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Sample records for severely obese non-diabetic

  1. Comparison of frequency of obesity in high risk non diabetic young individuals with low risk non diabetic young individuals

    International Nuclear Information System (INIS)

    Shaikh, M.A.; Kumar, R.; Ghori, R.A.

    2011-01-01

    Objective: To assess the body mass index and waist circumferences of high risk non diabetic young individuals and compare them with low risk non diabetic young individuals. Method: A cross sectional, case control comparative study was conducted in the department of medicine, LUMHS from January 2008 to March 2009. Five hundred individuals 20-40 years of age were selected and divided into two groups i.e. Group A: high risk (250 individuals) and Group B: low risk (250 individuals) on the basis of same age and gender. Group A included those who had positive family history of type 2 DM in first degree relatives while group B had no family history of type 2 DM in first degree relatives. The blood pressure, BMI and Waist Circumference was measured and Fasting Blood Sugar was estimated in each individual. In each group 125 (50%) were males and 125 (50%) were females. Results: In group A 58% and in group B 28.8% individuals represented raised BMI whereas 42% in group A and 36% in group B individuals showed an increased waist circumference. Mean fasting blood glucose was significantly higher in Group A than in Group B (P=0.001). Conclusion: Impaired Fasting Glucose is strongly associated with family history of type 2 diabetes mellitus. Presence of obesity specially in high risk non-diabetic young individuals emphasize the need for routine health screening for early institution of preventive measures. (author)

  2. Acute differential effects of dietary protein quality on postprandial lipemia in obese non-diabetic subjects

    DEFF Research Database (Denmark)

    Holmer-Jensen, Jens; Mortensen, Lene Sundahl; Astrup, Arne

    2013-01-01

    Non-fasting triglyceridemia is much closer associated to cardiovascular risk compared to fasting triglyceridemia. We hypothesized that there would be acute differential effects of four common dietary proteins (cod protein, whey isolate, gluten, and casein) on postprandial lipemia in obese non......-diabetic subjects. To test the hypothesis we conducted a randomized, acute clinical intervention study with crossover design. We supplemented a fat rich mixed meal with one of four dietary proteins i.e. cod protein, whey protein, gluten or casein. Eleven obese non-diabetic subjects (age: 40-68, body mass index: 30...... concentration in the chylomicron rich fraction (P = .0293). Thus, we have demonstrated acute differential effects on postprandial metabolism of four dietary proteins supplemented to a fat rich mixed meal in obese non-diabetic subjects. Supplementation with whey protein caused lower postprandial lipemia compared...

  3. Glycohemoglobin levels with severity of periodontitis in non-diabetic population.

    Science.gov (United States)

    Ghalaut, Pankaj; Sharma, Tarun Kumar; Ghalaut, Veena Singh; Singh, Ragini; Ghalaut, P S

    2013-01-01

    Periodontal disease is closely related to type 2 diabetes and is an important complication of diabetes. There are few studies about the relationship the glycohemoglobin levels with severity of periodontitis in non-diabetic population. We therefore planned this study to evaluate the glycohemoglobin levels with severity of periodontitis in non-diabetic population. This study was conducted on 50 age and gender matched subjects in each of the three groups (according to the grades of mobility in periodontitis), a total of 150 non-diabetic periodontitis patients (Grade 1, Grade 2, and Grade 3 mobility) and 50 non-diabetic periodontitis patients with Grade 0 mobility (controls), in collaboration with the Department of Periodontics of Dental College and Department of Biochemistry, PGIMS, Rohtak, Haryana. After obtaining informed consent, fasting venous blood samples of all the non-diabetic periodontitis patients of all grades were collected aseptically for HbA1c, plasma glucose, and serum C-reactive protein (CRP) estimation. A total of 150 non-diabetic periodontitis patients (Grade 1, Grade 2, and Grade 3 mobility) and 50 age and gender matched controls participated in the study. There was no significant difference in fasting plasma glucose and postprandial plasma glucose in non-diabetic periodontitis patients with Grade 1, Grade 2, and Grade 3 mobility as compared to controls, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 2, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 3 and non-diabetic periodontitis patients with Grade 2 mobility as compared to Grade 3. Glycohemoglobin and serum C-reactive protein levels were significantly increased in non-diabetic periodontitis patients with Grade 1, Grade 2, and Grade 3 mobility as compared to controls, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 3 and non-diabetic periodontitis patients with Grade 2 mobility as compared to Grade 3

  4. Obese Japanese adults with type 2 diabetes have higher basal metabolic rates than non-diabetic adults.

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    Miyake, Rieko; Ohkawara, Kazunori; Ishikawa-Takata, Kazuko; Morita, Akemi; Watanabe, Shaw; Tanaka, Shigeho

    2011-01-01

    Several cross-sectional studies in Pima Indians and Caucasians have indicated that obese individuals with type 2 diabetes have a higher basal metabolic rate (BMR) than healthy, obese individuals. However, no study has investigated this comparison in Japanese subjects, who are known to be susceptible to type 2 diabetes due to genetic characteristics. Thirty obese Japanese adults with pre-type 2 diabetes (n=7) or type 2 diabetes (n=13) or without diabetes (n=10) participated in this study. BMR was measured using indirect calorimetry. The relationships between residual BMR (calculated as measured BMR minus BMR adjusted for fat-free mass, fat mass, age, and sex) and biomarkers including fasting glucose, glycosylated hemoglobin (HbA(1c)), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-R), triglycerides, and free fatty acids were examined using Pearson's correlation. BMR in diabetic subjects adjusted for fat-free mass, fat mass, age, and sex was 7.1% higher than in non-diabetic subjects. BMR in diabetic subjects was also significantly (pBMR and fasting glucose (r=0.391, p=0.032). These results indicate that in the Japanese population, obese subjects with type 2 diabetes have higher BMR compared with obese non-diabetic subjects. The fasting glucose level may contribute to these differences.

  5. Association between insulin resistance and preeclampsia in obese non-diabetic women receiving metformin.

    Science.gov (United States)

    Balani, Jyoti; Hyer, Steve; Syngelaki, Argyro; Akolekar, Ranjit; Nicolaides, Kypros H; Johnson, Antoinette; Shehata, Hassan

    2017-12-01

    To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia. At 28 weeks, median HOMA-IR was significantly lower in the metformin group. Logistic regression analysis demonstrated that there was a significant contribution in the prediction of preeclampsia from maternal history of chronic hypertension and gestational weight gain, but not HOMA-IR either at randomisation ( p  = 0.514) or at 28 weeks ( p  = 0.643). Reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is unlikely to be due to changes in insulin resistance.

  6. Effect of a hypocaloric diet on serum visfatin in obese non-diabetic patients.

    Science.gov (United States)

    de Luis, Daniel A; Gonzalez Sagrado, Manuel; Conde, Rosa; Aller, Rocio; Izaola, Olatz; Romero, Enrique

    2008-06-01

    Obesity and insulin resistance are associated with classic and new cardiovascular risk factors, such as inflammatory markers and adipocytokines. The aim of this study was to examine whether weight reduction could change visfatin serum concentrations in obese patients. This was an interventional longitudinal study analyzing a population of 80 obese non-diabetic outpatients. Weight, blood pressure, fasting serum glucose, C-reactive protein, plasma insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols, and insulin resistance (homeostatic model assessment) were measured before and after 3 mo on a hypocaloric diet. Eighty patients were enrolled. The mean age was 46.7 +/- 16.7 y, the mean body mass index was 34.1 +/- 4.8 kg/m(2), with 20 men (25%) and 60 women (75%). After 3 mo on a hypocaloric diet, body mass index, fat mass, waist circumference, systolic blood pressure, fasting serum glucose, total cholesterol, and low-density lipoprotein cholesterol decreased. The serum concentration of visfatin decreased with weight loss (112.14 +/- 70.2 versus 99.4 +/- 58.1 ng/mL, P hypocaloric diet is associated with a significant decrease in circulating serum concentrations of the novel adipokine visfatin in obese subjects. Visfatin is inversely correlated with age.

  7. Effect of metformin on maternal and neonatal outcomes in pregnant obese non-diabetic women: A meta-analysis

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    Ahmed Elmaraezy

    2017-09-01

    Full Text Available Background: Metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women. Objective: We performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women. Materials and Methods: We searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software (Version 5.3. Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects (miscarriage, stillbirth and congenital anomalies. Results: Pooled data from two RCTs (n=843 showed that metformin caused a significant reduction in maternal gestational weight gain (MD-1.35, 95% CI: [2.08, -0.630], compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score (MD-0.09, 95% CI: [0.23, 0.06]. Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]. None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10] and congenital anomalies (RR= 1.36, 95% CI: [0.58, 3.21] differed significantly between the two groups. Conclusion: For obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women.

  8. Plasma metabolomic profiles reflective of glucose homeostasis in non-diabetic and type 2 diabetic obese African-American women.

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    Oliver Fiehn

    2010-12-01

    Full Text Available Insulin resistance progressing to type 2 diabetes mellitus (T2DM is marked by a broad perturbation of macronutrient intermediary metabolism. Understanding the biochemical networks that underlie metabolic homeostasis and how they associate with insulin action will help unravel diabetes etiology and should foster discovery of new biomarkers of disease risk and severity. We examined differences in plasma concentrations of >350 metabolites in fasted obese T2DM vs. obese non-diabetic African-American women, and utilized principal components analysis to identify 158 metabolite components that strongly correlated with fasting HbA1c over a broad range of the latter (r = -0.631; p<0.0001. In addition to many unidentified small molecules, specific metabolites that were increased significantly in T2DM subjects included certain amino acids and their derivatives (i.e., leucine, 2-ketoisocaproate, valine, cystine, histidine, 2-hydroxybutanoate, long-chain fatty acids, and carbohydrate derivatives. Leucine and valine concentrations rose with increasing HbA1c, and significantly correlated with plasma acetylcarnitine concentrations. It is hypothesized that this reflects a close link between abnormalities in glucose homeostasis, amino acid catabolism, and efficiency of fuel combustion in the tricarboxylic acid (TCA cycle. It is speculated that a mechanism for potential TCA cycle inefficiency concurrent with insulin resistance is "anaplerotic stress" emanating from reduced amino acid-derived carbon flux to TCA cycle intermediates, which if coupled to perturbation in cataplerosis would lead to net reduction in TCA cycle capacity relative to fuel delivery.

  9. Morbidity of severe obesity.

    Science.gov (United States)

    Kral, J G

    2001-10-01

    Although obesity is an easy diagnosis to make, its etiologies, pathophysiology, and symptomatology are extraordinarily complex. Progress in surgical technique and anesthesiological management has substantially improved the safety of performing operations on the severely obese in the last 20 years. These improvements have occurred more or less empirically, without a full understanding of etiology or pathophysiology, although this has advanced concomitantly with improvements in practice. This review has attempted to provide a framework to facilitate progress in the neglected areas of patient selection and choice of operation, in an effort to improve long-term outcome. Despite the disparate etiologies of obesity and its diverse comorbidities and complications, there are unifying interdependent pathogenetic mechanisms of great relevance to the practice of antiobesity surgery. The rate of eating, whether driven by HPA dysfunction, ambient stress, or related hereditary susceptibility factors including the increased energy demands of an expanded body fat mass, participates in a cycle that results in disordered satiety (see Fig. 3). This leads to substrate overload, causing extensive metabolic abnormalities such as atherogenesis, insulin resistance, thrombogenesis, and carcinogenesis. This interpretation of the pathophysiology of obesity ironically accords with the original meaning of the word obesity: "to overeat." The ultimate solution to the problem of obesity--preventing it--will not be forthcoming until the food industry is forced to lower production and change its marketing strategies, as the liquor and tobacco industries in the United States were compelled to do. This cannot occur until the large and fast-growing populations of industrialized nations become educated in the personal implications of the energy principle. Regardless of whether school curricula are modified to prioritize health education, the larger problems of cultural and economic change remain for

  10. Pro-inflammatory adipocytokines, oxidative stress, insulin, Zn and Cu: Interrelations with obesity in Egyptian non-diabetic obese children and adolescents.

    Science.gov (United States)

    Habib, Salem A; Saad, Entsar A; Elsharkawy, Ashraf A; Attia, Zeinab R

    2015-09-01

    To investigate the inter-relationships between adipocytokines, oxidative stress, insulin, Zn and Cu and obesity among Egyptian obese non-diabetic children and adolescents. 72 obese children and adolescents of both sexes (5-17 years) were recruited for the study. 40 healthy normal non-obese persons of matched ages and sexes were used as control group. Lipid profile, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) and leptin levels were measured. Malondialdehyde (MDA) and reduced glutathione (GSH) concentrations and superoxide dismutase (SOD) activity were estimated. Micronutrients (Zn and Cu) concentrations in addition to insulin and fasting blood sugar (FBS) levels were also evaluated. Estimation of insulin resistance (homeostatic model assessment (HOMA-IR)) was derived from FBS measurements. Significant elevations (Pobese individuals as compared with control group. Insulin and triglyceride levels were significantly increased in obese male children and HDL-cholesterol level was increased significantly in obese adolescent females compared to controls. However, total cholesterol and LDL-cholesterol levels were significantly high in all obese cases as compared with controls. Insulin resistance was detected in 100% of the patients. We concluded that obesity with pro-inflammatory adipocytokines and hypozincemia together by many mechanisms participate in excessive oxidative stress and are highly associated with inflammation and the development of obesity-related complications. Obesity represents a critical risk factor for development of insulin resistance status. Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  11. Altered plasma lysophosphatidylcholines and amides in non-obese and non-diabetic subjects with borderline-to-moderate hypertriglyceridemia: a case-control study.

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    Sae Young Lee

    Full Text Available Hypertriglyceridemia (HTG is a risk factor for atherosclerotic cardiovascular disease (CVD. We investigated alterations in plasma metabolites associated with borderline-to-moderate HTG (triglycerides (TG 150-500 mg/dL. Using UPLC-LTQ-Orbitrap mass spectrometry analysis, the metabolomics profiles of 111 non-diabetic and non-obese individuals with borderline-to-moderate HTG were compared with those of 111 age- and sex-matched controls with normotriglyceridemia (NTG, TG <150 mg/dL. When compared to the NTG control group, the HTG group exhibited higher plasma levels of lysophosphatidylcholines (lysoPCs, including C14:0 (q = 0.001 and C16:0 (q = 1.8E-05, and several amides, including N-ethyldodecanamide (q = 2.9E-05, N-propyldodecanamide (q = 3.5E-05, palmitoleamide (q = 2.9E-06, and palmitic amide (q = 0.019. The metabolomic profiles of the HTG group also exhibited lower plasma levels of cis-4-octenedioic acid (q<1.0E-9 and docosanamide (q = 0.002 compared with those of the NTG controls. LysoPC 16:0 and palmitoleamide emerged as the primary metabolites able to discriminate the HTG group from the NTG group in a partial least-squares discriminant analysis and were positively associated with the fasting triglyceride levels. We identified alterations in lysoPCs, amides, and cis-4-octenedioic acid among non-diabetic and non-obese individuals with borderline-to-moderate HTG. These results provide novel insights into the metabolic alterations that occur in the early metabolic stages of HTG. This information may facilitate the design of early interventions to prevent disease progression.

  12. The Relationship Between Retinol/Retinol Binding Protein 4 ratio, resistin and inflammation in non diabetic obese Indonesian men

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    Anna Meiliana

    2010-02-01

    Full Text Available Aim To verify the correlation between Retinol/RBP4 Ratio, and resistin with inflammation (represented by hsCRP in non-diabetic obese Indonesian menMethods This was a cross sectional study using 125 subjects. Measured parameters were retinol, RBP4, resistin, and hsCRP. Correlation between retinol, RBP4, resistin, hsCRP and Retinol/RBP4 Ratio was calculated. Cut off point of hsCRP were classiied as follows: <1 mg/l for low risk of inflammation, 1-3 mg/l for moderate risk, and 3-10 mg/l for high risk (according to CVD risk. The Retinol/RBP4 ratio was dichotomized into high (>0.9 and low ratio (≤0.9. The cross tabulation test was performed to predict the inflammation trends described by Retinol/RBP4 Ratio and resistin.Results Retinol was found strongly correlated with RBP4 and resistin (r=0.53; p<0.01. A positive but not significant correlation was found between resistin and Retinol/RBP4 Ratio with hsCRP. In high ratio group, 17.6% subjects were found with low risk inflammation, 26.4% with moderate risk, and 20.8% with high risk, in low ratio group, 8% subjects were low risk inflammation, 20% moderate risk, and 7.2% high risk. Combination between ratio and resistin showed that in “high ratio and low resistin” group, 12% subjects have low risk of inflammation and 8% have high risk. Meanwhile in “low ratio and high resistin” group, 3.2% subjects were found having low risk and 13.6% high risk of inflammation.Conclusions Combination between Retinol/RBP4 Ratio and resistin showed better description about the inflammation risk in non-diabetic obese subjects compare to the ratio itself. (Med J Indones 2010; 19:57-63Keywords: Retinol, RBP4, resistin, hsCRP, obesity, inflammation

  13. RISK OF OBESITY FOR HYPERTENSION DIFFERS BETWEEN DIABETIC AND NON-DIABETIC SUBJECTS

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    MA Sayeed

    2007-01-01

    Full Text Available In recent years, non-communicable diseases (NCD like obesity, hypertension (HTN and Type2 diabetes (T2DM are on the increase, specially in the developing nations. Body mass index (BMI, waist-to-hip ratio (WHR and Waist-to-height ratio (WHtR are used as indices of obesity to relate T2DM, HTN and coronary artery disease (CAD. This study addresses whether the risk of obesity for HTN differs between T2DM and non-DM subjects. We investigated 693 diabetic patients from BIRDEM and 2384 from communities. We measured height, weight, waist-girth, hip-girth and blood pressure. All subjects underwent oral glucose tolerance test (OGTT. BMI, WHR and WHtR were calculated. Systolic and diastolic hypertension (sHTN and dHTN were defined as SBP >=140 and DBP >= 90 mmHg, respectively. The prevalence of both sHTN and dHTN in T2DM was higher than the non-DM subjects (sHTN: 49.1 vs 14.3%, dHTN 19.6 vs. 9.5%. The comparison of characteristics between subjects with and without hypertension showed that the differences were significant for age, weight, waist-girth, BMI, WHR and WHtR for both T2DM and non-DM subjects (for all p<0.001. The increasing trend of hypertension with increasing obesity was observed more in the non-DM than in the T2DM subjects. The risk (OR of obesity for hypertension increased with increasing WHR and WHtR in the non-DM than the T2DM subjects. Compared with the non-DM the T2DM participants had two to three folds higher prevalence of HTN. In either group, BMI, WHR and WHtR were significantly higher in the hypertensive than the non-hypertensive subjects. The prevalence of hypertension increased with the increasing BMI, WHR and WHtR but significant only in the non-DM. Further studies may confirm these findings and determine whether there was any altered association between blood pressure and obesity in diabetes possibily, with or without autonomic neuropathy. Ibrahim Med. Coll. J. 2007; 1(1: 1-6

  14. Severe childhood obesity matters

    NARCIS (Netherlands)

    Slootweg, O.H.

    2014-01-01

    To date, obesity represents a major public health challenge. Obesity is at any age a concern but in pediatric populations it is particularly alarming because of its immediate biomedical and psychosocial consequences and the expectation that it will lead to an increase in morbidity and mortality and

  15. Impaired glucose homeostasis in non-diabetic Greek hypertensives with diabetes family history. Effect of the obesity status.

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    Vyssoulis, Gregory P; Liakos, Charalampos I; Karpanou, Eva A; Triantafyllou, Athanasios I; Michaelides, Andreas P; Tzamou, Vanessa E; Markou, Maria I; Stefanadis, Christodoulos I

    2013-01-01

    Arterial hypertension (AH) and diabetes mellitus (DM) are established cardiovascular risk factors. Impaired glucose homeostasis (IGH; impaired fasting glucose or/and impaired glucose tolerance) or pre-diabetes, obesity, and DM family history identify individuals at risk for type 2 DM in whom preventive interventions are necessary. The aim of this study was to determine the glycemic profile in non-diabetic Greek adult hypertensive men and women according to DM family history and the obesity status. Diabetes family history, obesity markers (waist-to-hip ratio, WHR; body mass index, BMI), glycemic parameters (fasting and 2-hour post-load plasma glucose, if necessary; glycated hemoglobin, HbA1c; fasting insulin), insulin resistance indices (homeostasis model assessment, HOMA; quantitative insulin sensitivity check index, QUICKI; Bennett; McAuley), and IGH prevalence were determined in a large cohort of 11,540 Greek hypertensives referred to our institutions. Positive DM family history was associated with elevated fasting glucose (98.6 ± 13.1 vs 96.5 ± 12.3 mg/dL), HbA1c (5.58% ± 0.49% vs 5.50% ± 0.46%), fasting insulin (9.74 ± 4.20 vs 9.21 ± 3.63 μU/mL) and HOMA (2.43 ± 1.19 vs 2.24 ± 1.01) values, lower QUICKI (0.342 ± 0.025 vs 0.345 ± 0.023), Bennett (0.285 ± 0.081 vs 0.292 ± 0.078) and McAuley (6.73 ± 3.43 vs 6.95 ± 3.44) values, and higher IGH prevalence (45.3% vs 38.7%); P history was significant (P history present with higher IGH prevalence and worse glycemic indices levels compared with those with negative family history, especially in the higher WHR/BMI subgroups. Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  16. Significant sE-Selectin levels reduction after 6 months of anti-TNF-α therapy in non-diabetic patients with moderate-to-severe psoriasis.

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    Genre, Fernanda; Armesto, Susana; Corrales, Alfonso; López-Mejías, Raquel; Remuzgo-Martínez, Sara; Pina, Trinitario; Ubilla, Begoña; Mijares, Verónica; Martín-Varillas, José Luis; Rueda-Gotor, Javier; Portilla, Virginia; Dierssen-Sotos, Trinidad; González-López, Marcos Antonio; González-Vela, María Del Carmen; Blanco, Ricardo; Llorca, Javier; Hernández, José Luis; González-Gay, Miguel Ángel

    2017-12-01

    Psoriasis patients have high risk of atherosclerosis, characterized by endothelial dysfunction. We aimed to study the association of the endothelial activation biomarkers monocyte chemoattractant protein 1 (MCP-1), soluble (s) E-selectin and P-selectin with disease activity and severity in psoriasis patients treated with anti-TNF-α therapy. Also, to evaluate the relationship of metabolic syndrome features with these biomarkers and the effect of anti-TNF-α therapy on these molecules. Twenty-nine consecutive non-diabetic patients with moderate-to-severe psoriasis who underwent 6 months of anti-TNF-α-adalimumab therapy were studied. Metabolic and clinical evaluation was performed prior to anti-TNF-α treatment (time 0) and 6 months later. MCP-1, sE-selectin and sP-selectin serum levels were determined by ELISA. Dyslipidemic and obese patients showed higher MCP-1 levels at month 6 from the onset of anti-TNF-α therapy (p = .05 and .01, respectively). sE-selectin positively correlated with pro-inflammatory molecules such as asymmetric dimethylarginine, sP-selectin and resistin at baseline and month 6 (p psoriasis. Adalimumab therapy led to a reduction in sE-selectin levels, supporting the beneficial effect of anti-TNF-α therapy on mechanisms associated with the development of atherosclerosis in psoriasis.

  17. Differential effects of dietary protein sources on postprandial low-grade inflammation after a single high fat meal in obese non-diabetic subjects

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    Herzig Karl-Heinz

    2011-10-01

    Full Text Available Abstract Background Obesity is a state of chronic low-grade inflammation. Chronic low-grade inflammation is associated with the pathophysiology of both type-2 diabetes and atherosclerosis. Prevention or reduction of chronic low-grade inflammation may be advantageous in relation to obesity related co-morbidity. In this study we investigated the acute effect of dietary protein sources on postprandial low-grade inflammatory markers after a high-fat meal in obese non-diabetic subjects. Methods We conducted a randomized, acute clinical intervention study in a crossover design. We supplemented a fat rich mixed meal with one of four dietary proteins - cod protein, whey isolate, gluten or casein. 11 obese non-diabetic subjects (age: 40-68, BMI: 30.3-42.0 kg/m2 participated and blood samples were drawn in the 4 h postprandial period. Adiponectin was estimated by ELISA methods and cytokines were analyzed by multiplex assay. Results MCP-1 and CCL5/RANTES displayed significant postprandial dynamics. CCL5/RANTES initially increased after all meals, but overall CCL5/RANTES incremental area under the curve (iAUC was significantly lower after the whey meal compared with the cod and casein meals (P = 0.0053. MCP-1 was initially suppressed after all protein meals. However, the iAUC was significantly higher after whey meal compared to the cod and gluten meals (P = 0.04. Conclusion We have demonstrated acute differential effects on postprandial low grade inflammation of four dietary proteins in obese non-diabetic subjects. CCL5/RANTES initially increased after all meals but the smallest overall postprandial increase was observed after the whey meal. MCP-1 was initially suppressed after all 4 protein meals and the whey meal caused the smallest overall postprandial suppression. Trial Registration ClinicalTrials.gov ID: NCT00863564

  18. Association Between Free Fatty Acid (FFA and Insulin Resistance: The Role of Inflammation (Adiponectin and high sensivity C-reactive Protein/hs-CRP and Stress Oxidative (Superoxide Dismutase/SOD in Obese Non-Diabetic Individual

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    Indriyanti Rafi Sukmawati

    2009-12-01

    Full Text Available BACKGROUND: Obesity is highly related to insulin resistance, therefore, the increased number of obesity is followed by the increased prevalence of type 2 Diabetes Melitus. Obesity is associated with increased of reactive oxygen species (ROS in muscle, liver and endothelial cells. The increase of ROS would lead to insulin resistance (IR and increased pro-inflammatory protein. FFA plays an important role in IR by inhibiting muscle glucose transport and oxidation via effects on serine/threonine phosphorylation of IRS-1. The aim of this study was discover the existence of SOD, hs-CRP and and adiponectin levels towards the occurrence of insulin resistance which was caused by elevated level of FFA and to discover the interaction between SOD, hs-CRP and adiponectin in non diabetic obese adult male. METHODS: This was observational study with cross sectional design. There were 65 obese male non diabetic subjects and 45 non obese male non diabetic subjects who met the criteria. In this study, measurements were done on body mass index (BMI, fasting glucose, insulin, adiponectin, hs-CRP and SOD. Obese was defined as BMI >25 kg/m2, normal weight was defined as BMI 18.5-23 kh/m2 and Insulin Resistance was defined as HOMA-IR >1. RESULTS: This study showed that Hypoadiponectinemia condition, decreased SOD level and high level of hs-CRP is associated with insulin resistance in obese non diabetic subject. Adiponectin and SOD were correlated negatively with insulin resistance in obese non diabetic (Adiponectin, r=-0.455, p<0.001; SOD, r=-0.262, p=0.003, hs-CRP was positively correlated with insulin resistance in obese non diabetic (r=0.592, p<0.001. FFA levels was increased in obese insulin resistance compared with non obese non insulin resistance. The Odds Ratio of Adiponectin, hs-CRP and SOD in this study was analyzed by logistic binary. The OR for SOD 3.6 (p=0.001, hs-CRP 9.1 (p<0.001 and Adiponectin 7.2 (p<0.001. CONCLUSIONS: This study suggested that FFA

  19. Altered Plasma Lysophosphatidylcholines and Amides in Non-Obese and Non-Diabetic Subjects with Borderline-To-Moderate Hypertriglyceridemia: A Case-Control Study

    Science.gov (United States)

    Jung, Saem; Lee, Sang-Hyun; Lee, Jong Ho

    2015-01-01

    Hypertriglyceridemia (HTG) is a risk factor for atherosclerotic cardiovascular disease (CVD). We investigated alterations in plasma metabolites associated with borderline-to-moderate HTG (triglycerides (TG) 150-500 mg/dL). Using UPLC-LTQ-Orbitrap mass spectrometry analysis, the metabolomics profiles of 111 non-diabetic and non-obese individuals with borderline-to-moderate HTG were compared with those of 111 age- and sex-matched controls with normotriglyceridemia (NTG, TG amides, including N-ethyldodecanamide (q = 2.9E-05), N-propyldodecanamide (q = 3.5E-05), palmitoleamide (q = 2.9E-06), and palmitic amide (q = 0.019). The metabolomic profiles of the HTG group also exhibited lower plasma levels of cis-4-octenedioic acid (qamides, and cis-4-octenedioic acid among non-diabetic and non-obese individuals with borderline-to-moderate HTG. These results provide novel insights into the metabolic alterations that occur in the early metabolic stages of HTG. This information may facilitate the design of early interventions to prevent disease progression. PMID:25856314

  20. A prospective 4-year study of insulin resistance and adipokines in morbidly obese diabetic and non-diabetic patients after gastric banding.

    Science.gov (United States)

    Urbanavicius, Vaidotas; Juodeikis, Zygimantas; Dzenkeviciute, Vilma; Galkine, Aiste; Petrulioniene, Zaneta; Sapoka, Virginijus; Brimiene, Vilma; Vitkus, Dalius; Brimas, Gintautas

    2017-06-01

    There are insufficient data regarding the changes in adipokine levels after laparoscopic adjustable gastric banding (LAGB) in diabetic and non-diabetic patients and their effects on insulin resistance and type 2 diabetes remission. To assess leptin, adiponectin, and insulin resistance changes after LAGB in diabetic and non-diabetic morbidly obese patients. One hundred and three patients (37 with and 66 without type 2 diabetes) underwent LAGB from January 2009 to January 2010. Glycated hemoglobin, insulin, adipokine levels and insulin resistance were evaluated preoperatively, and 1 and 4 years after LAGB. The mean patient age was 45.9 ±11.7 years and mean preoperative body mass index was 47.5 ±7.3 kg/m 2 . A total of 80 of 103 patients (77.6%) completed the 4-year follow-up. After 4 years the mean excess weight loss was 38.8% and 39.5% in diabetic and non-diabetic patients respectively. Leptin levels decreased significantly in both groups at 1 year, but after 4 years this was noted only in non-diabetic patients. After 1 year adiponectin levels increased significantly only in non-diabetic patients (p = 0.003) and remained almost the same at 4 years. A significant decrease in insulin resistance was noted in both groups 1 year after LAGB and diabetes remission was observed in 23 (62.1%) patients. There was a negative correlation between preoperative insulin resistance and adiponectin levels throughout the follow-up period. Leptin levels positively correlated with BMI throughout the study period (baseline r = 0.45; p < 0.001; after 1 year r = 0.71; p < 0.001; after 4 years r = 0.68; p < 0.001). There was no significant correlation between leptin and adiponectin concentrations preoperatively or after 1 year; however, at 4 years it was significant (r = 0.27; p < 0.02). The most significant metabolic changes occurred within 1 year after LAGB. The 4-year follow-up revealed stabilization in metabolic indices rather than significant improvement.

  1. Effects of different sources of fructans on body weight, blood metabolites and fecal bacteria in normal and obese non-diabetic and diabetic rats.

    Science.gov (United States)

    Rendón-Huerta, Juan A; Juárez-Flores, Bertha; Pinos-Rodríguez, Juan M; Aguirre-Rivera, J Rogelio; Delgado-Portales, Rosa E

    2012-03-01

    Fructans contribute significantly to dietary fiber with beneficial effects on gastrointestinal physiology in healthy individuals and offer a promising approach to treating some diseases. Two experiments (Experiment 1 = rats with normal weight; Experiment 2 = obese rats) were developed to compare the effects of three fructan sources (Cichorium intybus L. Asteraceae, Helianthus tuberosus L. Asteraceae and Agave angustifolia ssp. tequilana Haw, Agavaceae) on body weight change, blood metabolites and fecal bacteria in non-diabetic (ND) and diabetic (D) rats. In Experiment 1 total body weight gain and daily feed intake in D and ND rats decreased (P tequilana decreased blood cholesterol and LDL and liver steatosis. For both ND and D rats, fecal Lactobacillus spp. and Bifidobacterium spp. counts were higher (P < 0.05) with fructan supplements.

  2. Effect of L-Tryptophan and L-Leucine on Gut Hormone Secretion, Appetite Feelings and Gastric Emptying Rates in Lean and Non-Diabetic Obese Participants

    DEFF Research Database (Denmark)

    Meyer-Gerspach, Anne Christin; Häfliger, Simon; Meili, Julian

    2016-01-01

    in relation to peptide release. In contrast, the role of proteins or amino acids is less clear. Our aim was to compare the effects of the amino acids L-tryptophan (L-trp) and L-leucine (L-leu) separately on gastric emptying and gut peptide secretion. PARTICIPANTS/METHODS: The study was conducted...... as a randomized (balanced), double-blind, parallel-group trial. A total of 10 lean and 10 non-diabetic obese participants were included. Participants received intragastric loads of L-trp (0.52 g and 1.56 g) and L-leu (1.56 g), dissolved in 300 mL tap water; 75 g glucose and 300 mL tap water served as control...

  3. Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population.

    Directory of Open Access Journals (Sweden)

    Bridget Ann Knight

    Full Text Available Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and folate at 28 weeks' gestation with maternal adiposity and related biochemical markers in a white non diabetic UK obstetric cohort.Anthropometry and biochemistry data was available on 995 women recruited at 28 weeks gestation to the Exeter Family Study of Childhood Health. Associations between B12 and folate with maternal BMI and other obesity-related biochemical factors (HOMA-R, fasting glucose, triglycerides, HDL and AST were explored using regression analysis, adjusting for potential confounders (socioeconomic status, vegetarian diet, vitamin supplementation, parity, haemodilution (haematocrit.Higher 28 week BMI was associated with lower circulating vitamin B12 (r = -0.25; P<0.001 and folate (r = -0.15; P<0.001. In multiple regression analysis higher 28 week BMI remained an independent predictor of lower circulating B12 (β (95% CI = -0.59 (-0.74, -0.44 i.e. for every 1% increase in BMI there was a 0.6% decrease in circulating B12. Other markers of adiposity/body fat metabolism (HOMA-R, triglycerides and AST were also independently associated with circulating B12. In a similar multiple regression AST was the only independent obesity-related marker associated with serum folate (β (95% CI = 0.16 (0.21, 0.51.In conclusion, our study has replicated the previous Indian findings of associations between lower serum B12 and higher obesity and insulin resistance during pregnancy in a non-diabetic White British population. These findings may have important implications for

  4. Plasma phospholipid transfer protein activity is independently determined by obesity and insulin resistance in non-diabetic subjects

    NARCIS (Netherlands)

    de Vries, Rindert; Kappelle, Paul J. W. H.; Dallinga-Thie, Geesje M.; Dullaart, Robin P. F.

    2011-01-01

    Phospholipid transfer protein (PLTP) is an emerging cardio-metabolic risk factor which is intricately involved in lipoprotein metabolism. Elevated plasma PLTP activity levels are reported in obesity and diabetes mellitus, but the relative contributions of obesity and insulin resistance to plasma

  5. Plasma phospholipid transfer protein activity is independently determined by obesity and insulin resistance in non-diabetic subjects

    NARCIS (Netherlands)

    de Vries, Rindert; Kappelle, Paul J.W.H.; Dallinga-Thie, Geesje M.; Dullaart, Robin P. F.

    Background: Phospholipid transfer protein (PLTP) is an emerging cardio-metabolic risk factor which is intricately involved in lipoprotein metabolism. Elevated plasma PLTP activity levels are reported in obesity and diabetes mellitus, but the relative contributions of obesity and insulin resistance

  6. A STUDY OF THE EFFECT OF LIPOSUCTION ON CORONARY DISEASE RISK FACTORS, INFLAMMATORY MARKERS, AND LEFT VENTRICULAR MASS IN NON-DIABETIC OBESE WOMEN

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2010-12-01

    Full Text Available AbstractINTRODUCTION: Liposuction is a surgical procedure effective in reducing body fat, withgrowing application in conjunction with diet and exercise therapy in the treatment of obesity.In view of the positive effect of weight reduction on cardiovascular disease (CVD riskfactors, such as body mass index (BMI, waist circumference (WC, waist-to-hip ratio(WHR, systolic and diastolic pressure, lipid profile, fasting blood sugar, insulin resistance,inflammatory markers (e.g. chronic reactive protein: CRP, antioxidant capacity, fibrinogenand lipoprotein A (Lpa, this study was conducted to assess the effect of liposuction as atherapeutic procedure in the treatment of obesity.METHODS: A total of 24 non-diabetic obese women (BMI>30 with a mean age of48.7±7.3 years were studied. Before liposuction, the subjects filled out questionnairesobtaining demographic information. Complete physical examination, measurement of waistand hip circumference, height, weight and calculation of WHR and BMI were performed.Fasting blood samples were taken to measure fasting blood glucose, total cholesterol, highdensitylipoprotein (HDL, low-density lipoprotein (LDL, triglyceride (TG, fibrinogen,antioxidant capacity, CRP, lipoprotein A, serum insulin, and insulin resistance. Allmeasurements and physical examinations were repeated 12-14 weeks after liposuction.Data were analyzed with SPSS11 software using paired t-test and repeated measureANOVA.RESULTS: WHR, BMI and LDL decreased significantly following liposuction (P<0.05.Other parameters, however, did not change significantly, although there were signs ofpositive changes.DISCUSSION: Liposuction decreases BMI, WHR and LDL within 12-14 weeks ofliposuction. Providing these reductions are maintained, liposuction may prove valuable inreducing CVD risk factors, besides offering a means for obesity control.Keywords • Liposuction • Obesity

  7. HOMA-IR is associated with significant angiographic coronary artery disease in non-diabetic, non-obese individuals: a cross-sectional study.

    Science.gov (United States)

    Mossmann, Márcio; Wainstein, Marco V; Gonçalves, Sandro C; Wainstein, Rodrigo V; Gravina, Gabriela L; Sangalli, Marlei; Veadrigo, Francine; Matte, Roselene; Reich, Rejane; Costa, Fernanda G; Bertoluci, Marcello C

    2015-01-01

    Insulin resistance is a major component of metabolic syndrome, type 2 Diabetes Mellitus (T2DM) and coronary artery disease (CAD). Although important in T2DM, its role as a predictor of CAD in non-diabetic patients is less studied. In the present study, we aimed to evaluate the association of HOMA-IR with significant CAD, determined by coronary angiography in non-obese, non-T2DM patients. We also evaluate the association between 3 oral glucose tolerance test (OGTT) based insulin sensitivity indexes (Matsuda, STUMVOLL-ISI and OGIS) and CAD. We conducted a cross-sectional study with 54 non-obese, non-diabetic individuals referred for coronary angiography due to suspected CAD. CAD was classified as the "anatomic burden score" corresponding to any stenosis equal or larger than 50 % in diameter on the coronary distribution. Patients without lesions were included in No-CAD group. Patients with at least 1 lesion were included in the CAD group. A 75 g oral glucose tolerance test (OGTT) with measurements of plasma glucose and serum insulin at 0, 30, 60, 90 and 120 min was obtained to calculate insulin sensitivity parameters. HOMA-IR results were ranked and patients were also categorized into insulin resistant (IR) or non-insulin resistant (NIR) if they were respectively above or below the 75th percentile (HOMA-IR > 4.21). The insulin sensitivity tests results were also divided into IR and NIR, respectively below and above each 25th percentile. Chi square was used to study association. Poisson Regression Model was used to compare prevalence ratios between categorized CAD and IR groups. Fifty-four patients were included in the study. There were 26 patients (48 %) with significant CAD. The presence of clinically significant CAD was significant associated with HOMA-IR above p75 (Chi square 4.103, p = 0.0428) and 71 % of patients with HOMA-IR above p75 had significant CAD. Subjects with CAD had increased prevalence ratio of HOMA-IR above p75 compared to subjects without

  8. The Relationship of Fetuin-A, Adiponectin, Retinol Binding Protein-4 (RBP-4 and High Sensitivity C-Reactive Protein (hsCRP with Insulin Resistance (HOMA-IR in Obese Non Diabetic Men

    Directory of Open Access Journals (Sweden)

    Imelda Novianti

    2012-04-01

    Full Text Available BACKGROUND: Central obesity is the accumulation of visceral (intra-abdominal fat and is strongly known to be associated with insulin resistance and type 2 diabetes mellitus (T2DM. Obesity can cause adipocyte hypertrophy that results in dysregulation of adipokine expression. The abnormal function of adipocytes may play an important role in the development of a chronic low-grade proinflammatory state associated with obesity. Adiponectin, retinol binding protein (RBP-4 and fetuin-A play a role in the pathophysiology of insulin resistance. Expression of fetuin-A is increased due to fat accumulation in the liver. Elevated concentration of fetuin-A in the circulation can impair insulin signaling in muscle and liver as well as suppress adiponectin secretion, although its molecular mechanism is still unclear. The aim of this study was to identify the relationship of fetuin-A, adiponectin, RBP-4 and hsCRP with insulin resistance in obese non diabetic men. METHODS: This was an observational study with a cross-sectional design. The study subjects were 64 men with non diabetic abdominal obesity, characterized by waist circumference of 98.47±5.88 cm and fasting blood glucose of 85.75±8.36 mg/dL. RESULTS: This study showed that fetuin-A was positively correlated with HOMA-IR in obese non diabetic men with insulin resistance (r=0.128; p=0.570, although not significant. Fetuin-A was found to be correlated with adiponectin, RBP-4 and hsCRP (r=0.150; p=0.233; r=0.050; p=0.711; r=-0.04; p=0.445, although not significant. CONCLUSIONS: The concentration of fetuin-A showed a tendency to be positively correlated with HOMA-IR and with RBP-4 in obese non diabetic men, although statistically not significant. The concentration of fetuin-A showed a tendency to be negatively correlated with adiponectin and hsCRP although statistically not significant. There was no interrelationship between fetuin-A, adiponectin, RBP-4, hsCRP and HOMA-IR. Elevated concentrations of fetuin

  9. Fibroblast Growth Factor 21 (FGF21, Free Fatty Acid (FFA, High Sensitivity C-reactive Protein (hsCRP and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR Among Indonesian Obese Non-Diabetic Males

    Directory of Open Access Journals (Sweden)

    Yani Lina

    2009-12-01

    Full Text Available BACKGROUND: Fibroblast growth factor-21 (FGF21 is known as an important endocrine and paracrine regulator of metabolic homeostasis. Recent studies have shown that FGF21 attenuates lipolysis in human adipocytes, which is suggested as a FGF21's mechanism as anti-hyperlipidemia, anti-hyperglycemia and anti-obesity. The aim of this study was to measure the correlation between FGF21, FFA, hsCRP and HOMA-IR among Indonesian obese non diabetic males. METHODS: The study was observational with cross sectional design. The analysis was done in 137 subjects aged 30-60 years with non diabetic abdominal obesity. We measured the biochemical markers FGF21, FFA, hsCRP, fasting insulin and fasting glucose. We also measured weight, height, waist circumrefence (WC, creatinine, serum glutamin oxaloacetic transaminase (SGOT, and serum glutamic pyruvic transaminase (SGPT, systolic blood pressure (SBP and diastolic blood pressure (DBP. Correlation between markers was measured using Pearson and Spearman's analysis. RESULTS: There were significant positive correlations between FGF21-HOMA-IR (r=0.314, p=0.000; FGF21-WC (r=0.173, p=0.043; FFA=hsCRP r=0.270, p=0.001; and WC-HOMA-IR (r=0.279, p=0.001. There was significant negative correlation between FGF21-FFA (r=-0.038, p=0.657 and FGF21-hsCRP (r=-0.061, p=0.482. CONCLUSIONS: In this study we found that although there was no significant correlation, FGF21 might act as an anti-lipolytic and anti-inflammation agent among Indonesian obese non-diabetic males. Our findings agree with results of previous studies that the positive correlation between FGF21-WC and FGF21-HOMA-IR might occur as a compensatory mechanism or resistance to FGF21 in obesity. KEYWORDS: obesity, FGF21, FFA, hsCRP, HOMA-IR.

  10. Bariatric surgery for severely obese adolescents.

    Science.gov (United States)

    Fitzgerald, Dominic A; Baur, Louise

    2014-09-01

    Severe obesity is increasing in adolescents and is associated with cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnoea, polycystic ovarian syndrome and a range of musculoskeletal problems. Premature death is the inevitable outcome of persistent severe obesity in adolescents. In adults with severe obesity, medical and lifestyle interventions have been shown to be expensive and less effective in terms of weight loss than has bariatric surgery. The single completed randomised controlled trial in adolescents shows the same outcome. This is supported by meta analyses of bariatric surgery in adolescent subjects. A more aggressive approach to severe obesity, utilising bariatric surgery in selected cases, within the context of a multi-disciplinary team, is required. Copyright © 2014. Published by Elsevier Ltd.

