is linked to cardiovascular diseases and increasingly common in type 1 diabetes mellitus (T1DM) since the introduction of intensified insulin therapy. Our main aim was to explore associations between obesity and depression, anxiety, alexithymia and self-image measures and to control for lifestyle variables in a sample of persons with T1DM. Secondary aims were to explore associations between abdominal and general obesity and cardiovascular complications in T1DM. Cross sectional study of 284 persons with T1DM (age 18-59 years, men 56%), consecutively recruited from one secondary care hospital diabetes clinic in Sweden. Assessments were performed with self-report instruments (Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale-20 items and Structural Analysis of Social Behavior). Anthropometrics and blood samples were collected for this study and supplemented with data from the patients' medical records. Abdominal obesity was defined as waist circumference men/women (meters): ≥1.02/≥0.88, and general obesity as BMI ≥30 kg/m 2 for both genders. Abdominal obesity was chosen in the analyses due to the high association with cardiovascular complications. Different explanatory logistic regression models were elaborated for the associations and calibrated and validated for goodness of fit with the data variables. The prevalence of abdominal obesity was 49/284 (17%), men/women: 8%/29% ( P  < 0.001). Abdominal obesity was associated with women (AOR 4.9), physical inactivity (AOR 3.1), alexithymia (AOR 2.6) and age (per year) (AOR 1.04). One of the three alexithymia sub factors, "difficulty identifying feelings" (AOR 3.1), was associated with abdominal obesity. Gender analyses showed that abdominal obesity in men was associated with "difficulty identifying feelings" (AOR 7.7), and in women with use of antidepressants (AOR 4.3) and physical inactivity (AOR 3.6). Cardiovascular complications were associated with abdominal obesity (AOR 5

The effects of body mass index on complications and mortality after emergency abdominal operations: The obesity paradox.

PubMed

Benjamin, Elizabeth R; Dilektasli, Evren; Haltmeier, Tobias; Beale, Elizabeth; Inaba, Kenji; Demetriades, Demetrios

2017-11-01

Recent literature suggests that obesity is protective in critically illness. This study addresses the effect of BMI on outcomes after emergency abdominal surgery (EAS). Retrospective, ACS-NSQIP analysis. All patients that underwent EAS were included. The study population was divided into five groups based on BMI; regression models were used to evaluate the role of obesity in morbidity and mortality. 101,078 patients underwent EAS; morbidity and mortality were 19.5% and 4.5%, respectively. Adjusted mortality was higher in underweight patients (AOR 1.92), but significantly lower in all obesity groups (AOR's 0.73, 0.66, 0.70, 0.70 respectively). Underweight and class III obesity was associated with increased complications (AOR 1.47 and 1.30), while mild obesity was protective (AOR 0.92). Underweight patients undergoing EAS have increased morbidity and mortality. Although class III obesity is associated with increased morbidity, overweight and class I obesity were protective. All grades of obesity may be protective against mortality after EAS relative to normal weight patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Aldosterone Is Not Associated With Metabolic and Microvascular Insulin Sensitivity in Abdominally Obese Men.

PubMed

Schütten, Monica T J; Kusters, Yvo H A M; Houben, Alfons J H M; Scheijen, Jean L J M; van de Waarenburg, Marjo P H; Schalkwijk, Casper G; Joris, Peter J; Plat, Jogchum; Mensink, Ronald P; de Leeuw, Peter W; Stehouwer, Coen D A

2018-02-01

Impaired insulin-mediated muscle microvascular recruitment (IMMR) may add to the development of insulin resistance and hypertension. Increased aldosterone levels have been linked to these obesity-related complications in severely to morbidly obese individuals and to impaired microvascular function in experimental studies. To investigate whether aldosterone levels are associated with IMMR, insulin sensitivity, and blood pressure in lean and moderately abdominally obese men, and to study the effect of weight loss. In 25 lean and 53 abdominally obese men, 24-hour blood pressure measurement was performed, and aldosterone levels were measured using ultra-performance liquid chromatography tandem mass spectrometry. Insulin sensitivity was assessed by determining whole-body glucose disposal during a hyperinsulinemic clamp. IMMR in forearm skeletal muscle was measured with contrast-enhanced ultrasonography. These assessments were repeated in the abdominally obese men following an 8-week weight loss or weight stable period. Sodium excretion and aldosterone levels were similar in lean and abdominally obese participants, but sodium excretion was inversely associated with aldosterone concentration only in the lean individuals [lean, β/100 mmol sodium excretion (adjusted for age and urinary potassium excretion) = -0.481 (95% confidence interval, -0.949 to -0.013); abdominally obese, β/100 mmol sodium excretion = -0.081 (95% confidence interval, -0.433 to 0.271); P for interaction = 0.02]. Aldosterone was not associated with IMMR, insulin sensitivity, or blood pressure and was unaffected by weight loss. In moderately abdominally obese men, the inverse relationship between sodium excretion and aldosterone concentration is less than that in lean men but does not translate into higher aldosterone levels. The absolute aldosterone level does not explain differences in microvascular and metabolic insulin sensitivity and blood pressure between lean and moderately abdominally obese men

Does abdominal obesity accelerate the effect of hypertriglyceridemia on impaired fasting glucose?

PubMed

Lee, Soojin; Chun, Kihong; Lee, Soonyoung; Kim, Daejung

2010-05-01

This study sought to determine whether abdominal obesity is a risk factor for impaired fasting glucose (IFG) and hypertriglyceridemia and to verify whether moderate effect of abdominal obesity on the relationship between IFG and hypertriglyceridemia in Korea. Data from the Korean National Health and Nutrition Examination Survey was used for the analysis. The study population included 5,938 subjects aged 20 year old drawn from non-diabetic participants in a health examination survey. The subjects were classified according to the presence of abdominal obesity based on waist circumference, IFG based on their fasting blood glucose level, and hypertriglyceridemia on their fasting triglyceride. The multivariate-adjusted odds ratios for the occurrence of hypertriglyceridemia were 2.91 in the abdominal obesity group as compared with the nonobesity group and 1.31 in subjects with IFG compared with the normoglycemia controls. Abdominal obesity was found to be positively moderated in the interaction between waist circumference and fasting blood sugar. The moderate effect between abdominal obesity and IFG contributes to the development of hypertriglyceridemia in Korea.

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

PubMed

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

2016-01-01

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. 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. 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. WC is the best indicator as compared with WHR for abdominal obesity for Malaysian adults.

Long-term lifestyle intervention with optimized high-intensity interval training improves body composition, cardiometabolic risk, and exercise parameters in patients with abdominal obesity.

PubMed

Gremeaux, Vincent; Drigny, Joffrey; Nigam, Anil; Juneau, Martin; Guilbeault, Valérie; Latour, Elise; Gayda, Mathieu

2012-11-01

The aim of this study was to study the impact of a combined long-term lifestyle and high-intensity interval training intervention on body composition, cardiometabolic risk, and exercise tolerance in overweight and obese subjects. Sixty-two overweight and obese subjects (53.3 ± 9.7 yrs; mean body mass index, 35.8 ± 5 kg/m(2)) were retrospectively identified at their entry into a 9-mo program consisting of individualized nutritional counselling, optimized high-intensity interval exercise, and resistance training two to three times a week. Anthropometric measurements, cardiometabolic risk factors, and exercise tolerance were measured at baseline and program completion. Adherence rate was 97%, and no adverse events occurred with high-intensity interval exercise training. Exercise training was associated with a weekly energy expenditure of 1582 ± 284 kcal. Clinically and statistically significant improvements were observed for body mass (-5.3 ± 5.2 kg), body mass index (-1.9 ± 1.9 kg/m(2)), waist circumference (-5.8 ± 5.4 cm), and maximal exercise capacity (+1.26 ± 0.84 metabolic equivalents) (P < 0.0001 for all parameters). Total fat mass and trunk fat mass, lipid profile, and triglyceride/high-density lipoprotein ratio were also significantly improved (P < 0.0001). At program completion, the prevalence of metabolic syndrome was reduced by 32.5% (P < 0.05). Independent predictors of being a responder to body mass and waist circumference loss were baseline body mass index and resting metabolic rate; those for body mass index decrease were baseline waist circumference and triglyceride/high-density lipoprotein cholesterol ratio. A long-term lifestyle intervention with optimized high-intensity interval exercise improves body composition, cardiometabolic risk, and exercise tolerance in obese subjects. This intervention seems safe, efficient, and well tolerated and could improve adherence to exercise training in this population.

International Day for the Evaluation of Abdominal Obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries

PubMed Central

Balkau, Beverley; Deanfield, John E.; Després, Jean-Pierre; Bassan, Jean-Pierre; Fox, Keith A.A.; Smith, Sidney C.; Barter, Philip; Tan, Chee E.; Van Gaal, Luc; Wittchen, Hans-Ulrich; Massien, Christine; Haffner, Steven M.

2007-01-01

Background Abdominal adiposity is a growing clinical and public health problem. It is not known whether it is similarly associated with cardiovascular disease (CVD) and diabetes in different regions around the world, and thus whether measuring waist circumference (WC) in addition to body mass index (BMI) is useful in primary care practice. Methods and Results Randomly chosen primary care physicians (PCPs) in 63 countries recruited consecutive patients aged 18 to 80 years, on two pre-specified half-days. WC and BMI were measured and the presence of CVD and diabetes recorded. Of the patients consulting the PCPs, 97% agreed to participate in this study. Overall, 24% of 69,409 men and 27% of 98,750 women were obese (BMI ≥ 30 kg/m2). A further 40% and 30% of men and women, respectively, were overweight (BMI 25 to 30 kg/m2). In men and women, respectively, increased WC (>102/88cm, men/women) was recorded in 29% and 48%, CVD in 16% and 13%, and diabetes in 13% and 11%. There was a statistically significant graded increase in the frequency of CVD and diabetes with both BMI and WC, with a stronger relationship for WC than for BMI across regions, for both genders. This relationship between WC, CVD and particularly diabetes was seen even in lean patients (BMI <25 kg/m2). Conclusions Among men and women consulting PCPs, BMI and particularly WC were both strongly linked to CVD and especially to diabetes. Strategies to address this global problem are required to prevent an epidemic of these major causes of morbidity and mortality. PMID:17965405

Elevated fasting insulin levels increase the risk of abdominal obesity in Korean men.

PubMed

Park, Sung Keun; Oh, Chang-Mo; Jung, Taegi; Choi, Young-Jun; Chung, Ju Youn; Ryoo, Jae-Hong

2017-04-01

This study was designed to investigate whether an elevated fasting insulin level predicts abdominal obesity. A cohort study was conducted with 13,707 non-obese Korean men. They were categorized into 4 groups according to the quartile of fasting insulin level, and followed up from 2005 to 2010. Incidence rates of obesity were compared among the 4 groups during follow-up, and a Cox proportional hazards model was used to calculate hazard ratios (HRs) for abdominal obesity according to fasting insulin level. The overall incidence rate of obesity was 16.2%, but the rate increased in proportion to the fasting insulin level (quartiles 1-4: 9.8%, 12.4%, 16.9%, 25.5%, P<0.001). When HR of the 1st quartile was regarded as the reference, HRs for abdominal obesity increased proportionally to baseline fasting insulin level in an unadjusted model. However, after adjustment for covariates, including baseline waist circumference (WC), only in the quartile 4 group was the statistical significance of the association maintained [quartile 2-4; abdominal obesity: 0.89 (0.76-1.02), 1.00 (0.86-1.14) and 1.24 (1.08-1.43), P for trend <0.001]. Although the risk of incident abdominal obesity was highest in the group with the highest fasting insulin levels, an overall proportional relationship between fasting insulin level and incident abdominal obesity was not found. Additionally, this association was largely accounted for by baseline WC. Copyright © 2017 Elsevier B.V. All rights reserved.

Sitting Time and Obesity or Abdominal Obesity in Older South Koreans: Korean National Health and Nutrition Examination Survey 2013.

PubMed

Sohn, Minsung; Cho, Kyung-Hwan; Han, Kyung-Do; Choi, Mankyu; Kim, Yang-Hyun

2017-01-01

We examined relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status in elderly people. We analyzed data from the Korean National Health and Nutrition Examination Survey 2013, and 1565 participants were included in the study. Multivariate logistic regression analysis was used to examine relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status. Sitting time was positively correlated with body mass index in men and women and waist circumference in men. When considering socioeconomic factors, men who sat for 5 hours or longer and fell within the lowest income were more likely to have obesity and abdominal obesity relative to men who sat for 5 hours or shorter and earned higher incomes (odds ratio [95% confidence interval] = 1.80 [1.14-2.84] and 1.63 [1.02-2.61] respectively), and women who sat for 5 hours or longer and fell within the lowest educational level were more likely to have obesity relative to women who sat for 5 hours or less and were educated to a higher level (1.24 [1.01-1.85]). Strategies to reduce sedentary behavior would help to prevent obesity in older men who earn low incomes and women with lower levels of educational attainment.

The high burden of obesity and abdominal obesity in urban Indian schoolchildren: a multicentric study of 38,296 children.

PubMed

Misra, Anoop; Shah, Priyali; Goel, Kashish; Hazra, Daya Kishore; Gupta, Rajeev; Seth, Payal; Tallikoti, Pooja; Mohan, Indu; Bhargava, Rooma; Bajaj, Sarita; Madan, Jagmeet; Gulati, Seema; Bhardwaj, Swati; Sharma, Rekha; Gupta, Nidhi; Pandey, Ravindra Mohan

2011-01-01

The objective of this study was to assess the prevalence of overweight, obesity and abdominal obesity and their associated factors in a large sample of urban Indian schoolchildren. This is a cross-sectional study conducted in 5 cities in India. Height and weight were measured in 38,296 children and waist circumference was measured in 29,244 children aged 8-18 years. The prevalence was compared with respect to age, gender, type of school and city of residence. The mean ± standard deviation for age was 13.3 ± 2.4 years and 18.3 ± 4.3 kg/m(2) for BMI. The prevalence of overweight and obesity in 8- to 18-year-old children, respectively, was 14.4 and 2.8% by IOTF cutoffs, 14.5 and 4.8% by CDC cutoffs and 18.5 and 5.3% by WHO cutoffs. When applying the cutoffs specific for Indian ethnicity in 14- to 18-year-old children, the prevalence was higher (21.1 and 12.3%, respectively) as compared to the IOTF, WHO and CDC cutoffs. The overall prevalence of abdominal obesity in urban Indian schoolchildren was 4.5%. The prevalence of overweight and abdominal obesity was significantly higher in females than males (p < 0.001). High socioeconomic status and residing in cities with a population greater than 4 million were independently associated with overweight and abdominal obesity (p < 0.001). On extrapolating these data, more than 15 million children would currently be overweight and 4 million abdominally obese in urban India. There is a substantial burden of childhood obesity in India, which necessitates comprehensive urban-based campaigns for its prevention and control. Copyright © 2011 S. Karger AG, Basel.

Constipation Risk in Patients Undergoing Abdominal Surgery

PubMed Central

Celik, Sevim; Atar, Nurdan Yalcin; Ozturk, Nilgun; Mendes, Guler; Kuytak, Figen; Bakar, Esra; Dalgiran, Duygu; Ergin, Sumeyra

2015-01-01

Background: Problems regarding bowel elimination are quite common in patients undergoing abdominal surgery. Objectives: To determine constipation risk before the surgery, bowel elimination during postoperative period, and the factors affecting bowel elimination. Patients and Methods: This is a cross-sectional study. It was conducted in a general surgery ward of a university hospital in Zonguldak, Turkey between January 2013 and May 2013. A total of 107 patients were included in the study, who were selected by convenience sampling. Constipation Risk Assessment Scale (CRAS), patient information form, medical and nursing records were used in the study. Results: The mean age of the patients was found to be 55.97 ± 15.74 (year). Most of the patients have undergone colon (37.4%) and stomach surgeries (21.5%). Open surgical intervention (83.2%) was performed on almost all patients (96.3%) under general anesthesia. Patients were at moderate risk for constipation with average scores of 11.71 before the surgery. A total of 77 patients (72%) did not have bowel elimination problem during postoperative period. The type of the surgery (P < 0.05), starting time for oral feeding after the surgery (P < 0.05), and mobilization (P < 0.05) were effective on postoperative bowel elimination. Conclusions: There is a risk for constipation after abdominal surgery. Postoperative practices are effective on the risk of constipation. PMID:26380107

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.

Bioimpedance to screen for abdominal fat in patients with breast cancer treatment-related lymphedema.

PubMed

de Fátima Guerreiro Godoy, Maria; Silva, Edivandra Buzato; de Godoy, Jose Maria Pereira

2016-07-28

One of the dreaded complications after the treatment of breast cancer is lymphedema. Therapies used in the treatment of breast cancer such as surgery, radiotherapy, hormone therapy and chemotherapy may be adversely affected by obesity. The objective of this study was to use bioimpedance to assess abdominal fat in women with breast cancer treatment-related lymphedema and suggest this as a screening method. Forty-five female patients with clinical diagnosis of breast cancer treatment-related lymphedema were evaluated in this quantitative cross-sectional study. A control group, composed of 38 patients with varicose veins and women attending a social support group, was matched for age and body mass index (BMI). All participants were submitted to a bioimpedance evaluation (In Body S 10), with particular attention being paid to abdominal fat and their BMI. The unpaired t -test, Fisher Exact test and Mann-Whitney test were used for statistical analysis and an alpha error of 5%. There was no significant difference (p -value = 0.23) in the mean BMI between the study group (27.79 kg∕m2) and the control group (28.80 kg∕m2). The mean abdominal circumference, a measure of abdominal fat, of the women in the study group was 130.54 cm2 and for the control group it was 102.24 cm2 (p -value = 0.0037). Thus the study group had more abdominal fat (p -value = 0.0003). Moreover, on comparing obese patients in the two groups, the study group had more abdominal fat (p -value = 0.02). However, no significant difference was observed comparing non-obese patients (p -value = 0.6). The comparison of obese patients with non-obese patients in the control group identifies an association between obesity and abdominal fat (p -value < 0.04). Overweight and obese women with breast cancer treatment-related lymphedema are more likely to have increased abdominal fat than the general population with bioimpedance.

Prevalence and geographic variation of abdominal obesity in 7- and 9-year-old children in Greece; World Health Organization Childhood Obesity Surveillance Initiative 2010.

PubMed

Hassapidou, Maria; Tzotzas, Themistoklis; Makri, Evangelia; Pagkalos, Ioannis; Kaklamanos, Ioannis; Kapantais, Efthymios; Abrahamian, Annet; Polymeris, Antonis; Tziomalos, Konstantinos

2017-01-28

In children, abdominal obesity is a better predictor of the presence of cardiovascular risk factors than body mass index (BMI)-defined obesity. We aimed to evaluate the prevalence of abdominal obesity in the Greek pediatric population and to assess the impact of residence on the prevalence of both BMI-defined and abdominal obesity. In the context of the Childhood Obesity Surveillance Initiative of the World Health Organization (WHO) Regional Office for Europe, a national representative sample of 7.0-7.9 and 9.0-9.9-year-old children was evaluated (n = 2,531 and 2,700, respectively). Overweight and obesity according to BMI were estimated using both the WHO and International Obesity Task Force cut-off points. Abdominal obesity was defined as waist circumference/height ratio >0.5. The prevalence of abdominal obesity did not differ between 7-year-old boys and girls (25.2 and 25.3%, respectively; p = NS). Among 9-year-old children, abdominal obesity was more prevalent in boys than in girls (33.2 and 28.2%, respectively; p = 0.005). Among normal weight and overweight children, the prevalence of abdominal obesity was 1.6-6.8 and 21.8-49.1%, respectively. The prevalence of abdominal and BMI-defined obesity did not differ between children living in the mainland, in Crete and in other islands except in 7-year-old girls, where the prevalence of BMI-defined obesity was highest in those living in Crete, intermediate in those living in other islands and lowest in those living in the mainland. In 9-year-old boys and in 7- and 9-year-old girls, the prevalence of abdominal obesity was highest in children living in Athens and lowest in children living in Thessaloniki, whereas children living in other cities and in villages showed intermediate rates. The prevalence of abdominal obesity in 7-year-old boys and the prevalence of BMI-defined obesity did not differ between children living in cities and villages. The prevalence of pediatric abdominal obesity in Greece is among

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

Associations of polymorphisms in circadian genes with abdominal obesity in Chinese adult population.

PubMed

Ye, Ding; Cai, Shaofang; Jiang, Xiyi; Ding, Ye; Chen, Kun; Fan, Chunhong; Jin, Mingjuan

2016-09-01

Circadian rhythm, which is controlled by circadian genes, regulates metabolic balance including the circulating levels of glucose, fatty acids, triglycerides, various hormones and so on. The study aimed to investigate the impact of potential polymorphisms in circadian genes on abdominal obesity among Chinese Han adults. A total of 260 cases with abdominal obesity and 260 controls were recruited by individual matching. Demographic characteristics and lifestyle information were collected by a validated questionnaire, and anthropometric parameters was measured by physical examination. Twenty-three single nucleotide polymorphisms (SNPs) in three circadian genes, CLOCK, CRY1 and CRY2, were genotyped by MassArray technique. Five SNPs significantly deviated from Hardy-Weinberg equilibrium (HWE) among controls, so eighteen SNPs were taken into logistic regression analysis. Independently, CLOCK rs10002541 (CC genotype vs. TT genotype: OR: 0.45, 95% CI: 0.23-0.86), CLOCK rs6850524 (CC genotype vs. GG genotype: OR: 0.50, 95% CI: 0.25-0.99) and CRY1 rs10861688 (TT genotype vs. CC genotype: OR: 0.50, 95% CI: 0.25-0.97) were negatively associated with the risk of abdominal obesity. Haplotype analysis showed that the haplotypes of CG and TG for CLOCK rs10002541 and rs4864546 had significant associations with abdominal obesity. Compared with the carriers of TA, those of CG were observed to have a lower risk (OR: 0.74, 95% CI: 0.56-0.99) of abdominal obesity, and those of TG presented a higher risk (OR: 1.70, 95% CI: 1.03-2.81). Our findings suggest that CLOCK and CRY1 polymorphisms might be involved in individual susceptibility to abdominal obesity in Chinese Han population. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

PERIOD2 variants are associated with abdominal obesity, psycho-behavioral factors, and attrition in the dietary treatment of obesity.

PubMed

Garaulet, Marta; Corbalán-Tutau, M Dolores; Madrid, Juan A; Baraza, Juan C; Parnell, Laurence D; Lee, Yu-Chi; Ordovas, Jose M

2010-06-01

The purpose of this research was to test for association between polymorphisms in the circadian clock-related gene PERIOD2 (PER2) and attrition in patients prone to withdrawal from a behavioral weight-reduction program based on the Mediterranean diet. A total of 454 overweight/obese participants (women=380, men=74), aged 20 to 65 years, who attended outpatient clinics specializing in obesity between January and December 2008, were studied. Anthropometric, biochemical, and dietary-intake variables were analyzed. Effectiveness of the program was assessed, and a questionnaire of barriers to weight loss was considered. Multivariate analysis and logistic regression models were performed. Results indicate that PER2 polymorphisms rs2304672C>G and rs4663302C>T were associated with abdominal obesity (P<0.05). Participants who withdrew from treatment were significantly more obese and had more barriers to lose weight (P<0.05). They also displayed a lower likelihood of planning eating in advance and experiencing stress with dieting than those who completed treatment. Frequency of rs4663307 minor allele was significantly greater in withdrawers than in those who successfully completed treatment (P<0.05). Logistic regression analysis showed that rs2304672 C>G minor allele carriers had a greater probability of dropping out, displaying extreme snacking, experiencing stress with dieting, eating when bored, and skipping breakfast than noncarriers. PER2 is implicated in attrition in weight-loss treatment and may modulate eating-behavior-related phenotypes. These findings could represent a step toward personalized health care and nutrition based on a combination of genotyping and psycho-behavioral characterization. 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

[Evaluate the Efficacy of Electroacupuncture Therapy on Abdominal Fat in Obese Women by Using Magnetic Resonance Imaging].

PubMed

Lei, Hong; Chen, Xiao; Hu, Dong-Gang; Chen, Yu-Ting; Feng, Li-Cheng; Chen, Zhen-Yan; Li, Fang

2016-10-25

To evaluate the efficacy of electroacupuncture (EA) therapy on abdominal fat in obese women by using magnetic resonance imaging(MRI). Thirty abdominal obesity women patients were randomly divided into control group ( n =15) and EA group ( n =15). The obesity patients of the control group did not receive any treatment for weight reduction, and those of the EA group were treated by EA stimulation of bilateral Neiting (ST 44), Fenglong (ST 40), Zusanli (ST 36), Huaroumen (ST 24), Tianshu (ST 25), Wailing (ST 26), Shuidao (ST 28), Fujie (SP 14), Daheng (SP 13), etc. for 25 min, once every other day, 3 times per week for 3 months. The patient's body weight, height, waist circumference (WC) were mea-sured with different devices, and the body mass index (BMI) was calculated, and the subcutaneous adipose tissue thickness at the inferior edges of L 4 , L 5 and S 3 and the superior edge of the pubic symphysis and the total abdominal fat volume between the L 4 and S 3 levels were detected using MRI systems before and after the treatment. The effects of the EA group were significantly superior to those of the control group in lowering difference values (between pre- and post-treatment) of BMI, WC and subcutaneous adipose tissue thickness at the levels of the inferior edges of L 4 , L 5 , S 3 and the superior edge of the pubic symphysis(all P <0.01)and in reducing total abdominal fat volume between L 4 and S 3 (all P <0.01). After the treatment, the subcutaneous adipose tissue thickness at the superior edge of the pubic symphysis ( P <0.01) and the total abdominal fat volume between L 4 and S 3 ( P <0.05) were significantly decreased in the EA group compared to pre-treatment. There were no significant differences between post- and pre-treatment in BMI, WC, subcutaneous adipose tissue thickness at the levels of the L 4 , L 5 and S 3 in both EA and control groups and in the subcutaneous adipose tissue thickness at the level of the superior edge of the pubic symphysis and the

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. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physical activity level of postmenopausal women in Nigeria: Association with self-rated health status, overall obesity, and abdominal obesity.

PubMed

Ogwumike, Omoyemi O; Adeniyi, Ade F; Orogbemi, Oluwakemi O

2016-07-01

Regular physical activity (PA) has been shown to have many health benefits in various populations, including postmenopausal women (n = 310). Self-rated health has been positively associated with PA. This cross-sectional survey of postmenopausal women in Nigeria was conducted from April to September 2012 to investigate associations among PA level, self-rated health, overall obesity (body mass index [BMI]), and abdominal obesity (waist-height ratio, waist-hip ratio, and waist circumference). The International Physical Activity Questionnaire was used to classify PA. Chi-square and logistic regression were used for analyses with level of significance set at .05. Participants were aged 53.0 ± 4.2 years; moderate to vigorous PA was reported by 188 (60.0%), while 26 (8.4%) self-rated their health as poor/fair, and 242 (78.1%) were either predominantly overweight or obese when classified according to BMI. Participants with fair/poor self-rated health had less odds of involvement in moderate to vigorous PA. Obese postmenopausal women had greater odds of reporting lower PA. PA was positively related to self-rated health, which was negatively associated with overall obesity but not abdominal obesity. Measures to control obesity among postmenopausal women are essential in view of its direct association with poor self-rated health and low PA in this group of women.

Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study.

PubMed

Sangrós, F Javier; Torrecilla, Jesús; Giráldez-García, Carolina; Carrillo, Lourdes; Mancera, José; Mur, Teresa; Franch, Josep; Díez, Javier; Goday, Albert; Serrano, Rosario; García-Soidán, F Javier; Cuatrecasas, Gabriel; Igual, Dimas; Moreno, Ana; Millaruelo, J Manuel; Carramiñana, Francisco; Ruiz, Manuel Antonio; Pérez, Francisco Carlos; Iriarte, Yon; Lorenzo, Ángela; González, María; Álvarez, Beatriz; Barutell, Lourdes; Mayayo, M Soledad; Del Castillo, Mercedes; Navarro, Emma; Malo, Fernando; Cambra, Ainhoa; López, Riánsares; Gutiérrez, M Ángel; Gutiérrez, Luisa; Boente, Carmen; Mediavilla, J Javier; Prieto, Luis; Mendo, Luis; Mansilla, M José; Ortega, Francisco Javier; Borras, Antonia; Sánchez, L Gabriel; Obaya, J Carlos; Alonso, Margarita; García, Francisco; Gutiérrez, Ángela Trinidad; Hernández, Ana M; Suárez, Dulce; Álvarez, J Carlos; Sáenz, Isabel; Martínez, F Javier; Casorrán, Ana; Ripoll, Jazmín; Salanova, Alejandro; Marín, M Teresa; Gutiérrez, Félix; Innerárity, Jaime; Álvarez, M Del Mar; Artola, Sara; Bedoya, M Jesús; Poveda, Santiago; Álvarez, Fernando; Brito, M Jesús; Iglesias, Rosario; Paniagua, Francisca; Nogales, Pedro; Gómez, Ángel; Rubio, José Félix; Durán, M Carmen; Sagredo, Julio; Gijón, M Teresa; Rollán, M Ángeles; Pérez, Pedro P; Gamarra, Javier; Carbonell, Francisco; García-Giralda, Luis; Antón, J Joaquín; de la Flor, Manuel; Martínez, Rosario; Pardo, José Luis; Ruiz, Antonio; Plana, Raquel; Macía, Ramón; Villaró, Mercè; Babace, Carmen; Torres, José Luis; Blanco, Concepción; Jurado, Ángeles; Martín, José Luis; Navarro, Jorge; Sanz, Gloria; Colas, Rafael; Cordero, Blanca; de Castro, Cristina; Ibáñez, Mercedes; Monzón, Alicia; Porta, Nuria; Gómez, María Del Carmen; Llanes, Rafael; Rodríguez, J José; Granero, Esteban; Sánchez, Manuel; Martínez, Juan; Ezkurra, Patxi; Ávila, Luis; de la Sen, Carlos; Rodríguez, Antonio; Buil, Pilar; Gabriel, Paula; Roura, Pilar; Tarragó, Eduard; Mundet, Xavier; Bosch, Remei; González, J Carles; Bobé, M Isabel; Mata, Manel; Ruiz, Irene; López, Flora; Birules, Marti; Armengol, Oriol; de Miguel, Rosa Mar; Romera, Laura; Benito, Belén; Piulats, Neus; Bilbeny, Beatriz; Cabré, J José; Cos, Xavier; Pujol, Ramón; Seguí, Mateu; Losada, Carmen; de Santiago, A María; Muñoz, Pedro; Regidor, Enrique

2018-03-01

Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m 2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Household food insecurity is associated with abdominal but not general obesity among Iranian children.

PubMed

Jafari, Fateme; Ehsani, Simin; Nadjarzadeh, Azadeh; Esmaillzadeh, Ahmad; Noori-Shadkam, Mahmood; Salehi-Abargouei, Amin

2017-04-21

Childhood obesity is increasing all over the world. Food insecurity is mentioned as a possible risk factor; however, previous studies have led to inconsistent results in different societies while data are lacking for the Middle East. We aimed to investigate the relationship between food insecurity and general or abdominal obesity in Iranian children in a cross-sectional study. Anthropometric data including height, weight, and waist circumference were measured by trained nutritionists. General and abdominal obesity were defined based on world health organization (WHO) and Iranian reference curves for age and gender, respectively. Radimer/Cornell food security questionnaire was filled by parents. Data about the physical activity of participants, family socio-economic status, parental obesity and data about perinatal period were also gathered using self-administered questionnaires. Logistic regression was incorporated to investigate the association between food insecurity and obesity in crude and multi-variable adjusted models. A total of 587 children aged 9.30 ± 1.49 years had complete data for analysis. Food insecurity at household level was significantly associated with abdominal obesity (odds ratio (OR) = 1.54; confidence interval (CI):1.01-2.34, p <0.05) and the relationship remained significant after adjusting for all potential confounding variables (OR = 2.02; CI:1.01-4.03, p <0.05). Food insecurity was associated with general obesity neither in crude analysis and multi-variable adjusted models. The slight levels of food insecurity might increase the likelihood of abdominal obesity in Iranian children and macroeconomic policies to improve the food security are necessary. Large-scale prospective studies, particularly in the Middle East, are highly recommended to confirm our results.

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.

Outcome of Laparoscopic Adrenalectomy in Obese Patients.

PubMed

Paun, Diana; Petris, Rodica; Ganescu, Roxana; Paun, Sorin; Vartic, Mihaela; Beuran, Mircea

2015-09-01

To compare early morbidity of obese and nonobese patients with minimally invasive adrenalectomies. Retrospective study of a prospectively maintained database, between June 2003 - December 2012, in a universitary affiliated tertiary hospital. Selection criteria: Minimally invasive adrenalectomy. Obese patients were defined as BMI over 30 kg/m2. From 205 patient with laparoscopic adrenalectomies we counted 30 obese patients (OG), 25 of them female and only 5 men with a median age of 54,20 years versus 47,94 years for nonobese group (NOG) (p=0.008). In OG were 15 right sided tumor, 11 on the left side and 4 bilateral all treated with transperitoneal antero-lateral approach. Median operating time was 92.20 minutes for OG versus 91.13 minutes for NOG (p=0.924). In OG, 5 patients had previous abdominal surgeries and we counted 4 conversion to open surgery, 2 postoperative complications (6.6%) and no mortality. All OG patients have diverse comorbidities, 50% of them more then 3. Median specimen size was 5.92 cm for OG versus 4.85 cm for NOG (p=0.057). The histology of OG was: adenoma 11 cases, hiperplasia 13 cases and pheochromocytoma 6. In NOG we had: postoperative hospital stay was 6.57 days in OG versus 4.11 days in NOG (p=0.009). Although obese patients had a higher rate for early morbidities, the minimally invasive approach has particular benefits for them. Although postoperative hospital stay was significantly longer, we believe that advantages of minimal invasive surgery for obese patients remains valid even in a BMI over 30.

Efficacy of octreotide-LAR in dieting women with abdominal obesity and polycystic ovary syndrome.

PubMed

Gambineri, Alessandra; Patton, Laura; De Iasio, Rosaria; Cantelli, Barbara; Cognini, Graciela Estela; Filicori, Marco; Barreca, Antonina; Diamanti-Kandarakis, Evanthia; Pagotto, Uberto; Pasquali, Renato

2005-07-01

Somatostatin reduces LH, GH, and insulin, and somatostatin receptors are present at the ovarian level; somatostatin analogs are thus potential candidates for treatment of the polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate the effect of octreotide-LAR, a long-acting somatostatin analog, in anovulatory abdominal obese women with PCOS. A single-blind, placebo-controlled study was performed, lasting for 7 months. The patients were ambulatory throughout the study. Twenty PCOS subjects were enrolled. Eighteen completed the study. A low-calorie diet was given during the first month, a low-calorie diet plus octreotide-LAR (10 mg; n = 10 subjects) or placebo (n = 10 subjects) was then given, with one im injection every 28 d (for 6 months). The main outcome measures were clinical features, computerized tomography measurement of fat distribution, androgens, GH, IGF-I, IGF-binding proteins (IGFBPs), fasting and glucose-stimulated insulin, and ovulation. Octreotide had no additional effect in reducing body fat or improving fat distribution than placebo. Conversely, octreotide produced an additional decrease in fasting (P = 0.018) and glucose-stimulated (P = 0.038) insulin levels, an increase in IGFBP-2 (P = 0.042) and IGFBP-3 (P = 0.047), and an improvement in hirsutism (P = 0.004). Moreover, a trend toward greater reductions in testosterone (P = 0.061) and androstenedione (P = 0.069) was observed in women treated with octreotide-LAR compared with those given placebo. All women treated with octreotide ovulated at the end of the study compared with only one of those receiving placebo (P < 0.001). Octreotide-LAR may be usefully applied to hypocalorically dieting, abdominal obese PCOS women to improve hyperandrogenism and the insulin-IGF-I system. Restoration of ovulatory menstrual cycles appears to be another advantage of this treatment.

of obese Turkish female patients

PubMed

Özşahin, Akatlı Kürşad; Altıntaş, Ebru

2018-04-30

Background/aim: Mental disorders may accompany obesity. This study aims to evaluate the association between social anxiety disorder (SAD) and obesity and the risk factors for SAD in obese female patients. Materials and methods: A total of 114 obese patients and 110 healthy controls were included. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI I-II), and Liebowitz Social Anxiety Scale (LSAS) were administered to assess anxiety, depression, and social anxiety levels. Scale scores were analyzed statistically. Results: The rate of SAD in obese female patients was found to be 8.8%. Anxiety, depression, and social anxiety levels were significantly higher in the obesity group compared to the control group (P < 0.05). According to linear regression analyses, a significant association between LSAS anxiety level and age, prior surgery, social support, history of being teased, BDI, and BAI was found. Conclusion: The present study shows that many factors are related to obesity and SAD in obese female patients. The clinical implications of these findings should be considered. Interventions for these factors may help prevent SAD in obese female patients.

The prevalence of abdominal obesity among pupils with visual impairment in Poland.

PubMed

Wrzesińska, Magdalena; Urzędowicz, Beata; Nawarycz, Tadeusz; Motylewski, Sławomir; Pawlicki, Lucjan

2017-10-01

Obesity particularly affects young people with disabilities, whose ability to participate in health promotion programs is reduced. The aim of the study is to determine the prevalence of abdominal obesity among students with visual impairment in Poland according to waist-to-height ratio, including indicators such as gender, age or certain additional coexisting disabilities or disorders. A total of 238 students who were blind or partially-sighted, aged 7.35-23.35 years (mean age 15.5; ±3.9 years), were included in the study. Abdominal obesity was estimated using waist-to-height ratio; a cutoff point of ≥0.50 was determined as central obesity. Abdominal obesity was identified among 26.9% [N = 64] of the participants: 33.1% [N = 41] of male students and 20.2% [N = 23] of female students (ch2 = 5.02; p = 0.025; Phi = 0.145). Of all the students, the multivariate logistic regression showed that abdominal obesity was one and a half times more likely to be detected in the 7-9 year age group (OR = 1.56; 95% CI 0.58-4.18; P = 0.376) than the 19-23 year age group. However, among the female subjects, abdominal obesity was over six times more common in the 7-9 year group (OR = 6.48; 95% CI 1.29-32.5; P = 0.022) than in the group of early adults. Central obesity was detected almost three times more frequently among students with visual impairment and additional intellectual disability (OR = 2.99; 95% CI 0.52-17.1; P = 0.215) than those with only visual impairment. Prevention programs aimed at reducing abdominal obesity among pupils with visual impairment from special schools are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevalence of abdominal obesity and its association with cardio metabolic risk factors among older adults in Ecuador.

PubMed

Orces, Carlos H; Montalvan, Martha; Tettamanti, Daniel

2017-12-01

To describe the prevalence of abdominal obesity and its association with cardio metabolic risk factors among older adults in Ecuador. The present study used data from the National Survey of Health, Wellbeing, and Aging survey to examine the prevalence of abdominal obesity according to certain demographic, behavioral, and health characteristics of the participants. Logistic regression models adjusted for potential confounders were used to evaluate the association of abdominal obesity with cardio metabolic risk factors. Of 2053 participants aged 60 years and older, the prevalence of abdominal obesity was 65.9% (95% CI; 62.2%, 69.4%) in women and 16.3% (95% CI; 13.8%, 19.2%) in men. Notably, a higher prevalence of abdominal obesity was seen among residents in the urban areas of the country, those who reported their race as black or mulatto, individuals with sedentary lifestyle and obesity, and older adults with greater number of comorbidities. Moreover, after adjustment for potential confounders, women with abdominal obesity were 2.0, 2.8, and 1.6 times more likely to have diabetes, the metabolic syndrome, and hypertriglyceridemia as compared with those without, respectively. Likewise, men with abdominal obesity had 51% and 22% higher rates of hypertension and diabetes than their non-obese counterparts, respectively. the prevalence of abdominal obesity is high among older adults in Ecuador. Moreover, abdominal obesity is significantly associated with cardio metabolic risk factors. Therefore, further research is needed to evaluate sociodemographic and nutritional determinants of this emerging public health burden among older Ecuadorians. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Association between general and abdominal obesity with high blood pressure: difference between genders.

PubMed

Silva, Alison O; Silva, Micaelly V; Pereira, Lisley K N; Feitosa, Wallacy M N; Ritti-Dias, Raphael M; Diniz, Paula R B; Oliveira, Luciano M F T

2016-01-01

To assess the association between general and abdominal obesity with high blood pressure in adolescents of both genders from the public school system. This was an epidemiological, descriptive, exploratory study, with a quantitative approach and local scope whose sample consisted of 481 high school students (aged 14-19), selected by using a random cluster sampling strategy. Blood pressure was measured through the use of automated monitor and was considered high when the pressure values were at or above the 95th percentile. The analyses were performed using the chi-squared test and binary logistic regression. The prevalence of high blood pressure was 6.4%, and it was higher among boys (9.0% vs. 4.7%, p<0.05). There was no significant difference between general (p=0.903) and abdominal obesity (p=0.157) when genders were compared. After adjusting for age, high blood pressure was associated with general (OR=6.4; p<0.001) and abdominal obesity (OR=7.0; p<0.001) only among boys, when comparing the fourth quartile with the first quartile of body mass index (≤ 18.6 kg/m(2)vs. ≥ 23.5 kg/m(2)) and waist circumference (≤ 69 cm vs. ≥ 80.1cm). It was observed that general and abdominal obesity are associated with high blood pressure only in boys, regardless of age. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Gestational diabetes predicts the risk of childhood overweight and abdominal circumference independent of maternal obesity.

PubMed

Nehring, I; Chmitorz, A; Reulen, H; von Kries, R; Ensenauer, R

2013-12-01

Gestational diabetes mellitus is believed to be a risk factor for childhood overweight/obesity. We aimed to assess whether this association is either a reflection or independent of confounding by maternal BMI. Data from 7355 mother-child dyads of the German Perinatal Prevention of Obesity cohort with full anthropometric information on mothers and children, gestational diabetes and confounding factors were obtained at school entry health examination. We calculated crude and adjusted logistic regression models for the association of gestational diabetes and childhood overweight/obesity and abdominal adiposity defined by age- and sex-specific percentiles for BMI and waist circumference. Among all children (mean age 5.8 years), 8.1% were overweight, 2.6% were obese and 15.5% had abdominal adiposity. The prevalence of overweight (obesity) was 21% (8.2%) in children of mothers with gestational diabetes and 10.4% (2.4%) in children of healthy mothers. Analyses with adjustment for maternal BMI and other potential confounders yielded an odds ratio of 1.81 (95% CI 1.23-2.65) and 2.80 (95% CI 1.58-4.99) for the impact of gestational diabetes on childhood overweight and obesity, respectively. Similar results were obtained for the risk of childhood abdominal adiposity (odds ratio 1.64, 95% CI 1.16-2.33) by maternal gestational diabetes. The postulated increased risk of overweight and abdominal adiposity in offspring of mothers with gestational diabetes cannot be explained by maternal BMI alone and may be stronger for childhood obesity than for overweight. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Somatization symptoms in pediatric abdominal pain patients: relation to chronicity of abdominal pain and parent somatization.

PubMed

Walker, L S; Garber, J; Greene, J W

1991-08-01

Symptoms of somatization were investigated in pediatric patients with recurrent abdominal pain (RAP) and comparison groups of patients with organic etiology for abdominal pain and well patients. Somatization scores were higher in RAP patients than well patients at the clinic visit, and higher than in either well patients or organic patients at a 3-month followup. Higher somatization scores in mothers and fathers were associated with higher somatization scores in RAP patients, but not in organic or well patients. Contrary to the findings of Ernst, Routh, and Harper (1984), chronicity of abdominal pain in RAP patients was not significantly associated with their level of somatization symptoms. Psychometric information about the Children's Somatization Inventory is presented.

Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend.

PubMed

Mainous, Arch G; Tanner, Rebecca J; Jo, Ara; Anton, Stephen D

2016-07-01

Trends in sedentary lifestyle may have influenced adult body composition and metabolic health among individuals at presumably healthy weights. This study examines the nationally representative prevalence of prediabetes and abdominal obesity among healthy-weight adults in 1988 through 2012. We analyzed the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES for the years 1999 to 2012, focusing on adults aged 20 years and older who have a body mass index (BMI) of 18.5 to 24.99 and do not have diabetes, either diagnosed or undiagnosed. We defined prediabetes using glycated hemoglobin (HbA1c) level ranges from 5.7% to 6.4%, as specified by the American Diabetes Association. Abdominal obesity was measured by waist circumference and waist-to-height ratio. The prevalence of prediabetes among healthy-weight adults, aged 20 years and older and without diagnosed or undiagnosed diabetes, increased from 10.2% in 1988-1994 to 18.5% in 2012. Among individuals aged 45 years and older, the prevalence of prediabetes increased from 22.0% to 33.1%. The percentage of adults aged 20 years and older with an unhealthy waist circumference increased from 5.6% in 1988-1994 to 7.6% in 2012. The percentage of individuals with an unhealthy waist-to-height ratio increased from 27.2% in 1988-1994 to 33.7% in 2012. Adjusted models found that measures of abdominal obesity were not independent predictors of prediabetes among adults with a healthy BMI. Among individuals within a healthy BMI range, the prevalence of prediabetes and abdominal obesity has substantially increased. Abdominal obesity does not appear to be the primary cause of the increase. © 2016 Annals of Family Medicine, Inc.

Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend

PubMed Central

Mainous, Arch G.; Tanner, Rebecca J.; Jo, Ara; Anton, Stephen D.

2016-01-01

PURPOSE Trends in sedentary lifestyle may have influenced adult body composition and metabolic health among individuals at presumably healthy weights. This study examines the nationally representative prevalence of prediabetes and abdominal obesity among healthy-weight adults in 1988 through 2012. METHODS We analyzed the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and NHANES for the years 1999 to 2012, focusing on adults aged 20 years and older who have a body mass index (BMI) of 18.5 to 24.99 and do not have diabetes, either diagnosed or undiagnosed. We defined prediabetes using glycated hemoglobin (HbA1c) level ranges from 5.7% to 6.4%, as specified by the American Diabetes Association. Abdominal obesity was measured by waist circumference and waist-to-height ratio. RESULTS The prevalence of prediabetes among healthy-weight adults, aged 20 years and older and without diagnosed or undiagnosed diabetes, increased from 10.2% in 1988–1994 to 18.5% in 2012. Among individuals aged 45 years and older, the prevalence of prediabetes increased from 22.0% to 33.1%. The percentage of adults aged 20 years and older with an unhealthy waist circumference increased from 5.6% in 1988–1994 to 7.6% in 2012. The percentage of individuals with an unhealthy waist-to-height ratio increased from 27.2% in 1988–1994 to 33.7% in 2012. Adjusted models found that measures of abdominal obesity were not independent predictors of prediabetes among adults with a healthy BMI. CONCLUSIONS Among individuals within a healthy BMI range, the prevalence of prediabetes and abdominal obesity has substantially increased. Abdominal obesity does not appear to be the primary cause of the increase. PMID:27401417

Fatty and lean red meat consumption in China: differential association with Chinese abdominal obesity

PubMed Central

Wang, Z.; Zhang, B.; Zhai, F.; Wang, H.; Zhang, J.; Du, W.; Su, C.; Zhang, J.; Jiang, H.; Popkin, B. M.