  11. Exenatide has a Pronounced Effect on Energy Intake but not Energy Expenditure in Non-Diabetic Subjects with Obesity: A Randomized, Double-blind, Placebo-Controlled Trial.

    Science.gov (United States)

    Basolo, Alessio; Burkholder, Joshua; Osgood, Kristy; Graham, Alexis; Bundrick, Sarah; Frankl, Joseph; Piaggi, Paolo; Thearle, Marie S; Krakoff, Jonathan

    2018-03-26

    Exenatide is a glucagon-like peptide 1 (GLP-1) mimetic which induces weight loss predominantly, it is presumed, via decreased food intake. However, circulating GLP-1 is also a determinant of energy expenditure. We sought to quantify the effect of exenatide on energy expenditure (EE) and energy intake. In this single-center, randomized double-blind placebo controlled trial, we randomized 80 healthy, non-diabetic volunteers with obesity (46 women, age: 34.4±8.7 y, body fat by DXA: 44.2±7.8%) to subcutaneous exenatide 10 μg twice daily or placebo. Subjects were admitted to our clinical research unit for measurement of 24h-EE in a whole-room indirect calorimeter and ad libitum food intake using an automated vending machine paradigm before and after randomization. Furthermore, energy expenditure and ad libitum food intake measures were repeated at 24-week after readmission for 7-day inpatient stay. Body weight was obtained weekly for up to 5 weeks and was recorded at each monthly follow up visit up to 24 weeks. Prior to randomization, participants over ate during the 3-day vending machine period in the whole study group (114.6±35.2 %), expressed as percentage of weight maintaining energy needs (WMEN) with those who were eventually randomized to exenatide overeating more (121.6±37.7 %) compared to placebo group (107.6±31.5 %). In the exenatide group, ad libitum absolute energy intake decreased by 1016.1±724.5 kcal/day (95% CI: -1250.9 to -781.2) versus a 245.1±710.5 kcal/day (95% CI: -475.4 to -14.7) decrease in placebo (Δ= -624.8 Kcal/day, p energy intake between exenatide group and placebo group and the treatment group decreased 24-h EE more compared to placebo (β = -160.6 Kcal/day, 95% CI: -307.6 to 13.6, p = 0.03) compared to their pre-randomization measurement. However, this reduction was not present after adjustment for changes in FM and FFM (β = -87 kcal/day, p = 0.14). No difference was observed in body weight (Δ = -1.72 kg, 95% CI: -5.77 to 2.30, p

  12. Metabolic profile of clinically severe obese patients.

    Science.gov (United States)

    Faria, Silvia Leite; Faria, Orlando Pereira; Menezes, Caroline Soares; de Gouvêa, Heloisa Rodrigues; de Almeida Cardeal, Mariane

    2012-08-01

    Since low basal metabolic rate (BMR) is a risk factor for weight regain, it is important to measure BMR before bariatric surgery. We aimed to evaluate the BMR among clinically severe obese patients preoperatively. We compared it with that of the control group, with predictive formulas and correlated it with body composition. We used indirect calorimetry (IC) to collect BMR data and multifrequency bioelectrical impedance to collect body composition data. Our sample population consisted of 193 patients of whom 130 were clinically severe obese and 63 were normal/overweight individuals. BMR results were compared with the following predictive formulas: Harris-Benedict (HBE), Bobbioni-Harsch (BH), Cunningham (CUN), Mifflin-St. Jeor (MSJE), and Horie-Waitzberg & Gonzalez (HW & G). This study was approved by the Ethics Committee for Research of the University of Brasilia. Statistical analysis was used to compare and correlate variables. Clinically severe obese patients had higher absolute BMR values and lower adjusted BMR values (p BMR were found in both groups. Among the clinically severe obese patients, the formulas of HW & G and HBE overestimated BMR values (p = 0.0002 and p = 0.0193, respectively), while the BH and CUN underestimated this value; only the MSJE formulas showed similar results to those of IC. The clinically severe obese patients showed low BMR levels when adjusted per kilogram per body weight. Body composition may influence BMR. The use of the MSJE formula may be helpful in those cases where it is impossible to use IC.

  13. [Eating habits of patients with severe obesity].

    Science.gov (United States)

    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.

  14. Characterization of human myotubes from type 2 diabetic and non-diabetic subjects using complementary quantitative mass spectrometric methods

    DEFF Research Database (Denmark)

    Thingholm, Tine E; Bak, Steffen; Beck-Nielsen, Henning

    2011-01-01

    2 diabetes. Several abnormalities have been identified in skeletal muscle from type 2 diabetic subjects, however, the exact molecular mechanisms leading to the diabetic phenotype has still not been found. Here we present a large-scale study in which we combine a quantitative proteomic discovery...... strategy using iTRAQ and a label-free study with a targeted quantitative proteomic approach using selected reaction monitoring (SRM) to identify, quantify and validate changes in protein abundance between human myotubes obtained from non-diabetic lean, non-diabetic obese and type 2 diabetic subjects...

  15. The effect of salsalate on insulin action and glucose tolerance in obese non-diabetic patients: results of a randomised double-blind placebo-controlled study

    DEFF Research Database (Denmark)

    Koska, J; Ortega, E; Bunt, J C

    2009-01-01

    Low-grade inflammation may contribute to obesity-related insulin resistance and has been associated with increased risk of type 2 diabetes mellitus. The present study evaluated whether treatment with salsalate, a traditional anti-inflammatory medication, would improve insulin action in obese non-...

  16. Rare Variant Analysis of Human and Rodent Obesity Genes in Individuals with Severe Childhood Obesity

    NARCIS (Netherlands)

    Hendricks, Audrey E.; Bochukova, Elena G.; Marenne, Gaëlle; Keogh, Julia M.; Atanassova, Neli; Bounds, Rebecca; Wheeler, Eleanor; Mistry, Vanisha; Henning, Elana; Körner, Antje; Muddyman, Dawn; McCarthy, Shane; Hinney, Anke; Hebebrand, Johannes; Scott, Robert A.; Langenberg, Claudia; Wareham, Nick J.; Surendran, Praveen; Howson, Joanna M M; Butterworth, Adam S.; Danesh, John; Nordestgaard, Børge G.; Nielsen, Sune F.; Afzal, Shoaib; Papadia, Sofia; Ashford, Sofie; Garg, Sumedha; Millhauser, Glenn L.; Palomino, Rafael I.; Kwasniewska, Alexandra; Tachmazidou, Ioanna; O'Rahilly, Stephen; Zeggini, Eleftheria; Barroso, Inês; Farooqi, I. Sadaf; Benzeval, Michaela; Burton, Jonathan; Buck, Nicholas; Jäckle, Annette; Kumari, Meena; Laurie, Heather; Lynn, Peter; Pudney, Stephen; Rabe, Birgitta; Wolke, Dieter; Overvad, Kim; Tjønneland, Anne; Clavel-Chapelon, Francoise; Kaaks, Rudolf; Boeing, Heiner; Trichopoulou, Antonia; Ferrari, Pietro; Palli, Domenico; Krogha, Vittorio; Panico, Salvatore; Tuminoa, Rosario; Matullo, Giuseppe; Boer, Jolanda Ma; Van Der Schouw, Yvonne; Weiderpass, Elisabete; Quiros, J. Ramon; Sánchez, María José; Navarro, Carmen; Moreno-Iribas, Conchi; Arriola, Larraitz; Melander, Olle; Wennberg, Patrik; Key, Timothy J.; Riboli, Elio; Al-Turki, Saeed; Anderson, Carl A; Anney, Richard; Antony, Dinu; Soler Artigas, María; Ayub, Muhammad; Bala, Senduran; Barrett, Jeffrey C; Beales, Phil; Bentham, Jamie; Bhattacharyaa, Shoumo; Birney, Ewan; Blackwooda, Douglas; Bobrow, Martin; Bolton, Patrick F.; Boustred, Chris; Breen, Gerome; Calissanoa, Mattia; Carss, Keren; Charlton, Ruth; Chatterjee, Krishna; Chen, Lu; Ciampia, Antonio; Cirak, Sebahattin; Clapham, Peter; Clement, Gail; Coates, Guy; Coccaa, Massimiliano; Collier, David A; Cosgrove, Catherine; Coxa, Tony; Craddock, Nick; Crooks, Lucy; Curran, Sarah; Curtis, David; Daly, Allan; Danecek, Petr; Day, Ian N M; Day-Williams, Aaron G; Dominiczak, Anna; Down, Thomas; Du, Yuanping; Dunham, Ian; Durbin, Richard; Edkins, Sarah; Ekong, Rosemary; Ellis, Peter; Evansa, David M.; FitzPatrick, David R.; Flicek, Paul; Floyd, James S.; Foley, A. Reghan; Franklin, Christopher S.; Futema, Marta; Gallagher, Louise; Gaunt, Tom R.; Geihs, Matthias; Geschwind, Daniel H.; Greenwood, Celia M.T.; Griffin, Heather; Grozeva, Detelina; Guo, Xiaosen; Guo, Xueqin; Gurling, Hugh; Hart, Deborah J.; Holmans, Peter A; Howie, Bryan; Huang, Jie; Huang, Liren; Hubbard, Tim; Humphries, Steve E.; Hurles, Matthew E.; Hysi, Pirro G.; Iotchkova, Valentina; Jackson, David K.; Jamshidi, Yalda; Joyce, Chris; Karczewski, Konrad J.; Kaye, Jane; Keane, Thomas; Kemp, John P.; Kennedy, Karen; Kent, Alastair; Khawaja, Farrah; Van Kogelenberg, Margriet; Kolb-Kokocinski, Anja; Lachance, Genevieve; Langford, Cordelia; Lawson, Daniel; Lee, Irene; Lek, Monkol; Li, Rui; Li, Yingrui; Liang, Jieqin; Lin, Hong; Liu, Ryan; Lönnqvist, Jouko; Lopes, Luis R.; Lopes, Margarida; MacArthur, Daniel G.; Mangino, Massimo; Marchini, Jonathan; Maslen, John; Mathieson, Iain; McGuffin, Peter; McIntosh, Andrew M.; McKechanie, Andrew G.; McQuillin, Andrew; Memari, Yasin; Metrustry, Sarah; Migone, Nicola; Min, Josine L.; Mitchison, Hannah M; Moayyeri, Alireza; Morris, Andrew D.; Morris, James; Muntoni, Francesco; Northstone, Kate; O'Donovan, Michael C.; Onoufriadis, Alexandros; Oualkacha, Karim; Owen, Michael J; Palotie, Aarno; Panoutsopoulou, Kalliope; Parker, Victoria; Parr, Jeremy R.; Paternoster, Lavinia; Paunio, Tiina; Payne, Felicity; Payne, Stewart J.; Perry, John R. B.; Pietilainen, Olli; Plagnol, Vincent; Pollitt, Rebecca C.; Porteous, David J.; Povey, Sue; Quail, Michael A.; Quaye, Lydia; Raymond, F. Lucy; Rehnström, Karola; Richards, J Brent; Ridout, Cheryl K.; Ring, Susan M.; Ritchie, Graham R.S.; Roberts, Nicola; Robinson, Rachel L.; Savage, David B.; Scambler, Peter; Schiffels, Stephan; Schmidts, Miriam; Schoenmakers, Nadia; Scott, Richard H.; Semple, Robert K.; Serra, Eva; Sharp, Sally I.; Shaw, Adam; Shihab, Hashem A.; Shin, So Youn; Skuse, David; Small, Kerrin S; Smee, Carol; Smith, Blair H.; Davey Smith, George; Soranzo, Nicole; Southam, Lorraine; Spasic-Boskovic, Olivera; Spector, Timothy D; St Clair, David; St Pourcain, Beate; Stalker, Jim; Stevens, Elizabeth; Sun, Jianping; Surdulescu, Gabriela L; Suvisaari, Jaana; Syrris, Petros; Taylor, Rohan; Tian, Jing; Timpson, Nicholas J.; Tobin, Martin D; Valdes, Ana M.; Vandersteen, Anthony M.; Vijayarangakannan, Parthiban; Visscher, Peter M.; Wain, Louise V.; Walter, Klaudia; Walters, James T.R.; Wang, Guangbiao; Wang, Jun; Wang, Nai-Yu; Ward, Kirsten; Whyte, Tamieka; Williams, Hywel J.; Williamson, Kathleen A.; Wilson, Crispian; Wilson, Scott G.; Wong, Kim; Xu, Changjiang; Yang, Jian; Zhang, Feng; Zhang, Pingbo; Zheng, Hou Feng

    2017-01-01

    Obesity is a genetically heterogeneous disorder. Using targeted and whole-exome sequencing, we studied 32 human and 87 rodent obesity genes in 2,548 severely obese children and 1,117 controls. We identified 52 variants contributing to obesity in 2% of cases including multiple novel variants in GNAS,

  17. Rare variant analysis of human and rodent obesity genes in individuals with severe childhood obesity

    DEFF Research Database (Denmark)

    Hendricks, Audrey E.; Bochukova, Elena G.; Marenne, Gaëlle

    2017-01-01

    Obesity is a genetically heterogeneous disorder. Using targeted and whole-exome sequencing, we studied 32 human and 87 rodent obesity genes in 2,548 severely obese children and 1,117 controls. We identified 52 variants contributing to obesity in 2% of cases including multiple novel variants in GN...

  18. Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

    DEFF Research Database (Denmark)

    Hendel, H W; Højgaard, L; Andersen, T

    1998-01-01

    OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism influence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not...... with a specific radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat...... mass (P=0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P=0.001). The lithogenic index was > 1 in all subjects and correlated with total fat mass (P=0.04). CONCLUSION: Gallstone pathogenesis in obesity seems to be influenced by the total body fat mass and its regional...

  19. Impact of Severe Obesity on Cardiovascular Risk Factors in Youth.

    Science.gov (United States)

    Zabarsky, Gali; Beek, Cherise; Hagman, Emilia; Pierpont, Bridget; Caprio, Sonia; Weiss, Ram

    2018-01-01

    To compare cardiovascular risk factor clustering (CVRFC) in severely obese youth with those with lower degrees of obesity. We divided a childhood obesity clinic derived cohort into the degrees of obesity (class I, II, and III) and added a "class IV" category corresponding to >160% of the 95th centile of body mass index (BMI) for age and sex. In a cross-sectional analysis, we investigated the presence of CVRFC in 2244 participants; in 621 who were followed longitudinally, we investigated the determinants of endpoint CVRFC. Class IV obesity was associated with increased risk for CVRFC compared with overweight (OR = 17.26, P obesity (OR = 17.26, P obesity. Baseline class IV obesity was associated with increased risk compared with overweight of having CVRFC at follow-up (OR = 5.76, P = .001), to a similar extent as class III obesity (OR = 5.36, P = .001). Changes in the degree of obesity were significant predictors of CVRFC on follow-up (OR = 1.04, P obesity in childhood is conferred prior to reaching class IV obesity. An individualized risk stratification approach in children with severe obesity should be based on presence of complications rather than simple BMI cutoffs. ClinicalTrials.gov NCT01967849. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Correlation between Body Composition and Walking Capacity in Severe Obesity

    OpenAIRE

    Correia de Faria Santar?m, G; de Cleva, R; Santo, Marco Aur?lio; Bernhard, Aline Biaseto; Gadducci, Alexandre Vieira; Greve, Julia Maria D?Andrea; Silva, Paulo Roberto Santos

    2015-01-01

    Background Obesity is associated with mobility reduction due to mechanical factors and excessive body fat. The six-minute walk test (6MWT) has been used to assess functional capacity in severe obesity. Objective To determine the association of BMI, total and segmental body composition with distance walked (6MWD) during the six-minute walk test (6MWT) according to gender and obesity grade. Setting University of S?o Paulo Medical School, Brazil; Public Practice. Methods Functional capacity was ...

  1. Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study.

    Science.gov (United States)

    Barr, E L M; Boyko, E J; Zimmet, P Z; Wolfe, R; Tonkin, A M; Shaw, J E

    2009-03-01

    Hyperglycaemia is a risk factor for cardiovascular disease (CVD) and all-cause mortality in individuals without diabetes. We investigated: (1) whether the risk of all-cause and CVD mortality extended continuously throughout the range of fasting plasma glucose (FPG), 2 h plasma glucose (2hPG) and HbA(1c) values; and (2) the ability of these measures to improve risk prediction for mortality. Data on 10,026 people aged >or=25 years without diagnosed diabetes were obtained from the population-based Australian Diabetes, Obesity and Lifestyle study. Between 1999 and 2000, FPG, 2hPG and HbA(1c) were assessed and all-cause (332 deaths) and CVD (88 deaths) mortality were obtained after 7 years. Both 2hPG and HbA(1c) exhibited linear relationships with all-cause and CVD mortality, whereas FPG showed J-shaped relationships. The adjusted HR (95% CI) for all-cause mortality per SD increase was 1.2 (1.1-1.3) for 2hPG and 1.1 (1.0-1.2) for HbA(1c). The HR for FPG or=5.1 mmol/l (per SD increase) the HR was 1.1 (1.0-1.2). Corresponding HRs for CVD mortality were 1.2 (1.0-1.4), 1.2 (1.0-1.3), 4.0 (2.1-7.6) and 1.3 (1.1-1.4). The discriminative ability of each measure was similar; no measure substantially improved individual risk identification over traditional risk factors. In individuals without diagnosed diabetes, 2hPG and FPG, but not HbA(1c) were significant predictors of all-cause mortality, whereas all measures were significant predictors of CVD mortality. However, these glucose measures did not substantially improve individual risk identification.

  2. The obesity paradox in patients with severe soft tissue infections.

    Science.gov (United States)

    Rios-Diaz, Arturo J; Lin, Elissa; Williams, Katherine; Jiang, Wei; Patel, Vihas; Shimizu, Naomi; Metcalfe, David; Olufajo, Olubode A; Cooper, Zara; Havens, Joaquim; Salim, Ali; Askari, Reza

    2017-09-01

    The "obesity paradox" has been demonstrated in chronic diseases but not in acute surgery. We sought to determine whether obesity is associated with improved outcomes in patients with severe soft tissue infections (SSTIs). The 2006 to 2010 Nationwide Inpatient Sample was used to identify adult patients with SSTIs. Patients were categorized into nonobese and obese (nonmorbid [body mass index 30 to 39.9] and morbid [body mass index ≥ 40]). Logistic regression provided risk-adjusted association between obesity categories and inhospital mortality. There were 2,868 records with SSTI weighted to represent 14,080 patients. Obese patients were less likely to die in hospital than nonobese patients (odds ratio [OR] = .42; 95% confidence interval [CI], .25 to .70; P = .001). Subanalysis revealed a similar trend, with lower odds of mortality in nonmorbid obesity (OR = .46; 95% CI, .23 to .91; P = .025) and morbid obesity (OR = .39; 95% CI, .19 to .80; P = .011) groups. Obesity is independently associated with reduced inhospital mortality in patients with SSTI regardless of the obesity classification. This suggests that the obesity paradox exists in this acute surgical population. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Severe Obesity Decreasing in Children in Cincinnati, Ohio.

    Science.gov (United States)

    Kharofa, Roohi Y; Klein, Jillian A; Khoury, Philip; Siegel, Robert M

    2017-07-01

    Childhood obesity rates appear to be leveling off. Studies not looking at severe obesity may be masking a rightward shift in the distribution of body mass indexes. Our objective was to provide current prevalence rates and examine trends in overweight, obesity, class 2 obesity, and class 3 obesity for youth in Cincinnati, Ohio. We performed a retrospective chart review of children 2 to 18 years old seen at Cincinnati Children's Hospital Medical Center between July 1, 2011, and June 30, 2014. Data from 217 037 BMIs were obtained; 35.2% of children were found to have an elevated BMI. Prevalence rates were highest in older, Hispanic, and Medicaid-insured children. The only significant trend over the 3-year period was a downward shift in class 3 obesity ( P = .02), contrary to national findings. Further studies assessing which clinical/community efforts have led to this downward trend will be essential to target future resources and facilitate continued progress.

  4. Health Behaviours during Pregnancy in Women with Very Severe Obesity

    Directory of Open Access Journals (Sweden)

    Nor A. Mohd-Shukri

    2015-10-01

    Full Text Available The health behaviours of pregnant women with very severe obesity are not known, though these women are at high risk of pregnancy complications. We carried out a prospective case-control study including 148 very severely obese (BMI >40 kg/m2 and 93 lean (BMI <25 kg/m2 pregnant women. Diet, physical activity, smoking, alcohol and folic acid consumption were assessed by questionnaire in early and late (16 and 28 weeks gestation pregnancy. Circulating levels of iron, vitamin B12 and folate and other essential trace elements and minerals were measured in a subset at each time point. The findings biochemically confirmed that very severely obese women consumed diets that were energy-rich but poor in essential micronutrients. A third of all women met physical activity recommendations for pregnancy. A third of very severely obese women and two thirds of lean women took folic acid supplements prior to pregnancy. Very severely obese women were more likely to smoke but less likely to drink alcohol than lean women (all p < 0.05. Women with very severe obesity have low self-reported intakes and circulating levels of essential micronutrients in pregnancy and few follow current recommendations for pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy.

  5. The fast food and obesity link: consumption patterns and severity of obesity.

    Science.gov (United States)

    Garcia, Ginny; Sunil, Thankam S; Hinojosa, Pedro

    2012-05-01

    Rates of extreme forms of obesity are rapidly rising, as is the use of bariatric surgery for its treatment. The aim of the present study was to examine selected behavioral factors associated with severity of obesity among preoperative bariatric surgery patients in the San Antonio area, focusing specifically on the effects of fast food consumption. We used ordered logistic regression to model behavioral and attitudinal effects on obesity outcomes among 270 patients. These outcomes were based on the severity of obesity and were measured on the basis of body mass index. Our results indicated that, among the behavioral factors, fast food consumption exerted the largest influence on higher levels of obesity. These remained after controlling for several social and demographic characteristics. Our findings suggest that higher rates of fast food consumption are connected to the increasing rates of severe obesity. Given that morbid and super morbid obesity rates are growing at a more advanced pace than moderate obesity, it is necessary to explore the behavioral characteristics associated with these trends.

  6. Biomarkers of endocannabinoid system activation in severe obesity.

    Directory of Open Access Journals (Sweden)

    Jack C Sipe

    2010-01-01

    Full Text Available Obesity is a worldwide epidemic, and severe obesity is a risk factor for many diseases, including diabetes, heart disease, stroke, and some cancers. Endocannabinoid system (ECS signaling in the brain and peripheral tissues is activated in obesity and plays a role in the regulation of body weight. The main research question here was whether quantitative measurement of plasma endocannabinoids, anandamide, and related N-acylethanolamines (NAEs, combined with genotyping for mutations in fatty acid amide hydrolase (FAAH would identify circulating biomarkers of ECS activation in severe obesity.Plasma samples were obtained from 96 severely obese subjects with body mass index (BMI of > or = 40 kg/m(2, and 48 normal weight subjects with BMI of A (P129T mutation by comparing plasma ECS metabolite levels in the FAAH 385 minor A allele carriers versus wild-type C/C carriers in both groups. The main finding was significantly elevated mean plasma levels of anandamide (15.1+/-1.4 pmol/ml and related NAEs in study subjects that carried the FAAH 385 A mutant alleles versus normal subjects (13.3+/-1.0 pmol/ml with wild-type FAAH genotype (p = 0.04, and significance was maintained after controlling for BMI.Significantly increased levels of the endocannabinoid anandamide and related NAEs were found in carriers of the FAAH 385 A mutant alleles compared with wild-type FAAH controls. This evidence supports endocannabinoid system activation due to the effect of FAAH 385 mutant A genotype on plasma AEA and related NAE analogs. This is the first study to document that FAAH 385 A mutant alleles have a direct effect on elevated plasma levels of anandamide and related NAEs in humans. These biomarkers may indicate risk for severe obesity and may suggest novel ECS obesity treatment strategies.

  7. Does Family History of Obesity, Cardiovascular, and Metabolic Diseases Influence Onset and Severity of Childhood Obesity?

    Directory of Open Access Journals (Sweden)

    Domenico Corica

    2018-05-01

    Full Text Available ObjectivesThe objectives were to evaluate (1 the metabolic profile and cardiometabolic risk in overweight/obese children at first assessment, stratifying patients according to severity of overweight and age; and (2 to investigate the relationship between family history (FH for obesity and cardiometabolic diseases and severity of childhood obesity.MethodsIn this cross-sectional, retrospective, observational study, 260 children (139 female, aged between 2.4 and 17.2 years, with overweight and obesity were recruited. Data regarding FH for obesity and cardiometabolic diseases were collected. Each patient underwent clinical and auxological examination and fasting blood sampling for metabolic profile. Homeostasis model assessment of insulin resistance (HOMA-IR, triglyceride-to-high-density lipoprotein cholesterol ratio, and atherogenic index of plasma were calculated. To evaluate the severity of obesity, children were divided into two groups for BMI standard deviation (SD ≤2.5 and BMI SD >2.5. Moreover, study population was analyzed, dividing it into three groups based on the chronological age of patient (<8, 8–11, >11 years.ResultsBMI SD was negatively correlated with chronological age (p < 0.005 and significantly higher in the group of children <8 years. BMI SD was positively associated with FH for obesity. Patients with more severe obesity (BMI SD >2.5 were younger (p < 0.005, mostly prepubertal, presented a significantly higher HOMA-IR (p = 0.04, and had a significantly higher prevalence of FH for arterial hypertension, type 2 diabetes mellitus, and coronary heart disease than the other group.Conclusion(1 Family history of obesity and cardiometabolic diseases are important risk factors for precocious obesity onset in childhood and are related to the severity of obesity. (2 Metabolic profile, especially HOMA-IR, is altered even among the youngest obese children at first evaluation. (3 Stratification of obesity severity

  8. Arterial alterations in severely obese children with obstructive sleep apnoea.

    Science.gov (United States)

    Dubern, Beatrice; Aggoun, Yacine; Boulé, Michèle; Fauroux, Brigitte; Bonnet, Damien; Tounian, Patrick

    2010-05-03

    Obstructive sleep apnoea (OSA) in obese adults is associated with cardiovascular disease independently of obesity. Vascular alterations exist in children with obesity and may constitute the first stage in the development of adulthood cardiovascular disease. To investigate the relationship between OSA and early arterial alterations in obese children. Cross-sectional study of a prospective cohort. A total of 51 children with severe obesity managed at a teaching hospital outpatient clinic. Polysomnography was performed. We measured the intima-media thickness and incremental elastic modulus (Einc) to assess the mechanical characteristics of the common carotid artery. Arterial endothelial function was evaluated by measuring flow-mediated dilation and glyceryl trinitrate-mediated dilation (GTNMD) of the brachial artery. A total of 24 (47%) children had a desaturation index (DI) >10/h and 7 (14%) had a respiratory event index >10/h. DI >10/h was associated with significantly higher values of Einc (4.0 + or - 0.5 vs. 2.4 + or - 0.4 mm Hg(-1) x 10(3), p=0.003) and GTNMD (18.0 + or - 1.1 vs. 14.1 + or - 1.0 %, p=0.02) after adjustment for age, sex, body mass index, fasting insulin, and leptin. In the univariate analysis, GTNMD correlated positively with DI (r=0.14, p=0.02) after adjustment for age, sex, fasting insulin and leptin. By multivariate analysis with BMI as an additional independent variable, both GTNMD and Einc correlated significantly with DI (beta=0.4, p=0.02 and beta=0.27, p=0.04, respectively). OSA in children is associated with arterial alterations independently from obesity. The increased vasodilation in response to glyceryl trinitrate reflects pre-existing vasoconstriction probably induced by intermittent hypoxia. OSA should be detected early in children with severe obesity.

  9. Smoking Habit in Severe Obese after bariatric procedures.

    Science.gov (United States)

    Maniscalco, Mauro; Carratù, Pierluigi; Faraone, Stanislao; Cerbone, Maria Rosaria; Cristiano, Stefano; Zedda, Anna; Resta, Onofrio

    2015-01-01

    Bariatric procedures provide an effective means of short term weight loss and sustained weight control for the morbidly obese. The effect of bariatric procedures on smoking habit in obese subjects is not well known. Therefore, we examined the short term effect of bariatric surgery on smoking habit of severe obese patients up to 12 months from the intervention. Smoking habit was assessed in a cohort of 78 morbid smoking obese patients followed at our clinic for bariatric procedures. They underwent non surgical intra-gastric balloon (IB) or surgical procedures such as lap-band laparoscopic surgery (LAGB) or sleeve gastrectomy/gastric by-pass (SPG). Subjects were administered a written questionnaire about their smoking habit before and 3, 6 and 12 months after the procedures. No differences were found among the three groups at 6 and 12 months after the procedures (IB 21 %, LAGB 6 %, SPG 5 %; and IB 14 %, LAGB 3 %, SPG 5 %). Only after 3 months, the rate of quitting of the IB group was higher than LAGB and SPG groups (36 %, 6 % and 5 %, respectively; p = 0.02). Bariatric procedures have no effects on smoking habit of moderate-to-heavy smoker severe obese patients. The use of other traditional smoking cessation methods in patients undergone to bariatric procedures should be implemented.

  10. Characteristics of failed fertilized oocytes in patients with severe obesity

    Directory of Open Access Journals (Sweden)

    E A Pigarova

    2012-12-01

    Full Text Available Реферат по статье: Machtinger R, Combelles CM, Missmer SA, Correia KF, Fox JH, Racowsky C. The association between severe obesity and characteristics of failed fertilized oocytes. Hum Reprod. 2012 Nov;27(11:3198-207.

  11. Associations between severity of obesity in childhood and adolescence, obesity onset and parental BMI: a longitudinal cohort study.

    Science.gov (United States)

    Svensson, V; Jacobsson, J A; Fredriksson, R; Danielsson, P; Sobko, T; Schiöth, H B; Marcus, C

    2011-01-01

    To explore the relationship between severity of obesity at age 7 and age 15, age at onset of obesity, and parental body mass index (BMI) in obese children and adolescents. Longitudinal cohort study. Obese children (n = 231) and their parents (n = 462) from the Swedish National Childhood Obesity Centre. Multivariate regression analyses were applied with severity of obesity (BMI standard deviation score (BMI SDS)) and onset of obesity as dependent variables. The effect of parental BMI was evaluated and in the final models adjusted for gender, parental education, age at onset of obesity, severity of obesity at age 7 and obesity treatment. For severity of obesity at age 7, a positive correlation with maternal BMI was indicated (P = 0.05). Severity of obesity at this age also showed a strong negative correlation with the age at onset of obesity. Severity of obesity at age 15 was significantly correlated with both maternal and paternal BMI (P obesity at age 7 and negatively correlated with treatment. Also, a negative correlation was indicated at this age for parental education. No correlation with age at onset was found at age 15. For age at onset of obesity there was no relevant correlation with parental BMI. Children within the highest tertile of the BMI SDS range were more likely to have two obese parents. The impact of parental BMI on the severity of obesity in children is strengthened as the child grows into adolescence, whereas the age at onset is probably of less importance than previously thought. The influence of parental relative weight primarily affects the severity of childhood obesity and not the timing.

  12. Correlation between Body Composition and Walking Capacity in Severe Obesity.

    Science.gov (United States)

    Correia de Faria Santarém, G; de Cleva, R; Santo, Marco Aurélio; Bernhard, Aline Biaseto; Gadducci, Alexandre Vieira; Greve, Julia Maria D'Andrea; Silva, Paulo Roberto Santos

    2015-01-01

    Obesity is associated with mobility reduction due to mechanical factors and excessive body fat. The six-minute walk test (6MWT) has been used to assess functional capacity in severe obesity. To determine the association of BMI, total and segmental body composition with distance walked (6MWD) during the six-minute walk test (6MWT) according to gender and obesity grade. University of São Paulo Medical School, Brazil; Public Practice. Functional capacity was assessed by 6MWD and body composition (%) by bioelectrical impedance analysis in 90 patients. The mean 6MWD was 514.9 ± 50.3 m for both genders. The male group (M: 545.2 ± 46.9 m) showed a 6MWD higher (p = 0.002) than the female group (F: 505.6 ± 47.9 m). The morbid obese group (MO: 524.7 ± 44.0 m) also showed a 6MWD higher (p = 0.014) than the super obese group (SO: 494.2 ± 57.0 m). There was a positive relationship between 6MWD and fat free mass (FFM), FFM of upper limps (FFM_UL), trunk (FFM_TR) and lower limbs (FFM_LL). Female group presented a positive relationship between 6MWD and FFM, FFM_UL and FFM_LL and male group presented a positive relationship between 6MWD and FFM_TR. In morbid obese group there was a positive relationship between 6MWD with FFM, FFM_UL, FFM_TR and FFM_LL. The super obese group presented a positive relationship between 6MWD with FFM, FFM_TR and FFM_LL. Total and segmental FFM is associated with a better walking capacity than BMI.

  13. Respiratory Tract Infections in Diabetic and Non-Diabetic Individuals are Linked with Serum Surfactant Protein-D

    International Nuclear Information System (INIS)

    Jawed, S.; Parveen, N.

    2015-01-01

    Objective: To find out the rate of respiratory tract infections in diabetic and non-diabetic individuals and their relation with surfactant protein D. Methods: The cross-sectional study was conducted at Dow University of Health Sciences, Karachi, from September 2011 to April 2012, and comprised subjects of both genders between ages of 30 and 60 years. The subjects were divided into four groups: diabetic obese, non-diabetic obese, diabetic non-obese, and non-diabetic-non-obese. A structured questionnaire was used to collect information about respiratory tract infections. Serum surfactant protein D levels were analysed using human surfactant protein D enzyme-linked immunosorbent assay kit. Statistical analysis was performed using SPSS 16. Results: Of the 90 subjects, there were 20(22.2 percent) diabetic obese, 30(33.3 percent) non-diabetic obese, 10(11.1 percent) diabetic non-obese, and 30(33.3 percent) non-diabetic-non-obese. The overall mean age was 36.6±103 years. Among the diabetic obese, 15(75 percent) had respiratory tract infections which was higher than the other study groups, and patients having respiratory tract infections had lower surfactant protein D levels than those who did not have infections (p=0.01). Conclusion: Diabetic obese subjects had greater rate of recurrent respiratory tract infections and had lower concentration of serum surfactant protein D compared to subjects without respiratory tract infections. (author)

  14. Self-Reported Disability in Adults with Severe Obesity

    Directory of Open Access Journals (Sweden)

    I. Kyrou

    2011-01-01

    Full Text Available Self-reported disability in performing daily life activities was assessed in adults with severe obesity (BMI ≥ 35 kg/m2 using the Health Assessment Questionnaire (HAQ. 262 participants were recruited into three BMI groups: Group I: 35–39.99 kg/m2; Group II: 40–44.99 kg/m2; Group III: ≥45.0 kg/m2. Progressively increasing HAQ scores were documented with higher BMI; Group I HAQ score: 0.125 (median (range: 0–1.75; Group II HAQ score: 0.375 (0–2.5; Group III HAQ score: 0.75 (0–2.65 (Group III versus II P 0. The prevalence of this degree of disability increased with increasing BMI and age. It also correlated to type 2 diabetes, metabolic syndrome, and clinical depression, but not to gender. Our data suggest that severe obesity is associated with self-reported disability in performing common daily life activities, with increasing degree of disability as BMI increases over 35 kg/m2. Functional assessment is crucial in obesity management, and establishing the disability profiles of obese patients is integral to both meet the specific healthcare needs of individuals and develop evidence-based public health programs, interventions, and priorities.

  15. Severe pulmonary metastasis in obese and diabetic mice.

    Science.gov (United States)

    Mori, Akinori; Sakurai, Hiroaki; Choo, Min-Kyung; Obi, Ryosuke; Koizumi, Keiichi; Yoshida, Chiho; Shimada, Yutaka; Saiki, Ikuo

    2006-12-15

    Although obesity is known as a risk factor for several human cancers, the association of obesity with cancer recurrence and metastasis remains to be characterized. Here, B16-BL6 melanoma and Lewis lung carcinoma cells were intravenously injected into diabetic (db/db) and obese (ob/ob) mice. The number of experimental lung colonies was markedly promoted in these mice when compared with C57BL/6 mice. In contrast, tumor growth at the implanted site was comparable when cells were inoculated orthotopically. The use of B16-BL6 cells stably transfected with the luciferase gene revealed that the increased metastasis reflected a difference mainly within 6 hr after the intravenous inoculation of tumor cells. Administration of recombinant leptin in ob/ob mice abolished the increase in metastasis early on as well as the decrease in the splenic NK cell number. In addition, depletion of NK cells by an anti-asialo-GM1 antibody abrogated the enhanced metastasis in db/db mice. These results demonstrate that metastasis is markedly promoted in diabetic and obese mice mainly because of decreased NK cell function during the early phase of metastasis. Copyright 2006 Wiley-Liss, Inc.

  16. Impact of obesity on bone mass throughout adult life: Influence of gender and severity of obesity.

    Science.gov (United States)

    Maïmoun, Laurent; Mura, Thibault; Leprieur, Elodie; Avignon, Antoine; Mariano-Goulart, Denis; Sultan, Ariane

    2016-09-01

    Obesity improves areal bone mineral density (aBMD). However, it is unknown whether gender, ageing or the severity of obesity could modulate this effect and whether different bone sites are similarly affected. The aim of this observational study was to model the aBMD variation in obese patients from peak bone period to old age according to gender, bone localisation and severity of obesity. Five hundred and four obese patients (363 women, 72%) with a mean BMI of 38.5 ± 6.0 kg/m2, aged from 18.1 to 81.9 years (mean age 49.6 ± 14.6 years) were recruited. The whole body (WB), hip, lumbar spine (L1–L4) and one-third radius aBMDs were determined using dual-energy x-ray absorptiometry (DXA). Z-scores were significantly increased, above the age- and gender-related mean, both for women and men at WB (respectively 0.79 SD and 0.32 SD), hip (1.09 SD and 1.06 SD), one-third radius (1.70 SD and 0.45 SD) and L1–L4 levels (0.86 SD for women only). The improvement of Z-scores was significantly more marked in women compared to men at all bone sites, hip excepted. Furthermore, differences compared with normal values were significantly accentuated by ageing, without noticeable gender effect. In women, regardless of BMI and bone site, Z-scores were higher than normal values, this difference being most marked at WB, L1–L4 and hip levels for obese patients with a BMI above 40 kg/m2. Lean mass, but not fat mass, was independently associated with aBMD in men and women. This study demonstrated for the first time that obesity induces an improvement of aBMD, which is modulated by bone site location, severity of obesity, age and gender. The accentuation of peak bone mass combined with a reduction of bone loss rate with ageing may explain why obese patients present a lower prevalence of osteoporosis.

  17. Full fat milk consumption protects against severe childhood obesity in Latinos

    OpenAIRE

    Amy L. Beck; Melvin Heyman; Cewin Chao; Janet Wojcicki

    2017-01-01

    Consumption of non- or low-fat dairy products is recommended as a strategy to lower the risk of childhood obesity. However, recent evidence suggests that consumption of whole fat dairy products may, in fact, be protective against obesity. Our objective was to determine the association between milk fat consumption and severe obesity among three-year-old Latino children, a population with a disproportionate burden of obesity and severe obesity. 24-hour-dietary recalls were conducted to determin...

  18. Altered DNA methylation of glycolytic and lipogenic genes in liver from obese and type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Henriette Kirchner

    2016-03-01

    Conclusion: Severely obese non-diabetic and type 2 diabetic patients have distinct alterations in the hepatic methylome and transcriptome, with hypomethylation of several genes controlling glucose metabolism within the ATF-motif regulatory site. Obesity appears to shift the epigenetic program of the liver towards increased glycolysis and lipogenesis, which may exacerbate the development of insulin resistance.

  19. Practical approaches to the treatment of severe pediatric obesity.

    Science.gov (United States)

    Lenders, C M; Gorman, K; Lim-Miller, A; Puklin, S; Pratt, J

    2011-12-01

    Pediatric obesity is a major public health threat. Obese children and adolescents are at increased risk for many medical and surgical conditions. These conditions may affect their quality of life and life expectancy. The rapidly progressive nature of type 2 diabetes mellitus within the first 5 years of obesity diagnosis is particularly concerning. Because health risk increases with degree of obesity, adolescents who may be eligible for more aggressive obesity treatment should be identified and counseled. Published by Elsevier Inc.

  20. Association Between Free Fatty Acid (FFA) and Insulin Resistance: the Role of Inflammation (Adiponectin and High Sensivity C-reactive Protein/hs-CRP) and Stress Oxidative (Superoxide Dismutase/SOD) in Obese Non-Diabetic Individual

    OpenAIRE

    Sukmawati, Indriyanti Rafi; Donoseputro, Marsetio; Lukito, Widjaja

    2009-01-01

    BACKGROUND: Obesity is highly related to insulin resistance, therefore, the increased number of obesity is followed by the increased prevalence of type 2 Diabetes Melitus. Obesity is associated with increased of reactive oxygen species (ROS) in muscle, liver and endothelial cells. The increase of ROS would lead to insulin resistance (IR) and increased pro-inflammatory protein. FFA plays an important role in IR by inhibiting muscle glucose transport and oxidation via effects on serine/threonin...

  1. ANEMIA IN HEMODIALYSIS PATIENTS: DIABETIC VS NON DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    SH SHAHIDI

    2002-12-01

    Full Text Available Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8 ± 1.7 in diabetic and non diabetic patients (P<0.05. Mean corposcular volume in diabetic patients (91±3.1 fl was more higher than non diabetic ones (87.1 ± 8.9 (P < 0.05. Other indices had no differences between two groups (P > 0.05. Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.

  2. Copy number variations in "classical" obesity candidate genes are not frequently associated with severe early-onset obesity in children.

    Science.gov (United States)

    Windholz, Jan; Kovacs, Peter; Schlicke, Marina; Franke, Christin; Mahajan, Anubha; Morris, Andrew P; Lemke, Johannes R; Klammt, Jürgen; Kiess, Wieland; Schöneberg, Torsten; Pfäffle, Roland; Körner, Antje

    2017-05-01

    Obesity is genetically heterogeneous and highly heritable, although polymorphisms explain the phenotype in only a small proportion of obese children. We investigated the presence of copy number variations (CNVs) in "classical" genes known to be associated with (monogenic) early-onset obesity in children. In 194 obese Caucasian children selected for early-onset and severe obesity from our obesity cohort we screened for deletions and/or duplications by multiplex ligation-dependent probe amplification reaction (MLPA). As we found one MLPA probe to interfere with a polymorphism in SIM1 we investigated its association with obesity and other phenotypic traits in our extended cohort of 2305 children. In the selected subset of most severely obese children, we did not find CNV with MLPA in POMC, LEP, LEPR, MC4R, MC3R or MC2R genes. However, one SIM1 probe located at exon 9 gave signals suggestive for SIM1 insufficiency in 52 patients. Polymerase chain reaction (PCR) analysis identified this as a false positive result due to interference with single nucleotide polymorphism (SNP) rs3734354/rs3734355. We, therefore, investigated for associations of this polymorphism with obesity and metabolic traits in our extended cohort. We found rs3734354/rs3734355 to be associated with body mass index-standard deviation score (BMI-SDS) (p = 0.003), but not with parameters of insulin metabolism, blood pressure or food intake. In our modest sample of severely obese children, we were unable to find CNVs in well-established monogenic obesity genes. Nevertheless, we found an association of rs3734354 in SIM1 with obesity of early-onset type in children, although not with obesity-related traits.

  3. Severe Obesity in Adolescents and Young Adults Is Associated With Subclinical Cardiac and Vascular Changes.

    Science.gov (United States)

    Shah, Amy S; Dolan, Lawrence M; Khoury, Philip R; Gao, Zhiqan; Kimball, Thomas R; Urbina, Elaine M

    2015-07-01

    Severe obesity is the fastest growing subgroup of obesity in youth. We sought to explore the association between severe obesity and subclinical measures of cardiac and vascular structure and function in adolescents and young adults. This was a cross-sectional comparison of 265 adolescents and young adults with severe obesity (defined as body mass index [BMI] ≥120% of the 95th percentile) to 182 adolescents and young adults with obesity (defined as BMI ≥100-119th of the 95th percentile) at tertiary medical center. Noninvasive measures of cardiac and vascular structure and function were assessed. Participants were a mean age of 17.9 years, 62% were non-Caucasian, and 68% were female. Systolic blood pressure, fasting insulin, C-reactive protein, IL-6, and frequency of type 2 diabetes were higher in participants with severe obesity (all P obesity as measured by higher left ventricular mass index, worse diastolic function, higher carotid intima media thickness, and pulse wave velocity and lower brachial distensibility (all P obesity (compared with obesity) was independently associated with each of the above outcomes after adjustment for age, race, sex, blood pressure, lipids, and inflammatory markers (P young adults with severe obesity have a more adverse cardiovascular risk profile and worse cardiac and vascular structure and function. More importantly, severe obesity is independently associated with these subclinical cardiac and vascular changes.