2014-01-01

Aim We examined the longitudinal association between red meat (RM) consumption and the risk of abdominal obesity in Chinese adults. Methods and results Our data are from 16,822 adults aged 18 to 75 in the China Health and Nutrition Survey from 1993 to 2011. We assessed RM intake with three 24-hour dietary recalls. We defined abdominal obesity as a waist circumference (WC) ≥ 85 centimeters (cm) for men and ≥ 80 cm for women. Multilevel mixed-effect regression models showed that men experienced WC increases of 0.74 cm (95% confidence interval [CI]: 0.39–1.09) from a higher total intake of fresh RM and 0.59 cm (95% CI: 0.24–0. 95) from a higher intake of fatty fresh RM but 0.14 cm (95% CI: −0.39–0.66) from a higher intake of lean fresh RM in the top versus the bottom quartile when adjusted for potential confounders. In contrast, after additional adjustment for baseline WC, the odds ratios of abdominal obesity in men were attenuated for total fresh RM (1.25 [95% CI: 1.06–1.47]) and fatty fresh RM (1.22 [95% CI: 1.03–1.44]) but were still not affected by lean fresh RM (0.95 [95% CI: 0.75–1.22]). Women also showed a positive association of fatty fresh RM intake with abdominal obesity. Conclusion Greater intake of fatty fresh RM was significantly associated with higher WC (men only) and abdominal obesity risk in Chinese adults. The gender-specific differential association of fatty versus lean fresh RM warrants further study. PMID:24795160

Fatty and lean red meat consumption in China: differential association with Chinese abdominal obesity.

PubMed

Wang, Z; Zhang, B; Zhai, F; Wang, H; Zhang, J; Du, W; Su, C; Zhang, J; Jiang, H; Popkin, B M

2014-08-01

We examined the longitudinal association between red meat (RM) consumption and the risk of abdominal obesity in Chinese adults. Our data are from 16,822 adults aged 18-75 in the China Health and Nutrition Survey from 1993 to 2011. We assessed RM intake with three 24-h dietary recalls. We defined abdominal obesity as a waist circumference (WC) ≥85 centimeters (cm) for men and ≥80 cm for women. Multilevel mixed-effect regression models showed that men experienced WC increases of 0.74 cm (95% confidence interval [CI]: 0.39-1.09) from a higher total intake of fresh RM and 0.59 cm (95% CI: 0.24-0. 95) from a higher intake of fatty fresh RM but 0.14 cm (95% CI: -0.39 to 0.66) from a higher intake of lean fresh RM in the top quartile versus non-consumers when adjusted for potential confounders. In contrast, after additional adjustment for baseline WC, the odds ratios of abdominal obesity in men were attenuated for total fresh RM (1.25 [95% CI: 1.06-1.47]) and fatty fresh RM (1.22 [95% CI: 1.03-1.44]) but were still not affected by lean fresh RM (0.95 [95% CI: 0.75-1.22]). Women also showed a positive association of fatty fresh RM intake with abdominal obesity. Greater intake of fatty fresh RM was significantly associated with higher WC (men only) and abdominal obesity risk in Chinese adults. The gender-specific differential association of fatty versus lean fresh RM warrants further study. Copyright © 2014 Elsevier B.V. All rights reserved.

First national epidemiological survey on the prevalence of obesity and abdominal fat distribution in Greek adults.

PubMed

Kapantais, E; Tzotzas, T; Ioannidis, I; Mortoglou, A; Bakatselos, S; Kaklamanou, M; Lanaras, L; Kaklamanos, I

2006-01-01

To provide estimates of the prevalence of obesity, overweight and body fat distribution among the adult population of Greece. Epidemiological, cross-sectional nationwide survey providing self-reported data. A total of 17,341 men and women aged from 20 to 70 years and classified into five 10-year age groups participated. The selection was conducted by stratified sampling through household family members of Greek children attending school. The participants reported data on weight, height, waist and hip circumference. BMI and waist-to-hip ratio were calculated. Abdominal obesity was defined as waist circumference > or = 102 cm in men and > or = 88 cm in women. In the total population, the mean BMI was 26.5 kg/m2, (27.3 in men, 25.7 in women). The overall prevalence of obesity was 22.5%, (26% in men, 18.2% in women) while that of overweight was 35.2% (41.1% in men, 29.9% in women). The percentages of obesity and overweight in men were similar in almost all age groups, while in women they progressively increased with age. Abdominal obesity was more frequent among women than men (35.8 vs. 26.6%, respectively), especially after the age of 50. Excess body weight is reaching epidemic proportions in Greece and obesity rates are among the highest, if not the highest, in Western society. The problem affects particularly men, and women after menopause. Interestingly, more women than men present with abdominal obesity. Preventive and treatment strategies are urgently needed to stop the obesity epidemic in this Mediterranean European country. Copyright 2006 S. Karger AG, Basel.

Survey of abdominal obesities in an adult urban population of Kinshasa, Democratic Republic of Congo

PubMed Central

Kasiam Lasi On’kin, JB; Longo-Mbenza, B; Okwe, A Nge; Kabangu, N Kangola

2007-01-01

Summary Background The prevalence of overweight/obesity, which is an important cardiovascular risk factor, is rapidly increasing worldwide. Abdominal obesity, a fundamental component of the metabolic syndrome, is not defined by appropriate cutoff points for sub-Saharan Africa. Objective To provide baseline and reference data on the anthropometry/body composition and the prevalence rates of obesity types and levels in the adult urban population of Kinshasa, DRC, Central Africa. Methods During this cross-sectional study carried out within a random sample of adults in Kinshasa town, body mass index, waist circumference and fatty mass were measured using standard methods. Their reference and local thresholds (cut-off points) were compared with those of WHO, NCEP and IFD to define the types and levels of obesity in the population. Results From this sample of 11 511 subjects (5 676 men and 5 835 women), the men presented with similar body mass index and fatty mass values to those of the women, but higher waist measurements. The international thresholds overestimated the prevalence of denutrition, but underscored that of general and abdominal obesity. The two types of obesity were more prevalent among women than men when using both international and local thresholds. Body mass index was negatively associated with age; but abdominal obesity was more frequent before 20 years of age and between 40 and 60 years old. Local thresholds of body mass index (≥ 23, ≥ 27 and ≥ 30 kg/m2) and waist measurement (≥ 80, ≥ 90 and ≥ 94 cm) defined epidemic rates of overweight/general obesity (52%) and abdominal obesity (40.9%). The threshold of waist circumference ≥ 94 cm (90th percentile) corresponding to the threshold of the body mass index ≥ 30 kg/m2 (90th percentile) was proposed as the specific threshold of definition of the metabolic syndrome, without reference to gender, for the cities of sub-Saharan Africa. Conclusion Further studies are required to define the

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. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Cardiovascular risk assessment according to the Framingham score and abdominal obesity in individuals seen by a clinical school of nutrition.

PubMed

Oliveira, Alane Cabral Menezes de; Ferreira, Raphaela Costa; Santos, Arianne Albuquerque

2016-04-01

To analyze the relation of abdominal obesity on cardiovascular risk in individuals seen by a clinic school of nutrition, classifying them based on Framingham score. Cross-sectional study, conducted at the nutrition clinic of a private college in the city of Maceió, Alagoas. We included randomly selected adults and elderly individuals with abdominal obesity, of both sexes, treated from August to December of 2009, with no history of cardiomyopathy or cardiovascular events. To determine the cardiovascular risk, the Framingham score was calculated. All analyzes were performed with SPSS software version 20.0, with p <0.05 as significative. We studied 54 subjects, 83% female, the mean age was 48 years old, ranging from 31 to 73 years. No correlation was observed between measurements of waist circumference and cardiovascular risk in the subjects studied (r=0.065, p=0.048), and there was no relationship between these parameters. Abdominal fat distribution was weakly related to cardiovascular risk in patients seen by a clinical school of nutrition.

Abdominal obesity validates the association between elevated alanine aminotransferase and newly diagnosed diabetes mellitus.

PubMed

Yueh, Chen-Yu; Yang, Yao-Hsu; Sung, Yi-Ting; Lee, Li-Wen

2014-01-01

To examine how elevated alanine aminotransferase (ALT) could be associated with newly diagnosed diabetes mellitus. We conducted a cross-sectional analysis on a mass health examination. The odds ratios (ORs) for diabetes mellitus and newly diagnosed diabetes mellitus were compared between people with and without abdominal obesity, together with and without elevated ALT levels. 5499 people were included in this study. Two hundred fifty two (4.6%) fulfilled the diagnosis of diabetes mellitus with 178 (3.2%) undiagnosed before. Metabolic syndrome was vigorously associated with diabetes mellitus and newly diagnosed diabetes mellitus (12.4% vs. 1.4% and 9.0% vs. 0.9%), but elevated ALT alone was not. However, coexisting with obesity, elevated ALTs were robustly associated with diabetes mellitus and newly diagnosed diabetes mellitus. For the incidence of newly diagnosed diabetes mellitus, in comparison to non-obese people with normal ALT (1.7%, OR = 1), obese people especially with elevated ALT levels had significantly higher ORs (obese with ALT ≤ 40 U/L: 4.7%, OR 1.73, 95% CI 1.08-2.77, P 0.023; ALT 41-80 U/L: 6.8%, OR 2.06, 95% CI 1.20-3.55, P 0.009; ALT 81-120 U/L: 8.8%, OR 3.07, 95% CI 1.38-6.84, P 0.006; ALT > 120 U/L: 18.2%, OR 7.44, 95% CI 3.04-18.18, P < 0.001). Abdominal obesity validates the association between elevated alanine aminotransferase and diabetes mellitus and newly diagnosed diabetes mellitus. People with abdominal obesity, especially with coexisting elevated ALT levels should be screened for undiagnosed diabetes mellitus.

Association of abdominal obesity, insulin resistance, and oxidative stress in adipose tissue in women with polycystic ovary syndrome.

PubMed

Chen, Li; Xu, Wen Ming; Zhang, Dan

2014-10-01

To study the expression of insulin signaling-related genes and oxidative stress markers in the visceral adipose tissue obtained from polycystic ovary syndrome (PCOS) patients and healthy control subjects and to investigate the relationships among abdominal obesity, insulin resistance, and oxidative stress at the tissue level. Case-control study. University teaching hospital. In total, 30 PCOS patients and 30 healthy control subjects, who underwent laparoscopic surgery, were included in the study. Abdominal obesity was defined based on waist circumference (WC). The homeostasis model index was used to assess insulin resistance (HOMA-IR). Gene expression of glucose transporter 4 (GLUT4) and insulin receptor substrate 1 (IRS1) in visceral adipose tissue (VAT) and the parameters of oxidative stress, such as superoxide dismutase, enzyme glutathione reductase, and dimethylarginine, were measured, and the expression of protein oxidative damage product 3-nitro-tyrosine residues (nitrotyrosine) in VAT was identified with the use of immunohistochemistry. PCOS was associated with lower expression of GLUT4 and IRS1 and a higher level of oxidative stress in VAT, which was strongly correlated with WC and HOMA-IR. Presence of abdominal obesity further intensified the correlations observed in our measurements. The nitrotyrosine expression in VAT was stronger in PCOS patients. The strong correlation of insulin resistance with oxidative stress at the VAT level suggests that local oxidative stress and abnormalities of insulin signaling in adipose tissue play critical roles in the pathogenesis of PCOS. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Abdominal obesity in older women: potential role for disrupted fatty acid reesterification in insulin resistance.

PubMed

Yeckel, Catherine W; Dziura, James; DiPietro, Loretta

2008-04-01

Excess abdominal adiposity is a primary factor for insulin resistance in older age. Our objectives were to examine the role of abdominal obesity on adipose tissue, hepatic, and peripheral insulin resistance in aging, and to examine impaired free fatty acid metabolism as a mechanism in these relations. This was a cross-sectional study. The study was performed at a General Clinical Research Center. Healthy, inactive older (>60 yr) women (n = 25) who were not on hormone replacement therapy or glucose-lowering medication were included in the study. Women with abdominal circumference values above the median (>97.5 cm) were considered abdominally obese. Whole-body peripheral glucose utilization, adipose tissue lipolysis, and hepatic glucose production were measured using in vivo techniques according to a priori hypotheses. In the simple analysis, glucose utilization at the 40 mU insulin dose (6.3 +/- 2.8 vs. 9.1 +/- 3.4; P < 0.05), the index of the insulin resistance of basal hepatic glucose production (23.6 +/- 13.0 vs. 15.1 +/- 6.0; P < 0.05), and insulin-stimulated suppression of lipolysis (35 vs. 54%; P < 0.05) were significantly different between women with and without abdominal obesity, respectively. Using the glycerol appearance rate to free fatty acid ratio as an index of fatty acid reesterification revealed markedly blunted reesterification in the women with abdominal adiposity under all conditions: basal (0.95 +/- 0.29 vs. 1.35 +/- 0.47; P < 0.02); low- (2.58 +/- 2.76 vs. 6.95 +/- 5.56; P < 0.02); and high-dose (4.46 +/- 3.70 vs. 12.22 +/- 7.13; P < 0.01) hyperinsulinemia. Importantly, fatty acid reesterification was significantly (P < 0.01) associated with abdominal circumference and hepatic and peripheral insulin resistance, regardless of total body fat. These findings support the premise of dysregulated fatty acid reesterification with abdominal obesity as a pathophysiological link to perturbed glucose metabolism across multiple tissues in aging.

Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia - a decomposition analysis approach.

PubMed

Pujilestari, Cahya Utamie; Nyström, Lennarth; Norberg, Margareta; Weinehall, Lars; Hakimi, Mohammad; Ng, Nawi

2017-12-12

Obesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, hence requiring different focal points to design public health policies in the latter contexts. We examined socioeconomic inequalities in abdominal obesity in Purworejo District, Central Java, Indonesia and identified factors contributing to the inequalities. We utilised data from the WHO-INDEPTH Study on global AGEing and adult health (WHO-INDEPTH SAGE) conducted in the Purworejo Health and Demographic Surveillance System (HDSS) in Purworejo District, Indonesia in 2010. The study included 14,235 individuals aged 50 years and older. Inequalities in abdominal obesity across wealth groups were assessed separately for men and women using concentration indexes. Decomposition analysis was conducted to assess the determinants of socioeconomic inequalities in abdominal obesity. Abdominal obesity was five-fold more prevalent among women than in men (30% vs. 6.1%; p < 0.001). The concentration index (CI) analysis showed that socioeconomic inequalities in abdominal obesity were less prominent among women (CI = 0.26, SE = 0.02, p < 0.001) compared to men (CI = 0.49, SE = 0.04, p < 0.001). Decomposition analysis showed that physical labour was the major determinant of socioeconomic inequalities in abdominal obesity among men, explaining 47% of the inequalities, followed by poor socioeconomic status (31%), ≤ 6 years of education (15%) and current smoking (11%). The three major determinants of socioeconomic inequalities in abdominal obesity among women were poor socio-economic status (48%), physical labour (17%) and no formal education (16%). Abdominal obesity was more prevalent among older women in a rural Indonesian setting. Socioeconomic inequality in

Abdominal Subcutaneous Fat Thickness Measured by Ultrasonography Correlates with Hyperlipidemia and Steatohepatitis in Obese Children.

PubMed

Lee, Sung Hyun; Kim, Dongwan; Baek, Min Young; Tchah, Hann; Kim, Yeon Sun; Ryoo, Eell; Kim, Yun Mi

2015-06-01

The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured 2.9±0.8 cm and 1.9±0.7 cm in the normal group, 3.3±0.8 cm and 2.0±0.7 cm in grade I, 3.8±0.8 cm and 2.3±0.8 cm in grade II, and 4.1±0.8 cm and 2.8±1.4 cm in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage.

Elephantiasis nostras verrucosa on the abdomen of a Turkish female patient caused by morbid obesity.

PubMed

Buyuktas, D; Arslan, E; Celik, O; Tasan, E; Demirkesen, C; Gundogdu, S

2010-08-15

Elephantiasis Nostras Verrucosa is a rare disorder of an extremity or a body region, which is associated with chronic lymphedema. There are 7 reported cases of abdominal elephantiasis in the medical literature. Here we report a morbidly obese female patient with elephantiasis nostras verrucosa on the abdominal wall.

Abdominal Pain in the Geriatric Patient.

PubMed

Leuthauser, Amy; McVane, Benjamin

2016-05-01

Abdominal pain in the elderly can be a challenging and difficult condition to diagnose and treat. The geriatric population has significant comorbidities and often takes polypharmacy that can mask symptoms. The presentation of common conditions can be different than that in the younger population, often lacking the traditional indicators of disease, making it of pivotal importance for the clinician to consider a wide differential during their workup. It is also important to consider extra-abdominal abnormality that may manifest as abdominal pain. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of abdominal pain in the AIDS patient.

PubMed Central

Potter, D A; Danforth, D N; Macher, A M; Longo, D L; Stewart, L; Masur, H

1984-01-01

Acquired immune deficiency syndrome (AIDS) is a recently recognized entity characterized by a deficiency in cell mediated immune response. The syndrome is manifested by the development of otherwise rare malignant neoplasms and severe life-threatening opportunistic infections. Case histories of five AIDS patients evaluated for abdominal pain are presented to demonstrate the unusual spectrum of intra-abdominal pathology that may be encountered in the AIDS patient. As the number of patients with AIDS continues to escalate, surgical evaluation and intervention will be required more frequently. An understanding of this syndrome and its complications is mandatory for the surgeon to adequately evaluate AIDS patients with abdominal pain. PMID:6322708

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

PubMed

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

2013-01-01

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. 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. 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. The prevalence of abdominal obesity is high in Nigeria, and needs to be monitored because it is associated with increased cardiovascular risk.

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

Gender differences in the prevalence and development of metabolic syndrome in Chinese population with abdominal obesity.

PubMed

Xu, Shaoyong; Gao, Bin; Xing, Ying; Ming, Jie; Bao, Junxiang; Zhang, Qiang; Wan, Yi; Ji, Qiuhe

2013-01-01

Not all the people with metabolic syndrome (MS) have abdominal obesity (AO). The study aimed to investigate gender differences in the prevalence and development of MS in Chinese population with abdominal obesity, which has rarely been reported. Data were obtained from the 2007-08 China National Diabetes and Metabolic Disorders Study, and participants were divided into two samples for analysis. Sample 1 consisted of 19,046 people with abdominal obesity, while sample 2 included 2,124 people meeting pre-specified requirements. Survival analysis was used to analyze the development of MS. The age-standardized prevalence of MS in Chinese population with AO was 49.5%. The prevalence in males (73.7%) was significantly higher than that in females (36.9%). Males had significantly higher proportions of combinations of three or four MS components than females (36.4% vs. 30.2% and 18.4% vs. 5%, respectively). MS developed quick at first and became slow down later. Half of the participants with AO developed to MS after 3.9 years (95% CI: 3.7-4.1) from the initial metabolic abnormal component, whereas 75% developed to MS after 7.7 years (95% CI: 7.5-7.9). Compared with females, Chinese males with AO should receive more attention because of their higher prevalence of MS and its components, more complex and risky combinations of abnormal components, and faster development of MS.

Association of acrylamide hemoglobin biomarkers with obesity, abdominal obesity and overweight in general US population: NHANES 2003-2006.

PubMed

Huang, Mengmeng; Zhuang, Pan; Jiao, Jingjing; Wang, Jun; Zhang, Yu

2018-08-01

Exposure to chemical contaminants is considered as one of risk factors to the current epidemic of obesity. Acrylamide (AA) is a ubiquitous chemical contaminant in environmental waste, mainstream cigarette smoke and carbohydrate-rich foods, and widely used in industrial manufacturers and cosmetics. Few studies have highlighted the association of daily exposure to AA with obesity-related outcomes. We analyzed data from 8364 participants who aged 20-85years and were recruited in National Health and Nutrition Examination Surveys (NHANES) 2003-2006. We established the model of PROC Survey Logistic regressions via using AA biomarkers in blood, hemoglobin adducts of acrylamide and glycidamide (HbAA and HbGA), as the measure of internal exposure to AA, and assessing obesity, abdominal obesity and overweight with body mass index (BMI) or waist circumference (WC). After the adjustment of sociodemographic variables, lifestyle behaviors, and health-related factors, the ratio of HbGA to HbAA (HbGA/HbAA) was significantly associated with obesity (p for trend<0.0001). The odd ratios (ORs) with 95% confidence intervals (CIs) of HbGA/HbAA across increasing quartiles were 1.740 (1.413-2.144), 2.604 (2.157-3.144), and 2.863 (2.425-3.380) compared with the lowest quartile. HbGA was positively associated with obesity [OR (95% CI): 1.226 (1.041-1.443), 1.283 (1.121-1.468), and 1.398 (1.165-1.679); p for trend=0.0004], while HbAA was inversely associated with obesity [OR (95% CI): 0.839 (0.718-0.980), 0.713 (0.600-0.848), and 0.671 (0.554-0.811); p for trend<0.0001]. Negative associations were found between the sum of HbAA and HbGA (HbAA+HbGA) and the body weight outcomes. Similar associations were also observed between the hemoglobin biomarkers of AA and abdominal obesity as well as overweight. Thus, the hemoglobin adducts of AA as long-term internal exposure biomarkers are strongly associated with obesity-related outcomes in a population of US adults. Copyright © 2018 Elsevier B

The midabdominal TRAM flap for breast reconstruction in morbidly obese patients.

PubMed

Gabbay, Joubin S; Eby, Joseph B; Kulber, David A

2005-03-01

The transverse rectus abdominis myocutaneous (TRAM) flap is ideal for postmastectomy reconstruction but is tenuous in morbidly obese patients. Because of their relatively high incidence of postoperative complications, morbidly obese patients are often not considered candidates for autogenous reconstruction. The midabdominal TRAM flap has a more favorable anatomy and may represent an alternative technique in this patient population. The records of 18 morbidly obese patients who underwent postmastectomy reconstruction using a mid-abdominal TRAM flap from 1998 through 2002 were retrospectively reviewed. The mid-abdominal TRAM flap territory includes more of the supraumbilical region than the traditional TRAM flap, corresponding to an area with more abundant musculocutaneous perforators and greater dependence on the superior epigastric vascular system. All patients underwent unipedicled mid-abdominal TRAM flap surgery. Four patients with previous subumbilical midline incisions had a delay procedure with ligation of the inferior epigastric vessels. Complications investigated were flap necrosis greater than 10 percent or sufficient to require surgical revision, abdominal donor-site breakdown, seroma formation, umbilical necrosis, abdominal wall bulging or hernia, deep vein thrombosis, infected mesh, surgical revisions, fat necrosis, and extended hospital stay. At a mean follow-up time of 15.6 months (range, 12 to 24 months), three patients had postoperative complications requiring surgical revision. Two of these patients had previous midline abdominal incisions. One patient had both partial flap necrosis and a donor-site complication. The second patient had partial flap necrosis, and the third had an abdominal donor-site complication. No occurrences of abdominal wall hernia, total flap loss, deep vein thrombosis, infected mesh, extensive surgical revision, or extended hospitalization were noted in this series. The mid-abdominal TRAM flap represents an alternative method

Antimicrobial Dose in Obese Patient

PubMed Central

Kassab, Sawsan; Syed Sulaiman, Syed Azhar; Abdul Aziz, Noorizan

2007-01-01

Introduction Obesity is a chronic disease that has become one of major public health issue in Malaysia because of its association with other disease states including cardiovascular disease and diabetes. Despite continuous efforts to educate the public about the health risks associated with obesity, prevalence of the disease continues to increase. Dosing of many medications are based on weight, limited data are available on how antimicrobial agents should be dosed in obesity. The aim of this case presentation is to discuss dose of antibiotic in obese patient. Case report: Patient: GMN, Malay, Female, 45 year old, 150kg, transferred from medical ward to ICU with problems of fever, orthopnea, sepsis secondary to nosocomial pneumonia. She was admitted to hospital a week ago for SOB on exertion, cyanosis, mildly dyspneic, somasthenia, bilateral ankle swelling. There was no fever, cough, chest pain, clubbing, flapping tremor. Her grand father has pre-morbid history of obesity, HPT, DM and asthma. She was non alcoholic, smoker, and not on diet control. The diagnosis Pickwickian syndrome was made. Patient was treated with IV Dopamine 11mcg/kg/min, IV Morphine 4mg/h. IV GTN 15mcg/min, IV Ca gluconate 10g/24h for 3/7, IV Zantac 50mg tds, IV Augmentin 1.2g tds, IV Lasix 40mg od, IV Plasil 10mg tds, S.c heparin 5000IU bd. patient become stable and moved to medical ward to continue her treatment. Discussion: The altered physiologic function seen in obese patients is a concern in patients receiving antimicrobial agents because therapeutic outcomes depend on achieving a minimum inhibitory concentration (MIC). The therapeutic effect of any drug can be altered when any of the 4 pharmacokinetic processes (absorption, distribution, metabolism, or elimination) are altered. Decreased blood flow rates and increased renal clearance in obese patients can affect drug distribution and elimination. Changes in serum protein levels can change the metabolism and distribution of drugs that are

Abdominal obesity and its association with socioeconomic factors among adolescents from different living environments.

PubMed

Costa de Oliveira Forkert, E; de Moraes, A C F; Carvalho, H B; Kafatos, A; Manios, Y; Sjöström, M; González-Gross, M; Gottrand, F; Beghin, L; Censi, L; Kersting, M; Moreno, L A

2017-04-01

Socioeconomic status has been associated with obesity in children and adolescents. This association may be dependent according with where adolescents lives. The aim of this study was to evaluate the association between different socioeconomic indicators such as parental education and occupation and socioeconomic status with abdominal obesity in adolescents from two observational studies: the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (HELENA-CSS) and the Brazilian Cardiovascular Adolescent Health (BRACAH) study. European (n = 3192, aged 12.5-17.5 years, with 53.1% girls from HELENA-CSS) and Brazilian (n = 991, aged 14-18 years, with 54.5% girls from BRACAH study) adolescents from two cross-sectional studies were included in this analysis. Complete data on waist circumference (WC), height, socioeconomic status indicators and several confounders were collected. Socioeconomic indicators were measured using a self-reported questionnaire in order to assess the family social status of the adolescents. Multilevel linear regression models were used to examine associations, and results were adjusted for potential confounders. Adjusted results showed inverse associations between mother's and father's education levels (p < 0.001) and father's occupation level (p < 0.001) with waist-to-height ratio (WHtR) and WC in HELENA-CSS girls. Similarly in European girls, socioeconomic indicators by socioeconomic status and maternal occupation level were associated with WHtR. In HELENA-CSS boys, the same significant association was found between WHtR and WC with maternal occupation level. Moreover, in European boys WHtR was also associated with parental education. In Brazilian adolescents, both indicators of abdominal obesity did not remain associated with the independents variables, after adjustment for potential confounders. Abdominal obesity was associated with socioeconomic indicators in higher-income countries, but this

Regional Differences in Adipose Tissue Hormone/Cytokine Production Before and After Weight Loss in Abdominally Obese Women

PubMed Central

You, Tongjian; Wang, Xuewen; Murphy, Karin M.; Lyles, Mary F.; Demons, Jamehl L.; Yang, Rongze; Gong, Da-Wei; Nicklas, Barbara J.

2014-01-01

Objective To compare the regional differences in subcutaneous adipose tissue hormone/cytokine production in abdominally obese women during weight loss. Design and Methods Forty-two abdominally obese, older women underwent a 20-week weight loss intervention composed of hypocaloric diet with or without aerobic exercise (total energy expenditure: ~2800 kcal/week). Subcutaneous (gluteal and abdominal) adipose tissue biopsies were conducted before and after the intervention. Results Adipose tissue gene expression and release of leptin, adiponectin, and interleukin 6 (IL-6) were determined. The intervention resulted in significant weight loss (−10.1 ±0.7 kg, P<0.001). At baseline, gene expression of adiponectin were higher (P<0.01), and gene expression and release of IL-6 were lower (both P<0.05) in abdominal than in gluteal adipose tissue. After intervention, leptin gene expression and release were lower in both gluteal and abdominal adipose tissue compared to baseline (P<0.05 to P<0.01). Abdominal, but not gluteal, adipose tissue adiponectin gene expression and release increased after intervention (both P<0.05). Conclusion A 20-week weight loss program decreased leptin production in both gluteal and abdominal adipose tissue, but only increased adiponectin production from abdominal adipose tissue in obese women. This depot-specific effect may be of importance for the treatment of health complications associated with abdominal adiposity. PMID:24634403

[Abdominal ultrasonography in patients with diabetes mellitus. Part 1: Liver].

PubMed

Jenssen, C; Pietsch, C; Gottschalk, U; Barreiros, A P; Teufel, A; Cui, X W; Dietrich, C F

2015-04-01

In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.

Dual antiplatelet treatment in patients candidates for abdominal surgery.

PubMed

Illuminati, Giulio; Ceccanei, Gianluca; Pacilè, Maria A; Pizzardi, Giulia; Palumbo, Piergaspare; Vietri, Francesco

2013-01-01

With the increasing diffusion of percutaneous interventions (PCI), surgeons are often faced with the problem of operating on patients under dual antiplatelet treatment. Replacing dual antiplatelet regiment with low molecular weight heparin may expose to the abrupt thrombosis of coronary stent and massive myocardial infarction. The purpose of this study was to test the hypothesis that abdominal operations can be safely performed under dual antiplatelet treatment. Eleven patients underwent 5 colectomies, 3 nefrectomies, 2 gastrectomies and 1 hysterectomy under aspirin and plavix without any significant perioperative hemorrhage. These preliminary results show that abdominal operations can be safely performed under dual antiplatelet regimen. Abdominal surgery, Dual antiplatelet treatment.

The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults.

PubMed

Alexandre, Tiago da Silva; Scholes, Shaun; Ferreira Santos, Jair Licio; Duarte, Yeda Aparecida de Oliveira; de Oliveira, Cesar

2017-10-02

The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older adults over eight and ten years of follow-up, respectively. We used longitudinal data from 3374 participants from the English Longitudinal Study of Ageing (ELSA) and 1040 participants from the Brazilian Health, Well-being and Aging Study (SABE) who were free from disability as assessed by IADL at baseline. IADL disability was defined herein as a difficulty to perform the following: preparing meals, managing money, using transportation, shopping, using the telephone, house cleaning, washing clothes, and taking medications according to the Lawton IADL modified scale. The study population in each country was categorized into non-dynapenic/non-abdominal obese (reference group), abdominal obese, dynapenic and dynapenic abdominal obese according to their handgrip strength (<26 kg for men and <16 kg for women) and waist circumference (>102 cm for men and >88 cm for women). We used generalized linear mixed models with IADL as the outcome. The estimated change over time in IADL disability was significantly higher for participants with dynapenic abdominal obesity compared to those with neither condition in both cohorts (ELSA: +0.023, 95% CI = 0.012-0.034, p < 0.001; SABE: +0.065, 95% CI = 0.038-0.091, p < 0.001). Abdominal obesity was also associated with changes over time in IADL disability (ELSA: +0.009, 95% CI = 0.002-0.015, p < 0.05; SABE: +0.021, 95% CI = 0.002-0.041, p < 0.05), which was not observed for dynapenia. Abdominal obesity is an important risk factor for IADL decline but

Educational inequalities in obesity, abdominal obesity, and metabolic syndrome in seven Latin American cities: the CARMELA Study.

PubMed

Boissonnet, Carlos; Schargrodsky, Herman; Pellegrini, Fabio; Macchia, Alejandro; Marcet Champagne, Beatriz; Wilson, Elinor; Tognoni, Gianni

2011-08-01

Earlier reviews have found that the proportion of inverse associations between socioeconomic status and obesity increased according to the level of development of the studied country. Based on this finding, it has been hypothesized that in low- to middle- income countries the burden of obesity shifts to disadvantaged groups as a country develops. CARMELA is a cross-sectional, population-based observational study that sampled 11,550 women and men age 25-64 from seven major Latin American cities. We analyzed by gender the association of educational attainments (as proxy of socioeconomic status) with body mass index, waist circumference and metabolic syndrome. Participating cities were divided by country Human Development Index (HDI). An inverse gradient between socioeconomic status and body mass index in women was uniformly present in High HDI cities (Buenos Aires, Santiago, Mexico) but not in Medium HDI group (Barquisimeto, Bogota, Lima, Quito), where two cities showed an inverse gradient and two cities did not. In men, no clear socioeconomic gradients were found. Findings regarding waist circumference and metabolic syndrome closely mirrored those about body mass index. In women but not men, these results give support to the hypothesis of obesity shifting to the poor and extend it to the related concepts of abdominal obesity and metabolic syndrome. Obesity should be considered as a socially-generated disease and an indicator of socioeconomic disadvantage, to be approached by comprehensive strategies that bear in mind this perspective.

Incidence, Patterns, and Factors Predicting Mortality of Abdominal Injuries in Trauma Patients

PubMed Central

Gad, Mohammad A; Saber, Aly; Farrag, Shereif; Shams, Mohamed E; Ellabban, Goda M

2012-01-01

Background: Abdominal trauma is a major public health problem for all nations and all socioeconomic strata. Aim: This study was designed to determine the incidence and patterns of abdominal injuries in trauma patients. Materials and Methods: We classified and identified the incidence and subtype of abdominal injuries and associated trauma, and identified variables related to morbidity and mortality. Results: Abdominal trauma was present in 248 of 300 cases; 172 patients with blunt abdominal trauma and 76 with penetrating. The most frequent type of abdominal trauma was blunt trauma; its most common cause was motor vehicle accident. Among patients with penetrating abdominal trauma, the most common cause was stabbing. Most abdominal trauma patients presented with other injuries, especially patients with blunt abdominal trauma. Mortality was higher among penetrating abdominal trauma patients. Conclusions: Type of abdominal trauma, associated injuries, and Revised Trauma Score are independent risk factors for mortality in abdominal trauma patients. PMID:22454826

Endocannabinoid antagonism: blocking the excess in the treatment of high-risk abdominal obesity.

PubMed

Duffy, Danielle; Rader, Daniel

2007-02-01

Abdominal obesity is a prevalent, worldwide problem linked to cardiometabolic comorbidities and an increased risk of coronary heart disease. First-line therapy to reduce such risk revolves around diet and exercise; however, such changes are often difficult to implement and unsuccessful. Understanding the underlying pathophysiology of underlying metabolic derangements could provide new targets for pharmacologic therapy. One system that has gained recent attention is the endocannabinoid system. The endocannabinoid system has a significant role in central appetite control and peripheral lipogenesis and is up-regulated in diet-induced obesity. Rimonabant is a selective cannabinoid-1 receptor antagonist and is the first compound of its type to test the hypothesis that down-regulating an overactive endocannabinoid system could have therapeutic benefit not only for weight loss but also for the atherogenic dyslipidemia and insulin resistance that cluster with abdominal obesity in particular. Animal models have been critical for elucidating the role of the endocannabinoid system in obesity and in demonstrating that antagonism with rimonabant can induce loss of visceral fat and improve insulin sensitivity. Early human trials with rimonabant have confirmed significant reductions in weight, as well as favorable changes in atherogenic dyslipidemia, insulin resistance, and markers of inflammation. Interestingly, some of these beneficial metabolic effects are partially weight-loss-independent, confirming the importance of peripheral endocannabinoid system effects in addition to central effects.

Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies.

PubMed

Du, Xuan; Hidayat, Khemayanto; Shi, Bi-Min

2017-06-30

To systematically and quantitatively review the relation of abdominal obesity, as measured by waist circumference (WC) and waist to hip ratio (WHR), to total gastroesophageal cancer, gastric cancer (GC), and esophageal cancer. PubMed and Web of Science databases were searched for studies assessing the association between abdominal obesity and gastroesophageal cancer (GC and/or esophageal cancer) up to August 2016. A random-effect model was used to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Seven prospective cohort studies - one publication included two separate cohorts - from six publications were included in the final analysis. A total of 2130 gastroesophageal cancer cases diagnosed amongst 913182 participants. Higher WC and WHR were significantly associated with increased risk of total gastroesophageal cancer (WC: RR 1.68, 95% CI: 1.38, 2.04; WHR: RR 1.49, 95% CI: 1.19, 1.88), GC (WC: RR 1.48, 95% CI: 1.24, 1.78; WHR: 1.33, 95% CI: 1.04, 1.70), and esophageal cancer (WC: RR 2.06, 95% CI: 1.30, 3.24; WHR: RR 1.99, 95% CI: 1.05, 3.75).Findings from our subgroup analyses showed non-significant positive associations between gastric non-cardia adenocarcinoma (GNCA) and both measures of abdominal adiposity, while gastric cardia adenocarcinoma (GCA) was positively associated with WC but not with WHR. On analysis restricted to studies that adjusted for body mass index (BMI), WC was positively associated with GC and esophageal cancer, whereas WHR was positively associated with risk of GC only. Although limited, the findings from our meta-analysis suggest the potential role of abdominal obesity in the etiology of gastric and esophageal cancers. © 2017 The Author(s).

Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies

PubMed Central

Du, Xuan; Hidayat, Khemayanto

2017-01-01

To systematically and quantitatively review the relation of abdominal obesity, as measured by waist circumference (WC) and waist to hip ratio (WHR), to total gastroesophageal cancer, gastric cancer (GC), and esophageal cancer. PubMed and Web of Science databases were searched for studies assessing the association between abdominal obesity and gastroesophageal cancer (GC and/or esophageal cancer) up to August 2016. A random-effect model was used to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Seven prospective cohort studies – one publication included two separate cohorts – from six publications were included in the final analysis. A total of 2130 gastroesophageal cancer cases diagnosed amongst 913182 participants. Higher WC and WHR were significantly associated with increased risk of total gastroesophageal cancer (WC: RR 1.68, 95% CI: 1.38, 2.04; WHR: RR 1.49, 95% CI: 1.19, 1.88), GC (WC: RR 1.48, 95% CI: 1.24, 1.78; WHR: 1.33, 95% CI: 1.04, 1.70), and esophageal cancer (WC: RR 2.06, 95% CI: 1.30, 3.24; WHR: RR 1.99, 95% CI: 1.05, 3.75).Findings from our subgroup analyses showed non-significant positive associations between gastric non-cardia adenocarcinoma (GNCA) and both measures of abdominal adiposity, while gastric cardia adenocarcinoma (GCA) was positively associated with WC but not with WHR. On analysis restricted to studies that adjusted for body mass index (BMI), WC was positively associated with GC and esophageal cancer, whereas WHR was positively associated with risk of GC only. Although limited, the findings from our meta-analysis suggest the potential role of abdominal obesity in the etiology of gastric and esophageal cancers. PMID:28336766

Green tea consumption, abdominal obesity as related factors of lacunar infarction in Korean women.

PubMed

Ko, S-G; Go, H; Sun, S; Lee, S; Park, W; Choi, Y; Song, Y; Hwang, G; Kim, G; Jeon, C; Park, J; Lee, K; Cha, M; Bang, O; Jung, H; Kim, N; Shin, Y-C

2011-08-01

Our purpose was to evaluate interaction of green tea consumption and abdominal obesity as related factors for lacunar infarction in Korean women. A hospital-based, incident case-control study. The Prevention and Managements of Stroke in Women study. Cases (n=233) of first incident lacunar infarction were enrolled and matched by age to stroke-free hospital controls (n=204). The data were collected through face-to-face interviews by well trained research assistants to assess demographic, medical, lifestyle, marital status, religions status, green tea consumptions, family history of stroke, smoking status, alcohol consumption, meat and vegetable intake frequency, and past history of hypertension. Biochemical analysis, fasting blood specimens for lipid, glucose, and cholesterol level were acquired. Compared with the non green tea consumer and obese women group, only the green tea consumption and non obese women group had a protective effect of lacunar infarction when adjusted for age, and age plus diet factors (OR, 0.23; 95% CI, 0.09, 0.59; OR, 0.21; 95% CI, 0.08, 0.56 respectively), but lost their significance after adjustment for age, diet factors, vascular risk factors and full model included atherogenic index factors (OR, 0.32; 95% CI, 0.09 to 1.01; OR, 0.49; 95% CI, 0.12, 1.89 respectively). The interaction of green tea consumption and non obesity have reduced risk of lacunar infarction, but not after adjustment for age, diet factors, vascular risk factors and atherogenic index. Also individually green tea consumption and abdominal obesity have failed to find an independent relationship with lacunar infarction after adjustment by all risk factors. Green tea consumption and green tea consumption with non obese group seemed to have a protective effect for lacunar infarction. In the results of our study, these results still remain controversial, and then we need further and larger study to get at the root of real causal effect of both relationships.

Volunteer patients and small groups contribute to abdominal examination's success.

PubMed

Shields, Helen M; Fernandez-Becker, Nielsen Q; Flier, Sarah N; Vaughn, Byron P; Tukey, Melissa H; Pelletier, Stephen R; Horst, Douglas A

2017-01-01

Prior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its "Introduction to Physical Examination" session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session. Our aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time? A total of 43-46 patients and 43-46 faculty were recruited and 43-46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43-46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient. Over the 5-year time period (2008-2012), the abdominal examination ranked first among all organ systems' "Introductory Sessions". The abdominal examination ratings had the best mean score (1.35) on a Likert scale where 1 is excellent and 5 is poor. The students gave the most positive spontaneous comments to having volunteer patients, with small groups coming in as the second most appreciated educational element. We successfully quadrupled the number of faculty, patients, and examining rooms and created a highly rated educational program as measured by anonymous student evaluations, patient and faculty participation, and the medical school's selecting the abdominal examination methods as an "Advanced Examination" for the Pathways

Skeletal maturation in obese patients.

PubMed

Giuca, Maria Rita; Pasini, Marco; Tecco, Simona; Marchetti, Enrico; Giannotti, Laura; Marzo, Giuseppe

2012-12-01

The objective of this study was to compare skeletal maturation in obese patients and in subjects of normal weight to evaluate the best timing for orthopedic and orthodontic treatment. The null hypothesis was that obese and normal-weight patients show similar degrees of skeletal maturation. The sample for this retrospective study consisted of 50 white patients (28 boys, 22 girls) whose x-rays (hand-wrist and lateral cephalometric radiographs) were already available. The test group included 25 obese patients (11 girls, 14 boys; average age, 9.8 ± 2.11 years), and the control group included 25 subjects of normal weight (11 girls, 14 boys; average age, 9.9 ± 2.5 years). Skeletal maturation was determined by using the carpal analysis method and the cervical vertebral maturation method. According to the carpal analysis, there was a significant difference between skeletal and chronologic ages between the test group (11.8 ± 11.4 months) and the control group (-2.9 ± 3.1 months). Furthermore, the obese subjects exhibited a significantly higher mean cervical vertebral maturation score (2.8 ± 0.7) than did the control subjects (2 ± 0.6) (P <0.05). Compared with the normal-weight subjects, the obese subjects showed a higher mean discrepancy between skeletal and chronologic ages according to the carpal analysis and had a significantly higher cervical vertebral maturation score. Thus, to account for the growth in obese patients with skeletal discrepancies, it might be necessary to perform examinations and dentofacial and orthopedic treatments earlier than in normal-weight subjects. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Neuropeptide Y genotype, central obesity, and abdominal fat distribution: the POUNDS LOST trial1,2

PubMed Central

Lin, Xiaochen; Qi, Qibin; Zheng, Yan; Huang, Tao; Lathrop, Mark; Zelenika, Diana; Bray, George A; Sacks, Frank M; Liang, Liming; Qi, Lu

2015-01-01

Background: Neuropeptide Y is a key peptide affecting adiposity and has been related to obesity risk. However, little is known about the role of NPY variations in diet-induced change in adiposity. Objective: The objective was to examine the effects of NPY variant rs16147 on central obesity and abdominal fat distribution in response to dietary interventions. Design: We genotyped a functional NPY variant rs16147 among 723 participants in the Preventing Overweight Using Novel Dietary Strategies trial. Changes in waist circumference (WC), total abdominal adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue (SAT) from baseline to 6 and 24 mo were evaluated with respect to the rs16147 genotypes. Genotype–dietary fat interaction was also examined. Results: The rs16147 C allele was associated with a greater reduction in WC at 6 mo (P < 0.001). In addition, the genotypes showed a statistically significant interaction with dietary fat in relation to WC and SAT (P-interaction = 0.01 and 0.04): the association was stronger in individuals with high-fat intake than in those with low-fat intake. At 24 mo, the association remained statistically significant for WC in the high-fat diet group (P = 0.02), although the gene–dietary fat interaction became nonsignificant (P = 0.30). In addition, we found statistically significant genotype–dietary fat interaction on the change in total abdominal adipose tissue, visceral adipose tissue, and SAT at 24 mo (P = 0.01, 0.05, and 0.04): the rs16147 T allele appeared to associate with more adverse change in the abdominal fat deposition in the high-fat diet group than in the low-fat diet group. Conclusion: Our data indicate that the NPY rs16147 genotypes affect the change in abdominal adiposity in response to dietary interventions, and the effects of the rs16147 single-nucleotide polymorphism on central obesity and abdominal fat distribution were modified by dietary fat. This trial was registered at clinicaltrials.gov as

Neuropeptide Y genotype, central obesity, and abdominal fat distribution: the POUNDS LOST trial.

PubMed

Lin, Xiaochen; Qi, Qibin; Zheng, Yan; Huang, Tao; Lathrop, Mark; Zelenika, Diana; Bray, George A; Sacks, Frank M; Liang, Liming; Qi, Lu

2015-08-01

Neuropeptide Y is a key peptide affecting adiposity and has been related to obesity risk. However, little is known about the role of NPY variations in diet-induced change in adiposity. The objective was to examine the effects of NPY variant rs16147 on central obesity and abdominal fat distribution in response to dietary interventions. We genotyped a functional NPY variant rs16147 among 723 participants in the Preventing Overweight Using Novel Dietary Strategies trial. Changes in waist circumference (WC), total abdominal adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue (SAT) from baseline to 6 and 24 mo were evaluated with respect to the rs16147 genotypes. Genotype-dietary fat interaction was also examined. The rs16147 C allele was associated with a greater reduction in WC at 6 mo (P < 0.001). In addition, the genotypes showed a statistically significant interaction with dietary fat in relation to WC and SAT (P-interaction = 0.01 and 0.04): the association was stronger in individuals with high-fat intake than in those with low-fat intake. At 24 mo, the association remained statistically significant for WC in the high-fat diet group (P = 0.02), although the gene-dietary fat interaction became nonsignificant (P = 0.30). In addition, we found statistically significant genotype-dietary fat interaction on the change in total abdominal adipose tissue, visceral adipose tissue, and SAT at 24 mo (P = 0.01, 0.05, and 0.04): the rs16147 T allele appeared to associate with more adverse change in the abdominal fat deposition in the high-fat diet group than in the low-fat diet group. Our data indicate that the NPY rs16147 genotypes affect the change in abdominal adiposity in response to dietary interventions, and the effects of the rs16147 single-nucleotide polymorphism on central obesity and abdominal fat distribution were modified by dietary fat. © 2015 American Society for Nutrition.

Effects of combined physical activity and dietary intervention on obesity and metabolic parameters in adults with abdominal obesity.

PubMed

Soon, Heng Kiang; Saad, Hazizi Abu; Taib, Mohd Nasir Mohd; Rahman, Hejar Abd; Mun, Chan Yoke

2013-03-01

A twelve-week controlled intervention trial was carried out to evaluate the effects of combined physical activity and dietary intervention on obesity and metabolic risk factors among employees of Universiti Putra Malaysia. Participants consisted of adults aged 25-55 years with no reported chronic diseases but with abdominal obesity. They were assigned to either a combined physical activity and dietary intervention group or a control group. The final sample consisted of 56 participants, with an equal number of 28 for each study group. No significant group effect was observed for any variable except for hip circumference (HC) and fasting plasma glucose (FPG). There was a significant increase in HC (p=0.007) and reduction in FPG (p=0.02) in the intervention group compared to the control group. In the intervention group, HC (p=0.002), triglycerides (TG) (p=0.0001), total cholesterol (TC) (p=0.0001), LDL cholesterol (LDLC) (p=0.0001) and FPG (p=0.005) were significantly reduced, while waist circumference (WC) (p=0.025) and the waist-to-hip ratio (WHR) (p=0.027) were significantly reduced in the control group. No significant change in steps/day or calorie intake'was observed in either group. Taken together, these data indicate that the combined physical activity and dietary intervention was not effective at improving diet or physical activity level. However, the intervention was effective in improving FPG among participants with abdominal obesity. The significant increase in HC in the interventions group warrants further study. These findings will be useful to further improve group-based intervention for the prevention and management of obesity.

Prevalence of overweight/obesity, abdominal obesity and metabolic syndrome and atypical cardiometabolic phenotypes in the adult Romanian population: PREDATORR study.

PubMed

Popa, S; Moţa, M; Popa, A; Moţa, E; Serafinceanu, C; Guja, C; Catrinoiu, D; Hâncu, N; Lichiardopol, R; Bala, C; Popa, A; Roman, G; Radulian, G; Timar, R; Mihai, B

2016-09-01

The objectives were to assess the prevalence of overweight/obesity, abdominal obesity and metabolic syndrome (MetS), and to evaluate the characteristics of the metabolically unhealthy lean (MUHL) and metabolically healthy overweight/obese (MHO) phenotypes in a Romanian population-based sample from the PREDATORR study. PREDATORR was an epidemiological study with a stratified, cross-sectional, cluster random sampling design. Participants were classified into four cardiometabolic phenotypes based on the BMI, the cut-off value being 25 kg/m(2), and the presence of MetS (defined according to the Harmonization definition 2009): MUHL, MHO, metabolically healthy lean (MHL) and metabolically unhealthy overweight/obese (MUHO). Overall, 2681 subjects aged 20-79 years were included in the analysis. The overall age and sex-adjusted prevalence of obesity was 31.90 %, overweight was 34.7 %, abdominal obesity was 73.90 % and MetS was 38.50 %. The age- and sex-adjusted prevalence of MHO phenotype was 31.60 %, while MUHL phenotype prevalence was 3.90 %. MUHL and MHO participants had a cardiometabolic profile, kidney function and CVD risk intermediary between MHL and MUHO. MUHL had higher odds of being associated with CVD risk (OR 5.8; p < 0.001), abdominal obesity, prediabetes, diabetes, hypertriglyceridemia and hypo-HDL cholesterolemia than MHL, while MHO phenotype was associated with hypo-HDL cholesterolemia (OR 3.1; p = 0.002), prediabetes (OR 2.9; p < 0.001) and abdominal obesity. PREDATORR study showed a high prevalence of obesity/overweight, abdominal obesity and MetS in the adult Romanian population, and their association with kidney function and several cardiometabolic factors.

Wide topical negative pressure wound dressing treatment for patients undergoing abdominal dermolipectomy following massive weight loss.

PubMed

Dragu, Adrian; Schnürer, Stefan; Unglaub, Frank; Wolf, Maya B; Beier, Justus P; Kneser, Ulrich; Horch, Raymund E

2011-11-01

Postbariatric plastic surgery is considered to be a high-risk procedure, which entails such frequent minor complications as postoperative seroma, bleeding and wound dehiscence. These occur with a high incidence, especially, following postbariatric abdominal dermolipectomy. In order to reduce these complication rates, a new type of dressing with wide abdominal topical negative pressure (TNP) application was applied. We performed abdominal dermolipectomy in 23 obese patients. The average body mass index was 32.8 kg/m(2), and the median age of the patients was 42.9 years. Ten patients received conventional standard dressings (control group I), whereas the other 13 patients received a wide TNP dressing including the ventral and lateral trunk (negative pressure group II). Postoperative exudate volumes were collected, tallied and documented for each group separately until all drains could be removed. The conventionally treated control group (I) showed a significantly higher postoperative secretion volume compared with the negative pressure group (II). In addition, the average time to postoperative final drain removal was significantly lower in the negative pressure group (II) compared with the control group (I). The results indicate that widely applied external TNP wound dressing on the ventral and lateral trunk following postbariatric abdominal dermolipectomy leads to a significant reduction in exudate formation, enables early drain removal and thus, decreases length of hospitalization.

Impact of abdominal obesity and ambulatory blood pressure in the diagnosis of left ventricular hypertrophy in never treated hypertensives.

PubMed

Rodilla, Enrique; Costa, José A; Martín, Joaquin; González, Carmen; Pascual, Jose M; Redon, Josep

2014-03-20

The principal objective was to assess the prevalence of left ventricular hypertrophy (LVH) in hypertensive, never treated patients, depending on adjustment for body surface or height. Secondary objectives were to determine geometric alterations of the left ventricle and to analyze the interdependence of hypertension and obesity to induce LVH. Cross-sectional study that included 750 patients (387 men) aged 47 (13, SD) years who underwent ambulatory blood pressure (ABPM) monitoring and echocardiography. The prevalence of LVH was 40.4% (303 patients), adjusted for body surface area (BSA, LVHBSA), and 61.7% (463 patients), adjusted for height(2.7) (LVHheight(2.7)). In a multivariate logistic analysis, systolic BP24h, gender and presence of elevated microalbuminuria were associated with both LVHBSA and LVHheight(2.7). Increased waist circumference was the strongest independent predictor of LVHheight(2.7), but was not associated with LVHBSA. We found a significant interaction between abdominal obesity and systolic BP24h in LVHheight(2.7). Concentric remodelling seems to be the most prevalent alteration of left ventricular geometry in early stages of hypertension (37.5%). The impact of obesity as predictor of LVH in never treated hypertensives is present only when left ventricular mass (LVM) is indexed to height(2.7). Obesity interacts with systolic BP24h in an additive but not merely synergistic manner. Systolic BP24h is the strongest determinant of LVH when indexed for BSA. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Bicycling but not walking is independently associated with fasting insulin in abdominally obese women.

PubMed

Hemmingsson, Erik; Ekelund, Ulf; Udden, Joanna

2011-08-01

The impact of walking and bicycling on insulin resistance (IR) in women with abdominal obesity is unclear. Pooled analysis of data from a randomized trial on physically active commuting (bicycling + walking vs walking only) in women with abdominal obesity [n = 98; age:47.3 ± 7.6 yrs; waist circumference (WC):103.1 ± 7.8 cm]. Bicycling and walking data were collected during 7 consecutive days by trip meters (Trelock FC-410) and pedometers (Yamax digiwalker SW-200) at baseline, 2, 4, and 6 months. Owing to a skew distribution we analyzed bicycling as a binary dummy variable with a 10 km/week cut-off. Fasting serum insulin and homeostatic model assessment - insulin resistance (HOMA-IR) were assessed at baseline and 6 months, as were body mass index (BMI), WC, and dual x-ray absorptiometry (DXA)-assessed % whole-body fat. Increased bicycling by 10 km/wk was associated with reductions in fasting serum insulin at follow-up independent of age, treatment allocation, baseline phenotype, Δ walking, and Δ % body fat (β = -10.9, P = .042), but not HOMA-IR (β = -2.0, P = .13). Increased walking was not associated with fasting serum insulin (P = .33) or HOMA-IR (P = .44) at follow-up, after adjustment for the same covariates and Δ bicycling. Increased bicycling but not walking was associated with reduced insulin levels at follow-up. Bicycling may be more effective than walking for reducing insulin levels in abdominally obese women.

Physical activity in adolescence and abdominal obesity in adulthood: a case-control study among women shift workers.

PubMed

Garcez, Anderson da Silva; Olinto, Maria Teresa Anselmo; Canuto, Raquel; Olinto, Beatriz Anselmo; Pattussi, Marcos Pascoal; Paniz, Vera Maria Vieira

2015-01-01

Physical activity may have a protective effect against abdominal obesity, an important risk factor for cardiometabolic diseases. Thus, the aim of this study was to examine the association between the practice of physical activities in adolescence and abdominal obesity in adulthood among women shift workers in Southern Brazil in 2011. This case-control study included 215 cases (waist circumference greater than or equal to 88 cm) and 326 controls. For both the case and control groups, participation in leisure-time physical activities was most frequent in adolescence and was significantly less in adulthood. After adjusting for potential confounding factors, women who participated in five or more physical activities in adolescence were 50 percent less likely to have abdominal obesity than women who participated in one activity or no physical activities (Odds Ratio = 0.50; 95% confidential interval: 0.27-0.93, p value = .029). Participation in various types of leisure-time physical activities in adolescence may protect against abdominal obesity in adulthood, even if the number of physical activities decreases over time. This finding demonstrated the importance of physical activity as well as the period of life in which these should be encouraged for the prevention of health disorders, such as abdominal obesity.

Malaysia Shape of the Nation (MySoN): a primary care based study of abdominal obesity in Malaysia.

PubMed

Zaki, M; Robaayah, Z; Chan, S P; Vadivale, M; Lim, T O

2010-06-01

Abdominal obesity (AO), measured by waist circumference (WC), is a stronger predictor of subsequent development of cardiovascular disease (CVD) than generalised obesity, which is measured by body mass index (BMI). This study aimed to measure WC and prevalence of AO in Malaysians visiting primary care physicians. 1893 patients between the ages of 18 and 80 attending primary care clinics in Malaysia were recruited over two days for this multi-centre cross-sectional study. Pregnant women were excluded, their medical history, weight, height and WC were examined. The prevalence of co-morbidities were as follows: (1) CVD-4%, lipid disorder-17%, hypertension-26%, diabetes-14% and any of the clinical characteristics of CVD/lipid disorder/hypertension/diabetes-38%. The mean BMI for men and women was 25.62 +/- 4.73 kg/m2 and 26.63 +/- 5.72 kg/m2, respectively. Based on WHO criteria for BMI (overweight, 25-29.9 kg/m2; obese, > 30 kg/m2), 34.2% were overweight and 20.4% were obese. The mean WC for men and women was 89.03 +/- 13.45 cm and 84.26 +/- 12.78 cm, respectively. Overall, 55.6% had AO and there was higher prevalence among women (based on International Diabetes Federation criteria: WC > or = 90 cm for men and > or = 80 cm for women). AO was present in approximately 71% patients with lipid disorder, in 76% with hypertension and in 75% with diabetes. Patients with AO were also at a higher risk of developing co-morbidities. Malaysia has a high prevalence of AO and associated cardiovascular risk factors. This needs to be addressed by public health programs, which should also include routine measurement of WC.

[Characterisation of Candida sp. isolated from patients after abdominal surgery].

PubMed

Adámková, V; Vaňková, A; Ulrych, J; Matek, K

2017-01-01

Intraabdominal candidiasis (IAC) is the predominant type of invasive candidiasis after candidemia. The majority of epidemiological studies on Candida are focused only on bloodstream infections. Nevertheless, the role of blood cultures has limited application in patients with abdominal candidiasis. IAC, which includes peritonitis and intraabdominal abscesses, may occur in around 40% of patients following repeat gastrointestinal (GI) surgery or GI perforation. Retrospective analysis of culture isolates of Candida sp. from clinical specimens of patients after abdominal surgery. The study period was from January 1 to October 31, 2016. Our study of 33 patients with findings of Candida sp. from the abdominal cavity found a mortality of 15.2%, the most frequent strain being C. albicans and C. glabrata. All strains of Candida sp. were susceptible to echinocandins. Candida sp. is part of normal microbiota of the gastrointestinal tract and its isolation is often difficult to interpret. Unfortunately, the pathophysiologic importance of Candida isolation from the abdominal space is not completely clear in many clinical situations.Key words: invasive candidiasis intra-abdominal candidiasis laboratory diagnostics.

Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study.

PubMed

Suk, Seung-Han; Sacco, Ralph L; Boden-Albala, Bernadette; Cheun, Jian F; Pittman, John G; Elkind, Mitchell S; Paik, Myunghee C

2003-07-01

Obesity is well recognized as a risk factor for coronary heart disease and mortality. The relationship between abdominal obesity and ischemic stroke remains less clear. Our aim was to evaluate abdominal obesity as an independent risk factor for ischemic stroke in a multiethnic community. A population-based, incident case-control study was conducted July 1993 through June 1997 in northern Manhattan, New York, NY. Cases (n=576) of first ischemic stroke (66% >or=BORDER="0">65 years of age; 56% women; 17% whites; 26% blacks; 55% Hispanics) were enrolled and matched by age, sex, and race-ethnicity to stroke-free community controls (n=1142). All subjects were interviewed and examined and had measurements of waist-to-hip ratio (WHR). Odds ratios (ORs) of ischemic stroke were calculated with gender-specific quartiles (GQs) and gender-specific medians of WHR adjusted for stroke risk factors and body mass index (BMI). Compared with the first quartile, the third and fourth quartiles of WHR had an increased risk of stroke (GQ3: OR, 2.4; 95% CI, 1.5 to 3.9; GQ4: OR, 3.0; 95% CI, 1.8 to 4.8) adjusted for other risk factors and BMI. Those with WHR equal to or greater than the median had an overall OR of 3.0 (95% CI, 2.1 to 4.2) for ischemic stroke even after adjustment for other risk factors and BMI. Increased WHR was associated with a greater risk of stroke in men and women and in all race-ethnic groups. The effect of WHR was stronger among younger persons (test for heterogeneity, P<0.0002) (<65 years of age: OR, 4.4; 95%CI, 2.2 to 9.0; >or=65 years of age: OR, 2.2; 95% CI, 1.4 to 3.2). WHR was associated with an increased risk among those with and without large-artery atherosclerotic stroke. Abdominal obesity is an independent, potent risk factor for ischemic stroke in all race-ethnic groups. It is a stronger risk factor than BMI and has a greater effect among younger persons. Prevention of obesity and weight reduction need greater emphasis in stroke prevention programs.

Changes in abdominal obesity in Chilean university students stratified by body mass index.

PubMed

Cossio-Bolaños, Marco; Vilchez-Avaca, Catalina; Contreras-Mellado, Victor; Andruske, Cynthia Lee; Gómez-Campos, Rossana

2016-01-13

Studies based on Body Mass Index (BMI) and waist circumference (WC) are generally used to examine the prevalence and tendency of overweight and obesity. These studies help determine the socioeconomic development of a country and improve public health policies. Therefore, the goal of this research was to determine the trend of change in abdominal obesity of Chilean university students according to the Body Mass Index (BMI) measured in intervals of three and six years. For this study, a total of 1598 students of both sexes ranging in age from 18 to 26 from a Chilean university were evaluated. Students were assessed commencing in 2007 (372 males and 315 females), 2010 (250 males and 330 females), and ending in 2013 (153 males and 178 females). During the three transversal assessments, weight, height, and waist circumference were evaluated. BMI was calculated for both sexes. No significant differences were found in age and BMI during the three years evaluated (2007, 2010, and 2013). In 2013, waist circumference (WC) increased significantly (p < 0.001 for both sexes). Moreover, in 2013, in all the percentiles evaluated, high values of WC were compared in relation to previous years. Furthermore, in 2013, in all four BMI categories (underweight, normal, overweight, and obese), the university students showed significant increases in WC (Females: p = 0.004; Males: p = 0.035) whereas in 2007 and 2010, the values remained relatively stable. BMI remained constant during 2007, 2010, and 2013. However, the university students of both sexes showed greater risk of abdominal obesity as a result of increased WC in 2013.

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.

Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: A clinico epidemiological evidence summary.

PubMed

Prasad, D S; Kabir, Zubair; Dash, A K; Das, B C

2011-10-01

Evidence is emerging that obesity-associated cardiovascular disorders (CVD) show variations across regions and ethnicities. However, it is unclear if there are distinctive patterns of abdominal obesity contributing to an increased CVD risk in South Asians. Also, potential underlying mechanistic pathways of such unique patterns are not comprehensively reported in South Asians. This review sets out to examine both. A comprehensive database search strategy was undertaken, namely, PubMed, Embase and Cochrane Library, applying specific search terms for potentially relevant published literature in English language. Grey literature, including scientific meeting abstracts, expert consultations, text books and government/non-government publications were also retrieved. South Asians have 3-5% higher body fat than whites, at any given body mass index. Additional distinctive features, such as South Asian phenotype, low adipokine production, lower lean body mass, ethno-specific socio-cultural and economic factors, were considered as potential contributors to an early age-onset of obesity-linked CVD risk in South Asians. Proven cost-effective anti-obesity strategies, including the development of ethno-specific clinical risk assessment tools, should be adopted early in the life-course to prevent premature CVD deaths and morbidity in South Asians.

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.

Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management.

PubMed

Misra, A; Chowbey, P; Makkar, B M; Vikram, N K; Wasir, J S; Chadha, D; Joshi, Shashank R; Sadikot, S; Gupta, R; Gulati, Seema; Munjal, Y P

2009-02-01

Asian Indians exhibit unique features of obesity; excess body fat, abdominal adiposity, increased subcutaneous and intra-abdominal fat, and deposition of fat in ectopic sites (liver, muscle, etc.). Obesity is a major driver for the widely prevalent metabolic syndrome and type 2 diabetes mellitus (T2DM) in Asian Indians in India and those residing in other countries. Based on percentage body fat and morbidity data, limits of normal BMI are narrower and lower in Asian Indians than in white Caucasians. In this consensus statement, we present revised guidelines for diagnosis of obesity, abdominal obesity, the metabolic syndrome, physical activity, and drug therapy and bariatric surgery for obesity in Asian Indians after consultations with experts from various regions of India belonging to the following medical disciplines; internal medicine, metabolic diseases, endocrinology, nutrition, cardiology, exercise physiology, sports medicine and bariatric surgery, and representing reputed medical institutions, hospitals, government funded research institutions, and policy making bodies. It is estimated that by application of these guidelines, additional 10-15% of Indian population would be labeled as overweight/obese and would require appropriate management. Application of these guidelines on countrywide basis is also likely to have a deceleration effect on the escalating problem of T2DM and cardiovascular disease. These guidelines could be revised in future as appropriate, after another large and countrywide consensus process. Till that time, these should be used by clinicians, researchers and policymakers dealing with obesity and related diseases.

Prevalence of abdominal obesity in Spanish children and adolescents. Do we need waist circumference measurements in pediatric practice?

PubMed

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

2014-01-01

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. 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. 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≥90(th) 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). 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. 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.

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

Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a prospective study.

PubMed

Chuang, Shao-Yuan; Chiu, Tina H T; Lee, Chun-Yi; Liu, Ting-Ting; Tsao, Chwen Keng; Hsiung, Chao A; Chiu, Yen-Feng

2016-11-01

A vegetarian diet may prevent elevation of blood pressures and lower the risk for hypertension through lower degrees of obesity, inflammation, and insulin resistance. This study investigated the association between a vegetarian diet and hypertension incidence in a cohort of Taiwanese adult nonsmokers and examined whether this association was mediated through inflammation, abdominal obesity, or insulin resistance (using fasting glucose as a proxy). This matched cohort study was from the 1994-2008 MJ Health Screening Database. Each vegetarian was matched with five nonvegetarians by age, sex, and study site. The analysis included 4109 nonsmokers (3423 nonvegetarians and 686 vegetarians), followed for a median of 1.61 years. The outcome includes hypertension incidence, as well as SBP and DBP levels. Regression analysis was performed to assess the association between vegetarian diet and hypertension incidence or future blood pressure levels in the presence/absence of potential mediators. Vegetarians had a 34% lower risk for hypertension, adjusting for age and sex (odds ratio: 0.66, 95% confidence interval: 0.50-0.87; SBP: -3.3 mmHg, P < 0.001; DBP: -1.5 mmHg, P < 0.001). The results stay statistically significant after further adjustment for C-reactive protein, waist circumference, and fasting glucose (odds ratio: 0.72, 95% confidence interval: 0.55-0.86; SBP: -2.4 mmHg, P < 0.05; DBP: -1.1 mmHg, P < 0.05). The protective association between vegetarian diet and hypertension appeared to be consistent across age groups. Taiwanese vegetarians had lower incidence of hypertension than nonvegetarians. Vegetarian diets may protect against hypertension beyond lower abdominal obesity, inflammation, and insulin resistance.

Obesity Paradox in End-Stage Kidney Disease Patients

PubMed Central

Park, Jongha; Ahmadi, Seyed-Foad; Streja, Elani; Molnar, Miklos Z; Flegal, Katherine M.; Gillen, Daniel; Kovesdy, Csaba P.; Kalantar-Zadeh, Kamyar

2016-01-01

In the general population, obesity is associated with increased cardiovascular risk and decreased survival. In patients with end-stage renal disease (ESRD), however, an “obesity paradox” or “reverse epidemiology” (to include lipid and hypertension paradoxes) has been consistently reported, i.e. a higher body mass index (BMI) is paradoxically associated with better survival. This survival advantage of large body size is relatively consistent for hemodialysis patients across racial and regional differences, although published results are mixed for peritoneal dialysis patients.. Recent data indicate that both higher skeletal muscle mass and increased total body fat are protective, although there are mixed data on visceral (intra-abdominal) fat. The obesity paradox in ESRD is unlikely to be due to residual confounding alone and has biologic plausibility. Possible causes of the obesity paradox include protein-energy wasting and inflammation, time discrepancy among competitive risk factors (undernutrition versus overnutrition), hemodynamic stability, alteration of circulatory cytokines, sequestration of uremic toxin in adipose tissue, and endotoxin-lipoprotein interaction. The obesity paradox may have significant clinical implications in the management of ESRD patients especially if obese dialysis patients are forced to lose weight upon transplant wait-listing. Well-designed studies exploring the causes and consequences of the reverse epidemiology of cardiovascular risk factors, including the obesity paradox, among ESRD patients could provide more information on mechanisms. These could include controlled trials of nutritional and pharmacologic interventions to examine whether gain in lean body mass or even body fat can improve survival and quality of life in these patients. PMID:24438733

Abdomino-phrenic dyssynergia in patients with abdominal bloating and distension.

PubMed

Villoria, Albert; Azpiroz, Fernando; Burri, Emanuel; Cisternas, Daniel; Soldevilla, Alfredo; Malagelada, Juan-R

2011-05-01

The abdomen normally accommodates intra-abdominal volume increments. Patients complaining of abdominal distension exhibit abnormal accommodation of colonic gas loads (defective contraction and excessive protrusion of the anterior wall). However, abdominal imaging demonstrated diaphragmatic descent during spontaneous episodes of bloating in patients with functional gut disorders. We aimed to establish the role of the diaphragm in abdominal distension. In 20 patients complaining of abdominal bloating and 15 healthy subjects, we increased the volume of the abdominal cavity with a colonic gas load, while measuring abdominal girth and electromyographic activity of the anterior abdominal muscles and of the diaphragm. In healthy subjects, the colonic gas load increased girth, relaxed the diaphragm, and increased anterior wall tone. With the same gas load, patients developed significantly more abdominal distension; this was associated with paradoxical contraction of the diaphragm and relaxation of the internal oblique muscle. In this experimental provocation model, abnormal accommodation of the diaphragm is involved in abdominal distension.

Overall and abdominal obesity and incident aortic valve stenosis: two prospective cohort studies

PubMed Central

Larsson, Susanna C.; Wolk, Alicja; Håkansson, Niclas; Bäck, Magnus

2017-01-01

Abstract Aims The aim of this study was to examine the association of overall and abdominal obesity with aortic valve stenosis (AVS) incidence in two prospective cohorts. Methods and results We used data from the Cohort of Swedish Men and the Swedish Mammography Cohort, involving 71 817 men and women who were free of cardiovascular disease and had reported their anthropometric measures in 1997. Aortic valve stenosis cases were ascertained through linkage with nationwide registers on hospitalization and causes of death. Data were analysed using Cox proportional hazards regression. During a mean follow-up of 15.3 years, 1297 incident AVS cases (771 in men; 526 in women) were ascertained. Both overall and abdominal obesity, measured as body mass index (BMI) and waist circumference, respectively, was associated with AVS incidence, with similar associations in men and women. Compared with BMI 18.5–22.5 kg/m2, the multivariable hazard ratios were 1.24 (95% confidence interval [CI] 1.05–1.48) for overweight (BMI 25.0–29.9 kg/m2) and 1.81 (95% CI 1.47–2.23) for obesity (BMI ≥30 kg/m2). The hazard ratio for substantially increased waist circumference (men: ≥102 cm; women: ≥88 cm) compared with normal waist circumference (men: <94 cm; women: <80 cm) was 1.30 (95% CI 1.12–1.51). The proportion of AVS cases estimated to be attributed to overweight and obesity combined (BMI ≥25 kg/m2) was 10.8% (95% CI 5.2–16.4%). Conclusion These findings indicate that obesity is associated with an increased risk of AVS and that a large proportion of the cases may be prevented if the population maintained a healthy BMI. PMID:28402538

Changes in abdominal obesity and age-related macular degeneration: the Atherosclerosis Risk in Communities Study.

PubMed

Peeters, Anna; Magliano, Dianna J; Stevens, June; Duncan, Bruce B; Klein, Ronald; Wong, Tien Y

2008-11-01

To examine the association between changes in waist-hip ratio (WHR), a measure of abdominal obesity, and age-related macular degeneration (AMD). A total of 12 515 persons from a population-based cohort study, aged 45 to 64 years in 1987 to 1989, were followed up over 6 years. The percentage change in WHR during follow-up was ranked into sex-specific deciles; an increase in WHR was defined as the top 10% of change and a decrease in WHR as the bottom 10%. The association of increased or decreased WHR and presence of AMD at follow-up was determined using logistic regression adjusting for potential confounders. The average change in WHR was an increase of 2%, ranging from a decrease of 44% to an increase of 102%. A decrease in WHR of 3% or more was associated with 29% lower odds of any AMD (odds ratio = 0.71; 95% confidence interval, 0.52-0.97). This effect was most pronounced among obese participants at baseline, where a decrease in WHR was associated with 59% lower odds of AMD (odds ratio = 0.41; 95% confidence interval, 0.20-0.82). Middle-aged persons who had a 3% or greater reduction in WHR over time were less likely to have AMD, particularly among those who were initially obese.

Recurrent severe abdominal pain in the pediatric patient.

PubMed

Homme, James L; Foster, Ashley A

2014-05-01

Ureteropelvic junction obstruction (UPJO) is a blockage occurring at the junction of the ureter and the renal pelvis. Pediatric patients with UPJO pose a diagnostic challenge when they present to the emergency department (ED) with severe recurrent abdominal pain if there is not a level of suspicion for this condition. Our aim was to review presentation of UPJO to the ED, methods of diagnosis, and treatment of this common but often overlooked condition. We report on 2 patients, a 9-year-old and 3-year-old, who had multiple presentations to health care providers and the ED with intermittent and recurrent abdominal pain. Subsequent testing, including ultrasound (US) and computed tomography (CT) with diuretic-recreated symptoms, revealed UPJO. Open pyeloplasty was performed, resulting in complete resolution of symptoms. UPJO is an important diagnosis to consider when patients present to the ED with recurrent abdominal pain. US can be helpful in suspecting the diagnosis, but often CT, magnetic resonance urography, or diuretic scintigraphy is required for confirmation. Diuretics can be used to aid diagnostic testing by reproducing abdominal pain at the time of imaging. Referral to a urologist for open pyeloplasty is definitive treatment for this condition. Copyright © 2014 Elsevier Inc. All rights reserved.

Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of northeast china: the CHPSNE study

PubMed Central

2012-01-01

Background Obesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults. Methods A representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, weight and waist circumference (WC) were taken from 2009–2010. Definitions of overweight and obesity by the World Health Organization (WHO) were used. Results The overall prevalence rates of general obesity and overweight classified by BMI were 15.0% (15.7% for men and 14.3% for women, p<0.01) and 19.2% (20.8% for men and 17.7% for women, p<0.01), respectively, and the overall prevalence rate of abdominal obesity was 37.6% (31.1% for men and women 43.9% for women, p<0.01). Multivariable logistic regression showed that the elderly and those who had a history of parental obesity, alcohol drinking, or former cigarette smoking were at high risk of obesity classified by BMI or WC, whereas those with a higher level of education, higher family income, or a healthy and balanced diet were at low risk of obesity. Analysis stratified by gender showed that men with a higher level education level, a white-collar job, a cadre job, or higher family income were the high risk group, and women with a higher level of education or higher family income were the low risk group. Conclusions Obesity and overweight have become epidemic in urban populations in China; associations of risk factors with obesity differ between men and women. PMID:23146089

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

USDA-ARS?s Scientific Manuscript database

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 ...

Dynapenic Abdominal Obesity Increases Mortality Risk among English and Brazilian Older Adults: A 10-Year Follow-Up of the ELSA and SABE Studies.

PubMed

da Silva Alexandre, T; Scholes, S; Ferreira Santos, J L; de Oliveira Duarte, Y A; de Oliveira, C

2018-01-01

There is little epidemiological evidence demonstrating that dynapenic abdominal obesity has higher mortality risk than dynapenia and abdominal obesity alone. Our main aim was to investigate whether dynapenia combined with abdominal obesity increases mortality risk among English and Brazilian older adults over ten-year follow-up. Cohort study. United Kingdom and Brazil. Data came from 4,683 individuals from the English Longitudinal Study of Ageing (ELSA) and 1,490 from the Brazilian Health, Well-being and Aging study (SABE), hence the final sample of this study was 6,173 older adults. The study population was categorized into the following groups: non-dynapenic/non-abdominal obese, abdominal obese, dynapenic, and dynapenic abdominal obese according to their handgrip strength (< 26 kg for men and < 16 kg for women) and waist circumference (> 102 cm for men and > 88 cm for women). The outcome was all-cause mortality over a ten-year follow-up. Adjusted hazard ratios by sociodemographic, behavioural and clinical characteristics were estimated using Cox proportional hazards models. The fully adjusted model showed that dynapenic abdominal obesity has a higher mortality risk among the groups. The hazard ratios (HR) were 1.37 for dynapenic abdominal obesity (95% CI = 1.12 - 1.68), 1.15 for abdominal obesity (95% CI = 0.98 - 1.35), and 1.23 for dynapenia (95% CI = 1.04 - 1.45). Dynapenia is an important risk factor for mortality but dynapenic abdominal obesity has the highest mortality risk among English and Brazilian older adults.

Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults: a randomized trial.

PubMed

Ross, Robert; Hudson, Robert; Stotz, Paula J; Lam, Miu

2015-03-03

Exercise reduces obesity and related glucose tolerance, but whether increasing exercise intensity offers additional benefit at fixed exercise amounts is unknown. To determine the separate effects of exercise amount and intensity on abdominal obesity and glucose tolerance. 24-week, single-center, parallel-group trial from 2009 to 2013. (ClinicalTrials.gov: NCT00955071). Kingston, Ontario, Canada. 300 abdominally obese adults. Control (no exercise) (n = 75) or 5 weekly sessions of low-amount, low-intensity exercise (LALI) (180 and 300 kcal/session for women and men, respectively, at 50% of maximum oxygen consumption [V̇o2peak]) (n = 73); high-amount, low-intensity exercise (HALI) (360 and 600 kcal/session, respectively, at 50% of V̇o2peak) (n = 76); or high-amount, high-intensity exercise (HAHI) (360 and 600 kcal/session, respectively, at 75% of V̇o2peak) (n = 76). Daily unsupervised physical activity and sedentary time were measured by accelerometer. Waist circumference and 2-hour glucose level (primary outcomes) and cardiorespiratory fitness and measures of insulin action (secondary measurements). 217 participants (72.3%) completed the intervention. Mean exercise time in minutes per session was 31 (SD, 4.4) for LALI, 58 (SD, 7.6) for HALI, and 40 (SD, 6.2) for HAHI. Daily unsupervised physical activity and sedentary time did not change in any exercise group versus control (P > 0.33). After adjustment for age and sex in a linear mixed model, reductions in waist circumference were greater in the LALI (-3.9 cm [95% CI, -5.6 to -2.3 cm]; P < 0.001), HALI (-4.6 cm [CI, -6.2 to -3.0 cm]; P < 0.001), and HAHI (-4.6 cm [CI, -6.3 to -2.9 cm]; P < 0.001) groups than the control group but did not differ among the exercise groups (P > 0.43). After adjustment for covariates, reductions in 2-hour glucose level were greater in the HAHI group (-0.7 mmol/L [-12.5 mg/dL] [CI, -1.3 to -0.1 mmol/L {-23.5 to -1.5 mg/dL}]; P = 0.027) than the control group but did not differ for the

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys.

PubMed

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N

2018-06-05

Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization's Asian body mass index cut-off points of ≥23.0 kg/m 2 and ≥27.5 kg/m 2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys

PubMed Central

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N.

2018-01-01

Background Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected. PMID:29657257

Intestinal obstruction management in patients with advanced abdominal neoplasia.

PubMed

Simion, L; Straja, Nd; Alecu, M; Poroch, V; Moşoiu, D; Panti, C; Grigorean, V; Brătucu, E

2014-01-01

The present study describes the difficulties encountered in the diagnostic process and treatment of intestinal obstruction developed by patients with advanced abdominal neoplasia. This unicentric and retrospective study evaluates patients suffering from intestinal occlusion operated on at the First Surgical Clinic of the Oncology Institute in Bucharest, over a period of 4 years (2010 - 2013). Of these, 61 cases in which the occlusion occurred on the background of an advanced abdominal neoplasia were selected. We considered as advanced those cases of abdominal cancer where curative oncologic treatment is no longer possible due to the evolution stage. The random selection of the study period, the introduction of all the patients identified with this type of pathology, as well as the concentration of advanced abdominal neoplasia at the Oncology Institute in Bucharest are the elements that allow us to state that the results of this study are representative. Particularities related to the clinical aspects of the intestinal occlusion in these patients, as well as difficulties in establishing the correct diagnosis were encountered.Surgical cure of the occlusion, with palliative aim of course,was possible in only 47 cases (representing 77.05%). A standard treatment course cannot be devised for this type of patients. Palliative care, indispensable in cases of advanced neoplastic disease, remains the sole therapeutic method available for patients with no surgical cure for the obstruction. The main objective, for the entire study lot, was to ensure an as high as possible quality of life,a factor we must bear in mind as often as possible when choosing a surgical solution. Of course, when surgical treatment can be applied, overcoming the occlusive episode prolongs these patients' life and can even allow for other courses of complementary treatment to be undertaken. Celsius.

Population-attributable fraction of hypertension associated with obesity, abdominal obesity, and the joint effect of both in the Central Provinces of Iran.

PubMed

Mohammadi, Masoud; Mirzaei, Masoud

2017-03-01

The prevalence of obesity has been increasing in Iran over the past decade. This study aimed to determine the population-attributable fraction (PAF) of hypertension associated with obesity, abdominal obesity, and the joint effect of both in the central provinces of Iran. Prevalence of hypertension was extracted from the Iranian Ministry of Health Non-Communicable Disease Risk Factor InfoBase 2009. Measure of association between obesity and hypertension was extracted from Tehran Lipid and Glucose Study, for males and females, in order to calculate the PAF of hypertension associated with obesity. Age standardization of the reported prevalence of obesity was done using the World Health Organization method. The PAF of hypertension associated with the joint effect of obesity and abdominal obesity in females was highest in Semnan Province: 22.7 [95% confidence interval (CI): 4.2-35.6], followed by Qom 21.09 (95% CI: 3.7-33.1), and Yazd 20.3 (95% CI: 3.5-32.1). In males, the highest PAF was observed in Qom Province 31.07 (95% CI: 16.7-41.1), followed by Semnan 29.6 (95% CI: 15.9-39.3), Qazvin 25.9 (95% CI: 13.7-34.5), Tehran 24.2 (95% CI: 12.7-32.3), and Isfahan 20.4 (95% CI: 3.5-27.4). Prevalence of hypertension is higher in more developed provinces. PAFs suggest that a sizable share of hypertension in these provinces is associated with obesity. It is recommended that health promotion programs focus on obesity in the provinces with a higher share of hypertension due to obesity. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Dietary Patterns of Women Are Associated with Incident Abdominal Obesity but Not Metabolic Syndrome123

PubMed Central

Kimokoti, Ruth W.; Gona, Philimon; Zhu, Lei; Newby, P. K.; Millen, Barbara E.; Brown, Lisa S.; D’Agostino, Ralph B.; Fung, Teresa T.

2012-01-01

Data on the relationship between empirical dietary patterns and metabolic syndrome (MetS) and its components in prospective study designs are limited. In addition, demographic and lifestyle determinants of MetS may modify the association between dietary patterns and the syndrome. We prospectively examined the relationship between empirically derived patterns and MetS and MetS components among 1146 women in the Framingham Offspring/Spouse cohort. They were aged 25–77 y with BMI ≥18.5 kg/m2 and free of cardiovascular disease, diabetes, cancer, and MetS at baseline, and followed for a mean of 7 y. Five dietary patterns, Heart Healthier, Lighter Eating, Wine and Moderate Eating, Higher Fat, and Empty Calorie, were previously identified using cluster analysis from food intake collected using a FFQ. After adjusting for potential confounders, we observed lower odds for abdominal obesity for Higher Fat [OR = 0.48 (95% CI: 0.25, 0.91)] and Wine and Moderate Eating clusters [OR = 0.28 (95% CI: 0.11, 0.72)] compared with the Empty Calorie cluster. Additional adjustment for BMI somewhat attenuated these OR [Higher Fat OR = 0.52 (95% CI: 0.27, 1.00); Wine and Moderate Eating OR = 0.34 (95% CI: 0.13, 0.89)]. None of the clusters was associated with MetS or other MetS components. Baseline smoking status and age did not modify the relation between dietary patterns and MetS. The Higher Fat and Wine and Moderate Eating patterns showed an inverse association with abdominal obesity; certain foods might be targeted in these habitual patterns to achieve optimal dietary patterns for MetS prevention. PMID:22833658

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.

Relationships between metabolic profile, hypertension and uric acid with cardiometabolic risk in adolescents with abdominal obesity: impact of geodemographic factors on the prevalence of abdominal obesity.

PubMed

Bouhenni, Hamida; Daoudi, Hadjer; Djemai, Haidar; Noirez, Philippe; Rouabah, Abdelkader; Vitiello, Damien; Rouabah, Leila

2017-11-23

Background Association of hyperuricemia, dyslipidemia and high blood pressure (BP) among adolescents with high waist-to-height ratio (WHtR) remains not fully addressed and could represent a new way to diagnose adolescents early with cardiometabolic risk. Objective We aimed to determine abdominal obesity (AO) prevalence and investigate relations between AO, uric acid (UA), lipid profiles, BP and geographical patterns in adolescents. Subjects 577 and 204 Algerian students aged between 10 and 19 years were included in our epidemiological and biochemical studies, respectively. Methods Height, weight, waist circumference (Wc) and hip circumferences, body mass index (BMI) and BP were measured. Fasting blood sampling was performed to measure glycemia, lipid profile, uricemia, insulinemia and leptinemia. The WHtR ≥0.50 was applied for the diagnosis of AO and geodemographics was evaluated. Results The prevalence of AO was 12.13% among all students, 19.17% and 16.39% among students living in urban and plain areas, respectively. The risk of AO may be reduced in rural and mountainous areas. Lipid parameters, UA, insulin and leptin serum concentrations were significantly increased in adolescents with WHtR ≥0.50 compared to those with WHtR <0.50. Cardiometabolic risk was increased with WHtR ≥0.50 and BMI >26. Means of BMI, Wc, BP, and lipid parameters were significantly increased in the fourth quartiles compared to the first quartile of UA. Conclusion Urban areas and plains represent factors contributing to AO and WHtR ≥0.50 may be used as a cut-off point to define risks of high BP, lipid abnormalities and UA serum level in Algerian adolescents.

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.

Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age.

PubMed

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

2013-07-17

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. 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. 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. 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. 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 for each additional year of overall or abdominal obesity were 1.02 (95% CI, 1.01-1.03) and 1.03 (95% CI

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

Laparoendoscopic single-site nephroureterectomy for morbid obese patients.

PubMed

Juliano, Cesar Augusto Braz; Carlos, Alexandre Stievano; Costa, Renato Meirelles Mariano; Tobias-Machado, Marcos; Pompeo, Antonio Carlos Lima

2013-01-01

Since the first laparoendoscopic single-site (LESS) surgery report in urology in 2007 (1) (Rane A e Cadeddu JA), the few reports of LESS extraperitoneal access in the literature were mainly described for less complex cases. The aim of this video is to demonstrate the feasibility of LESS extraperitoneal access in a morbid obese patient presenting a malignant tumor in the renal pelvis. The patient is positioned in 90-degree lateral decubitus. An incision is made below the abdominal skin crease on the left side of the patient and the anterior rectus fascia is vertically incised with manual dissection of the extra/retroperitoneal space. We use an Alexis® retractor to retract the skin maximizing the incision orifice. Three trocars (12, 10 and 5 mm) are inserted through a sigle-port. The pedicle was controlled "en bloc" with a vascular stapler and the bladder cuff treated by the conventional open approach through the same incision. Operative time was 126 minutes with minimal blood loss. The pathology reported high grade papillary urothelial carcinoma in the pelvis (pT3N0M0) and in the ureter (pTa). LESS extraperitoneal nephroureterectomy is feasible and safe, even in more complex cases. It is a good alternative for morbid obese patients and for patients with synchronous distal ureteral tumors for whom an open approach to the bladder cuff is proposed to avoid incisions in two compartments of the abdominal wall.

Associations of Diabetes and Obesity with Risk of Abdominal Aortic Aneurysm in Men.

PubMed

Wang, Lu; Djousse, Luc; Song, Yiqing; Akinkuolie, Akintunde O; Matsumoto, Chisa; Manson, JoAnn E; Gaziano, J Michael; Sesso, Howard D

2017-01-01

Background. The associations of diabetes and obesity with the risk of abdominal aortic aneurysm (AAA) are inconclusive in previous studies. Subjects/Methods. We conducted prospective analysis in the Physicians' Health Study. Among 25,554 male physicians aged ≥ 50 years who reported no AAA at baseline, 471 reported a newly diagnosed AAA during a mean of 10.4 years' follow-up. Results. Compared with men who had baseline body mass index (BMI) < 25 kg/m 2 , the multivariable hazard ratio (HR [95% CI]) of newly diagnosed AAA was 1.30 [1.06-1.59] for BMI 25-<30 kg/m 2 and 1.69 [1.24-2.30] for BMI ≥ 30 kg/m 2 . The risk of diagnosed AAA was significantly higher by 6% with each unit increase in baseline BMI. This association was consistent regardless of the other known AAA risk factors and preexisting vascular diseases. Overall, baseline history of diabetes tended to be associated with a lower risk of diagnosed AAA (HR = 0.79 [0.57-1.11]); this association appeared to vary by follow-up time (HR = 1.56 and 0.63 during ≤ and >2 years' follow-up, resp.). Conclusion. In a large cohort of middle-aged and older men, obesity was associated with a higher risk, while history of diabetes tended to associate with a lower risk of diagnosed AAA, particularly over longer follow-up.

Abdominal Obesity and Risk of Hip Fracture: A Systematic Review and Meta-Analysis of Prospective Studies.

PubMed

Sadeghi, Omid; Saneei, Parvaneh; Nasiri, Morteza; Larijani, Bagher; Esmaillzadeh, Ahmad

2017-09-01

Data on the association between general obesity and hip fracture were summarized in a 2013 meta-analysis; however, to our knowledge, no study has examined the association between abdominal obesity and the risk of hip fracture. The present systematic review and meta-analysis of prospective studies was undertaken to summarize the association between abdominal obesity and the risk of hip fracture. We searched online databases for relevant publications up to February 2017, using relevant keywords. In total, 14 studies were included in the systematic review and 9 studies, with a total sample size of 295,674 individuals (129,964 men and 165,703 women), were included in the meta-analysis. Participants were apparently healthy and aged ≥40 y. We found that abdominal obesity (defined by various waist-hip ratios) was positively associated with the risk of hip fracture (combined RR: 1.24, 95% CI: 1.05, 1.46, P = 0.01). Combining 8 effect sizes from 6 studies, we noted a marginally significant positive association between abdominal obesity (defined by various waist circumferences) and the risk of hip fracture (combined RR: 1.36; 95% CI: 0.97, 1.89, P = 0.07). This association became significant in a fixed-effects model (combined effect size: 1.40, 95% CI: 1.25, 1.58, P < 0.001). Based on 5 effect sizes, we found that a 0.1-U increase in the waist-hip ratio was associated with a 16% increase in the risk of hip fracture (combined RR: 1.16, 95% CI: 1.04, 1.29, P = 0.007), whereas a 10-cm increase in waist circumference was not significantly associated with a higher risk of hip fracture (combined RR: 1.13, 95% CI: 0.94, 1.36, P = 0.19). This association became significant, however, when we applied a fixed-effects model (combined effect size: 1.21, 95% CI: 1.15, 1.27, P < 0.001). We found that abdominal obesity was associated with a higher risk of hip fracture in 295,674 individuals. Further studies are needed to test whether there are associations between abdominal obesity and

Changes in visceral adiposity and serum cholesterol with a novel viscous polysaccharide in Japanese adults with abdominal obesity.

PubMed

Reimer, Raylene A; Yamaguchi, Hideyo; Eller, Lindsay K; Lyon, Michael R; Gahler, Roland J; Kacinik, Veronica; Juneja, Prateek; Wood, Simon

2013-09-01

Evidence supports the role of dietary fiber in improving metabolic health. PolyGlycopleX (PGX), a viscous functional polysaccharide improves lipidemia and glycemia in healthy adults. Our objective was to examine the effects of PGX on risk factors associated with the metabolic syndrome in Japanese adults with abdominal obesity. Sixty four subjects assigned to 14 weeks of 15 g day(-1) of PGX or placebo were assessed in a randomized, double-blind, placebo-controlled, parallel group trial. At week 0 and 14, primary outcome measures were serum lipids, abdominal adiposity, glucose tolerance and blood pressure. Total and LDL cholesterol were reduced at week 14 with PGX but not placebo (P < 0.05). The reduction in waist circumference at week 14 was greater with PGX versus placebo (P < 0.05). In females, abdominal visceral fat was decreased to a greater extent with PGX versus placebo (P < 0.05). While glucose tolerance worsened with placebo over time, PGX reduced glucose total area under the curve from week 0 to 6 (P = 0.039). Serum concentrations of resistin and IL6 increased slightly in placebo and decreased slightly with PGX . PGX is a functional fiber that shows promise in reducing risk factors related to the metabolic syndrome in Japanese adults with abdominal obesity. Copyright © 2013 The Obesity Society.