  4. An obesity drug sibutramine reduces brain natriuretic peptide (BNP) levels in severely obese patients.

    Science.gov (United States)

    Taner Ertugrul, D; Yavuz, B; Okhan Akin, K; Arif Yalcin, A; Ata, N; Kucukazman, M; Algul, B; Dal, K; Sinan Deveci, O; Tutal, E

    2010-03-01

    Sibutramine is a selective inhibitor of the reuptake of monoamines. Plasma levels of brain natriuretic peptide (BNP) appear to be inversely associated with body mass index (BMI) in subjects with and without heart failure for reasons that remain unexplained. The aim of this study was to investigate the possible influence of sibutramine treatment on BNP levels in severely obese patients. Fifty-two severely obese female patients with BMI > 40 kg/m(2) were included to this study. The women were recommended to follow a weight-reducing daily diet of 25 kcal/kg of ideal body weight. During the treatment period, all patients were to receive 15 mg of sibutramine once a day. Blood chemistry tests were performed before the onset of the medication and after 12 weeks of treatment. None of the subjects was withdrawn from the study because of the adverse effects of sibutramine. Body weight (108.8 +/- 13.3 kg vs. 101.7 +/- 15.6 kg, p sibutramine treatment. Total cholesterol (5.19 +/- 0.90 mmol/l vs. 4.82 +/- 1.05 mmol/l respectively; p sibutramine treatment. Further randomised studies are needed to be conducted to clarify the relationship between sibutramine and BNP.

  5. The relationship of omental and subcutaneous adipocyte size to metabolic disease in severe obesity.

    LENUS (Irish Health Repository)

    O'Connell, Jean

    2010-01-01

    Several studies have reported the existence of a subgroup of obese individuals with normal metabolic profiles. It remains unclear what factors are responsible for this phenomenon. We proposed that adipocyte size might be a key factor in the protection of metabolically healthy obese (MHO) individuals from the adverse effects of obesity.

  6. RELATIONSHIPS AMONG THYROID HORMONES AND OBESITY SEVERITY, METABOLIC SYNDROME AND ITS COMPONENTS IN TURKISH CHILDREN WITH OBESITY.

    Science.gov (United States)

    Özer, Samet; Bütün, İlknur; Sönmezgöz, Ergün; Yılmaz, Resul; Demir, Osman

    2015-08-01

    we investigated the relationships between thyroid function and obesity severity, metabolic syndrome (MS) and MS components in 260 obese children and adolescents 10-17 years of age. we aimed to determine the association of thyroid functions with obesity severity and the components of metabolic syndrome (MS) in pediatric obese patients. only obese children and adolescents were included, and divided the obese children into three groups according to body mass index (BMI)-SDS quartiles. The first quartile was group 1, the second and third quartiles were group 2, and the fourth quartile was group 3. Group 3 indicated severe obesity. The modified WHO criteria adapted for children were used to diagnose MS. We assessed anthropometric data and serum biochemical parameters, including the lipid profile and fasting glucose (FG), insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. Blood pressure (BP) was measured with a standard digital sphygmomanometer. The homeostasis model assessment of insulin resistance was calculated to determine insulin resistance (IR). TSH level was significantly higher in obese children with MS than that in the others (p = 0.045). Mean TSH level was not different among the BMI-SDS groups (p = 0.590). TSH levels and the fT3/fT4 ratio were not different in children with dyslipidemia, IR or hypertension (p = 0.515, 0.805, 0.973, 0.750, 0.515, and 0.805, respectively). obesity severity does not affect TSH level or the fT3/fT4 ratio in obese children and adolescents. IR is in close relationship with TSH level. Elevated TSH level is a risk factor for MS. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  7. Comparison of iron status and insulin resistance between non-diabetic offspring of type 2 diabetics and non-diabetic offspring of non-diabetics

    International Nuclear Information System (INIS)

    Zafar, U.; Qureshi, H.J.

    2015-01-01

    Insulin resistance is positively correlated with body iron. It is unclear whether iron is a cause or an outcome of insulin resistance. Insulin resistance precedes type 2 diabetes mellitus. Offspring of type 2 diabetics are insulin resistant as compared to those of the non-diabetics. The present study was designed to compare and correlate insulin resistance with iron parameters (including serum ferritin, transferrin saturation and blood haemoglobin) in non-diabetic offspring of type 2 diabetics and non-diabetic offspring of non-diabetics. Methods: It was a cross-sectional study, conducted on one hundred and twenty male subjects 20-40 years of age. They were divided into two groups, each group having 60 subjects. Group A included non-diabetic offspring of type 2 diabetics, while Group B included non-diabetic offspring of non-diabetics. Fasting blood sample was taken and examined for glucose, haemoglobin, insulin, iron, TIBC and ferritin. Data was analysed by SPSS-17. Results: Insulin resistance and iron parameters were significantly higher (p<0.05) in non-diabetic offspring of type 2 diabetics as compared to those of the non-diabetics. There was significant positive correlation (p=0.027) between insulin resistance and serum iron in non-diabetic offspring of type 2 diabetics. There was also significant positive correlation between insulin resistance and serum iron, transferrin saturation and haemoglobin in non-diabetic offspring of non-diabetics. Conclusion: Non-diabetic offspring of type 2 diabetics have iron load and insulin resistance, that predispose them to the development of type 2 diabetes. (author)

  8. Full fat milk consumption protects against severe childhood obesity in Latinos

    Directory of Open Access Journals (Sweden)

    Amy L. Beck

    2017-12-01

    Full Text Available Consumption of non- or low-fat dairy products is recommended as a strategy to lower the risk of childhood obesity. However, recent evidence suggests that consumption of whole fat dairy products may, in fact, be protective against obesity. Our objective was to determine the association between milk fat consumption and severe obesity among three-year-old Latino children, a population with a disproportionate burden of obesity and severe obesity. 24-hour-dietary recalls were conducted to determine child intake in San Francisco based cohort recruited in 2006–7. Mother-child dyads were weighed and measured. The 24-hour recall data was analyzed to determine participants' consumption of whole milk, 2% milk, and 1% milk. The milk consumption data was used to calculate grams of milk fat consumed. The cross-sectional association between milk fat intake and severe obesity (BMI ≥ 99th percentile was determined using multivariable logistic regression. Data were available for 145 children, of whom 17% were severely obese. Severely obese children had a lower mean intake of milk fat (5.3 g vs. 8.9 g and fewer drank any milk (79% versus 95% for not severely obese children (p < 0.01. Among the potential confounders assessed, maternal BMI and maternal marital status were associated with severe obesity and were included in a multivariate model. In the multivariate model, higher milk fat consumption was associated with lower odds of severe obesity (OR 0.88 CI 0.80–0.97. Higher milk fat consumption is associated with lower odds of severe obesity among Latino preschoolers. These results call into question recommendations that promote consumption of lower fat milk. Keywords: Preschoolers, Dairy products, Latinos, Nutrition policy, Health disparities

  9. The degree of coronary atherosclerosis as a marker of insulin resistance in non-diabetics

    Directory of Open Access Journals (Sweden)

    Parapid Biljana

    2010-01-01

    Full Text Available Introduction. The metabolic syndrome and its influence on coronary artery disease development and progression remains in focus of international research debates, while insulin resistance, which represents its core, is the key component of hypertension, dyslipidaemias, glucose intolerance and obesity. Objective. The aim of this study was to establish relationship between basal glucose and insulin levels, insulin sensitivity and lipid panel and the degree of coronary atherosclerosis in nondiabetic patients. Methods. The coronary angiograms were evaluated for the presence of significant stenosis, insulin sensitivity was assessed using the intravenous glucose tolerance test with a minimal model according to Bergman, while baseline glucose (G0, insulin (I0 and lipid panel measurements (TC, HDL, LDL, TG were taken after a 12-hour fasting. Results. The protocol encompassed 40 patients (19 men and 21 women treated at the Institute for Cardiovascular Diseases of the Clinical Centre of Serbia, Belgrade. All were non-diabetics who were divided into 3 groups based on their angios: Group A (6 patients, 15%, with no significant stenosis, Group B (18 patients, 45%, with a single-vessel disease and Group C (16 patients, 40%, with multi-vessel disease. Presence of lower insulin sensitivity, higher I0 and TC in the group of patients with a more severe degree of coronary atherosclerosis (insulin sensitivity: F=4.279, p=0.023, A vs. C p=0.012, B vs. C p=0.038; I0: F=3.461 p=0.042, A vs. B p=0.045, A vs. C p=0.013; TC: F=2.572, p=0.09, while no significant difference was found for G0, LDL, HDL and TG. Conclusion. Baseline insulinaemia, more precisely, fasting hyperinsulinaemia could be a good predictor of significant coronary atherosclerosis in non-diabetic patients, which enables a more elegant cardiometabolic risk assessment in the setting of everyday clinical practice.

  10. Convergence in insulin resistance between very severely obese and lean women at the end of pregnancy.

    Science.gov (United States)

    Forbes, Shareen; Barr, Sarah M; Reynolds, Rebecca M; Semple, Scott; Gray, Calum; Andrew, Ruth; Denison, Fiona C; Walker, Brian R; Norman, Jane E

    2015-11-01

    Disrupted intermediary metabolism may contribute to the adverse pregnancy outcomes in women with very severe obesity. Our aim was to study metabolism in such pregnancies. We recruited a longitudinal cohort of very severely obese (n = 190) and lean (n = 118) glucose-tolerant women for anthropometric and metabolic measurements at early, mid and late gestation and postpartum. In case-control studies of very severely obese and lean women we measured glucose and glycerol turnover during low- and high-dose hyperinsulinaemic-euglycaemic clamps (HEC) at early and late pregnancy and in non-pregnant women (each n = 6-9) and body fat distribution by MRI in late pregnancy (n = 10/group). Although greater glucose, insulin, NEFA and insulin resistance (HOMA-IR), and greater weight and % fat mass (FM) was observed in very severely obese vs lean participants, the degree of worsening was attenuated in the very severely obese individuals with advancing gestation, with no difference in triacylglycerol (TG) concentrations between very severely obese and lean women at term. Enhanced glycerol production was observed in early pregnancy only in very severely obese individuals, with similar intrahepatic FM in very severely obese vs lean women by late gestation. Offspring from obese mothers were heavier (p = 0.04). Pregnancies complicated by obesity demonstrate attenuation in weight gain and insulin resistance compared with pregnancies in lean women. Increased glycerol production is confined to obese women in early pregnancy and obese and lean individuals have similar intrahepatic FM by term. When targeting maternal metabolism to treat adverse pregnancy outcomes, therapeutic intervention may be most effective applied early in pregnancy.

  11. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox.

    Science.gov (United States)

    Lavie, Carl J; McAuley, Paul A; Church, Timothy S; Milani, Richard V; Blair, Steven N

    2014-04-15

    Obesity has been increasing in epidemic proportions, with a disproportionately higher increase in morbid or class III obesity, and obesity adversely affects cardiovascular (CV) hemodynamics, structure, and function, as well as increases the prevalence of most CV diseases. Progressive declines in physical activity over 5 decades have occurred and have primarily caused the obesity epidemic. Despite the potential adverse impact of overweight and obesity, recent epidemiological data have demonstrated an association of mild obesity and, particularly, overweight on improved survival. We review in detail the obesity paradox in CV diseases where overweight and at least mildly obese patients with most CV diseases seem to have a better prognosis than do their leaner counterparts. The implications of cardiorespiratory fitness with prognosis are discussed, along with the joint impact of fitness and adiposity on the obesity paradox. Finally, in light of the obesity paradox, the potential value of purposeful weight loss and increased physical activity to affect levels of fitness is reviewed. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults.

    Science.gov (United States)

    Skinner, Asheley C; Perrin, Eliana M; Moss, Leslie A; Skelton, Joseph A

    2015-10-01

    The prevalence of severe obesity among children and young adults has increased over the past decade. Although the prevalence of cardiometabolic risk factors is relatively low among children and young adults who are overweight or obese, those with more severe forms of obesity may be at greater risk. We performed a cross-sectional analysis of data from overweight or obese children and young adults 3 to 19 years of age who were included in the National Health and Nutrition Examination Survey from 1999 through 2012 to assess the prevalence of multiple cardiometabolic risk factors according to the severity of obesity. Weight status was classified on the basis of measured height and weight. We used standard definitions of abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, glycated hemoglobin, and fasting glucose and report the prevalence of abnormal values in children and young adults according to weight status. Among 8579 children and young adults with a body-mass index at the 85th percentile or higher (according to the Centers for Disease Control and Prevention growth charts), 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. Mean values for some, but not all, cardiometabolic variables were higher with greater severity of obesity in both male and female participants, and the values were higher in male participants than in female participants; for HDL cholesterol, the mean values were lower with greater severity of obesity. Multivariable models that controlled for age, race or ethnic group, and sex showed that the greater the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels. Severe obesity in children and young adults was associated with an increased prevalence of cardiometabolic risk factors

  13. Factors Associated with Suicide Ideation in Severely Obese Bariatric Surgery-Seeking Individuals

    Science.gov (United States)

    Chen, Eunice Y.; Fettich, Karla C.; Tierney, Megan; Cummings, Hakeemah; Berona, Johnny; Weissman, Jessica; Ward, Amanda; Christensen, Kara; Southward, Matthew; Gordon, Kathryn H.; Mitchell, James; Coccaro, Emil

    2012-01-01

    There are high rates of suicide ideation and/or behavior in severely obese individuals. The potential contributors to suicide ideation in a sample of 334 severely obese bariatric surgery candidates was explored. Lack of college education, a history of suicide ideation and/or behavior, psychological distress, hopelessness, loneliness, history of…

  14. Severe obesity in young women and reproductive health: the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard; Timpson, Nicholas J; Andersen, Camilla S

    2009-01-01

    the association between different levels of severe obesity and reproductive outcomes. PRINCIPAL FINDINGS: Subfecundity was more frequent in severely obese women, and during pregnancy, they had an excess risk of urinary tract infections, gestational diabetes, preeclampsia and other hypertensive disorders which...

  15. Cardiometabolic risk factors and quality of life in severely obese children and adolescents in The Netherlands

    NARCIS (Netherlands)

    Makkes, Sabine; Renders, Carry M; Bosmans, Judith E; van der Baan-Slootweg, Olga H; Seidell, Jacob C

    2013-01-01

    BACKGROUND: The prevalence of severe obesity in children and adolescents is increasing. However, little is known about cardiometabolic risk factors and quality of life of children with severe obesity.Therefore, the aim of this study was to assess the demographic characteristics and the prevalence of

  16. The development of youth-onset severe obesity in urban US girls

    Directory of Open Access Journals (Sweden)

    Kathleen M. McTigue

    2015-12-01

    Conclusions: Youth-onset severe obesity warrants particular concern in urban girls due to high prevalence and an increasing secular prevalence trend. Late childhood and early adolescence may represent a key developmental window for prevention and treatment, but is too late to prevent youth-onset severe obesity entirely.

  17. Association between cardiorespiratory fitness and metabolic risk factors in a population with mild to severe obesity.

    Science.gov (United States)

    Do, Kathy; Brown, Ruth E; Wharton, Sean; Ardern, Chris I; Kuk, Jennifer L

    2018-01-01

    Previous literature suggests the beneficial effects of fitness on abdominal obesity may be attenuated in obesity and abolished in severe obesity. It is unclear whether the beneficial association between fitness and health is similarly present in those with mild and severe obesity. Patients from the Wharton Medical Clinic ( n  = 853) completed a clinical examination and maximal treadmill test. Patients were categorized into fit and unfit based on age- and sex-categories and body mass index (BMI) class (mild: ≤ 34.9 kg/m 2 , moderate: 35-39.9 kg/m 2 or severe obesity: ≥ 40 kg/m 2 ). Within the sample, 41% of participants with mild obesity had high fitness whereas only 25% and 11% of the participants with moderate and severe obesity, respectively, had high fitness. BMI category was independently associated with most of the metabolic risk factors, while fitness was only independently associated with systolic blood pressure and triglycerides ( P  fitness groups were only significantly different in their relative risk for prevalent pre-clinical hypertension within the severe obesity group ( p  = 0.03). High fitness was associated with smaller waist circumferences, with differences between high and low fitness being larger in those with severe obesity than mild obesity (Men: P  = 0.06, Women: P  = 0.0005). Thus, in contrast to previous observations, the favourable associations of having high fitness and health may be similar if not augmented in individuals with severe compared to mild obesity.

  18. A randomized controlled trial to evaluate the effects of high Protein Complete (lActo VEgetaRian (PACER diet in non-diabetic obese Asian Indians in North India

    Directory of Open Access Journals (Sweden)

    Swati Bhardwaj

    2017-12-01

    There was significant weight loss along with improvements in cardio-metabolic risk factors among both the groups post intervention. Percent reductions in the intervention group for weight (6.1± 2.9; p < 0.001, WC (3.9 ± 1.7; p < 0.001, FPG (5.9 ± 3.2; p < 0.001, total cholesterol (10.2 ± 6.3: p < 0.001, serum triacylglycerol (13.6 ± 10.6; p < 0.001 and low-density lipoprotein cholesterol (11.9 ± 7.1; p < 0.001] were significantly greater than the control diet group. In summary, intervention with a PACER diet (high protein, high fat and moderately low carbohydrate, lacto-vegetarian diet showed significant improvement in weight loss, body composition and cardio-metabolic profile as compared to a standard vegetarian diet among obese Asian Indians in north India.

  19. Energetic adaptations persist after bariatric surgery in severely obese adolescents

    Science.gov (United States)

    Energetic adaptations induced by bariatric surgery have not been studied in adolescents or for extended periods postsurgery. Energetic, metabolic, and neuroendocrine responses to Roux-en-Y gastric bypass (RYGB) surgery were investigated in extremely obese adolescents. At baseline and at 1.5, 6, and...

  20. Severe obesity and high blood pressure among children, Philadelphia health centers, 2010.

    Science.gov (United States)

    Nguyen, John V; Robbins, Jessica M; Houck, Kevin L; Nobis, Elizabeth A; Inman, Katelyn A; Khan, Khudsiya S; Robbins, Susan W

    2014-04-01

    Child obesity is a major health problem particularly affecting disadvantaged population groups. Severe obesity carries additional health risks for children. In the context of the childhood obesity epidemic, high blood pressure among children is of increasing concern. Chart reviews were carried out to examine the prevalence of severe obesity and its association with high blood pressure measurements among randomly selected patients aged 3 to 17 years who had well-child care visits at 8 public community health centers during 2010. A majority of the 691 patients reviewed were African American (58%); an additional 16% were Hispanic. The prevalence of severe obesity was 7.7% (95% confidence interval = 5.8% to 9.9%) and the prevalence of high blood pressure measurements was 17.5% (95% confidence interval = 14.8% to 20.6%). Patients who were severely obese were more than twice as likely as other children to have high blood pressure values. Severe obesity is associated with substantially increased frequency of high blood pressure measurements in children, and should be investigated further as a potential marker for hypertension in children. Primary care providers should be prepared to diagnose and treat hypertension in severely obese children.

  1. Altered DNA methylation of glycolytic and lipogenic genes in liver from obese and type 2 diabetic patients

    DEFF Research Database (Denmark)

    Kirchner, Henriette; Sinha, Indranil; Gao, Hui

    2016-01-01

    OBJECTIVE: Epigenetic modifications contribute to the etiology of type 2 diabetes. METHOD: We performed genome-wide methylome and transcriptome analysis in liver from severely obese men with or without type 2 diabetes and non-obese men to discover aberrant pathways underlying the development...... in four of these genes in liver of severely obese non-diabetic and type 2 diabetic patients, suggesting epigenetic regulation of transcription by altered ATF-DNA binding. CONCLUSION: Severely obese non-diabetic and type 2 diabetic patients have distinct alterations in the hepatic methylome...... and transcriptome, with hypomethylation of several genes controlling glucose metabolism within the ATF-motif regulatory site. Obesity appears to shift the epigenetic program of the liver towards increased glycolysis and lipogenesis, which may exacerbate the development of insulin resistance....

  2. Risk Perception for Developing Diabetes among Non-diabetic Individuals

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2016-06-01

    Full Text Available Background: the incidence and prevalence of type 2 diabetes mellitus have increased in recent decades and this trend is expected to continue. Objective: to determine the risk perception for developing type 2 diabetes among non-diabetic individuals. Methods: a cross-sectional study involving non-diabetic individuals in the catchment area of the doctor-and-nurse office No.15 of the Manuel Fajardo Polyclinic in Cienfuegos was conducted between May 2013 and June 2014. The universe consisted of 1145 people, and the sample included 323 individuals of different age groups selected by sex. The variables studied were: age, sex, body mass index, nutritional assessment, and having a perceived risk when they answered 70 % of questions correctly. The arithmetic mean, standard deviation, Chi-square test, and risk estimation were calculated with a 95 % confidence interval. Results: individuals aged 25 to 34 years and females predominated. Fifty nine point two percent of the study participants knew of their risk. Eighty one point one percent understood that diabetes is preventable and 93.5 % stated that it is their responsibility to prevent its development. Thirty five point two percent of women considered normal-weight/thin fully agreed on the importance of physical activity and diabetes prevention. Eighty point five percent of women and 78.5 % of men answered positively to the question about obesity and diabetes. Conclusions: study participants knew of their risk of developing type 2 diabetes, although a large number of them attributed all responsibility for prevention to the health personnel.

  3. Association between vitamin D status and physical function in the severely obese.

    LENUS (Irish Health Repository)

    Ahern, T

    2014-07-01

    Mortality is 85% higher in severely obese subjects (body mass index [BMI] > 40 kg\\/m(2)) than in subjects with a healthy BMI; poor physical function may be contributory. Hypovitaminosis D is common in obese subjects and is associated with physical dysfunction in the elderly.

  4. Resting and exercise energy metabolism in weight-reduced adults with severe obesity.

    Science.gov (United States)

    Hames, Kazanna C; Coen, Paul M; King, Wendy C; Anthony, Steven J; Stefanovic-Racic, Maja; Toledo, Frederico G S; Lowery, Jolene B; Helbling, Nicole L; Dubé, John J; DeLany, James P; Jakicic, John M; Goodpaster, Bret H

    2016-06-01

    To determine effects of physical activity (PA) with diet-induced weight loss on energy metabolism in adults with severe obesity. Adults with severe obesity (n = 11) were studied across 6 months of intervention, then compared with controls with less severe obesity (n = 7) or normal weight (n = 9). Indirect calorimetry measured energy metabolism during exercise and rest. Markers of muscle oxidation were determined by immunohistochemistry. Data were presented as medians. The intervention induced 7% weight loss (P = 0.001) and increased vigorous PA by 24 min/wk (P = 0.02). During exercise, energy expenditure decreased, efficiency increased (P ≤ 0.03), and fatty acid oxidation (FAO) did not change. Succinate dehydrogenase increased (P = 0.001), but fiber type remained the same. Post-intervention subjects' resting metabolism remained similar to controls. Efficiency was lower in post-intervention subjects compared with normal-weight controls exercising at 25 W (P ≤ 0.002) and compared with all controls exercising at 60% VO2peak (P ≤ 0.019). Resting and exercise FAO of post-intervention subjects remained similar to adults with less severe obesity. Succinate dehydrogenase and fiber type were similar across all body weight statuses. While metabolic adaptations to PA during weight loss occur in adults with severe obesity, FAO does not change. Resulting FAO during rest and exercise remains similar to adults with less severe obesity. © 2016 The Obesity Society.

  5. Ethnic Differences in Lipid Profiles of Overweight, Obese, and Severely Obese Children and Adolescents 6-19 Years of Age.

    Science.gov (United States)

    Dhuper, Sarita; Bayoumi, Nagla S; Shah, Yash D; Mehta, Shilpa

    2017-06-01

    Ethnic differences in lipid profiles exist in children and adolescents. This study assessed whether variations in lipid profiles present in overweight and obese youth were also observed in severely obese youth. Variations could explain the lower prevalence of the metabolic syndrome in certain ethnic groups at even severe levels of obesity. Data were obtained from the National Health and Nutrition Examination Survey for the years of 2001 through 2012. Subjects were divided into groups according to BMI classification. Normal weight was defined as a BMI less than the 85th percentile. Overweight was defined as a BMI between the 85th and 95th percentile. Class 1 obesity was defined as a BMI greater than the 95th percentile up to 120% of the 95th percentile. A BMI between 120% and 140% of the 95th percentile was defined as Class 2 obesity. Class 3 was defined as a BMI above 140% of the 95th percentile. Primary outcomes were mean total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein levels (HDL). The sample included 14,481 non-Hispanic black (NHB) (N = 4710), non-Hispanic white (N = 4910), and Mexican American (N = 4861) subjects. Across all BMI categories, the NHB group had significantly lower mean TG and higher mean HDL levels (p Ethnic variations in lipid profiles were found in severely obese youth. These findings could explain the lower prevalence of the metabolic syndrome in NHB youth. Ethnic-specific guidelines are necessary for improved identification of those at risk at all levels of obesity.

  6. The disproportionate economic burden associated with severe and complicated obesity: a systematic review.

    Science.gov (United States)

    Grieve, E; Fenwick, E; Yang, H-C; Lean, M

    2013-11-01

    Burden of disease studies typically classify individuals with a body mass index (BMI) ≥ 30 kg m(-2) as a single group ('obese') and make comparisons to those with lower BMIs. Here, we review the literature on the additional economic burden associated with severe obesity or classes 3 and 4 obesity (BMI ≥ 40 kg m(-2) ), the fastest growing category of obesity, with the aim of exploring and disaggregating differences in resource use as BMI increases beyond 40 kg m(-2) . We recognize the importance of comparing classes 3 and 4 obesity to less severe obesity (classes 1 and 2) as well as quantifying the single sub-class impacts (classes 3 and 4). Although the latter analysis is the aim of this review, we include results, where found in the literature, for movement between the recognized subclasses and within classes 3 and 4 obesity. Articles presenting data on the economic burden associated with severe obesity were identified from a search of Ovid MEDLINE, EMBASE, EBSCO CINAHL and Cochrane Library databases. Data were extracted on the direct costs, productivity costs and resource use associated with severe obesity along with estimates of the multiplier effects associated with increasing BMI. Fifteen studies were identified, of which four disaggregated resource use for BMI ≥ 40 kg m(-2) . The multiplier effects derived for a variety of different types of costs incurred by the severely obese compared with those of normal weight (18.5 kg m(-2)  productivity costs. There are few published data on the economic burden of obesity disaggregated by BMI ≥ 40 kg m(-2) . By grouping people homogenously above a threshold of BMI 40 kg m(-2) , the multiplier effects for those at the highest end of the spectrum are likely to be underestimated. This will, in turn, impact on the estimates of cost-effectiveness for interventions and policies aimed at the severely obese. © 2013 The Authors. obesity reviews © 2013 International

  7. Comparison of inflammation and oxidative stress levels by the severity of obesity in prepubertal children

    Directory of Open Access Journals (Sweden)

    Ni Luh Putu Surya Candra Eka Pertiwi

    2018-01-01

    Full Text Available Background Children with severe obesity are more likely to develop diabetes and cardiovascular diseases at a younger age. Inflammation and oxidative stress associated with childhood obesity may be important in the development of insulin resistance and atherosclerosis. Objective To compare levels of high-sensitivity C-reactive protein (hsCRP and malondialdehyde (MDA by the severity of obesity in prepubertal children aged 6 to 10 years. Methods We conducted a cross-sectional study at the Pediatric Nutrition and Metabolic Syndrome Clinic, Sanglah Hospital, Bali, from August to December 2015. Subjects were categorized into three body mass index (BMI groups, according to the 2000 Centers for Disease Control and Prevention growth chart: overweight (85th-94.9th percentile, obese (95th-98.9th percentile, or severely obese (≥ 99th percentile. Plasma MDA and serum hsCRP were analyzed in blood specimens obtained at enrollment. Data were analyzed by Kruskal-Wallis test, followed by Mann-Whitney U test for post-hoc comparison between groups. Results Subjects were 20 overweight children, 29 obese children, and 28 severely obese children. Levels of MDA were significantly higher in the severely obese [median 0.25 (IQR 0.1 μmol/L] than in obese subjects [median 0.19 (IQR 0.1 μmol/L; P=0.001], and than in overweight subjects [median 0.16 (IQR 0.1 μmol/L; P<0.0001]. Also, the severely obese children had significantly higher hsCRP levels compared to obese [median 3.2 (IQR 2.0 mg/L vs. 1.3 (1.6 mg/L, respectively; P<0.0001] and compared to overweight children [median 0.7 (IQR 0.6 mg/L; P<0.0001].     Conclusion Prepubertal children at the ≥ 99th percentile for BMI (severely obese are more likely to have significantly higher hsCRP and MDA compared to those in the obese and overweight groups.

  8. Inpatient Treatment of Children and Adolescents With Severe Obesity in the Netherlands: a randomized clinical trial

    NARCIS (Netherlands)

    van der Baan-Slootweg, Olga; Benninga, Marc A.; Beelen, Anita; van der Palen, Jacobus Adrianus Maria; Tamminga-Smeulders, Christine; Tijssen, Jan G.P.; van Aalderen, Wim M.C.

    2014-01-01

    Importance Severe childhood obesity has become a major health problem, and effective, evidence-based interventions are needed. The relative effectiveness of inpatient compared with ambulatory treatment remains unknown. Objective To determine whether an inpatient treatment program is more effective

  9. Miscarriage after sonographic confirmation of an ongoing pregnancy in women with moderate and severe obesity.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2012-01-01

    To compare the incidence of spontaneous miscarriage in women with moderate to severe obesity to that in women with a normal BMI after sonographic confirmation of the foetal heart rate in the first trimester.

  10. FAT-FREE MASS, METABOLICALLY HEALTHY OBESITY, AND TYPE 2 DIABETES IN SEVERELY OBESE ASIAN ADULTS.

    Science.gov (United States)

    Pramyothin, Pornpoj; Limpattanachart, Vichol; Dawilai, Suwitcha; Sarasak, Rungnapha; Sukaruttanawong, Chariya; Chaiyasoot, Kusuma; Keawtanom, Songsri; Yamwong, Preyanuj

    2017-08-01

    To determine whether fat free mass (FFM) is independently associated with the metabolically healthy obesity (MHO) phenotype, the metabolic syndrome (MS), and type 2 diabetes (T2D) in obese Asian adults. Obese patients (body mass index [BMI] ≥25 kg/m 2 ) seeking weight management at an academic medical center from 2007 to 2016 were included. FFM was measured by bioelectrical impedance. Of the 552 patients (67.0% female, median age 40.5 years, median BMI 38.3 kg/m 2 ), MHO was present in 19%, MS in 55.4%, and T2D in 32.6%. In multivariate models, higher fat-free mass index (FFMI) was independently associated with the metabolically abnormal obesity (MAO) phenotype, (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.09-1.37), and increased risk of MS (OR 1.12, 95% CI 1.03-1.22) in women but not in men. Older age was independently associated with the MAO phenotype (OR 1.06, 95% CI 1.04-1.09 in women; OR 1.06, 95% CI 1.02-1.09 in men), MS (OR 1.05, 95% CI 1.03-1.06 in women; OR 1.05, 95% CI 1.02-1.07 in men), and T2D (OR 1.07, 95% CI 1.05-1.09 in women; OR 1.06, 95% CI 1.04-1.09 in men). Waist-hip ratio was independently associated with the MAO phenotype in men (OR 1.08, 95% CI 1.01-1.15), while waist circumference was associated with T2D in women (OR 1.03, 95% CI 1.01-1.05). Older age, central fat distribution, and-in contrast to previous findings-an increase in FFMI among women were independent predictors of adverse metabolic health in this cohort of middle-aged obese Asian adults. Further studies are required to elucidate underlying mechanisms and therapeutic implications of these findings. BIA = bioelectrical impedance analysis BMI = body mass index CI = confidence interval DXA = dual-energy X-ray absorptiometry FFM = fat-free mass FFMI = fat-free mass index FM = fat mass HbA1c = glycated hemoglobin A1c MAO = metabolically abnormal obesity MHO = metabolically healthy obesity MS = metabolic syndrome OR = odds ratio T2D = type 2 diabetes WC = waist circumference

  11. Effect of CPAP on arterial stiffness in severely obese patients with obstructive sleep apnoea.

    Science.gov (United States)

    Seetho, Ian W; Asher, Rebecca; Parker, Robert J; Craig, Sonya; Duffy, Nick; Hardy, Kevin J; Wilding, John P H

    2015-12-01

    Obstructive sleep apnoea (OSA) may independently increase cardiovascular risk in obesity. Although there is evidence that arterial stiffness is altered in OSA, knowledge of these effects with continuous positive airway pressure (CPAP) in severe obesity (body mass index (BMI) ≥ 35 kg/m(2)) is limited. This study aimed to explore how arterial stiffness, as measured by the augmentation index (Aix), changed in severely obese patients with OSA who were treated with CPAP and in patients without OSA. Forty-two patients with severe obesity-22 with OSA, 20 without OSA-were recruited at baseline and followed-up after a median of 13.5 months. Pulse wave analysis (PWA) was performed using applanation tonometry at the radial artery to measure augmentation index (Aix), augmentation pressure (AP) and subendocardial viability ratio (SEVR). Cardiovascular parameters and body composition were also measured. There were significant improvements in Aix, AP (both P CPAP compared with subjects without OSA. Epworth scores (P CPAP. Regression showed that CPAP was significantly associated with change in arterial stiffness from baseline. However, patients with OSA on CPAP continued to have increased arterial stiffness (Aix) (P CPAP in severe obesity, CPAP alone is not sufficient to modify PWA measures to levels comparable with non-OSA patients. This supports a need for a multifaceted approach when managing cardiovascular risk in patients with severe obesity and obstructive sleep apnoea receiving CPAP therapy.

  12. Experimental evidence of obesity as a risk factor for severe acute pancreatitis.

    Science.gov (United States)

    Frossard, Jean-Louis; Lescuyer, Pierre; Pastor, Catherine M

    2009-11-14

    The incidence of acute pancreatitis, an inflammation of the pancreas, is increasing worldwide. Pancreatic injury is mild in 80%-90% of patients who recover without complications. The remaining patients may develop a severe disease with local complications such as acinar cell necrosis, abscess and remote organ injury including lung injury. The early prediction of the severity of the disease is an important goal for physicians in management of patients with acute pancreatitis in order to optimize the therapy and to prevent organ dysfunction and local complications. For that purpose, multiple clinical scale scores have been applied to patients with acute pancreatitis. Recently, a new problem has emerged: the increased severity of the disease in obese patients. However, the mechanisms by which obesity increases the severity of acute pancreatitis are unclear. Several hypotheses have been suggested: (1) obese patients have an increased inflammation within the pancreas; (2) obese patients have an increased accumulation of fat within and around the pancreas where necrosis is often located; (3) increase in both peri- and intra-pancreatic fat and inflammatory cells explain the high incidence of pancreatic inflammation and necrosis in obese patients; (4) hepatic dysfunction associated with obesity might enhance the systemic inflammatory response by altering the detoxification of inflammatory mediators; and (5) ventilation/perfusion mismatch leading to hypoxia associated with a low pancreatic flow might reduce the pancreatic oxygenation and further enhance pancreatic injury. Recent experimental investigations also show an increased mortality and morbidity in obese rodents with acute pancreatitis and the implication of the adipokines leptin and adiponectin. Such models are important to investigate whether the inflammatory response of the disease is enhanced by obesity. It is exciting to speculate that manipulation of the adipokine milieu has the potential to influence the

  13. Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity.

    Science.gov (United States)

    Viljakainen, H T; Valta, H; Lipsanen-Nyman, M; Saukkonen, T; Kajantie, E; Andersson, S; Mäkitie, O

    2015-10-01

    Childhood obesity is associated with compromised bone health. We studied bone characteristics and their determinants in obese young adults. The study included 68 subjects with early-onset severe obesity and 73 normal-weight controls. Data on physical activity (PA), diet and smoking were collected. Bone characteristics were measured using peripheral QCT. The obese and control subjects were similar in age (mean 19.6 ± 2.6 years) and height but BMIs differed (39.7 and 22.6 kg/m(2)). A clustering of unhealthy lifestyles was marked: Obese subjects reported less supervised PA in childhood, adolescence and currently (p obese women, all crude bone characteristics were higher than in controls; in men, the differences were smaller. Associations of lifestyle factors with bone characteristics were tested using partial correlations. Independently of BMI, supervised PA in adolescence and alcohol consumption were related positively to bone characteristics in both groups. HEI associated positively with bone characteristics only in controls, while smoking was a positive determinant of bone characteristics only in obese subjects. The multivariate model showed that the contribution of lifestyle factors to bone characteristics was minimal compared with BMI. Early-onset obesity is accompanied by poor dietary quality, sedentary lifestyle, and more frequent smoking, but the overall contribution of these lifestyle factors to bone strength is limited. Bone strength is more likely to be compromised in men and in unloaded bone sites in subjects with early-onset severe obesity. The impact of obesity-related endocrine changes on bone characteristics need to be evaluated in future studies.

  14. Similar incretin secretion in obese and non-obese Japanese subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Kozawa, Junji; Okita, Kohei; Imagawa, Akihisa

    2010-01-01

    Incretin secretion and effect on insulin secretion are not fully understood in patients with type 2 diabetes. We investigated incretin and insulin secretion after meal intake in obese and non-obese Japanese patients with type 2 diabetes compared to non-diabetic subjects. Nine patients with type 2......, incretin secretion does not differ between Japanese obese and non-obese patients with type 2 diabetes and non-diabetic subjects....... diabetes and 5 non-diabetic subjects were recruited for this study. Five diabetic patients were obese (BMI > or = 25) and 4 patients were non-obese (BMI

  15. Prenatal exposure to very severe maternal obesity is associated with adverse neuropsychiatric outcomes in children.

    Science.gov (United States)

    Mina, T H; Lahti, M; Drake, A J; Räikkönen, K; Minnis, H; Denison, F C; Norman, J E; Reynolds, R M

    2017-01-01

    Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress. We evaluated neuropsychiatric symptoms in 112 children aged 3-5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5-25 kg/m2). The mothers completed the Conners' Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively. Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners' Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and

  16. Cardiovascular Response Of Diabetic And Non-Diabetic Nigerian ...

    African Journals Online (AJOL)

    This study assessed the cardiovascular responses of diabetic and non-diabetic subjects to a single bout of bicycle ergometry. Ten male volunteer diabetics and ten male non-diabetic healthy subjects constituted the study and control groups respectively. The subjects exercised for ten minutes on a bicycle ergometer.

  17. Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

    Science.gov (United States)

    Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

    2018-06-01

    Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

  18. Superstorm Sandy's forgotten patient: a lesson in emergency preparedness in severe obesity.

    Science.gov (United States)

    Ramme, Austin J; Vira, Shaleen; McLaurin, Toni M

    2015-02-01

    Superstorm Sandy gained national attention in late 2012 after its impact on the Northeastern US. In New York City, thousands of residents lost power, and multiple hospitals were forced to evacuate. Bellevue Hospital Center (BHC), the nation's oldest public hospital, was forced to close for the first time in over 275 years. Two patients remained in BHC three days after the primary evacuation without water service and minimal power. Herein, we describe the challenges associated with evacuating a severely obese patient. Obesity management is challenging and at an institutional level must be addressed in emergency preparedness plans. © 2014 The Obesity Society.

  19. Liver enzymes in diabetic and non diabetic subjects with clinically diagnosed hepatitis

    Directory of Open Access Journals (Sweden)

    Bidhan Chandra Sarkar

    2011-07-01

    Full Text Available The occurrence of liver disease and raised liver enzymes is common in diabetic patients and the increasing level of enzymes indicates the severity of hepatic injury. Very few studies have addressed this issue in Bangladesh though Bangladeshi population is very much susceptible to diabetes. This study investigated a total of 1400 diabetic patients and 100 non diabetic individuals to compare the level of liver enzymes between diabetic and non-diabetic subjects. The comparisons were made among subjects who were referred to the department of Gastro-hepato-pancreatic diseases (GHPD of BIRDEM with the clinical diagnosis of chronic hepatitis and other gastro-intestinal disorders. The investigations included alanine aminotransferase (ALT, aspartate aminotransferase (AST, alkaline phosphatase (ALP and bilirubin levels. The subjects were categorized with and without hepatitis based on these investigations. The biochemical markers (ALT, AST, ALP, bilirubin did not differ significantly between non-diabetic male and female subjects. Neither the differences were significant between diabetic males and females though the diabetic patients had higher level of markers. In contrast, when compared between diabetic and non-diabetic subjects there were striking differences in either sex. Compared with the non-diabetic the diabetic subjects had significantly higher level of ALT (48.3 vs. 277.0, AST (42.0 vs. 213.0 and ALP (148 vs. 302 in males (p<0.005 for all. Similarly, these values were found significantly higher in diabetic females than their non-diabetic counterparts (p<0.01. For bilirubin, it was also found significant in males (p<0.001. The study revealed that the liver enzymes were found elevated in both diabetic and non-diabetic subjects who were referred with clinically diagnosed hepatitis. The enzymes were found markedly elevated among the diabetic than non diabetic patients, which indicate hepatic injury was more marked among the diabetic patients. Further

  20. Cardiometabolic risk is associated with the severity of sleep-disordered breathing in children with obesity.

    Science.gov (United States)

    Isacco, Laurie; Roche, Johanna; Quinart, Sylvain; Thivel, David; Gillet, Valérie; Nègre, Véronique; Mougin, Fabienne

    2017-03-01

    The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean±SD, age: 10.7±2.7years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScore BMI and MetScore WC ). Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScore BMI and MetScore WC (pobese children. There is no association between SDB and PAL. In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Subclinical kidney injury before and 1 year after bariatric surgery among adolescents with severe obesity.

    Science.gov (United States)

    Xiao, Nianzhou; Devarajan, Prasad; Inge, Thomas H; Jenkins, Todd M; Bennett, Michael; Mitsnefes, Mark M

    2015-06-01

    To assess subclinical kidney injury in adolescents with severe obesity by measuring biomarkers of early kidney disease and to assess changes in the levels of these biomarkers following bariatric procedures. Twenty-two adolescents undergoing bariatric surgery with no microalbuminuria and normal kidney function were selected. Urinary NGAL, IL-18, and KIM-1 were measured at baseline, 6 and 12 months postoperatively. Biomarker levels were compared to 44 age-gender-matched lean controls. Subjects with obesity had a mean baseline BMI of 48 kg/m(2) that decreased by 34% at 1-year follow-up. Urine NGAL, IL-18, and KIM-1 were significantly elevated in subjects with obesity compared to lean controls at baseline. The obese cohort had a further significant increase in NGAL and KIM-1 at 6 months, followed by decline at 1 year. The overall change in levels of all three biomarkers through 1 year after surgery, however, was not significant compared to baseline. Adolescent severe obesity is associated with increased urinary excretion of novel biomarkers of kidney injury, despite no microalbuminuria or decreased kidney function. This subclinical kidney injury persists 1 year after significant weight loss induced by bariatric surgery, suggesting that close, long-term follow-up of kidney status is warranted in these adolescents. © 2015 The Obesity Society.

  2. Lack of support for the association between GAD2 polymorphisms and severe human obesity.

    Directory of Open Access Journals (Sweden)

    Michael M Swarbrick

    2005-09-01

    Full Text Available The demonstration of association between common genetic variants and chronic human diseases such as obesity could have profound implications for the prediction, prevention, and treatment of these conditions. Unequivocal proof of such an association, however, requires independent replication of initial positive findings. Recently, three (-243 A>G, +61450 C>A, and +83897 T>A single nucleotide polymorphisms (SNPs within glutamate decarboxylase 2 (GAD2 were found to be associated with class III obesity (body mass index > 40 kg/m2. The association was observed among 188 families (612 individuals segregating the condition, and a case-control study of 575 cases and 646 lean controls. Functional data supporting a pathophysiological role for one of the SNPs (-243 A>G were also presented. The gene GAD2 encodes the 65-kDa subunit of glutamic acid decarboxylase-GAD65. In the present study, we attempted to replicate this association in larger groups of individuals, and to extend the functional studies of the -243 A>G SNP. Among 2,359 individuals comprising 693 German nuclear families with severe, early-onset obesity, we found no evidence for a relationship between the three GAD2 SNPs and obesity, whether SNPs were studied individually or as haplotypes. In two independent case-control studies (a total of 680 class III obesity cases and 1,186 lean controls, there was no significant relationship between the -243 A>G SNP and obesity (OR = 0.99, 95% CI 0.83-1.18, p = 0.89 in the pooled sample. These negative findings were recapitulated in a meta-analysis, incorporating all published data for the association between the -243G allele and class III obesity, which yielded an OR of 1.11 (95% CI 0.90-1.36, p = 0.28 in a total sample of 1,252 class III obese cases and 1,800 lean controls. Moreover, analysis of common haplotypes encompassing the GAD2 locus revealed no association with severe obesity in families with the condition. We also obtained functional data for the

  3. Cost-effectiveness of bariatric surgery in adolescents with severe obesity in the UK.

    Science.gov (United States)

    Panca, M; Viner, R M; White, B; Pandya, T; Melo, H; Adamo, M; Batterham, R; Christie, D; Kinra, S; Morris, S

    2018-04-01

    Evidence shows that surgery for severe obesity in adults improves health and psychological functioning, and is cost-effective. Data on bariatric surgery for adolescents with severe obesity are extremely limited, with no evidence on cost-effectiveness. We evaluated the lifetime cost-effectiveness of bariatric surgery compared with no surgery in adolescents with severe obesity from the UK's National Health Service perspective. Eighteen adolescents with body mass index ≥40 kg m -2 who underwent bariatric surgery (laparoscopic Roux en Y Gastric Bypass [RYGB] [N = 9], and laparoscopic Sleeve Gastrectomy [SG] [N = 9]) at University College London Hospitals between January 2008 and December 2013 were included. We used a Markov cohort model to compare the lifetime expected costs and quality-adjusted life years (QALYs) between bariatric surgery and no surgery. Mean cost of RYGB and SG procedures were £7100 and £7312, respectively. For RYGB vs. no surgery, the incremental cost/QALY was £2018 (95% CI £1942 - £2042) for males and £2005 (95% CI £1974 - £2031) for females. For SG vs. no surgery, the incremental cost/QALY was £1978 (95% CI £1954 - £2002) for males and £1941 (95% CI £1915 - £1969) for females. Bariatric surgery in adolescents with severe obesity is cost-effective; it is more costly than no surgery however it markedly improved quality of life. © 2017 World Obesity Federation.

  4. Atopy, but not obesity is associated with asthma severity among children with persistent asthma.

    Science.gov (United States)

    Lu, Kim D; Phipatanakul, Wanda; Perzanowski, Matthew S; Balcer-Whaley, Susan; Matsui, Elizabeth C

    2016-12-01

    Obesity is associated with an increased risk of asthma in children. Atopic sensitization is a major risk factor for asthma including severe asthma in children. It is unclear if obesity is associated with worse asthma control or severity in children and how its effects compare to atopy. We sought to examine relationships of weight status and atopy to asthma control and severity among a population of predominantly low income, minority children and adolescents with persistent asthma. A cross-sectional analysis of 832 children and adolescents, age range 5-17 years, with persistent asthma was performed. Clinical assessments included asthma questionnaires of symptoms, asthma severity score, health care utilization and medication treatment step, lung function testing, and skin prick testing as well as measures of adiposity. Data were collected between December 2010 and August 2014 from Johns Hopkins Hospital in Baltimore, MD and Children's Hospital of Boston, MA. Obesity was not associated with worse asthma control or severity in this group of predominantly low income, minority children and adolescents with persistent asthma. However, a greater degree of atopy was associated with lower lung function, higher asthma severity score, and higher medication treatment step. Atopy may be a more important risk factor for asthma severity than obesity among low-income minority children and adolescents with persistent asthma living in Northeastern cities in the United States.

  5. Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial.

    Science.gov (United States)

    Blackman, A; Foster, G D; Zammit, G; Rosenberg, R; Aronne, L; Wadden, T; Claudius, B; Jensen, C B; Mignot, E

    2016-08-01

    Obesity is strongly associated with prevalence of obstructive sleep apnea (OSA), and weight loss has been shown to reduce disease severity. To investigate whether liraglutide 3.0 mg reduces OSA severity compared with placebo using the primary end point of change in apnea-hypopnea index (AHI) after 32 weeks. Liraglutide's weight loss efficacy was also examined. In this randomized, double-blind trial, non-diabetic participants with obesity who had moderate (AHI 15-29.9 events h(-1)) or severe (AHI ⩾30 events h(-1)) OSA and were unwilling/unable to use continuous positive airway pressure therapy were randomized for 32 weeks to liraglutide 3.0 mg (n=180) or placebo (n=179), both as adjunct to diet (500 kcal day(-1) deficit) and exercise. Baseline characteristics were similar between groups (mean age 48.5 years, males 71.9%, AHI 49.2 events h(-1), severe OSA 67.1%, body weight 117.6 kg, body mass index 39.1 kg m(-2), prediabetes 63.2%, HbA1c 5.7%). After 32 weeks, the mean reduction in AHI was greater with liraglutide than with placebo (-12.2 vs -6.1 events h(-1), estimated treatment difference: -6.1 events h(-1) (95% confidence interval (CI), -11.0 to -1.2), P=0.0150). Liraglutide produced greater mean percentage weight loss compared with placebo (-5.7% vs -1.6%, estimated treatment difference: -4.2% (95% CI, -5.2 to -3.1%), P3.0 mg was similar to that seen with doses ⩽1.8 mg. As an adjunct to diet and exercise, liraglutide 3.0 mg was generally well tolerated and produced significantly greater reductions than placebo in AHI, body weight, SBP and HbA1c in participants with obesity and moderate/severe OSA. The results confirm that weight loss improves OSA-related parameters.

  6. Severity of coronary artery disease in obese patients undergoing coronary angiography

    International Nuclear Information System (INIS)

    Javed, A.; Ali, J.; Kayani, A.M.

    2012-01-01

    Objective: To assess the relationship of severity of coronary artery disease with obesity in patients undergoing coronary angiography. Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology - National Institute of Heart Diseases (AFIC-NIHD), 1st February 2010 to 31st August 2010 Patients and Methods: The study population included 468 patients undergoing coronary angiography. Obesity was classified according to the BMI using the National Institutes of Health (NIH) criteria as normal (BMI 21-24 kg/m2), overweight (BMI 25-29 kg/m2), obesity class I (BMI 30-34 kg/m2), obesity class II (BMI 35 to 39 kg/m2 and obesity class III (BMI 40 or above kg/m2). Coronary angiography data were obtained from the Siemens Queries software system, which maintains the database including detailed angiographic findings of all patients at this institution. Significant lesions were defined as those with >70% diameter narrowing of coronary arteries (>50% for the left main coronary artery). We attempted to quantify the 'severity of CAD' by ascertaining the prevalence of High-Risk Coronary Anatomy (HRCA). Results: Insignificant difference was observed in traditional risk factors i.e. age, diabetes mellitus and smoking except hypertension and gender. Statistically significantly low prevalence of HRCA was encountered in the obese group (57.7%) as compared to normal/overweight group (75.8%) (p < 0.05). Conclusion: We conclude that obesity is associated with less severe coronary artery disease. (author)

  7. Effectiveness of a Low-Calorie Weight Loss Program in Moderately and Severely Obese Patients

    Directory of Open Access Journals (Sweden)

    Julia K. Winkler

    2013-10-01

    Full Text Available Aims: To compare effectiveness of a 1-year weight loss program in moderately and severely obese patients. Methods: The study sample included 311 obese patients participating in a weight loss program, which comprised a 12-week weight reduction phase (low-calorie formula diet and a 40-week weight maintenance phase. Body weight and glucose and lipid values were determined at the beginning of the program as well as after the weight reduction and the weight maintenance phase. Participants were analyzed according to their BMI class at baseline (30-34.9 kg/m2; 35-39.9 kg/m2; 40-44.9 kg/m2; 45-49.9 kg/m2; ≥50 kg/m2. Furthermore, moderately obese patients (BMI 2 were compared to severely obese participants (BMI ≥ 40 kg/m2. Results: Out of 311 participants, 217 individuals completed the program. Their mean baseline BMI was 41.8 ± 0.5 kg/m2. Average weight loss was 17.9 ± 0.6%, resulting in a BMI of 34.3 ± 0.4 kg/m2 after 1 year (p Conclusion: 1-year weight loss intervention improves body weight as well as lipid and glucose metabolism not only in moderately, but also in severely obese individuals.

  8. Surgical treatment of nonalcoholic fatty liver disease in severely obese patients

    Directory of Open Access Journals (Sweden)

    Vander Naalt SJ

    2014-10-01

    Full Text Available Steven J Vander Naalt, Juan P Gurria, AiXuan L HoltermanUniversity of Illinois College of Medicine at Peoria, Children's Hospital of Illinois, Department of Surgery/Pediatric Surgery, Peoria, IL, USAAbstract: Obesity is a multi-organ system disease with underlying metabolic abnormalities and chronic systemic inflammation. Nonalcoholic fatty liver disease (NAFLD is a hepatic manifestation of obesity metabolic dysfunction and its associated cardiovascular- and liver-related morbidities and mortality. Our current understanding of NAFLD pathogenesis, disease characteristics, the role of insulin resistance, chronic inflammation, gut–liver and gut–brain crosstalk and the effectiveness of pharmacotherapy is still evolving. Bariatric surgery significantly improves metabolic and NAFLD histology in severely obese patients, although its positive effects on fibrosis are not universal. Bariatric surgery benefits NAFLD through its metabolic effect on insulin resistance, inflammation, and insulinotropic and anorexinogenic gastrointestinal hormones. Further studies are needed to understand the natural course of NAFLD in severely obese patients and the role of weight loss surgery as a primary treatment for NAFLD.Keywords: NAFLD, severe obesity, bariatric surgery

  9. Severe obesity, heart disease, and death among white, African American, and Hispanic postmenopausal women.

    Science.gov (United States)

    McTigue, Kathleen M; Chang, Yue-Fang; Eaton, Charles; Garcia, Lorena; Johnson, Karen C; Lewis, Cora E; Liu, Simin; Mackey, Rachel H; Robinson, Jennifer; Rosal, Milagros C; Snetselaar, Linda; Valoski, Alice; Kuller, Lewis H

    2014-03-01

    To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity. Copyright © 2012 The Obesity Society.

  10. Obesity and nutrition behaviours in Western and Palestinian outpatients with severe mental illness

    Directory of Open Access Journals (Sweden)

    Aljeesh Yousef

    2011-10-01

    Full Text Available Abstract Background While people with severe mental illness have been found to be more overweight and obese in Western nations, it is unknown to what extent this occurs in Middle Eastern nations and which eating behaviours contribute to obesity in Middle Eastern nations. Method A total of 665 responses were obtained from patients with serious mental illness attending out-patient clinics in Western developed countries (Germany, UK and Australia; n = 518 and Palestine (n = 147. Patients were evaluated by ICD-10 clinical diagnosis, anthropometric measurements and completed a self-report measure of frequencies of consuming different food items and reasons for eating. Nutritional habits were compared against a Western normative group. Results More participants from Palestine were overweight or obese (62% compared to Western countries (47%. In the Western sample, obese patients reported consuming more low-fat products (OR 2.54, 95% CI 1.02-6.33 but also greater eating due to negative emotions (OR 1.84, 95% CI 1.31-2.60 than patients with a healthy body-mass index. In contrast, obese patients from Palestine reported increased consumption of unhealthy snacks (OR 3.73 95% CI 1.16-12.00. Conclusion Patients with mental illness have poorer nutritional habits than the general population, particularly in Western nations. Separate interventions to improve nutritional habits and reduce obesity are warranted between Western nations and Palestine.

  11. Influence of obesity on mortality of drivers in severe motor vehicle crashes.

    Science.gov (United States)

    Jehle, Dietrich; Gemme, Seth; Jehle, Christopher

    2012-01-01

    The purpose of the study was to investigate the relationship between obesity and mortality of drivers in severe motor vehicle crashes involving at least one fatality. Fatalities were selected from 155,584 drivers included in the 2000-2005 Fatality Analysis Reporting System. Drivers were stratified by body mass index, confounders were adjusted for, and multiple logistic regression was used to determine the odds ratio (OR) of death in each body mass index class compared with normal weight. The adjusted risk of death from lowest to highest, reported as the OR of death compared with normal weight with 95% confidence intervals, was as follows: (1) overweight (OR, 0.952; 0.911-0.995; P = .0293), (2) slightly obese (OR, 0.996; 0.966-1.026; P = .7758), (3) normal weight, (4) underweight (OR, 1.115; 1.035-1.201; P = .0043), (5) moderately obese (OR, 1.212; 1.128-1.302; P obese (OR, 1.559; 1.402-1.734; P obese, morbidly obese, and underweight drivers and a decreased risk in overweight drivers. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Prognostic value of admission plasma glucose in non-diabetic ...

    African Journals Online (AJOL)

    Prognostic value of admission plasma glucose in non-diabetic Nigerians with stroke. ... International Journal of Medicine and Health Development ... Outcome was measured using the Modified Rankin scale based on the last score of each ...

  13. The study of Insulin Resistance in the Off Springs of Diabetics and Non Diabetic Patients

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    Ganesh Manoorkar

    2017-12-01

    Full Text Available Introduction: Insulin resistance is one of the main cause in the pathogenesis of the development of type- 2 diabetes mellitus. Elevated insulin levels and insulin resistance may be present several years prior to the development of hyperglycaemia. Hence the diagnosis of insulin resistance at the initial stages in risk group people could be used as an effective measure to prevent type 2 diabetes mellitus and its outcome, including reduction in morbidity and mortality. Though type 2 diabetes mellitus has multifactorial aetiology, genetic factor plays an important role in the development of diabetes mellitus. So we have tried to establish relation between genetic factor and insulin resistance by studying the insulin resistance in off springs of diabetics and non diabetics patients. Aims and objectives: Estimation of insulin levels in the off springs (non diabetics of diabetics and non diabetics patients. Comparision of insulin resistance in the off springs (non diabetics of diabetics and non diabetics. To find the relation between insulin resistance and genetic factor. Material and method: This study was carried out in the department of Biochemistry Grant Government Medical College Mumbai. Total 100 non diabetic people were included in the study of age above 30 years. These are divided into two groups as- Group-I includes 50 off springs (Ist degree relatives of non diabetic people. Group-II includes 50 off springs (Ist degree relatives of diabetic people. The fasting plasma glucose and serum insulin levels are estimated in the above two groups. The insulin resistance was calculated by using HOMA-IR model. Result: Fasting plasma glucose, serum insulin level and insulin resistance is significantly increased in group-II people as compared to group-I people. Conclusion: There is a strong relation between genetic factor and insulin resistance which exist prior to the development of diabetes mellitus. The people of group-II are susceptible for the

  14. Estrogen exposure, obesity and thyroid disease in women with severe pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Sweeney Lori

    2009-09-01

    Full Text Available Abstract Severe pulmonary hypertension is a lethal group of disorders which preferentially afflicts women. It appears that in recent years the patient profile has shifted towards older, obese, and postmenopausal women, suggesting that endocrine factors may be important. Several studies have revealed an increased prevalence of thyroid disease in these patients, but no studies have evaluated for a coexistence of endocrine factors. In particular, no studies have attempted to evaluate for concurrent thyroid disease, obesity and long-term estrogen exposure in patients. 88 patients attending the Pulmonary Hypertension Association 8th International meeting completed a questionnaire and were interviewed. Information was collected regarding reproductive history, height, weight, and previous diagnosis of thyroid disease. 46% met criteria for obesity. 41% reported a diagnosis of thyroid disease. 81% of women reported prior use of hormone therapy. 70% reported greater than 10 years of exogenous hormone use. 74% of female patients reported two or more of potentially disease modifying endocrine factors (obesity, thyroid disease or estrogen therapy. The coexistent high prevalence in our cohort of exogenous estrogen exposure, thyroid disease and obesity suggests that an interaction of multiple endocrine factors might contribute to the pathogenesis of pulmonary hypertension and may represent epigenetic modifiers in genetically-susceptible individuals.

  15. Changes in radiation dose with variations in human anatomy: moderately and severely obese adults.

    Science.gov (United States)

    Clark, Landon D; Stabin, Michael G; Fernald, Michael J; Brill, Aaron B

    2010-06-01

    The phantoms used in standardized dose assessment are based on a median (i.e., 50th percentile) individual of a large population, for example, adult males or females or children of a particular age. Here we describe phantoms that model instead the influence of obesity on specific absorbed fractions (SAFs) and dose factors in adults. The literature was reviewed to evaluate how individual organ sizes change with variations in body weight in mildly and severely obese adult men and women. On the basis of the literature evaluation, changes were made to our deformable reference adult male and female total-body models. Monte Carlo simulations of radiation transport were performed. SAFs for photons were generated for mildly and severely obese adults, and comparisons were made to the reference (50th) percentile SAF values. SAFs studied between the obese phantoms and the 50th percentile reference phantoms were not significantly different from the reference 50th percentile individual, with the exception of intestines irradiating some abdominal organs, because of an increase in separation between folds caused by an increase in mesenteric adipose deposits. Some low-energy values for certain organ pairs were different, possibly due only to the statistical variability of the data at these low energies. The effect of obesity on dose calculations for internal emitters is minor and may be neglected in the routine use of standardized dose estimates.

  16. Inpatient treatment of children and adolescents with severe obesity in the Netherlands: a randomized clinical trial

    NARCIS (Netherlands)

    van der Baan-Slootweg, Olga; Benninga, Marc A.; Beelen, Anita; van der Palen, Job; Tamminga-Smeulders, Christine; Tijssen, Jan G. P.; van Aalderen, Wim M. C.

    2014-01-01

    Severe childhood obesity has become a major health problem, and effective, evidence-based interventions are needed. The relative effectiveness of inpatient compared with ambulatory treatment remains unknown. To determine whether an inpatient treatment program is more effective than an ambulatory

  17. Bariatric surgery in adolescents with severe obesity: Review and state of the art in France.

    Science.gov (United States)

    Coutant, Régis; Bouhours-Nouet, Natacha; Donzeau, Aurélie; Fauchard, Mathilde; Decrequy, Anne; Malka, Jean; Riquin, Elise; Beaumesnil, Marion; Sallé, Agnès; Briet, Claire; Topart, Philippe; Schmitt, Françoise

    2017-10-01

    Severe obesity (body mass index>120% of BMI IOTF-30 cut off) and morbid obesity (BMI>140% of BMI IOTF-30 cut off) affect 5 to 10% of obese adolescents in France. Organic complications can be found in about 50% of these patients, and depressive symptoms in one-third of them. Finally, over 70% will suffer from adult morbid obesity associated with a marked increase in morbidity and mortality. However, the reversion of obesity strongly decreases, and may even cancels, these risks. In controlled randomized studies, lifestyle interventions have limited effectiveness on BMI in children (and none in adolescents). Bariatric surgery has been shown to have short-term effectiveness in adolescents with severe and morbid obesity: the average BMI loss after gastric banding was 11.6kg/m 2 (95% confidence interval from 9.8 to 13.4), 16.6kg/m 2 (95% confidence interval from 13.4 to 19.8) after bypass, and 14.1kg/m 2 (95% confidence interval 10.8 to 17.5) after sleeve gastrectomy. The resolution of comorbidities was the main aim, as well as the improvement of quality of life. This is not a simple surgical intervention, and minor side effects have been reported in approximately 10-15% of teenagers who underwent surgery (more common with the gastric band), and severe side effects in nearly 1-5% (mainly with bypass). In France, recommendations regarding indications, the care pathway, multidisciplinary meetings, reference management structures and postoperative care have been published by the French National Health Authority (HAS) in 2016 to provide a framework for bariatric surgery in underage patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Decreased serum glicentin concentration in patients with severe and morbid obesity.

    Science.gov (United States)

    Raffort, Juliette; Panaïa-Ferrari, Patricia; Lareyre, Fabien; Blois, Mathilde; Bayer, Pascale; Staccini, Pascal; Fénichel, Patrick; Chinetti, Giulia

    2018-03-01

    Background Proglucagon-derived hormones represent a family of peptides mainly produced in the pancreas and the intestine. While several proglucagon-derived peptides play key roles in metabolic diseases, little is known about glicentin. The aim of the present study was to investigate serum glicentin concentrations in individuals with adult obesity and to study its potential link with various metabolic parameters. Methods Fifty-two individuals with normal body mass index (BMI  35 kg/m 2 ) were prospectively included at the University Hospital of Nice between January 2014 and April 2016. Clinical data were recorded, and a fasting blood sample was collected to measure glicentin, glucose, insulin, C-peptide, total cholesterol, triglyceride, LDL and HDL-cholesterol. In addition, a homeostasis model assessment for insulin resistance (HOMA2-IR) was also calculated. Results Patients with severe and morbid obesity had significantly higher plasma glucose, together with higher serum concentrations of insulin, C-peptide, HOMA2-IR, triglyceride, LDL-cholesterol and lower serum concentrations of HDL-cholesterol compared with individuals with a normal body mass index. The obese patients displayed significantly lower fasting serum concentrations of glicentin compared with subjects with a normal body mass index (12 pmol/L vs. 24 pmol/L, P < 0.0001). In the total population, fasting glicentin concentrations did not correlate with BMI, glycaemic parameters (glucose, insulin, C-peptide, HOMA-IR) or lipid parameters (total cholesterol, triglyceride, LDL and HDL-cholesterol). Conclusion To the best of our knowledge, this is the first study reporting serum glicentin concentrations in healthy lean and obese adult subjects. We found that fasting serum glicentin concentrations are decreased in patients with severe or morbid obesity suggesting the potential interest of this peptide in obesity and metabolic-related disorders.

  19. Lack of Support for the Association Between GAD2 Polymorphisms andSevere Human Obesity

    Energy Technology Data Exchange (ETDEWEB)

    Swarbrick, Michael M.; Waldenmaier, Bjorn; Pennacchio, Len A.; Lind,Denise L.; Cavazos, Martha M.; Geller, Frank; Merriman, Raphael; Ustaszewska, Anna; Malloy, Mary; Scherag, Andre; Hsueh, Wen-Chi; Rief,Winfried; Mauvais-Jarvis, Franck; Pullinger, Clive R.; Kane, John P.; Dent, Robert; McPherson, Ruth; Kwok, Pui-Yan; Hinney, Anke; Hebebrand,Johannes; Vaisse, Christian

    2004-11-17

    Demonstration of association between common genetic variants and chronic human diseases such as obesity could have profound implications for the prediction, prevention and treatment of these conditions. Unequivocal proof of such an association, however, requires adherence to established methodological guidelines, which include independent replication of initial positive findings. Recently, single nucleotide polymorphisms (SNPs) within GAD2 were found to be associated with class III obesity (BMI > 40 kg/m2) in 188 families (612 individuals) segregating the condition and a case-control study of 575 cases and 646 lean controls. Functional data supporting a pathophysiological role for one of the SNPs (-243A>G) were also presented. In the present study, we attempted to replicate this association in larger groups of subjects, and to extend the functional studies of the -243A>G SNP. In 2,327 subjects comprising 692 German nuclear families with severe, early-onset obesity, we found no evidence for a relationship between the three GAD2 SNPs and obesity, whether SNPs were studied individually or as haplotypes. In two independent case-control studies (a total of 680 class III obesity cases and 1,186 lean controls), there was no significant relationship between the -243A>G SNP and obesity (odds ratio (OR) = 0.99, 95% CI 0.83 - 1.18,in the pooled sample). These negative findings were reinforced by a meta-analysis for the association between the 243G allele and class III obesity, which yielded an OR of 1.11 (95% CI 0.90 - 1.36) in a total sample of 1,252 class III obese cases and 1,800 lean controls. Finally,we were unable to confirm or extend the functional data pertaining to the -243A>G variant. Potential confounding variables in association studies involving common variants and complex diseases (low power to detect modest genetic effects, over-interpretation of marginal data, population stratification and biological plausibility) are also discussed in the context of GAD2 and

  20. Metabolic and cardiovascular improvements after biliopancreatic diversion in a severely obese patient

    Directory of Open Access Journals (Sweden)

    Lescelleur Odette

    2004-04-01

    Full Text Available Abstract Background Severe obesity is associated with important morbidity and increased mortality. The successes of lifestyle modifications and drug therapy have been partial and mostly unsustained in reducing obesity and its comorbidities. Bariatric surgery, particularly biliopancreatic diversion with duodenal switch reduces efficiently excess body weight and improves metabolic and cardiovascular functions. Case presentation A 56-year-old man with severe clinical obesity underwent a biliopancreatic diversion with a duodenal switch after unsuccessful treatment with weight loss pharmacotherapy. He had diabetes, hypertension and sleep apnea syndrome and was on three medications for hypertension and two hypoglycemic agents in addition to > 200 insulin units daily. Eleven months after the surgery, he had lost 40% of his body weight. The lipid profile showed great improvement and the hypertension and diabetes were more easily controlled with no more insulin needed. The pseudonormalized pattern of left ventricular diastolic function improved and ventricular walls showed decreased thickness. Conclusion Biliopancreatic diversion may bring metabolic and cardiovascular benefits in severely obese patients from a cardiovascular perspective.

  1. Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

    Science.gov (United States)

    Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

    2015-03-01

    The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa. © The Author(s) 2014.

  2. Disease severity and staging of obesity: a rational approach to patient selection.

    Science.gov (United States)

    Whyte, M B; Velusamy, S; Aylwin, S J B

    2014-11-01

    The increasing prevalence of obesity places ever-increasing cost demands on healthcare systems. One million individuals are eligible for bariatric surgery in the UK, and yet less than 6000 bariatric procedures are performed annually. Bariatric surgery reverses or improves almost all the medical and psychosocial co-morbidities associated with obesity. Although the BMI is a simple method to estimate adiposity at a population level, it is relatively inaccurate within an individual and provides little-to-no indication of overall health status or disease severity. Staging systems overcome the inherent limitations of BMI and allow highly informed decision-making for an individual. At a societal level, this helps to identify those most likely to gain and maximise economic benefit. This review summarises the co-morbidities associated with obesity and the evidence for their improvement following surgery. The rationale for new staging criteria and appropriate patient selection are discussed.

  3. Effect of GLP-1 Receptor Agonist Treatment on Body weight in Obese Antipsychotic-treated Patients with Schizophrenia

    DEFF Research Database (Denmark)

    Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V

    2017-01-01

    AIMS: Schizophrenia is associated with cardiovascular co-morbidity and a reduced life-expectancy of up to 20 years. Antipsychotics are dopamine D2 receptor antagonists and the standard of medical care in schizophrenia, but the drugs are associated with severe metabolic side effects like obesity...... and diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are registered for treatment of both obesity and type 2 diabetes. We investigated metabolic effects of the GLP-1RA, exenatide once-weekly, in non-diabetic, antipsychotic-treated, obese patients with schizophrenia. MATERIAL AND METHODS......: Antipsychotic-treated, obese, non-diabetic, schizophrenia spectrum patients were randomized to double-blinded adjunctive treatment with once-weekly subcutaneous exenatide (n = 23) or placebo (n = 22) injections for three months. The primary outcome was body weight loss after treatment and repeated measures...

  4. Severe obesity, emotions and eating habits: a case-control study.

    Science.gov (United States)

    Koski, M; Naukkarinen, H

    2017-01-01

    Obesity has a multifaceted etiology that involves genetic, biological and behavioral factors, body growth, eating habits, energy expenditure and the function of adipose tissue. The present study aimed to expand upon knowledge about the relationships among obesity, emotions and eating habits in severely obese individuals using a case-control method. The subject group consisted of 112 individuals (81 females and 31 males) receiving a permanent disability pension primarily for obesity. The control subjects were randomly selected from the same area and were receiving a disability pension for a different primary illness. The controls were matched with the subjects by the place of residence, sex, age, the time since the pension was granted and occupation. Psychiatric interviews were conducted on all participants. The results were analyzed using the chi-squared test (χ 2 -test) and the percent distribution. The subject and control groups were compared using the t-test for paired variables. Conditional logistic regression analysis was also conducted. The emotional state of eating was significantly associated with quarrels and feelings of loneliness. The subjects suffered from night eating syndrome, which was associated with an increased risk of early retirement. Binge eating syndrome was observed more frequently in the study group. The subjects reported feeling increased hunger compared with the controls. A significant percentage of the subjects had a body mass index of ≥ 40. No differences in eating habits were observed between the groups. This study provides information on the relationship between emotions and eating habits in obesity, which is a rarely studied topic. We believe that our study provides a novel and necessary overview of the associations among severe obesity, emotions and eating habits.

  5. The obesity gene, TMEM18, is of ancient origin, found in majority of neuronal cells in all major brain regions and associated with obesity in severely obese children

    Directory of Open Access Journals (Sweden)

    Levine Allen S

    2010-04-01

    Full Text Available Abstract Background TMEM18 is a hypothalamic gene that has recently been linked to obesity and BMI in genome wide association studies. However, the functional properties of TMEM18 are obscure. Methods The evolutionary history of TMEM18 was inferred using phylogenetic and bioinformatic methods. The gene's expression profile was investigated with real-time PCR in a panel of rat and mouse tissues and with immunohistochemistry in the mouse brain. Also, gene expression changes were analyzed in three feeding-related mouse models: food deprivation, reward and diet-induced increase in body weight. Finally, we genotyped 502 severely obese and 527 healthy Swedish children for two SNPs near TMEM18 (rs6548238 and rs756131. Results TMEM18 was found to be remarkably conserved and present in species that diverged from the human lineage over 1500 million years ago. The TMEM18 gene was widely expressed and detected in the majority of cells in all major brain regions, but was more abundant in neurons than other cell types. We found no significant changes in the hypothalamic and brainstem expression in the feeding-related mouse models. There was a strong association for two SNPs (rs6548238 and rs756131 of the TMEM18 locus with an increased risk for obesity (p = 0.001 and p = 0.002. Conclusion We conclude that TMEM18 is involved in both adult and childhood obesity. It is one of the most conserved human obesity genes and it is found in the majority of all brain sites, including the hypothalamus and the brain stem, but it is not regulated in these regions in classical energy homeostatic models.

  6. Impact of bariatric surgery on life expectancy in severely obese patients with diabetes: A Decision analysis

    Science.gov (United States)

    Schauer, Daniel P.; Arterburn, David E.; Livingston, Edward H.; Coleman, Karen J.; Sidney, Steve; Fisher, David; O'Connor, Patrick; Fischer, David; Eckman, Mark H.

    2014-01-01

    Objective To create a decision analytic model to estimate the balance between treatment risks and benefits for severely obese patients with diabetes. Summary Background Data Bariatric surgery leads to many desirable metabolic changes, but long-term impact of bariatric surgery on life expectancy in patients with diabetes has not yet been quantified. Methods We developed a Markov state transition model with multiple Cox proportional hazards models and logistic regression models as inputs to compare bariatric surgery versus no surgical treatment for severely obese diabetic patients. The model is informed by data from three large cohorts: 1) 159,000 severely obese diabetic patients (4,185 had bariatric surgery) from 3 HMO Research Network sites, 2) 23,000 subjects from the Nationwide Inpatient Sample (NIS), and 3) 18,000 subjects from the National Health Interview Survey linked to the National Death Index. Results In our main analyses, we found that a 45 year-old female with diabetes and a BMI of 45 kg/m2 gained an additional 6.7 years of life expectancy with bariatric surgery (38.4 years with surgery vs. 31.7 without). Sensitivity analyses revealed that the gain in life expectancy decreased with increasing BMI, until a BMI of 62 kg/m2 is reached, at which point nonsurgical treatment was associated with greater life expectancy. Similar results were seen for both men and women in all age groups. Conclusions For most severely obese patients with diabetes, bariatric surgery appears to improve life expectancy; however, surgery may reduce life expectancy for the super obese with BMIs over 62 kg/m2. PMID:25844968

  7. The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mohd Syis Zulkipli

    2018-02-01

    Full Text Available Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity.We performed a systematic search of relevant studies on Ovid (MEDLINE, EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI.We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73 of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity.This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection.

  8. The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis

    Science.gov (United States)

    Dahlui, Maznah; Jamil, Nor’ashikin; Peramalah, Devi; Wai, Hoe Victor Chee; Bulgiba, Awang; Rampal, Sanjay

    2018-01-01

    Background Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity. Methods We performed a systematic search of relevant studies on Ovid (MEDLINE), EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI). Findings We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73) of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity. Conclusion This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection. PMID:29415036

  9. Impact of weight loss achieved through a multidisciplinary intervention on appetite in patients with severe obesity

    DEFF Research Database (Denmark)

    Coutinho, Silvia R; Rehfeld, Jens F; Holst, Jens J

    2018-01-01

    The impact of lifestyle-induced weight loss (WL) on appetite in patients with obesity remains controversial. This study aimed was to assess the short- and long-term impact of WL achieved by diet and exercise, on appetite in patients with obesity. Thirty-five (22 females) adults with severe obesity......), in the fasting and postprandial states, were measured at baseline (B), week 4 (W4), 1 and 2-years (and average values for all fasting and postprandial time points computed). BW was significantly reduced and VO2max (ml/kg/min) increased at all time points compared with B (3.5, 8.1 and 8.4 % WL and 7, 11 and 8...... compared with B. Average GLP-1 was reduced at W4 and CCK increased at 2y. After lifestyle-induced WL, patients with severe obesity will, therefore, have to deal with increased hunger in the long-term. In conclusion, sustained WL at 2y achieved with diet and exercise is associated with increased hunger...

  10. Different cycle ergometer outcomes in severely obese men and women without documented cardiopulmonary morbidities before bariatric surgery

    NARCIS (Netherlands)

    Dolfing, JG; Dubois, EF; Wolffenbuttel, BHR; ten Hoor-Aukema, NM; Schweitzer, DH

    Study objectives: The number of severely obese patients undergoing bariatric surgery is increasing. No incremental cycle ergometer data are available in this category of patients. The current study was undertaken to provide information and to compare outcomes between severely obese men and women

  11. Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity.

    Science.gov (United States)

    Kelly, A S; Ryder, J R; Marlatt, K L; Rudser, K D; Jenkins, T; Inge, T H

    2016-02-01

    Inflammation, oxidative stress and dysregulation of adipokines are thought to be pathophysiological mechanisms linking obesity to the development of insulin resistance and atherosclerosis. In adults, bariatric surgery reduces inflammation and oxidative stress, and beneficially changes the levels of several adipokines, but little is known about the postsurgical changes among adolescents. In two separate longitudinal cohorts we evaluated change from baseline of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemo-attractant protein-1 (MCP-1), oxidized low-density lipoprotein cholesterol (oxLDL), adiponectin, leptin and resistin up to 12 months following elective laparoscopic Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG) surgery in adolescents with severe obesity. In cohort 1, which consisted of 39 adolescents (mean age 16.5±1.6 years; 29 females) undergoing either RYGB or VSG, IL-6 (baseline: 2.3±3.4 pg ml(-1) vs 12 months: 0.8±0.6 pg ml(-1), Padolescents (mean age 16.5±1.6 years; 10 females) undergoing RYGB, results were similar: IL-6 (baseline: 1.7±0.9 pg ml(-1) vs 12 months: 0.4±0.9 pg ml(-1), PBariatric surgery produced robust improvements in markers of inflammation, oxidative stress and several adipokines among adolescents with severe obesity, suggesting potential reductions in risk for type 2 diabetes and cardiovascular disease.

  12. Prevalence of severe obesity among New Zealand adolescents and associations with health risk behaviors and emotional well-being.

    Science.gov (United States)

    Farrant, Bridget; Utter, Jennifer; Ameratunga, Shanthi; Clark, Terryann; Fleming, Theresa; Denny, Simon

    2013-07-01

    To describe the prevalence of severe obesity among New Zealand young people attending secondary school and the associations of severe obesity with health risk behaviors and emotional well-being. A random sample of 9107 secondary school students in New Zealand participated in a 2007 health survey. Participants had their height and weight measured and answered an anonymous survey on multiple aspects of their health and well-being. Overall, 2.5% of students met the International Obesity Task Force definition of severe obesity. Students with severe obesity had more weight-related concerns, were more likely to have used unhealthy weight control strategies, and were more likely to experience bullying compared with healthy weight students. For example, students with severe obesity were 1.7 times more likely to have been bullied at school (95% CI 1.2-2.7) and 1.9 times more likely to vomit for weight loss (95% CI 1.1-3.3) than were healthy weight students. Indicators of emotional well-being and most health risk behaviors were similar among young people with severe obesity and a healthy weight. Clinicians who work with young people with severe obesity should prioritize discussing issues of bullying and healthy weight control strategies with families and their children. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. Metabolic and Hormonal Determinants of Glomerular Filtration Rate and Renal Hemodynamics in Severely Obese Individuals

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    Edoardo Vitolo

    2016-10-01

    Full Text Available Objective: Renal function is often compromised in severe obesity. A true measurement of glomerular filtration rate (GFR is unusual, and how estimation formulae (EstForm perform in such individuals is unclear. We characterized renal function and hemodynamics in severely obese individuals, assessing the reliability of EstForm. Methods: We measured GFR (mGFR by iohexol plasma clearance, renal plasma flow (RPF by 123I-ortho-iodo-hippurate, basal and stimulated vascular renal indices, endothelium-dependent and -independent vasodilation using flow-mediated dilation (FMD as well as metabolic and hormonal profile in morbid, otherwise healthy, obese subjects. Results: Compared with mGFR, the better performing EstForm was CKD-EPI (5.3 ml/min/1.73 m2 bias by Bland-Altman analysis. mGFR was directly related with RPF, total and incremental glucose AUC, and inversely with PTH and h8 cortisol. Patients with mGFR below the median shown significantly higher PTH and lower vitamin D3. Basal or dynamic renal resistive index, FMD, pulse wave velocity were not related with mGFR. In an adjusted regression model, renal diameter and plasma flow remained related with mGFR (R2 = 0.67, accounting for 15% and 21% of mGFR variance, respectively. Conclusions: CKD-EPI formula should be preferred in morbid obesity; glucose increments during oral glucose tolerance test correlate with hyperfiltration; RPF and diameter are independent determinants of mGFR; slightly high PTH values, frequent in obesity, might influence mGFR.

  14. Several dominants risk factors related to obesity in urban childbearing age women in Indonesia

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    Kencana Sari

    2016-01-01

    analyze several dominant riskfactors related to obesity in childbearing age women living in urban areas in Indonesia.Methods: This analysis used a part of Basic Health Research (Riskesdas 2007 data. The samples werederived from 258366 households. Riskesdas data on socio-demographic and other factors was collectedby questionnaire. Nutritional status was measured using body mass index (BMI. Cox regression withconstant time analysis was used for the analysis.Results: This analysis noted that there are 14357 (18.8% of women were obese and 62052 (81.2%normal. Compared with the respective reference groups, women aged 25-49 had a 3.5-fold greater riskof becoming obese [adjusted relative risk (RRa = 3.49; P = 0.000, and divorced or married had 2.5-foldhigher risk to be obese (RRa = 2.58; P= 0.000 and RRa = 2.62; P = 0.000, respectively. Furthermore,unemployed women had higher risk to be obese (RRa = 1.06; P = 0.000, and consuming excess proteinas well as often consume fatty foods made women had a higher risk of obesity (RRa = 1.09; P = 0.000 andRRa = 1.17; P = 0.000, respectively.Conclusion: Women aged 25-49, divorced or married, unemployed, consumed excess protein, and often consumefatty foods have a higher risk for becoming obese. (Health Science Journal of Indonesia 2015;6:63-8Key words: obesity, urban, women

  15. The Relationship between Symptom Severity and Cognitive Functions with Obesity in Fibromyalgia Syndrome

    OpenAIRE

    Selçuk Sayılır

    2017-01-01

    Objective: To investigate the relationship between obesity with symptom severity and cognitive functions in Fibromyalgia syndrome (FMS) patients. Materials and Methods: The study comprised 33 FMS patients (mean age 41.21±7.6 years). The patients who have hypertension, hypercholesterolaemia or diabetes, chronic inflammatory disorders, cardiovascular-pulmonary diseases, rheumatological/endocrine diseases, using anticoagulant therapy or have thrombotic disorders, malignancies and pregnant wom...

  16. The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain.

    Science.gov (United States)

    Espallardo, Olga; Busutil, Rafael; Torres, Antonio; Zozaya, Néboa; Villoro, Renata; Hidalgo-Vega, Álvaro

    2017-08-01

    Obesity is not only a health problem but also a source of increased monetary expenditures. The objectives of this study were to analyse the use of healthcare resources in the Spanish adult population with class II obesity and above (BMI ≥35 kg/m 2 ) and to compare it with other BMI groups. We used the Spanish National Health Survey, a longitudinal population-based survey (n = 18,682), to analyse healthcare resource utilisation by BMI groups. Adjusted and unadjusted logistic regression models were used to calculate odds ratios (OR) for healthcare use among class II and over obese subjects versus normal BMI. Persons with BMI ≥35 are more likely to attend general practitioner (GP)'s consultations (17%), to visit the emergency department (26%), to consume medications (36%), to be hospitalised (49%), to require nursing consultations (61%) and to require psychology consultations (83%). The proportion of obese people receiving home visits is 2.6 times higher than among normal BMI. After controlling for sex and age groups, people with severe obesity (BMI ≥35 kg/m 2 ) were more prone to requiring home care visits (OR 2.3; CI [1.3; 4.2]), GP visits (OR 2.1; CI [1.5; 3.0]), psychologist visits (OR 1.96; CI [1.3; 2.99]), emergency service visits (OR 1.5; CI [1.2; 1.8]), nurse visits (OR 1.46; CI [1.2; 1.9]) and hospitalisations (OR 1.43; CI [1.1; 1.9]) and after also adjusting for relevant comorbidities like hypertension, diabetes and cardiovascular diseases: GP visits (OR 1.85; CI [1.3; 2.7]), psychologist visits (OR 1.8; CI [1.2; 2.7]), specialised care visits (OR 0.92; CI [0.7; 1.2]) and physiotherapist visits (OR 0.7; CI [0.5; 1.0]). Severe obesity significantly increases healthcare resource utilisation in Spain. The results shed light on the real magnitude of the burden of obesity in Spain.

  17. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease.

    Science.gov (United States)

    Azimi, Aziza; Charlot, Mette Gitz; Torp-Pedersen, Christian; Gislason, Gunnar H; Køber, Lars; Jensen, Lisette Okkels; Thayssen, Per; Ravkilde, Jan; Tilsted, Hans-Henrik; Lassen, Jens Flensted; Thuesen, Leif

    2013-05-01

    Obesity is paradoxically associated with enhanced survival in patients with established cardiovascular disease. We explored this paradox further by examining the influence of obesity on survival in patients with verified atherosclerotic heart disease. This retrospective registry based cohort study included all patients from the Western Denmark Heart Registry with coronary atherosclerosis confirmed by coronary angiography from January 2000 to December 2010. Patients were divided into eight groups according to body mass index (BMI) based on WHO BMI classification. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. The study included 37 573 patients (70.7% men) with a mean age of (66.3 ± 11.1) years. During the 11 years of follow-up, 5866 (15.6%) patients died. Multivariable analysis confirmed that the risk of death was the lowest among the preobese patients (27.5 ≤ BMIObese classes I and II did not differ from the reference group (23 ≤ BMIheart disease patients have improved survival compared with normal weight patients. Underweight and severely obese patients have increased mortality. Our results lean more towards an overweight paradox than an obesity paradox.

  18. Predictors of health-related quality of life in 500 severely obese patients.

    Science.gov (United States)

    Warkentin, Lindsey M; Majumdar, Sumit R; Johnson, Jeffrey A; Agborsangaya, Calypse B; Rueda-Clausen, Christian F; Sharma, Arya M; Klarenbach, Scott W; Birch, Daniel W; Karmali, Shahzeer; McCargar, Linda; Fassbender, Konrad; Padwal, Raj S

    2014-05-01

    To characterize health-related quality of life (HRQL) impairment in severely obese subjects, using several validated instruments. A cross-sectional analysis of 500 severely obese subjects was completed. Short-Form (SF)-12 [Physical (PCS) and Mental (MCS) component summary scores], EuroQol (EQ)-5D [Index and Visual Analog Scale (VAS)], and Impact of Weight on Quality of Life (IWQOL)-Lite were administered. Multivariable linear regression models were performed to identify independent predictors of HRQL. Increasing BMI was associated with lower PCS (-1.33 points per 5 kg/m(2) heavier; P fibromyalgia for PCS (-5.84 points), depression for MCS (-7.49 points), stroke for EQ-index (-0.17 points), less than full-time employment for EQ-VAS (-7.06 points), and coronary disease for IWQOL-Lite (-10.86 points). Chronic pain, depression, and sleep apnea were associated with reduced HRQL using all instruments. The clinical impact of BMI on physical and general HRQL was small, and mental health scores were not associated with BMI. Chronic pain, depression, and sleep apnea were consistently associated with lower HRQL. Copyright © 2014 The Obesity Society.