Serum Fatty Acids, Desaturase Activities and Abdominal Obesity – A Population-Based Study of 60-Year Old Men and Women

PubMed Central

Alsharari, Zayed D.; Risérus, Ulf; Leander, Karin; Sjögren, Per; Carlsson, Axel C.; Vikström, Max; Laguzzi, Federica; Gigante, Bruna; Cederholm, Tommy; De Faire, Ulf; Hellénius, Mai-Lis

2017-01-01

Abdominal obesity is a key contributor of metabolic disease. Recent trials suggest that dietary fat quality affects abdominal fat content, where palmitic acid and linoleic acid influence abdominal obesity differently, while effects of n-3 polyunsaturated fatty acids are less studied. Also, fatty acid desaturation may be altered in abdominal obesity. We aimed to investigate cross-sectional associations of serum fatty acids and desaturases with abdominal obesity prevalence in a population-based cohort study. Serum cholesteryl ester fatty acids composition was measured by gas chromatography in 60-year old men (n = 1883) and women (n = 2015). Cross-sectional associations of fatty acids with abdominal obesity prevalence and anthropometric measures (e.g., sagittal abdominal diameter) were evaluated in multivariable-adjusted logistic and linear regression models, respectively. Similar models were employed to investigate relations between desaturase activities (estimated by fatty acid ratios) and abdominal obesity. In logistic regression analyses, palmitic acid, stearoyl-CoA-desaturase and Δ6-desaturase indices were associated with abdominal obesity; multivariable-adjusted odds ratios (95% confidence intervals) for highest versus lowest quartiles were 1.45 (1.19–1.76), 4.06 (3.27–5.05), and 3.07 (2.51–3.75), respectively. Linoleic acid, α-linolenic acid, docohexaenoic acid, and Δ5-desaturase were inversely associated with abdominal obesity; multivariable-adjusted odds ratios (95% confidence intervals): 0.39 (0.32–0.48), 0.74 (0.61–0.89), 0.76 (0.62–0.93), and 0.40 (0.33–0.49), respectively. Eicosapentaenoic acid was not associated with abdominal obesity. Similar results were obtained from linear regression models evaluating associations with different anthropometric measures. Sex-specific and linear associations were mainly observed for n3-polyunsaturated fatty acids, while associations of the other exposures were generally non-linear and similar across

Copy Number Variations in Candidate Genes and Intergenic Regions Affect Body Mass Index and Abdominal Obesity in Mexican Children

PubMed Central

Burguete-García, Ana Isabel; Bonnefond, Amélie; Peralta-Romero, Jesús; Froguel, Philippe

2017-01-01

Introduction. Increase in body weight is a gradual process that usually begins in childhood and in adolescence as a result of multiple interactions among environmental and genetic factors. This study aimed to analyze the relationship between copy number variants (CNVs) in five genes and four intergenic regions with obesity in Mexican children. Methods. We studied 1423 children aged 6–12 years. Anthropometric measurements and blood levels of biochemical parameters were obtained. Identification of CNVs was performed by real-time PCR. The effect of CNVs on obesity or body composition was assessed using regression models adjusted for age, gender, and family history of obesity. Results. Gains in copy numbers of LEPR and NEGR1 were associated with decreased body mass index (BMI), waist circumference (WC), and risk of abdominal obesity, whereas gain in ARHGEF4 and CPXCR1 and the intergenic regions 12q15c, 15q21.1a, and 22q11.21d and losses in INS were associated with increased BMI and WC. Conclusion. Our results indicate a possible contribution of CNVs in LEPR, NEGR1, ARHGEF4, and CPXCR1 and the intergenic regions 12q15c, 15q21.1a, and 22q11.21d to the development of obesity, particularly abdominal obesity in Mexican children. PMID:28428959

Physical activity and hypocaloric diet recovers osteoblasts homeostasis in women affected by abdominal obesity.

PubMed

Bimonte, Viviana M; Fittipaldi, Simona; Marocco, Chiara; Emerenziani, Gian Pietro; Fornari, Rachele; Guidetti, Laura; Poggiogalle, Eleonora; Nicolai, Emanuele; Di Luigi, Luigi; Donini, Lorenzo M; Baldari, Carlo; Lenzi, Andrea; Greco, Emanuela A; Migliaccio, Silvia

2017-11-01

Obesity is a multifactorial disease linked to metabolic chronic disorders such as diabetes, and hypertension. Also, it has recently been associated with skeletal alterations and low bone mineral density. We previously demonstrated that exposure of osteoblasts to sera of sedentary subjects affected by obesity alters cell homeostasis in vitro, leading to disruption of intracellular differentiation pathways and cellular activity. Thus, the purpose of the present study has been to evaluate whether sera of sedentary obese women, subjected to physical activity and hypocaloric diet, could recover osteoblast homeostasis in vitro as compared to the sera of same patients before intervention protocol. To this aim, obese women were evaluated at time 0 and after 4, 6, and 12 months of individualized prescribed physical activity and hypocaloric diet. Dual-energy-X-ray absorptiometry measurements were performed at each time point, as well as blood was collected at the same points. Cells were incubated with sera of subjects before and after physical activity as described: obese at baseline and after for 4, 6, and 12 months of physical activity and nutritional protocol intervention. Osteoblasts exposed to sera of patients, who displayed increased lean and decreased fat mass (from 55.5 ± 6.5 to 57.1 ± 5.6% p ≤ 0.05; from 44.5 ± 1.1 to 40.9 ± 2.6% p ≤ 0.01 respectively), showed a time-dependent increase of Wnt/β-catenin signaling, versus cells exposed to sera of obese patients before intervention protocol, suggesting recovery of osteoblast homeostasis upon improvement of body composition. An increase in β-catenin nuclear accumulation and nuclear translocation was also observed, accompanied by an increase in Adiponectin receptor 1 protein expression, suggesting positive effect on cell differentiation program. Furthermore, a decrease in sclerostin amount and an increase of type 1 procollagen amino-terminal-propeptide were depicted as compared to

TNP-assisted fascial closure in a patient with acute abdomen and abdominal compartment syndrome.

PubMed

Gourgiotis, S; Villias, C; Benetatos, C; Tsakiris, A; Parisis, C; Aloizos, S; Salemis, N S

2009-02-01

Topical negative pressure was applied to prevent abdominal compartment syndrome in a patient following surgery for an acute abdomen. It delayed fascial closure, protected the underlying bowel and facilitated abdominal re-entry.

Managing acute abdominal pain in pediatric patients: current perspectives

PubMed Central

Hijaz, Nadia M; Friesen, Craig A

2017-01-01

Acute abdominal pain in pediatric patients has been a challenge for providers because of the nonspecific nature of symptoms and difficulty in the assessment and physical examination in children. Although most children with acute abdominal pain have self-limited benign conditions, pain may be a manifestation of an urgent surgical or medical condition where the biggest challenge is making a timely diagnosis so that appropriate treatment can be initiated without any diagnostic delays that increase morbidity. This is weighed against the need to decrease radiation exposure and avoid unnecessary operations. Across all age groups, there are numerous conditions that present with abdominal pain ranging from a very simple viral illness to a life-threatening surgical condition. It is proposed that the history, physical examination, laboratory tests, and imaging studies should initially be directed at differentiating surgical versus nonsurgical conditions both categorized as urgent versus nonurgent. The features of the history including patient’s age, physical examination focused toward serious conditions, and appropriate tests are highlighted in the context of making these differentiations. Initial testing and management is also discussed with an emphasis on making use of surgeon and radiologist consultation and the need for adequate follow-up and reevaluation of the patient. PMID:29388612

Pharmacokinetics of fentanyl in patients undergoing abdominal aortic surgery.

PubMed

Hudson, R J; Thomson, I R; Cannon, J E; Friesen, R M; Meatherall, R C

1986-03-01

The authors determined the pharmacokinetics of fentanyl 100 micrograms X kg-1 iv in patients undergoing elective abdominal aortic surgery. The mean (+/- SD) age of the ten patients was 67.2 +/- 8.7 yr; their mean weight was 78.5 +/- 13.7 kg. Seven patients had aortic aneurysm repair, and the other three patients had aortobifemoral grafts. Serum fentanyl concentrations were determined from samples drawn at increasing intervals over a 24-h period. A three-compartment pharmacokinetic model was fit to the concentration versus time data. Total drug clearance was 9.8 +/- 1.8 ml X min-1 X kg-1. The volume of distribution at steady-state (Vdss) was 5.4 +/- 1.9 X 1 kg-1. Elimination half-time was 8.7 +/- 2.5 h. There were no significant correlations between these pharmacokinetic parameters and patient's age, duration of aortic cross-clamping, duration of surgery, intraoperative blood loss, or volume of iv fluids given intraoperatively. In healthy volunteers or patients undergoing general surgery, other investigators report mean elimination half-times for fentanyl ranging from 1.7 to 4.4 h. The prolonged elimination half-time in patients having abdominal aortic surgery has important clinical implications. In particular, recovery from large doses will take much longer than would have been anticipated from previously published fentanyl pharmacokinetic data.

A case-control study of rheumatoid arthritis revealed abdominal obesity and environmental risk factor interactions in northern China.

PubMed

Fu, Lingyu; Zhang, Jianming; Jin, Lei; Zhang, Yao; Cui, Saisai; Chen, Meng

2018-03-01

The aim of this study was to evaluate new and previously hypothesized environmental risk factors and their interaction with rheumatoid arthritis (RA). Four hundred patients recently diagnosed with RA and 400 controls frequency-matched by gender and birth year using Propensity Score Matching (PSM) were selected from northern China. Investigation was performed using self-reported data from interviewer-administered surveys. Associations between exposure variables and risk of RA were evaluated using multifactor non-conditional logistic regression. It showed that damp localities, draft indoor, abdominal obesity (AO), and family history of RA among first-degree relatives were independent risk factors and drinking of milk was independent protective factors for RA. Besides these risk factors, in women, infrequent delivery times, early age at menopause, and late age at menarche were also independent risk factors for RA. Both the additive model and the multiplication model suggested that there was an interaction relationship between AO and damp localities (p < .001), and only the additive model suggested that there was interaction relationship between AO and no milk drinking (p < .001) in our study population. In women, there was interaction relationship between AO and damp localities (p < .001) and between AO and age at menopause (p < .001). In northern China, damp localities, draft indoor, AO, family history of RA among first-degree relatives, and no milk drinking may be important risk factors of RA patients.

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

The effects of nursing activities on the intra-abdominal pressure of patients at risk for intra-abdominal hypertension.

PubMed

Lee, Rosemary K

2017-01-01

Intra-abdominal hypertension (IAH) occurs frequently in critically ill patients, and adds to their morbidity and mortality. There is no published evidence on the effects of nursing activities on the intra-abdominal pressure (IAP) for patients at risk of IAH. The purpose of this study was to identify the effects of hygiene care on the IAP of patients at risk for IAH. Hygiene care was provided to 34 at-risk patients. IAP was measured prior to initiating the hygiene care, immediately after and 10 minutes later. This was a quasi-experimental, pre-test/ post-test design. The 10 minute post-hygiene care measurement of the IAP was significantly lower than the pre or immediate post-measurement of the IAP. There were no significant changes in the mean arterial pressure (MAP) or the abdominal perfusion pressure (APP). It is safe and possibly therapeutic to provide hygiene care to patients at risk for IAH.

Overweight and abdominal obesity in women of childbearing age of Russian, Somali and Kurdish origin and the general Finnish population.

PubMed

Kinnunen, Tarja I; Skogberg, Natalia; Härkänen, Tommi; Lundqvist, Annamari; Laatikainen, Tiina; Koponen, Päivikki

2017-05-15

Migrant background and higher parity may increase the risk of being overweight. We compared the prevalence of overweight (body mass index ≥25 kg/m2) and abdominal obesity (waist-to-height ratio ≥0.5) between non-pregnant migrant and Finnish women aged 18-45 years. The participants were 165 Russian, 164 Somali and 179 Kurdish origin women from the cross-sectional Migrant Health and Wellbeing study. The reference group included 388 women from the general Finnish population. Body anthropometrics were measured. The main statistical methods were logistic regression adjusted for sociodemographic and reproductive variables. The unadjusted prevalence of overweight and obesity, respectively, were higher among Somali (32.9%, 30.9%, P < 0.001) and Kurdish women (41.1%, 19.5%, P < 0.001) than among Finnish women (19.9%, 9.8%). The adjusted odds ratios (95% CI) for overweight (including obesity) were 0.54 (0.33; 0.89) for Russian, 2.89 (1.66; 5.03) for Somali and 2.56 (1.64; 4.00) for Kurdish women compared with Finnish women. Kurdish women had 2.96-fold (1.75; 5.00) adjusted odds ratio for abdominal obesity compared with Finnish women. Being parous was associated with overweight and abdominal obesity among Kurdish women. Overweight and obesity were very common among Somali and Kurdish origin women. Information on diet and physical activity in these groups is needed. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study.

PubMed

Aranceta-Bartrina, Javier; Pérez-Rodrigo, Carmen; Alberdi-Aresti, Goiuri; Ramos-Carrera, Natalia; Lázaro-Masedo, Sonia

2016-06-01

According to the 2013 analysis of the Institute of Health Metrics, high body mass index values are the most important risk factor for disease in Spain. Consequently, we describe the prevalence of total obesity and abdominal obesity in the Spanish adult population (25-64 years) for 2014-2015. The sample was taken from the ENPE study, a cross-sectional study with a representative sample of the noninstitutionalized population (n = 6800) carried out between May 2014 and May 2015. This analysis refers to the population between age 25 and 64 years (n = 3966). The anthropometric measurements were performed by trained observers at participants' homes according to standard international protocols. Body mass index ≥ 25 was defined as overweight and ≥ 30 as obesity. Abdominal obesity was classified as waist > 102 cm in men and > 88 cm in women. The estimated prevalence of overweight in the Spanish adult population (25-64 years) was 39.3% 95% confidence interval [95%CI], 35.7%-42.9%). The prevalence of general obesity was 21.6% (95%CI, 19.0%-24.2%) and, more specifically, was 22.8% (95%CI, 20.6%-25.0%) among men and 20.5% (95%CI, 18.5%-22.5%) among women, and rose with age. The prevalence of abdominal obesity was estimated at 33.4% (95%CI, 31.1%-35.7%) and was higher among women (43.3%; 95%CI, 41.1%-45.8%) than among men (23.3%; 95%CI, 20.9%-25.5%), and also rose with age. The prevalence of general obesity and abdominal obesity in Spain is high, although the distribution differs according to autonomous community. A comparison with earlier data reveals a considerable increase in overweight, indicating the need for routine monitoring and comprehensive initiatives. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Common iliac artery aneurysms in patients with abdominal aortic aneurysms.

PubMed

Armon, M P; Wenham, P W; Whitaker, S C; Gregson, R H; Hopkinson, B R

1998-03-01

To determine the incidence of common iliac artery (CIA) aneurysms in patients with abdominal aortic aneurysms (AAA) and to evaluate the relationship between AAA and CIA diameter. Spiral CT angiography was used to measure the maximum diameters of the abdominal aorta and the common iliac arteries of 215 patients with AAA. The median CIA diameter was 1.7 cm--significantly greater than the published mean of 1.25 (2 S.D. = 0.85-1.65) cm of an age-matched, non-vascular population. Thirty-four patients (16%) had unilateral and 26 patients (12%) bilateral CIA aneurysms > or = 2.4 cm diameter. Eight-six vessels (20%) were affected. Right CIA diameters were wider than left CIA diameters (p < 0.0001, Wilcoxon matched-pairs signed rank test). The correlation between AAA size and CIA diameter was weak. The AAA population has abnormally dilated common iliac arteries. In this population, common iliac artery aneurysms should be defined as those greater than 2.4 cm diameter. 20% of CIAs in patients with AAA are aneurysmal according to this definition.

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.

Abdominal hernias: Radiological features

PubMed Central

Lassandro, Francesco; Iasiello, Francesca; Pizza, Nunzia Luisa; Valente, Tullio; Stefano, Maria Luisa Mangoni di Santo; Grassi, Roberto; Muto, Roberto

2011-01-01

Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external, diaphragmatic and internal hernias on the basis of their localisation. Groin hernias are the most common with a prevalence of 75%, followed by femoral (15%) and umbilical (8%). There is a higher prevalence in males (M:F, 8:1). Diagnosis is usually made on physical examination. However, clinical diagnosis may be difficult, especially in patients with obesity, pain or abdominal wall scarring. In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used: conventional radiographs or barium studies, ultrasonography and Computed Tomography. Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents such as fatty tissue, bowel, other organs or fluid. This work focuses on the main radiological findings of abdominal herniations. PMID:21860678

A Study of Physicochemical Properties of Subcutaneous Fat of the Abdomen and its Implication in Abdominal Obesity

PubMed Central

Kumar, Pramod; Kodavoor, Srinivas Aithal; Kotian, Sushma Rama; Yathdaka, Sudhakar Narahari; Nayak, Dayanand; Souza, Anne D; Souza, Antony Sylvan D

2016-01-01

Introduction The lower abdominal obesity is more resistant to absorption as compared to that of upper abdomen. Differences in the physicochemical properties of the subcutaneous fat of the upper and lower abdomen may be responsible for this variation. There is paucity of the scientific literature on the physicochemical properties of the subcutaneous fat of abdomen. Aim The present study was undertaken to create a database of physicochemical properties of abdominal subcutaneous fat. Materials and Methods The samples of subcutaneous fat from upper and lower abdomen were collected from 40 fresh autopsied bodies (males 33, females 7). The samples were prepared for physicochemical analysis using organic and inorganic solvents. Various physicochemical properties of the fat samples analysed were surface tension, viscosity, specific gravity, specific conductivity, iodine value and thermal properties. Data was analysed by paired and independent sample t-tests. Results There was a statistically significant difference in all the physicochemical parameters between males and females except surface tension (organic) and surface tension (inorganic) of upper abdominal fat, and surface tension (organic) of lower abdominal fat. In males, viscosity of upper abdominal fat was more compared to that of lower abdomen (both organic and inorganic) unlike the specific conductivity that was higher for the lower abdominal fat as compared to that of the upper abdomen. In females there were statistically significant higher values of surface tension (inorganic) and specific gravity (organic) of the upper abdomen fat as compared to that of lower abdomen. The initial and final weight loss of the lower abdominal fat as indicated by Thermo Gravimetric Analysis was significantly more in males than in female Conclusion The difference in the physicochemical properties of subcutaneous fat between upper and lower abdomen and between males and females could be responsible for the variant behaviour of

A Study of Physicochemical Properties of Subcutaneous Fat of the Abdomen and its Implication in Abdominal Obesity.

PubMed

Pandey, Arvind Kumar; Kumar, Pramod; Kodavoor, Srinivas Aithal; Kotian, Sushma Rama; Yathdaka, Sudhakar Narahari; Nayak, Dayanand; Souza, Anne D; Souza, Antony Sylvan D

2016-05-01

The lower abdominal obesity is more resistant to absorption as compared to that of upper abdomen. Differences in the physicochemical properties of the subcutaneous fat of the upper and lower abdomen may be responsible for this variation. There is paucity of the scientific literature on the physicochemical properties of the subcutaneous fat of abdomen. The present study was undertaken to create a database of physicochemical properties of abdominal subcutaneous fat. The samples of subcutaneous fat from upper and lower abdomen were collected from 40 fresh autopsied bodies (males 33, females 7). The samples were prepared for physicochemical analysis using organic and inorganic solvents. Various physicochemical properties of the fat samples analysed were surface tension, viscosity, specific gravity, specific conductivity, iodine value and thermal properties. Data was analysed by paired and independent sample t-tests. There was a statistically significant difference in all the physicochemical parameters between males and females except surface tension (organic) and surface tension (inorganic) of upper abdominal fat, and surface tension (organic) of lower abdominal fat. In males, viscosity of upper abdominal fat was more compared to that of lower abdomen (both organic and inorganic) unlike the specific conductivity that was higher for the lower abdominal fat as compared to that of the upper abdomen. In females there were statistically significant higher values of surface tension (inorganic) and specific gravity (organic) of the upper abdomen fat as compared to that of lower abdomen. The initial and final weight loss of the lower abdominal fat as indicated by Thermo Gravimetric Analysis was significantly more in males than in female. The difference in the physicochemical properties of subcutaneous fat between upper and lower abdomen and between males and females could be responsible for the variant behaviour of subcutaneous abdominal fat towards resorption.

The subcutaneous abdominal fat and not the intraabdominal fat compartment is associated with anovulation in women with obesity and infertility.

PubMed

Kuchenbecker, Walter K H; Groen, Henk; Zijlstra, Tineke M; Bolster, Johanna H T; Slart, Riemer H J; van der Jagt, Erik J; Kobold, Anneke C Muller; Wolffenbuttel, Bruce H R; Land, Jolande A; Hoek, Annemieke

2010-05-01

Abdominal fat contributes to anovulation. We compared body fat distribution measurements and their contribution to anovulation in obese ovulatory and anovulatory infertile women. Seventeen ovulatory and 40 anovulatory women (age, 30 +/- 4 yr; body mass index, 37.7 +/- 6.1 kg/m(2)) participated. Body fat distribution was measured by anthropometrics, dual-energy x-ray absorptiometry, and single-sliced abdominal computed tomography scan. Multiple logistic regression analysis was applied to determine which fat compartments significantly contributed to anovulation. Anovulatory women had a higher waist circumference (113 +/- 11 vs. 104 +/- 9 cm; P < 0.01) and significantly more trunk fat (23.0 +/- 5.3 vs. 19.1 +/- 4.2 kg; P < 0.01) and abdominal fat (4.4 +/- 1.3 kg vs. 3.5 +/- 0.9 kg; P < 0.05) on dual-energy x-ray absorptiometry scan than ovulatory women despite similar body mass index. The volume of intraabdominal fat on single-sliced abdominal computed tomography scan was not significantly different between the two groups (203 +/- 56 vs. 195 +/- 71 cm(3); P = 0.65), but anovulatory women had significantly more sc abdominal fat (SAF) (992 +/- 198 vs. 864 +/- 146 cm(3); P < 0.05). After multiple logistic regression analysis, only trunk fat, abdominal fat, and SAF were associated with anovulation. Abdominal fat is increased in anovulatory women due to a significant increase in SAF and not in intraabdominal fat. SAF and especially abdominal and trunk fat accumulation are associated with anovulation.

Accuracy and Consistency of Respiratory Gating in Abdominal Cancer Patients

SciTech Connect

Ge, Jiajia; Santanam, Lakshmi; Yang, Deshan

2013-03-01

Purpose: To evaluate respiratory gating accuracy and intrafractional consistency for abdominal cancer patients treated with respiratory gated treatment on a regular linear accelerator system. Methods and Materials: Twelve abdominal patients implanted with fiducials were treated with amplitude-based respiratory-gated radiation therapy. On the basis of daily orthogonal fluoroscopy, the operator readjusted the couch position and gating window such that the fiducial was within a setup margin (fiducial-planning target volume [f-PTV]) when RPM indicated “beam-ON.” Fifty-five pre- and post-treatment fluoroscopic movie pairs with synchronized respiratory gating signal were recorded. Fiducial motion traces were extracted from the fluoroscopic movies using a template matchingmore » algorithm and correlated with f-PTV by registering the digitally reconstructed radiographs with the fluoroscopic movies. Treatment was determined to be “accurate” if 50% of the fiducial area stayed within f-PTV while beam-ON. For movie pairs that lost gating accuracy, a MATLAB program was used to assess whether the gating window was optimized, the external-internal correlation (EIC) changed, or the patient moved between movies. A series of safety margins from 0.5 mm to 3 mm was added to f-PTV for reassessing gating accuracy. Results: A decrease in gating accuracy was observed in 44% of movie pairs from daily fluoroscopic movies of 12 abdominal patients. Three main causes for inaccurate gating were identified as change of global EIC over time (∼43%), suboptimal gating setup (∼37%), and imperfect EIC within movie (∼13%). Conclusions: Inconsistent respiratory gating accuracy may occur within 1 treatment session even with a daily adjusted gating window. To improve or maintain gating accuracy during treatment, we suggest using at least a 2.5-mm safety margin to account for gating and setup uncertainties.« less

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

PubMed

Peplonska, Beata; Bukowska, Agnieszka; Sobala, Wojciech

2015-01-01

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. 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. 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. The results of the study support the previously reported relations between night shift work and development of obesity.

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

Associations of Diabetes and Obesity with Risk of Abdominal Aortic Aneurysm in Men

PubMed Central

Djousse, Luc; Song, Yiqing; Akinkuolie, Akintunde O.; Matsumoto, Chisa; Manson, JoAnn E.; Gaziano, J. Michael; Sesso, Howard D.

2017-01-01

Background. The associations of diabetes and obesity with the risk of abdominal aortic aneurysm (AAA) are inconclusive in previous studies. Subjects/Methods. We conducted prospective analysis in the Physicians' Health Study. Among 25,554 male physicians aged ≥ 50 years who reported no AAA at baseline, 471 reported a newly diagnosed AAA during a mean of 10.4 years' follow-up. Results. Compared with men who had baseline body mass index (BMI) < 25 kg/m2, the multivariable hazard ratio (HR [95% CI]) of newly diagnosed AAA was 1.30 [1.06–1.59] for BMI 25–<30 kg/m2 and 1.69 [1.24–2.30] for BMI ≥ 30 kg/m2. The risk of diagnosed AAA was significantly higher by 6% with each unit increase in baseline BMI. This association was consistent regardless of the other known AAA risk factors and preexisting vascular diseases. Overall, baseline history of diabetes tended to be associated with a lower risk of diagnosed AAA (HR = 0.79 [0.57–1.11]); this association appeared to vary by follow-up time (HR = 1.56 and 0.63 during ≤ and >2 years' follow-up, resp.). Conclusion. In a large cohort of middle-aged and older men, obesity was associated with a higher risk, while history of diabetes tended to associate with a lower risk of diagnosed AAA, particularly over longer follow-up. PMID:28326193

Interactive relations of type 2 diabetes and abdominal obesity to cognitive impairment: A cross-sectional study in rural area of Xi'an in China.

PubMed

Li, Yanbo; Shang, Suhang; Fei, Yulang; Chen, Chen; Jiang, Yu; Dang, Liangjun; Liu, Jie; Ma, Louyan; Wei, Meng; Qu, Qiumin

2018-01-01

Type 2 diabetes and obesity, which are frequently comorbid, have been associated with cognitive impairment. We aim to examine the potential modulating effect between obesity and diabetes on cognitive impairment. We recruited 865 adults (aged ≥55years) lived in a village of Xi'an in China from October 2014 to March 2015. All participants underwent biomedical and neuropsychological assessment. Relations of diabetes and abdominal obesity to cognitive impairment were examined in multiple regression models. A total of 155 participants (17.9%) presented with the diagnosis of cognitive impairment. Diabetes or obesity alone wasn't significantly associated with cognitive impairment. Interaction analysis showed a significant interaction between abdominal obesity and diabetes on cognitive impairment. Stratified multivariate analysis revealed that the association between diabetes and cognitive impairment was positive in participants with abdominal obesity (OR 2.436, 95% CI 1.345-4.411, p=0.003, in diabetics with high WC, and OR 2.348, 95% CI 1.373-4.014, p=0.002, in diabetics with high WHR), but negative in those without abdominal obesity. Type 2 diabetes interacts with abdominal obesity to be associated with an increased risk of cognitive impairment by more than two times. Copyright © 2017 Elsevier Inc. All rights reserved.

The Treatment of Achalasia in Obese Patients.

PubMed

Wesp, Julie A; Farrell, Timothy M

2018-04-01

Epidemiological studies have demonstrated that obesity is frequently associated with esophageal motility disorders. Morbid obesity and achalasia may coexist in the same patient. The management of the morbidly obese patient with achalasia is complex and the most effective treatment remains controversial. The aim of this study is to review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of achalasia in morbidly obese patients. PubMed search from January 1990 to July 2017, including the following terms: achalasia, morbid obesity, bariatric, and treatment. Achalasia in the setting of morbid obesity may be successfully treated by endoscopic or surgical methods. Surgeons may choose to add a bariatric procedure, with various strategies present in the literature. A review of the present literature suggests that the preferred approach to achalasia in the morbidly obese patient is to address both disease processes simultaneously with a laparoscopic Heller myotomy and a Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is cited by most experts as the bariatric procedure of choice, given its antireflux benefits. A well-powered study, comparing the various approaches to the treatment of achalasia in the setting of morbid obesity, is required to establish a consensus.

Fatty Acid Content of Plasma Triglycerides May Contribute to the Heterogeneity in the Relationship Between Abdominal Obesity and the Metabolic Syndrome.

PubMed

Aristizabal, Juan C; Barona, Jacqueline; Gonzalez-Zapata, Laura I; Deossa, Gloria C; Estrada, Alejandro

2016-08-01

About one-third of the people with abdominal obesity do not exhibit the metabolic syndrome (MetS). Fatty acids in plasma triglycerides (TGs) may help to explain part of this heterogeneity. This study compared TG fatty acid profile of adults with and without abdominal obesity and examined the associations of these fatty acids with MetS components. Fifty-four abdominally obese subjects were matched by age and sex with 54 adults without abdominal obesity. People were classified with MetS according to the harmonizing criteria for MetS. Fatty acids in plasma TGs were analyzed by gas chromatography. There were no differences in fatty acids of plasma TGs between people with and without abdominal obesity. However, there were differences between abdominally obese people with and without MetS. The abdominally obese group with MetS had higher palmitic (+2.9%; P = 0.012) and oleic (+4.0%; P = 0.001) acids and lower linoleic (-6.4%; P = 0.018) and arachidonic (-1.2%; P = 0.004) acids. After adjustment for abdominal obesity, age, and sex, a stepwise regression analysis showed that palmitic acid positively contributed to the variance in insulin (β = +1.08 ± 1.01; P = 0.000) and homeostasis model assessment of insulin resistance (HOMA-IR) index (β = +1.09 ± 1.01; P = 0.000) and myristic acid positively contributed to the variance in systolic blood pressure (β = +1.09 ± 1.03; P = 0.006). In contrast, linoleic acid negatively contributed to the variance in glucose (β = -0.321 ± 0.09; P = 0.001) and high-sensitivity C-reactive protein (hsCRP; β = -1.05 ± 1.01; P = 0.000). There were no differences in the plasma TG fatty acid profile between people with and without abdominal obesity. Likewise, fatty acids in plasma TGs associated with many of the MetS variables independently of abdominal obesity. These results suggest that the plasma TG fatty acid profile may help to explain part of the heterogeneity

Abdominal obesity and hyperglycemia mask the effect of a common APOC3 haplotype on the risk of myocardial infarction123

PubMed Central

Ruiz-Narváez, Edward A; Sacks, Frank M; Campos, Hannia

2013-01-01

Background Plasma apolipoprotein (apo) C-III strongly predicts myocardial infarction (MI) and directly activates atherogenic processes invascularcells.Geneticvariationintheinsulinresponseelementofthe APOC3 promoter is associated with an increased risk of MI. Objective The objective was to determine whether the APOC3 promoter variation affects plasma apo C-III concentrations and MI only when insulin sensitivity is normal. Design TheAPOC3*222haplotype,definedbytheminorallelesofthe single nucleotide polymorphisms 3238C→G, –455T→C, and –482C→T, was studied in 1703 matched nonfatal case-control pairs with MI in the Central Valley of Costa Rica. We used fasting hyper-glycemia and abdominal obesity as surrogates for insulin sensitivity. Results The APOC3*222 haplotype was associated with higher apo C-III concentrations only in those with the lowest waist circumference or fasting glucose concentration. The association between the APOC3*222 haplotype and nonfatal MI, previously reported in this population, was strongly influenced by fasting hyperglycemia and abdominal obesity. The odds ratios for MI for the APOC3*222 haplotype were 1.72 (95% CI: 1.16, 2.54) and 1.84 (1.31, 2.59) in subjects in the lowest quintiles of abdominal obesity and fasting hyperglycemia, respectively, and were 0.75 (0.54, 1.05) and 1.16 (0.85, 1.59) in subjects in the highest quintiles, respectively (P for interaction <0.05). Conclusion The results support the concept that mutations in the APOC3 promoter inhibit the down-regulation of APOC3 expression by insulin. This cardioprotective system becomes dysfunctional in abdominal obesity and hyperglycemia. PMID:18541587

Abdominal obesity and hyperglycemia mask the effect of a common APOC3 haplotype on the risk of myocardial infarction.

PubMed

Ruiz-Narváez, Edward A; Sacks, Frank M; Campos, Hannia

2008-06-01

Plasma apolipoprotein (apo) C-III strongly predicts myocardial infarction (MI) and directly activates atherogenic processes in vascular cells. Genetic variation in the insulin response element of the APOC3 promoter is associated with an increased risk of MI. The objective was to determine whether the APOC3 promoter variation affects plasma apo C-III concentrations and MI only when insulin sensitivity is normal. The APOC3*222 haplotype, defined by the minor alleles of the single nucleotide polymorphisms 3238C-->G, -455T-->C, and -482C-->T, was studied in 1703 matched nonfatal case-control pairs with MI in the Central Valley of Costa Rica. We used fasting hyperglycemia and abdominal obesity as surrogates for insulin sensitivity. The APOC3*222 haplotype was associated with higher apo C-III concentrations only in those with the lowest waist circumference or fasting glucose concentration. The association between the APOC3*222 haplotype and nonfatal MI, previously reported in this population, was strongly influenced by fasting hyperglycemia and abdominal obesity. The odds ratios for MI for the APOC3*222 haplotype were 1.72 (95% CI: 1.16, 2.54) and 1.84 (1.31, 2.59) in subjects in the lowest quintiles of abdominal obesity and fasting hyperglycemia, respectively, and were 0.75 (0.54, 1.05) and 1.16 (0.85, 1.59) in subjects in the highest quintiles, respectively (P for interaction <0.05). The results support the concept that mutations in the APOC3 promoter inhibit the down-regulation of APOC3 expression by insulin. This cardioprotective system becomes dysfunctional in abdominal obesity and hyperglycemia.

Discordance of metabolic syndrome and abdominal obesity prevalence according to different criteria in Andean highlanders: A community-based study.

PubMed

Herrera-Enriquez, Karela; Narvaez-Guerra, Offdan

2017-11-01

There is no consensus as to which Metabolic Syndrome (MetS) definition to use for South-American populations. The aim of this study is to compare the prevalence of MetS and abdominal obesity using different criteria in Andean adults aged 40 and older living permanently at high altitude. We conducted a cross-sectional study in Chivay (Andean highlands). 237 participants were included. Anthropometric measurements, glucose and lipid assessments were done in all subjects. Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria for MetS were used. Abdominal obesity prevalence was determined using the American Diabetes Association (ADA), IDF, and PREVENCION Study criteria. Cohen's Kappa coefficient (κ) was analyzed to assess agreement level between different criteria. Multiple regression analyses were performed to find predictors for waist circumference. MetS was identified in 28.7% (95%CI=23.8-33.5) using ATPIII criteria, and 37.9% (95%CI=32.7-43.0) using IDF criteria, with higher prevalence in women. The κ statistics for agreement between both criteria was 0.775 (95%CI=0.690-0.859). Abdominal obesity prevalence according to ADA, IDF, and PREVENCION criteria was 35.9% (95%CI=29.7-42.0), 75.9% (95%CI=70.5-81.4), and 42.6% (95%CI=36.3-49.0), respectively. Agreement between ADA and PREVENCION criteria was highest (κ=0.859, 95%CI=0.792-0.925). The strongest predictors for higher waist circumference values were triglycerides and BMI in women, and systolic blood pressure, triglycerides, fasting plasma glucose, and HDL-cholesterol in men. MetS according to ATP III and IDF criteria was highly prevalent. IDF criteria identified a larger number of subjects with MetS. Different abdominal obesity criteria tended to show variation when applied to our sample population. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Abdominal adiposity, general obesity, and subclinical systolic dysfunction in the elderly: A population-based cohort study.

PubMed

Russo, Cesare; Sera, Fusako; Jin, Zhezhen; Palmieri, Vittorio; Homma, Shunichi; Rundek, Tatjana; Elkind, Mitchell S V; Sacco, Ralph L; Di Tullio, Marco R

2016-05-01

General obesity, measured by body mass index (BMI), and abdominal adiposity, measured as waist circumference (WC) and waist-to-hip ratio (WHR), are associated with heart failure and cardiovascular events. However, the relationship of general and abdominal obesity with subclinical left ventricular (LV) dysfunction is unknown. We assessed the association of general and abdominal obesity with subclinical LV systolic dysfunction in a population-based elderly cohort. Participants from the Cardiovascular Abnormalities and Brain Lesions study underwent measurement of BMI, WC, and WHR. Left ventricular systolic function was assessed by two-dimensional echocardiographic LV ejection fraction (LVEF) and speckle-tracking global longitudinal strain (GLS). The study population included 729 participants (mean age 71 ± 9 years, 60% women). In multivariate analysis, higher BMI (but not WC and WHR) was associated with higher LVEF (β = 0.11, P = 0.003). Higher WC (β = 0.08, P = 0.038) and higher WHR (β = 0.15, P < 0.001) were associated with lower GLS, whereas BMI was not (P = 0.720). Compared with normal WHR, high WHR was associated with lower GLS in all BMI categories (normal, overweight, and obese), and was associated with subclinical LV dysfunction by GLS both in participants without [adjusted odds ratio (OR) 2.0, 95% confidence interval (CI) 1.1-3.6, P = 0.020] and with general obesity (adjusted OR 5.4, 95% CI 1.1-25.9, P = 0.034). WHR was incremental to BMI and risk factors in predicting LV dysfunction. Abdominal adiposity was independently associated with subclinical LV systolic dysfunction by GLS in all BMI categories. BMI was not associated with LV dysfunction. Increased abdominal adiposity may be a risk factor for LV dysfunction regardless of the presence of general obesity. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

Abdominal obesity and its association with health-related quality of life in adults: a population-based study in five Chinese cities

PubMed Central

2014-01-01

Background This study aimed to investigate the prevalence of abdominal obesity and its association with the health-related quality of life (HRQOL) in a randomly selected Chinese sample. Methods A population-based sample of 3,600 residents aged 18–80 years was selected randomly from 5 Chinese cities. Demographic information, and waist and hip circumference measurements were obtained. The Mandarin version of the Short Form 36 Health Survey questionnaire (SF-36) was used to assess the HRQOL. Waist circumference (WC) and waist-to-hip ratio (WHR) were used as measures of abdominal obesity, and the prevalence of abdominal obesity and its association with HRQOL were analysed. Results Among the 3,184 participants included in the analysis, the prevalence of abdominal obesity was about 45% in both women and men as evaluated by WC, and about 40% in women and 33% in men as evaluated by WHR. The prevalence varied by city, region, age, marital status, education level, family income, smoking, and the presence of chronic diseases. Both WC and WHR increased with age, and men had larger WC and WHR than women in most age groups. In women, abdominal obesity, as determined by both WC and WHR, was associated with meaningful impairments in 4 physical health scales and 2 mental health scales. In men, abdominal obesity, as determined by WC, was associated with 1 physical health scale and 1 mental health scale, and it was associated with 2 physical health scales based on WHR. Conclusions Physical health, but not mental health, was more vulnerable to impairment with abdominal obesity, and the impairments varied between genders. Public health agencies should emphasize that abdominal obesity impairs physical health. PMID:24925310

Respiratory Management of Perioperative Obese Patients.

PubMed

Imber, David Ae; Pirrone, Massimiliano; Zhang, Changsheng; Fisher, Daniel F; Kacmarek, Robert M; Berra, Lorenzo

2016-12-01

With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique. Although strong evidence and research are lacking regarding how to best ventilate the obese surgical patient, we aim with this review to provide an assessment of the small amount of research that has been conducted and the pathophysiology we believe influences the apparent results. We will provide a basic overview of the anatomy and pathophysiology of the obese respiratory system and review studies concerning pre-, intra-, and postoperative respiratory care. Our focus in this review centers on the best approach to keeping the lung recruited through the prevention of compression atelectasis and the maintaining of physiological lung volumes. We recommend the use of PEEP via noninvasive ventilation (NIV) before induction and endotracheal intubation, the use of both PEEP and periodic recruitment maneuvers during mechanical ventilation, and the use of PEEP via NIV after extubation. It is our hope that by studying the underlying mechanisms that make ventilating obese patients so difficult, future research can be better tailored to address this increasingly important challenge to the field of anesthesia. Copyright © 2016 by Daedalus Enterprises.

Cross-sectional association between cigarette smoking and abdominal obesity among Austrian bank employees.

PubMed

de Oliveira Fontes Gasperin, Lizia; Neuberger, Manfred; Tichy, Alexander; Moshammer, Hans

2014-07-29

There is increasing evidence that smoking is associated with abdominal obesity and other risk factors for the metabolic syndrome. The aim of this study is to investigate these associations in a sample of healthy Austrian adults. Data of 986 employees of an Austrian company (405 men and 581 women; participation rate approximately 80%) obtained during their annual medical check-up at the workplace were analysed. Information on smoking status, education level, physical activity, diet, body weight, height, body mass index (BMI), waist circumference and biochemical parameters was obtained. The influence of smoking on health and anthropometric measures was investigated. No differences in total body fat and/or body fat distribution were found between non-smokers, smokers and former smokers; however, among daily smokers, the number of cigarettes smoked per day was significantly associated with higher body weight (p=0.001) and BMI (p=0.009). Male and female smokers had significantly higher white cell count than non-smokers and former smokers. Heavy smokers also had an unhealthier lipid profile (lower high-density lipoprotein cholesterol) and higher fasting glucose levels even after controlling for physical activity and calorie intake. Contrary to the beliefs of many smokers, heavy smoking is associated with higher body weight and unfavourable metabolic changes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Abdominal obesity is strongly associated to blood pressure in young Mexicans.

PubMed

Urquidez Romero, Rene; Murguía Romero, Miguel; Esparza Romero, Julián; Díaz Torres, Beatriz Araceli; Rodríguez Tadeo, Alejandra; Medrano Donlucas, Gabriel; Ramos Jiménez, Arnulfo; Wall Medrano, Abraham; Gallardo Ortíz, Itzell A; Tapia Pancardo, Diana C Tapia-Pancardo C; Méndez Cruz, A René; Jiménez Flores, J Rafael; Villalobos Molina, Rafael

2017-03-30

The objective of this study was to determine associations between abdominal obesity (AOb) and the other components of metabolic syndrome (MetS) in young Mexicans in a cross-sectional survey completed during a 4 year period. This cross-sectional study reports on components and prevalence of MetS by using Alberti et al. (16) criteria, as well as association between AOb and elevated blood pressure (BP) of 2,993 Mexican university students, ages 17 to 25 years (66% women) from central and northern Mexico, over a 4-year survey (2010-2013). The most prevalent MetS components in the total sample were low HDL-C concentration (43.6%) and AOb (41.1%). MetS prevalence was 11.8%, more men than women were classified with MetS (14.3% vs. 10.5%, p < 0.01). BP was the MetS component with the lowest prevalence (8.6%). A strong association between AOb and altered BP with in both men and women was found (OR 4.3, IC95% 2.5-7.4). Even BP was the component with the lowest prevalence, AOb was more strongly associated with it. This fact, could explain the prevalence of hypertension among young Mexican adults.

Optimal definitions for abdominal obesity and the metabolic syndrome in Andean Hispanics: the PREVENCION study.

PubMed

Medina-Lezama, Josefina; Pastorius, Catherine A; Zea-Diaz, Humberto; Bernabe-Ortiz, Antonio; Corrales-Medina, Fernando; Morey-Vargas, Oscar Leopoldo; Chirinos, Diana Andrea; Muñoz-Atahualpa, Edgar; Chirinos-Pacheco, Julio; Chirinos, Julio Alonso

2010-06-01

We aimed to establish optimal definitions for abdominal obesity and metabolic syndrome (MetS) among Andean adults. Among 1,448 Andean adults, we assessed the relationship between waist circumference and subclinical vascular disease assessed by carotid intima-media thickness (cIMT) and manifest cardiovascular disease (M-CVD). Optimal waist circumference cutoffs to classify individuals with abnormal cIMT or M-CVD were >97 and >87 cm in men and women, respectively. With these cutoffs, there was substantial disagreement between the original American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and the recently updated MetS definition, particularly among men (kappa = 0.85). Subjects with MetS identified by the updated definition but not meeting the original AHA/NHLBI MetS criteria demonstrated significantly increased cIMT (P < 0.001) compared with subjects who did not meet the MetS criteria by either definition. Our findings support the use of ethnic-specific waist circumference cutoffs and the updated MetS definition in Andean adults.

Cross-sectional association between cigarette smoking and abdominal obesity among Austrian bank employees

PubMed Central

de Oliveira Fontes Gasperin, Lizia; Neuberger, Manfred; Tichy, Alexander; Moshammer, Hans

2014-01-01

Objectives There is increasing evidence that smoking is associated with abdominal obesity and other risk factors for the metabolic syndrome. The aim of this study is to investigate these associations in a sample of healthy Austrian adults. Setting and participants Data of 986 employees of an Austrian company (405 men and 581 women; participation rate approximately 80%) obtained during their annual medical check-up at the workplace were analysed. Primary and secondary outcome measures Information on smoking status, education level, physical activity, diet, body weight, height, body mass index (BMI), waist circumference and biochemical parameters was obtained. The influence of smoking on health and anthropometric measures was investigated. Results No differences in total body fat and/or body fat distribution were found between non-smokers, smokers and former smokers; however, among daily smokers, the number of cigarettes smoked per day was significantly associated with higher body weight (p=0.001) and BMI (p=0.009). Male and female smokers had significantly higher white cell count than non-smokers and former smokers. Heavy smokers also had an unhealthier lipid profile (lower high-density lipoprotein cholesterol) and higher fasting glucose levels even after controlling for physical activity and calorie intake. Conclusions Contrary to the beliefs of many smokers, heavy smoking is associated with higher body weight and unfavourable metabolic changes. PMID:25079922

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

USDA-ARS?s Scientific Manuscript database

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...

The severity of nocturnal hypoxia but not abdominal adiposity is associated with insulin resistance in non-obese men with sleep apnea.

PubMed

Borel, Anne-Laure; Monneret, Denis; Tamisier, Renaud; Baguet, Jean-Philippe; Faure, Patrice; Levy, Patrick; Halimi, Serge; Pépin, Jean-Louis

2013-01-01

Beyond obesity, sleep apnea syndrome is frequently associated with excess abdominal adiposity that could contribute to the deteriorated cardiometabolic risk profile of apneic patients. The present study addressed the respective contribution of the severity of sleep apnea syndrome and excess abdominal adiposity to the cardiometabolic risk profile of 38 non obese men with polysomnography-diagnosed sleep apnea syndrome (apnea-hypopnea index >15 events/hour). These otherwise healthy men performed a 75g-oral glucose tolerance test (OGTT) with plasma lipid/inflammatory and redox profiles. Twenty-one apneic men with high-waist circumference (>94 cm) were compared to 17 apneic men with low-waist circumference. Apneic men with high-waist circumference had higher AUC glucose and AUC insulin than apneic men with low-waist circumference. Accordingly, apneic men with high-waist circumference had higher hepatic insulin resistance as reflected by higher HOMA-resistance index, and lower global insulin sensitivity as reflected by lower insulin sensitivity index of Matsuda (derived from OGTT). The sleep structure and the apnea-hypopnea index were not different between the two groups. However, apneic men with high-waist circumference presented with lower mean nocturnal oxyhemoglobin (SpO2). In the 38 men, waist circumference and mean nocturnal SpO2 were inversely correlated (r = -0.43, p = 0.011) and were both associated with plasma glucose/insulin homeostasis indices: the higher the waist circumference, the lower the mean nocturnal SpO2, the lower the insulin-sensitivity. Finally, in multivariable regression model, mean nocturnal SpO2 and not waist circumference was associated with insulin-resistance. Thus, excess abdominal adiposity in non obese apneic men was associated with a deteriorated insulin-sensitivity that could be driven by a more severe nocturnal hypoxemia.