  19. Body Fat Distribution Ratios and Obstructive Sleep Apnea Severity in Youth With Obesity.

    Science.gov (United States)

    Glicksman, Amy; Hadjiyannakis, Stasia; Barrowman, Nicholas; Walker, Scott; Hoey, Lynda; Katz, Sherri Lynne

    2017-04-15

    Obesity and regional fat distribution, measured by neck fat mass percentage using dual-energy X-ray absorptiometry (DXA), correlate with obstructive sleep apnea (OSA) severity in adults. In obese children, neck-to-waist-circumference ratio predicts OSA. This study examined associations between body fat percentage and distribution and sleep-disordered breathing (SDB) severity in obese youth, measured with DXA. Cross-sectional retrospective study conducted at a tertiary children's hospital. Participants were aged 6 to 18 years with obesity (body mass index [BMI] > 99th percentile [BMI z-score 2.35] or > 95th percentile with comorbidity). They underwent polysomnography and DXA to quantify body fat percentage and distribution ratios (neck-to-abdominal fat percentage [NAF % ratio]). SDB was defined as apnea-hypopnea index (AHI) > 5 and OSA as obstructive AHI (OAHI) > 1 event/h. Relationships of BMI z-score and NAF % ratio to log AHI and log OAHI were evaluated. Thirty individuals participated; 18 male; median age 14.1 years. Twenty-four individuals had BMI z-scores > 2.35. Ten had AHI > 5 events/h. NAF % ratio was significantly associated with log AHI in males and with log OAHI in all, whereas total fat mass percent was not. The association between log OAHI and NAF % ratio was significant in males, but not females. NAF % ratio was significantly associated with log OAHI in those with BMI z-score above 2.35. NAF % ratio was associated with OSA severity in males and youth with BMI > 99th percentile; however, total fat mass percentage was not, suggesting that body fat distribution is associated with OSA risk in youth. © 2017 American Academy of Sleep Medicine

  20. Brd2 disruption in mice causes severe obesity without Type 2 diabetes.

    Science.gov (United States)

    Wang, Fangnian; Liu, Hongsheng; Blanton, Wanda P; Belkina, Anna; Lebrasseur, Nathan K; Denis, Gerald V

    2009-12-14

    Certain human subpopulations are metabolically healthy but obese, or metabolically obese but normal weight; such mutations uncouple obesity from glucose intolerance, revealing pathways implicated in Type 2 diabetes. Current searches for relevant genes consume significant effort. We have reported previously a novel double bromodomain protein called Brd2, which is a transcriptional co-activator/co-repressor with SWI/SNF (switch mating type/sucrose non-fermenting)-like functions that regulates chromatin. In the present study, we show that wholebody disruption of Brd2, an unusual MHC gene, causes lifelong severe obesity in mice with pancreatic islet expansion, hyperinsulinaemia, hepatosteatosis and elevated pro-inflammatory cytokines, but, surprisingly, enhanced glucose tolerance, elevated adiponectin, increased weight of brown adipose tissue, heat production and expression of mitochondrial uncoupling proteins in brown adipose tissue, reduced macrophage infiltration in white adipose tissue, and lowered blood glucose, leading to an improved metabolic profile and avoiding eventual Type 2 diabetes. Brd2 is highly expressed in pancreatic beta-cells, where it normally inhibits beta-cell mitosis and insulin transcription. In 3T3-L1 pre-adipocytes, Brd2 normally co-represses PPAR-gamma (peroxisome-proliferator-activated receptor-gamma) and inhibits adipogenesis. Brd2 knockdown protects 3T3-L1 adipocytes from TNF-alpha (tumour necrosis factor-alpha)-induced insulin resistance, thereby decoupling inflammation from insulin resistance. Thus hypomorphic Brd2 shifts energy balance toward storage without causing glucose intolerance and may provide a novel model for obese metabolically healthy humans.

  1. Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity.

    Science.gov (United States)

    Ford, Margaret C; Gordon, Nancy P; Howell, Amanda; Green, Cheryl E; Greenspan, Louise C; Chandra, Malini; Mellor, R Grant; Lo, Joan C

    2016-01-01

    Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3-5, 44.2% were 6-11, and 41.6% were 12-17 years old. One-quarter (24.9%) were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%), especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.

  2. Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

    Directory of Open Access Journals (Sweden)

    Margaret C. Ford

    2016-01-01

    Full Text Available Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise. Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3–5, 44.2% were 6–11, and 41.6% were 12–17 years old. One-quarter (24.9% were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%, especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.

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

    Science.gov (United States)

    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.

  4. Hypothalamic obesity in patients with craniopharyngioma: Profound changes of several weight regulatory circuits

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    Christian eRoth

    2011-10-01

    Full Text Available One of the most striking examples of dysfunctional hypothalamic signaling of energy homeostasis is observed in patients with hypothalamic lesions leading to hypothalamic obesity (HO. This drastic condition is frequently seen in patients with craniopharyngioma (CP, an embryological tumor located in the hypothalamic and/or pituitary region, frequently causing not only hypopituitarism, but also leading to damage of medial hypothalamic nuclei due to the tumor and its treatment. HO syndrome in CP patients is characterized by fatigue, decreased physical activity, uncontrolled appetite, and morbid obesity, and is associated with insulin and leptin resistance. Mechanisms leading to the profoundly disturbed energy homeostasis are complex. This review summarizes different aspects of important clinical studies as well as data obtained in rodent studies. In addition a model is provided describing how medial hypothalamic lesion can interact simultaneously with several weight regulating circuitries.

  5. Individual, social and environmental predictors of physical activity in severe to morbid obese African American adolescents

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Martin

    2016-12-01

    Full Text Available The purpose of this study was to predict low, moderate, hard and very hard physical activity (PA and walking/biking/jogging based PA. One-hundred and fifty-nine severe to morbid obese African-American adolescents participated. We predicted 8% of the variance in hard PA largely due to family support and 10% of the variance in very hard PA due to other support (e.g. counselor and having home PA equipment. We also predicted 10% of the variance in walking/biking/jogging due to the walkability of the neighborhood. Our findings support the value of social support and environmental supports in helping obese African American adolescents increase PA.

  6. Structured Dietary Interventions in the Treatment of Severe Pediatric Obesity: A Pilot Study.

    Science.gov (United States)

    Kalarchian, Melissa A; Levine, Michele D; Marcus, Marsha D

    2013-06-01

    Structured dietary interventions have been associated with improved outcomes in adult weight-control programs, but virtually no research has focused on children. Thus, we conducted an uncontrolled pilot study to determine the potential utility of structured approaches to enhance the dietary component of family-based treatment of severe pediatric obesity (body mass index [BMI] >97th percentile for age and sex). Children aged 8-12 years participated with a parent or guardian. Individualized menu plans were provided (MENU, n =12) alone, or along with meals and snacks for the child (MENU+MEAL, n =6). All families received up to $30/week reimbursement for foods included in the menus. Median BMI change was -1.2 kg/m 2 for MENU ( n =12), and -1.8 kg/m 2 for MENU+MEAL ( n =6). Both approaches were associated with significant reductions in BMI ( p obesity are acceptable to families and warrant further development.

  7. Relationship between severe obesity and gut inflammation in children: what's next?

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    Assante Luca

    2010-10-01

    Full Text Available Abstract Background Preliminary evidence suggests an association between obesity and gut inflammation. Aims To evaluate the frequency of glucose abnormalities and their correlation with systemic and intestinal inflammation in severely obese children. Patients and Methods Thirty-four children (25 males; median age 10.8 ± 3.4 yrs with severe obesity (BMI >95% were screened for diabetes with oral glucose tolerance test (OGTT, systemic inflammation with C-reactive protein (CRP and gut inflammation with rectal nitric oxide (NO and faecal calprotectin. Results BMI ranged from 23 to 44 kg/m2, and BMI z-score between 2.08 e 4.93 (median 2.69 ± 0.53. Glucose abnormalities were documented in 71% of patients: type 2 diabetes in 29%, impaired fasting glucose (IFG in 58%, and impaired glucose tolerance (IGT in 37.5%. Thirty-one patients (91% were hyperinsulinemic. CRP was increased in 73.5% with a correlation between BMI z-score and CRP (p 0.03. Faecal calprotectin was increased in 47% patients (mean 77 ± 68, and in 50% of children with abnormal glucose metabolism (mean 76 ± 68 μg/g, with a correlation with increasing BMI z-score. NO was pathological in 88%, and in 87.5% of glucose impairment (mean 6.8 ± 5 μM. Conclusions In this study, the prevalence of glucose abnormalities in obese children is higher than in other series; furthermore, a correlation is present between markers of systemic and intestinal inflammation and glucose abnormalities.

  8. Biliopancreatic Diversion for Severe Obesity: Long-Term Effectiveness and Nutritional Complications.

    Science.gov (United States)

    Ballesteros-Pomar, María D; González de Francisco, Tomás; Urioste-Fondo, Ana; González-Herraez, Luis; Calleja-Fernández, Alicia; Vidal-Casariego, Alfonso; Simó-Fernández, Vicente; Cano-Rodríguez, Isidoro

    2016-01-01

    Bariatric surgery is currently the treatment of choice for those patients with severe obesity, but the procedure of choice is not clearly established. We describe weight loss and nutritional parameters in severely obese patients after biliopancreatic diversion for 10 years of follow-up. Patients were followed by the same multidisciplinary team, and data are shown for 10 years. Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, data regarding the evolution of obesity-related diseases, and nutritional parameters are reported. Two hundred ninety-nine patients underwent biliopancreatic diversion, 76.1 % women, initial BMI 50.1 kg/m(2) (7.2). Weight loss was maintained throughout 10 years with EWL% around 65 % and EBMIL% around 70 %. More than 80 % of the patients showed EWL higher than 50 %. Blood pressure, glucose metabolism, and lipid profile clearly improved after surgery. Mean nutritional parameters remained within the normal range during follow-up. Protein malnutrition affected less than 4 % and anemia up to 16 %. Fat-soluble vitamin levels decreased along the time, with vitamin D deficiency in 61.5 % of patients. No significant differences were found either in nutritional parameters or weight loss regarding gastrectomy or gastric preservation, or common limb length longer or shorter than 55 cm Biliopancreatic diversion is an effective surgical procedure in terms of weight loss, quality of life, and evolution of obesity-related diseases. Nutritional deficiencies are less frequent than feared for a malabsorptive procedure, but must be taken into account, especially for fat-soluble vitamins.

  9. Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010

    OpenAIRE

    Robbins, Jessica M.; Mallya, Giridhar; Polansky, Marcia; Schwarz, Donald F.

    2012-01-01

    Introduction Epidemic increases in obesity negatively affect the health of US children, individually and at the population level. Although surveillance of childhood obesity at the local level is challenging, height and weight data routinely collected by school districts are valuable and often underused public health resources. Methods We analyzed data from the School District of Philadelphia for 4 school years (2006–2007 through 2009–2010) to assess the prevalence of and trends in obesity and...

  10. Skeletal muscle myotubes of the severely obese exhibit altered ubiquitin-proteasome and autophagic/lysosomal proteolytic flux

    Science.gov (United States)

    Bollinger, Lance M.; Powell, Jonathan J. S.; Houmard, Joseph A.; Witczak, Carol A.; Brault, Jeffrey J.

    2015-01-01

    Objective Whole-body protein metabolism is dysregulated with obesity. Our goal was to determine if activity and expression of major protein degradation pathways are compromised specifically in human skeletal muscle with obesity. Methods We utilized primary Human Skeletal Muscle cell (HSkM) cultures since cellular mechanisms can be studied absent of hormones and contractile activity that could independently influence metabolism. HSkM from 10 lean (BMI ≤ 26.0 kg/m2) and 8 severely obese (BMI ≥ 39.0) women were examined basally and when stimulated to atrophy (serum and amino acid starvation). Results HSkM from obese donors had a lower proportion of type I myosin heavy chain and slower flux through the autophagic/lysosomal pathway. During starvation, flux through the ubiquitin-proteasome system diverged according to obesity status, with a decrease in the lean and an increase in HSkM from obese subjects. HSkMC from the obese also displayed elevated proteasome activity despite no difference in proteasome content. Atrophy-related gene expression and myotube area were similar in myotubes derived from lean and obese individuals under basal and starved conditions. Conclusions Our data indicate that muscle cells of the lean and severely obese have innate differences in management of protein degradation, which may explain their metabolic differences. PMID:26010327

  11. Psychological characterisation of severely obese patients: pre- and post-bariatric surgery

    Directory of Open Access Journals (Sweden)

    André Ferreira

    2013-06-01

    Full Text Available Although psychological disorders are more prevalent among candidates for bariatric surgery than among non-obese populations, there is limited knowledge about the impact of this type of surgery on psychopathology. The main goal of this study was to characterize the evolution of psychopathological morbidity among obese patients after surgery. This was an observational longitudinal study. All patients submitted to bariatric surgery between March 2008 and June 2010, in a general hospital located in the south of Portugal were invited to participate. Psychological assessment was done through structured clinical interviews and administration of MCMI-III. Participants were assessed with the same protocol before and after surgery (minimum, 12 months after surgery. Overall, 20 patients (19 women were assessed. The most prevalent clinical syndromes (axis I before surgery were: anxiety (40%, dysthymia disorder (20%, somatoform disorder and delusional disorder (both 15%. After surgery, the most prevalent clinical syndromes were: anxiety (40%, bipolar disorder, dysthymia disorder, and delusional disorder (all with 15%. Before surgery, compulsive personality was the most prevalent personality disorder (15%. After surgery, the most prevalent ones were: histrionic personality, compulsive personality disorder, and paranoia (all with 10%. These findings may suggest that bariatric surgery per se is not enough as treatment for the remission of psychopathology among severe obese patients.

  12. Characterizing severe obesity in children and youth referred for weight management.

    Science.gov (United States)

    Salawi, Hebah A; Ambler, Kathryn A; Padwal, Rajdeep S; Mager, Diana R; Chan, Catherine B; Ball, Geoff D C

    2014-06-19

    Severe obesity (SO) in pediatrics has become increasing prevalent in recent decades.The objective of our study was to examine differences in demographic, anthropometric, cardiometabolic, and lifestyle variables in children and youth with SO versus their less overweight/obese (OW/OB) peers. A retrospective medical record review of 6-19 year old participants enrolled in an outpatient pediatric weight management clinic was conducted. SO (body mass index [BMI] ≥99(th) percentile) and OW/OB (BMI ≥85(th) and $50,000/year (65.7%). The SO group (n = 161) had lower HDL-cholesterol and higher liver enzymes, insulin resistance and blood pressure than the OW/OB group (n = 184; all p youth in the SO group failed to meet moderate-to-vigorous physical activity (48.4% vs 31.9%) and leisure-time-screen-time recommendations (43.4% vs 28.3%; both p youth with SO have a worse cardiometabolic profile and less favorable lifestyle habits than their OW/OB peers. These differences emphasize the heightened obesity-related health risks associated with SO in the pediatric years.

  13. The relationship of omental and subcutaneous adipocyte size to metabolic disease in severe obesity.

    LENUS (Irish Health Repository)

    O'Connell, Jean

    2012-02-01

    OBJECTIVE: Several studies have reported the existence of a subgroup of obese individuals with normal metabolic profiles. It remains unclear what factors are responsible for this phenomenon. We proposed that adipocyte size might be a key factor in the protection of metabolically healthy obese (MHO) individuals from the adverse effects of obesity. SUBJECTS: Thirty-five patients undergoing bariatric surgery were classified as MHO (n = 15) or metabolically unhealthy obese (MUO, n = 20) according to cut-off points adapted from the International Diabetes Federation definition of the metabolic syndrome. Median body mass index (BMI) was 48 (range 40-71). RESULTS: There was a moderate correlation between omental adipocyte size and subcutaneous adipocyte size (r = 0.59, p<0.05). The MHO group had significantly lower mean omental adipocyte size (80.9+\\/-10.9 microm) when compared with metabolically unhealthy patients (100.0+\\/-7.6 microm, p<0.0001). Mean subcutaneous adipocyte size was similar between the two groups (104.1+\\/-8.5 microm versus 107.9+\\/-7.1 microm). Omental, but not subcutaneous adipocyte size, correlated with the degree of insulin resistance as measured by HOMA-IR (r = 0.73, p<0.0005), as well as other metabolic parameters including triglyceride\\/HDL-cholesterol ratio and HbA1c. Twenty-eight patients consented to liver biopsy. Of these, 46% had steatohepatitis and fibrosis. Fifty percent (including all the MHO patients) had steatosis only. Both omental and subcutaneous adipocyte size were significantly associated with the degree of steatosis (r = 0.66, p<0.0001 and r = 0.63, p<0.005 respectively). However, only omental adipocyte size was an independent predictor of the presence or absence of fibrosis. CONCLUSION: Metabolically healthy individuals are a distinct subgroup of the severely obese. Both subcutaneous and omental adipocyte size correlated positively with the degree of fatty liver, but only omental adipocyte size was related to metabolic health

  14. Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Sabine Makkes

    2017-10-01

    Full Text Available Background: Considering the large economic consequences of severe childhood obesity for the society, we aimed to conduct an economic evaluation comparing two intensive 1-year lifestyle treatments with varying inpatient periods for severely obese children and adolescents with regard to standard deviation score BMI (SDS-BMI and quality-adjusted life years (QALYs. Methods: An economic evaluation from a societal perspective accompanying a randomized controlled trial with a 24-month follow-up. 80 participants (8-19 years with severe obesity were included. Participants received an intensive 1-year lifestyle treatment with an inpatient period of 2 months (short-stay group or 6 months (long-stay group. Data were collected at baseline, 6, 12 ,and 24 months and included SDS-BMI and QALYs. Results: SDS-BMI decreased in the first 6 months of treatment, stabilized in the second 6 months, and increased during the 2nd year in both groups. After 24 months, SDS-BMI was similar in both groups, but remained lower than baseline values (mean difference -0.24, 95% CI -0.42; -0.06. There was no difference in QALYs between the groups after 24 months. For SDS-BMI, the probability of the short-stay treatment being cost-effective in comparison with the long-stay treatment was 1 at a willingness-to-pay of 0 EUR/unit of effect, which slowly decreased to 0.54 for larger willingness-to-pay values. Conclusions: Based on the results of this study, the short-stay treatment is considered to be more cost-effective from the societal perspective in comparison with the long-stay treatment. Future research should provide insight in whether the short-stay treatment is cost-effective in comparison with usual care.

  15. Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity.

    Science.gov (United States)

    Blümel, Juan E; Fica, Juan; Chedraui, Peter; Mezones-Holguín, Edward; Zuñiga, María C; Witis, Silvina; Vallejo, María S; Tserotas, Konstantinos; Sánchez, Hugo; Onatra, William; Ojeda, Eliana; Mostajo, Desireé; Monterrosa, Alvaro; Lima, Selva; Martino, Mabel; Hernández-Bueno, José A; Gómez, Gustavo; Espinoza, María T; Flores, Daniel; Calle, Andrés; Bravo, Luz M; Benítez, Zully; Bencosme, Ascanio; Barón, Germán; Aedo, Sócrates

    2016-05-01

    The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.57 ± 6.71 vs 8.01 ± 6.27 points, P sedentary lifestyle. Having a stable partner (OR 0.85; 95% CI, 0.76-0.96), using hormone therapy (OR 0.75; 95% CI, 0.64-0.87) and having a higher educational level (OR 0.66; 95% CI, 0.60-0.74) were negatively related to sedentary lifestyle. There was a high prevalence of sedentary lifestyle in this middle-aged Latin American female sample which was associated with more severe menopausal symptoms and obesity.

  16. Obese adolescent girls with polycystic ovary syndrome (PCOS) have more severe insulin resistance measured by HOMA-IR score than obese girls without PCOS.

    Science.gov (United States)

    Sawathiparnich, Pairunyar; Weerakulwattana, Linda; Santiprabhob, Jeerunda; Likitmaskul, Supawadee

    2005-11-01

    The prevalence of obesity in Thai children is increasing. These individuals are at increased risks of metabolic syndrome that includes insulin resistance, type 2 diabetes mellitus (T2DM), polycystic ovary syndrome (PCOS), dyslipidemia and hypertension. PCOS has been known to be associated with insulin resistance. To compare the insulin sensitivity between obese adolescent girls with PCOS and those without PCOS. We reviewed demographic and hormonal data of 6 obese adolescent girls with PCOS and compared with 6 age, weight and BMI-matched non-PCOS controls. Each subject underwent an oral glucose tolerance test. Homeostasis model assessment of insulin resistance score (HOMA-IR score) in obese adolescent girls with PCOS was significantly higher than in girls without PCOS with median and range as follows (16.5 [3.8, 21.8] vs. 4.1 [3.3, 6.9], p = 0.04). Our study demonstrates that obese adolescent girls with PCOS have more severe insulin resistance measured by HOMA-IR score than girls without PCOS independent of the degree of obesity. Since insulin resistance is a metabolic precursor of future cardiovascular diseases, obese adolescent girls with PCOS might be at greater risk of developing cardiovascular disease in later adulthood than their non-PCOS counterparts.

  17. Inpatient treatment of children and adolescents with severe obesity in the Netherlands: a randomized clinical trial.

    Science.gov (United States)

    van der Baan-Slootweg, Olga; Benninga, Marc A; Beelen, Anita; van der Palen, Job; Tamminga-Smeulders, Christine; Tijssen, Jan G P; van Aalderen, Wim M C

    2014-09-01

    Severe childhood obesity has become a major health problem, and effective, evidence-based interventions are needed. The relative effectiveness of inpatient compared with ambulatory treatment remains unknown. To determine whether an inpatient treatment program is more effective than an ambulatory treatment program at achieving a sustained weight loss in children and adolescents with severe obesity. We conducted a randomized clinical trial with a 2-year follow-up at a tertiary referral center for pediatric obesity in the Netherlands. We recruited 90 children and adolescents aged 8 to 18 years with severe obesity (body mass index [BMI] z score, ≥3.0 or >2.3 with obesity-related health problems). Patients were randomly assigned to an inpatient (6 months of hospitalization on working days) or an ambulatory (12 days of hospital visits at increasing intervals during a 6-month period) treatment program. Both treatment programs involved an intensive, family-based, lifestyle intervention, including exercise, nutritional education, and behavior modification for the patients and their caregiver(s). Change in BMI z score. Secondary outcomes included fasting insulin, fasting plasma glucose, 2-hour plasma glucose, and lipid levels, insulin sensitivity, liver function test results, waist circumference, blood pressure, body composition, and aerobic fitness (peak oxygen consumption, Vo₂). Outcomes were analyzed by intention to treat. Immediately after treatment, reductions in the BMI z score were significantly larger for the inpatient than the ambulatory groups (mean [SE] difference, -0.26 [0.12; 95% CI, -0.59 to -0.01]; P = .04). Change from baseline for the BMI z score in the inpatient group was -18.0% (P = .001) immediately after treatment, -8.5% (P = .008) at 18 months, and -6.3% (P = .38) at 30 months; in the ambulatory group, changes from baseline were -10.5% (P = .001), -6.2% (P = .39), and -1.5% (P > .99), respectively. The favorable outcomes

  18. Understanding High Incidence of Severe Obesity and Very Low Food Security in Food Pantry Clients: Implications For Social Work.

    Science.gov (United States)

    Kaiser, Michelle L; Cafer, Anne

    2018-01-01

    The United States is facing two interconnected social and public health crises of severe obesity and food insecurity within the social-ecological environment. Marginalized groups experience the highest rates and the greatest impacts in terms of morbidity, mortality, and financial burdens. Consequences include experiencing multimorbidities, mental health issues, and decreased quality of life. Food pantries have served as spaces to obtain food to meet household needs, but for some, food pantries have become long-term solutions. We surveyed 2,634 people who accessed pantries in 2005, 2010, and 2013 across 32 counties in a Midwest state. The authors sought to understand to what extent does length of time using a food pantry, food security status, income sources, use of federal food benefits, visiting a doctor, and demographic variables increase odds of severe obesity. More than 14% were severely obese; those who were long-term food pantry users and very low food secure were 1.732 times more likely to be severely obese. Receiving Disability/Supplemental Security Income, seeing a doctor in the last year, being female, and older age reduced the odds of severe obesity. Discussion includes implications for social workers who interact with groups likely to experience very low food security and severe obesity at different systems levels.

  19. Use of Fentanyl in Adolescents with Clinically Severe Obesity Undergoing Bariatric Surgery: A Pilot Study.

    Science.gov (United States)

    Vaughns, Janelle D; Ziesenitz, Victoria C; Williams, Elaine F; Mushtaq, Alvina; Bachmann, Ricarda; Skopp, Gisela; Weiss, Johanna; Mikus, Gerd; van den Anker, Johannes N

    2017-06-01

    The number of obese pediatric patients requiring anesthesia is rapidly increasing. Although fentanyl is a commonly used narcotic during surgery, there are no pharmacokinetic (PK) data available for optimal dosing of fentanyl in adolescents with clinically severe obesity. An institutional review board-approved exploratory pilot study was conducted in six adolescents aged 14-19 years undergoing bariatric surgery. Mean total body weight (TBW) and mean BMI were 137.4 ± 14.3 kg and 49.6 ± 6.4 kg/m 2 (99.5th BMI percentile), respectively. Fentanyl was administered intravenously for intraoperative analgesia based on ideal body weight per standard of care. PK blood samples were drawn over a 24-h post-dose period. Fentanyl PK parameters were calculated by non-compartmental analysis. Mean fentanyl AUC 0-∞ was 1.5 ± 0.5 h·ng/mL. Systemic clearance of fentanyl was 1522 ± 310 mL/min and 11.2 ± 2.6 mL/min·kg TBW. Volume of distribution was 635 ± 282 L and 4.7 ± 2.1 L/kg TBW. While absolute clearance was increased, absolute volume of distribution was comparable to previously established adult values. These results suggest that fentanyl clearance is enhanced in adolescents with clinically severe obesity while volume of distribution is comparable to previously published studies. NCT01955993 (clinicaltrials.gov).

  20. Obesity

    Science.gov (United States)

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

  1. Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults

    DEFF Research Database (Denmark)

    Larsen, Nadja; Vogensen, Finn Kvist; van der Berg, Franciscus Winfried J

    2010-01-01

    . Methods and Findings The study included 36 male adults with a broad range of age and body-mass indices (BMIs), among which 18 subjects were diagnosed with diabetes type 2. The fecal bacterial composition was investigated by real-time quantitative PCR (qPCR) and in a subgroup of subjects (N = 20) by tag...... = 0.04). Conclusions The results of this study indicate that type 2 diabetes in humans is associated with compositional changes in intestinal microbiota. The level of glucose tolerance should be considered when linking microbiota with metabolic diseases such as obesity and developing strategies......Background Recent evidence suggests that there is a link between metabolic diseases and bacterial populations in the gut. The aim of this study was to assess the differences between the composition of the intestinal microbiota in humans with type 2 diabetes and non-diabetic persons as control...

  2. Severe obesity and cardiometabolic risk in children: comparison from two international classification systems.

    Directory of Open Access Journals (Sweden)

    Giuliana Valerio

    Full Text Available There is no agreed-upon definition for severe obesity (Sev-OB in children. We compared estimates of Sev-OB as defined by different cut-points of body mass index (BMI from the Centers for Disease Control and Prevention (CDC or the World Health Organization (WHO curves and the ability of each set of cut-points to screen for the presence of cardiometabolic risk factors.Cross-sectional, multicenter study involving 3,340 overweight/obese young subjects. Sev-OB was defined as BMI ≥ 99(th percentile or ≥ 1.2 times the 95(th percentile of the CDC or the WHO curves. High blood pressure, hypertriglyceridemia, low High Density Lipoprotein -cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors.The estimated prevalence of Sev-OB varied widely between the two reference systems. Either using the cut-point ≥ 99(th percentile or ≥ 1.2 times the 95(th percentile, less children were defined as Sev-OB by CDC than WHO (46.8 vs. 89.5%, and 63.3 vs. 80.4%, respectively p<0.001. The CDC 99(th percentile had lower sensitivity (58.5 vs 94.2, higher specificity (57.6 vs 12.3 and higher positive predictive value (34.4 vs 28.9 than WHO in identifying obese children with ≥ 2 cardiometabolic risk factors. These differences were mitigated using the 1.2 times the 95(th percentile (sensitivity 73.9 vs. 88.1; specificity 40.7 vs. 22.5; positive predictive value 32.1 vs. 30.1. Substantial agreement between growth curves was found using the 1.2 times the 95(th percentile, in particular in children ≤ 10 years.Estimates of Sev-OB and cardiometabolic risk as defined by different cut-points of BMI are influenced from the reference systems used. The 1.2 times the 95(th percentile of BMI of either CDC or WHO standard has a discriminatory advantage over the 99(th percentile for identifying severely obese children at increased cardiometabolic risk, particularly under 10 years of age.

  3. The Relationship between Symptom Severity and Cognitive Functions with Obesity in Fibromyalgia Syndrome

    Directory of Open Access Journals (Sweden)

    Selçuk Sayılır

    2017-01-01

    Full Text Available Objective: To investigate the relationship between obesity with symptom severity and cognitive functions in Fibromyalgia syndrome (FMS patients. Materials and Methods: The study comprised 33 FMS patients (mean age 41.21±7.6 years. The patients who have hypertension, hypercholesterolaemia or diabetes, chronic inflammatory disorders, cardiovascular-pulmonary diseases, rheumatological/endocrine diseases, using anticoagulant therapy or have thrombotic disorders, malignancies and pregnant women were excluded from the study. Fibromyalgia Impact Questionnaire (FIQ, Perceived Stress Scale (PSS-10 and Mini Mental State Examination tests were used. The data of FMS patients were recorded by the same physician. Results: There were not statistically significant differences between PSS-10 and MMSE with body mass index (BMI levels. There was a statistically significant difference between FIQ and BMI values. Conclusion: In conclusion, the result of this study showed a statistical relationship between the increased BMI levels and FMS symptom severity that could be beneficial in clinical practice.

  4. Changes in human dendritic cell number and function in severe obesity may contribute to increased susceptibility to viral infection.

    LENUS (Irish Health Repository)

    O'Shea, D

    2013-02-26

    Dendritic cells (DCs) are key immune sentinels linking the innate and adaptive immune systems. DCs recognise danger signals and initiate T-cell tolerance, memory and polarisation. They are critical cells in responding to a viral illness. Obese individuals have been shown to have an impaired response to vaccinations against virally mediated conditions and to have an increased susceptibility to multi-organ failure in response to viral illness. We investigated if DCs are altered in an obese cohort (mean body mass index 51.7±7.3 kg m(-2)), ultimately resulting in differential T-cell responses. Circulating DCs were found to be significantly decreased in the obese compared with the lean cohort (0.82% vs 2.53%). Following Toll-like receptor stimulation, compared with lean controls, DCs generated from the obese cohort upregulated significantly less CD83 (40% vs 17% mean fluorescence intensity), a molecule implicated in the elicitation of T-cell responses, particularly viral responses. Obese DCs produced twofold more of the immunosuppressive cytokine interleukin (IL)-10 than lean controls, and in turn stimulated fourfold more IL-4-production from allogenic naive T cells. We conclude that obesity negatively impacts the ability of DCs to mature and elicit appropriate T-cell responses to a general stimulus. This may contribute to the increased susceptibility to viral infection observed in severe obesity.International Journal of Obesity advance online publication, 26 February 2013; doi:10.1038\\/ijo.2013.16.

  5. Kidney outcomes three years after bariatric surgery in severely obese adolescents.

    Science.gov (United States)

    Nehus, Edward J; Khoury, Jane C; Inge, Thomas H; Xiao, Nianzhou; Jenkins, Todd M; Moxey-Mims, Marva M; Mitsnefes, Mark M

    2017-02-01

    A significant number of severely obese adolescents undergoing bariatric surgery have evidence of early kidney damage. To determine if kidney injury is reversible following bariatric surgery, we investigated renal outcomes in the Teen-Longitudinal Assessment of Bariatric Surgery cohort, a prospective multicenter study of 242 severely obese adolescents undergoing bariatric surgery. Primary outcomes of urine albumin-to-creatinine ratio and cystatin C-based estimated glomerular filtration rate (eGFR) were evaluated preoperatively and up to 3 years following bariatric surgery. At surgery, mean age of participants was 17 years and median body mass index (BMI) was 51 kg/m 2 . In those with decreased kidney function at baseline (eGFR under 90 mL/min/1.73m 2 ), mean eGFR significantly improved from 76 to 102 mL/min/1.73m 2 at three-year follow-up. Similarly, participants with albuminuria (albumin-to-creatinine ratio of 30 mg/g and more) at baseline demonstrated significant improvement following surgery: geometric mean of ACR was 74 mg/g at baseline and decreased to 17 mg/g at three years. Those with normal renal function and no albuminuria at baseline remained stable throughout the study period. Among individuals with a BMI of 40 kg/m 2 and more at follow-up, increased BMI was associated with significantly lower eGFR, while no association was observed in those with a BMI under 40 kg/m 2 . In adjusted analysis, eGFR increased by 3.9 mL/min/1.73m 2 for each 10-unit loss of BMI. Early kidney abnormalities improved following bariatric surgery in adolescents with evidence of preoperative kidney disease. Thus, kidney disease should be considered as a selection criteria for bariatric surgery in severely obese adolescents who fail conventional weight management. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  6. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease

    DEFF Research Database (Denmark)

    Azimi, Aziza; Charlot, Mette Gitz; Torp-Pedersen, Christian

    2013-01-01

    Obesity is paradoxically associated with enhanced survival in patients with established cardiovascular disease. We explored this paradox further by examining the influence of obesity on survival in patients with verified atherosclerotic heart disease.......Obesity is paradoxically associated with enhanced survival in patients with established cardiovascular disease. We explored this paradox further by examining the influence of obesity on survival in patients with verified atherosclerotic heart disease....

  7. Shoulder dystocia in diabetic and non-diabetic pregnancies.

    Science.gov (United States)

    Malinowska-Polubiec, Aneta; Romejko-Wolniewicz, Ewa; Szostak, Oksana; Dobrowolska-Redo, Agnieszka; Tolloczko, Justyna; Zareba-Szczudlik, Julia; Smolarczyk, Roman; Czajkowski, Krzysztof

    2014-01-01

    Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women. We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women. The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012. Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dystocia were more likely to deliver before completion of the 38th week of gestation (30.8% vs. 5.7%, p=0.02) and had a higher incidence of 1st and 2nd stage perineal tears compared with the non-diabetic group (23.1% vs. 0%, p=0.02). There were two cases of symphysis pubis dehiscence in non-diabetic women. Children of diabetic mothers had a significantly higher birth weight (4,425.4±561.6 g vs. 4,006.9±452.8 g, p=0.03). Children of diabetic mothers with dystocia were at significantly higher risk of peripartum injuries (92.3% vs. 45.7%). A significant difference was observed in the percentage of brachial plexus palsy (61.5% vs. 17.1%). Children of diabetic women experiencing shoulder dystocia were more frequently affected by Erb's brachial plexus palsy and respiratory disturbances. These children had an increased likelihood of birth weights above the 90th percentile (not necessarily reaching 4,000 g) compared to children born to non-diabetic mothers. Shoulder dystocia in women with

  8. Dietary patterns and metabolic syndrome factors in a non-diabetic Italian population.

    Science.gov (United States)

    Leite, Maria Léa Corrêa; Nicolosi, Alfredo

    2009-09-01

    To examine the relationship between dietary patterns and metabolic syndrome. Population-based cross-sectional study. The K-means clustering method was used to identify dietary patterns and logistic regression models were used to compare the adjusted prevalence rates of metabolic syndrome factors, stratifying by obesity status. The 1992-3 Italian Bollate Eye Study, a population-based survey carried out in the town of Bollate (Milan), Italy. A total of 1052 non-diabetic Italian subjects, 527 men and 525 women, aged 42-74 years. Five dietary clusters were identified: common, animal products, starch, vegetal/fat and vitamin/fibre. After adjusting for potential confounders, the starch group showed the highest prevalence of metabolic syndrome (36%) followed by the animal products group (30%); the vitamin/fibre (20%) and vegetal/fat groups (19%) showed the lowest prevalence. The starch group had more dyslipidaemia (higher TAG and lower HDL cholesterol levels) and the animal products group had a higher prevalence of impaired fasting glucose. The vitamin/fibre group had the lowest prevalence of abdominal obesity. The beneficial effect of the vegetal/fat and vitamin/fibre dietary patterns seemed stronger among the obese. Our results confirm the deleterious effect of a very-low-fat, high-carbohydrate diet and also of high intakes of animal products. The consumption of a diet high in vegetal fats or rich in fruits and vegetables is associated with a healthier metabolic profile. Reducing obesity is essential to prevent metabolic syndrome, but even among the obese dietary habits are important for preserving healthy lipid and glycaemic profiles.

  9. A low-carbohydrate as compared with a low-fat diet in severe obesity.

    Science.gov (United States)

    Samaha, Frederick F; Iqbal, Nayyar; Seshadri, Prakash; Chicano, Kathryn L; Daily, Denise A; McGrory, Joyce; Williams, Terrence; Williams, Monica; Gracely, Edward J; Stern, Linda

    2003-05-22

    The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed. We randomly assigned 132 severely obese subjects (including 77 blacks and 23 women) with a mean body-mass index of 43 and a high prevalence of diabetes (39 percent) or the metabolic syndrome (43 percent) to a carbohydrate-restricted (low-carbohydrate) diet or a calorie- and fat-restricted (low-fat) diet. Seventy-nine subjects completed the six-month study. An analysis including all subjects, with the last observation carried forward for those who dropped out, showed that subjects on the low-carbohydrate diet lost more weight than those on the low-fat diet (mean [+/-SD], -5.8+/-8.6 kg vs. -1.9+/-4.2 kg; P=0.002) and had greater decreases in triglyceride levels (mean, -20+/-43 percent vs. -4+/-31 percent; P=0.001), irrespective of the use or nonuse of hypoglycemic or lipid-lowering medications. Insulin sensitivity, measured only in subjects without diabetes, also improved more among subjects on the low-carbohydrate diet (6+/-9 percent vs. -3+/-8 percent, P=0.01). The amount of weight lost (Plow-carbohydrate diet (P=0.01) were independent predictors of improvement in triglyceride levels and insulin sensitivity. Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost. This finding should be interpreted with caution, given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study. Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed. Copyright 2003 Massachusetts Medical Society

  10. Short term variation in NTproBNP after lifestyle intervention in severe obesity.

    Directory of Open Access Journals (Sweden)

    Debora Fedele

    Full Text Available Natriuretic peptides are not only involved in cardiovascular adaption to various conditions, but also in metabolic diseases. We performed this study to assess the effect of a very short time of lifestyle inpatient intervention on NTproBNP values in normotensive subjects with severe obesity and normal cardiac function.We recruited 14 consecutive obese normotensive subjects with normal cardiac function who were aged 30 years and more and were referred to inpatient rehabilitation in an academic clinic over a two months period. They were examined at baseline and after a 3-weeks program including dietary intervention with hypocaloric diet and assisted personalized physical aerobic and anaerobic activities and compared to age, sex and BMI-matched control subjects under usual care.BMI significantly decreased (40.8 ±1.6 vs 42.3 ± 1.6 kg/m2, p <0.0001. Median reduction in body weight was 4.9 kg (interquartile range 2.4-5.2 kg. After diet and exercise-induced weight loss, plasma NTproBNP levels showed an almost two-fold increase, which was statistically significant (28.2 ± 12.3 vs 17.2 ± 13.2 ng/L, p = 0.01, and particularly relevant in the subgroup with NT-proBNP values below median values compared to those with higher values (p = 0.02. No significant variations were found in control subjects (18.0 ± 13.0 vs 16.5 ± 11.2 ng/L, p = 0.18. The lipid profile was significantly ameliorated, and both HbA1c and insulin levels showed a marginally non-significant decrease after treatment.An almost two-fold increase in NTproBNP levels was evident after a very short time period of lifestyle intervention in normotensive severe obese patients without cardiac disease. This finding might have clinical relevance, considering the role of NT-proBNP as risk factor of impaired glucose tolerance.

  11. Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management.

    Science.gov (United States)

    Tucker, Jared M; Howard, Kathleen; Guseman, Emily H; Yee, Kimbo E; Saturley, Heather; Eisenmann, Joey C

    The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management. Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression. Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours. Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  12. GH and cortisol responses following an acute session of respiratory muscle endurance training in severely obese patients.

    Science.gov (United States)

    Sartorio, A; Agosti, F; Patrizi, A; Gattico, A; Tringali, G; Giunta, M; Muller, E E; Rigamonti, A E

    2013-03-01

    It is well established that obese patients are hypo-responsive to classical GH-releasing stimuli, including aerobic exercise. Recently, we have demonstrated that whole body vibration was able to markedly stimulate GH secretion in obese patients, thus suggesting that this refractoriness is not absolute but dependent on the GH-releasing stimulus. Furthermore, we have shown the ability of a respiratory muscle endurance training (RMET) to stimulate GH and cortisol secretion in healthy subjects. The objective of this study was to evaluate the effects of RMET on GH and cortisol responses in severely obese patients. Eight severely obese patients (4 M/4 F, mean age±SEM: 22.8±1.6 years, body mass index, BMI: 39.9±1.1 kg/m2) underwent an incremental progressive RMET protocol of 11 daily sessions, obtained through the use of a specifically designed respiratory device (Spiro Tiger®). The 12th session of RMET (15 min duration: 1 min at a respiration rate of 28 acts/min, 5 min at 32 acts/min, 5 min at 34 acts/min, 4 min at 36 acts/min) was associated with blood samplings for determination of GH, cortisol, and lactate (LA) levels. An age- and sex-matched normal-weighted control group (n=7, 4 M/3 F, age: 26.1±3.1 years, BMI: 22.4±0.6 kg/m2) was also recruited. In both normal-weighted subjects and obese patients, GH secretion significantly increased after a 15-min RMET session. Although serum GH levels at 30 min were higher in normal-weighted subjects than in obese patients, there was no statistically significant difference in either GH peaks or net GH areas under the curve between the 2 groups. RMET significantly increased serum cortisol levels in normal-weighted subjects, but was associated to a progressive cortisol decline in obese patients. RMET stimulated LA production, with no significant differences in normal-weighted subjects and in obese patients. A 15-min RMET session was capable to induce a GH response in severely obese patients, which was comparable to that

  13. Secretory granule neuroendocrine protein 1 (SGNE1 genetic variation and glucose intolerance in severe childhood and adult obesity

    Directory of Open Access Journals (Sweden)

    Charpentier Guillaume

    2007-07-01

    Full Text Available Abstract Background 7B2 is a regulator/activator of the prohormone convertase 2 which is involved in the processing of numerous neuropeptides, including insulin, glucagon and pro-opiomelanocortin. We have previously described a suggestive genetic linkage peak with childhood obesity on chr15q12-q14, where the 7B2 encoding gene, SGNE1 is located. The aim of this study is to analyze associations of SGNE1 genetic variation with obesity and metabolism related quantitative traits. Methods We screened SGNE1 for genetic variants in obese children and genotyped 12 frequent single nucleotide polymorphisms (SNPs. Case control analyses were performed in 1,229 obese (534 children and 695 adults, 1,535 individuals with type 2 diabetes and 1,363 controls, all French Caucasians. We also studied 4,922 participants from the D.E.S.I.R prospective population-based cohort. Results We did not find any association between SGNE1 SNPs and childhood or adult obesity. However, the 5' region SNP -1,701A>G associated with higher area under glucose curve after oral glucose tolerance test (p = 0.0005, higher HOMA-IR (p = 0.005 and lower insulinogenic index (p = 0.0003 in obese children. Similar trends were found in obese adults. SNP -1,701A>G did not associate with risk of T2D but tends to associate with incidence of type 2 diabetes (HR = 0.75 95%CI [0.55–1.01]; p = 0.06 in the prospective cohort. Conclusion SGNE1 genetic variation does not contribute to obesity and common forms of T2D but may worsen glucose intolerance and insulin resistance, especially in the background of severe and early onset obesity. Further molecular studies are required to understand the molecular bases involved in this process.

  14. Obesity

    Science.gov (United States)

    ... improve or prevent the health problems associated with obesity. Dietary changes, increased physical activity and behavior changes can ... more calories than you burn. And most Americans' diets are too high in calories and are ... factors Obesity usually results from a combination of causes and ...