The Severity of Nocturnal Hypoxia but Not Abdominal Adiposity Is Associated with Insulin Resistance in Non-Obese Men with Sleep Apnea

PubMed Central

Borel, Anne-Laure; Monneret, Denis; Tamisier, Renaud; Baguet, Jean-Philippe; Faure, Patrice; Levy, Patrick; Halimi, Serge; Pépin, Jean-Louis

2013-01-01

Background Beyond obesity, sleep apnea syndrome is frequently associated with excess abdominal adiposity that could contribute to the deteriorated cardiometabolic risk profile of apneic patients. Methods The present study addressed the respective contribution of the severity of sleep apnea syndrome and excess abdominal adiposity to the cardiometabolic risk profile of 38 non obese men with polysomnography-diagnosed sleep apnea syndrome (apnea-hypopnea index >15 events/hour). These otherwise healthy men performed a 75g-oral glucose tolerance test (OGTT) with plasma lipid/inflammatory and redox profiles. Twenty-one apneic men with high-waist circumference (>94 cm) were compared to 17 apneic men with low-waist circumference. Results Apneic men with high-waist circumference had higher AUC glucose and AUC insulin than apneic men with low-waist circumference. Accordingly, apneic men with high-waist circumference had higher hepatic insulin resistance as reflected by higher HOMA-resistance index, and lower global insulin sensitivity as reflected by lower insulin sensitivity index of Matsuda (derived from OGTT). The sleep structure and the apnea-hypopnea index were not different between the two groups. However, apneic men with high-waist circumference presented with lower mean nocturnal oxyhemoglobin (SpO2). In the 38 men, waist circumference and mean nocturnal SpO2 were inversely correlated (r = −0.43, p = 0.011) and were both associated with plasma glucose/insulin homeostasis indices: the higher the waist circumference, the lower the mean nocturnal SpO2, the lower the insulin-sensitivity. Finally, in multivariable regression model, mean nocturnal SpO2 and not waist circumference was associated with insulin-resistance. Conclusion Thus, excess abdominal adiposity in non obese apneic men was associated with a deteriorated insulin-sensitivity that could be driven by a more severe nocturnal hypoxemia. PMID:23951064

Association of white and red meat consumption with general and abdominal obesity: a cross-sectional study among a population of Iranian military families in 2016.

PubMed

Dabbagh-Moghadam, Arasb; Mozaffari-Khosravi, Hassan; Nasiri, Morteza; Miri, Ali; Rahdar, Maliehe; Sadeghi, Omid

2017-12-01

To assess the association of red and white meat consumption with general and abdominal obesity among Iranian military families. In this cross-sectional study, 525 subjects with age range of 19-55 years belong to military families of Army of Islamic Republic of Iran were recruited during 2016. Dietary data were collected using semi-quantitative food-frequency questionnaire. A self-reported questionnaire was used to collect data on demographic characteristics and anthropometric measurements. General obesity was defined as body mass index ≥25 kg/m 2 and abdominal obesity as waist circumference ≥80 cm for women and ≥ 94 cm for men. Finally, we had complete data on 170 subjects for analysis. Mean age of subjects was 33.78 ± 6.48. We found a significant positive association between red meat consumption and abdominal obesity in fully adjusted model, so that subjects in the fourth quartile had 4.51 more odds to be abdominally obese compared with those in the first quartile of red meat consumption (OR 4.51, 95% CI 1.32-15.40). Such relationship was not seen for general obesity. In addition, white meat consumption was not associated with general and abdominal obesity either before or after adjustment for covariates. Red meat consumption was positively associated with abdominal obesity. No significant relationship was found between white meat consumption, and general and abdominal obesity. Therefore, further studies are needed to shed light our findings.

Models Predictive of Metabolic Syndrome Components in Obese Pediatric Patients.

PubMed

Ortega-Cortes, Rosa; Trujillo, Xóchitl; Hurtado López, Erika Fabiola; López Beltrán, Ana Laura; Colunga Rodríguez, Cecilia; Barrera-de Leon, Juan Carlos; Tlacuilo-Parra, Alberto

2016-01-01

Components of metabolic syndrome (MetS) are complications caused by abdominal obesity and insulin resistance (IR). Diagnosis of MetS by clinical indicators could help to identify patients at risk of cardiovascular disease and type 2 diabetes. We undertook this study to propose predictive indicators of MetS in obese children and adolescents. A cross-sectional study was carried out. After obtaining informed consent and the registration of the study with an institutional research committee, 172 obese patients from an Obesity Clinic, aged 6-15 years, were included. Variables included were waist circumference (WC), glucose, high-density lipoprotein (HDL), triglycerides (TGL), blood pressure, insulin resistance (by homeostatic model assessment HOMA-index), acanthosis nigricans (AN), uric acid, serum glutamic oxaloacetic transaminase (GOT) and alanine transaminase, and hepatic sonogram. International standards for age and sex variables were used. Multivariate analysis was applied. Variables predicted components of MetS in children: HOMA-IR (insulin resistance by HOMA index) was increased by 2.4 in hepatic steatosis, by 0.6 for each unit of SUA (serum uric acid), and by 0.009 for every mg/dL of triglycerides. In adolescents, every cm of waist circumference increased systolic blood pressure by 0.6 mmHg, and each unit of SUA increased it by 2.9 mmHg. Serum uric acid and waist circumference are useful and accessible variables that can predict an increased risk of cardiovascular disease in obese pediatric patients. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

Incentive spirometry in postoperative abdominal/thoracic surgery patients.

PubMed

Rupp, Michael; Miley, Helen; Russell-Babin, Kathleen

2013-01-01

Postoperative patients have higher incidences of respiratory complications. Patients undergoing abdominal or thoracic surgical procedures are at greater risk of having such complications. Incentive spirometry is an inhalation-based prophylactic technique that encourages patients to mimic a natural deep sigh to periodically increase lung volume. As this technique is the prophylactic method of choice for many hospitals, several studies have tested its efficacy. Five articles, including 4 systematic reviews and 1 clinical practice guideline, are analyzed and summarized. Each article was reviewed by a multidisciplinary team of health care providers and is discussed herein. A clinical recommendation for practice change is provided on the basis of the results. Incentive spirometry is only as effective as cough/deep-breathing regimens and other means of postoperative pulmonary prophylaxis. No single prophylactic technique clearly outperforms all others in preventing pulmonary complications. Future research is needed to determine the best method to prevent postoperative pulmonary complications.

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

PubMed

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

2016-01-01

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. 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. 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. 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.

Sex-Specific Difference in the Association Between Poor Sleep Quality and Abdominal Obesity in Rural Chinese: A Large Population-Based Study.

PubMed

Liu, Ru-Qing; Qian, Zhengmin; Wang, Si-Quan; Vaughn, Michael G; Geiger, Sarah Dee; Xian, Hong; Lin, Shao; Paul, Gunther; Zeng, Xiao-Wen; Yang, Bo-Yi; Hu, Li-Wen; Xu, Shu-Li; Yang, Mo; Dong, Guang-Hui

2017-04-15

Existing studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population. A representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women. Male participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females. Poor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females. © 2017 American Academy of Sleep Medicine

Abdominal Aortic Aneurysms in “High-Risk” Surgical Patients

PubMed Central

Jordan, William D.; Alcocer, Francisco; Wirthlin, Douglas J.; Westfall, Andrew O.; Whitley, David

2003-01-01

Objective To evaluate the early results of endovascular grafting for high-risk surgical candidates in the treatment of abdominal aortic aneurysms (AAA). Summary Background Data Since the approval of endoluminal grafts for treatment of AAA, endovascular repair of AAA (EVAR) has expanded to include patients originally considered too ill for open AAA repair. However, some concern has been expressed regarding technical failure and the durability of endovascular grafts. Methods The University of Alabama at Birmingham (UAB) Computerized Vascular Registry identified all patients who underwent abdominal aneurysm repair between January 1, 2000, and June 12, 2002. Patients were stratified by type of repair (open AAA vs. EVAR) and were classified as low risk or high risk. Patients with at least one of the following classifications were classified as high risk: age more than 80 years, chronic renal failure (creatinine > 2.0), compromised cardiac function (diminished ventricular function or severe coronary artery disease), poor pulmonary function, reoperative aortic procedure, a “hostile” abdomen, or an emergency operation. Death, systemic complications, and length of stay were tabulated for each group. Results During this 28-month period, 404 patients underwent AAA repair at UAB. Eighteen patients (4.5%) died within 30 days of their repair or during the same hospitalization. Two hundred seventeen patients (53%) were classified as high risk. Two hundred fifty-nine patients (64%) underwent EVAR repair, and 130 (50%) of these were considered high-risk patients (including four emergency procedures). One hundred forty-five patients (36%) underwent open AAA repair, including 15 emergency operations. All deaths occurred in the high-risk group: 12 (8.3%) died after open AAA repair and 6 (2.3%) died after EVAR repair. Postoperative length of stay was shorter for EVAR repair compared to open AAA. Conclusions High-risk and low-risk patients can undergo EVAR repair with a lower rate

Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999–2004

USDA-ARS?s Scientific Manuscript database

Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12–18 y of age (n = 5811). ...

Importance of Different Grades of Abdominal Obesity on Testosterone Level, Erectile Dysfunction, and Clinical Coincidence.

PubMed

Fillo, Juraj; Levcikova, Michaela; Ondrusova, Martina; Breza, Jan; Labas, Peter

2017-03-01

The aim of the current study was to investigate the influence of different grades of abdominal obesity (AO) on the prevalence of testosterone deficiency syndrome (TDS), erectile dysfunction (ED), and metabolic syndrome (MetS). In a cross-sectional descriptive study, a total of 216 males underwent a complete urological, internal, and hormonal evaluation. Males were divided according to waist circumference into five groups: less than 94 cm (Grade [G] 0), 94 to 101 cm (G1), 102 to 109 cm (G2), 110 to 119 cm (G3), and more than 120 cm (G4). Incidence of ED, TDS, and MetS was compared in these groups and in participants without AO. Some degree of ED was identified in 74.7% of males with AO. In G1, there were 61% of males with ED, in G2 68%, in G3 83%, and in G4 87%. A strong correlation between testosterone (TST) level and AO was identified. Ninety-eight out of 198 (49.5%) males with AO and 1/18 (5.5%) males without AO had TDS. There were significant differences between individual groups. In the group of males with AO G4 (more than 120 cm), 87.1% had TDS. MetS was diagnosed in 105/198 (53.0%) males with AO, but in G4, 83.9% of males with AO had MetS. Males older than 40 years of age with AO have a higher incidence of ED, TDS, and MetS. Dividing males into five groups according to waist circumference seems to be reasonable. With growing AO, there were significantly more males with ED, TDS, and MetS.

Risk factors associated with abdominal obesity in suburban adolescents from a Malaysian district.

PubMed

Chew, Wai Fong; Leong, Pooi Pooi; Yap, Sook Fan; Yasmin, A Malik; Choo, Kong Bung; Low, Gary Kim Kuan; Boo, Nem Yun

2018-02-01

We aimed to determine the risk factors associated with abdominal obesity (AO) in suburban adolescents. This cross-sectional study included adolescents aged 15-17 years from five randomly selected secondary schools in the Hulu Langat district of Selangor state, Malaysia. Waist circumference (WC) was measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. Information on sociodemographic data, dietary habits, physical activity levels and duration of sleep was obtained via interviewer-administered questionnaires. Participants' habitual food intake was determined using a 73-item Food Frequency Questionnaire. Among 832 participants, 56.0% were girls; 48.4% were Malay, 40.5% Chinese, 10.2% Indian and 0.8% of other ethnic groups. Median age and WC were 16 (interquartile range [IQR] 15-16) years and 67.9 (IQR 63.0-74.6) cm, respectively. Overall prevalence of AO (> 90th percentile on the WC chart) was 11.3%. A higher proportion (22.4%) of Indian adolescents were found to have AO compared with Malay and Chinese adolescents. Logistic regression analysis showed that female gender (adjusted odds ratio [OR] 7.064, 95% confidence interval [CI] 2.087-23.913; p = 0.002), Indian ethnicity (adjusted OR 10.164, 95% CI 2.182-47.346; p = 0.003), irregular meals (adjusted OR 3.193, 95% CI 1.043-9.774; p = 0.042) and increasing body mass index (BMI) (adjusted OR 2.867, 95% CI 2.216-3.710; p < 0.001) were significantly associated with AO. AO was common among Malaysian adolescents. Female gender, Indian ethnicity, irregular meals and increasing BMI were significant risk factors. Copyright: © Singapore Medical Association.

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

PubMed Central

Cheifetz, Oren; Overend, Tom J.; Crowe, Jean

2010-01-01

ABSTRACT Purpose: Immobility and pain are modifiable risk factors for development of venous thromboembolism and pulmonary morbidity after major abdominal surgery (MAS). The purpose of this study was to investigate the effect of abdominal incision support with an elasticized abdominal binder on postoperative walk performance (mobility), perceived distress, pain, and pulmonary function in patients following MAS. Methods: Seventy-five patients scheduled to undergo MAS via laparotomy were randomized to experimental (binder) or control (no binder) groups. Sixty (33 male, 27 female; mean age 58±14.9 years) completed the study. Preoperative measurements of 6-minute walk test (6MWT) distance, perceived distress, pain, and pulmonary function were repeated 1, 3, and 5 days after surgery. Results: Surgery was associated with marked postoperative reductions (p<0.001) in walk distance (∼75–78%, day 3) and forced vital capacity (35%, all days) for both groups. Improved 6MWT distance by day 5 was greater (p<0.05) for patients wearing a binder (80%) than for the control group (48%). Pain and symptom-associated distress remained unchanged following surgery with binder usage, increasing significantly (p<0.05) only in the no binder group. Conclusion: Elasticized abdominal binders provide a non-invasive intervention for enhancing recovery of walk performance, controlling pain and distress, and improving patients' experience following MAS. PMID:21629603

Consumption of a liquid high-fat meal increases triglycerides but decreases high-density lipoprotein cholesterol in abdominally obese subjects with high postprandial insulin resistance.

PubMed

Wang, Feng; Lu, Huixia; Liu, Fukang; Cai, Huizhen; Xia, Hui; Guo, Fei; Xie, Yulan; Huang, Guiling; Miao, Miao; Shu, Guofang; Sun, Guiju

2017-07-01

Abdominal obesity is associated with an increased risk of insulin resistance, which may be a potential contributor to dyslipidemia. However, the relationship between postprandial insulin resistance and lipid metabolism in abdominally obese subjects remains unknown. We hypothesized that postprandial dyslipidemia would be exaggerated in abdominally obese subjects with high postprandial insulin resistance. To test this hypothesis, serum glucose, insulin, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and apolipoprotein B were measured at baseline and postprandial state at 0.5, 1, 2, 4, 6, and 8 hours after a liquid high-fat meal in non-abdominally obese controls (n=44) and abdominally obese subjects with low (AO-LPIR, n=40), middle (n=40), and high postprandial insulin resistance (AO-HPIR, n=40) based on the tertiles ratio of the insulin to glucose areas under the curve (AUC). Their serum adipokines were tested at baseline only. Fasting serum leptin was higher (P<.05) in AO-HPIR than that in AO-LPIR and controls. Postprandial triglycerides AUC was higher (P<.05), whereas high-density lipoprotein cholesterol AUC was lower (P<.05), in AO-HPIR than those in AO-LPIR and controls. Postprandial AUCs for total cholesterol and apolipoprotein B were similar in abdominally obese subjects with different degrees of postprandial insulin resistance and controls. The present study indicated that the higher degree of postprandial insulin resistance, the more adverse lipid profiles in abdominally obese subjects, which provides insight into opportunity for screening in health. Copyright © 2017 Elsevier Inc. All rights reserved.

Determinants and definition of abdominal obesity as related to risk of diabetes, metabolic syndrome and coronary disease in Turkish men: a prospective cohort study.

PubMed

Onat, Altan; Uyarel, Hüseyin; Hergenç, Gülay; Karabulut, Ahmet; Albayrak, Sinan; Can, Günay

2007-03-01

We aimed to investigate determinants of abdominal obesity and its clinical impact on metabolic syndrome (MS), diabetes (DM) and coronary heart disease (CHD) in men. Prospective evaluation of 1638 male participants (aged 48.5+/-12.3), representative of Turkey's men who have a high prevalence of MS. For components of MS, criteria of NCEP guidelines were adopted, modified for abdominal obesity. Follow-up constituted 9650 person-years. Insulin level (relative risk [RR] 1.40 for doubling), C-reactive protein (CRP) and heavy smoking (protective) were independent predictors of newly developing abdominal obesity. High triglyceride and low HDL-cholesterol were significantly associated already with waist girth quartile II, apolipoprotein B with quartile III. Waist girth significantly predicted future MS from quartile II on, independent of insulin resistance (IR) by homeostatic model assessment, whereby its hazard ratio (HR, 2.6) exceeded double that of HOMA. CRP independently predicted MS. Age-adjusted HR of waist girth (1.59) was significant in predicting DM. Age- and smoking-adjusted top waist quartile conferred significant risk for incident CHD (RR 1.71) but not for overall mortality. As judged by sensitivity and specificity rates for future CHD, DM and MS, abdominal obesity was most appropriately defined with a waist girth of >or=95 cm, and an action level 1 of >or=87 cm was proposed for MS in this population. Serum insulin, CRP levels and (inversely) heavy smoking are predictors for abdominal obesity in Turkish men. Atherogenic dyslipidemia and elevated blood pressure are associated significantly already with modest rises in waist girth adjusted for age and smoking. Abdominal obesity shows substantial independence of IR in the development of MS. Increasing waist girth was predictive of MS, more strongly than of DM. Risk for CHD imparted by abdominal obesity is essentially mediated by risk factors it induces.

LINEA ALBA COLLAGEN ASSESSMENT IN MORBIDLY OBESE PATIENTS.

PubMed

Grossi, João Vicente Machado; Nicola, Felipe Fernandes; Zepeda, Ivan Alberto; Becker, Martina; Trindade, Eduardo Neubarth; Diemen, Vinicius Von; Cavazzola, Leandro Totti; Trindade, Manoel Roberto Maciel

The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group. A avaliação do colágeno na parede abdominal é cada vez mais estudada, em virtude da relevância dele no processo cicatricial após laparotomia. Avaliar a quantidade de colágeno na linha alba de pacientes submetidos à cirurgia bariátrica e compará-la com a de cadáveres não-obesos. Foram avaliados dois grupos com total de 88 amostras da aponeurose da linha alba abdominal, divididas em 44 de pacientes obesos (grupo obesidade) com indicação de cirurgia bariátrica e 44 de cadáveres n

Obese ZDF rats fermented resistant starch with effects on gut microbiota but no reduction in abdominal fat.

PubMed

Goldsmith, Felicia; Guice, Justin; Page, Ryan; Welsh, David A; Taylor, Christopher M; Blanchard, Eugene E; Luo, Meng; Raggio, Anne M; Stout, Rhett W; Carvajal-Aldaz, Diana; Gaither, Amanda; Pelkman, Christine; Ye, Jianping; Martin, Roy J; Geaghan, James; Durham, Holiday A; Coulon, Diana; Keenan, Michael J

2017-01-01

To determine if whole-grain (WG) flour with resistant starch (RS) will produce greater fermentation than isolated RS in obese Zucker Diabetic Fatty (ZDF) rats, and whether greater fermentation results in different microbiota, reduced abdominal fat, and increased insulin sensitivity. This study utilized four groups fed diets made with either isolated digestible control starch, WG control flour (6.9% RS), isolated RS-rich corn starch (25% RS), or WG corn flour (25% RS). ZDF rats fermented RS and RS-rich WG flour to greatest extent among groups. High-RS groups had increased serum glucagon-like peptide 1 (GLP-1) active. Feeding isolated RS showed greater Bacteroidetes to Firmicutes phyla among groups, and rats consuming low RS diets possessed more bacteria in Lactobacillus genus. However, no differences in abdominal fat were observed, but rats with isolated RS had greatest insulin sensitivity among groups. Data demonstrated ZDF rats (i) possess a microbiota that fermented RS, and (ii) WG high-RS fermented better than purified RS. However, fermentation and microbiota changes did not translate into reduced abdominal fat. The defective leptin receptor may limit ZDF rats from responding to increased GLP-1 and different microbiota for reducing abdominal fat, but did not prevent improved insulin sensitivity. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity.

PubMed

Skrypnik, Damian; Bogdański, Paweł; Mądry, Edyta; Karolkiewicz, Joanna; Ratajczak, Marzena; Kryściak, Jakub; Pupek-Musialik, Danuta; Walkowiak, Jarosław

2015-01-01

To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity. © 2015 S. Karger GmbH, Freiburg.

Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity

PubMed Central

Skrypnik, Damian; Bogdański, Paweł; Mądry, Edyta; Karolkiewicz, Joanna; Ratajczak, Marzena; Kryściak, Jakub; Pupek-Musialik, Danuta; Walkowiak, Jarosław

2015-01-01

Aims To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. Methods 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. Results Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. Conclusion Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity. PMID:25968470

Effects of endurance and endurance-strength exercise on biochemical parameters of liver function in women with abdominal obesity.

PubMed

Skrypnik, Damian; Ratajczak, Marzena; Karolkiewicz, Joanna; Mądry, Edyta; Pupek-Musialik, Danuta; Hansdorfer-Korzon, Rita; Walkowiak, Jarosław; Jakubowski, Hieronim; Bogdański, Paweł

2016-05-01

Obesity is a risk factor of nonalcoholic fatty liver disease. Although the standard therapy for obesity involves physical exercise, well-planned studies of the changes in liver function in response to different exercise intensities in obese subjects are scarce. The aim of the present study was to examine a question of how does exercise mode affect the liver function. 44 women with abdominal obesity were randomized into two exercise groups: endurance (group A) and endurance-strength (group B). Women in each group exercised for 60min 3 times/week for a 3-month period. Markers of liver function: serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), alkaline phosphatase (ALP) activities, and bilirubin levels were quantified. We found significant differences in ALT (p<0.01) and AST (p<0.05) activities between group A and B after training exercise. Blood ALT and AST tended to decrease in group B, increase in group A. Significant reduction in serum GGT level after exercise in both groups was observed (p<0.001, group A; p<0.01, group B). Neither endurance nor endurance-strength exercise led to changes in serum ALP activity and total or direct bilirubin level. However, endurance-strength training resulted in significant decreases in serum indirect bilirubin (p<0.05). Strong positive correlations between serum indirect bilirubin and body mass (r=0.615; p=0.0085) and BMI (r=0.576; p=0.0154) were found after endurance-strength exercise (group B). The mode of exercise does matter: endurance-strength exercise led to a greater improvement, compared to endurance exercise, in the liver function in women with abdominal obesity. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Mediterranean dietary pattern in pregnant women and offspring risk of overweight and abdominal obesity in early childhood: the INMA birth cohort study.

PubMed

Fernández-Barrés, S; Romaguera, D; Valvi, D; Martínez, D; Vioque, J; Navarrete-Muñoz, E M; Amiano, P; Gonzalez-Palacios, S; Guxens, M; Pereda, E; Riaño, I; Tardón, A; Iñiguez, C; Arija, V; Sunyer, J; Vrijheid, M

2016-12-01

Animal models have suggested that maternal diet quality may reduce offspring obesity risk regardless of maternal body weight; however, evidence from human studies is scarce. The aim of this study was to evaluate associations between adherence to the Mediterranean diet (MD) during pregnancy and childhood overweight and abdominal obesity risk at 4 years of age. We analysed 1827 mother-child pairs from the Spanish 'Infancia y Medio Ambiente' cohort study, recruited between 2003 and 2008. Diet was assessed during pregnancy using a food frequency questionnaire and MD adherence by the relative Mediterranean diet score (rMED). Overweight (including obesity) was defined as an age-specific and sex-specific body mass index ≥85th percentile (World Health Organization referent), and abdominal obesity as a waist circumference (WC) >90th percentile. Multivariate adjusted linear and logistic regression models were used to evaluate associations between pregnancy rMED and offspring overweight and abdominal obesity. There was no association between rMED and body mass index z-score, whereas there was a significant association between higher adherence to MD and lower WC (β of high vs. low rMED: -0.62 cm; 95% confidence interval: -1.10, -0.14 cm, P for trend = 0.009). Pregnancy adherence to the MD was not associated with childhood overweight risk, but it was associated with lower WC, a marker of abdominal obesity. © 2016 World Obesity Federation.

Couch height–based patient setup for abdominal radiation therapy

SciTech Connect

Ohira, Shingo; Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita; Ueda, Yoshihiro

2016-04-01

There are 2 methods commonly used for patient positioning in the anterior-posterior (A-P) direction: one is the skin mark patient setup method (SMPS) and the other is the couch height–based patient setup method (CHPS). This study compared the setup accuracy of these 2 methods for abdominal radiation therapy. The enrollment for this study comprised 23 patients with pancreatic cancer. For treatments (539 sessions), patients were set up by using isocenter skin marks and thereafter treatment couch was shifted so that the distance between the isocenter and the upper side of the treatment couch was equal to that indicated on themore » computed tomographic (CT) image. Setup deviation in the A-P direction for CHPS was measured by matching the spine of the digitally reconstructed radiograph (DRR) of a lateral beam at simulation with that of the corresponding time-integrated electronic portal image. For SMPS with no correction (SMPS/NC), setup deviation was calculated based on the couch-level difference between SMPS and CHPS. SMPS/NC was corrected using 2 off-line correction protocols: no action level (SMPS/NAL) and extended NAL (SMPS/eNAL) protocols. Margins to compensate for deviations were calculated using the Stroom formula. A-P deviation > 5 mm was observed in 17% of SMPS/NC, 4% of SMPS/NAL, and 4% of SMPS/eNAL sessions but only in one CHPS session. For SMPS/NC, 7 patients (30%) showed deviations at an increasing rate of > 0.1 mm/fraction, but for CHPS, no such trend was observed. The standard deviations (SDs) of systematic error (Σ) were 2.6, 1.4, 0.6, and 0.8 mm and the root mean squares of random error (σ) were 2.1, 2.6, 2.7, and 0.9 mm for SMPS/NC, SMPS/NAL, SMPS/eNAL, and CHPS, respectively. Margins to compensate for the deviations were wide for SMPS/NC (6.7 mm), smaller for SMPS/NAL (4.6 mm) and SMPS/eNAL (3.1 mm), and smallest for CHPS (2.2 mm). Achieving better setup with smaller margins, CHPS appears to be a reproducible method for abdominal patient setup.« less

Association of the Myostatin gene with obesity, abdominal obesity and low lean body mass and in non-diabetic Asian Indians in north India.

PubMed

Bhatt, Surya Prakash; Nigam, Priyanka; Misra, Anoop; Guleria, Randeep; Luthra, Kalpana; Jain, S K; Qadar Pasha, M A

2012-01-01

To determine the association of the A55T and K153R polymorphisms of the Myostatin gene with obesity, abdominal obesity and lean body mass (LBM) in Asian Indians in north India. A total of 335 subjects (238 men and 97 women) were assessed for anthropometry, % body fat (BF), LBM and biochemical parameters. Associations of Myostatin gene polymorphisms were evaluated with anthropometric, body composition and biochemical parameters. In A55T polymorphism, BMI (p=0.04), suprailiac skinfold (p=0.05), total skinfold (p=0.008), %BF (p=0.002) and total fat mass (p=0.003) were highest and % LBM (p=0.03) and total LBM (Kg) were lowest (p=0.04) in subjects with Thr/Thr genotype as compared to other genotypes. Association analysis of K153R polymorphism showed that subjects with R/R genotype had significantly higher BMI (p=0.05), waist circumference (p=0.04), %BF (p=0.04) and total fat mass (p=0.03), and lower %LBM (p=0.02) and total LBM [(Kg), (p=0.04)] as compared to other genotypes. Using a multivariate logistic regression model after adjusting for age and sex, subjects with Thr/Thr genotype of A55T showed high risk for high %BF (OR, 3.92, 95% Cl: 2.61-12.41), truncal subcutaneous adiposity (OR, 2.9, 95% Cl: 1.57-6.60)] and low LBM (OR, 0.64, 95% CI: 0.33-0.89) whereas R/R genotype of K153R showed high risk of obesity (BMI; OR, 3.2, 95% CI: 1.2-12.9; %BF, OR, 3.6, 95% CI: 1.04-12.4), abdominal obesity (OR, 2.12, 95% CI: 2.71-14.23) and low LBM (OR, 0.61, 95% CI: 0.29-0.79). We report that variants of Myostatin gene predispose to obesity, abdominal obesity and low lean body mass in Asian Indians in north India.

Association of perceived ethnic discrimination with general and abdominal obesity in ethnic minority groups: the HELIUS study.

PubMed

Schmengler, Heiko; Ikram, Umar Z; Snijder, Marieke B; Kunst, Anton E; Agyemang, Charles

2017-05-01

Discrimination is associated with obesity, but this may differ according to the type of obesity and ethnic group. This study examines the association of perceived ethnic discrimination (PED) with general and abdominal obesity in 5 ethnic minority groups. We used cross-sectional data from the HELIUS study, collected from 2011 to 2015. The study sample included 2297 Ghanaians, 4110 African Surinamese, 3021 South-Asian Surinamese, 3562 Turks and 3868 Moroccans aged 18-70 years residing in Amsterdam, the Netherlands. Body mass index (BMI) was used as a measure for general obesity, and waist circumference (WC) for abdominal obesity. PED was measured using the Everyday Discrimination Scale. We used linear regression models adjusted for sociodemographics, psychosocial stressors and health behaviours. In additional analysis, we used standardised variables to compare the strength of the associations. In adjusted models, PED was significantly, positively associated with BMI in the South-Asian Surinamese (β coefficient 0.338; 95% CI 0.106 to 0.570), African Surinamese (0.394; 0.171 to 0.618) and Turks (0.269; 0.027 to 0.510). For WC, a similar pattern was seen: positive associations in the South-Asian Surinamese (0.759; 0.166 to 1.353), African Surinamese (0.833; 0.278 to 1.388) and Turks (0.870; 0.299 to 1.440). When stratified by sex, we found positive associations in Surinamese women, Turkish men and Moroccan men. The strength of the associations with BMI and WC was comparable in the groups. Among the Ghanaians, no significant associations were observed. Ethnic and sex variations are observed in the association of PED with both general and abdominal obesity. Further research on psychosocial buffers and underlying biological mechanisms might help in understanding these variations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Association between the abdominal obesity anthropometric indicators and metabolic disorders in a Chinese population.

PubMed

Dong, J; Ni, Y-Q; Chu, X; Liu, Y-Q; Liu, G-X; Zhao, J; Yang, Y-B; Yan, Y-X

2016-02-01

Obesity has become a major health problem in contemporary society and it is closely related to many chronic diseases, so it is an important issue for measuring adiposity accurately and predicting its future. Prevention and treatment of overweight and obesity has become one of the key prevention and treatment of metabolic disorders. In this study, we compared the ability of the four anthropometric indicators (body mass index, waist circumstance, waist-height ratio, waist-to-hip ratio) to identify metabolic disorders (hypertension, hyperlipidaemia, hyperglycemia and hyperuricemia) by receiver operating characteristic (ROC) curve analyses and to provide evidence for clinical practice. In this large scale cross-sectional study, 13,275 Han adults (including 7595 males and 5680 females) received physical examination between January, 2009 and January, 2010 in Xuanwu Hospital of Capital Medical University were investigated by the means of questionnaire, Meanwhile, the physical examination and serological results were recorded. A package known as Statistical Package for Social Scientist (SPSS) was employed to analyse the responses while t-test, one-way analysis of variance (ANOVA), ROC analysis and chi-square statistical methods were used to test the hypotheses. WC, WHtR, WHR and BMI were all significantly (P < 0.001) correlated with all metabolic risk factors regardless of gender. And the area under the curve (AUC) of WHtR was significantly greater than that of WC, BMI or WHR in the prediction of hypertension, hyperlipidaemia, hyperglycemia and hyperuricemia. Our data show that WHtR was the best predictor of various metabolic disorders. The diagnostic value in descending order was WHtR > WHR > WC > BMI. Therefore we recommend WHtR in assessment of obese patients, in order to better assess the risks of their metabolic diseases. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Strategies for the management of patients with obesity.

PubMed

Hamilton, Michael

2002-01-01

The prevalence of overweight and obesity is increasing worldwide. During the last two decades, the prevalence of adults in the higher body mass index (BMI) categories in the US has increased the most, as much as 300% for those with a BMI above 40kg/m2. In children and adolescents, a doubling of the prevalence of severe overweight poses a serious health risk to future generations of young adults who may develop chronic diseases normally associated with aging. The simple definition of obesity, an imbalance between energy intake and energy expenditure, ignores the complexity of, and largely unknown interactions between, genes, food intake and physical activity, which together determine bodyweight and fat distribution. Although the etiology and manifestations of overweight and obesity are complex, the assessment of overweight and obesity requires only an accurate measurement of bodyweight, height and abdominal circumference, as well as a history and physical examination attuned to the morbidities that commonly accompany overweight and obesity such as diabetes mellitus, hypertension, dyslipidemia and sleep apnea. The treatment of patients with overweight and obesity continues to be based on changes to diet and physical activity. Simple behavior modification techniques are within the reach of busy clinicians. The additional use of available bodyweight reduction medications can reliably lead to a 5 to 10% reduction from initial bodyweight, a loss that has been shown to provide significant health benefit. The use of meal replacements has also been shown to be effective and is probably an under-appreciated treatment resource. Surgery is the most successful treatment for those with severe obesity and should be discussed as an option for those in the appropriate bodyweight categories. Because societal trends favor the greater intake of calorie-dense foods and less physical activity to accomplish the activities of daily life, the future of obesity treatment will require the

The Impact of Obesity on Patient Reported Outcomes Following Stereotactic Body Radiation Therapy for Prostate Cancer

PubMed Central

Cyr, Robyn; Feng, Li Rebekah; Bae, Edward; Danner, Malika T; Ayoob, Marilyn; Yung, Thomas M; Lei, Siyuan; Collins, Brian T; Saligan, Leorey; Simeng, Suy; Kumar, Deepak; Collins, Sean P

2016-01-01

Objectives The relationship between obesity (Body Mass Index ­>30 kg/m2) and quality of life (QoL) following prostate cancer (PCa) radiation therapy (RT) is unknown. Excess abdominal fat may compromise the precise delivery of radiation, putting surrounding organs at risk for greater radiation exposure. Stereotactic body radiation therapy (SBRT) utilizes a real-time tracking system that provides updated prostate position information and allows for correction of the therapeutic beam during treatment with high accuracy. In this study, we evaluate the impact of obesity on patient reported outcomes following SBRT for prostate cancer. Materials and methods Between February 2008 and April 2012, 88 obese and 178 non-obese patients with PCa were treated with SBRT at Georgetown University Hospital, Washington, DC. Health-related quality of life (HRQol) was assessed via the expanded prostate cancer index composite (EPIC)-26 at baseline, 6, 12, 18, and 24 months after 5-fraction delivery of 35-36.25 Gy with the CyberKnife. Patients who received androgen deprivation therapy (ADT) were excluded from this analysis due to its known negative impact on HRQoL. Results Pretreatment characteristics of obese and non-obese patient groups were similar except that obese patients had lower total testosterone levels. Urinary and bowel function and bother scores between the two patient cohorts were comparable at baseline and subsequent follow-ups. Sexual function and bother were also similar at baseline between both groups. Bother was defined by displeasure patients may experience from functional decline. At 24 months post-SBRT, obese men experienced borderline clinically significant decrease in sexual function and greater sexual bother compared to non-obese patients. Fatigue was significantly higher in obese patients compared to non-obese patients at 18 months post-SBRT. Conclusions Prostate SBRT affects obese and non-obese patients similarly in total HRQoL scores and majority of its

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

USDA-ARS?s Scientific Manuscript database

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 ...

The influence of abdominal obesity and chronic work stress on ambulatory blood pressure in men and women.

PubMed

Steptoe, A; Cropley, M; Griffith, J; Joekes, K

1999-11-01

To assess the influence of abdominal obesity and work stress (operationalised as low control over work) on ambulatory blood pressure on a working day and evening. 156 school teachers (58 men and 98 women) carried out ambulatory blood pressure and heart rate monitoring on a work day and evening. Cardiovascular activity was also measured under baseline conditions on another occasion, when body weight, height, waist and hip circumference were assessed. Perceived control over work was assessed by questionnaire, along with mental health, anger expression and social support. 126 participants repeated the protocol after 12 months. Waist/hip ratio was used as the index of abdominal obesity. Baseline blood pressure was positively associated with waist/hip ratio in men, but ambulatory blood pressure and heart rate were not independently related to waist/hip ratio or job control. However, blood pressure and heart rate recorded during the working day and evening were elevated in men with high waist/hip ratio who experienced low job control, independently of age and body weight. Effects for diastolic blood pressure and heart rate were replicated after 12 months. Body mass index was not related to blood pressure or heart rate during the day or evening after adjustment for age and waist circumference. Low job control was associated with poor psychological well-being, negative mood and lack of social support. The results are consistent with the hypothesis that abdominal obesity in men is characterised by a tendency towards heightened stress-induced physiological activation, but that this tendency will only be manifest in the presence of appropriate environmental challenges such as chronic work stress.

In women with polycystic ovary syndrome and obesity, loss of intra-abdominal fat is associated with resumption of ovulation.

PubMed

Kuchenbecker, Walter K H; Groen, Henk; van Asselt, Sophie J; Bolster, Johanna H T; Zwerver, J; Slart, Riemer H J; Vd Jagt, Erik J; Muller Kobold, Anneke C; Wolffenbuttel, Bruce H R; Land, Jolande A; Hoek, Annemieke

2011-09-01

It is not clear why some anovulatory women with polycystic ovary syndrome (PCOS) and obesity resume ovulation and others remain anovulatory after weight loss. The objective of this study was to compare the changes in body fat distribution and specifically intra-abdominal fat (IAF) and subcutaneous abdominal fat (SAF) between a group of anovulatory women with PCOS and obesity who resume ovulation (RO+) to those who remain anovulatory (RO-) during a lifestyle program. In a prospective pilot cohort study, anovulatory women with PCOS underwent a 6 month lifestyle program in a tertiary fertility clinic. Body fat distribution was assessed by anthropometrics, dual-energy X-ray absorptiometry (DEXA) and single slice abdominal CT scan at intake, after 3 months and after 6 months. Baseline-corrected changes over time were analysed using generalized estimating equations longitudinal regression analysis. In 32 anovulatory women with PCOS (age, 28 ± 4 years; BMI, 37.5 ± 5.0 kg/m²), there were no significant baseline differences in anthropometrics and biochemical assessment between 14 RO+ participants and 18 RO- participants. RO+ women lost more weight (6.3 versus 3.0%) and abdominal fat on DEXA (15.0 versus 4.3%) compared with RO- women. Resumption of ovulation was associated with early and consistent loss of IAF (12.4 versus 5.0% at 3 months and 18.5 versus 8.6% at 6 months). Loss of SAF between the RO+ women and the RO- women was similar at 3 months (6.2 versus 6.1%) but did not change any further in RO- women (6.1%) as it did in RO+ women (11.4%) at 6 months. In anovulatory women with PCOS and obesity undergoing a lifestyle program, RO+ women lose more body weight and abdominal fat on DEXA than RO- women. In addition, this study shows that early and consistent loss of IAF is associated with resumption of ovulation. Future studies should address the mechanisms behind these changes and should assess interventions aimed at loss of IAF to facilitate resumption of ovulation.

[Lifestyle changes: effects on an obese patient].

PubMed

Wu, Ya-Ke; Lin, Chiu-Chu

2011-08-01

Obesity is often caused by an unhealthy lifestyle, which is a composite of various individual behaviors. Nurses may assist obese patients to lose weight and avoid chronic disease by identifying risky lifestyle behaviors and helping to develop improvement strategies. This article describes the nursing experience of the authors in caring for an obese patient who had made several unsuccessful attempts to reduce weight. An intervention approach was used to review the patient's lifestyle. Using self-regulation theory, the authors identified that the patient's fat-related daily behavior included: lack of exercise, high-fat diet, and daily snacks consumed even late at night. The authors also helped the patient discover the reasons underlying his fat- related behavior and his previous failed attempts to lose weight and to develop a feasible improved approach that considered such. After six weeks of care, the patient's body weight had reduced and body fat and body mass index had decreased with no relapse. The patient further lost significant weight and body fat during the three-month follow up period. The authors would like to share with nursing professionals this approach to weight loss, with the hope that this case study can contribute to medical efforts to help obese patients not only lose weight but also prevent chronic illnesses.

Wireless system for monitoring Intra-abdominal pressure in patient with severe abdominal pathology

NASA Astrophysics Data System (ADS)

Sokolovskiy, S. S.; Shtotskiy, Y. V.; Leljanov, A. D.

2017-01-01

The paper discusses an experimental design of the wireless system for monitoring intra-abdominal pressure (IAP) using Bluetooth Low Energy technology. The possibility of measuring IAP via the bladder using a wireless pressure sensor with a hydrophobic bacteria filter between the liquid transmitting medium and the sensor element is grounded.

Prevalence of general and abdominal obesity and overweight among adults in Poland. Results of the WOBASZ II study (2013-2014) and comparison with the WOBASZ study (2003-2005).

PubMed

Stepaniak, Urszula; Micek, Agnieszka; Waśkiewicz, Anna; Bielecki, Wojciech; Drygas, Wojciech; Janion, Marianna; Kozakiewicz, Krystyna; Niklas, Arkadiusz; Puch-Walczak, Aleksandra; Pająk, Andrzej

2016-08-18

INTRODUCTION There are limited data on the current prevalence of overweight and obesity as well as its changes with time in Poland. OBJECTIVES The aim of the study was to assess the prevalence of general and abdominal obesity and overweight in Polish adults in the years 2013-2014, and to compare it with the prevalence in the years 2003-2005. PATIENTS AND METHODS The study was conducted in 2 independent, representative samples of the Polish population, comprising 14 537 persons (aged 20-74 years) examined in the years 2003-2005 and 6164 persons (aged ≥20 years) examined in the years 2013-2014. Anthropometric measurements were done by trained nurses. RESULTS In the years 2013-2014, the age-standardized prevalence of obesity (body mass index [BMI] ≥30 kg/m2) was 24.4% in men and 25.0% in women. The prevalence of overweight (BMI, 25.0-29.9 kg/m2) was 43.2% in men and 30.5% in women. Abdominal obesity (waist circumference ≥102 cm in men or ≥88 cm in women) was noted in 32.2% of men and 45.7% of women. Abdominal overweight (waist circumference, 94-101.9 cm in men or 80-87.9 cm in women) was present in 27.2% of men and 21.7% of women. Since the years 2003-2005, the distribution of body mass according to the BMI category had shifted to higher values, and an increase in the prevalence of obesity was observed in men. The percentage of adults with normal waist circumference decreased significantly in both sexes. CONCLUSIONS Every fourth inhabitant of Poland is obese, and during the last decade, the prevalence of obesity has increased, particularly in men. Abdominal obesity is observed in every third man and nearly every second woman, and an excess of abdominal fat has increased in both sexes.

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

Pharmacological management of obesity in pediatric patients.

PubMed

Boland, Cassie L; Harris, John Brock; Harris, Kira B

2015-02-01

To review current evidence of pharmacological options for managing pediatric obesity and provide potential areas for future research. A MEDLINE search (1966 to October 2014) was conducted using the following keywords: exenatide, liraglutide, lorcaserin, metformin, obesity, orlistat, pediatric, phentermine, pramlintide, topiramate, weight loss, and zonisamide. Identified articles were evaluated for inclusion, with priority given to randomized controlled trials with orlistat, metformin, glucagon-like peptide-1 agonists, topiramate, and zonisamide in human subjects and articles written in English. References were also reviewed for additional trials. Whereas lifestyle modification is considered first-line therapy for obese pediatric patients, severe obesity may benefit from pharmacotherapy. Orlistat is the only Food and Drug Administration (FDA)-approved medication for pediatric obesity and reduced body mass index (BMI) by 0.5 to 4 kg/m(2), but gastrointestinal (GI) adverse effects may limit use. Metformin has demonstrated BMI reductions of 0.17 to 1.8 kg/m(2), with mild GI adverse effects usually managed with dose titration. Exenatide reduced BMI by 1.1 to 1.7 kg/m(2) and was well-tolerated with mostly transient or mild GI adverse effects. Topiramate and zonisamide reduced weight when used in the treatment of epilepsy. Future studies should examine efficacy and safety of pharmacological agents in addition to lifestyle modifications for pediatric obesity. Lifestyle interventions remain the treatment of choice in pediatric obesity, but concomitant pharmacotherapy may be beneficial in some patients. Orlistat should be considered as second-line therapy for pediatric obesity. Evidence suggests that other diabetes and antiepileptic medications may also provide weight-loss benefits, but safety should be further evaluated. © The Author(s) 2014.

The potential impact of animal protein intake on global and abdominal obesity: evidence from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study.

PubMed

Alkerwi, Ala'a; Sauvageot, Nicolas; Buckley, Jonathan D; Donneau, Anne-Françoise; Albert, Adelin; Guillaume, Michèle; Crichton, Georgina E

2015-07-01

To examine the association of total animal protein intake and protein derived from different dietary sources (meat; fish and shellfish; eggs; milk products) with global and abdominal obesity among adults in Luxembourg. Binary logistic regression analysis was used to assess the relationship between animal protein intake (as a percentage of total energy intake) and global obesity (BMI ≥ 30.0 kg/m(2)) and abdominal obesity (waist circumference ≥ 102 cm for men and ≥ 88 cm for women), after controlling for potential confounders. Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study. The study population was derived from a national cross-sectional stratified sample of 1152 individuals aged 18-69 years, recruited between November 2007 and January 2009. There was an independent positive association between total animal protein intake and both global (OR = 1.18; 95% CI 1.12, 1.25) and abdominal obesity (OR = 1.14; 95% CI 1.08, 1.20) after adjustment for age, gender, education, smoking, physical activity and intakes of total fat, carbohydrate, fibre, and fruit and vegetables. Protein intakes from meat, fish and shellfish were positively associated with global and abdominal obesity with further adjustment for vegetal protein and other sources of animal-derived protein (all P < 0.01). Protein derived from eggs or milk products was unrelated to global or abdominal obesity. Our findings suggest that protein derived from animal sources, in particular from meat, fish and shellfish, may be associated with increased risk of both global and abdominal obesity among presumably healthy adults in Luxembourg. These findings suggest that lower animal protein intakes may be important for maintenance of healthy body weight.

Could the Sasang constitution itself be a risk factor of abdominal obesity?

PubMed Central

2013-01-01

Background Abdominal obesity (AO) is a medical condition in which excess body fat accumulates in the abdomen. It may cause adverse effects on health and result in reduced life expectancy or increased health problems. While various genetic approaches have explained the risks of AO in Western society, the Sasang constitution (SC) has been identified as a risk factor in Korean medicine. Different SC types are associated with different fat distribution, body shapes and susceptibility to diseases. We evaluated whether the SC type could be a risk for AO in a cross-sectional study among Koreans. Methods In total, 2,528 subjects aged over 30 years were recruited from 23 medical clinics. We collected waist circumference (WC), weight, height, and some clinical information for AO from the subjects. A Chi-square test and a one-way ANOVA were performed according to SC type (p < .05), while multiple logistic regression was used to produce odds ratios (ORs). Results The rates of AO in Tae-eumin (TE), Soeumin (SE), and Soyangin (SY) types were 63.7%, 14.7%, and 32.8% in males and 84.8%, 41.7%, and 52.8% in females, respectively. The TE type was associated with increased AO prevalence compared with the SE and SY types in males (OR 1.79; 95% CI 1.02–3.15, p = 0.044 and OR 1.74; 95% CI 1.18–2.58, p = 0.006, respectively) and females (OR 1.51; 95% CI 1.03–2.23, p = 0.037 and OR 1.88; 95% CI 1.32–2.68, p < 0.001, respectively) after adjusting for age, BMI, hypertension, diabetes mellitus, hypertriglyceridemia, and low HDL cholesterol. Conclusions This study suggested that SC, particularly the TE type, might be significantly and independently associated with AO and could be considered a risk factor in predicting AO. PMID:23548105

Waist circumference cut-off points for identification of abdominal obesity among the tunisian adult population.

PubMed

Bouguerra, R; Alberti, H; Smida, H; Salem, L B; Rayana, C B; El Atti, J; Achour, A; Gaigi, S; Slama, C B; Zouari, B; Alberti, K G M M

2007-11-01

Waist circumference (WC) is a convenient measure of abdominal adipose tissue. It itself is a cardiovascular disease (CVD) and diabetes-risk factor and is strongly linked to other CVD risk factors. There are, however, ethnic differences in the relationship of WC to the other risk factors. The aim of this study was to determine the optimal cut-off points of WC and body mass index (BMI) at which cardiovascular risk factors can be identified with maximum sensitivity and specificity in a representative sample of the Tunisian adult population and to investigate any correlation between WC and BMI. We used a sample of the Tunisian National Nutrition Survey, a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. WC, BMI, blood pressure and fasting blood measurements (plasma glucose, total cholesterol, triglycerides) were recorded. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of WC and BMI to identify with maximum sensitivity and specificity the detection of high blood pressure, hyperglycaemia, high blood cholesterol and hypertriglyceridaemia. ROC curve analysis suggested WC cut-off points of 85 cm in men and 85 cm in women for the optimum detection of high blood pressure, diabetes and dyslipidaemia. The optimum BMI cut-off points for predicting cardiovascular risk factors were 24 kg/m(2) in men and 27 kg/m(2) in women. The cut-off points recommended for the Caucasian population differ from those appropriate for the Tunisian population. The data show a continuous increase in odds ratios of each cardiovascular risk factor, with increasing level of WC and BMI. WC exceeding 85 cm in men and 79 cm in women correctly identified subjects with a BMI of >/=25 kg/m(2), sensitivity of >90% and specificity of >83%. Based on the ROC analysis, we suggest a WC of 85 cm for both men and women as appropriate cut

Lipoprotein(a) Levels in Patients With Abdominal Aortic Aneurysm.

PubMed

Kotani, Kazuhiko; Sahebkar, Amirhossein; Serban, Maria-Corina; Ursoniu, Sorin; Mikhailidis, Dimitri P; Mariscalco, Giovanni; Jones, Steven R; Martin, Seth; Blaha, Michael J; Toth, Peter P; Rizzo, Manfredi; Kostner, Karam; Rysz, Jacek; Banach, Maciej

2017-02-01

Circulating markers relevant to the development of abdominal aortic aneurysm (AAA) are currently required. Lipoprotein(a), Lp(a), is considered a candidate marker associated with the presence of AAA. The present meta-analysis aimed to evaluate the association between circulating Lp(a) levels and the presence of AAA. The PubMed-based search was conducted up to April 30, 2015, to identify the studies focusing on Lp(a) levels in patients with AAA and controls. Quantitative data synthesis was performed using a random effects model, with standardized mean difference (SMD) and 95% confidence interval (CI) as summary statistics. Overall, 9 studies were identified. After a combined analysis, patients with AAA were found to have a significantly higher level of Lp(a) compared to the controls (SMD: 0.87, 95% CI: 0.41-1.33, P < .001). This result remained robust in the sensitivity analysis, and its significance was not influenced after omitting each of the included studies from the meta-analysis. The present meta-analysis confirmed a higher level of circulating Lp(a) in patients with AAA compared to controls. High Lp(a) levels can be associated with the presence of AAA, and Lp(a) may be a marker in screening for AAA. Further studies are needed to establish the clinical utility of measuring Lp(a) in the prevention and management of AAA.

Intake and Dietary Food Sources of Fibre in Spain: Differences with Regard to the Prevalence of Excess Body Weight and Abdominal Obesity in Adults of the ANIBES Study

PubMed Central

González-Rodríguez, Liliana G.; Perea Sánchez, José Miguel; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

2017-01-01

The aim was to study the intake and food sources of fibre in a representative sample of Spanish adults and to analyse its association with excess body weight and abdominal obesity. A sample of 1655 adults (18–64 years) from the ANIBES (“Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles”) cross-sectional study was analysed. Fibre intake and dietary food sources were determined by using a three-day dietary record. Misreporters were identified using the protocol of the European Food Safety Authority. Mean (standard deviation) fibre intake was 12.59 (5.66) g/day in the whole sample and 15.88 (6.29) g/day in the plausible reporters. Mean fibre intake, both in the whole sample and the plausible reporters, was below the adequate intake established by European Food Safety Authority (EFSA) and the Institute of Medicine of the United States (IOM). Main fibre dietary food sources were grains, followed by vegetables, fruits, and pulses. In the whole sample, considering sex, and after adjusting for age and physical activity, mean (standard error) fibre intake (adjusted by energy intake) was higher in subjects who had normal weight (NW) 13.40 (0.184) g/day, without abdominal obesity 13.56 (0.192) g/day or without excess body weight and/or abdominal obesity 13.56 (0.207) g/day compared to those who were overweight (OW) 12.31 (0.195) g/day, p < 0.001 or obese (OB) 11.83 (0.266) g/day, p < 0.001, with abdominal obesity 12.09 (0.157) g/day, p < 0.001 or with excess body weight and/or abdominal obesity 12.22 (0.148) g/day, p < 0.001. There were no significant differences in relation with the fibre intake according to the body mass index (BMI), presence or absence of abdominal obesity or excess body weight and/or abdominal obesity in the plausible reporters. Fibre from afternoon snacks was higher in subjects with NW (6.92%) and without abdominal obesity (6.97%) or without excess body weight and

Intake and Dietary Food Sources of Fibre in Spain: Differences with Regard to the Prevalence of Excess Body Weight and Abdominal Obesity in Adults of the ANIBES Study.

PubMed

González-Rodríguez, Liliana G; Perea Sánchez, José Miguel; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

2017-03-25

The aim was to study the intake and food sources of fibre in a representative sample of Spanish adults and to analyse its association with excess body weight and abdominal obesity. A sample of 1655 adults (18-64 years) from the ANIBES ("Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles") cross-sectional study was analysed. Fibre intake and dietary food sources were determined by using a three-day dietary record. Misreporters were identified using the protocol of the European Food Safety Authority. Mean (standard deviation) fibre intake was 12.59 (5.66) g/day in the whole sample and 15.88 (6.29) g/day in the plausible reporters. Mean fibre intake, both in the whole sample and the plausible reporters, was below the adequate intake established by European Food Safety Authority (EFSA) and the Institute of Medicine of the United States (IOM). Main fibre dietary food sources were grains, followed by vegetables, fruits, and pulses. In the whole sample, considering sex, and after adjusting for age and physical activity, mean (standard error) fibre intake (adjusted by energy intake) was higher in subjects who had normal weight (NW) 13.40 (0.184) g/day, without abdominal obesity 13.56 (0.192) g/day or without excess body weight and/or abdominal obesity 13.56 (0.207) g/day compared to those who were overweight (OW) 12.31 (0.195) g/day, p < 0.001 or obese (OB) 11.83 (0.266) g/day, p < 0.001, with abdominal obesity 12.09 (0.157) g/day, p < 0.001 or with excess body weight and/or abdominal obesity 12.22 (0.148) g/day, p < 0.001. There were no significant differences in relation with the fibre intake according to the body mass index (BMI), presence or absence of abdominal obesity or excess body weight and/or abdominal obesity in the plausible reporters. Fibre from afternoon snacks was higher in subjects with NW (6.92%) and without abdominal obesity (6.97%) or without excess body weight and/or abdominal

Colonic obstruction secondary to incarcerated Spigelian hernia in a severely obese patient.

PubMed

Salemis, Nikolaos S; Kontoravdis, Nikolaos; Gourgiotis, Stavros; Panagiotopoulos, Nikolaos; Gakis, Christos; Dimitrakopoulos, Georgios

2010-01-01

Spigelian hernia is a rare hernia of the ventral abdominal wall accounting for 1-2% of all hernias. Incarceration of a Spigelian hernia has been reported in 17-24% of the cases. We herein describe an extremely rare case of a colonic obstruction secondary to an incarcerated Spigelian hernia in a severely obese patient. Physical examination was inconclusive and diagnosis was established by computed tomography scans. The patient underwent an open intraperitoneal mesh repair. A high level of suspicion and awareness is required as clinical findings of a Spigelian hernia are often nonspecific especially in obese patients. Computed tomography scan provides detailed information for the surgical planning. Open mesh repair is safe in the emergent surgical intervention of a complicated Spigelian hernia in severely obese patients.

Colonic obstruction secondary to incarcerated Spigelian hernia in a severely obese patient

PubMed Central

Salemis, Nikolaos S.; Kontoravdis, Nikolaos; Gourgiotis, Stavros; Panagiotopoulos, Nikolaos; Gakis, Christos; Dimitrakopoulos, Georgios

2010-01-01

Spigelian hernia is a rare hernia of the ventral abdominal wall accounting for 1–2% of all hernias. Incarceration of a Spigelian hernia has been reported in 17–24% of the cases. We herein describe an extremely rare case of a colonic obstruction secondary to an incarcerated Spigelian hernia in a severely obese patient. Physical examination was inconclusive and diagnosis was established by computed tomography scans. The patient underwent an open intraperitoneal mesh repair. A high level of suspicion and awareness is required as clinical findings of a Spigelian hernia are often nonspecific especially in obese patients. Computed tomography scan provides detailed information for the surgical planning. Open mesh repair is safe in the emergent surgical intervention of a complicated Spigelian hernia in severely obese patients. PMID:22096670

Perioperative lung protective ventilation in obese patients.

PubMed

Fernandez-Bustamante, Ana; Hashimoto, Soshi; Serpa Neto, Ary; Moine, Pierre; Vidal Melo, Marcos F; Repine, John E

2015-05-06

The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. The number of surgical patients with obesity is increasing, and facing these challenges is common in the operating rooms and critical care units worldwide. In this review we summarize the existing literature which supports the following recommendations for the perioperative ventilation in obese patients: (1) the use of protective ventilation with low tidal volumes (approximately 8 mL/kg, calculated based on predicted -not actual- body weight) to avoid volutrauma; (2) a focus on lung recruitment by utilizing PEEP (8-15 cmH2O) in addition to recruitment maneuvers during the intraoperative period, as well as incentivized deep breathing and noninvasive ventilation early in the postoperative period, to avoid atelectasis, hypoxemia and atelectrauma; and (3) a judicious oxygen use (ideally less than 0.8) to avoid hypoxemia but also possible reabsorption atelectasis. Obesity poses an additional challenge for achieving adequate protective ventilation during one-lung ventilation, but different lung isolation techniques have been adequately performed in obese patients by experienced providers. Postoperative efforts should be directed to avoid hypoventilation, atelectasis and hypoxemia. Further studies are needed to better define optimum protective ventilation strategies and analyze their impact on the perioperative outcomes of surgical patients with obesity.

Abdominal Assessment.

PubMed

Fritz, Deborah; Weilitz, Pamela Becker

2016-03-01

Abdominal pain is one of the most common complaints by patients, and assessment of abdominal pain and associated symptoms can be challenging for home healthcare providers. Reasons for abdominal pain are related to inflammation, organ distention, and ischemia. The history and physical examination are important to narrow the source of acute or chronic problems, identify immediate interventions, and when necessary, facilitate emergency department care.

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

Higher association of coronary artery calcification with non-alcoholic fatty liver disease than with abdominal obesity in middle-aged Korean men: the Kangbuk Samsung Health Study.

PubMed

Lee, Min-Kyung; Park, Hye-Jeong; Jeon, Won Seon; Park, Se Eun; Park, Cheol-Young; Lee, Won-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung

2015-07-15

It is uncertain whether non-alcoholic fatty liver disease (NAFLD) or abdominal obesity is more associated with atherosclerosis. The aim of this study was to determine whether NAFLD or abdominal obesity is more strongly associated with subclinical atherosclerosis represented by coronary artery calcification (CAC). A total of 21,335 male participants in a health screening program (mean age 41 years) were enrolled. Ultrasonographic measurements of fatty liver and multi-detector computed tomography were performed to determine the coronary artery calcium score (CACS). The presence of CAC was defined as CACS > 0. Subjects were divided into four groups according to the presence or absence of NAFLD and/or abdominal obesity as assessed by waist-hip ratio (WHR) > 0.9. The presence of CAC was detected in 2,385 subjects (11.2%). The proportion of subjects with CAC was highest in the abdominal obesity only group (23.2%). After adjustment for age, diabetes history, hypertension, cigarette smoking, and physical inactivity, the odds ratio (OR) for CAC was the highest in the group with both abnormalities [1.465 (1.324-1.623)]. The NAFLD only group showed significantly increased OR for CAC compared to that in the abdominal obesity only group [1.286 (1.151-1.436) vs. 1.076 (0.939-1.233)]. Non-alcoholic fatty liver disease is more closely associated with CAC than abdominal obesity as assessed by the WHR. NAFLD could be considered an independent determinant of subclinical atherosclerosis as assessed by CAC.

Obesity paradox in patients undergoing coronary intervention: A review

PubMed Central

Patel, Nirav; Elsaid, Ossama; Shenoy, Abhishek; Sharma, Abhishek; McFarlane, Samy I

2017-01-01

There is strong relationship exist between obesity and cardiovascular disease including coronary artery disease (CAD). However, better outcomes noted in obese patients undergoing percutaneous cardiovascular interventions for CAD, a phenomenon known as the obesity paradox. In this review, we performed extensive search for obesity paradox in obese patients undergoing percutaneous coronary intervention and discussed possible mechanism and disparities in different race and sex. PMID:29081905

Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial.

PubMed

Kadooka, Y; Sato, M; Imaizumi, K; Ogawa, A; Ikuyama, K; Akai, Y; Okano, M; Kagoshima, M; Tsuchida, T

2010-06-01

In spite of the much evidence for the beneficial effects of probiotics, their anti-obesity effects have not been well examined. We evaluated the effects of the probiotic Lactobacillus gasseri SBT2055 (LG2055) on abdominal adiposity, body weight and other body measures in adults with obese tendencies. We conducted a multicenter, double-blind, randomized, placebo-controlled intervention trial. Subjects (n=87) with higher body mass index (BMI) (24.2-30.7 kg/m(2)) and abdominal visceral fat area (81.2-178.5 cm(2)) were randomly assigned to receive either fermented milk (FM) containing LG2055 (active FM; n=43) or FM without LG2055 (control FM; n=44), and were asked to consume 200 g/day of FM for 12 weeks. Abdominal fat area was determined by computed tomography. In the active FM group, abdominal visceral and subcutaneous fat areas significantly (P<0.01) decreased from baseline by an average of 4.6% (mean (confidence interval): -5.8 (-10.0, -1.7) cm(2)) and 3.3% (-7.4 (-11.6, -3.1) cm(2)), respectively. Body weight and other measures also decreased significantly (P<0.001) as follows: body weight, 1.4% (-1.1 (-1.5, -0.7) kg); BMI, 1.5% (-0.4 (-0.5, -0.2) kg/m(2)); waist, 1.8% (-1.7 (-2.1, -1.4) cm); hip, 1.5% (-1.5 (-1.8, -1.1) cm). In the control group, by contrast, none of these parameters decreased significantly. High-molecular weight adiponectin in serum increased significantly (P<0.01) in the active and control groups by 12.7% (0.17 (0.07, 0.26) microg/ml) and 13.6% (0.23 (0.07, 0.38) microg/ml), respectively. The probiotic LG2055 showed lowering effects on abdominal adiposity, body weight and other measures, suggesting its beneficial influence on metabolic disorders.

Effect of beta-adrenergic stimulation on whole-body and abdominal subcutaneous adipose tissue lipolysis in lean and obese men.

PubMed

Jocken, J W E; Goossens, G H; van Hees, A M J; Frayn, K N; van Baak, M; Stegen, J; Pakbiers, M T W; Saris, W H M; Blaak, E E

2008-02-01

Obesity is characterised by increased triacylglycerol storage in adipose tissue. There is in vitro evidence for a blunted beta-adrenergically mediated lipolytic response in abdominal subcutaneous adipose tissue (SAT) of obese individuals and evidence for this at the whole-body level in vivo. We hypothesised that the beta-adrenergically mediated effect on lipolysis in abdominal SAT is also impaired in vivo in obese humans. We investigated whole-body and abdominal SAT glycerol metabolism in vivo during 3 h and 6 h [2H5]glycerol infusions. Arterio-venous concentration differences were measured in 13 lean and ten obese men after an overnight fast and during intravenous infusion of the non-selective beta-adrenergic agonist isoprenaline [20 ng (kg fat free mass)(-1) min(-1)]. Lean and obese participants showed comparable fasting glycerol uptake by SAT (9.7+/-3.4 vs 9.3+/-2.5% of total release, p=0.92). Furthermore, obese participants showed an increased whole-body beta-adrenergically mediated lipolytic response versus lean participants. However, their fasting lipolysis was blunted [glycerol rate of appearance: 7.3+/-0.6 vs 13.1+/-0.9 micromol (kg fat mass)(-1) min(-1), p<0.01], as was the beta-adrenergically mediated lipolytic response per unit SAT [Delta total glycerol release: 140+/-71 vs 394+/-112 nmol (100 g tissue)(-1) min(-1), p<0.05] compared with lean participants. Net triacylglycerol flux tended to increase in obese compared with lean participants during beta-adrenergic stimulation [Delta net triacylglycerol flux: 75+/-32 vs 16+/-11 nmol (100 g tissue)(-1) min(-1), p=0.06]. We demonstrated in vivo that beta-adrenergically mediated lipolytic response is impaired systematically and in abdominal SAT of obese versus lean men. This may be important in the development or maintenance of increased triacylglycerol stores and obesity.

[When should a patient with abdominal pain be referred to the emergency ward?].

PubMed

de Saussure, Wassila Oulhaci; Andereggen, Elisabeth; Sarasin, François

2010-08-25

When should a patient with abdominal pain be referred to the emergency ward? The following goals must be achieved upon managing patients with acute abdominal pain: 1) identify vital emergency situations; 2) detect surgical conditions that require emergency referral without further diagnostic procedures; 3) in "non surgical acute abdomen patients" perform appropriate diagnostic procedures, or in selected cases delay tests and reevaluate the patient after an observation period, after which a referral decision is made. Clues from the history and physical examination are critical to perform this evaluation. A good knowledge of the most frequent acute abdominal conditions, and identifying potential severity criteria allow an appropriate management and decision about emergency referral.

Abdominal pain in adult sickle cell disease patients: a nigerian experience.

PubMed

Akingbola, T S; Kolude, B; Aneni, E C; Raji, A A; Iwara, K U; Aken'Ova, Y A; Soyannwo, O A

2011-12-01

Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence, diagnostic dilemma, and the need for an accurate, early diagnosis, abdominal pain in sickle cell disease has not been rigorously studied. We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. A prospective case series of 20 patients was done in which data was collected on demographic characteristics, hemoglobin electrophoresis patterns, a description of the abdominal pain including sites, severity, and type of pain, packed cell volume and the provisional and final diagnosis. Haemoglobin S patients were 17 in number constituting eightyfive percent (85%) of our study population whilst the rest 3 were Hb S+C. Most patients (70%) had one site of abdominal pain. The pain was mainly colicky or tightening, moderate to severe in nature and, in some cases, associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8% of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67%. Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving.

Coping behavior and loneliness among obese patients.

PubMed

Hörchner, Rogier; Tuinebreijer, Wim E; Kelder, Hans; van Urk, Elly

2002-12-01

Morbid obesity can be accompanied by physical and social problems that may influence interpersonal relationships and the recruitment of social support. The problems can be tackled with a variety of coping strategies. 104 patients with a body mass index (BMI) 32-64 kg/m2 and mean age 36 yr were presented with the Utrecht Coping List (UCL) and the Loneliness Scale. Of these patients, 94 were female, and this cohort was analyzed more extensively. Patients exhibited elevated values on the Loneliness Scale and in the UCL sub-scales palliative response, avoidance / wait-and-see, passive / depressive response pattern and expression of emotions / anger. The active approach UCL sub-scale scored lower than in a control group. Obese female patients displayed avoidance, wait-and-see and passive response pattern as coping behavior, experiencing their intimate relationships as relatively unreliable and not very intimate. More research is needed to determine the effect of coping behavior on therapeutic effect.

The Effects of Exercise on Abdominal Fat and Liver Enzymes in Pediatric Obesity: A Systematic Review and Meta-Analysis.

PubMed

González-Ruiz, Katherine; Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique; Peterson, Mark D; García-Hermoso, Antonio

2017-08-01

Despite the prevalence of obesity and the multiple position stands promoting exercise for the treatment of obesity and hepatic function, a meta-analytic approach has not previously been used to examine the effects in the pediatric population. The aim of the study was to determine the effectiveness of exercise interventions on abdominal fat, liver enzymes, and intrahepatic fat in overweight and obese youth. A computerized search was made using three databases. The analysis was restricted to studies that examined the effect of supervised exercise interventions on abdominal fat (visceral and subcutaneous fat), liver enzymes (alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase), and intrahepatic fat. Fourteen clinical trials (1231 youths) were eligible for inclusion in this systematic review and meta-analysis. Standardized mean difference [SMD] and 95% confidence intervals (CIs) were calculated. Exercise was associated with a significant reduction in visceral (SMD = -0.661; 95% CI, -0.976 to -0.346; p < 0.001), subcutaneous (SMD = -0.352; 95% CI, -0.517 to -0.186; p < 0.001) and intrahepatic fat (SMD = -0.802; 95% CI, -1.124 to -0.480; p < 0.001), as well as gamma-glutamyl transferase (SMD = -0.726; 95% CI, -1.203 to -0.249; p < 0.001), but did not alter any other liver enzyme. Subgroup analysis recommends exercise programs that involve aerobic exercise longer than three sessions per week. This meta-analysis supports current recommendation for physical exercise, mainly aerobic, as an effective intervention for nonalcoholic fatty liver disease progression by targeting hepatic lipid composition, visceral and subcutaneous adipose tissue. Systematic review registration: PROSPERO CRD42016042163.

Adherence to the Baltic Sea diet consumed in the Nordic countries is associated with lower abdominal obesity.

PubMed

Kanerva, Noora; Kaartinen, Niina E; Schwab, Ursula; Lahti-Koski, Marjaana; Männistö, Satu

2013-02-14

Due to differences in food cultures, dietary quality measures, such as the Mediterranean Diet Score, may not be easily adopted by other countries. Recently, the Baltic Sea Diet Pyramid was developed to illustrate healthy choices for the diet consumed in the Nordic countries. We assessed whether the Baltic Sea Diet Score (BSDS) based on the Pyramid is associated with a decreased risk of obesity and abdominal obesity. The population-based cross-sectional study included 4720 Finns (25-74 years) from the National FINRISK 2007 study. Diet was assessed using a validated FFQ. The score included Nordic fruits and berries, vegetables, cereals, ratio of PUFA:SFA and trans-fatty acids, low-fat milk, fish, red and processed meat, total fat (percentage of energy), and alcohol. Height, weight and waist circumference (WC) were measured and BMI values were calculated. In a multivariable model, men in the highest v. lowest BSDS quintile were more likely to have normal WC (OR 0·48, 95 % CI 0·29, 0·80). In women, this association was similar but not significant (OR 0·65, 95 % CI 0·39, 1·09). The association appeared to be stronger in younger age groups (men: OR 0·23, 95 % CI 0·08, 0·62; women: OR 0·17, 95 % CI 0·05, 0·58) compared with older age groups. Nordic cereals and alcohol were found to be the most important BSDS components related to WC. No association was observed between the BSDS and BMI. The present study suggests that combination of Nordic foods, especially cereals and moderate alcohol consumption, is likely to be inversely associated with abdominal obesity.

The obese patient undergoing nonbariatric surgery.

PubMed

Bluth, Thomas; Pelosi, Paolo; de Abreu, Marcelo Gama

2016-06-01

This article provides the reader with recent findings on the pathophysiology of comorbidities in the obese, as well as evidence-based treatment options to deal with perioperative respiratory challenges. Our understanding of obesity-associated asthma, obstructive sleep apnea, and obesity hypoventilation syndrome is still expanding. Routine screening for obstructive sleep apnea using the STOP-Bang score might identify high-risk patients that benefit from perioperative continuous positive airway pressure and close postoperative monitoring. Measures to most effectively support respiratory function during induction of and emergence from anesthesia include optimal patient positioning and use of noninvasive positive pressure ventilation. Appropriate mechanical ventilation settings are under investigation, so that only the use of protective low tidal volumes could be currently recommended. A multimodal approach consisting of adjuvants, as well as regional anesthesia/analgesia techniques reduces the need for systemic opioids and related respiratory complications. Anesthesia of obese patients for nonbariatric surgical procedures requires knowledge of typical comorbidities and their respective treatment options. Apart from cardiovascular diseases associated with the metabolic syndrome, awareness of any pulmonary dysfunction is of paramount. A multimodal analgesia approach may be useful to reduce postoperative pulmonary complications.

Malnutrition in morbidly obese patients: fact or fiction?

PubMed

Kaidar-Person, O; Rosenthal, R J

2009-06-01

Reports of nutritional deficiencies after Bariatric surgery have lead investigators to inquire about the preoperative nutritional status of morbidly obese patients. Interestingly, numerous reports demonstrated a pattern of low levels of various micronutrients among overweight and obese patients, even in comparison with normal weight population. In this article we reviewed the literature for micronutrient deficiencies in obese patients prior to weight reduction surgery.

Outcome following total knee arthroplasty in obese versus non-obese Asian patients.

PubMed

Goh, Graham Seow-Hng; Liow, Ming Han Lincoln; Mitra, Amit Kanta

2015-12-01

To compare the outcome following total knee arthroplasty (TKA) in obese and non-obese Asian patients. 27 obese patients were compared with 27 non-obese controls matched for age, gender, diagnosis (osteoarthritis), prosthesis, preoperative Knee Society knee and function scores, preoperative Oxford Knee Score, and follow-up duration. All TKAs were performed by a single surgeon. Patients were assessed at 6 months and 2 years for the range of motion, Knee Society knee and function scores, Oxford Knee Score, and Short Form-36 Health Survey (SF-36). The obese and non-obese groups did not differ significantly in pre- and post-operative variables: range of motion, Knee Society knee and function scores, Oxford Knee Score, and SF-36 score. Using revision as an end-point, implant survival was 100%. There were no intra- or post-operative complications in either group. Obese and non-obese Asian patients achieved a comparable outcome following TKA.

Massive Blood Transfusion in Patients with Ruptured Abdominal Aortic Aneurysm.

PubMed

Montan, C; Hammar, U; Wikman, A; Berlin, E; Malmstedt, J; Holst, J; Wahlgren, C M

2016-11-01

The aim was to study blood transfusions and blood product ratios in massively transfused patients treated for ruptured abdominal aortic aneurysms (rAAAs). This was a registry based cohort study of rAAA patients repaired at three major vascular centres between 2008 and 2013. Data were collected from the Swedish Vascular Registry, hospitals medical records, and local transfusion registries. The transfusion data were analysed for the first 24 h of treatment. Massive transfusion (MT) was defined as 4 or more units of red blood cell (RBC) transfused within 1 h, or 10 or more RBC units within 24 h. Logistic regression was used to calculate the odds ratio of 30 day mortality associated with the ratios of blood products and timing of first units of platelets (PLTs) and fresh frozen plasma (FFP) transfused. Three hundred sixty nine rAAA patients were included: 80% men; 173 endovascular aneurysm repairs (EVARs) and 196 open repairs (ORs) with median RBC transfusion 8 units (Q1-Q3, 4-14) and 14 units (Q1-Q3, 8-28), respectively. A total of 261 (71%) patients required MT. EVAR patients with MT (n = 96) required less transfusion than OR patients (n = 165): median RBC 10 units (Q1-Q3, 6-16.5) vs. 15 units (Q1-Q3, 9-26) (p = .002), FFP 6 units (Q1-Q3, 2-14.5) vs. 13 units (Q1-Q3, 7-24) (p < .001), and PLT 0 units (Q1-Q3, 0-2) vs. 2 units (Q1-Q3, 0-4) (p = .01). Median blood product ratios in MT patients were FFP/RBC (EVAR group 0.59 [0.33-0.86], OR group 0.84 [0.67-1.2]; p < .001], and PLT/RBC (EVAR 0 [0-0.17], OR 0.12 (0-0.18); p < .001]. In patients repaired by OR a FFP/RBC ratio close to 1 was associated with reduced 30 day mortality (p = .003). The median PLT/RBC ratio was higher during the later part of the study period (p < .001, median test), whereas there was no significant difference in median FFP/RBC ratio (p = .101, median test). The majority of rAAA patients undergoing EVAR required MT. EVAR patients treated with MT had lower FFP/RBC and PLT

Multiple abdominal cysts in a patient with Gorlin-Goltz syndrome: a case report.

PubMed

Haenen, F; Hubens, G; Creytens, D; Vaneerdeweg, W

2013-01-01

A rare case of symptomatic mesenteric cysts in a patient with Gorlin-Goltz syndrome, associated with various neoplasms, is presented. The patient, known with Gorlin-Goltz syndrome, consulted with increasingly severe abdominal pain and large abdominal cysts. At surgery, the cysts were excised and the postoperative course was uneventful. In conclusion, this case reminds clinicians to always maintain a wide differential diagnosis when dealing with patients known with Gorlin-Goltz syndrome.

Associated cutaneous diseases in obese adult patients: a prospective study from a skin referral care center.

PubMed

Al-Mutairi, Nawaf

2011-01-01

The aim of the present study was to determine the spectrum of skin diseases seen among adult obese patients referred to Farwaniya Hospital. A total of 437 overweight/obese subjects (200 men and 237 women) aged 18-74 years were enrolled in the study, which was conducted from October 2008 to November 2009. Demographic details such as age, sex, occupation, personal and family history of diabetes mellitus, hypertension, and obesity were recorded. A thorough examination was performed by an experienced dermatologist (N.A.M.). Blood investigations such as complete blood count, fasting and postprandial blood sugar levels, liver function tests, kidney function tests, lipid profile, and thyroid function tests were done for all patients in addition to hormonal assay and abdominal sonar to exclude polycystic ovary disease for indicated patients. Common skin diseases found among these patients were plantar hyperkeratosis: n = 197; acanthosis nigricans: n = 144; skin tags: n = 131; striae cutis distensae: n = 102; intertrigo: n = 97; acne vulgaris: n = 94. Diabetes mellitus was diagnosed in 87 patients, polycystic ovary syndrome/hyperandrogenism in 74 female patients, and hyperlipidemia in 209 patients. This study shows that certain dermatoses such as plantar hyperkeratosis, acanthosis nigricans, skin tags, striae cutis distensae, and intertrigo are more common among obese persons. Some, such as plantar hyperkeratosis, could serve as markers of obesity and its severity, while the presence of acanthosis nigricans and skin tags may point to underlying internal disease such as diabetes and polycystic ovary syndrome. Copyright © 2011 S. Karger AG, Basel.

Surgery for Gastroesophageal Reflux Disease in the Morbidly Obese Patient.

PubMed

Duke, Meredith C; Farrell, Timothy M

2017-01-01

The prevalence of gastroesophageal reflux disease (GERD) has mirrored the increase in obesity, and GERD is now recognized as an obesity-related comorbidity. There is growing evidence that obesity, specifically central obesity, is associated with the complications of chronic reflux, including erosive esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. While fundoplication is effective in creating a competent gastroesophageal junction and controlling reflux in most patients, it is less effective in morbidly obese patients. In these patients a bariatric operation has the ability to correct both the obesity and the abnormal reflux. The Roux-en-Y gastric bypass is the preferred procedure.

Clinical and critical care concerns in severely ill obese patient

PubMed Central

Bajwa, Sukhminder Jit Singh; Sehgal, Vishal; Bajwa, Sukhwinder Kaur

2012-01-01

The incidence of obesity has acquired an epidemic proportion throughout the globe. As a result, increasing number of obese patients is being presented to critical care units for various indications. The attending intensivist has to face numerous challenges during management of such patients. Almost all the organ systems are affected by the impact of obesity either directly or indirectly. The degree of obesity and its prolong duration are the main factors which determine the harmful effect of obesity on human body. The present article reviews few of the important clinical and critical care concerns in critically ill obese patients. PMID:23087857

Effect of Daikenchuto (TJ-100) on abdominal bloating in hepatectomized patients.

PubMed

Hanazaki, Kazuhiro; Ichikawa, Kengo; Munekage, Masaya; Kitagawa, Hiroyuki; Dabanaka, Ken; Namikawa, Tsutomu

2013-04-27

To evaluate the clinical usefulness of Daikenchuto (DKT) in hepatecomized patients. Twenty patients were enrolled with informed consent. Two patients were excluded because of cancelled operations. The remaining 18 patients were randomly chosen for treatment with DKT alone or combination therapy of DKT and lactulose (n = 9, each group). Data were prospectively collected. Primary end points were Visual Analogue Scale (VAS) score for abdominal bloating, total Gastrointestinal Symptoms Rating Scale (GSRS) score for abdominal symptoms, and GSRS score for abdominal bloating. The VAS score for abdominal bloating and total GSRS score for abdominal symptoms recovered to levels that were not significantly different to preoperative levels by 10 d postoperation. Combination therapy of DKT and lactulose was associated with a significantly poorer outcome in terms of VAS and GSRS scores for abdominal bloating, total GSRS score, and total daily calorie intake, when compared with DKT alone therapy. DKT is a potentially effective drug for postoperative management of hepatectomized patients, not only to ameliorate abdominal bloating, but also to promote nutritional support by increasing postoperative dietary intake.

Effect of Daikenchuto (TJ-100) on abdominal bloating in hepatectomized patients

PubMed Central

Hanazaki, Kazuhiro; Ichikawa, Kengo; Munekage, Masaya; Kitagawa, Hiroyuki; Dabanaka, Ken; Namikawa, Tsutomu

2013-01-01

AIM: To evaluate the clinical usefulness of Daikenchuto (DKT) in hepatecomized patients. METHODS: Twenty patients were enrolled with informed consent. Two patients were excluded because of cancelled operations. The remaining 18 patients were randomly chosen for treatment with DKT alone or combination therapy of DKT and lactulose (n = 9, each group). Data were prospectively collected. Primary end points were Visual Analogue Scale (VAS) score for abdominal bloating, total Gastrointestinal Symptoms Rating Scale (GSRS) score for abdominal symptoms, and GSRS score for abdominal bloating. RESULTS: The VAS score for abdominal bloating and total GSRS score for abdominal symptoms recovered to levels that were not significantly different to preoperative levels by 10 d postoperation. Combination therapy of DKT and lactulose was associated with a significantly poorer outcome in terms of VAS and GSRS scores for abdominal bloating, total GSRS score, and total daily calorie intake, when compared with DKT alone therapy. CONCLUSION: DKT is a potentially effective drug for postoperative management of hepatectomized patients, not only to ameliorate abdominal bloating, but also to promote nutritional support by increasing postoperative dietary intake. PMID:23671738

Ultrasound-guided percutaneous tracheostomy in critically ill obese patients

PubMed Central

2012-01-01

Introduction The purpose of this study was to evaluate the feasibility of ultrasound (US)-guided percutaneous tracheostomy (PCT) and the incidence of complications in critically ill, obese patients. Methods Fifty consecutive patients were included in a prospective study in two surgical and critical care medicine departments. Obesity was defined as a body mass index (BMI) of at least 30 kg/m2. The feasibility of PCT and the incidence of complications were compared in obese patients (n = 26) and non-obese patients (n = 24). Results are expressed as the median (25th-75th percentile) or number (percentage). Results The median BMIs were 34 kg/m2 (32-38) in the obese patient group and 25 kg/m2 (24-28) in the non-obese group (p < 0.001). The median times for tracheostomy were 10 min (8-14) in non-obese patients and 9 min (5-10) in obese-patients (p = 0.1). The overall complication rate was similar in obese and non-obese patient groups (35% vs. 33%, p = 0.92). Most complications were minor (hypotension, desaturation, tracheal cuff puncture and minor bleeding), with no differences between obese and non-obese groups. Bronchoscopic inspection revealed two cases of granuloma (8%) in obese patients. One non-obese patient developed a peristomal skin infection, which was treated with intravenous antibiotics. Ultrasound-guided PCT was possible in all enrolled patients and there were no surgical conversions or deaths. Conclusions This study demonstrated that US-guided PCT is feasible in obese patients with a low complication rate. Obesity may not constitute a contra-indication for US-guided PCT. A US examination provides information on cervical anatomy and hence modifies and guides choice of the PCT puncture site. Trial registration ClinicalTrials.gov: NCT01502657. PMID:22390815

Ultrasound-guided percutaneous tracheostomy in critically ill obese patients.

PubMed

Guinot, Pierre-Grégoire; Zogheib, Elie; Petiot, Sandra; Marienne, Jean-Pierre; Guerin, Anne-Marie; Monet, Pauline; Zaatar, Rody; Dupont, Hervé

2012-12-12

The purpose of this study was to evaluate the feasibility of ultrasound (US)-guided percutaneous tracheostomy (PCT) and the incidence of complications in critically ill, obese patients. Fifty consecutive patients were included in a prospective study in two surgical and critical care medicine departments. Obesity was defined as a body mass index (BMI) of at least 30 kg/m². The feasibility of PCT and the incidence of complications were compared in obese patients (n = 26) and non-obese patients (n = 24). Results are expressed as the median (25th-75th percentile) or number (percentage). The median BMIs were 34 kg/m² (32-38) in the obese patient group and 25 kg/m² (24-28) in the non-obese group (p < 0.001). The median times for tracheostomy were 10 min (8-14) in non-obese patients and 9 min (5-10) in obese-patients (p = 0.1). The overall complication rate was similar in obese and non-obese patient groups (35% vs. 33%, p = 0.92). Most complications were minor (hypotension, desaturation, tracheal cuff puncture and minor bleeding), with no differences between obese and non-obese groups. Bronchoscopic inspection revealed two cases of granuloma (8%) in obese patients. One non-obese patient developed a peristomal skin infection, which was treated with intravenous antibiotics. Ultrasound-guided PCT was possible in all enrolled patients and there were no surgical conversions or deaths. This study demonstrated that US-guided PCT is feasible in obese patients with a low complication rate. Obesity may not constitute a contra-indication for US-guided PCT. A US examination provides information on cervical anatomy and hence modifies and guides choice of the PCT puncture site. ClinicalTrials.gov: NCT01502657.

Optimizing care for the obese patient in interventional radiology

PubMed Central

Aberle, Dwight; Charles, Hearns; Hodak, Steven; O’Neill, Daniel; Oklu, Rahmi; Deipolyi, Amy R.

2017-01-01

With the rising epidemic of obesity, interventional radiologists are treating increasing numbers of obese patients, as comorbidities associated with obesity preclude more invasive treatments. These patients are at heightened risk of vascular and oncologic disease, both of which often require interventional radiology care. Obese patients pose unique challenges in imaging, technical feasibility, and periprocedural monitoring. This review describes the technical and clinical challenges posed by this population, with proposed methods to mitigate these challenges and optimize care. PMID:28082253

[Risk factors for nosocomial pneumonia in patients with abdominal surgery].

PubMed

Evaristo-Méndez, Gerardo; Rocha-Calderón, César Haydn

2016-01-01

The risk of post-operative pneumonia is a latent complication. A study was conducted to determine its risk factors in abdominal surgery. A cross-sectional study was performed that included analysing the variables of age and gender, chronic obstructive pulmonary disease and smoking, serum albumin, type of surgery and anaesthesia, emergency or elective surgery, incision site, duration of surgery, length of hospital stay, length of stay in the intensive care unit, and time on mechanical ventilation. The adjusted odds ratio for risk factors was obtained using multivariate logistic regression. The study included 91 (9.6%) patients with pneumonia and 851 (90.4%) without pneumonia. Age 60 years or over (OR=2.34), smoking (OR=9.48), chronic obstructive pulmonary disease (OR=3.52), emergency surgery (OR=2.48), general anaesthesia (OR=3.18), surgical time 120 minutes or over (OR=5.79), time in intensive care unit 7 days or over (OR=1.23), time on mechanical ventilation greater than or equal to 4 days (OR=5.93) and length of post-operative hospital stay of 15 days or over (OR=1.20), were observed as independent predictors for the development of postoperative pneumonia. Identifying risk factors for post-operative pneumonia may prevent their occurrence. The length in the intensive care unit of greater than or equal to 7 days (OR=1.23; 95% CI 1.07 - 1.42) and a length postoperative hospital stay of 15 days or more (OR=1.20; 95% CI 1.07 - 1.34) were the predictive factors most strongly associated with lung infection in this study. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

[Transcranial magneto- and electrostimulation in patients with obesity and erectile dysfunction].

PubMed

Ponomarenko, G N; Bin'iash, T G; Raĭgorodskiĭ, Iu M; Guliaev, A S; Shul'diakov, V A; Kiriliuk, A M; Vartanova, L Iu

2009-01-01

The objective of the present study was to evaluate therapeutic efficiency of transcranial magnetotherapy (TcMT) and electric stimulation (ES) included in the combined treatment of 143 patients with erectile dysfunction (ED) and abdominal obesity. The majority of the patients had waist circumference over 102 cm. An AMO-ATOS complex was used to stimulate the hypothalamic region and other brain structures. Transdermal myostimulation of the abdominal and femoral regions was achieved with a Miovolna device. It was shown that both TcM and ES improved lipid metabolism and erectile function; moreover, they exerted hypotensive and sedative action. Specifically, the testosterone level in the patients increased by a mean of 27% compared with the pre-treatment values while the number of patients complaining of erectile dysfunction decreased by 31%.

Functional disability in paediatric patients with recurrent abdominal pain.

PubMed

Wendland, M; Jackson, Y; Stokes, L D

2010-07-01

Recurrent abdominal pain (RAP) is common in childhood, affecting approximately 12% of children and adolescents. Children with RAP tend to experience impairments in functioning, such as increased school absences, anxiety and depression. The current study investigated the potential influences on the relation between functional disability and RAP in 100 school-aged children. A series of hierarchical regression analyses were conducted to test two models: main effects and moderation of the relation between abdominal pain symptoms, child anxiety, child depression, maternal emotional distress, maternal encouragement of child illness behaviour and functional disability. The results indicated support for abdominal pain symptoms and child depression in predicting functional disability. The results also indicated that child anxiety and child depression each moderated the relation between pain symptoms and functional disability. Implications of the findings are discussed in terms of potential influences on the development of functional disability in youth.

[Self-perception in obese patients].

PubMed

Ríos-Martínez, Blanca P; Rangel-Rodríguez, Gabriela Alejandra

2011-01-01

The perception of obese people has about themselves is often paradoxical, seeing themselves with several virtues and flaws that take them to have an ambiguous attitude about themselves. The aim was to evaluate the perception that the obese people has about their body and relationships. Multidimensional Body-Self Relations Questionnaire was applied; obtaining a descriptive analysis (mean and standard deviation) of each item and contrasting by gender (male and female) and proposal treatment (surgical and nonsurgical). Significant differences were found (p value<.05) between genders and type of treatment in some phrases of the applied questionnaire. Self-perception in the obese patient seems to be strongly related to the perception that society has of them, which is usually negative in relation to their appearance. Patients tend to perceive themselves as unappealing, although this perception is greater in patients canalized to surgical treatment; likewise, tendency to think about their appearance is greater in non-surgical patients. About personal care, it was found that participants pay less attention to improving their personal appearance, women having a slightly greater concern.

[Eating habits of patients with severe obesity].

PubMed

Reséndiz Barragán, Aída Monserrat; Hernández Altamirano, Sheila Viridiana; Sierra Murguía, Mariana Alejandra; Torres Tamayo, Margarita

2014-11-30

Severe obesity is a health problem that has medical, emotional and economic consequences. The etiology of severe obesity is multifactorial; however, it is known that the eating habits represent a major factor in the development of this disease. This study aimed to identify eating patterns and specific habits that need to be changed to achieve weight loss. An observational, descriptive, retrospective and cross-sectional study with 250 candidates for bariatric surgery, 79.2% women and 20.8% men aged 37.7 ± 10.2 years and 44.3 ± 7.7 kg/m2 BMI patients was performed. It was found that "drinking water", "eat faster than most people", "leave the plate empty", "have long fasts", "sweet cravings", and "drinking soda" were the most common habits in patients with severe obesity. The existence of significant differences between the habits of men and women and between BMI strata or groups are also discussed. "Snacking" and "eat until you feel uncomfortable" were significantly different between men and women and "eat by yourself because you feel ashamed of eating with others" was significant between BMI strata. It was concluded that it is important that the treatment of these patients includes assessment techniques and behavior modification aimed at these habits. It is recommended to include in future studies patients with normal weight and overweight as well as the use of instruments with adequate psychometric properties. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease.

PubMed

Graham, Emily; Rao, Krishna; Cinti, Sandro

2017-01-01

Few studies exist to guide the treatment approach to intra-abdominal abscesses in Crohn disease, which can include antimicrobials alone or in conjunction with percutaneous drainage or surgery. The primary aim of this study is to review outcomes from different treatment approaches to intra-abdominal abscess in Crohn disease. Medical records were reviewed for patients admitted to the University of Michigan health care system with Crohn disease and intra-abdominal abscess over a 4-year period. Outcomes were compared among medical and interventional approaches. The χ 2 test was used to test for statistical significance. Of the 33 patients included, 13 were in the medical group and 20 were in the interventional group. Abscess recurrence/nonresolution occurred in 31% of patients in the medical group and 25% of patients in the interventional group ( P = .7). In this study, there was no significant difference in outcome between medical and interventional therapy for intra-abdominal abscess in Crohn disease.

Postoperative Development of Abdominal Compartment Syndrome among Patients Undergoing Endovascular Aortic Repair for Ruptured Abdominal Aortic Aneurysms.