  15. Predictive score of sarcopenia occurrence one year after bariatric surgery in severely obese patients.

    Science.gov (United States)

    Voican, Cosmin Sebastian; Lebrun, Amandine; Maitre, Sophie; Lainas, Panagiotis; Lamouri, Karima; Njike-Nakseu, Micheline; Gaillard, Martin; Tranchart, Hadrien; Balian, Axel; Dagher, Ibrahim; Perlemuter, Gabriel; Naveau, Sylvie

    2018-01-01

    Sarcopenic obesity is a risk factor of morbidity and mortality. The aim of this study was to generate a predictive score of sarcopenia occurrence one year after bariatric surgery. We conducted an observational prospective cohort study on a total of 184 severely obese patients admitted to our institution to undergo sleeve gastrectomy. Skeletal muscle cross-sectional area at the third lumbar vertebrae (SMA, cm2) was measured from the routinely performed computed tomography. The skeletal muscle index (SMI) was calculated as follows: SMA/height2 (cm2/m2). Sarcopenia was defined as an SMI predictive sarcopenia occurrence scores were constructed using SMA and gender (SS1 score) or SMI and gender (SS2 score). The area under receiver operating characteristic (AUROC) curve of the SS2 score was significantly greater than that of the SS1 score for the diagnosis of postoperative sarcopenia occurrence (0.95±0.02 versus 0.90±0.02; ppredictive value of 83%, and a negative predictive value of 95%. In the group of patients without baseline sarcopenia, the SS2 score had still an excellent AUROC of 0.92±0.02. A cut-off of 0.55 predicted development of sarcopenia one year after sleeve gastrectomy in these patients with a sensitivity of 87%, a specificity of 88%, and negative predictive value of 95%. The SS2 score has excellent predictive value for the occurrence of sarcopenia one year after sleeve gastrectomy. This score can be used to target early intensification of nutritional and dietetic follow-up to the predicted high-risk population.

  16. A neuron-specific deletion of the microRNA-processing enzyme DICER induces severe but transient obesity in mice.

    Directory of Open Access Journals (Sweden)

    Géraldine M Mang

    Full Text Available MicroRNAs (miRNAs are small, non-coding RNA molecules that regulate gene expression post-transcriptionally. MiRNAs are implicated in various biological processes associated with obesity, including adipocyte differentiation and lipid metabolism. We used a neuronal-specific inhibition of miRNA maturation in adult mice to study the consequences of miRNA loss on obesity development. Camk2a-CreERT2 (Cre+ and floxed Dicer (Dicerlox/lox mice were crossed to generate tamoxifen-inducible conditional Dicer knockouts (cKO. Vehicle- and/or tamoxifen-injected Cre+;Dicerlox/lox and Cre+;Dicer+/+ served as controls. Four cohorts were used to a measure body composition, b follow food intake and body weight dynamics, c evaluate basal metabolism and effects of food deprivation, and d assess the brain transcriptome consequences of miRNA loss. cKO mice developed severe obesity and gained 18 g extra weight over the 5 weeks following tamoxifen injection, mainly due to increased fat mass. This phenotype was highly reproducible and observed in all 38 cKO mice recorded and in none of the controls, excluding possible effects of tamoxifen or the non-induced transgene. Development of obesity was concomitant with hyperphagia, increased food efficiency, and decreased activity. Surprisingly, after reaching maximum body weight, obese cKO mice spontaneously started losing weight as rapidly as it was gained. Weight loss was accompanied by lowered O2-consumption and respiratory-exchange ratio. Brain transcriptome analyses in obese mice identified several obesity-related pathways (e.g. leptin, somatostatin, and nemo-like kinase signaling, as well as genes involved in feeding and appetite (e.g. Pmch, Neurotensin and in metabolism (e.g. Bmp4, Bmp7, Ptger1, Cox7a1. A gene cluster with anti-correlated expression in the cerebral cortex of post-obese compared to obese mice was enriched for synaptic plasticity pathways. While other studies have identified a role for miRNAs in obesity, we

  17. The rehabilitation of children and adolescents with severe or medically complicated obesity: an ISPED expert opinion document.

    Science.gov (United States)

    Grugni, Graziano; Licenziati, Maria Rosaria; Valerio, Giuliana; Crinò, Antonino; Maffeis, Claudio; Tanas, Rita; Morino, Giuseppe Stefano

    2017-03-01

    Severe/medically complicated obesity in childhood, and particularly in adolescence, is a real disability that requires an intensive and continuous approach which should follow the procedures and schedule of rehabilitation medicine. Given the lack of a specific document focusing on children and adolescents, the Childhood Obesity Study Group set out to explore the available evidence for the treatment of severe or medically complicated obesity and to set standards tailored to the specific context of the Italian Health Service. Through a series of meetings and electronic communications, the writing committee (selected from members of the Study Group) selected the key issues, explored the literature and produced a draft document which was submitted to the other experts until the final synthesis was approved by the group. In brief, the following issues were involved: (1) definition and epidemiology; (2) identification of common goals designed to regain functional competence and limit the progression of metabolic and psychological complications; (3) a multi-professional team approach; (4) the care setting. This paper is an expert opinion document on the rehabilitation of severe and medically complicated obesity in children and adolescents produced by experts belonging to the Childhood Obesity Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED).

  18. Weight-Related Correlates of Psychological Dysregulation in Adolescent and Young Adult (AYA) Females with Severe Obesity

    Science.gov (United States)

    Gowey, Marissa A.; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E.; Zeller, Meg H.

    2016-01-01

    Objective Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Methods Fifty-four AYA females with severe obesity (MBMI=48.71 kg/m2; Mage=18.29, R=15–21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Results Breakfast was the most frequently skipped meal (consumed 3–4 times/week). Eating out was common (4–5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Conclusions Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may

  19. The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health.

    Science.gov (United States)

    Richardson, A S; Dietz, W H; Gordon-Larsen, P

    2014-10-01

    Severe obesity has increased, yet childhood antecedents of adult severe obesity are not well understood. Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared with those who did not report abuse. Longitudinal analysis of participants from the US National Longitudinal Study of Adolescent Health (n = 10,774) wave II (1996; aged 12-22 years) followed through wave IV (2008-2009; aged 24-34 years). New cases of adult-onset severe obesity (body mass index [BMI] ≥ 40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (hazard ratio [HR; 95% Confidence Interval] = 2.5; 1.3, 4.8) and males (HR = 3.6; 1.5, 8.5) compared with individuals with no history of abuse. In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

  20. Implementation of a School Nurse-led Intervention for Children With Severe Obesity in New York City Schools.

    Science.gov (United States)

    Schroeder, Krista; Jia, Haomiao; Wang, Y Claire; Smaldone, Arlene

    The Healthy Options and Physical Activity Program (HOP) is a school nurse-led intervention for children with severe obesity. HOP was developed by experts at the New York City Department of Health and Mental Hygiene and implemented in New York City schools beginning in 2012. The purpose of this study was to evaluate HOP implementation with the goal of informing HOP refinement and potential future HOP dissemination. This study entailed a retrospective analysis of secondary data. Analytic methods included descriptive statistics, Wilcoxon rank sum and Chi square tests, and multivariate logistic regression. During the 2012-2013 school year, 20,518 children were eligible for HOP. Of these, 1054 (5.1%) were enrolled in the program. On average, enrolled children attended one HOP session during the school year. Parent participation was low (3.2% of HOP sessions). Low nurse workload, low school poverty, higher grade level, higher BMI percentile, and chronic illness diagnosis were associated with student enrollment in HOP. As currently delivered, HOP is not likely to be efficacious. Lessons learned from this evaluation are applicable to future nurse-led obesity interventions. Prior to implementing a school nurse-led obesity intervention, nursing workload and available support must be carefully considered. Interventions should be designed to facilitate (and possibly require) parent involvement. Nurses who deliver obesity interventions may require additional training in obesity treatment. With attention to these lessons learned, evidence-based school nurse-led obesity interventions can be developed. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Bariatric surgery in severely obese adolescents: a single-centre experience.

    Science.gov (United States)

    Sachdev, Pooja; Makaya, Taffy; Marven, Sean S; Ackroyd, Roger; Wales, Jerry K; Wright, Neil P

    2014-10-01

    Increasing numbers of severely obese young people undergo bariatric surgery in the USA with reports of substantial weight loss after 1 year. National Institute for Clinical Excellence 2006 suggests considering surgery for young people in 'exceptional circumstances'. We present six patients operated upon 2004-2012 at our centre in the UK. Six patients (4 male) aged 14-16 years (mean age 15.10) underwent surgery. Mean preoperative body mass index (BMI) was 62.7 kg/m(2) and BMI SDS +4.4. Comorbidities included hypertension, insulin resistance, obstructive sleep apnoea, limited mobility, benign intracranial hypertension and psychosocial issues. All six patients had prior involvement with local lifestyle weight management services and had pharmacological intervention. Four laparoscopic gastric bypass procedures, one laparoscopic gastric banding (patient had a gastric balloon prior to band) and one laparoscopic sleeve gastrectomy were performed. There were no major postoperative procedural complications (one patient had a port rotation). Mean percentage of weight loss, as a percentage of total body weight at 6 and 12 months, was 22 and 27%, respectively. Average absolute weight loss at current follow-up is 54 kg. Mean BMI at 12 months postprocedure was 46.5 kg/m(2)-a mean fall of 16.2 kg/m(2). Mean BMI SDS fell from +4.4 to +3.8 at 12 months and +3.1 at 2 years. Resolution of hypertension, improved school attendance and no progression to T2DM were the benefits noted. Recent systematic reviews and meta-analyses suggest that bariatric surgery results in sustained and clinically significant weight loss in paediatric populations. The surgical option should continue to be exercised with extreme caution only in severely obese adolescents and done so in appropriate case results in positive outcomes. 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.

  2. Urinary adiponectin and albuminuria in non-diabetic hypertensive patients: an analysis of the ESPECIAL trial.

    Science.gov (United States)

    Han, Seung Seok; Bae, Eunjin; Ahn, Shin Young; Kim, Sejoong; Park, Jung Hwan; Shin, Sung Joon; Lee, Sang Ho; Choi, Bum Soon; Chin, Ho Jun; Lim, Chun Soo; Kim, Suhnggwon; Kim, Dong Ki

    2015-08-01

    Although adiponectin levels have been reported to be correlated with albuminuria, this issue remains unresolved in non-diabetic hypertensive subjects, particularly when urinary adiponectin is considered. Urinary adiponectin levels were examined using an enzyme-linked immunosorbent assay in 229 participants. who used olmesartan as a hypertensive agent. Their albuminuria levels were measured for 16 weeks after randomization and initiation of conventional or intensive diet education. Linear or logistic regression models were applied, as appropriate, to explore the relationship with albuminuria itself or its response after the intervention. Urinary adiponectin levels were positively related to baseline albuminuria level (r = 0.529). After adjusting for several covariates, the adiponectin level was associated with the albuminuria level (β = 0.446). Among the 159 subjects with baseline macroalbuminuria, the risk of consistent macroalbuminuria (> 300 mg/day) at 16 weeks was higher in the 3(rd) tertile of adiponectin than in the 1(st) tertile (odds ratio = 6.9), despite diet education. In contrast, among all subjects, the frequency of the normoalbuminuria achievement (< 30 mg/day) at 16 weeks was higher in the 1(st) tertile than in the 3(rd) tertile (odds ratio = 13.0). Urinary adiponectin may be a useful biomarker for albuminuria or its response after treatment in non-diabetic hypertensive patients.

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

    Science.gov (United States)

    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.

  4. Obesity

    Science.gov (United States)

    ... Peer Support Resources Diseases and Conditions Adrenal Disorders Osteoporosis and Bone Health Children and Teen Health Diabetes Heart Health Men's Health Rare Diseases Pituitary Disorders Thyroid Disorders Transgender Health Obesity and Weight Management Women's Health You and Your ...

  5. Preadipocyte factor-1 is associated with metabolic profile in severe obesity.

    LENUS (Irish Health Repository)

    O'Connell, J

    2011-04-01

    Dysfunctional adipose tissue has been proposed as a key pathological process linking obesity and metabolic disease. Preadipocyte factor-1 (Pref-1) has been shown to inhibit differentiation in adipocyte precursor cells and could thereby play a role in determining adipocyte size, adipose tissue functioning, and metabolic profile in obese individuals.

  6. Severe obesity is a limitation for the use of body mass index standard deviation scores in children and adolescents.

    Science.gov (United States)

    Júlíusson, Pétur B; Roelants, Mathieu; Benestad, Beate; Lekhal, Samira; Danielsen, Yngvild; Hjelmesaeth, Jøran; Hertel, Jens K

    2018-02-01

    We analysed the distribution of the body mass index standard deviation scores (BMI-SDS) in children and adolescents seeking treatment for severe obesity, according to the International Obesity Task Force (IOTF), World Health Organization (WHO) and the national Norwegian Bergen Growth Study (BGS) BMI reference charts and the percentage above the International Obesity Task Force 25 cut-off (IOTF-25). This was a cross-sectional study of 396 children aged four to 17 years, who attended a tertiary care obesity centre in Norway from 2009 to 2015. Their BMI was converted to SDS using the three growth references and expressed as the percentage above IOTF-25. The percentage of body fat was assessed by bioelectrical impedance analysis. Regardless of which BMI reference chart was used, the BMI-SDS was significantly different between the age groups, with a wider range of higher values up to 10 years of age and a more narrow range of lower values thereafter. The distributions of the percentage above IOTF-25 and percentage of body fat were more consistent across age groups. Our findings suggest that it may be more appropriate to use the percentage above a particular BMI cut-off, such as the percentage above IOTF-25, than the IOTF, WHO and BGS BMI-SDS in paediatric patients with severe obesity. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  7. Severe obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient.

    Science.gov (United States)

    Zeller, Meg H; Inge, Thomas H; Modi, Avani C; Jenkins, Todd M; Michalsky, Marc P; Helmrath, Michael; Courcoulas, Anita; Harmon, Carroll M; Rofey, Dana; Baughcum, Amy; Austin, Heather; Price, Karin; Xanthakos, Stavra A; Brandt, Mary L; Horlick, Mary; Buncher, Ralph

    2015-03-01

    To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight-loss surgery (WLS) to inform clinical care. Baseline (preoperative) data from Teen Longitudinal Assessment of Bariatric Surgery, a prospective multicenter observational study of 242 adolescents with severe obesity (MedianBMI = 50.5 kg/m(2); Meanage = 17.1; 75.6% female; 71.9% white) undergoing WLS, were used to examine the impact of demographics, body mass index (BMI), presence/absence of 16 comorbid conditions, and a cumulative comorbidity load (CLoad) index on WRQOL scores (Impact of Weight on Quality of Life-Kids). WRQOL was significantly lower than reference samples of healthy weight, overweight, and obese samples. Of 16 comorbid conditions, the most prevalent were dyslipidemia (74.4%), chronic pain (58.3%), and obstructive sleep apnea (56.6%). Male subjects had a greater CLoad (P = .01) and BMI (P = .01), yet less impairment in total WRQOL (P conditions (eg, stress urinary incontinence) also emerged as contributors to lower WRQOL. WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals before WLS. Furthermore, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes after WLS, as weight and comorbidity profiles change over time. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity.

    Science.gov (United States)

    Bond, Dale S; Pavlović, Jelena M; Lipton, Richard B; Graham Thomas, J; Digre, Kathleen B; Roth, Julie; Rathier, Lucille; O'Leary, Kevin C; Evans, E Whitney; Wing, Rena R

    2017-03-01

    Previous studies suggest that migraine might be associated with female sexual dysfunction (FSD), although this association may be complicated by overweight/obesity. To disentangle relationships of migraine and obesity with FSD, we examined: (1) FSD rates in women who had migraine and obesity with a matched sample of women with obesity who were free of migraine and (2) associations between indices of migraine severity and FSD in a larger sample of participants with migraine and overweight/obesity, controlling for important confounders. Women with migraine and obesity seeking behavioral weight loss treatment to decrease headaches (n = 37) and nonmigraine controls (n = 37) with obesity seeking weight loss via bariatric surgery were matched on age (±5 years), body mass index (BMI; ±3 kg/m 2 ), and reported sexual activity during the past month. Both groups completed the Female Sexual Function Index (FSFI), with a validated FSFI-total cutoff score used to define FSD. In participants with migraine and overweight/obesity (n = 105), separate logistic regression models evaluated associations of migraine attack frequency, intensity, and duration with odds of having FSD, controlling for age, BMI, depression, and anxiety. On average, participants and matched controls had severe obesity (BMI = 42.4 ± 3.8 kg/m 2 ; range = 35-49.9) and were 37.3 ± 7.2 years of age (range = 22-50). FSD rate did not differ between migraine participants and controls (56.8% vs. 54.1%, P = .82). In the larger sample of participants with migraine and overweight/obesity (38.2 ± 7.8 years of age; BMI = 34.8 ± 6.4 [range = 25-50 kg/m 2 ]; 8.0 ± 4.3 migraine days/month, maximum pain intensity = 5.9 ± 1.4 on 0-10 scale; average attack duration = 18.3 ± 9.7 hours), FSD was not associated with attack frequency (P = .31), pain intensity (P = .92), or attack duration (P = .35) but was associated with more severe anxiety

  9. The systemic inflammome of severe obesity before and after bariatric surgery.

    Directory of Open Access Journals (Sweden)

    Ebymar Arismendi

    Full Text Available Obesity is associated with low-grade systemic inflammation. The "inflammome" is a network layout of the inflammatory pattern. The systemic inflammome of obesity has not been described as yet. We hypothesized that it can be significantly worsened by smoking and other comorbidities frequently associated with obesity, and ameliorated by bariatric surgery (BS. Besides, whether or not these changes are mirrored in the lungs is unknown, but obesity is often associated with pulmonary inflammation and bronchial hyperresponsiveness.We sought to: (1 describe the systemic inflammome of morbid obesity; (2 investigate the effects of sex, smoking, sleep apnea syndrome, metabolic syndrome and BS upon this systemic inflammome; and, (3 determine their interplay with pulmonary inflammation.We studied 129 morbidly obese patients (96 females; age 46 ± 12 years; body mass index [BMI], 46 ± 6 kg/m2 before and one year after BS, and 20 healthy, never-smokers, (43 ± 7 years, with normal BMI and spirometry.Before BS, compared with controls, all obese subjects displayed a strong and coordinated (inflammome systemic inflammatory response (adiponectin, C-reactive protein, interleukin (IL-8, IL-10, leptin, soluble tumor necrosis factor-receptor 1(sTNF-R1, and 8-isoprostane. This inflammome was not modified by sex, smoking, or coexistence of obstructive sleep apnea and/or metabolic syndrome. By contrast, it was significantly ameliorated, albeit not completely abolished, after BS. Finally, obese subjects had evidence of pulmonary inflammation (exhaled condensate that also decreased after BS.The systemic inflammome of morbid obesity is independent of sex, smoking status and/or comorbidities, it is significantly reduced by BS and mirrored in the lungs.

  10. Meal replacements followed by topiramate for the treatment of adolescent severe obesity: A pilot randomized controlled trial.

    Science.gov (United States)

    Fox, Claudia K; Kaizer, Alexander M; Rudser, Kyle D; Nathan, Brandon M; Gross, Amy C; Sunni, Muna; Jennifer Abuzzahab, M; Schwartz, Betsy L; Kumar, Seema; Petryk, Anna; Billington, Charles J; Ryder, Justin R; Kelly, Aaron S

    2016-12-01

    To assess the safety and efficacy of short-term meal replacement therapy followed by topiramate for body mass index (BMI) reduction in adolescents with severe obesity. Adolescents (ages 12-18 years) with severe obesity (BMI ≥1.2 times the 95th percentile or BMI ≥35 kg/m 2 ) were recruited for this double-blind, randomized, placebo-controlled trial. Participants completed 4 weeks of meal replacement therapy followed by randomization (1:1) to either 24 weeks of topiramate 75 mg/day or placebo. Mean changes were compared between groups. Thirty adolescents (mean age 15.2 ± 1.7 years, mean BMI 40.3 ± 4.6 kg/m 2 ) completed the meal replacement phase and were randomized; 21 completed the study. The difference in mean percent change in BMI between the topiramate and placebo groups was not significant (-1.9%; 95% CI: -5.2% to +1.5%; P = 0.291). Significant improvements in visceral fat and very-low-density lipoprotein cholesterol were observed in the topiramate compared with the placebo group. There were no concerning changes in neurocognitive function or bone health. In this pilot study, 4 weeks of meal replacement therapy followed by 24 weeks of low-dose topiramate compared with meal replacement therapy alone did not result in significant BMI reduction for adolescents with severe obesity. © 2016 The Obesity Society.

  11. Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity.

    Science.gov (United States)

    Brewerton, Timothy D

    2017-06-01

    Food addiction (FA) is a newly defined yet still controversial condition that has important etiological, developmental, treatment, prevention, and social policy implications. In this review, the case is made that FA (or high scores on the Yale Food Addiction Scale) may be used as a proxy measure for a matrix of interrelated clinical features, including greater eating disorder severity, greater obesity severity, more severe trauma histories, greater symptoms of posttraumatic stress disorder (PTSD), greater psychiatric comorbidity, as well as greater medical morbidity and mortality. A Medline search was undertaken using the following terms: food addiction cross-referenced with eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and binge eating), obesity, trauma, posttraumatic stress disorder, and comorbidity. The thesis is that the identification and acknowledgment of the concept of FA, when integrated into an overall, trauma-focused and transdiagnostic treatment approach, are supported and can be useful in understanding clinically the "big picture." Food addiction (FA) may be used as a proxy for (1) bulimic eating disorder severity, (2) complex trauma histories, (3) severity of PTSD and PTSD symptoms, (4) intensity of psychiatric comorbidity, (5) severity of obesity, as well as (6) their combination. Implications for developing treatment strategies are discussed. The case for a comprehensive management that requires careful attention to medical and psychiatric assessment and integrated care that incorporates trauma-focused treatment is made.

  12. Body weight loss by very-low-calorie diet program improves small artery reactive hyperemia in severely obese patients.

    Science.gov (United States)

    Merino, J; Megias-Rangil, I; Ferré, R; Plana, N; Girona, J; Rabasa, A; Aragonés, G; Cabré, A; Bonada, A; Heras, M; Masana, L

    2013-01-01

    Endothelial dysfunction is a major underlying mechanism for the elevated cardiovascular risk associated with increased body weight. We aimed to assess the impact of weight loss induced by an intensive very-low-calorie diet (VLCD) on arterial wall function in severely obese patients (SOP). Thirty-four SOP were admitted to the metabolic ward of the hospital for a 3-week period. A VLCD characterized by a liquid diet providing 800 kcal/day was administered. The small artery reactivity to postischemic hyperemia index (saRHI), a surrogate marker of endothelial function, was assessed before and 1 week after hospital discharge. Anthropometry and biochemical parameters were also measured. Obese and non-obese age- and gender-matched groups were recruited for baseline comparisons. SOP had significantly lower saRHI compared with obese and non-obese individuals. SaRHI significantly increased after the intervention in SOP (1.595 ± 0.236 vs. 1.737 ± 0.417, p = 0.015). A significant improvement in glucose (p = 0.026), systolic blood pressure (p = 0.049), LDLc (p reactivity, and it was associated with the amelioration of metabolic and inflammation markers. Endothelial dysfunction may be softened by body weight loss interventions and useful in the management of cardiovascular risk factors in SOP.

  13. The p. N103K mutation of leptin (LEP gene and severe early onset obesity in Pakistan

    Directory of Open Access Journals (Sweden)

    Shabana

    Full Text Available BACKGROUND: Obesity is a complex disorder and has been increasing globally at alarming rates including Pakistan. However, there is scarce research on understanding obesity genetics in Pakistan. Leptin is a hormone secreted by adipocytes in response to satiety and correlates with body weight. Any mutations in the LEP gene have an adverse effect on energy regulation pathway and lead to severe, early onset obesity. To date, only eight mutations have been described in the LEP gene of which p. N103K is one. METHODS: We aimed to analyze the prevalence of this mutation in Pakistani subjects. A total of 475 subjects were genotyped by PCR-RFLP analysis and their serum profiling was done. RESULTS: Results showed that this mutation was present only in one male child with early onset obesity (10 year. He had very low serum leptin levels suggestive of functional impact of the mutation. The prevalence of such mutations is, however, low due to the drastic effects on the energy regulation. CONCLUSION: In conclusion, LEP gene mutations contribute significantly to the monogenic forms of obesity and are important due to the availability of treatment options. Such mutations may exert their effect by directly affecting energy regulation pathway and are more prominent in the early stages of life only.

  14. The influence of sex and obesity on gait biomechanics in people with severe knee osteoarthritis scheduled for arthroplasty.

    Science.gov (United States)

    Paterson, K L; Sosdian, L; Hinman, R S; Wrigley, T V; Kasza, J; Dowsey, M; Choong, P; Bennell, K L

    2017-11-01

    Sex and body mass may influence knee biomechanics associated with poor total knee arthroplasty (TKA) outcomes for knee osteoarthritis (OA). This study aimed to determine if gait differed between men and women, and overweight and class I obese patients with severe knee OA awaiting TKA. 34 patients with severe knee OA (average age 70.0 (SD 7.2) years, body mass index 30.3 (4.1kg/m 2 )) were recruited from a TKA waiting list. Three-dimensional gait analysis was performed at self-selected walking speed. Comparisons were made between men and women, and overweight (body mass index (BMI) 25.0-29.9kg/m 2 ) and class I obese (BMI 30.0-34.9kg/m 2 ) participants. Biomechanical outcomes included absolute and body size-adjusted peak knee adduction moment (KAM), KAM impulse, peak knee flexion moment, as well as peak knee flexion and varus-valgus angles, peak varus-valgus thrust, and peak vertical ground reaction force (GRF). Men had a higher absolute peak KAM, KAM impulse and peak GRF compared to women, and this sex-difference in frontal plane moments remained after adjusting for body size. However, when additionally adjusting for static knee alignment, differences disappeared. Knee biomechanics were similar between obesity groups after adjusting for the greater body weight of those with class I obesity. Men had greater KAM and KAM impulse even after adjustment for body size; however adjustment for their more varus knees removed this difference. Obesity group did not influence knee joint kinematics or moments. This suggests sex- and obesity-differences in these variables may not be associated with TKA outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Obesity

    DEFF Research Database (Denmark)

    Morgen, Camilla Schmidt; Sørensen, Thorkild I A

    2014-01-01

    A new report provides compelling evidence of the high prevalence of overweight and obesity throughout the world. The prevalence has increased since 1980, but at different rates across ages, times and locations. Studies exploring the causes of these differences could aid development of effective...

  16. Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive Characterization with Emphasis on Mental Health.

    Science.gov (United States)

    Dreber, Helena; Reynisdottir, Signy; Angelin, Bo; Hemmingsson, Erik

    2015-01-01

    To characterize treatment-seeking young adults (16-25 years) with severe obesity, particularly mental health problems. Cross-sectional study of 165 participants (132 women, 33 men) with BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities, enrolling in a multidisciplinary obesity treatment program. Data collection at admission of present and life-time health issues including symptomatology of anxiety, depression (Hospital Anxiety and Depression Scale) and attention-deficit/hyperactivity disorder (Adult ADHD Self-Report scale); self-esteem (Rosenberg Self-Esteem Scale), suicide attempts, health-related quality of life (Short Form-36 Health Survey), psychosocial functioning related to obesity (Obesity-related Problems Scale), cardiorespiratory fitness (Astrand's bicycle ergometer test), somatic and psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional status. We used multiple regression analysis to identify variables independently associated with present anxiety and depressive symptomatology. Mean body mass index was 39.2 kg/m2 (SD = 5.2). We found evidence of poor mental health, including present psychiatric diagnoses (29%), symptomatology of anxiety (47%), depression (27%) and attention-deficit/hyperactivity disorder (37%); low self-esteem (42%), attempted suicide (12%), and low quality of life (physical component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, Pobesity-related problems (P = 0.018). The prevalence of type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in 82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%. Forty-eight percent had at least one micronutritional deficiency, vitamin D being the most common (35%). A wide range of health issues, including quite severe mental health problems, was prevalent in treatment-seeking young adults with severe obesity. These are likely to constitute a major treatment challenge, including options relating to bariatric surgery.

  17. Severe obesity and diabetes self-care attitudes, behaviours and burden : Implications for weight management from a matched case-controlled study. Results from Diabetes MILES-Australia

    NARCIS (Netherlands)

    Dixon, J.B.; Browne, J.L.; Mosely, K.G.; Jones, K.M.; Pouwer, F.; Speight, J.

    2014-01-01

    Aims To investigate whether diabetes self-care attitudes, behaviours and perceived burden, particularly related to weight management, diet and physical activity, differ between adults with Type 2 diabetes who are severely obese and matched non-severely obese control subjects. Methods The 1795

  18. The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health

    Science.gov (United States)

    Richardson, Andrea S.; Dietz, William H.; Gordon-Larsen, Penny

    2013-01-01

    Background Severe obesity has increased yet childhood antecedents of adult severe obesity are not well understood. Objective Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared to those who did not report abuse. Methods Longitudinal analysis of participants from the U.S. National Longitudinal Study of Adolescent Health (N=10,774) Wave II (1996; aged 12–22 years) followed through Wave IV (2008–09; aged 24–34 years). New cases of adult-onset severe obesity (BMI≥40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (Hazard Ratio=2.5; 1.3, 4.8) and males (Hazard Ratio=3.6; 1.5, 8.5) compared to individuals with no history of abuse. Conclusion In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity. PMID:24115589

  19. ENU mutagenesis identifies mice with morbid obesity and severe hyperinsulinemia caused by a novel mutation in leptin.

    Directory of Open Access Journals (Sweden)

    Chen-Jee Hong

    Full Text Available BACKGROUND: Obesity is a multifactorial disease that arises from complex interactions between genetic predisposition and environmental factors. Leptin is central to the regulation of energy metabolism and control of body weight in mammals. METHODOLOGY/PRINCIPAL FINDINGS: To better recapitulate the complexity of human obesity syndrome, we applied N-ethyl-N-nitrosourea (ENU mutagenesis in combination with a set of metabolic assays in screening mice for obesity. Mapping revealed linkage to the chromosome 6 within a region containing mouse Leptin gene. Sequencing on the candidate genes identified a novel T-to-A mutation in the third exon of Leptin gene, which translates to a V145E amino acid exchange in the leptin propeptide. Homozygous Leptin(145E/145E mutant mice exhibited morbid obesity, accompanied by adipose hypertrophy, energy imbalance, and liver steatosis. This was further associated with severe insulin resistance, hyperinsulinemia, dyslipidemia, and hyperleptinemia, characteristics of human obesity syndrome. Hypothalamic leptin actions in inhibition of orexigenic peptides NPY and AgRP and induction of SOCS1 and SOCS3 were attenuated in Leptin(145E/145E mice. Administration of exogenous wild-type leptin attenuated hyperphagia and body weight increase in Leptin(145E/145E mice. However, mutant V145E leptin coimmunoprecipitated with leptin receptor, suggesting that the V145E mutation does not affect the binding of leptin to its receptor. Molecular modeling predicted that the mutated residue would form hydrogen bond with the adjacent residues, potentially affecting the structure and formation of an active complex with leptin receptor within that region. CONCLUSIONS/SIGNIFICANCE: Thus, our evolutionary, structural, and in vivo metabolic information suggests the residue 145 as of special function significance. The mouse model harboring leptin V145E mutation will provide new information on the current understanding of leptin biology and novel mouse

  20. Euglycaemic ketoacidosis in a non-diabetic primigravida following an appendicectomy

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    Dinushi Dilanka Dikowita

    2017-03-01

    Full Text Available Pregnancy creates significant alterations in energy metabolism which itself is a physiological adaptation to provide continuous flow of energy metabolites to the foetus. The state of insulin resistance created by hormonal changes in pregnancy enables free flow of glucose to the foetus and allows its absorption through facilitated diffusion. As glucose is preferentially available for the foetus, maternal fasting glucose level would be less than that of a non-pregnant state and in contrast plasma ketones and free fatty acids levels are elevated, resulting in a state of accelerated starvation. These metabolic alterations place a pregnant woman at a higher risk of developing euglycaemic ketoacidosis when allowed to fast for prolonged periods due to medical, surgical and psychological reasons. We report a rare case of euglycaemic ketoacidosis causing severe increased anion gap metabolic acidosis in a non-diabetic mother following surgery for appendicitis at a gestation of 27 weeks.

  1. Gender-related differences in cardiometabolic risk factors and lifestyle behaviors in treatment-seeking adolescents with severe obesity.

    Science.gov (United States)

    Barstad, Lisa Ha; Júlíusson, Pétur B; Johnson, Line Kristin; Hertel, Jens Kristoffer; Lekhal, Samira; Hjelmesæth, Jøran

    2018-02-14

    Obesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls. Cross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis. Mean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m 2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders. Male treatment

  2. Effect of severe obesity in childhood and adolescence on risk of type 2 diabetes in youth and early adulthood in an American Indian population.

    Science.gov (United States)

    Tanamas, Stephanie K; Reddy, Sanil P; Chambers, Melissa A; Clark, Elena J; Dunnigan, Diana L; Hanson, Robert L; Nelson, Robert G; Knowler, William C; Sinha, Madhumita

    2017-12-28

    The risk of early-onset type 2 diabetes associated with the severity of obesity in youth is not well understood. This study aims to determine metabolic alterations and type 2 diabetes risk among American Indian children who are obese or severely obese. Incidence rates of diabetes before 20 years (youth-onset) and 45 years were computed in 2728 children who were from 5 to Obesity was defined as age-sex-adjusted body mass index (BMI) ≥95th percentile, and its severity was quantified as the percentage of the 95th percentile (%BMI p95 ). In the younger cohort, 0.9% of those non-obese and 2.9% of those with 100% to obese and 9.8% of those with 100% to youth-onset diabetes was 3.8 and 4.9/1000 person-years in the child and adolescent cohorts, respectively, and before the age of 45 was 12.3 and 16.8/1000 person-years, respectively. Incidence rates of youth-onset diabetes in those with the most severe obesity (≥140%BMI p95 ) were 2.3 to 5.1 times as high as in those with the least severe obesity (100 to obesity in an American Indian population is a major driver of type 2 diabetes developing in adolescents and young adults. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  3. Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity.

    Science.gov (United States)

    Gowey, Marissa A; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E; Zeller, Meg H

    2016-04-01

    Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Fifty-four AYA females with severe obesity (MBMI = 48.71 kg/m(2); Mage = 18.29, R = 15-21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Breakfast was the most frequently skipped meal (consumed 3-4 times/week). Eating out was common (4-5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional

  4. Gastric inhibitory polypeptide receptor: association analyses for obesity of several polymorphisms in large study groups

    Directory of Open Access Journals (Sweden)

    Rief Winfried

    2009-03-01

    Full Text Available Abstract Background Gastric inhibitory polypeptide (GIP is postulated to be involved in type 2 diabetes mellitus and obesity. It exerts its function through its receptor, GIPR. We genotyped three GIPR SNPs (rs8111428, rs2302382 and rs1800437 in German families with at least one obese index patient, two case-control studies and two cross-sectional population-based studies. Methods Genotyping was performed by MALDI-TOF, ARMS-PCR and RFLP. The family-study: 761 German families with at least one extremely obese child or adolescent (n = 1,041 and both parents (n = 1,522. Case-control study: (a German obese children (n = 333 and (b obese adults (n = 987 in comparison to 588 adult lean controls. The two cross-sectional population-based studies: KORA (n = 8,269 and SHIP (n = 4,310. Results We detected over-transmission of the A-allele of rs2302382 in the German families (pTDT-Test = 0.0089. In the combined case-control sample, we estimated an odd ratio of 1.54 (95%CI 1.09;2.19, pCA-Test = 0.014 for homozygotes of the rs2302382 A-allele compared to individuals with no A-allele. A similar trend was found in KORA where the rs2302382 A-allele led to an increase of 0.12 BMI units (p = 0.136. In SHIP, however, the A-allele of rs2302382 was estimated to contribute an average decrease of 0.27 BMI units (p-value = 0.031. Conclusion Our data suggest a potential relevance of GIPR variants for obesity. However, additional studies are warranted in light of the conflicting results obtained in one of the two population-based studies.

  5. Predicting glycated hemoglobin levels in the non-diabetic general population

    DEFF Research Database (Denmark)

    Rauh, Simone P; Heymans, Martijn W; Koopman, Anitra D M

    2017-01-01

    AIMS/HYPOTHESIS: To develop a prediction model that can predict HbA1c levels after six years in the non-diabetic general population, including previously used readily available predictors. METHODS: Data from 5,762 initially non-diabetic subjects from three population-based cohorts (Hoorn Study, I...

  6. Psychological aspects of eating behavior as predictors of 10-y weight changes after surgical and conventional treatment of severe obesity: results from the Swedish Obese Subjects intervention study.

    Science.gov (United States)

    Konttinen, Hanna; Peltonen, Markku; Sjöström, Lars; Carlsson, Lena; Karlsson, Jan

    2015-01-01

    There is a need for a better understanding of the factors that influence long-term weight outcomes after bariatric surgery. We examined whether pretreatment and posttreatment levels of cognitive restraint, disinhibition, and hunger and 1-y changes in these eating behaviors predict short- and long-term weight changes after surgical and conventional treatments of severe obesity. Participants were from an ongoing, matched (nonrandomized) prospective intervention trial of the Swedish Obese Subjects (SOS) study. The current analyses included 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. Physical measurements (e.g., weight and height) and questionnaires (e.g., Three-Factor Eating Questionnaire) were completed before the intervention and 0.5, 1, 2, 3, 4, 6, 8, and 10 y after the start of the treatment. Structural equation modeling was used as the main analytic strategy. The surgery group lost more weight and reported greater decreases in disinhibition and hunger at 1- and 10-y follow-ups (all P women) and experienced larger 1-y decreases in these behaviors (β = 0.31-0.48, P women) lost more weight 2, 6, and 10 y after surgery. In control patients, larger 1-y increases in cognitive restraint predicted a greater 2-y weight loss in both sexes. A higher tendency to eat in response to various internal and external cues shortly after surgery predicted less-successful short- and long-term weight outcomes, making postoperative susceptibility for uncontrolled eating an important indicator of targeted interventions. © 2015 American Society for Nutrition.

  7. Obesity.

    OpenAIRE

    Callaway, C W

    1987-01-01

    Obesity is not a single disease, but a variety of conditions resulting from different mechanisms and associated with various types and degrees of risks. To determine who should lose weight, how much weight should be lost, and how to undertake weight loss, the following types of information are needed: personal-demographic data, developmental patterns, family history, energy balance, body composition/fat distribution, psychological/behavioral measures, endocrine/metabolic measures, complicatio...

  8. Influence of nutrition on somatotropic axis: Milk consumption in adult individuals with moderate-severe obesity.

    Science.gov (United States)

    Barrea, Luigi; Di Somma, Carolina; Macchia, Paolo Emidio; Falco, Andrea; Savanelli, Maria Cristina; Orio, Francesco; Colao, Annamaria; Savastano, Silvia

    2017-02-01

    Nutrition is the major environmental factor that influences the risk of developing pathologies, such as obesity. Although a number of recent reviews pinpoint a protective effects of milk on body weight and obesity related co-morbidities, an inaccurate estimate of milk might contribute to hamper its beneficial effects on health outcomes. Seven-day food records provide prospective food intake data, reducing recall bias and providing extra details about specific food items. Milk intake stimulates the somatotropic axis at multiple levels by increasing both growth hormone (GH) and insulin-like growth factor-1 (IGF-1) secretion. On the other hand, obesity is associated with reduced spontaneous and stimulated GH secretion and basal IGF-1 levels. Aim of this study was to evaluate the milk consumption by using the 7-days food record in obese individuals and to investigate the association between milk intake and GH secretory status in these subjects. Cross-sectional observational study carried out on 281 adult individuals (200 women and 81 men, aged 18-74 years) with moderate-severe obesity (BMI 35.2-69.4 kg/m 2 ). Baseline milk intake data were collected using a 7 day food record. Anthropometric measurements and biochemical profile were determined. The GH/IGF-1 axis was evaluated by peak GH response after GHRH + ARGININE and IGF-1 standard deviation score (SDS). The majority of individuals (72.2%) reported consuming milk; 250 mL low-fat milk was the most frequently serving of milk consumed, while no subjects reported to consume whole milk. Milk consumers vs no milk consumers presented the better anthropometric measurements and metabolic profile. At the bivariate proportional odds ratio model, after adjusting for BMI, age and gender, milk consumption was associated the better GH status (OR = 0.60; p milk consumers, subjects consuming 250 mL reduced-fat milk vs 250 mL low-fat milk presented the better anthropometric measurements and metabolic profile. At the

  9. The number of metabolic abnormalities associated with the risk of gallstones in a non-diabetic population.

    Directory of Open Access Journals (Sweden)

    Chung-Hung Tsai

    Full Text Available AIM: To evaluate whether metabolic syndrome is associated with gallstones, independent of hepatitis C infection or chronic kidney disease (CKD, in a non-diabetic population. MATERIALS AND METHODS: A total of 8,188 Chinese adult participants that underwent a self-motivated health examination were recruited into the final analysis after excluding the subjects who had a history of cholecystectomy, diabetes mellitus, or were currently using antihypertensive or lipid-lowering agents. Gallstones were defined by the presence of strong intraluminal echoes that were gravity-dependent or that attenuated ultrasound transmission. RESULTS: A total of 447 subjects (5.5% had gallstones, with 239 (5.1% men and 208 (6.0% women. After adjusting for age, gender, obesity, education level, and lifestyle factors, included current smoking, alcohol drinking, regular exercise, hepatitis B, hepatitis C, and CKD, there was a positive association between metabolic syndrome and gallstones. Moreover, as compared to subjects without metabolic abnormalities, subjects with one, two, and three or more suffered from a 35, 40, and 59% higher risk of gallstones, respectively. CONCLUSIONS: Non-diabetic subjects with metabolic syndrome had a higher risk of gallstones independent of hepatitis C or CKD, and a dose-dependent effect of metabolic abnormalities also exists.

  10. Usefulness of an accelerated transoesophageal stress echocardiography in the preoperative evaluation of high risk severely obese subjects awaiting bariatric surgery

    Directory of Open Access Journals (Sweden)

    Tessier Michel

    2010-07-01

    Full Text Available Abstract Background Severe obesity is associated with an increased risk of coronary artery disease (CAD. Bariatric surgery is an effective procedure for long term weight management as well as reduction of comorbidities. Preoperative evaluation of cardiac operative risk may often be necessary but unfortunately standard imaging techniques are often suboptimal in these subjects. The purpose of this study was to demonstrate the feasibility, safety and utility of transesophageal dobutamine stress echocardiography (TE-DSE using an adapted accelerated dobutamine infusion protocol in severely obese subjects with comorbidities being evaluated for bariatric surgery for assessing the presence of myocardial ischemia. Methods Subjects with severe obesity [body mass index (BMI >40 kg/m2] with known or suspected CAD and being evaluated for bariatric surgery were recruited. Results Twenty subjects (9M/11F, aged 50 ± 8 years (mean ± SD, weighing 141 ± 21 kg and with a BMI of 50 ± 5 kg/m2 were enrolled in the study and underwent a TE-DSE. The accelerated dobutamine infusion protocol used was well tolerated. Eighteen (90% subjects reached their target heart rate with a mean intubation time of 13 ± 4 minutes. Mean dobutamine dose was 31.5 ± 9.9 ug/kg/min while mean atropine dose was 0.5 ± 0.3 mg. TE-DSE was well tolerated by all subjects without complications including no significant arrhythmia, hypotension or reduction in blood arterial saturation. Two subjects had abnormal TE-DSE suggestive of myocardial ischemia. All patients underwent bariatric surgery with no documented cardiovascular complications. Conclusions TE-DSE using an accelerated infusion protocol is a safe and well tolerated imaging technique for the evaluation of suspected myocardial ischemia and cardiac operative risk in severely obese patients awaiting bariatric surgery. Moreover, the absence of myocardial ischemia on TE-DSE correlates well with a low operative risk of cardiac event.