PubMed

Miranda, Elizabeth; Manzur, Miguel; Han, Sukgu; Ham, Sung Wan; Weaver, Fred A; Rowe, Vincent L

2018-05-01

Abdominal compartment syndrome (ACS) has a reported incidence of 9%-14% among trauma patients. However, in patients with similar hemodynamic changes, the incidence of ACS remains unclear. Our aim was to determine the incidence of ACS among patients undergoing endovascular aortic repair (EVAR) for ruptured abdominal aortic aneurysms (rAAAs) and to identify associated risk factors. A retrospective review was performed for consecutive patients who underwent EVAR for rAAA from March 2010 to November 2016 at our institution. The development of ACS was diagnosed based on a variety of factors, including bladder pressure, laboratory abnormalities, hemodynamic monitoring, and clinical evaluation. Previously validated risk factors for ACS development in trauma and EVAR patients (preoperative hypotension, aggressive fluid resuscitation, postoperative anemia, use of an aorto-uniiliac graft, and placement of an aortic occlusive balloon) were analyzed. Association between patient characteristics and ACS development was analyzed using the Fisher's exact test. During the study period, 25 patients had image-confirmed rAAA and underwent emergent EVAR. Mortality rate was 28% (n = 7), and ACS incidence was 12% (n = 3). Of the analyzed risk factors, hypotension on arrival (P = 0.037), transfusion of 3 or more units of packed red blood cells (P = 0.037), and postoperative anemia (P = 0.02) were all significantly associated with postoperative ACS development. In addition, having greater than 3 of the studied risk factors was associated with increased odds of developing ACS (P = 0.015), and having greater than 4 of the studied risk factors showed the strongest association with ACS development (P = 0.0017). Overresuscitation should be avoided in patients with rAAA. In addition, patients who present with multiple risk factors for ACS should be monitored very closely with serial bladder pressures and may require decompression laparotomy immediately after EVAR. Copyright © 2018

A renal transplant patient with abdominal discomfort, vomiting and diarrhoea for 1 week.

PubMed

Lutwak, Nancy; Dill, Curt

2011-08-24

The patient is a 61-year-old diabetic male with history of renal transplant who presented to the emergency department with complaints of intermittent abdominal discomfort accompanied by multiple episodes of vomiting and diarrhoea. He had delayed seeking medical attention until his friends insisted that he come to the emergency department, since the abdominal discomfort was worsening. The patient's ECG revealed an ST-segment elevation myocardial infarction.

Burns in Morbidly Obese Patients,

DTIC Science & Technology

1992-12-01

1970-1990, there were 4995 pa- and one Aspergillus wound infection. Two patients de- ’ tients admitted to the United States Army Institute of Surgical...8217 kg (296 Ib ) to 208.9 kg (459.6 lb). The average weight pulmonary embolism (0.99 Cl, I1.8%-9,1.5%) signifi- was 153.1 kg (336.8 1lb). Height ranged

Screening ultrasonography of 2,204 patients with blunt abdominal trauma in the Wenchuan earthquake.

PubMed

Zhou, Jixiang; Huang, Jiwei; Wu, Hong; Jiang, Hui; Zhang, Heqing; Prasoon, Pankaj; Xu, Yinglong; Bai, Yannan; Qiu, Jianguo; Zeng, Yong

2012-10-01

Abdominal injuries constitute a small proportion of all earthquake-related traumas; however, it often resulted in fatal hemorrhage. Ultrasonography has been described as an effective triage tool in the evaluation of blunt abdominal trauma. We aimed to present an overview of the diagnostic accuracy of screening ultrasonography for patients with blunt abdominal trauma admitted to various hospitals during the Wenchuan earthquake in China. We retrospectively analyzed the patients with blunt abdominal trauma who underwent ultrasonography after admission to various hospitals. Ultrasonography findings were considered positive if evidence of free fluid or a parenchymal injury was identified. Ultrasonography findings were compared with the findings of computed tomography, diagnostic peritoneal lavage, repeated ultrasonography, cystography, operation, and/or the clinical course. Findings from 2,204 ultrasonographic examinations were evaluated. Findings of 199 ultrasonographic examinations (9.0%) were considered positive. Of the patients, 12 (0.5%) had a false-negative ultrasonographic findings; of this group, 3 (25%) required exploratory laparotomy. Ultrasonography had a sensitivity of 91.9%, specificity of 96.9%, and an accuracy of 96.6% for detection of abdominal injuries. Positive predictive value was 68.3%, and negative predictive value was 99.4%. Screening ultrasonography is highly reliable in the setting of blunt abdominal trauma after earthquake. It should be used as an initial diagnostic modality in the evaluation of most blunt abdominal trauma. Diagnostic study, level III.

Effects of canola and high-oleic-acid canola oils on abdominal fat mass in individuals with central obesity.

PubMed

Liu, Xiaoran; Kris-Etherton, Penny M; West, Sheila G; Lamarche, Benoît; Jenkins, David J A; Fleming, Jennifer A; McCrea, Cindy E; Pu, Shuaihua; Couture, Patrick; Connelly, Philip W; Jones, Peter J H

2016-11-01

To determine the effect of diets low in saturated fatty acids and high in monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids on body composition in participants at risk for metabolic syndrome (MetS). This study was a randomized, crossover, controlled feeding study. Participants (n = 101, ages 49.5 ± 1.2, BMI 29.4 ± 0.4 kg/m 2 ) were randomized to five isocaloric diets containing treatment oils: Canola, CanolaOleic, CanolaDHA, Corn/Safflower, and Flax/Safflower. Each diet period was 4 weeks followed by a 2- to 4-week washout period. Canola (3.1 kg, P = 0.026) and CanolaOleic oil diets (3.09 kg, P = 0.03) reduced android fat mass compared with the Flax/Saff oil diet (3.2 kg), particularly in men. The decrease in abdominal fat mass was correlated with the reduction in blood pressure after the Canola (systolic blood pressure: r = 0.26, P = 0.062; diastolic blood pressure: r = 0.38, P = 0.0049) and CanolaOleic oil diets (systolic blood pressure: r = 0.39 P = 0.004; diastolic blood pressure: r = 0.45, P = 0.0006). The decrease in abdominal fat mass also was associated with a reduction in triglyceride levels after the CanolaOleic oil diet (r = 0.42, P = 0.002). Diets high in MUFA (compared with PUFA) reduced central obesity with an accompanying improvement in MetS risk factors. Diets high in MUFA may be beneficial for treating and perhaps preventing MetS. © 2016 The Obesity Society.

Abdominal obesity as a mediator of the influence of physical activity on insulin resistance in Spanish adults.

PubMed

García-Hermoso, Antonio; Martínez-Vizcaíno, Vicente; Recio-Rodriguez, Jose I; Díez-Fernández, Ana; Gómez-Marcos, Manuel A; García-Ortiz, Luis

2016-01-01

The aim of the study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and insulin resistance (IR) in Spanish adults and to examine whether this relationship is mediated by abdominal obesity (waist circumference - WC). The cross-sectional study included 1162 healthy subjects belonging to the EVIDENT study (mean age 55.0±13.3years; 61.8% women) from six different Spanish provinces. Moderate-to-vigorous physical activity (MVPA) was measured objectively over 7days using Actigraph accelerometers, collecting data in 60-second epochs, and retaining respondents with ≥4 valid days for the analysis. The homeostasis model of assessment (HOMA-IR) was used to determine IR, and its individual components - fasting glucose and insulin - were determined using standard protocols. Linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. Fasting insulin and HOMA-IR levels were significantly worse in adults who spent fewer minutes in MVPA (first quartile≤30.1 and 22.7min/day in men and women, respectively) after adjusting for age, sex, smoking habits, drinking habits, accelerometer wear time, sedentary time, and Mediterranean diet adherence. However, when WC was added to the ANCOVA models as a covariate, the effects disappeared. Mediation analysis reported that WC acts as a full mediator in the relationship between MVPA and IR (HOMA-IR and fasting insulin). These findings show that WC plays a pivotal role in the relationship between MVPA and IR, and therefore highlights that decreasing abdominal obesity might be considered as an intermediate outcome for evaluating interventions aimed at preventing diabetes mellitus. Copyright © 2015 Elsevier Inc. All rights reserved.

Changes in body weight are significantly associated with changes in fasting plasma glucose and HDL cholesterol in Japanese men without abdominal obesity (waist circumference < 85 cm).

PubMed

Oda, Eiji; Kawai, Ryu

2011-06-01

The aims are to examine whether changes in body weight (dBW) are associated with changes in cardiovascular risk factors in Japanese men without abdominal obesity (waist circumference (WC) < 85 cm) and which anthropometric index, dBW or changes in WC (dWC), is more strongly associated with changes in cardiovascular risk factors in men without abdominal obesity. It is a retrospective study in 692 Japanese men without abdominal obesity who took annual health screening tests consecutively over one year. Standardized linear regression coefficients (SRCs) of dBW and dWC were calculated for changes in systolic blood pressure (dSBP), diastolic blood pressure (dDBP), fasting plasma glucose (dFPG), triglycerides (dTG), HDL cholesterol (dHDL), and high-sensitivity C-reactive protein (dCRP). The SRCs of dBW for dFPG and dHDL were significant in all men and in men with each risk factor corresponding to the component of metabolic syndrome (MetS). The SRCs of dWC for dTG and dCRP were significant in all men but not in men with each risk factor corresponding to the MetS component. In conclusions, dBW were significantly associated with dFPG and dHDL in Japanese men without abdominal obesity. Therefore, abdominal obesity should not be considered as a necessary component of MetS in Japanese men. dBW may be more useful than dWC as a marker of changes in cardiovascular risk factors in lifestyle intervention programs.

Effects of Endurance and Endurance-strength Exercise on Renal Function in Abdominally Obese Women with Renal Hyperfiltration: A Prospective Randomized Trial.

PubMed

Szulińska, Monika; Skrypnik, Damian; Ratajczak, Marzena; Karolkiewicz, Joanna; Madry, Edyta; Musialik, Katarzyna; Walkowiak, Jaroslaw; Jakubowski, Hieronim; Bogdański, Pawel

2016-10-01

Obesity is associated with kidney defects. Physical activity is a key element in the treatment of obesity. The aim of this study was to compare the effect of endurance and endurance-strength training on kidney function in abdominally obese women. Forty-four abdominally obese women were randomized to endurance training or endurance-strength training, three times a week for 3 months. Before and after the intervention, kidney function was assessed by measuring blood creatinine, urine creatinine, and urine albumin levels, and the albumin-to-creatinine ratio and glomerular filtration rate (GFR) were calculated. Renal hyperperfusion was present in both groups before the study. Following both types of physical activity, similar modifications of the investigated parameters were observed, but with no significant between-group differences. Both courses of training led to a significant increase in blood creatinine and a subsequent decrease in the GFR. A significant increase in urine creatinine and album levels, though not exceeding the range for microalbuminuria, was not accompanied by any difference in the albumin-to-creatinine ratio after endurance-strength training alone. Three months of either endurance or endurance-strength training has a favorable and comparable effect on renal function in abdominally obese women with renal hyperfiltration. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

[Prediction of intra-abdominal hypertension risk in patients with acute colonic obstruction under epidural analgesia].

PubMed

Stakanov, A V; Potseluev, E A; Musaeva, T S

2013-01-01

Purpose of the study was to identify prediction possibility of direct current potential level for intra-abdominal hypertension risk in patients with acute colonic obstruction under preoperative epidural analgesia. Prospective analysis of the preoperative period was carried out in 140 patients with acute colonic obstruction caused by colon cancer. Relations between preoperative level of permanent capacity and risk of intra-abdominal hypertension was identified Direct current potential level is an independent predictor of intra-abdominal hypertension. Diagnostic significance increases from first to fifth hour of preoperative period according to AUROC data from 0.821 to 0.905 and calibration 6.9 (p > 0.37) and 4.7 (p > 0.54) by Hosmer-Lemeshou criteria. The use of epidural analgesia in the complex intensive preoperative preparation is pathogenically justified. It reduces intra-abdominal hypertension in patients with acute colonic obstruction.

Does this adult patient have a blunt intra-abdominal injury?

PubMed

Nishijima, Daniel K; Simel, David L; Wisner, David H; Holmes, James F

2012-04-11

Blunt abdominal trauma often presents a substantial diagnostic challenge. Well-informed clinical examination can identify patients who require further diagnostic evaluation for intra-abdominal injuries after blunt abdominal trauma. To systematically assess the precision and accuracy of symptoms, signs, laboratory tests, and bedside imaging studies to identify intra-abdominal injuries in patients with blunt abdominal trauma. We conducted a structured search of MEDLINE (1950-January 2012) and EMBASE (1980-January 2012) to identify English-language studies examining the identification of intra-abdominal injuries. A separate, structured search was conducted for studies evaluating bedside ultrasonography. We included studies of diagnostic accuracy for intra-abdominal injury that compared at least 1 finding with a reference standard of abdominal computed tomography, diagnostic peritoneal lavage, laparotomy, autopsy, and/or clinical course for intra-abdominal injury. Twelve studies on clinical findings and 22 studies on bedside ultrasonography met inclusion criteria for data extraction. Critical appraisal and data extraction were independently performed by 2 authors. The prevalence of intra-abdominal injury in adult emergency department patients with blunt abdominal trauma among all evidence level 1 and 2 studies was 13% (95% CI, 10%-17%), with 4.7% (95% CI, 2.5%-8.6%) requiring therapeutic surgery or angiographic embolization of injuries. The presence of a seat belt sign (likelihood ratio [LR] range, 5.6-9.9), rebound tenderness (LR, 6.5; 95% CI, 1.8-24), hypotension (LR, 5.2; 95% CI, 3.5-7.5), abdominal distention (LR, 3.8; 95% CI, 1.9-7.6), or guarding (LR, 3.7; 95% CI, 2.3-5.9) suggest an intra-abdominal injury. The absence of abdominal tenderness to palpation does not rule out an intra-abdominal injury (summary LR, 0.61; 95% CI, 0.46-0.80). The presence of intraperitoneal fluid or organ injury on bedside ultrasound assessment is more accurate than any history and

Predictors of Abdominal Pain in Depressed Pediatric Inflammatory Bowel Disease Patients

PubMed Central

Srinath, Arvind I.; Goyal, Alka; Zimmerman, Lori A.; Newara, Melissa C.; Kirshner, Margaret A.; McCarthy, F. Nicole; Keljo, David; Binion, David; Bousvaros, Athos; DeMaso, David R.; Youk, Ada; Szigethy, Eva M.

2015-01-01

Background Pediatric patients with inflammatory bowel disease (IBD) have high rates of abdominal pain. The study aims were to (1) Evaluate biological and psychological correlates of abdominal pain in depressed youth with IBD, (2) Determine predictors of abdominal pain in Crohn’s disease (CD) and ulcerative colitis (UC). Methods 765 patients ages 9–17 with IBD seen over 3 years at two sites were screened for depression. Depressed youth completed comprehensive assessments for abdominal pain, psychological (depression and anxiety), and biological (IBD-related, through disease activity indices and laboratory values) realms. Results 217 patients with IBD (161 CD, 56 UC) were depressed. 163 (120 CD, 43 UC) patients had complete API scores. In CD, abdominal pain was associated with depression (r=0.33; p<0.001), diarrhea (r=0.34; p=0.001), ESR (r=0.22; p=0.02), low albumin (r=0.24; p=.01), weight loss (r=0.33; p=0.001), and abdominal tenderness (r=0.38, p=0.002). A multivariate model with these significant correlates represented 32% of the variance in pain. Only depression (p=0.03), weight loss (p=0.04), and abdominal tenderness (p=0.01) predicted pain for CD patients. In UC, pain was associated with depression (r=0.46; p=0.002) and nocturnal stools (r=.32; p=.046). In the multivariate model with these significant correlates 23% of the variance was explained, and only depression (p=0.02) predicted pain. Conclusions The psychological state of pediatric patients with IBD may increase the sensitivity to abdominal pain. Thus, screening for and treating comorbid depression may prevent excessive medical testing and unnecessary escalation of IBD medications. PMID:24983975

Dynamics of Albumin Synthetic Response to Intra-Abdominal Abscess in Patients with Gastrointestinal Fistula

PubMed Central

Zhou, Bo; Han, Gang; Chen, Yu; A, Jiye; Gu, Guosheng; Chen, Jun; Wang, Gefei; Li, Jieshou

2014-01-01

Abstract Background: Low serum albumin concentration is a predictor of failure of source control for intra-abdominal infection. However, data on dynamics of albumin synthesis in these patients and to what extent these changes contribute to hypoalbuminemia are relatively scarce. We investigated in a group of patients with gastrointestinal fistula the dynamic response of liver albumin synthesis to intra-abdominal abscess and how these related to hypoalbuminemia and circulating endocrine hormone profiles. Methods: Eight gastrointestinal fistula patients scheduled to undergo percutaneous abscess sump drainage were enrolled prospectively to measure albumin synthesis rates at different stages of the inflammatory response (immediately after diagnosis and 7 d following sump drainage when clinical signs of intra-abdominal sepsis had been eradicated). Eight age-, sex-, and body mass index–matched intestinal fistula patients were studied as control patients. Consecutive arterial blood samples were drawn during a primed-constant infusion (priming dose: 4 micromol·kg−1, infusion rate: 6 micromol·kg−1·min−1) to determine the incorporation rate of L-[ring-2H5]-phenylalanine directly into plasma albumin using gas chromatography/mass spectrometry analysis. Results: Patients suffering from intra-abdominal infection had reduced plasma albumin and total plasma protein concentrations, compared with control patients. Albumin fractional synthesis rates in patients with intra-abdominal abscess were decreased, compared with those in the control group. When the source of infection was removed, albumin synthesis rates returned to control values, whereas albumin concentrations did not differ significantly from the corresponding concentrations in control subjects and patients with intra-abdominal abscess. Conclusion: Despite nutritional intervention, albumin synthesis rate is decreased in intestinal fistula patients with intra-abdominal abscess; albumin synthesis returns to

Dynamics of albumin synthetic response to intra-abdominal abscess in patients with gastrointestinal fistula.

PubMed

Zhou, Bo; Ren, Jianan; Han, Gang; Chen, Yu; A, Jiye; Gu, Guosheng; Chen, Jun; Wang, Gefei; Li, Jieshou

2014-04-01

Low serum albumin concentration is a predictor of failure of source control for intra-abdominal infection. However, data on dynamics of albumin synthesis in these patients and to what extent these changes contribute to hypoalbuminemia are relatively scarce. We investigated in a group of patients with gastrointestinal fistula the dynamic response of liver albumin synthesis to intra-abdominal abscess and how these related to hypoalbuminemia and circulating endocrine hormone profiles. Eight gastrointestinal fistula patients scheduled to undergo percutaneous abscess sump drainage were enrolled prospectively to measure albumin synthesis rates at different stages of the inflammatory response (immediately after diagnosis and 7 d following sump drainage when clinical signs of intra-abdominal sepsis had been eradicated). Eight age-, sex-, and body mass index-matched intestinal fistula patients were studied as control patients. Consecutive arterial blood samples were drawn during a primed-constant infusion (priming dose: 4 micromol·kg(-1), infusion rate: 6 micromol·kg(-1)·min(-1)) to determine the incorporation rate of L-[ring-(2)H5]-phenylalanine directly into plasma albumin using gas chromatography/mass spectrometry analysis. Patients suffering from intra-abdominal infection had reduced plasma albumin and total plasma protein concentrations, compared with control patients. Albumin fractional synthesis rates in patients with intra-abdominal abscess were decreased, compared with those in the control group. When the source of infection was removed, albumin synthesis rates returned to control values, whereas albumin concentrations did not differ significantly from the corresponding concentrations in control subjects and patients with intra-abdominal abscess. Despite nutritional intervention, albumin synthesis rate is decreased in intestinal fistula patients with intra-abdominal abscess; albumin synthesis returns to control values during convalescence.

Risk factors and bacterial spectrum for pneumonia after abdominal surgery in elderly Chinese patients.

PubMed

Chen, Peng; A, Yongjun; Hu, Zongqiang; Cun, Dongyun; Liu, Feng; Li, Wen; Hu, Mingdao

2014-01-01

Postoperative pneumonia is a common complication of abdominal surgery in the elderly. The aim of this study was to determine risk factors and bacterial spectrum for pneumonia after abdominal surgery in elderly Chinese patients. We performed a case-control study in a total of 5431 patients aged 65 years and over who had undergone abdominal surgery at the 2nd affiliated hospital of Kunming medical college between June 2003 and June 2011. Postoperative pneumonia developed in 86 patients (1.58%). Gram-negative bacilli were the principal microorganisms (82.86%) isolated from patients. The most common organisms isolated were Klebsiella spp. (28.57%), Acinetobacter spp. (17.14%) and Pseudomonas aeruginosa (17.14%). Multivariate analysis confirmed the following to be independent risk factors for postoperative pneumonia in the elderly after abdominal surgery: age ≥70 (OR 1.93, 95% CI 1.16-3.22, p=0.01), upper abdominal surgery (OR 2.07, 95% CI 1.18-3.64, p=0.01) and duration of operation >3 h (OR 2.48, 95% CI 1.49-4.15, p=0.00). Identifying these risk factors may help achieve better prevention and treatment for postoperative pneumonia in elderly patients after abdominal surgery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Employment discrimination against obese women in obesity clinic's patients perspective.

PubMed

Obara-Gołębiowska, Małgorzata

2016-01-01

The workplace is one of many areas of life where obese people are unfairly treated. According to the literature obese women are particularly susceptible to discrimination in employment. There is a lack of polish researches of this subject. The main objective of this study was to analyze personal, subjective experiences related to weight bias and discrimination against obese people in the workplace of obese Polish women. The study was carried out in a hospital clinic for obesity management. A total of 420 women with BMI>30, aged 21 to 72, participated in group interviews focused on the weight bias and discrimination against obese people in the workplace. In the group of clinically obese women, 5.3% of subjects had experienced employment discrimination and 10.5% had been victims of verbal and social abuse in the workplace. The most common psycho-physical consequences of the weight stigma were emotional problems, lack of motivation and overeating in response to stress. Weight-based discrimination in the workplace poses a problem in Poland. The weight stigma and occupational discrimination lead to psycho-physical discomfort which exacerbates overeating and obesity.

Effects of acupuncture therapy on abdominal fat and hepatic fat content in obese children: a magnetic resonance imaging and proton magnetic resonance spectroscopy study.

PubMed

Zhang, Hong; Peng, Yun; Liu, ZuXiang; Li, Shilian; Lv, Zhongli; Tian, LiFang; Zhu, Jie; Zhao, XuNa; Chen, Min

2011-05-01

The aim of this study was to use magnetic resonance imaging (MRI) together with proton magnetic resonance spectroscopy ((1)H-MRS) to study the influence of acupuncture therapy on abdominal fat and hepatic fat content in obese children. The design was a longitudinal, clinical intervention study of acupuncture therapy. SUBJECTS were 10 healthy, obese children (age: 11.4 ± 1.65 years, body-mass index [BMI]: 29.03 ± 4.81 kg/m(2)). Measurements included various anthropometric parameters, abdominal fat (assessed by MRI) and hepatic fat content (assessed by (1)H-MRS) at baseline and after 1 month of acupuncture therapy. One (1) month of acupuncture therapy significantly reduced the subjects' BMI by 3.5% (p = 0.005), abdominal visceral adipose tissue (VAT) volume by 16.04% (p < 0.0001), abdominal total adipose tissue volume by 10.45% (p = 0.001), and abdominal visceral to subcutaneous fat ratio by 10.59% (p = 0.007). Decreases in body weight (-2.13%), waist circumference (-1.44%), hip circumference (-0.33%), waist-to-hip ratio (WHR) (-0.99%), abdominal subcutaneous adipose tissue (SAT) volume (-5.63%), and intrahepatic triglyceride (IHTG) content (-9.03%) were also observed, although these were not significant (p > 0.05). There was a significant correlation between the level of abdominal fat (SAT, VAT) and anthropometric parameters (weight, BMI, waist circumferences, hip circumferences). There was no statistically significant correlation between IHTG and anthropometric parameters or abdominal fat content. The first direct experimental evidence is provided demonstrating that acupuncture therapy significantly reduces BMI and abdominal adipose tissue by reducing abdominal VAT content without significant changes in body weight, waist circumference, hip circumference, WHR, abdominal SAT, or IHTG content. Thus, the use of acupuncture therapy to selectively target a reduction in abdominal VAT content should become more important and more popular in

Volunteer patients and small groups contribute to abdominal examination’s success

PubMed Central

Shields, Helen M; Fernandez-Becker, Nielsen Q; Flier, Sarah N; Vaughn, Byron P; Tukey, Melissa H; Pelletier, Stephen R; Horst, Douglas A

2017-01-01

Background Prior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its “Introduction to Physical Examination” session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session. Aim Our aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time? Methods A total of 43–46 patients and 43–46 faculty were recruited and 43–46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43–46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient. Results Over the 5-year time period (2008–2012), the abdominal examination ranked first among all organ systems’ “Introductory Sessions”. The abdominal examination ratings had the best mean score (1.35) on a Likert scale where 1 is excellent and 5 is poor. The students gave the most positive spontaneous comments to having volunteer patients, with small groups coming in as the second most appreciated educational element. Conclusion We successfully quadrupled the number of faculty, patients, and examining rooms and created a highly rated educational program as measured by anonymous student evaluations, patient and faculty participation, and the medical school’s selecting the abdominal

When Should Abdominal Computed Tomography Be Considered in Patients with Lower Rib Fractures?

PubMed

Jeroukhimov, Igor; Hershkovitz, Yehuda; Wiser, Itay; Kessel, Boris; Ayyad, Mohammed; Gatot, Inbar; Shapira, Zahar; Jeoravlev, Svetlana; Halevy, Ariel; Lavy, Ron

2017-05-01

Lower rib fractures are considered as a marker of intra-abdominal organ injury. Abdominal computed tomography (CT) is the "gold standard" examination for patients with lower rib fractures. However, the reported incidence of concomitant intra-abdominal injuries (IAI) is 20%-40%. The purpose of this study was to evaluate the incidence of intra-abdominal organ injuries in blunt trauma patients with lower rib fractures. Medical charts and radiology reports of patients with lower rib (from the 8th to 12th rib) fractures admitted to our center during a 6-year period were retrospectively reviewed. Patients were divided into two groups. Group I included patients with intra-abdominal injury (IAI) diagnosed either by CT or on urgent laparotomy, and Group II included those with normal abdominal CT scans. Data included demographics, mechanism of injury, laboratory tests, radiology results including number and location of fractured ribs, and incidence of IAI. Overall 318 patients were included in the study. Fifty-seven patients (17.9%) had 71 IAIs compared with 265 (82.1%) patients with no IAI. Logistic regression identified age younger than 55 years (relative risk [RR] = 7.2; 95% confidence interval [CI] 3.1-16.8; p = 0.001), bilateral rib fractures (RR = 3.9; 95% CI 1.1-13.5; p = 0.03) and decreased levels of hematocrit (RR = 2.4; 95% CI 1.2-4.8; p = 0.016) as independent risk factors for the presence of IAI. Abdominal CT should be considered in blunt trauma patients with lower rib fractures who are younger than 55 years of age and have bilateral rib fractures and decreased levels of hematocrit on admission. Copyright © 2016 Elsevier Inc. All rights reserved.

Low-Dose Physiological Growth Hormone in Patients With HIV and Abdominal Fat Accumulation

PubMed Central

Lo, Janet; You, Sung Min; Canavan, Bridget; Liebau, James; Beltrani, Greg; Koutkia, Polyxeni; Hemphill, Linda; Lee, Hang; Grinspoon, Steven

2008-01-01

Context Antiretroviral therapy can be associated with visceral adiposity and metabolic complications, increasing cardiovascular risk, and reduced growth hormone (GH) secretion may be a contributing factor. Objective To investigate the effects of low-dose physiological GH administration on body composition, glucose, and cardiovascular parameters in patients with human immunodeficiency virus (HIV) having abdominal fat accumulation and relative GH deficiency. Design, Setting, and Patients A randomized, double-blind, placebo-controlled trial of 56 patients with HIV, abdominal fat accumulation, and reduced GH secretion (peak GH <7.5 ng/mL) conducted at a US academic medical center between November 2003 and October 2007. Intervention Patients were randomly assigned to receive either subcutaneous GH or matching placebo titrated to the upper quartile of normal insulinlike growth factor 1 (IGF-1) range for 18 months. Starting dose was 2 μg/kg/d and increased to maximum dose of 6 μg/kg/d (average dose, 0.33 mg/d). Main Outcome Measures Change in body composition assessed by computed tomographic scan and dual-energy x-ray absorptiometry. Secondary outcomes included glucose, IGF-1, blood pressure (BP), and lipids. Treatment effect was the difference in the change between GH and placebo groups, using all available data. Results Fifty-five patients (26 with GH and 29 with placebo) were included in the safety analyses and 52 patients (25 with GH and 27 with placebo) were included in the efficacy analyses. Visceral adipose tissue area (treatment effect [last-value-carried-forward analysis {n=56}, -19 cm2; 95% confidence interval {CI}, -37 to -0.3 cm2], -19 cm2; 95% CI, -38 to -0.5 cm2; P=.049); trunk fat (-0.8 kg; 95% CI, -1.5 to -0.04 kg; P=.04); diastolic BP (-7 mm Hg; 95% CI, -11 to -2 mm Hg; P=.006); and triglycerides (-7 mg/dL, P=.002) improved but 2-hour glucose levels on glucose tolerance testing increased in the GH group vs the placebo group (treatment effect, 22 mg

Concentrations of Plasma Free Palmitoleic and Dihomo-Gamma Linoleic Fatty Acids Are Higher in Children with Abdominal Obesity.

PubMed

Aristizabal, Juan C; González-Zapata, Laura I; Estrada-Restrepo, Alejandro; Monsalve-Alvarez, Julia; Restrepo-Mesa, Sandra L; Gaitán, Diego

2018-01-01

Increased plasma free fatty acids (FFAs) are associated with cardiometabolic risk factors in adults with abdominal obesity (AO). However, this association remains controversial in children. This study analyzed plasma FFA concentration in children with and without AO. Twenty-nine children classified with AO were matched by age and sex with 29 non-obese individuals. Blood samples were collected after fasting for 10-12 h. Plasma concentration of glucose, insulin, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined by automatized methods. FFAs were analyzed by gas chromatography. Children with and without AO had similar age (7.1 ± 2.6 vs. 7.2 ± 2.7 years; p > 0.05) but obese children showed higher ( p < 0.05) body mass index (BMI) (+4.3 kg/m²), systolic blood pressure (+5.1 mmHg), and insulin (+27.8 pmol/L). There were no significant differences in plasma total FFA concentration between groups (1.02 ± 0.61 vs. 0.89 ± 0.37 mmol/L; p > 0.05). However, children with AO had higher palmitoleic acid (0.94 vs. 0.70 wt %; p < 0.05) and dihomo-gamma linoleic acid (DHGL) (2.76 vs. 2.07 wt %; p < 0.05). Palmitoleic and DHGL acids correlated ( p < 0.05) with BMI ( r = 0.397; r = 0.296, respectively) and with waist circumference ( r = 0.380; r = 0.276, respectively). Palmitoleic acid correlated positively with systolic blood pressure ( r = 0.386; p < 0.05) and negatively with HDL-C (-0.572; p < 0.01). In summary, children with AO have higher plasmatic concentrations of free palmitoleic and DHGL fatty acids, which correlate with cardiometabolic risk factors.

Concentrations of Plasma Free Palmitoleic and Dihomo-Gamma Linoleic Fatty Acids Are Higher in Children with Abdominal Obesity

PubMed Central

González-Zapata, Laura I.; Estrada-Restrepo, Alejandro; Monsalve-Alvarez, Julia; Restrepo-Mesa, Sandra L.; Gaitán, Diego

2018-01-01

Increased plasma free fatty acids (FFAs) are associated with cardiometabolic risk factors in adults with abdominal obesity (AO). However, this association remains controversial in children. This study analyzed plasma FFA concentration in children with and without AO. Twenty-nine children classified with AO were matched by age and sex with 29 non-obese individuals. Blood samples were collected after fasting for 10–12 h. Plasma concentration of glucose, insulin, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined by automatized methods. FFAs were analyzed by gas chromatography. Children with and without AO had similar age (7.1 ± 2.6 vs. 7.2 ± 2.7 years; p > 0.05) but obese children showed higher (p < 0.05) body mass index (BMI) (+4.3 kg/m2), systolic blood pressure (+5.1 mmHg), and insulin (+27.8 pmol/L). There were no significant differences in plasma total FFA concentration between groups (1.02 ± 0.61 vs. 0.89 ± 0.37 mmol/L; p > 0.05). However, children with AO had higher palmitoleic acid (0.94 vs. 0.70 wt %; p < 0.05) and dihomo-gamma linoleic acid (DHGL) (2.76 vs. 2.07 wt %; p < 0.05). Palmitoleic and DHGL acids correlated (p < 0.05) with BMI (r = 0.397; r = 0.296, respectively) and with waist circumference (r = 0.380; r = 0.276, respectively). Palmitoleic acid correlated positively with systolic blood pressure (r = 0.386; p < 0.05) and negatively with HDL-C (−0.572; p < 0.01). In summary, children with AO have higher plasmatic concentrations of free palmitoleic and DHGL fatty acids, which correlate with cardiometabolic risk factors. PMID:29301242

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.

Diagnostic imaging of blunt abdominal trauma in pediatric patients.

PubMed

Miele, Vittorio; Piccolo, Claudia Lucia; Trinci, Margherita; Galluzzo, Michele; Ianniello, Stefania; Brunese, Luca

2016-05-01

Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements. The liver is the most common organ injured in blunt abdominal trauma followed by the spleen. Renal, pancreatic, and bowel injuries are quite rare. In this review we present various imaging findings of blunt abdominal trauma in children.

A renal transplant patient with abdominal discomfort, vomiting and diarrhoea for 1 week

PubMed Central

Lutwak, Nancy; Dill, Curt

2011-01-01

The patient is a 61-year-old diabetic male with history of renal transplant who presented to the emergency department with complaints of intermittent abdominal discomfort accompanied by multiple episodes of vomiting and diarrhoea. He had delayed seeking medical attention until his friends insisted that he come to the emergency department, since the abdominal discomfort was worsening. The patient’s ECG revealed an ST-segment elevation myocardial infarction. PMID:22678945

ABDOMINAL PAIN IN ADULT SICKLE CELL DISEASE PATIENTS: A NIGERIAN EXPERIENCE

PubMed Central

Akingbola, T.S.; Kolude, B.; Aneni, E.C.; Raji, A.A.; Iwara, K.U.; Aken’Ova, Y.A.; Soyannwo, O.A.

2011-01-01

Background: Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence, diagnostic dilemma, and the need for an accurate, early diagnosis, abdominal pain in sickle cell disease has not been rigorously studied. Objective: We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. Methods: A prospective case series of 20 patients was done in which data was collected on demographic characteristics, hemoglobin electrophoresis patterns, a description of the abdominal pain including sites, severity, and type of pain, packed cell volume and the provisional and final diagnosis. Results: Haemoglobin S patients were 17 in number constituting eightyfive percent (85%) of our study population whilst the rest 3 were Hb S+C. Most patients (70%) had one site of abdominal pain. The pain was mainly colicky or tightening, moderate to severe in nature and, in some cases, associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8% of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67%. Conclusion: Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving. PMID:25161492

Effects of inspiratory muscle training on balance ability and abdominal muscle thickness in chronic stroke patients

PubMed Central

Oh, Dongha; Kim, Gayeong; Lee, Wanhee; Shin, Mary Myong Sook

2016-01-01

[Purpose] This study evaluated the effects of inspiratory muscle training on pulmonary function, deep abdominal muscle thickness, and balance ability in stroke patients. [Subjects] Twenty-three stroke patients were randomly allocated to an experimental (n = 11) or control group (n = 12). [Methods] The experimental group received inspiratory muscle training-based abdominal muscle strengthening with conventional physical therapy; the control group received standard abdominal muscle strengthening with conventional physical therapy. Treatment was conducted 20 minutes per day, 3 times per week for 6 weeks. Pulmonary function testing was performed using an electronic spirometer. Deep abdominal muscle thickness was measured by ultrasonography. Balance was measured using the Berg balance scale. [Results] Forced vital capacity, forced expiratory volume in 1 second, deep abdominal muscle thickness, and Berg balance scale scores were significantly improved in the experimental group than in the control group. [Conclusion] Abdominal muscle strengthening accompanied by inspiratory muscle training is recommended to improve pulmonary function in stroke patients, and may also be used as a practical adjunct to conventional physical therapy. PMID:26957739

Body composition in 13-year-old adolescents with abdominal obesity, depending on the BMI value.

PubMed

Goluch-Koniuszy, Zuzanna S; Kuchlewska, Magdalena

2017-09-01

Excessive adipocyte growth during the pubertal transition predisposes to the development and persistence of obesity in adulthood. Visceral accumulation of body fat is particularly disadvantageous when it is correlated with insulin resistance, secondary hyperinsulinaemia, dysglicaemia, and atherogenic dyslipidemia. The aim of this study was to conduct a nutritional status assessment and body composition analysis in 13-year-old adolescents of both genders with visceral fat accumulation (WC ≥ 90th percentile) and different BMI values. The evaluation of state of nutrition of 1,738 Polish boys (n = 882) and girls (n = 856) aged 13 was done based on anthropometric measurements and calculated BMI (body mass index), WC (waist circumference) and WHtR indices (waist-to-height ratio). Taking into consideration the value of WC ≥ 90 pc, 353 people were designated (20.3 % of the total) with visceral obesity (but with various BMI), whose body composition was examined by the method of bioelectric impedance analysis (BIA). A total of 249 adolescents of both sexes (70.5% of the selected, 102 boys and 147 girls) and their parents agreed to the study. In adolescents with visceral obesity a significant change of body content was ascertained depending on the value of the BMI. Even in the people with a proper value of the BMI, a significantly higher than standard increase of the percentage of total body fat (TBF) and decrease of both the percentage of body lean (BL) and the content of total body water (TBW) in the body was observed. The values of the BMI, WC and WHtR in adolescents were significantly correlated with each other as well as with TBF, BL and TBW, and the strength of correlation was dependent on sex. The state of nutrition in adolescents with visceral obesity, even with a proper BMI, might contribute to the development of a metabolic syndrome.

Anterior Cutaneous Nerve Entrapment Syndrome in a Pediatric Patient Previously Diagnosed With Functional Abdominal Pain: A Case Report.

PubMed

DiGiusto, Matthew; Suleman, M-Irfan

2018-03-23

Chronic abdominal pain is common in children and adolescents but challenging to diagnose, because practitioners may be concerned about missing serious occult disease. Abdominal wall pain is an often ignored etiology for chronic abdominal pain. Anterior cutaneous nerve entrapment syndrome causes abdominal wall pain but is frequently overlooked. Correctly diagnosing patients with anterior cutaneous nerve entrapment syndrome is important because nerve block interventions are highly successful in the remittance of pain. Here, we present the case of a pediatric patient who received a diagnosis of functional abdominal pain but experienced pain remittance after receiving a trigger-point injection and transverse abdominis plane block.

Analysis of urobilinogen and urine bilirubin for intra-abdominal injury in blunt trauma patients.

PubMed

Gorchynski, Julie; Dean, Kevin; Anderson, Craig L

2009-05-01

To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury. Data analysis of 986 consecutive trauma patients of which 698 were adult blunt trauma patients. Five-hundred sixteen subjects had a urinalysis and a CT scan of the abdomen/pelvis or exploratory laparotomy. We reviewed initial urinalysis results from trauma patients in the emergency department (ED) for the presence of urine hemoglobin, uroblinogen and urine bilirubin. Computed tomography (CT) scan results and operative reports were reviewed from the trauma registry for evidence of liver laceration, spleen laceration, bowel or mesenteric injuries. There were 73 injuries and 57/516 patients (11%) with intra-abdominal injury. Urinalysis was positive for urobilinogen in 28/516 (5.4%) patients, urine bilirubin in 15/516 (2.9%) patients and urine hemoglobin in 313/516 (61%) patients. Nineteen/forty-seven (4%) subjects had liver lacerations, 28/56 (5%) splenic lacerations, and 15/5 (3%) bowel or mesenteric injury. Comparing the proportion of patients that had urobilinogen detected in the group with and without intra-abdominal injury, 8/28 (29%) subjects with urobilinogen, 5/15 (33%) subjects with bilirubin and 47/313 (15%) subjects with urine hemoglobin were found to have liver lacerations, spleen lacerations, or bowel/mesenteric injuries. Preexisting liver or biliary conditions were not statistically associated with elevation of urine bilirubin, urine hemoglobin or urobilinogen on initial urinalysis after blunt abdominal trauma. Point prevalence for urobilinogen, urine bilirubin and urine hemoglobin are 5.43% (28/516), 2.91% (15/516) and 60.7% (313/516) respectively. The utility of the initial routine urinalysis in the ED for adult blunt abdominal trauma patients should not be used as a screening tool for the evaluation of intra-abdominal injury.

Perioperative Care of the Obese Cardiac Surgical Patient.

PubMed

Chacon, M Megan; Cheruku, Sreekanth R; Neuburger, Peter J; Lester, Laeben; Shillcutt, Sasha K

2017-12-13

Morbid obesity is associated with impairment of cardiovascular, pulmonary, gastrointestinal, and renal physiology with significant perioperative consequences and has been linked with higher morbidity and mortality after cardiac surgery. Cardiac surgery patients have a higher incidence of difficult airway and difficult laryngoscopy than general surgery patients do, and obesity is associated with difficult mask ventilation and direct laryngoscopy. Positioning injuries occur more frequently because obese patients are at greater risk of pressure injury, such as rhabdomyolysis and compartment syndrome. Despite the association between obesity and several chronic disease states, the effects of obesity on perioperative outcomes are conflicting. Studies examining outcomes of overweight and obese patients in cardiac surgery have reported varying results. An "obesity paradox" has been described, in which the mortality for overweight and obese patients is lower compared with patients of normal weight. This review describes the physiologic abnormalities and clinical implications of obesity in cardiac surgery and summarizes recommendations for anesthesiologists to optimize perioperative care of the obese cardiac surgical patient. Copyright © 2017 Elsevier Inc. All rights reserved.

Obese patients overestimate physicians’ attitudes of respect

PubMed Central

Gudzune, Kimberly A.; Huizinga, Mary Margaret; Beach, Mary Catherine; Cooper, Lisa A.

2012-01-01

Objective To evaluate whether obese patients overestimate or underestimate the level of respect that their physicians hold towards them. Methods We performed a cross-sectional analysis of data from questionnaires and audio-recordings of visits between primary care physicians and their patients. Using multilevel logistic regression, we evaluated the association between patient BMI and accurate estimation of physician respect. Physician respectfulness was also rated independently by assessing the visit audiotapes. Results Thirty-nine primary care physicians and 199 of their patients were included in the analysis. The mean patient BMI was 32.8 kg/m2 (SD 8.2). For each 5 kg/m2 increase in BMI, the odds of overestimating physician respect significantly increased [OR 1.32, 95%CI 1.04–1.68, p=0.02]. Few patients underestimated physician respect. There were no differences in ratings of physician respectfulness by independent evaluators of the audiotapes. Conclusion We consider our results preliminary. Patients were significantly more likely to overestimate physician respect as BMI increased, which was not accounted for by increased respectful treatment by the physician. Practice Implications Among patients who overestimate physician respect, the authenticity of the patient-physician relationship should be questioned. PMID:22240006

Evaluation of mobile phone and Internet intervention on waist circumference and blood pressure in post-menopausal women with abdominal obesity.

PubMed

Park, Min-Jeong; Kim, Hee-Seung

2012-06-01

The present study evaluated whether an intervention using a short message service (SMS) by personal cellular phone and Internet would reduce cardiovascular risk factors in post-menopausal women with abdominal obesity over 12 weeks. This is a quasi-experimental design with pre and post tests. Participants were recruited from the gynecology outpatient and family medicine departments of a tertiary care hospital located in an urban city of South Korea. Only 67 subjects completed the entire study, 34 in the intervention group and 33 controls. The goal of intervention was to reduce waist circumference (WC), body weight (BW) and blood pressure (BP) levels. Before the intervention, demographic variables, WC, BW, BP, fasting plasma glucose (FPG) and serum lipids were measured as pre-test data. The WC, BW, BP, FPG and serum lipids were measured again 12 weeks later. Patients in the intervention group were requested to record their WC, BW, BP, type and amount of diet and exercise in a weekly web-based diary through the Internet or by cellular phone. The researchers sent weekly recommendations on diet and exercise as an intervention to each patient, by both cellular phone and Internet. The intervention was applied for 12 weeks. WC and BW significantly decreased by 3.0 cm and 2.0 kg, respectively, at 12 weeks compared with the baseline in the intervention group. However, the mean changes in the control group significantly increased by 0.9 cm and 0.7 kg. Systolic BP (SBP) and diastolic BP (DBP) significantly decreased by 6.5 and 4.6 mmHg in the intervention group, respectively. The mean changes in the control group were not significant in either SBP or DBP. A significant mean decrease in total cholesterol (TC) was observed for the intervention group by 12.9 mg/dl, while the control group showed a significant mean increase by 1.5mg/dl. Low-density lipoprotein-cholesterol (LDL-C) for the intervention group showed a significant mean decrease 11.3mg/dl. The mean change in the

[Abdominal ultrasound abnormalities incidentally discovered in patients with asymptomatic HIV in Lome (Togo)].

PubMed

Sonhaye, L; Tchaou, M; Amadou, A; Gbande, P; Assih, K; Djibril, M; Adjenou, K; Redah, D; N'Dakéna, K

2014-01-01

Few studies have examined ultrasound imaging of abdominal manifestations of HIV-AIDS, although these rank second only to its pleuropulmonary manifestations. Thus, this study sought to determine the features of abdominal ultrasound in HIV infection. This prospective, descriptive and analytical study took place in the radiology department of the University Hospital Campus Lomé and covered the three-year period of 2009-2011. It included all patients older than 15 years with positive HIV serology. During the study period, 566 patients met the inclusion criteria. Ultrasound examination showed the liver appeared normal in 153 patients (27.0%), but homogeneously hyperechoic and thus suggestive of hepatic steatosis in 107 (18.9%). The bile duct was dilatated in 12 patients or 2.1%. An anomaly in the corticomedullary differentiation in normal-sized kidneys was noted in 28.1% (159 patients). Diffuse homogeneous hypertrophy of the pancreas was found in 3 patients (0.53%). Splenomegaly was noted in 387 patients (68.4%); the echopattern of the spleen was diffusely micronodular in 6 patients (1.1%). Deep adenopathies were found in 29 patients (5.1%) and ascites in 46 patients (8.1%). Abdominal ultrasound is a medical imaging technique available in developing countries, less expensive than others, which can be considered an alternative to computed tomography (CT) in the countries of sub-Saharan Africa for the exploration of the abdominal manifestations of HIV.

Can you be large and not obese? The distinction between body weight, body fat, and abdominal fat in occupational standards.

PubMed

Friedl, Karl E

2004-10-01

Weight control is an important early intervention in diabetes, but the nature of the association between weight and disordered metabolism has been confused because fat mass and its distribution are only partly associated with increasing body size. Weight, fat, and regional fat placement, specifically in the abdominal site, may each have distinctly different associations with diabetes risk. Abdominal circumference may be the common marker of poor fitness habits and of increased risk for metabolic diseases such as diabetes. This is an important question for public health policy as well as for occupational standards such as those of the military, which are intended to promote fitness for military missions and include strength and aerobic capacity, as well as military appearance considerations. U.S. soldiers are heavier than ever before, reflecting both increased muscle and fat components. They also have better health care than ever before and are required to exercise regularly, and even the oldest soldiers are required to remain below body fat limits that are more stringent than the current median values of the U.S. population over age 40. The body fat standards assessed by circumference-based equations are 20-26% and 30-36%, for various age groups of men and women, respectively, and the upper limits align with threshold values of waist circumference recommended in national health goals. The basis and effects of the Army standards are presented in this paper. U.S. Army body fat standards may offer practical and reasonable health guidelines suitable for all active Americans that might help stem the increasing prevalence of obesity that is predicted to increase the prevalence of Type 2 diabetes.

Effects of Canola and High-Oleic Acid Canola Oils on Abdominal Fat Mass in Individuals with Central Obesity

PubMed Central

Liu, Xiaoran; Kris-Etherton, Penny M.; West, Sheila G.; Lamarche, Benoît; Jenkins, David J. A.; Fleming, Jennifer A.; McCrea, Cindy E.; Pu, Shuaihua; Couture, Patrick; Connelly, Philip W.; Jones, Peter J. H.

2016-01-01

Objective To determine the effect of diets low in saturated fatty acids (SFA), high in monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA) on body composition in participants at risk for MetS. Methods; The present study is a randomized, crossover, controlled feeding study. Participants (n = 101, ages 49.5 ± 1.2, BMI 29.4 ± 0.4 kg/m2) were randomized to five isocaloric diets contained treatment oils: Canola, CanolaOleic, CanolaDHA, Corn/Safflower and Flax/Safflower. Each diet period was 4-week followed by a 2–4 week washout period. Results Canola (3.1 kg, p=0.026) and CanolaOleic oil diets (3.1 kg, p=0.03) reduced android fat mass compared with the Flax/Saff oil diet (3.2 kg), particularly in males. The decrease in abdominal fat mass was correlated with the reduction in blood pressure after the Canola (SBP r = 0.26, p=0.062; DBP r=0.38, p=0.0049) and CanolaOleic oil diets (SBP r = 0.39 p=0.004; DBP r=0.45, p=0.0006). The decrease in abdominal fat mass also was associated with a reduction in TG levels after the CanolaOleic oil diet (r = 0.42, p=0.002). Conclusion Diets high in MUFA (compared with PUFA) reduced central obesity with an accompanying improvement in MetS risk factors. Our findings demonstrate that diets high in MUFA may be beneficial for treating and perhaps preventing MetS. PMID:27804268

Role of central obesity in risk stratification after an acute coronary event: does central obesity add prognostic value to the Global Registry of Acute Coronary Events (GRACE) risk score in patients with acute coronary syndrome?

PubMed

Martins, Albino; Ribeiro, Sílvia; Gonçalves, Pierre; Correia, Adelino

2013-10-01

Accurate risk stratification is an important step in the initial management of acute coronary syndrome (ACS), and current guidelines recommend the use of risk scores, such as the Global Registry of Acute Coronary Events risk score (GRACE RS). Recent studies have suggested that abdominal obesity is associated with cardiovascular events in patients with ACS. However, little is known about the additional value of abdominal obesity beyond risk scores. The aim of our study was thus to assess whether waist circumference, a surrogate of abdominal adiposity, adds prognostic information to the GRACE RS. This was a retrospective cohort study of ACS patients admitted consecutively to a cardiac care unit between June 2009 and July 2010. The composite of all-cause mortality or myocardial reinfarction within six months of index hospitalization was used as the endpoint for the analysis. A total of 285 patients were studied, 96.1% admitted for myocardial infarction (with or without ST elevation) and 3.9% for unstable angina. At the end of the follow-up period, 10 patients had died and the composite endpoint had been reached in 27 patients (9.5%). More than 70% of the study population were obese or overweight, and abdominal obesity was present in 44.6%. The GRACE RS showed poor predictive accuracy (area under the curve 0.60), and most of the GRACE variables did not reach statistical significance in multivariate analysis. The addition of waist circumference to the GRACE RS did not improve its discriminatory performance. Abdominal obesity does not add prognostic information to the GRACE RS to predict six-month mortality or myocardial reinfarction.

Impact of a 1-year lifestyle modification program on cholesterol efflux capacities in men with abdominal obesity and dyslipidemia.

PubMed

Boyer, Marjorie; Mitchell, Patricia L; Poirier, Dr Paul; Alméras, Natalie; Tremblay, Angelo; Bergeron, Jean; Despres, Jean-Pierre; Arsenault, Benoit J

2018-06-05

Cholesterol efflux capacities (CECs) are negatively associated with cardiovascular disease risk, irrespective of plasma high-density lipoprotein (HDL) cholesterol levels. Whether interventions targeting lifestyle improve HDL-CECs is unknown. Our objective was to determine whether improving dietary quality and increasing physical activity levels improves HDL-CECs in abdominally obese men with dyslipidemia. Our study sample included men (488.5 years) with an elevated waist circumference ({greater than or equal to}90 cm) associated with dyslipidemia (triglycerides {greater than or equal to}1.69 and/or HDL cholesterol <1.03 mmol/l); 113 men completed a 1-year intervention, consisting of a healthy eating and physical activity/exercise program and 32 were included in a control group. An oral lipid tolerance test (OLTT) was performed in a subsample of 28 men who completed the intervention and blood was collected every 2 hours during 8 hours. HDL-CECs were measured using 3 H cholesterol labeled J774 macrophages and HepG2 hepatocytes. The lifestyle modification program led to an overall improvement in the cardiometabolic risk profile, increases in J774-HDL-CEC by 14.1% (+0.881.09%, p<0.0001), HepG2-HDL-CEC by 3.4% (+0.170.75%, p=0.01), HDL-C and apolipoprotein A-1 levels (13.5%, p<0.0001 and 14.9%, p<0.0001, respectively). J774-HDL-CECs and HepG2-HDL-CECs did not change in the control group. The best predictor for changes in HDL-CEC was Apo A1 level. The lifestyle modification program also improved HDL-CECs response in postprandial lipemia during an OLTT. HDL-CEC did not change during the OLTT. Our results suggest that increasing physical activity levels and improving diet quality can have a positive impact on both HDL quantity and quality in abdominally obese men with dyslipidemia.

The focused abdominal sonography for trauma examination can reliably identify patients with significant intra-abdominal hemorrhage in life-threatening pelvic fractures.

PubMed

Christian, Nicole Townsend; Burlew, Clay Cothren; Moore, Ernest E; Geddes, Andrea E; Wagenaar, Amy E; Fox, Charles J; Pieracci, Fredric M

2018-06-01

The focused abdominal sonography for trauma (FAST) examination has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as resuscitative endovascular balloon occlusion of the aorta (REBOA), rapid identification of intra-abdominal hemorrhage compared with Zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intra-abdominal hemorrhage in the face of complex pelvic fractures. Our pelvic fracture database of all hemodynamically unstable patients requiring intervention from January 1, 2005, to July 1, 2015, was reviewed. The FAST examination was compared with operative and computed tomography (CT) scan findings. Confirmatory evaluation for FAST(-) patients was considered positive if therapeutic intervention was required. During the study period, 81 patients in refractory shock with FAST imaging in our emergency department (ED) underwent pelvic packing. Mean age was 45 ± 2 years and Injury Severity Score was 50 ± 1.5. The FAST examination was negative in 53 patients; 52 patients did not require operative intervention for abdominal bleeding while one patient required splenectomy. The FAST examination was positive in 28 patients; 26 had findings confirmed by CT or laparotomy while two patients did not have intra-abdominal hemorrhage on further evaluation. The sensitivity and specificity for FAST in this population was 96% and 96%, respectively, positive predictive value was 93%, and negative predictive value was 98%. The false-negative and -positive rates for FAST were 2% and 7%. Focused abdominal sonography for trauma examination reliably identifies clinically significant hemoperitoneum in life-threatening, pelvic fracture related hemorrhage. The incidence of a false-negative FAST in this unstable pelvic fracture population was 2%. FAST results may be used when determining the role of REBOA in these

Physical activity reduces the risk of incident type 2 diabetes in general and in abdominally lean and obese men and women: the EPIC-InterAct Study.

PubMed

Ekelund, U; Palla, L; Brage, S; Franks, P W; Peters, T; Balkau, B; Diaz, M J T; Huerta, J M; Agnoli, C; Arriola, L; Ardanaz, E; Boeing, H; Clavel-Chapelon, F; Crowe, F; Fagherazzi, G; Groop, L; Føns Johnsen, N; Kaaks, R; Khaw, K T; Key, T J; de Lauzon-Guillain, B; May, A; Monninkhof, E; Navarro, C; Nilsson, P; Nautrup Østergaard, J; Norat, T; Overvad, K; Palli, D; Panico, S; Redondo, M L; Ricceri, F; Rolandsson, O; Romaguera, D; Romieu, I; Sánchez Pérez, M J; Slimani, N; Spijkerman, A; Teucher, B; Tjonneland, A; Travier, N; Tumino, R; Vos, W; Vigl, M; Sharp, S; Langeberg, C; Forouhi, N; Riboli, E; Feskens, E; Wareham, N J

2012-07-01

We examined the independent and combined associations of physical activity and obesity with incident type 2 diabetes in men and women. The InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a randomly selected subcohort of 16,154 individuals, drawn from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. Physical activity was assessed by a four-category index. Obesity was measured by BMI and waist circumference (WC). Associations between physical activity, obesity and case-ascertained incident type 2 diabetes were analysed by Cox regression after adjusting for educational level, smoking status, alcohol consumption and energy intake. In combined analyses, individuals were stratified according to physical activity level, BMI and WC. A one-category difference in physical activity (equivalent to approximately 460 and 365 kJ/day in men and women, respectively) was independently associated with a 13% (HR 0.87, 95% CI 0.80, 0.94) and 7% (HR 0.93, 95% CI 0.89, 0.98) relative reduction in the risk of type 2 diabetes in men and women, respectively. Lower levels of physical activity were associated with an increased risk of diabetes across all strata of BMI. Comparing inactive with active individuals, the HRs were 1.44 (95% CI 1.11, 1.87) and 1.38 (95% CI 1.17, 1.62) in abdominally lean and obese inactive men, respectively, and 1.57 (95% CI 1.19, 2.07) and 1.19 (95% CI 1.01, 1.39) in abdominally lean and obese inactive women, respectively. Physical activity is associated with a reduction in the risk of developing type 2 diabetes across BMI categories in men and women, as well as in abdominally lean and obese men and women.

Influence of non-dietary factors on the prevalence of abdominal obesity as a major component of the metabolic syndrome among 17-18-year-old youth.

PubMed

Piotrowska, Ewa; Broniecka, Anna; Biernat, Jadwiga; Wyka, Joanna; Bronkowska, Monika

2015-01-01

Youth nutrition and their nutritional status are conditioned by many factors, some of the main ones being: economic, social, climatic, cultural, and psychological factors as well as nutritional knowledge. With the growing problem of overweight and obesity among children and young people, the incidence of the metabolic syndrome is also increasing. The aim of the study was to assess the impact of demographic, sociological and psychological factors on the incidence of obesity among 17-18-year-old adolescents from Wroclaw and vicinity as a major risk factor for the development of the metabolic syndrome. The study was conducted in three upper-secondary schools in Wroclaw, Poland. In the surveyed group (17-18 years old, n = 269) girls accounted for 59.5% and boys constituted 40.5%. Majority of young people were Wroclaw citizens (72.9%). Centile charts elaborated by the Children's Memorial Health Institute were adopted for the evaluation of anthropometric parameters. Evaluation of the impact of non-dietary factors on the manner of nutrition was carried out using own questionnaire. Based on the tests, abdominal obesity was determined among 34.5% of adolescents aged 17 years and among 65.5% of these aged 18 years. Obesity was more common in girls carrying genetic burden of the disease. Youth with the largest waist circumference most often declared to use slimming diets - 6.7%, and the lowest hunger sensation in stress - 3.4%. In addition, 30.5% of the adolescents with the smallest waist circumference and 11.5% with the largest waist circumference declared to be non-smoking. Occasional alcohol consumption was declared by 30.1% of young people with the smallest waist circumference, and 13.4% with the largest waist circumference. Youth with abdominal obesity significantly more likely than those with normal waist circumference applied slimming diets. Significant impact on the formation of abdominal obesity among girls had inherited disease burden.

Tissue Oxygenation in Obese and Non-obese Patients During Laparoscopy

PubMed Central

Fleischmann, Edith; Kurz, Andrea; Niedermayr, Monika; Schebesta, Karl; Kimberger, Oliver; Prager, Gerhard; Sessler, Daniel I.; Kabon, Barbara

2005-01-01

Background: Wound infection risk is inversely related to subcutaneous oxygenation, which is reduced in obese patients and may be reduced even more during laparoscopic procedures. Methods: We evaluated subcutaneous tissue oxygenation (PsqO2) in 20 patients with a body mass index (BMI) ≥40 kg·m–2 (obese) and 15 patients with BMI <30 kg·m-2 (non-obese) undergoing laparoscopic surgery with standardised anaesthesia technique and fluid administration. Arterial oxygen tension was maintained near 150 mmHg. PsqO2 was measured from a surrogate wound on the upper arm. Data were analyzed with unpaired two-tailed t or Wilcoxon rank-sum tests; P < 0.05 was statistically significant. Data are given as mean (SD). Results: An FIO2 of 51% (13%) was required in obese patients to reach an arterial oxygen tension of 150 mmHg; however, an FIO2 of only 40% (7%) was required to reach the same oxygen tension in non-obese patients (P=0.007). PsqO2 was significantly less in obese patients: 41 (10) vs. 57 (15) mmHg (P<0.001). Conclusion: Obesity reduces the amount of inspired oxygen required to obtain a given arterial partial pressure and tissue oxygenation. Both factors probably contribute to high infection risk in obese patients. PMID:15978153

Liver fat contents, abdominal adiposity and insulin resistance in non-diabetic prevalent hemodialysis patients.

PubMed

Chen, Hung-Yuan; Lin, Chien-Chu; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Wu, Hon-Yen; Peng, Yu-Sen

2014-01-01

The liver fat contents and abdominal adiposity correlate well with insulin resistance (IR) in the general population. However, the relationship between liver fat content, abdominal adiposity and IR in non-diabetic hemodialysis (HD) patients remains unclear. This study aimed to clarify the associations among these factors. This is a cross-sectional, observational study. All patients received abdominal ultrasound for liver fat content. Abdominal adiposity was quantified with the conicity index (Ci) and waist circumference (WC). We checked the homeostasis model assessment for insulin resistance index (HOMA-IR) for IR. A total of 112 patients (60 women) were analyzed. Subjects with higher liver fat contents and WC had higher IR indices. But Ci did not correlate with IR indices. In both the multi-variable linear regression model and the logistic regression model, only higher liver fat content predicted a severe IR status. Liver fat contents have a remarkable correlation with IR; however, abdominal adiposity, measured either by Ci or WC, dose not independently correlate with IR in non-diabetic prevalent HD patients. © 2014 S. Karger AG, Basel.

Obesity

MedlinePlus

... DC, Wewalka M, et al. Adjustable gastric band surgery or medical management in patients with type 2 diabetes: a randomized ... 25900871 . Kushner RF, Ryan DH. Assessment and lifestyle management of patients with ... surgery versus conventional medical treatment in obese patients with ...

Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity.

PubMed

Taskinen, M-R; Söderlund, S; Bogl, L H; Hakkarainen, A; Matikainen, N; Pietiläinen, K H; Räsänen, S; Lundbom, N; Björnson, E; Eliasson, B; Mancina, R M; Romeo, S; Alméras, N; Pepa, G D; Vetrani, C; Prinster, A; Annuzzi, G; Rivellese, A; Després, J-P; Borén, J

2017-08-01

Overconsumption of dietary sugars, fructose in particular, is linked to cardiovascular risk factors such as type 2 diabetes, obesity, dyslipidemia and nonalcoholic fatty liver disease. However, clinical studies have to date not clarified whether these adverse cardiometabolic effects are induced directly by dietary sugars, or whether they are secondary to weight gain. To assess the effects of fructose (75 g day -1 ), served with their habitual diet over 12 weeks, on liver fat content and other cardiometabolic risk factors in a large cohort (n = 71) of abdominally obese men. We analysed changes in body composition, dietary intake, an extensive panel of cardiometabolic risk markers, hepatic de novo lipogenesis (DNL), liver fat content and postprandial lipid responses after a standardized oral fat tolerance test (OFTT). Fructose consumption had modest adverse effects on cardiometabolic risk factors. However, fructose consumption significantly increased liver fat content and hepatic DNL and decreased β-hydroxybutyrate (a measure of β-oxidation). The individual changes in liver fat were highly variable in subjects matched for the same level of weight change. The increase in liver fat content was significantly more pronounced than the weight gain. The increase in DNL correlated positively with triglyceride area under the curve responses after an OFTT. Our data demonstrated adverse effects of moderate fructose consumption for 12 weeks on multiple cardiometabolic risk factors in particular on liver fat content despite only relative low increases in weight and waist circumference. Our study also indicates that there are remarkable individual differences in susceptibility to visceral adiposity/liver fat after real-world daily consumption of fructose-sweetened beverages over 12 weeks. © 2017 The Association for the Publication of the Journal of Internal Medicine.

[The prevalence of obesity and metabolic syndrome in paediatric patients with epilepsy treated in monotherapy with valproic acid].

PubMed

Carmona-Vazquez, C R; Ruiz-Garcia, M; Pena-Landin, D M; Diaz-Garcia, L; Greenawalt, S R

2015-09-01

Valproic acid (VPA) is a useful antiepileptic drug for controlling different types of epilepsy. It has several side effects and is associated to increased body weight, as well as metabolic and endocrine disorders, including metabolic syndrome. To determine the prevalence of obesity and metabolic syndrome among paediatric patients with epilepsy treated in monotherapy with VPA. The study was cross-sectional, observational and analytical. A sample of patients treated with VPA between 2010-2014 were studied and the body mass index (BMI), abdominal perimeter, arterial blood pressure, glucose, triglycerides and high density lipoproteins (HDL) were studied in search of obesity and metabolic syndrome. Obesity was defined as a BMI above the 95th percentile, and metabolic syndrome was considered if at least three of the following criteria were fulfilled: abdominal perimeter above the 90th percentile, systolic arterial pressure above the 90th percentile, triglycerides above 110 mg/dL and HDL below 40 mg/dL. A total of 47 patients with a mean age of 10.1 ± 4 years were studied; 51.06% were males. Eight (17%) of them developed obesity and, of those, two (25%) had metabolic syndrome. Three patients went on to become overweight (6%). Statistically significant differences were observed in the mean age in comparison to the BMI groups, where the obese patients were adolescents (ANOVA, p = 0.0001) and those who took more VPA per day were the obese (ANOVA, p = 0.024). Patients treated with VPA who become obese may go on to develop metabolic syndrome. They require careful monitoring and, if they are seen to put on weight, withdrawal of the drug should be considered.

Readmission After Abdominal Surgery for Crohn's Disease: Identification of High-Risk Patients.

PubMed

Mege, Diane; Michelassi, Fabrizio

2018-05-16

Although many predictive factors for postoperative morbidity are known, few data are available about readmission after abdominal surgery for Crohn's disease (CD). The objective of this study is to identify predictive factors and high-risk patients for readmission after abdominal CD surgery. All patients who underwent abdominal surgery for CD in one tertiary referral center between January 2004 and December 2016 were included. Patients who required readmission and those without were compared. Perineal procedures, elective readmissions, and abdominal procedures for non-Crohn's indications were not included. Nine hundred eight abdominal procedures were performed in 712 patients. Readmission rates were 8, 8.5, 8.6, 8.8, and 8.9% at 30, 60, and 90 days and 12 and 60 months, respectively. The main reasons were wound infection (14%), deep abscess (13%), small-bowel obstruction (13%), and dehydration (11%). Eight (11%) patients required percutaneous drainage and 19 (27%) underwent an unplanned surgery. After multivariate analysis, three independent predictive factors for readmission were identified: older age (OR 1.02, 95%CI 1.005-1.04; p < 0.006), a history of previous proctectomy (OR 3, 95%CI 1.2-9, p < 0.02), and higher blood loss volume during surgery (OR 1.0001, 95%CI 1-1.002, p < 0.05). Readmission occurred in 8-9% of abdominal procedures for CD within 1-3 months after surgery and it required unplanned reoperation in a quarter of them. Identification of high-risk groups and knowledge of the more common postoperative complications requiring readmission help in increasing postoperative vigilance to select patients who may benefit from early interventions.

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.

DICOM structured report to track patient's radiation dose to organs from abdominal CT exam

NASA Astrophysics Data System (ADS)

Morioka, Craig; Turner, Adam; McNitt-Gray, Michael; Zankl, Maria; Meng, Frank; El-Saden, Suzie

2011-03-01

The dramatic increase of diagnostic imaging capabilities over the past decade has contributed to increased radiation exposure to patient populations. Several factors have contributed to the increase in imaging procedures: wider availability of imaging modalities, increase in technical capabilities, rise in demand by patients and clinicians, favorable reimbursement, and lack of guidelines to control utilization. The primary focus of this research is to provide in depth information about radiation doses that patients receive as a result of CT exams, with the initial investigation involving abdominal CT exams. Current dose measurement methods (i.e. CTDIvol Computed Tomography Dose Index) do not provide direct information about a patient's organ dose. We have developed a method to determine CTDIvol normalized organ doses using a set of organ specific exponential regression equations. These exponential equations along with measured CTDIvol are used to calculate organ dose estimates from abdominal CT scans for eight different patient models. For each patient, organ dose and CTDIvol were estimated for an abdominal CT scan. We then modified the DICOM Radiation Dose Structured Report (RDSR) to store the pertinent patient information on radiation dose to their abdominal organs.

Behavioral management of the obese patient

USDA-ARS?s Scientific Manuscript database

Despite countless diets, exercise regimens, drugs, and behavior modification strategies, the prevalence of obesity continues its relentless increase in both developed and developing nations. Although many necessary components to treat obesity have been identified, behavior modification remains the b...

Acute transfusion-related abdominal injury in trauma patients: a case report.

PubMed

Michel, P; Wähnert, D; Freistühler, M; Laukoetter, M G; Rehberg, S; Raschke, M J; Garcia, P

2016-10-19

Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation. We report the case of an acute secondary abdominal compartment syndrome developing within 3 to 4 hours in a 74-year-old polytraumatized white woman. Although multiple fractures of her extremities and a B-type pelvic ring fracture were diagnosed by a full body computed tomography scan, no intra-abdominal injury could be detected. Hemorrhagic shock with a drop in her hemoglobin level to 5.7 g/dl was treated by massive transfusion of blood products and high doses of catecholamines. Shortly afterwards, her pulmonary gas exchange progressively deteriorated and mechanical ventilation became almost impossible with peak airway pressures of up to 60 cmH 2 O. Her abdomen appeared rigid and tense accompanied by a progressive hemodynamic decompensation necessitating mechanic cardiopulmonary resuscitation. Although preoperative computed tomography scans showed no signs of intra-abdominal fluid, a decompressive laparotomy under cardiopulmonary resuscitation conditions was performed and 2 liters of ascites-like fluid disgorged. Her hemodynamics and pulmonary ventilation improved immediately. This case report describes for the first time acute secondary abdominal compartment syndrome in a trauma patient, evolving in a very short time period. We hypothesize that the massive transfusion of blood products along with high doses of catecholamines triggered the acute

[Pathological gastroesophageal reflux in patients with severe, morbid and hyper obesity].

PubMed

Csendes, A; Burdiles, P; Rojas, J; Burgos, A; Henríquez, A

2001-09-01

Overweight can be a risk factor for pathological gastroesophageal reflux or hiatal hernia. To study the prevalence of gastroesophageal reflux in patients with severe obesity. Sixty seven patients, 51 female, aged 17 to 56 years old with a body mass index over 35 kg/m2, were studied. An upper gastrointestinal endoscopy was performed in all, esophageal manometry was done in 32 and 24 h pH monitoring was done in 32 patients. Seventy nine percent of patients complained of heartburn and 66% of regurgitation. In 16 patients, endoscopy was normal. An erosive esophagitis was found in 33 patients, a short columnar epithelium in 12 and a Barret esophagus with intestinal metaplasia in six. Normal endoscopic findings and erosive esophagitis were present with a higher frequency in women. No association between the degree of obesity and esophageal lesions was observed. Lower esophageal sphincter pressure and abdominal length were significantly higher in subjects with a body mass index over 50 compared to those with a body mass index between 35 and 39.9 kg/m2. No differences were observed in 24 h pH monitoring. A high proportion of severely obese patients had symptoms and endoscopical findings of pathological gastroesophageal reflux.

Predictors of "occult" intra-abdominal injuries in blunt trauma patients.

PubMed

Parreira, José Gustavo; Malpaga, Juliano Mangini Dias; Olliari, Camilla Bilac; Perlingeiro, Jacqueline A G; Soldá, Silvia C; Assef, José Cesar

2015-01-01

to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination. We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries) or Group 2 (without intra-abdominal injuries). Variables were compared between groups to identify those significantly associated with the presence of intra-abdominal injuries, adopting p<0.05 as significant. Subsequently, the variables with p<0.20 on bivariate analysis were selected to create a logistic regression model using the forward stepwise method. A total of 268 cases met the inclusion criteria. Patients in Group I were characterized as having significantly (p<0.05) lower mean AIS score for the head segment (1.0 ± 1.4 vs. 1.8 ± 1.9), as well as higher mean AIS thorax score (1.6 ± 1.7 vs. 0.9 ± 1.5) and ISS (25.7 ± 14.5 vs. 17,1 ± 13,1). The rate of abdominal injuries was significantly higher in run-over pedestrians (37.3%) and in motorcyclists (36.0%) (p<0.001). The resultant logistic regression model provided 73.5% accuracy for identifying abdominal injuries. The variables included were: motorcyclist accident as trauma mechanism (p<0.001 - OR 5.51; 95%CI 2.40-12.64), presence of rib fractures (p<0.003 - OR 3.00; 95%CI 1.47-6.14), run-over pedestrian as trauma mechanism (p=0.008 - OR 2.85; 95%CI 1.13-6.22) and abnormal neurological physical exam at admission (p=0.015 - OR 0.44; 95%CI 0.22-0.85). Intra-abdominal injuries were predominantly associated with trauma mechanism and presence of chest injuries.

Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents.

PubMed

Bacopoulou, Flora; Efthymiou, Vasiliki; Landis, Georgios; Rentoumis, Anastasios; Chrousos, George P

2015-05-04

Indices predictive of adolescent central obesity include waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). Such reference data are lacking for Greek adolescents. The aim of this study was to develop age- and gender-specific WC, WHR and WHtR smoothed reference percentiles for abdominal obesity among Greek adolescents aged 12-17 years, to investigate possible obesity cut-offs of WHR and WHtR and to compare WC percentiles to other adolescent populations. A representative sample of 1610 high school adolescents (42.2% boys, 57.8% girls; mean age ± sd 14.4 ± 1.72 years) participated in this cross-sectional study in Attica, Greece, in 2013. Weight, height, body mass index (BMI), WC, hip circumference (HC), WHR and WHtR were measured and percentiles were calculated using the LMS method. The relation between WHR, WHtR and general obesity, as defined by the International Obesity Task Force, was investigated with receiver operating characteristic (ROC) analysis. The discriminating power of WHR and WHtR was expressed as area under the curve (AUC). Greek adolescents' WC measurements at the 50th and 90th percentile were compared with their counterparts' smoothed percentiles from Norway, Turkey, Poland, South India, Germany and Kuwait. Boys had significantly higher mean in all measures than girls, except for BMI where there was no statistical difference in terms of gender. BMI, WC and HC showed an increasing trend with age. WC leveled off in both genders at the age of 17 years. WHR and WHtR showed a continuous decrease with advancing age. WHtR was a better predictor for general obesity in both boys and girls (AUC 95% CI 0.945-0.992) than the WHR (AUC 95% CI 0.758-0.870); the WHtR cut-off of 0.5 had sensitivity 91% and specificity 95% for both genders and all age groups combined. International comparisons showed that Greek adolescents had relatively high levels of abdominal obesity in early-middle adolescence but this did not persist at

Postoperative Outcomes in Vedolizumab-Treated Patients Undergoing Abdominal Operations for Inflammatory Bowel Disease.

PubMed

Lightner, Amy L; Raffals, Laura E; Mathis, Kellie L; Cima, Robert R; Tse, Chung Sang; Pemberton, John H; Dozois, Eric J; Loftus, Edward V

2017-02-01

Vedolizumab was recently approved by the Food and Drug Administration for the treatment of moderate to severe ulcerative colitis [UC] and Crohn's disease [CD]. No study to date has examined the rate of postoperative infectious complications among patients who received vedolizumab in the perioperative period. We sought to determine the 30-day postoperative infectious complication rate among inflammatory bowel disease [IBD] patients who received vedolizumab within 12 weeks of an abdominal operation as compared to patients who received tumour necrosis factor α [TNFα] inhibitors or no biological therapy. A retrospective chart review between May 1, 2014 and December 31, 2015 of adult IBD patients who underwent an abdominal operation was performed. The study cohort comprised patients who received vedolizumab within 12 weeks of their abdominal operation and the control cohorts were patients who received TNFα inhibitors or no biological therapy. In total, 94 patients received vedolizumab within 12 weeks of an abdominal operation. Fifty experienced postoperative complications [53%], 35 of which were surgical site infections [SSIs] [36%]. The vedolizumab group experienced significantly higher rates of any postoperative infection [53% vs 33% anti-TNF and 28% non-biologics; p<0.001] and SSI [37% vs 10% and 13%; p<0.001]. On univariate and multivariate analysis, exposure to vedolizumab remained a significant predictor of postoperative SSI [p<0.001]. Thirty-seven per cent of IBD patients who received vedolizumab within 30 days of a major abdominal operation experienced a 30-day postoperative SSI, significantly higher than patients receiving TNFα inhibitors or no biological therapy. Vedolizumab within 12 weeks of surgery remained the only predictor of 30-day postoperative SSI on multivariate analysis. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Automatic segmentation of abdominal organs and adipose tissue compartments in water-fat MRI: Application to weight-loss in obesity.

PubMed

Shen, Jun; Baum, Thomas; Cordes, Christian; Ott, Beate; Skurk, Thomas; Kooijman, Hendrik; Rummeny, Ernst J; Hauner, Hans; Menze, Bjoern H; Karampinos, Dimitrios C

2016-09-01

To develop a fully automatic algorithm for abdominal organs and adipose tissue compartments segmentation and to assess organ and adipose tissue volume changes in longitudinal water-fat magnetic resonance imaging (MRI) data. Axial two-point Dixon images were acquired in 20 obese women (age range 24-65, BMI 34.9±3.8kg/m(2)) before and after a four-week calorie restriction. Abdominal organs, subcutaneous adipose tissue (SAT) compartments (abdominal, anterior, posterior), SAT regions along the feet-head direction and regional visceral adipose tissue (VAT) were assessed by a fully automatic algorithm using morphological operations and a multi-atlas-based segmentation method. The accuracy of organ segmentation represented by Dice coefficients ranged from 0.672±0.155 for the pancreas to 0.943±0.023 for the liver. Abdominal SAT changes were significantly greater in the posterior than the anterior SAT compartment (-11.4%±5.1% versus -9.5%±6.3%, p<0.001). The loss of VAT that was not located around any organ (-16.1%±8.9%) was significantly greater than the loss of VAT 5cm around liver, left and right kidney, spleen, and pancreas (p<0.05). The presented fully automatic algorithm showed good performance in abdominal adipose tissue and organ segmentation, and allowed the detection of SAT and VAT subcompartments changes during weight loss. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

An ERβ agonist induces browning of subcutaneous abdominal fat pad in obese female mice.

PubMed

Miao, Yi-Fei; Su, Wen; Dai, Yu-Bing; Wu, Wan-Fu; Huang, Bo; Barros, Rodrigo P A; Nguyen, Hao; Maneix, Laure; Guan, You-Fei; Warner, Margaret; Gustafsson, Jan-Åke

2016-12-06

Estrogen, via estrogen receptor alpha (ERα), exerts several beneficial effects on metabolism and energy homeostasis by controlling size, enzymatic activity and hormonal content of adipose tissue. The actions of estrogen on sympathetic ganglia, which are key players in the browning process, are less well known. In the present study we show that ERβ influences browning of subcutaneous adipose tissue (SAT) via its actions both on sympathetic ganglia and on the SAT itself. A 3-day-treatment with a selective ERβ agonist, LY3201, induced browning of SAT in 1-year-old obese WT and ERα -/- female mice. Browning was associated with increased expression of ERβ in the nuclei of neurons in the sympathetic ganglia, increase in tyrosine hydroxylase in both nerve terminals in the SAT and sympathetic ganglia neurons and an increase of β3-adrenoceptor in the SAT. LY3201 had no effect on browning in young female or male mice. In the case of young females browning was already maximal while in males there was very little expression of ERβ in the SAT and very little expression of the β3-adrenoceptor. The increase in both sympathetic tone and responsiveness of adipocytes to catecholamines reveals a novel role for ERβ in controlling browning of adipose tissue.

An ERβ agonist induces browning of subcutaneous abdominal fat pad in obese female mice

PubMed Central

Miao, Yi-fei; Su, Wen; Dai, Yu-bing; Wu, Wan-fu; Huang, Bo; Barros, Rodrigo P. A.; Nguyen, Hao; Maneix, Laure; Guan, You-fei; Warner, Margaret; Gustafsson, Jan-Åke

2016-01-01

Estrogen, via estrogen receptor alpha (ERα), exerts several beneficial effects on metabolism and energy homeostasis by controlling size, enzymatic activity and hormonal content of adipose tissue. The actions of estrogen on sympathetic ganglia, which are key players in the browning process, are less well known. In the present study we show that ERβ influences browning of subcutaneous adipose tissue (SAT) via its actions both on sympathetic ganglia and on the SAT itself. A 3-day-treatment with a selective ERβ agonist, LY3201, induced browning of SAT in 1-year-old obese WT and ERα−/− female mice. Browning was associated with increased expression of ERβ in the nuclei of neurons in the sympathetic ganglia, increase in tyrosine hydroxylase in both nerve terminals in the SAT and sympathetic ganglia neurons and an increase of β3-adrenoceptor in the SAT. LY3201 had no effect on browning in young female or male mice. In the case of young females browning was already maximal while in males there was very little expression of ERβ in the SAT and very little expression of the β3-adrenoceptor. The increase in both sympathetic tone and responsiveness of adipocytes to catecholamines reveals a novel role for ERβ in controlling browning of adipose tissue. PMID:27922125

Segmental analysis of respiratory liver motion in patients with and without a history of abdominal surgery.

PubMed

Shimizu, Yasuhiro; Takamatsu, Shigeyuki; Yamamoto, Kazutaka; Maeda, Yoshikazu; Sasaki, Makoto; Tamamura, Hiroyasu; Bou, Sayuri; Kumano, Tomoyasu; Gabata, Toshifumi

2018-06-20

The purpose of this study was to analyze the respiratory motion of each segment of the liver in patients with or without a history of abdominal surgery using four-dimensional computed tomography. In total, 57 patients treated for abdominal tumors using proton beam therapy were enrolled. Eighteen patients had a history of abdominal surgery and 39 did not. The positions of clearly demarcated, high-density regions in the liver were measured as evaluation points with which to quantify the motion of each liver segment according to the Couinaud classification. In total, 218 evaluation points were analyzed. Comparison of differences in the motion of individual liver segments showed that among patients without a history of surgery, the maximum was 29.0 (7.2-42.1) mm in S6 and the minimum was 15.1 (10.6-19.3) mm in S4. Among patients with a history of surgery, the maximum was 28.0 (9.0-37.4) mm in S7 and the minimum was 6.3 (4.1-9.3) mm in S3. The distances and directions of respiratory motion differed for each liver segment, and a history of abdominal surgery reduced the respiratory motion of the liver. It is necessary to selectively use the internal margin setting.

Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery

PubMed Central

Ellakany, Mohamed Hamdy

2014-01-01

Aim: A double-blinded randomized controlled study to compare discharge time and patient satisfaction between two groups of patients submitted to open surgeries for abdominal malignancies using segmental thoracic spinal or general anesthesia. Background: Open surgeries for abdominal malignancy are usually done under general anesthesia, but many patients with major medical problems sometimes can’t tolerate such anesthesia. Regional anesthesia namely segmental thoracic spinal anesthesia may be beneficial in such patients. Materials and Methods: A total of 60 patients classified according to American Society of Anesthesiology (ASA) as class II or III undergoing surgeries for abdominal malignancy, like colonic or gastric carcinoma, divided into two groups, 30 patients each. Group G, received general anesthesia, Group S received a segmental (T9-T10 injection) thoracic spinal anesthesia with intrathecal injection of 2 ml of hyperbaric bupivacaine 0.5% (10 mg) and 20 ug fentanyl citrate. Intraoperative monitoring, postoperative pain, complications, recovery time, and patient satisfaction at follow-up were compared between the two groups. Results: Spinal anesthesia was performed easily in all 30 patients, although two patients complained of paraesthesiae, which responded to slight needle withdrawal. No patient required conversion to general anesthesia, six patients required midazolam for anxiety and six patients required phenylephrine and atropine for hypotension and bradycardia, recovery was uneventful and without sequelae. The two groups were comparable with respect to gender, age, weight, height, body mass index, ASA classification, preoperative oxygen saturation and preoperative respiratory rate and operative time. Conclusion: This preliminary study has shown that segmental thoracic spinal anesthesia can be used successfully and effectively for open surgeries for abdominal malignancies by experienced anesthetists. It showed shorter postanesthesia care unit stay

Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery.

PubMed

Ellakany, Mohamed Hamdy

2014-01-01

A double-blinded randomized controlled study to compare discharge time and patient satisfaction between two groups of patients submitted to open surgeries for abdominal malignancies using segmental thoracic spinal or general anesthesia. Open surgeries for abdominal malignancy are usually done under general anesthesia, but many patients with major medical problems sometimes can't tolerate such anesthesia. Regional anesthesia namely segmental thoracic spinal anesthesia may be beneficial in such patients. A total of 60 patients classified according to American Society of Anesthesiology (ASA) as class II or III undergoing surgeries for abdominal malignancy, like colonic or gastric carcinoma, divided into two groups, 30 patients each. Group G, received general anesthesia, Group S received a segmental (T9-T10 injection) thoracic spinal anesthesia with intrathecal injection of 2 ml of hyperbaric bupivacaine 0.5% (10 mg) and 20 ug fentanyl citrate. Intraoperative monitoring, postoperative pain, complications, recovery time, and patient satisfaction at follow-up were compared between the two groups. Spinal anesthesia was performed easily in all 30 patients, although two patients complained of paraesthesiae, which responded to slight needle withdrawal. No patient required conversion to general anesthesia, six patients required midazolam for anxiety and six patients required phenylephrine and atropine for hypotension and bradycardia, recovery was uneventful and without sequelae. The two groups were comparable with respect to gender, age, weight, height, body mass index, ASA classification, preoperative oxygen saturation and preoperative respiratory rate and operative time. This preliminary study has shown that segmental thoracic spinal anesthesia can be used successfully and effectively for open surgeries for abdominal malignancies by experienced anesthetists. It showed shorter postanesthesia care unit stay, better postoperative pain relief and patient satisfaction than

Use of the Gastrografin challenge in patients with a history of abdominal or pelvic malignancy.

PubMed

Khasawneh, Mohammad A; Eiken, Patrick W; Srvantstyan, Boris; Bannon, Michael P; Zielinski, Martin D

2013-10-01

The Gastrografin (GG) challenge was developed to predict the need for operative management in patients with small bowel obstruction (SBO). Although clinical trials have demonstrated that it is an effective diagnostic and therapeutic modality, these studies excluded patients with a history of abdominal/pelvic malignancy. This study aims to examine the outcomes of the GG challenge for patients with a history of abdominal/pelvic malignancies. Institutional review board approval was obtained to review retrospectively patients admitted with SBO in 3 separate categories: Group 1, patients presenting between 2010 and 2012 with SBO who received the GG challenge and had a concurrent history of abdominal or pelvic malignancy; group 2, patients presenting between 2010 and 2012 with SBO who underwent the GG challenge but did not have a concurrent history of abdominal or pelvic malignancy; and group 3, patients presenting between 2007 and 2010 (before our incorporation of the GG challenge protocol) with SBO and a concurrent history of abdominal or pelvic malignancy who did not receive GG . Two distinct comparisons were made. The first analysis was made between groups 1 and 2. The second comparison was performed comparing patients from groups 1 and 3. A total of 237 patients (74 group 1, 83 group 2, 80 group 3) were identified with a mean age of 69.1 years (range, 20-101); 115 were male (48%).There were no adverse events related to GG administration in our study. Analysis of groups 1 and 2 showed similar rates of exploration (25% vs 18%) and complications (32% vs 24%); however, mortality was greater among patients with history of malignancy at 12 months (26% vs 7%). Both groups had similar readmission rates for SBO, as well as exploration upon readmission. Analysis between groups 1 and 3 showed that the need for operative exploration at index admission was less in patients who underwent the GG challenge (26% vs 41%); however, hospital duration of stay was similar (8 vs 9 days

Abnormal temperament in patients with morbid obesity seeking surgical treatment.

PubMed

Amann, Benedikt; Mergl, Roland; Torrent, Carla; Perugi, Giulio; Padberg, Frank; El-Gjamal, Nadja; Laakmann, Gregor

2009-11-01

Obesity and its related disorders are growing epidemic across the world. Research on links between the bipolar spectrum and obesity has proliferated in the last few years. As some forms of abnormal temperament are considered as subtypes of the soft bipolar spectrum, we aimed to evaluate abnormal temperaments in morbidly obese patients. Using a short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego, we investigated abnormal depressive, cyclothymic, hyperthymic, irritable or anxious temperament in 213 patients with morbid obesity compared to a control group of 90 patients admitted prior to organ transplantation. Additionally, the Beck-Depression Inventory (BDI) and the Self-Report Manic Inventory (SRMI) were applied to assess current mood status. The obese group showed statistically significantly more psychiatric comorbidities compared to the control group. Abnormal temperaments were significantly more often observed in patients with morbid obesity rather than in controls. Cyclothymic, irritable and anxious temperaments showed specificity to obesity. Obese patients had significantly higher scores on the BDI, while no difference for SRMI scores was found among the whole groups. All temperaments were positively correlated with BDI and SRMI in the obese group. The control group was not matched for demographic characteristics. Our results need replication but indicate an affective overlap in the form of abnormal temperament and depressive symptoms in obese patients, whereas mood swings should be evaluated and early mood stabilization considered for patients with significant weight gain to prevent obesity or to reduce already existing overweight. Studies of mood stabilizers and prospective observations would shed further insight on this complex interface of a major clinical and public health issue.

Obesity and stroke: Can we translate from rodents to patients?

PubMed Central

Haley, Michael J

2016-01-01

Obesity is a risk factor for stroke and is consequently one of the most common co-morbidities found in patients. There is therefore an identified need to model co-morbidities preclinically to allow better translation from bench to bedside. In preclinical studies, both diet-induced and genetically obese rodents have worse stroke outcome, characterised by increased ischaemic damage and an altered inflammatory response. However, clinical studies have reported an ‘obesity paradox’ in stroke, characterised by reduced mortality and morbidity in obese patients. We discuss the potential reasons why the preclinical and clinical studies may not agree, and review the mechanisms identified in preclinical studies through which obesity may affects stroke outcome. We suggest inflammation plays a central role in this relationship, as obesity features increases in inflammatory mediators such as C-reactive protein and interleukin-6, and chronic inflammation has been linked to worse stroke risk and outcome. PMID:27655337

Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery.

PubMed

Maia, Lígia de Albuquerque; Silva, Pedro Leme; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

2017-06-01

The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes. Expert commentary: Before determining the ideal intraoperative ventilation strategy, it is important to analyze the pathophysiology and comorbidities of each obese patient. Protective ventilation with low tidal volume, driving pressure, energy, and mechanical power should be employed during surgery; however, further studies are required to clarify the most effective ventilation strategies, such as the optimal positive end-expiratory pressure and whether recruitment maneuvers minimize lung injury. In this context, an ongoing trial of intraoperative ventilation in obese patients (PROBESE) should help determine the mechanical ventilation strategy that best improves clinical outcome in patients with body mass index≥35kg/m 2 .

Abdominal obesity and physical inactivity are associated with erectile dysfunction independent of body mass index.

PubMed

Janiszewski, Peter M; Janssen, Ian; Ross, Robert

2009-07-01

Erectile dysfunction (ED) is common among men with an elevated body mass index (BMI). However, a high waist circumference (WC) and low levels of physical activity may predict ED independently of BMI. We investigated the independent relationships between BMI, WC, and physical activity with ED. Subjects consisted of 3,941 adult men (age > or = 20 years) with no history of prostate cancer from the 2001-2004 National Health and Nutrition Examination Survey. Logistic regression analyses were used to examine the relative odds of ED association with categories of BMI, WC, and physical activity. Established thresholds were used to divide subjects into three WC and BMI categories. Physical activity level was divided into active (> or =150 min/week), moderately active (30-149 min/week), and inactive (<30 min/week) categories. A single survey question was used to assess the presence of ED. After control for potential confounders, men with either a high WC or an obese BMI had an approximately 50% higher odds of having ED compared with men with a low WC or a normal BMI, respectively. Further, moderately active or inactive men had an approximately 40-60% greater odds of ED compared with active men. When all three predictors (WC, BMI, and physical activity level) were entered into the same logistic regression model, both a high WC and low physical activity level (moderately active and inactive) were independently associated with a greater odds of ED, whereas BMI level was not. Maintaining a WC level below 102 cm and achieving the recommended amount of moderate-intensity physical activity (>or =150 min/week) is associated with the maintenance of proper erectile function, regardless of BMI level. These findings suggest that the clinical screening for ED risk should include the assessment of WC and physical activity level in addition to BMI.

Metabolic syndrome and its characteristics among obese patients attending an obesity clinic.

PubMed

Termizy, H M; Mafauzy, M

2009-04-01

The increased prevalence of metabolic syndrome worldwide is closely related to the rising obesity epidemic. The objectives of the study were to determine the prevalence and identify the associated and prognostic factors that influence the risk of metabolic syndrome among obese patients attending the Obesity Clinic at Hospital Universiti Sains Malaysia. A study was conducted involving 102 obese persons who attended the Obesity Clinic from January 1 to December 31, 2005. Metabolic syndrome was defined according to the International Diabetes Federation criteria. The overall prevalence of metabolic syndrome among obese patients was 40.2 percent. The prevalence was higher in females (43.7 percent) than in males (32.3 percent). The prevalence of metabolic syndrome was noted to increase with increasing body mass index class, from class 1 to class 2. However, the prevalence was lower in obesity class 3. The prevalence of metabolic comorbidities of raised blood pressure, reduced high density lipoprotein, high triglyceride and raised fasting blood glucose was 42, 40, 36 and 17 percent, respectively. A quarter of obese patients in this study had no other comorbidity. Based on logistic regression multivariable analysis, age was the only significant associated factor that influenced the risk of having metabolic syndrome. The prevalence of metabolic syndrome was high and the highest comorbidity was high blood pressure. Age was the only significant risk factor of having this syndrome.

A patient education tool for nonoperative management of blunt abdominal trauma.

PubMed

Budinger, Julie Marie

2007-01-01

Blunt trauma is the primary mechanism of injury seen at Charleston Area Medical Center, a rural level I trauma center. Blunt abdominal trauma occurs as a result of various mechanisms. It can be safely managed nonoperatively and is considered to be the standard of care in hemodynamically stable patients. Appropriate patient education before discharge will enable patients to identify complications early and seek appropriate medical care.

[Obesity surgery in patients suffering from monogenetic adipositas].