  11. Two year reduction in sleep apnea symptoms and associated diabetes incidence after weight loss in severe obesity.

    Science.gov (United States)

    Grunstein, Ronald R; Stenlöf, Kaj; Hedner, Jan A; Peltonen, Markku; Karason, Kristjan; Sjöström, Lars

    2007-06-01

    To evaluate the effect of bariatric surgery on sleep apnea symptoms and obesity-associated morbidity in patients with severe obesity. Prospective study. University hospitals and community centers in Sweden. We investigated the influence of weight loss surgery (n=1729) on sleep apnea symptoms and obesity-related morbidity using a conservatively treated group (n=1748) as a control. Baseline BMI in surgical group (42.2+/-4.4 kg/m(2)) and control group (40.1+/-4.6 kg/m(2)) changed -9.7+/-5 kg/m(2) and 0+/-3 kg/m(2), respectively, at 2-year follow-up. In the surgery group, there was a marked improvement in all obstructive sleep apnea (OSA) symptoms compared with the control group (P sleep apnea symptoms at 2 years. Despite adjustment for weight change and baseline central obesity, subjects reporting loss of OSA symptoms had a lower 2-year incidence of diabetes and hypertriglyceridemia. Improvement in OSA in patients losing weight may provide health benefits in addition to weight loss alone.

  12. Gallstone disease in severely obese children participating in a lifestyle intervention program: incidence and risk factors

    NARCIS (Netherlands)

    Heida, A.; Koot, B. G. P.; Vd Baan-Slootweg, O. H.; Pels Rijcken, T. H.; Seidell, J. C.; Makkes, S.; Jansen, P. L. M.; Benninga, M. A.

    2014-01-01

    Cholelithiasis is increasingly encountered in childhood and adolescence due to the rise in obesity. As in adults, weight loss is presumed to be an important risk factor for cholelithiasis in children, but this has not been studied. In a prospective observational cohort study we evaluated the

  13. Gallstone disease in severely obese children participating in a lifestyle intervention program : incidence and risk factors

    NARCIS (Netherlands)

    Heida, A.; Koot, B.G.P.; vd Baan-Slootweg, O H; Pels Rijcken, T H; Seidell, J C; Makkes, S; Jansen, P L M; Benninga, M.A.

    INTRODUCTION: Cholelithiasis is increasingly encountered in childhood and adolescence due to the rise in obesity. As in adults, weight loss is presumed to be an important risk factor for cholelithiasis in children, but this has not been studied. METHODS: In a prospective observational cohort study

  14. Meal-Replacements followed by Topiramate for the Treatment of Adolescent Severe Obesity: A Pilot Randomized Controlled Trial

    Science.gov (United States)

    Fox, Claudia K.; Kaizer, Alexander M.; Rudser, Kyle D.; Nathan, Brandon M.; Gross, Amy C.; Sunni, Muna; Abuzzahab, M. Jennifer; Schwartz, Betsy L.; Kumar, Seema; Petryk, Anna; Billington, Charles J.; Ryder, Justin R.; Kelly, Aaron S.

    2016-01-01

    Objective The objective of this pilot study was to assess the safety and efficacy of short-term meal replacement therapy followed by topiramate for body mass index (BMI) reduction in adolescents with severe obesity. Methods Adolescents (ages 12-18 years) with severe obesity (BMI ≥1.2 times the 95th percentile or BMI ≥35 kg/m2) were recruited for this double-blind, randomized, placebo-controlled trial. Participants completed 4 weeks of meal replacement therapy followed by randomization (1:1) to either 24 weeks of topiramate 75 mg/day or placebo. Mean changes were compared between groups. Results Thirty adolescents (mean age 15.2 ± 1.7 years, mean BMI 40.3 ± 4.6 kg/m2) completed the meal replacement phase and were randomized; 21 completed the study. The difference in mean percent change in BMI between the topiramate and placebo groups was not significant (−1.9% [95% CI (−5.2%, +1.5%); P=0.291]). Significant improvements in visceral fat and VLDL-c were observed in the topiramate compared to the placebo group. There were no concerning changes in neurocognitive function or bone health. Conclusion In this pilot study, 4 weeks of meal replacement therapy followed by 24 weeks of low-dose topiramate compared to meal replacement therapy alone did not result in significant BMI reduction for adolescents with severe obesity. PMID:27807925

  15. Relations of mood with body mass index changes in severely obese women enrolled in a supported physical activity treatment.

    Science.gov (United States)

    Annesi, James J

    2008-01-01

    It has been suggested that physical activity may affect weight reduction outcomes through associated improvements in mood. Relations of physical activity, mood, and weight change are not well understood in persons classified as severely obese (BMI > or = 40 kg/m(2)), however. This research tested these relationships in women with severe obesity. 57 women with a mean BMI of 43.8 kg/m(2) were enrolled in a cognitive-behavioral exercise support treatment with group-based nutrition information. Measurement of depression, tension, overall mood, and BMI was taken at baseline and month 6, and exercise session attendance was recorded. The treatment was associated with significant improvements in depression, tension and total mood disturbance scores as well as in BMI over 6 months. Changes in mood scores that were more positive were correlated with a greater reduction in BMI. Mean attendance in the prescribed 3 session/week exercise regimen was 46.0%, and attendance was significantly correlated with changes in tension and total mood disturbance scores, and approached significance with changes in depression scores. Findings suggested significant relations of mood and weight change as well as of physical activity and mood in severely obese women associated with a treatment of moderate physical activity. With extensions of this research, weight loss theory and treatment may benefit. Copyright 2008 S. Karger AG, Basel.

  16. Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive Characterization with Emphasis on Mental Health.

    Directory of Open Access Journals (Sweden)

    Helena Dreber

    Full Text Available To characterize treatment-seeking young adults (16-25 years with severe obesity, particularly mental health problems.Cross-sectional study of 165 participants (132 women, 33 men with BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities, enrolling in a multidisciplinary obesity treatment program.Data collection at admission of present and life-time health issues including symptomatology of anxiety, depression (Hospital Anxiety and Depression Scale and attention-deficit/hyperactivity disorder (Adult ADHD Self-Report scale; self-esteem (Rosenberg Self-Esteem Scale, suicide attempts, health-related quality of life (Short Form-36 Health Survey, psychosocial functioning related to obesity (Obesity-related Problems Scale, cardiorespiratory fitness (Astrand's bicycle ergometer test, somatic and psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional status. We used multiple regression analysis to identify variables independently associated with present anxiety and depressive symptomatology.Mean body mass index was 39.2 kg/m2 (SD = 5.2. We found evidence of poor mental health, including present psychiatric diagnoses (29%, symptomatology of anxiety (47%, depression (27% and attention-deficit/hyperactivity disorder (37%; low self-esteem (42%, attempted suicide (12%, and low quality of life (physical component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, P<0.001 for difference. Variables independently associated with present anxiety symptomatology (R2 = 0.33, P<0.001 included low self-esteem (P<0.001 and pain (P = 0.003, whereas present depressive symptomatology (R2 = 0.38, P<0.001 was independently associated with low self-esteem (P<0.001, low cardiorespiratory fitness (P = 0.009 and obesity-related problems (P = 0.018. The prevalence of type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in 82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%. Forty-eight percent had at

  17. Mental distress in treatment seeking young adults (18-25 years) with severe obesity compared with population controls of different body mass index levels: cohort study.

    Science.gov (United States)

    Dreber, H; Reynisdottir, S; Angelin, B; Tynelius, P; Rasmussen, F; Hemmingsson, E

    2017-02-01

    Young adults (18-25) with severe obesity constitute a challenging patient group, and there is limited evidence about their mental health status compared to population controls. Mental distress in treatment seeking young adults with severe obesity (n = 121, mean body mass index [BMI] = 39.8 kg m -2 ) was compared with matched (1:3 for age, gender and socioeconomic status) population controls of normal weight (n = 363, mean BMI = 22.4 kg m -2 ), as well as unmatched population controls with class I obesity (n = 105, mean BMI = 32.1 kg m -2 ) or severe obesity (n = 41, mean BMI = 39.7 kg m -2 ). Mental distress was measured by the General Health Questionnaire-12 (GHQ-12), and we quantified physician-diagnosed depression, present anxiety and suicide attempts. Poisson regression and linear regression analysis were used for analysing differences in mental distress between groups. Treatment seekers experienced more mental distress than normal weight controls as measured by continuous (adjusted mean: 3.9 vs. 2.2 points, P obesity (adjusted mean: 2.3 points) or severe obesity (adjusted mean: 2.1; both, P Young adult treatment seekers with severe obesity constitute a risk group for mental distress compared to population controls of different BMI levels. © 2017 World Obesity Federation.

  18. Carpal Tunnel Release in Diabetic and Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Mohammad H Ebrahimzadeh

    2013-09-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is a compression neuropathy that causes paresthesia, pain or numbness in the territory of median nerve. The aim of this study is to compare the open surgery outcome and patients` satisfaction in carpal tunnel syndrome among diabetic and non-diabetic patients. Methods: In a retrospective cohort study from April 2011 to June 2012, patients suffered from carpal tunnel syndrome at least 6 months, without response to conservative treatment, who had the inclusion and exclusion criteria, were evaluated by the usage of MHQ and WHOQOL-BREEF tests, one month before surgery and three months after that. Carpal tunnel decompression surgery was performed by two surgeons, experienced in hand surgery, which used the same surgical method. Statistical analysis was performed by SPSS 19.0. Results: 24 of patient (34.2% were male and 46 (65.8% were female and there was no significant difference between two groups (P>0.05. MHQ total score before and after surgery was respectively 50.22±7.13 and 63.49±11.28 and this difference was significant (P

  19. Roux-en Y gastric bypass surgery reduces hedonic hunger and improves dietary habits in severely obese subjects.

    Science.gov (United States)

    Ullrich, Jennifer; Ernst, Barbara; Wilms, Britta; Thurnheer, Martin; Schultes, Bernd

    2013-01-01

    Many obese subjects suffer from an increased hedonic drive to consume palatable foods, i.e., hedonic hunger, and often show unfavorable dietary habits. Here, we investigated changes in the hedonic hunger and dietary habits after Roux-en-Y gastric bypass (RYGB) surgery. Forty-four severely obese patients were examined before and on average 15.9 ± 0.9 months after RYGB surgery with the Power of Food Scale (PFS), a questionnaire that reliably measures an individual's motivation to consume highly palatable foods but not actual consumptive behavior. Dietary habits were assessed by a food frequency questionnaire. After the RYGB procedure, patients showed markedly lower aggregated PFS scores and sub-domain scores related to generally available, physically present, as well as tasted foods than before the surgery (all P habits after the surgery were characterized by a more frequent consumption of poultry, fish, eggs, and cooked vegetables (P habits characterized by an increased intake of protein-rich foods and vegetables and a reduced consumption of sugar-containing snacks and beverages after RYGB surgery. Based on these findings, it can be speculated that the reduction of the hedonic drive to consume palatable foods induced by RYGB surgery helps severely obese patients to establish healthier dietary habits.

  20. The obesity paradox in stable chronic heart failure does not persist after matching for indicators of disease severity and confounders.

    Science.gov (United States)

    Frankenstein, Lutz; Zugck, Christian; Nelles, Manfred; Schellberg, Dieter; Katus, Hugo A; Remppis, B Andrew

    2009-12-01

    To verify whether controlling for indicators of disease severity and confounders represents a solution to the obesity paradox in chronic heart failure (CHF). From a cohort of 1790 patients, we formed 230 nested matched triplets by individually matching patients with body mass index (BMI) > 30 kg/m(2) (Group 3), BMI 20-24.9 k/m(2) (Group 1) and BMI 25-29.9 kg/m(2) (Group 2), according to NT-proBNP, age, sex, and NYHA class (triplet = one matched patient from each group). Although in the pre-matching cohort, BMI group was a significant univariable prognostic indicator, it did not retain significance [heart rate (HR): 0.91, 95% CI: 0.78-1.05, chi(2): 1.67] when controlled for group propensities as covariates. Furthermore, in the matched cohort, 1-year mortality and 3-year mortality did not differ significantly. Here, BMI again failed to reach statistical significance for prognosis, either as a continuous or categorical variable, whether crude or adjusted. This result was confirmed in the patients not selected for matching. NT-proBNP, however, remained statistically significant (log(NT-proBNP): HR: 1.49, 95% CI: 1.13-1.97, chi(2): 7.82) after multivariable adjustment. The obesity paradox does not appear to persist in a matched setting with respect to indicators of disease severity and other confounders. NT-proBNP remains an independent prognostic indicator of adverse outcome irrespective of obesity status.

  1. Relationship of plasma apolipoprotein M with proprotein convertase subtilisin-kexin type 9 levels in non-diabetic subjects

    DEFF Research Database (Denmark)

    Kappelle, Paul J W H; Lambert, Gilles; Dahlbäck, Björn

    2011-01-01

    PURPOSE: Apolipoprotein M (apoM) retards atherosclerosis development in murine models, and may be regulated by pathways involved in LDL metabolism. Proprotein convertase subtilisin-kexin type 9 (PCSK9) plays a key role in LDL receptor processing. We determined the extent to which plasma apo......M is related to PCSK9 levels in subjects with varying degrees of obesity. METHODS: We sought correlations between plasma apoM and PCSK9, measured using recently developed ELISAs, in 79 non-diabetic subjects. RESULTS: ApoM and PCSK9 levels were both correlated positively with total cholesterol, non...... contribute to plasma apoM regulation in humans. The influence of PCSK9 on circulating apoM appears to be modified by adiposity...

  2. The Influence of Radiographic Severity on the Relationship between Muscle Strength and Joint Loading in Obese Knee Osteoarthritis Patients

    Directory of Open Access Journals (Sweden)

    Jens Aaboe

    2011-01-01

    Full Text Available Objective. To investigate the relationship between knee muscle strength and the external knee adduction moment during walking in obese knee osteoarthritis patients and whether disease severity influences this relationship. Methods. This cross-sectional study included 136 elderly obese (BMI>30 adults with predominant medial knee osteoarthritis. Muscle strength, standing radiographic severity as measured by the Kellgren and Lawrence scale, and the peak external knee adduction moment were measured at self-selected walking speed. Results. According to radiographic severity, patients were classified as “less severe” (KL 1-2, N=73 or “severe” (KL 3-4, N=63. A significant positive association was demonstrated between the peak knee adduction moment and hamstring muscle strength in the whole cohort (P=.047. However, disease severity did not influence the relationship between muscle strength and dynamic medial knee joint loading. Severe patients had higher peak knee adduction moment and more varus malalignment (P<.001. Conclusion. Higher hamstring muscle strength relates to higher estimates of dynamic knee joint loading in the medial compartment. No such relationship existed for quadriceps muscle strength. Although cross sectional, the results suggest that hamstrings function should receive increased attention in future studies and treatments that aim at halting disease progression.

  3. Bariatric surgery for severe obesity in two adolescents with type 1 diabetes.

    Science.gov (United States)

    Chuang, Janet; Zeller, Meg H; Inge, Thomas; Crimmins, Nancy

    2013-10-01

    Bariatric surgery has been effective in treating type 2 diabetes mellitus (T2DM); it has not been used frequently in obese patients with type 1 diabetes mellitus (T1DM). This is the first case series reporting on the effect of bariatric surgery on diabetes control in adolescents with T1DM. Patient A is a 19-year-old obese man with T1DM who underwent vertical sleeve gastrectomy. At 12 months after surgery he demonstrated 28% reduction in BMI. His daily total insulin requirement had decreased; however, hemoglobin A1c remained primarily unchanged at 8.8%. Patient B is a 13-year-old obese girl with an initial clinical diagnosis of T2DM controlled on only metformin. She underwent Roux-en-Y gastric bypass; at 1 month after surgery she presented in diabetic ketoacidosis and was found to have positive islet cell antibodies, which were also present before surgery. Her diagnosis was revised to T1DM, and she was started on insulin. By 28 months after surgery her BMI had decreased by 42%. Since initiation of insulin, her daily total insulin requirement had decreased, but hemoglobin A1c had significantly worsened from 6.3% to 10%. We found that despite significant weight loss, improvements in cardiovascular risk factors (dyslipidemia and obstructive sleep apnea), and quality of life in our patients, bariatric surgery does not necessarily lead to improved glycemic control of T1DM. Patients with T1DM have ongoing dependency on exogenous insulin, and optimal glycemic control still depends on patient compliance with diabetes care.

  4. Prenatal exposure to maternal very severe obesity is associated with impaired neurodevelopment and executive functioning in children.

    Science.gov (United States)

    Mina, Theresia H; Lahti, Marius; Drake, Amanda J; Denison, Fiona C; Räikkönen, Katri; Norman, Jane E; Reynolds, Rebecca M

    2017-07-01

    BackgroundPrenatal maternal obesity has been associated with an increased risk of neurocognitive problems in childhood, but there are fewer studies on executive functioning.MethodsTests and questionnaires to assess neurodevelopment, executive functioning, and the ability to delay gratification were conducted in 113 children (mean (SD)=4.24 (0.63) years of age) born to mothers with very severe obesity (SO, body mass index (BMI)⩾40 kg/m 2 , n=51) or to lean mothers (BMI⩽25 kg/m 2 , n=62).ResultsPrenatal maternal SO predicted poorer neurodevelopment (unstandardized regression coefficient (B)=-0.42, 95% confidence interval (CI) (-0.82; -0.02)), worse problem-solving (odd ratio (OR)=0.60, 95% CI (1.13; 0.07)), and fine motor skills (OR=4.91, 95% CI (1.27; 19.04)), poorer executive functioning in areas of attention, inhibitory control, and working memory (standardized B=3.75, 95% CI (1.01; 13.93)) but not in self-gratification delay. The effects were independent of maternal concurrent psychological well-being and child's BMI, but not independent of maternal education.ConclusionFuture studies should investigate whether perinatal management of maternal obesity could prevent adverse outcomes in child neurodevelopment.

  5. Timing of bariatric surgery for severely obese adolescents: a Markov decision-analysis.

    Science.gov (United States)

    Stroud, Andrea M; Parker, Devin; Croitoru, Daniel P

    2016-05-01

    Although controversial, bariatric surgery is increasingly being performed in adolescents. We developed a model to simulate the effect of timing of gastric bypass in obese adolescents on quantity and quality of life. A Markov state-transition model was constructed comparing two treatment strategies: gastric bypass surgery at age 16 versus delayed surgery in adulthood. The model simulated a hypothetical cohort of adolescents with body mass index of 45kg/m(2). Model inputs were derived from current literature. The main outcome measure was quality and quantity of life, measured using quality-adjusted life-years (QALYs). For females, early gastric bypass surgery was favored by 2.02 QALYs compared to delaying surgery until age 35 (48.91 vs. 46.89 QALYs). The benefit was even greater for males, where early surgery was favored by 2.9 QALYs (48.30 vs. 45.40 QALYs). The absolute benefit of surgery at age 16 increased; the later surgery was delayed into adulthood. Sensitivity analyses demonstrated that adult surgery was favored only when the values for adverse events were unrealistically high. In our model, early gastric bypass in obese adolescents improved both quality and quantity of life. These findings are useful for surgeons and pediatricians when counseling adolescents considering weight loss surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Systematic review of bariatric surgery liver biopsies clarifies the natural history of liver disease in patients with severe obesity.

    Science.gov (United States)

    Bedossa, Pierre; Tordjman, Joan; Aron-Wisnewsky, Judith; Poitou, Christine; Oppert, Jean-Michel; Torcivia, Adriana; Bouillot, Jean-Luc; Paradis, Valerie; Ratziu, Vlad; Clément, Karine

    2017-09-01

    Non-alcoholic fatty liver disease (NAFLD) is a frequent complication of morbid obesity, but its severity varies greatly and thus there is a strong need to better define its natural history in these patients. Liver biopsies were systematically performed in 798 consecutive patients with severe obesity undergoing bariatric surgery. Histology was compared with clinical, biological, anthropometrical and body composition characteristics. Patients with presumably normal liver (n=179, 22%) were significantly younger at bariatric surgery than patients with NAFLD (37.0 vs 44.4 years, pliver reported the onset of obesity at a significantly younger age than those with NAFLD (14.8 vs 20.0 year, pliver disease severity (presumably normal liver: 1.00, steatosis: 1.21, non-alcoholic steatohepatitis (NASH): 1.34, pliver: 50%, steatosis: 49.1%, NASH: 47.4%, pliver disease but only in female patients (presumably normal liver: 8543 picolitres, steatosis: 9156 picolitres, NASH: 9996 picolitres). These results suggest that young adults are more prone to store fat in subcutaneous tissue and reach the threshold of bariatric surgery indication before their liver is damaged. A shift of fat storage from subcutaneous to visceral adipose tissue compartment is associated with liver damages. Liver might also be targeted by subcutaneous hypertrophic adipocytes in females since hypertrophic adipocytes are more exposed to lipolysis and to the production of inflammatory mediators. 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/.

  7. Relationship between severe obesity and depth to the cricothyroid membrane in third-trimester non-labouring parturients: a prospective observational study.

    Science.gov (United States)

    Gadd, K; Wills, K; Harle, R; Terblanche, N

    2018-05-01

    Severely obese parturients have increased 'cannot intubate, cannot oxygenate' risk during Caesarean section under general anaesthesia. Front-of-neck access (FONA) at the cricothyroid membrane (CTM) is definitive management; however, attempted FONA can fail. Point-of-care ultrasonography may provide useful information about CTM depth to aid FONA in obesity. This study determined the difference in CTM depth between severely obese and non-obese parturients, utilising ultrasonography. In this prospective observational study, two anaesthetists performed airway ultrasonography on 15 severely obese (BMI >45 kg m -2 ) and 15 normal-weight (BMI ≤25 kg m -2 ) parturients in the third trimester, using the transverse and longitudinal planes, sniffing and extended head positions, and nil and firm transducer pressures. The primary outcome was CTM depth (millimetres) measured in the transverse plane with the head extended and nil transducer pressure. Secondary outcomes included CTM depth measurements using other factor configurations. Intra-class correlation coefficients assessed the inter-observer reliability. CTM depth measured in the transverse plane with head extended and nil transducer pressure was significantly greater in severely obese parturients, mean 18.0 mm (95% confidence interval 16.3-19.8), vs 10.6 mm (8.81-12.4) in non-obese (P<0.001); mean difference 7.4 mm (4.9-9.9; P<0.001). CTM depths were increased in the severely obese group regardless of scanning plane, head and neck position, or transducer pressure (all P<0.001). There was excellent inter-observer reliability. Cricothyroid membrane depth is significantly increased in severely obese vs normal-weight parturients independently of scanning plane, head and neck position, or transducer pressure. Copyright © 2018 British Journal of Anaesthesia. All rights reserved.

  8. The hedonic drive to consume palatable foods appears to be lower in gastric band carriers than in severely obese patients who have not undergone a bariatric surgery.

    Science.gov (United States)

    Ullrich, J; Ernst, B; Wilms, B; Thurnheer, M; Hallschmid, M; Schultes, B

    2013-04-01

    We have recently shown that severely obese patients display a markedly enhanced drive to consume palatable food, and that this hedonic hunger is reduced after gastric bypass surgery. Adjustable gastric banding is another frequently performed bariatric operation with unknown effects on hedonic hunger motivation. Here, we compared the level of hedonic hunger in patients who have undergone a gastric banding with that in severely obese patients who have not undergone a bariatric operation and nonobese controls. In a cross-sectional case-control study, 116 gastric banding patients, 138 severely obese patients, and 133 nonobese controls were examined with the Power of Food Scale (PFS), a questionnaire that reliably measures an individual's motivation to consume highly palatable food. While the severely obese patients displayed markedly higher aggregated PFS scores and scores on the subdomain "generally available" and "physically present" food than the nonobese controls (all P needs to be confirmed in longitudinal studies.

  9. Polymorphism of the FTO Gene Influences Body Weight in Children with Type 1 Diabetes without Severe Obesity

    OpenAIRE

    Łuczyński, Włodzimierz; Fendler, Wojciech; Ramatowska, Anna; Szypowska, Agnieszka; Szadkowska, Agnieszka; Młynarski, Wojciech; Chumiecki, Miron; Jarosz-Chobot, Przemysława; Chrzanowska, Joanna; Noczyńska, Anna; Brandt, Agnieszka; Myśliwiec, Małgorzata; Głowińska-Olszewska, Barbara; Bernatowicz, Paweł; Kowalczuk, Oksana

    2014-01-01

    The objective was to compare the impact of clinical and genetic factors on body mass index (BMI) in children with type 1 diabetes (T1DM) without severe obesity. A total of 1,119 children with T1DM (aged 4–18 years) were qualified to take part in the study. All children were genotyped for variants of FTO, MC4R, INSIG2, FASN, NPC1, PTER, SIRT1, MAF, IRT1, and CD36. Results. Variants of FTO showed significant association with BMI-SDS in the T1DM group. The main factors influencing BMI-SDS in chi...

  10. Early-onset severe obesity with ACTH deficiency and red hair in a boy: the POMC deficiency.

    Science.gov (United States)

    Ozen, S; Aldemir, O

    2012-01-01

    The patient is a 2.8 years old male who is extremely obese and severe hyperphagic from birth. He had seizures attacks and apnea from the second week of his life. He has red hair and serum cortisol and ACTH levels are very low. We examined our patient as a hypocortisolism due to ACTH deficiency and central hypothyrodism. After the corticosteroid replacement therapy hair color changed to brown. We performed molecular genetic analysis at the Institue for Experimental Pediatric Endocrinology laboratory in Berlin, Germany by Krude H. and found compound heterozygous mutations. As a result the case is diagnosed as POMC deficiency.

  11. Comparative analysis of diabetic nephropathy and non-diabetic nephropathy disease

    Directory of Open Access Journals (Sweden)

    Qiuxiang Chen

    2017-12-01

    Conclusion: Treatment effect of diabetic nephropathy patients is relatively poor compared to that of non-diabetic patients. In clinics, management and prevention of diabetic patients should be strengthened to avoid complication of nephropathy which brings serious injury to patients.

  12. Carbenoxolone treatment ameliorated metabolic syndrome in WNIN/Ob obese rats, but induced severe fat loss and glucose intolerance in lean rats.

    Directory of Open Access Journals (Sweden)

    Siva Sankara Vara Prasad Sakamuri

    Full Text Available BACKGROUND: 11beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1 regulates local glucocorticoid action in tissues by catalysing conversion of inactive glucocorticoids to active glucocorticoids. 11β-HSD1 inhibition ameliorates obesity and associated co-morbidities. Here, we tested the effect of 11β-HSD inhibitor, carbenoxolone (CBX on obesity and associated comorbidities in obese rats of WNIN/Ob strain, a new animal model for genetic obesity. METHODOLOGY/PRINCIPAL FINDINGS: Subcutaneous injection of CBX (50 mg/kg body weight or volume-matched vehicle was given once daily for four weeks to three month-old WNIN/Ob lean and obese rats (n = 6 for each phenotype and for each treatment. Body composition, plasma lipids and hormones were assayed. Hepatic steatosis, adipose tissue morphology, inflammation and fibrosis were also studied. Insulin resistance and glucose intolerance were determined along with tissue glycogen content. Gene expressions were determined in liver and adipose tissue. CBX significantly inhibited 11β-HSD1 activity in liver and adipose tissue of WNIN/Ob lean and obese rats. CBX significantly decreased body fat percentage, hypertriglyceridemia, hypercholesterolemia, insulin resistance in obese rats. CBX ameliorated hepatic steatosis, adipocyte hypertrophy, adipose tissue inflammation and fibrosis in obese rats. Tissue glycogen content was significantly decreased by CBX in liver and adipose tissue of obese rats. Severe fat loss and glucose- intolerance were observed in lean rats after CBX treatment. CONCLUSIONS/SIGNIFICANCE: We conclude that 11β-HSD1 inhibition by CBX decreases obesity and associated co-morbidities in WNIN/Ob obese rats. Our study supports the hypothesis that inhibition of 11β-HSD1 is a key strategy to treat metabolic syndrome. Severe fat loss and glucose -intolerance by CBX treatment in lean rats suggest that chronic 11β-HSD1 inhibition may lead to insulin resistance in normal conditions.

  13. Comparative effects of several simple carbohydrates on erythrocyte insulin receptors in obese subjects.

    Science.gov (United States)

    Rizkalla, S W; Baigts, F; Fumeron, F; Rabillon, B; Bayn, P; Ktorza, A; Spielmann, D; Apfelbaum, M

    1986-09-01

    The effects of simple carbohydrates on erythrocyte insulin receptors, plasma insulin and plasma glucose were studied during four hypocaloric, hyperproteic, diets. One diet contained no carbohydrate; the other three contained 36 g of either glucose, galactose or fructose. These diets were given for a 14-day period to groups of moderately obese subjects. The hypocaloric carbohydrate-free diet produced a decrease in plasma insulin and glucose concentrations concomitant with an increase in the number of insulin receptors. A similar increase in insulin receptor number was found when the diet was supplemented with glucose or galactose, but not with fructose. The presence of fructose in the diet prevented any increase in insulin receptor number.

  14. Common Genetic Variant of INSIG2 Gene rs7566605 Polymorphism Is Associated with Severe Obesity in North India

    OpenAIRE

    Prakash, Jai; Mittal, Balraj; Srivastava, Apurva; Awasthi, Shally; Srivastava, Pranjal; Srivastava, Neena

    2017-01-01

    Background: Obesity is a very common disorder resulting from an imbalance between food intake and energy expenditure, and it has a substantial impact on the development of chronic diseases. The aim of this study was to examine the association of INSIG2 (rs7566605) gene polymorphism with obesity and obesity associated phenotypes in North Indian subjects. Methods: The variants were investigated for association in 642 obese and non-obese individuals. The genotyping of INSIG2 (rs7566605) single n...

  15. Cortisol in tissue and systemic level as a contributing factor to the development of metabolic syndrome in severely obese patients.

    Science.gov (United States)

    Constantinopoulos, Petros; Michalaki, Marina; Kottorou, Anastasia; Habeos, Ioannis; Psyrogiannis, Agathoklis; Kalfarentzos, Fotios; Kyriazopoulou, Venetsana

    2015-01-01

    Adrenal and extra-adrenal cortisol production may be involved in the development of metabolic syndrome (MetS). To investigate the activity of the hypothalamic-pituitary-adrenal (HPA) axis and the expression of HSD11B1, nuclear receptor subfamily 3, group C, member 1 (glucocorticoid receptors) α (NR3C1α) and β (NR3C1β) in the liver, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) of severely obese patients with and without MetS. The study included 37 severely obese patients (BMI ≥ 40 kg/m(2)), 19 with MetS (MetS+ group) and 18 without (MetS- group), studied before and during bariatric surgery. Before the day of surgery, urinary free cortisol (UFC) and diurnal variation of serum and salivary cortisol were estimated. During surgery, biopsies of the liver, VAT and SAT were obtained. The expression of HSD11B1, NR3C1α and NR3C1β was evaluated by RT-PCR. UFC and area under the curve for 24-h profiles of serum and salivary cortisol were lower in the MetS- group. In the MetS- group, mRNA levels of HSD11B1 in liver exhibited a negative correlation with liver NR3C1α (LNR3C1α) and VAT expression of HSD11B1 was lower than the MetS+ group. We observed a downregulation of the NR3C1α expression and lower VAT mRNA levels of HSD11B1 in the MetS- group, indicating a lower selective tissue cortisol production and action that could protect these patients from the metabolic consequences of obesity. In the MetS- group, a lower activity of the HPA axis was also detected. Taken together, cortisol in tissue and systematic level might play a role in the development of MetS in severely obese patients. © 2015 European Society of Endocrinology.

  16. Assessing the Feasibility of a Social Media to Promote Weight Management Engagement in Adolescents with Severe Obesity: Pilot Study.

    Science.gov (United States)

    Prout Parks, Elizabeth; Moore, Reneé H; Li, Ziyi; Bishop-Gilyard, Chanelle T; Garrett, Andrew R; Hill, Douglas L; Bruton, Yasmeen P; Sarwer, David B

    2018-03-19

    Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ≥ 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or "posts" 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 ±3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at

  17. Mediation of social cognitive theory variables in the relationship of exercise and improved eating in sedentary adults with severe obesity.

    Science.gov (United States)

    Annesi, James J; Tennant, Gisèle A

    2013-01-01

    Results from behavioral treatments for obesity have been disappointing due to an inability to sustain healthy eating. The concurrent use of theory, research, and practical application has the potential of reducing overeating through innovative treatments. When overweight individuals begin an exercise program their eating tends to improve, however, the basis of this relationship is not determined. If the psychosocial mediators of the relationship between exercise and improved eating are better understood, supported exercise may be a key component for improving the efficacy of behavioral weight management treatments. In Phase 1 of this research, psychosocial variables derived from social cognitive theory were tested as possible mediators of the relationship of exercise participation with increased fruit and vegetable intake in severely obese adults initiating a 26-week treatment of supported exercise and standard nutrition education (n = 161). Change in self-regulation for healthy eating and self-regulation at treatment end was a strong mediator; with the addition of mood and self-efficacy for healthy eating being additional mediators that notably increased effect ratios. In Phase 2, participants in a cognitive-behavioral nutrition treatment tailored to improve the identified mediators (n = 163) were contrasted with the original group. The cognitive-behavioral nutrition treatment was associated with significantly greater increases than standard nutrition education in self-regulation, p = 0.023, CIs [4.69, 6.48], and [3.19, 5.02], respectively; self-efficacy, p = 0.013, CIs [19.72, 29.41], and [11.70, 20.71], respectively; and a marginally significant decrease in negative mood, p = 0.062, CIs [-14.26, -9.36], and [-10.90, -6.45], respectively. Findings served to inform treatment designs concerning the use of supported exercise and cognitive-behavioral means to derive better outcomes related to nutrition and weight loss in individuals with severe

  18. Age threshold for moderate and severe periodontitis among Korean adults without diabetes mellitus, hypertension, metabolic syndrome, and/or obesity.

    Science.gov (United States)

    Han, Kyungdo; Park, Jun-Beom

    2017-08-01

    The purpose of this study is to determine an appropriate age threshold at which to recommend the evaluation of moderate and severe periodontitis among Korean adults.This study involved a cross-sectional analysis using data from the Korean National Health and Nutrition Examination Survey from 2012 to 2014. Incidence rates of periodontitis with the 95% confidence interval (CI) were evaluated. The predictive accuracy of age for periodontitis was determined by calculating the area under curve (AUC) on the basis of the receiver operating characteristic (ROC) curve.The cutoff value of age was 43 years in men having periodontitis with an AUC of 0.70 with 95% CI of 0.69 to 0.72. The AUC was 0.72 (95% CI: 0.70-0.73), and the cutoff value of age (49 years) was identified for the moderate periodontitis in women. The cutoff values for age with AUCs and 95% CI for individuals with periodontitis were 46 years (0.72 [0.71-0.73]), 43 years (0.73 [0.72, 0.74]), 45 years (0.71 [0.70,0.72]), 43 years (0.73 [0.72, 0.74]), and 45 years (0.74 [0.72, 0.75]) for no obesity, no abdominal obesity, no diabetes mellitus, no hypertension, and no metabolic syndrome groups, respectively.This study proposed the guideline for the appropriate age threshold at which to recommend the evaluation of moderate and severe periodontitis for the general population and additionally added the guideline for the individuals without systemic disease including diabetes mellitus, hypertension, metabolic syndrome, and obesity. This study suggests that the participants with certain age may be recommended for the regular periodontal evaluation.

  19. The potential association between obstructive sleep apnea and diabetic retinopathy in severe obesity-the role of hypoxemia.

    Directory of Open Access Journals (Sweden)

    Dev Banerjee

    Full Text Available Obstructive sleep apnea (OSA is common in obese patients with type 2 diabetes mellitus (DM and may contribute to diabetic microvascular complications.To investigate the association between OSA, hypoxemia during sleep, and diabetic retinal complications in severe obesity. This was a prospective observational study of 93 obese patients mean (SD age: 52(10 years; mean (SD body mass index (BMI: 47.3(8.3 kg/m(2 with DM undergoing retinal screening and respiratory monitoring during sleep. OSA was defined as apnea-hypopnea index (AHI of ≥15 events/hour, resulting in two groups (OSA+ vs. OSA-.Forty-six patients were OSA+: median (95% CI AHI = 37(23-74/hour and 47 were OSA-ve (AHI = 7(4-11/hour. Both groups were similar for ethnicity, BMI, cardiovascular co-morbidities, diabetes duration, HbA1c, and insulin treatment (p>0.05. The OSA+ group was significantly more hypoxemic. There was no significant difference between OSA+ and OSA- groups for the presence of retinopathy (39% vs. 38%. More OSA+ subjects had maculopathy (22% vs. 13%, but this did not reach statistical significance. Logistic regression analyses showed that AHI was not significantly associated with the presence of retinopathy or maculopathy (p>0.05. Whilst minimum oxygen saturation was not significantly associated with retinopathy, it was an independent predictor for the presence of maculopathy OR = 0.79 (95% CI: 0.65-0.95; p<0.05, after adjustment.The presence of OSA, as determined by AHI, was not associated with diabetic retinal complications. In contrast, severity of hypoxemia during sleep (minimum oxygen saturations may be an important factor. The importance of hypoxia in the development of retinal complications in patients with OSA remains unclear and further studies assessing the pathogenesis of hypoxemia in patients with OSA and diabetic retinal disease are warranted.

  20. Psychological Outcomes and Predictors of Initial Weight Loss Outcomes among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

    Science.gov (United States)

    Sysko, Robyn; Devlin, Michael J.; Hildebrandt, Tom B.; Brewer, Stephanie K.; Zitsman, Jeffrey L.; Walsh, B. Timothy

    2013-01-01

    Objective Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery. The role of mental health providers in this population is not well defined, and the selection of candidates is often the result of clinical judgment alone. The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric banding (LAGB) by: (1) examining changes in depressive symptoms and quality of life in the year following surgery, (2) evaluating the interaction between patterns of change in depression, quality of life, and weight post-surgery, and (3) identifying pre-surgical psychological predictors of initial weight change. Method Participants were 101 severely obese adolescents aged 14 to 18. Measures of height, weight, depressive symptoms, and quality of life were obtained in the first year following surgery. Changes in the Beck Depression Inventory (BDI), Pediatric Quality of Life Inventory (PedsQL), and body mass index were analyzed using latent growth curve modeling. Results Significant changes in total BDI [βslope=−0.885 SE=0.279, psurgery (pAdolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB, and measures of pre-operative binge eating and family conflict affected post-surgery body mass index among youth. PMID:23140654

  1. Nonalcoholic fatty liver disease in Japanese patients with severe obesity who received laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in comparison to non-Japanese patients

    International Nuclear Information System (INIS)

    Kakizaki, Satoru; Takizawa, Daichi; Yamazaki, Yuichi; Nakajima, Yuka; Ichikawa, Takeshi; Sato, Ken; Takagi, Hitoshi; Mori, Masatomo; Kasama, Kazunori

    2008-01-01

    The number of patients with morbid obesity is increasing worldwide. However, the prevalence of morbid obesity is still low in Japan, and therefore few systematic investigations of liver dysfunction in this population have so far been carried out. This study aimed to investigate the clinical characteristics in severe obese Japanese patients undergoing laparoscopic Roux-en-Y gastric bypass surgery (LRYGB). Eighty-four patients with severe obesity, including 61 Japanese and 23 non-Japanese patients, were analyzed. The mean body mass index (BMI) was 43.7±7.8 kg/m 2 , and there was no difference between Japanese and non-Japanese patients. Nonalcoholic fatty liver disease (NAFLD) was observed in 45/59 (76.2%) of the Japanese patients. Although there were no differences in the BMI and body weight, serum alanine aminotransferase (ALT) was higher in Japanese patients in comparison to non-Japanese patients (P<0.05). The indices for insulin resistance were significantly higher in the Japanese patients in comparison to non-Japanese patients (P<0.01). The liver/spleen computed tomography (CT) ratios were lower in Japanese patients (P<0.05). The laboratory data and BMI significantly improved at 1 year after LRYGB in both groups. Racial difference may exist difference may exist in NAFLD in patients with severe obesity. When the BMI is similar, liver dysfunction among Japanese patients with severe obesity tends to be higher than in non-Japanese patients. Japanese patients with severe obesity must therefore reduce their body weight to a greater degree in comparison to non-Japanese patients with the same BMI. LRYGB can achieve effective weight control and lower ALT levels in Japanese patients with severe obesity. (author)

  2. Sex, race, and consideration of bariatric surgery among primary care patients with moderate to severe obesity.

    Science.gov (United States)

    Wee, Christina C; Huskey, Karen W; Bolcic-Jankovic, Dragana; Colten, Mary Ellen; Davis, Roger B; Hamel, Marybeth

    2014-01-01

    Bariatric surgery is one of few obesity treatments to produce substantial weight loss but only a small proportion of medically-eligible patients, especially men and racial minorities, undergo bariatric surgery. To describe primary care patients' consideration of bariatric surgery, potential variation by sex and race, and factors that underlie any variation. Telephone interview of 337 patients with a body mass index or BMI > 35 kg/m(2) seen at four diverse primary care practices in Greater-Boston. Patients' consideration of bariatric surgery. Of 325 patients who had heard of bariatric surgery, 34 % had seriously considered surgery. Men were less likely than women and African Americans were less likely than Caucasian patients to have considered surgery after adjustment for sociodemographics and BMI. Comorbid conditions did not explain sex and racial differences but racial differences dissipated after adjustment for quality of life (QOL), which tended to be higher among African American than Caucasian patients. Physician recommendation of bariatric surgery was independently associated with serious consideration for surgery [OR 4.95 (95 % CI 2.81-8.70)], but did not explain variation in consideration of surgery across sex and race. However, if recommended by their doctor, men were as willing and African American and Hispanic patients were more willing to consider bariatric surgery than their respective counterparts after adjustment. Nevertheless, only 20 % of patients reported being recommended bariatric surgery by their doctor and African Americans and men were less likely to receive this recommendation; racial differences in being recommended surgery were also largely explained by differences in QOL. High perceived risk to bariatric surgery was the most commonly cited barrier; financial concerns were uncommonly cited. Single geographic region; examined consideration and not who eventually proceeded with bariatric surgery. African Americans and men were less likely to

  3. LINE-1 methylation in visceral adipose tissue of severely obese individuals is associated with metabolic syndrome status and related phenotypes

    Directory of Open Access Journals (Sweden)

    Turcot Valérie

    2012-07-01

    Full Text Available Abstract Background Epigenetic mechanisms may be involved in the regulation of genes found to be differentially expressed in the visceral adipose tissue (VAT of severely obese subjects with (MetS+ versus without (MetS- metabolic syndrome (MetS. Long interspersed nuclear element 1 (LINE-1 elements DNA methylation levels (%meth in blood, a marker of global DNA methylation, have recently been associated with fasting glucose, blood lipids, heart diseases and stroke. Aim To test whether LINE-1%meth levels in VAT are associated with MetS phenotypes and whether they can predict MetS risk in severely obese individuals. Methods DNA was extracted from VAT of 34 men (MetS-: n = 14, MetS+: n = 20 and 152 premenopausal women (MetS-: n = 84; MetS+: n = 68 undergoing biliopancreatic diversion for the treatment of obesity. LINE-1%meth levels were assessed by pyrosequencing of sodium bisulfite-treated DNA. Results The mean LINE-1%meth in VAT was of 75.8% (SD = 3.0%. Multiple linear regression analyses revealed that LINE-1%meth was negatively associated with fasting glucose levels (β = -0.04; P = 0.03, diastolic blood pressure (β =  -0.65; P = 0.03 and MetS status (β = -0.04; P = 0.004 after adjustments for the effects of age, sex, waist circumference (except for MetS status and smoking. While dividing subjects into quartiles based on their LINE-1%meth (Q1 to Q4: lower %meth to higher %meth levels, greater risk were observed in the first (Q1: odds ratio (OR = 4.37, P = 0.004 and the second (Q2: OR = 4.76, P = 0.002 quartiles compared to Q4 (1.00 when adjusting for age, sex and smoking. Conclusions These results suggest that lower global DNA methylation, assessed by LINE-1 repetitive elements methylation analysis, would be associated with a greater risk for MetS in the presence of obesity.

  4. Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

    OpenAIRE

    Ford, Margaret C.; Gordon, Nancy P.; Howell, Amanda; Green, Cheryl E.; Greenspan, Louise C.; Chandra, Malini; Mellor, R. Grant; Lo, Joan C.

    2016-01-01

    Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with B...

  5. Insulin resistance and the metabolic syndrome are related to the severity of steatosis in the pediatric population with obesity

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    Esther Ubiña-Aznar

    Full Text Available Background: To determine the factors associated with an increased risk for severe steatosis (SS and establish the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR as a screening tool. Methods: A cross-sectional study was performed in obese children to assess the relationship between the metabolic syndrome (MetS and glucose metabolism alterations (GMA and the risk for severe steatosis. Results: A total of 94 children (51 males aged from six to 14 years were included. Thirteen children (14.8% had severe steatosis (SS. The anthropometric variables associated with SS included body mass index (BMI (SS 34.1 vs non-SS 29.7, p = 0.005, waist circumference (cm (100 vs 92.5, p = 0.015 and hip circumference (cm (108 vs 100, p = 0.018. The blood parameters included alanine aminotransferase (ALT (UI/dl (27 vs 21, p = 0.002, gamma-glutamil transpeptidase (GGT (UI/dl (16 vs 15, p = 0.017, fasting glycemia (mg/dl (96 vs 88, p = 0.006, fasting insulin (UI/dl (25 vs 15.3, p < 0.001 and HOMA-IR score (7.1 vs 3.7, p < 0.001. Eighteen children with MetS were found to be at an increased risk for severe steatosis (odds ratio [OR] 11.36, p < 0.001. After receiver operating characteristic (ROC curve analysis, the best area under the curve (AUC was obtained for HOMA-R of 0.862. The HOMA-R 4.9 cut-off value had a 100% sensitivity (CI 95%: 96.2-100 and 67.9% specificity (CI 95%: 57.1-78.7 for severe steatosis. Conclusions: The presence of MetS and glucose metabolism alterations are risk factors for severe steatosis. The 4.9 cut-off value for HOMA-IR may be a risk factor for severe steatosis in obese children.

  6. Cardiovascular Risk Factors in Severely Obese Adolescents: The Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study.

    Science.gov (United States)

    Michalsky, Marc P; Inge, Thomas H; Simmons, Mark; Jenkins, Todd M; Buncher, Ralph; Helmrath, Michael; Brandt, Mary L; Harmon, Carroll M; Courcoulas, Anita; Chen, Michael; Horlick, Mary; Daniels, Stephen R; Urbina, Elaine M

    2015-05-01

    Severe obesity is increasingly common in the adolescent population but, as of yet, very little information exists regarding cardiovascular disease (CVD) risks in this group. To assess the baseline prevalence and predictors of CVD risks among severely obese adolescents undergoing weight-loss surgery. A prospective cohort study was conducted from February 28, 2007, to December 30, 2011, at the following 5 adolescent weight-loss surgery centers in the United States: Nationwide Children's Hospital in Columbus, Ohio; Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio; Texas Children's Hospital in Houston; University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania; and Children's Hospital of Alabama in Birmingham. Consecutive patients aged 19 years or younger were offered enrollment in a long-term outcome study; the final analysis cohort consisted of 242 participants. This report examined the preoperative prevalence of CVD risk factors (ie, fasting hyperinsulinemia, elevated high-sensitivity C-reactive protein levels, impaired fasting glucose levels, dyslipidemia, elevated blood pressure, and diabetes mellitus) and associations between risk factors and body mass index (calculated as weight in kilograms divided by height in meters squared), age, sex, and race/ethnicity. Preoperative data were collected within 30 days preceding bariatric surgery. The mean (SD) age was 17 (1.6) years and median body mass index was 50.5. Cardiovascular disease risk factor prevalence was fasting hyperinsulinemia (74%), elevated high-sensitivity C-reactive protein levels (75%), dyslipidemia (50%), elevated blood pressure (49%), impaired fasting glucose levels (26%), and diabetes mellitus (14%). The risk of impaired fasting glucose levels, elevated blood pressure, and elevated high-sensitivity C-reactive protein levels increased by 15%, 10%, and 6%, respectively, per 5-unit increase in body mass index (P adolescent boys compared with adolescent girls. White individuals

  7. Respiratory Failure due to Severe Obesity and Kyphoscoliosis in a 24-Year-Old Male with Molecularly Confirmed Prader-Willi Syndrome in Tertiary Hospital in Northern Tanzania

    Directory of Open Access Journals (Sweden)

    Elichilia R. Shao

    2017-01-01

    Full Text Available Obesity, mild intellectual disability, hypotonia, poor sucking, cryptorchidism in males, hypogonadism, and kyphoscoliosis are common features of Prader-Willi syndrome (PWS. We report a case who had severe respiratory complications due to extreme obesity and kyphoscoliosis, which are important causes of morbidity and mortality, and discuss management. Furthermore, this is the first molecularly confirmed PWS case in Sub-Saharan Africa outside South Africa.

  8. Adiponectin and Leptin Synovial Fluid Concentration as a Marker for the Severity of Knee Osteoarthritis in Obese Patients

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    Eddy Mart Salim

    2015-12-01

    Full Text Available Purpose: Osteoarthritis (OA is a chronic degenerative joint disorder of the synovial joint characterized by loss of articular cartilage, osteophyte formation, and alterations of subchondral bone. An increase of weight bearing affect on knee joint biomechanically and alter concentration of adipokines, such as adiponectin and leptin. Herein we reported a correlation between adiponectin and leptin synovial fluid concentration with the severity of knee OA in obese patients. Material and Methods: Totally 45 patients were included in this research. ELISA was used to determine adiponectin and leptin concentrations of synovial fluid. The severity of knee OA was classified by Kellgren-Lawrence grading scale. Data analysis was conducted using SPSS for windows. Results: Based on the leptin measurement, it was shown that leptin concentrations were correlated positively with the severity of knee OA. Vice versa, adiponectin concentrations were correlated negative. Conclusion: Our study was support the biomarker function of adiponectin and leptin concentration on synovial fluids, in which those concentrations were related with the severity of OA. Those results also suggested the function of leptin and adiponectin on OA. [Cukurova Med J 2015; 40(4.000: 746-756

  9. Expression Analysis of cPLA2 Alpha Interacting TIP60 in Diabetic KKAy and Non-Diabetic C57BL Wild-Type Mice: No Impact of Transient and Stable TIP60 Overexpression on Glucose-Stimulated Insulin Secretion in Pancreatic Beta-Cells

    DEFF Research Database (Denmark)

    Nordentoft, Iver Kristiansen; Jeppesen, Per Bendix; Nielsen, Anders Lade

    2007-01-01

    In the present study we investigate the expression levels of cytosolic phospholipase A2 alpha (cPLA2alpha) interacting histone acetyl transferase proteins TIP60alpha and TIP60beta in non-diabetic C57BL wild-type mice and obese type 2 diabetic KKAy model mice. The aim was to test our hypothesis...

  10. Perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted gastric sleeve resection

    Directory of Open Access Journals (Sweden)

    Anita Joselyn

    2015-01-01

    Full Text Available Purpose: One of the major advantages for patients undergoing minimally invasive surgery as compared to an open surgical procedure is the improved recovery profile and decreased opioid requirements in the perioperative period. There are no definitive studies comparing the analgesic requirements in patients undergoing two different types of minimally invasive procedure. This study retrospectively compares the perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted, laparoscopic gastric sleeve resection. Materials and Methods: With Institutional Review Board approval, the medication administration records of all severely obese patients who underwent gastric sleeve resection were retrospectively reviewed. Intra-operative analgesic and adjuvant medications administered, postoperative analgesic requirements, and visual analog pain scores were compared between those undergoing a laparoscopic procedure versus a robotic-assisted procedure. Results: This study cohort included a total of 28 patients who underwent gastric sleeve resection surgery with 14 patients in the laparoscopic group and 14 patients in the robotic-assisted group. Intra-operative adjuvant administration of both intravenous acetaminophen and ketorolac was similar in both groups. Patients in the robotic-assisted group required significantly less opioid during the intra-operative period as compared to patients in the laparoscopic group (0.15 ± 0.08 mg/kg vs. 0.19 ± 0.06 mg/kg morphine, P = 0.024. Cumulative opioid requirements for the first 72 postoperative h were similar in both the groups (0.64 ± 0.25 vs. 0.68 ± 0.27 mg/kg morphine, P = NS. No difference was noted in the postoperative pain scores. Conclusion: Although intraoperative opioid administration was lower in the robotic-assisted group, the postoperative opioid requirements, and the postoperative pain scores were similar in both groups.

  11. A Perfect Storm: Increased Colonization and Failure of Vaccination Leads to Severe Secondary Bacterial Infection in Influenza Virus-Infected Obese Mice

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    Erik A. Karlsson

    2017-09-01

    Full Text Available Obesity is a risk factor for developing severe disease following influenza virus infection; however, the comorbidity of obesity and secondary bacterial infection, a serious complication of influenza virus infections, is unknown. To fill this gap in knowledge, lean and obese C57BL/6 mice were infected with a nonlethal dose of influenza virus followed by a nonlethal dose of Streptococcus pneumoniae. Strikingly, not only did significantly enhanced death occur in obese coinfected mice compared to lean controls, but also high mortality was seen irrespective of influenza virus strain, bacterial strain, or timing of coinfection. This result was unexpected, given that most influenza virus strains, especially seasonal human A and B viruses, are nonlethal in this model. Both viral and bacterial titers were increased in the upper respiratory tract and lungs of obese animals as early as days 1 and 2 post-bacterial infection, leading to a significant decrease in lung function. This increased bacterial load correlated with extensive cellular damage and upregulation of platelet-activating factor receptor, a host receptor central to pneumococcal invasion. Importantly, while vaccination of obese mice against either influenza virus or pneumococcus failed to confer protection, antibiotic treatment was able to resolve secondary bacterial infection-associated mortality. Overall, secondary bacterial pneumonia could be a widespread, unaddressed public health problem in an increasingly obese population.

  12. One-Year Behavioral Treatment of Obesity: Comparison of Moderate and Severe Caloric Restriction and the Effects of Weight Maintenance Therapy.

    Science.gov (United States)

    Wadden, Thomas A.; And Others

    1994-01-01

    Compared weight losses of 49 obese women assigned to 52-week behavioral program combined with moderate or severe caloric restriction. Those in severe caloric restriction group lost significantly more weight during first 26 weeks but regained some weight. Reports of binge eating declined in both groups, and no relationship was observed between…

  13. CT findings of TB in diabetic and non-diabetic patients: A comparison before and after anti-tuberculous therapy

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    Hao Wu

    2016-03-01

    Conclusion: CT findings of tuberculosis in diabetic patients are different from those in non-diabetic patients, with a higher occurrence of non-segmental distribution and multiple cavities within a tuberculous lesion. By follow-up re-examination, diabetic patients show a slower and unobvious therapeutic response on CT scans compared to non-diabetic patients. CT can provide important information for the diagnosis and management of TB in diabetic and non-diabetic patients.

  14. Salivary flow and composition in diabetic and non-diabetic subjects.

    Science.gov (United States)

    Lasisi, T J; Fasanmade, A A

    2012-06-07

    The study investigated the effects of type 2 diabetes mellitus on salivary flow and composition in humans compared to healthy sex and age matched controls. Forty adult human subjects divided into 20 diabetic and 20 non-diabetic healthy subjects were included. Saliva samples were collected and analysed for glucose, total protein, calcium, sodium, potassium, chloride and bicarbonate. Salivary flow rate was also determined. The results showed that salivary glucose and potassium levels were significantly higher (p = 0.01 and 0.002 respectively) in diabetic patients compared with non-diabetic participants. It was also found that the diabetic patients had significant reduction in salivary flow rate when compared with non-diabetic individuals. In contrast, there was no significant difference in levels of total protein, Na+, Ca++, Cl- and HCO3- between the two groups. These results suggest that some oral diseases associated with diabetes mellitus may be due to altered levels of salivary glucose, potassium and flow.

  15. Hyperglycaemia and ketosis in a non-diabetic patient--an unusual cause of delayed recovery.

    Science.gov (United States)

    Pawar, Sundeep T; Nath, Soumya S; Ansari, Farrukh

    2014-01-01

    We report a case of hyperglycaemia and ketosis developing in a non-diabetic patient who underwent a neurosurgical procedure under general anaesthesia. A 52-year-old non-diabetic female patient underwent excision of acoustic neuroma under general anaesthesia. Pancreatic function was not disturbed and she received a single dose of dexamethasone (8 mg) and paracetamol (1 g). Delayed recovery from anaesthesia occurred. On investigation, she was found to have hyperglycaemia and ketosis. She was further managed on the line of diabetic ketoacidosis. After 24 hours, when blood glucose had normalised and ketosis abated, she could be weaned from mechanical ventilation and extubated. The patient did not receive any drugs known to cause such a condition. To the best of our knowledge, hyperglycaemia and ketosis developing in a non-diabetic patient causing delayed recovery and extubation is here reported for the first time.

  16. Transperitoneal transport in diabetic and non-diabetic patients on peritoneal dialysis

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, Steen; Nielsen, S L

    1999-01-01

    To investigate differences in the transport characteristics of the peritoneal membrane between diabetic and non-diabetic patients on chronic peritoneal dialysis, a study was conducted in 21 non-diabetic and 18 diabetic patients. Transperitoneal transport of small solutes was evaluated in terms...... of the mass transfer area coefficients (urea, creatinine and glucose), ultra-filtration sieving coefficients (urea and creatinine) and by peritoneal equilibration test results. The capacity of the peritoneal membrane to transport macromolecules was evaluated by albumin mass transfer rates and clearances......-labelled human albumin. Despite a significantly increased transcapillary escape rate of albumin in the diabetic patients, no differences in peritoneal membrane characteristics could be demonstrated between diabetic and non-diabetic patients on peritoneal dialysis....

  17. Impact of hyperglycemia on ischemic stroke mortality in diabetic and non-diabetic patients

    International Nuclear Information System (INIS)

    Kes, V.B.; Solter, V.V.; Supanc, V.; Demarin, V.

    2007-01-01

    Previous studies suggest that infarct expansion may be responsible for increased mortality after stroke onset in patients with prolonged stress hyperglycemia on stroke mortality in patients with and without diabetes. For 630 stroke patients admitted to the neurological intensive care department within 24 hours of stroke onset, we correlated mean blood glucose levels (MBGL) at admission and 72 hours after admission in diabetic and non-diabetic patients with final outcome. Blood glucose levels higher then 6.1 mmol/L (121mg/dL) was treated as hyperglycemia. Of 630 patients (mean age 71+-6), 410 were non-diabetic (mortality, 25%) and 220 patients were diabetic (mortality, 20%). All patients who died within 28 days of hospitalization had prolonged hyperglycemia at admission and after 72 hours, despite insulin therapy). The unadjusted relative risk of in-hospital mortality within 28 days of all stroke patients was 0.68 (95% CI, 0.14-1.9) for non-diabetic patients and 0.39 (95% CI, 0.27-1.56) for diabetic patients. The unadjusted relative risk of in-hospital mortality within 28 days in ischemic stroke in patients with MBGL> 6.1-8.0 mmol/L (121-144 mg/dL) at admission after 72 hours was 1.83 (95% CI, 0.41-5.5) for non-diabetic patients and 1.13 (95% CI, 0.78-4.5) for diabetic patients and 1.13 (95%, 0.78-4.5) for diabetic patients. Non-diabetic patients with hyperglycemia had a 1.7 times higher relative risk of in-hospital 28-day mortality than patients with diabetes. Prolonged stress hyperglycemia in ischemic stroke patients increases the risk of in-hospital 28-day mortality, especially in non-diabetic patients. (author)

  18. The Influence of Smoking on Pulmonary Tuberculosis in Diabetic and Non-Diabetic Patients

    Science.gov (United States)

    Bai, Kuan-Jen; Lee, Jen-Jyh; Chien, Shun-Tien; Suk, Chi-Won; Chiang, Chen-Yuan

    2016-01-01

    Background Both smoking and diabetes can increase the risk and influence the manifestations and outcomes of tuberculosis (TB). It is not clear whether the influence of smoking on pulmonary TB differs between non-diabetic and diabetic patients. Herein, we assessed the manifestations and outcomes of TB in relation to smoking in both diabetic and non-diabetic TB patients. Methodology/Principal Findings All diabetic culture-positive pulmonary TB patients notified from 2005–2010 at three teaching hospitals in Taiwan were enrolled. A culture-positive pulmonary TB patient without DM who was notified to the health authority immediately prior to each diabetic TB patient was selected for comparison. The 972 patients in this study cohort included 365 (37.6%) non-diabetic non-smokers, 149 (15.3%) non-diabetic smokers, 284 (29.2%) diabetic non-smokers, and 174 (17.9%) diabetic smokers. The adjusted relative risk of a pretreatment positive smear for a smoker compared with a non-smoker was 2.19 (95% CI 1.38–3.47) in non-diabetic patients and 2.23 (95% CI 1.29–3.87) in diabetic culture-positive pulmonary TB patients. The adjusted relative risk for a positive smear among diabetic smokers was 5.61 (95% CI 3.35–9.41) compared with non-diabetic non-smokers. Smoking was significantly associated with an increased frequency of bilateral lung parenchyma involvement (AdjOR 1.84, 95% CI 1.16–2.93), far-advanced pulmonary TB (AdjOR 1.91, 95% CI 1.04–3.50), cavitary lesions (AdjOR 2.03, 95% CI 1.29–3.20), and unfavorable outcomes of TB (AdjOR 2.35, 95% CI 1.02–5.41) in non-diabetic patients. However, smoking was not associated with cavitary lung parenchyma lesions regarding the location, number or size of the cavity in diabetic TB patients. Conclusions/Significance Smoking and diabetes have joint effects on a pretreatment positive smear. Diabetic smokers had more than a 5-fold increased risk of a pretreatment positive smear than did non-diabetic non-smokers, indicating

  19. Visual-Constructional Ability in Individuals with Severe Obesity: Rey Complex Figure Test Accuracy and the Q-Score

    Directory of Open Access Journals (Sweden)

    Hanna L. Sargénius

    2017-09-01

    Full Text Available The aims of this study were to investigate visual-construction and organizational strategy among individuals with severe obesity, as measured by the Rey Complex Figure Test (RCFT, and to examine the validity of the Q-score as a measure for the quality of performance on the RCFT. Ninety-six non-demented morbidly obese (MO patients and 100 healthy controls (HC completed the RCFT. Their performance was calculated by applying the standard scoring criteria. The quality of the copying process was evaluated per the directions of the Q-score scoring system. Results revealed that the MO did not perform significantly lower than the HC on Copy accuracy (mean difference −0.302, CI −1.374 to 0.769, p = 0.579. In contrast, the groups did statistically differ from each other, with MO performing poorer than the HC on the Q-score (mean −1.784, CI −3.237 to −0.331, p = 0.016 and the Unit points (mean −1.409, CI −2.291 to −0.528, p = 0.002, but not on the Order points score (mean −0.351, CI −0.994 to 0.293, p = 0.284. Differences on the Unit score and the Q-score were slightly reduced when adjusting for gender, age, and education. This study presents evidence supporting the presence of inefficiency in visuospatial constructional ability among MO patients. We believe we have found an indication that the Q-score captures a wider range of cognitive processes that are not described by traditional scoring methods. Rather than considering accuracy and placement of the different elements only, the Q-score focuses more on how the subject has approached the task.

  20. Genome-wide methylation analysis identifies differentially methylated CpG loci associated with severe obesity in childhood.

    Science.gov (United States)

    Huang, R C; Garratt, E S; Pan, H; Wu, Y; Davis, E A; Barton, S J; Burdge, G C; Godfrey, K M; Holbrook, J D; Lillycrop, K A

    2015-01-01

    Childhood obesity is a major public health issue. Here we investigated whether differential DNA methylation was associated with childhood obesity. We studied DNA methylation profiles in whole blood from 78 obese children (mean BMI Z-score: 2.6) and 71 age- and sex-matched controls (mean BMI Z-score: 0.1). DNA samples from obese and control groups were pooled and analyzed using the Infinium HumanMethylation450 BeadChip array. Comparison of the methylation profiles between obese and control subjects revealed 129 differentially methylated CpG (DMCpG) loci associated with 80 unique genes that had a greater than 10% difference in methylation (P-value obesity were validated using sodium bisulfite pyrosequencing across loci within the FYN, PIWIL4, and TAOK3 genes in individual subjects. Three CpG loci within FYN were hypermethylated in obese individuals (all P obesity was associated with lower methylation of CpG loci within PIWIL4 (P = 0.003) and TAOK3 (P = 0.001). After building logistic regression models, we determined that a 1% increase in methylation in TAOK3, multiplicatively decreased the odds of being obese by 0.91 (95% CI: 0.86 - 0.97), and an increase of 1% methylation in FYN CpG3, multiplicatively increased the odds of being obese by 1.03 (95% CI: 0.99 - 1.07). In conclusion, these findings provide evidence that childhood obesity is associated with specific DNA methylation changes in whole blood, which may have utility as biomarkers of obesity risk.

  1. NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity.

    Science.gov (United States)

    Welbourn, Richard; Dixon, John; Barth, Julian H; Finer, Nicholas; Hughes, Carly A; le Roux, Carel W; Wass, John

    2016-03-01

    Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.

  2. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity.

    Science.gov (United States)

    Lean, Michael; Brosnahan, Naomi; McLoone, Philip; McCombie, Louise; Higgs, Anna Bell; Ross, Hazel; Mackenzie, Mhairi; Grieve, Eleanor; Finer, Nick; Reckless, John; Haslam, David; Sloan, Billy; Morrison, David

    2013-02-01

    There is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) > 40 kg/m(2). This programme aimed to generate weight losses of ≥15 kg at 12 months, within routine primary care. Feasibility study in primary care. Patients with a BMI ≥40 kg/m(2) commenced a micronutrient-replete 810-833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months. Of 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m(2), age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of ≥15 kg at 12 months, six (7%) had a 10-15 kg loss, and 11 (12%) had a 5-10 kg loss. The indicative cost of providing this entire programme for wider implementation would be £861 per patient entered, or £2611 per documented 15 kg loss achieved. A care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of ≥15 kg for one-third of all patients entering the programme.

  3. High Adherence to CPAP Treatment Does Not Prevent the Continuation of Weight Gain among Severely Obese OSAS Patients

    Science.gov (United States)

    Myllylä, Minna; Kurki, Samu; Anttalainen, Ulla; Saaresranta, Tarja; Laitinen, Tarja

    2016-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) patients benefit from continuous positive airway pressure (CPAP) treatment in a dose-response manner. We determined adherence and weight control, as well as their predictors, among long-term CPAP users. Methods: Cohort of 1,023 OSAS patients had used CPAP on average of 6.6 ± 1.2 years. BMI was determined at baseline and at follow-up visits. There were 7.4 ± 1.7 BMI and 6.5 ± 1.8 CPAP usage measurements per patient on average. Using the Bayesian hierarchical model, we determined the patients' individual trends of BMI and adherence development. Patients with significantly increasing or decreasing trends were identified at the posterior probability level of > 90%. Results: The mean age in the cohort was 55.6 ± 9.8 years, BMI 33.5 ± 6.4 kg/m2, apnea-hypopnea index 33.7 ± 23.1, and CPAP usage 6.0 ± 1.8 h/day. The majority of patients had no significant change in BMI (mean annual weight gain 0.04 ± 0.29 kg/m2) or CPAP adherence (mean annual increase 11.4 ± 7.0 min/day). However, at the individual level, 10% of the patients showed significant annual weight gain (0.63 ± 0.35 kg/m2) during the 5-year follow-up period. At baseline these patients were already more severely obese (mean BMI 40.0 ± 5.9 kg/m2) despite being younger (mean 50.9 ± 9.5 years) than the rest of the cohort. Conclusions: In the majority of CPAP-treated OSAS patients, weight did not significantly change but gained slightly slower than in age-matched population in general. However, in 10% of patients, high adherence to CPAP treatment did not prevent the continuation of weight gain. These patients present a high-risk group for OSAS-related multimorbidity later in life. Citation: Myllylä M, Kurki S, Anttalainen U, Saaresranta T, Laitinen T. High adherence to CPAP treatment does not prevent the continuation of weight gain among severely obese OSAS patients. J Clin Sleep Med 2016;12(4):519–528. PMID:26888588

  4. Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men

    DEFF Research Database (Denmark)

    Håkonsen, Linn Berger; Thulstrup, Ane Marie; Aggerholm, Anette Skærbech

    2011-01-01

    A high body mass index (BMI) has been associated with reduced semen quality and male subfecundity, but no studies following obese men losing weight have yet been published. We examined semen quality and reproductive hormones among morbidly obese men and studied if weight loss improved...

  5. Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons.

    Science.gov (United States)

    Persson, Martina; Cnattingius, Sven; Villamor, Eduardo; Söderling, Jonas; Pasternak, Björn; Stephansson, Olof; Neovius, Martin

    2017-06-14

    Objective  To estimate the risks of major congenital malformations in the offspring of mothers who are underweight (body mass index (BMI) malformation, and subgroups of organ specific malformations diagnosed during the first year of life. Risk ratios were estimated using generalised linear models adjusted for maternal factors, sex of offspring, and birth year. Results  A total of 43 550 (3.5%) offspring had any major congenital malformation, and the most common subgroup was for congenital heart defects (n=20 074; 1.6%). Compared with offspring of normal weight mothers (risk of malformations 3.4%), the proportions and adjusted risk ratios of any major congenital malformation among the offspring of mothers with higher BMI were: overweight, 3.5% and 1.05 (95% confidence interval 1.02 to 1.07); obesity class I, 3.8% and 1.12 (1.08 to 1.15), obesity class II, 4.2% and 1.23 (1.17 to 1.30), and obesity class III, 4.7% and 1.37 (1.26 to 1.49). The risks of congenital heart defects, malformations of the nervous system, and limb defects also progressively increased with BMI from overweight to obesity class III. The largest organ specific relative risks related to maternal overweight and increasing obesity were observed for malformations of the nervous system. Malformations of the genital and digestive systems were also increased in offspring of obese mothers. Conclusions  Risks of any major congenital malformation and several subgroups of organ specific malformations progressively increased with maternal overweight and increasing severity of obesity. For women who are planning pregnancy, efforts should be encouraged to reduce adiposity in those with a BMI above the normal range. 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.

  6. Comparative analysis of diabetic nephropathy and non-diabetic nephropathy disease.

    Science.gov (United States)

    Chen, Qiuxiang; Zhu, Aimin; Wang, Junsheng; Huan, Xuelai

    2017-12-01

    Clinical symptoms of diabetic nephropathy patients and non-diabetic nephropathy are compared and analyzed, hemodialysis effect and quality of life of two kinds of nephrotic patients are analyzed. Respectively extract 1300 cases of diabetic nephropathy and non-diabetic nephropathy patients admitted to different hospitals during December 2011-December 2014. Based on whether the patient suffers from diabetes, they were divided into diabetic group and control group. Hemodialysis of two groups of patients were followed up to observe effectiveness of blood treatment, and complications were observed after one year of follow-up. Hematodialysis effectiveness of diabetic nephropathy patients is significantly lower than that of non-diabetic nephropathy group. After 1 year's follow-up, it can be found that survival rate of diabetic nephropathy patients is much lower than that of control group. In statistical comparison of data involved in the two groups of patients, P diabetic nephropathy patients is relatively poor compared to that of non-diabetic patients. In clinics, management and prevention of diabetic patients should be strengthened to avoid complication of nephropathy which brings serious injury to patients.

  7. Evaluation of Urinary Tryptophan Metabolite Levels in Non-diabetic Compared to Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Loredana Elena OLAR

    2017-11-01

    Full Text Available Diabetes mellitus is one of the most common metabolic disorders in animals. Thus, currently, it is imperative to introduce non-invasive, economical and rapid methods for the investigation of diabetes in animals. In this study, the urine samples collected from 10 non-diabetic and 10 streptozotocin-induced diabetic rats were investigated by the spectrofluorimetric technique. Emission spectra for the urine samples were obtained following an excitation wavelength of 280 and 400 nm. The investigated fluorophores were mainly tryptophan metabolites, and significant differences resulted between the mean heights of the emission bands attributed to these fluorophore compounds in diabetic compared to non-diabetic rats. The shape of the spectral windings after the utilization of these two excitation wavelengths was almost similar for diabetic and non-diabetic rats; however, there were some discriminatory elements between the two types of investigated samples. In conclusion, the obtained urine fluorescence spectra allow a clear differentiation between diabetic and non-diabetic rats.

  8. The prevalence of Hypogonadism among diabetic and non-diabetic men in Jordan.

    Science.gov (United States)

    Al Hayek, Ayman A; Khawaja, Nahla M; Khader, Yousef S; Jaffal, Sahar K; Ajlouni, Kamel M

    2014-01-01

    Determine the prevalence of hypogonadism among diabetic and non-diabetic men in Jordan. A cross-sectional study of 1717 men (1089 participants with type 2 diabetes and 628 non-diabetic subjects). Both groups were inquired to answer the Androgen Deficiency for aging male (ADAM) questionnaire. Early morning Total testosterone, prolactin, sex hormone binding globulin, follicle stimulating hormone, leutinizing hormone, HbA1c and fasting blood sugar were measured. Hypogonadism was defined as total testosterone Hypogonadism among all study participants was 18.5%. The prevalence of Hypogonadism in diabetic and non-diabetic men was 24.3% and 8.3%, respectively. The mean (SD) total testosterone concentration of diabetic and non-diabetic men was 3.78 ng/ml (1.7) and 4.92 ng/ml (2.5), respectively (P- value Hypogonadism and symptomatic androgen deficiency were negatively and significantly related to diabetes, monthly income and age (P value Hypogonadism is a prevalent disorder among Jordanian diabetic population. Symptoms of androgen deficiency should be corroborated with testosterone level to establish a multidisciplinary approach for management of hypogonadism. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Ghrelin and PYY levels in adolescents with severe obesity: effects of weight loss induced by long-term exercise training and modified food habits.

    Science.gov (United States)

    Gueugnon, Carine; Mougin, Fabienne; Nguyen, Nhu Uyen; Bouhaddi, Malika; Nicolet-Guénat, Marie; Dumoulin, Gilles

    2012-05-01

    This study investigated (a) changes in ghrelin and peptide YY (PYY) concentrations during a weight reduction programme and (b) baseline ghrelin and PYY levels as predictors of weight loss in 32 severely obese adolescents (BMI z score = 4.1). Subjects spent an academic year in an institution for childhood obesity. Fasting ghrelin and PYY, leptin, insulin levels and insulin resistance were measured at baseline (month 0) and during the programme (months 3, 6, 9). In addition, 15 normal-weight teenagers served as reference for the baseline assessments. At baseline, obese teenagers had lower ghrelin and PYY concentrations than normal-weight adolescents (P modification, there was a significant decrease in body weight among obese teenagers, associated with an increase in ghrelin (apparent from month 6; P modification. However, higher baseline PYY tended to correlate with greater anthropometrical changes (P < 0.1). In adolescents with severe obesity, a long-term combination of supervised aerobic exercises and a balanced diet led to weight reduction and increased ghrelin concentrations, without any change in PYY concentrations. Moreover, baseline PYY concentrations might be considered as predictors of weight loss.

  10. Comparison of diabetics and non-diabetics presenting with acute myocardial infraction

    International Nuclear Information System (INIS)

    Naseem, A.; Moin, S.

    2002-01-01

    Objective: To identify differences in incidence and clinical manifestations of acute myocardial infarction (AMI) and prevalence of coronary disease risk factors in diabetic and non-diabetics. Design: A prospective longitudinal survey. Place and duration of study: The study was carried out in Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi, over a period of one month (1st August to 1st September, 1994). Subject and Methods: After fulfilling the inclusion criteria, a total of 100 patients were included in the study. Fifty patients had diabetes and AMI while 50 patients had AMI but were not diabetic. All the patients were studies for at least 15 days in hospital and data collected on a pre-designed proforma. Results: Among diabetic patients, 84% were not insulin-dependant, while remaining 16% were on insulin therapy. Duration of diabetes was over 20 years in 18% between 10 and 20 years in 62% and less than 10 years in 8%. Male to female ratio was 7.3:1 in non-diabetic group while in diabetic group it was 4.5:1. Mean age at the time of the first AMI was 54.6 years in non-diabetic group and 52.8 years in diabetic group, with women in diabetic group having mean age of 51.9 years, men 53.2 years, while non-diabetic women had a mean age of 54.2 years and the men 55 years. Incidence of hypertension was 32% among diabetic patients and 24% among non-diabetics. Lipid abnormalities were 44% in diabetic group and 36% in non-diabetic group the most common mode of presentation in both groups was chest pain or chest discomfort, but one-fourth of the diabetics presented without any chest pain. Q-wave AMI of the anterior wall of the myocardium predominated in both group, but non-Q wave infarctions were more frequent in the diabetic group (28% vs. 16%). Diabetic group tended to be identified later and only half the diabetics with AMI qualified for thrombolytic therapy as compared to more than 2/3 cases of the non-diabetic group

  11. Cost-effectiveness of intensive inpatient treatments for severely obese children and adolescents in the Netherlands; a randomized controlled trial (HELIOS)

    NARCIS (Netherlands)

    Makkes, Sabine; Halberstadt, Jutka; Renders, Carry M; Bosmans, Judith E; van der Baan-Slootweg, Olga H; Seidell, Jacob C

    2011-01-01

    BACKGROUND: Intensive combined lifestyle interventions are the recommended treatment for severely obese children and adolescents, but there is a lack of studies and their cost-effectiveness. The objective of this study is to compare the cost-effectiveness of two intensive one-year inpatient

  12. Antioxidant status in diabetic and non-diabetic senile patients, with cataract or cardiovascular complications

    International Nuclear Information System (INIS)

    Gul, A.; Rahman, Muhammad A.

    2008-01-01

    Objective was to assess the total antioxidant status in diabetic and non-diabetic senile patients, with cataract or cardiovascular complications, and without complications. A comparative study on 186 senile patients and control subjects was carried from March 2004 to November 2006 on patients from Ziauddin University Hospital, Karachi, Pakistan. Among them 33 were diabetic patients without any clinical evidence of chronic diabetic complications, 32 with cardiovascular complications, 30 non-diabetic patients with cardiovascular complications, 30 diabetic patients with cataract and 31 apparently normal, age, gender and weight matched control subjects were investigated. All patients were selected on clinical grounds. Total antioxidant status was significantly decreased (p<0.001) in all diabetic patients with and without complications and non-diabetic patients with same complications (155 patients) as compared with control subjects (31 subjects). Fasting plasma glucose was increased (p<0.001) in all diabetic patients with and without complications (95 patients), and correlated significantly with glycosylated hemoglobin (HbA1c) and serum fructosamine concentrations. Fasting plasma glucose, HbA1c, and serum fructosamine were not different in diabetic patients with and without complications. Fasting plasma glucose, HbA1c, serum fructosamine and total serum protein were not different in non-diabetic patients with the same complications as compared with control subjects. Total antioxidant status is decreased in diabetic and non-diabetic senile patients with the same complication as compared with same complication as compared with control subjects. Some other factors may be responsible for decease antioxidant status. (author)

  13. Cardiac and metabolic changes in long-term high fructose-fat fed rats with severe obesity and extensive intramyocardial lipid accumulation

    DEFF Research Database (Denmark)

    Axelsen, Lene N; Lademann, Jacob B; Petersen, Jørgen S

    2010-01-01

    Metabolic syndrome and obesity-related diseases are affecting more and more people in the Western world. The basis for an effective treatment of these patients is a better understanding of the underlying pathophysiology. Here, we characterize fructose- and fat-fed rats (FFFRs) as a new animal model....... FFFRs developed severe obesity, decreased glucose tolerance, increased serum insulin and triglyceride levels, and an initial increased fasting glucose, which returned to control levels after 24 wk of feeding. The diet had no effect on blood pressure but decreased hepatic PEPCK levels. FFFRs showed...

  14. Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects

    DEFF Research Database (Denmark)

    Bruun, Jens M; Helge, Jørn W; Richelsen, Bjørn

    2006-01-01

    Obesity is associated with low-grade inflammation, insulin resistance, type 2 diabetes, and cardiovascular disease. This study investigated the effect of a 15-wk lifestyle intervention (hypocaloric diet and daily exercise) on inflammatory markers in plasma, adipose tissue (AT), and skeletal muscle...... (SM) in 27 severely obese subjects (mean body mass index: 45.8 kg/m2). Plasma samples, subcutaneous abdominal AT biopsies, and vastus lateralis SM biopsies were obtained before and after the intervention and analyzed by ELISA and RT-PCR. The intervention reduced body weight (P

  15. Severe maternal stress exposure due to bereavement before, during and after pregnancy and risk of overweight and obesity in young adult men: a Danish National Cohort Study.

    Directory of Open Access Journals (Sweden)

    Lena Hohwü

    Full Text Available BACKGROUND: Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men. METHODS: A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group. Median body mass index (BMI and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25 kg/m2 and obesity (BMI≥30 kg/m2 were estimated by logistic regression analysis adjusted for maternal educational level. RESULTS: Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02 and obesity (9.8% versus 8.5%, p = 0.06 was higher in the exposed group. Conscripts exposed 6 to 0 months before conception and during pregnancy had a higher risk of overweight (odds ratio 1.15, 95% confidence interval (CI: 1.03; 1.27 and odds ratio 1.13, 95% CI: 1.03; 1.25, respectively. Conscripts born to mothers who experienced death of the child's biological father before child birth had a two-fold risk of obesity (odds ratio 2.00, 95% CI: 0.93; 4.31. There was no elevated risk in those who experienced maternal bereavement postnatally. CONCLUSION: Maternal bereavement during the prenatal period was associated with increased risk of overweight or obesity in a group of young male conscripts, and this may possibly be reflected to severe stress exposure early in life. However, not all associations were clear, and further studies are warranted.

  16. Severe maternal stress exposure due to bereavement before, during and after pregnancy and risk of overweight and obesity in young adult men: a Danish National Cohort Study.

    Science.gov (United States)

    Hohwü, Lena; Li, Jiong; Olsen, Jørn; Sørensen, Thorkild I A; Obel, Carsten

    2014-01-01

    Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men. A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group). Median body mass index (BMI) and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) were estimated by logistic regression analysis adjusted for maternal educational level. Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02) and obesity (9.8% versus 8.5%, p = 0.06) was higher in the exposed group. Conscripts exposed 6 to 0 months before conception and during pregnancy had a higher risk of overweight (odds ratio 1.15, 95% confidence interval (CI): 1.03; 1.27 and odds ratio 1.13, 95% CI: 1.03; 1.25, respectively). Conscripts born to mothers who experienced death of the child's biological father before child birth had a two-fold risk of obesity (odds ratio 2.00, 95% CI: 0.93; 4.31). There was no elevated risk in those who experienced maternal bereavement postnatally. Maternal bereavement during the prenatal period was associated with increased risk of overweight or obesity in a group of young male conscripts, and this may possibly be reflected to severe stress exposure early in life. However, not all associations were clear, and further studies are warranted.

  17. Reduced Systemic Levels of IL-10 Are Associated with the Severity of Obstructive Sleep Apnea and Insulin Resistance in Morbidly Obese Humans

    Directory of Open Access Journals (Sweden)

    Sonia Leon-Cabrera

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA has been related to elevation of inflammatory cytokines and development of insulin resistance in morbidly obese (MO subjects. However, it is still unclear whether the systemic concentration of anti-inflammatory mediators is also affected in MO subjects directly related to the severity of OSA and level of insulin resistance. Normal weight and MO subjects were subjected to overnight polysomnography in order to establish the severity of OSA, according to the apnea-hypopnea index (AHI. Blood samples were obtained for estimation of total cholesterol and triglycerides, insulin, glucose, insulin resistance, tumor necrosis factor alpha (TNF-α, interleukin 12 (IL12, and interleukin 10 (IL-10. Serum levels of IL-10 were significantly lower in MO subjects with OSA than in MO and control individuals without OSA. Besides being inversely associated with serum TNF-α and IL-12, decreased IL-10 levels were significantly related to increased AHI, hyperinsulinemia, and insulin resistance. Serum IL-10 is significantly reduced in morbidly obese subjects with severe OSA while also showing a clear relationship with a state of hyperinsulinemia and insulin resistance probably regardless of obesity in the present sample. It may be of potential clinical interest to identify the stimulatory mechanisms of IL-10 in obese individuals with OSA.

  18. BMI-for-age graphs with severe obesity percentile curves: tools for plotting cross-sectional and longitudinal youth BMI data.

    Science.gov (United States)

    Racette, Susan B; Yu, Liyang; DuPont, Nicholas C; Clark, B Ruth

    2017-05-24

    Severe obesity is an important and distinct weight status classification that is associated with disease risk and is increasing in prevalence among youth. The ability to graphically present population weight status data, ranging from underweight through severe obesity class 3, is novel and applicable to epidemiologic research, intervention studies, case reports, and clinical care. The aim was to create body mass index (BMI) graphing tools to generate sex-specific BMI-for-age graphs that include severe obesity percentile curves. We used the Centers for Disease Control and Prevention youth reference data sets and weight status criteria to generate the percentile curves. The statistical software environments SAS and R were used to create two different graphing options. This article provides graphing tools for creating sex-specific BMI-for-age graphs for males and females ages 2 to obesity classes 2 and 3, the ability to plot individual data for thousands of children and adolescents on a single graph, and the ability to generate cross-sectional and longitudinal graphs. These new BMI graphing tools will enable investigators, public health professionals, and clinicians to view and present youth weight status data in novel and meaningful ways.

  19. Severe Obesity Impacts Recurrence-Free Survival of Women with High-Risk Endometrial Cancer: Results of a French Multicenter Study.

    Science.gov (United States)

    Canlorbe, Geoffroy; Bendifallah, Sofiane; Raimond, Emilie; Graesslin, Olivier; Hudry, Delphine; Coutant, Charles; Touboul, Cyril; Bleu, Géraldine; Collinet, Pierre; Darai, Emile; Ballester, Marcos

    2015-08-01

    Studies focusing on the impact of obesity on survival in endometrial cancer (EC) have reported controversial results and few data exist on the impact of obesity on recurrence rate and recurrence-free survival (RFS). The aim of this study was to assess the impact of obesity on surgical staging and RFS in EC according to the European Society of Medical Oncology (ESMO) risk groups. Data of 729 women with EC who received primary surgical treatment between January 2000 and December 2012 were abstracted from a multicenter database. RFS distributions according to body mass index (BMI) in each ESMO risk group were estimated using the Kaplan-Meier method. Survival was evaluated using the log-rank test, and the Cox proportional hazards model was used to determine influence of multiple variables. Distribution of the 729 women with EC according to BMI was BMI women with a BMI ≥ 35 (72 %) than for those with a BMI obese women in the low-/intermediate-risk groups, but a BMI ≥ 35 was independently correlated to a poorer RFS (hazard ratio 12.5; 95 % confidence interval 3.1-51.3) for women in the high-risk group. Severe obesity negatively impacts RFS in women with high-risk EC, underlining the importance of complete surgical staging and adapted adjuvant therapies in this subgroup of women.

  20. Effect of a dietary supplement containing kurozu (a Japanese traditional health drink concentrate on several obesity-related parameters in obese Japanese adults: a randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Naobumi Hamadate

    2013-08-01

    Full Text Available ABSTRACTObjective: This study was undertaken to examine the Kurozu concentrate (KC based dietary supplement on several obesity-related parameters in obese Japanese male and female adults.Background: Kurozu, which is a specific type of rice vinegar produced by fermentation of unpolished brown rice, has long been used as a traditional health food and folk medicine in Japan. A recent animal study and our preliminary human study suggest that the KC supplement has potential for use in the management of obesity.Materials and Methods: A 12-week, randomized, double-blind, placebo-controlled trial was conducted involving 48 Japanese adult subjects (28 males and 20 females with obesity. Subjects were either assigned to the group consuming the KC supplement for 12 weeks (870mg/day; 480 mg/day as KC (n=24; 14 males and 10 females or the placebo group (n=24; 14 males and 10 females. All test participants were assessed using several obesity-related parameters, including body weight, BMI, waist circumference, and abdominal fat computed tomography (CT sections. These measurements took place at baseline and at week 12. Results: At week 12, a significant decrease in body weight (P<0.043 and nearly significant decreased values of BMI (P=0.052 were observed in the KC group compared to the placebo group. The reduction in waist circumference at week 12 within the KC group was not significantly greater than the placebo group. Examination of abdominal CT sections around the navel indicated that, although most of the values of the total fat area, subcutaneous fat area, and visceral fat area for both of the placebo and KC groups significantly increased during the 12-week intervention, the magnitude of increase in the total fat area for all subjects and that of the total fat area, subcutaneous fat area, and visceral fat area for females on one or more of three CT sections were significantly lower in the KC group than the placebo group (P<0.05.Conclusion: Although the

  1. Severe Hypertriglyceridemia Possibly Masked Acute Pancreatitis and Led to a Difficult Diagnosis in an Obese Patient with Ketoacidosis-onset Type 2 Diabetes.

    Science.gov (United States)

    Fujishiro, Midori; Horita, Akiko; Nakagawara, Hiroshi; Mawatari, Takayuki; Kishigami, Yoshifusa; Tominaga, Yoshiteru; Moriyama, Mitsuhiko; Ishihara, Hisamitsu

    2017-10-01

    A young obese man with ketoacidosis-onset type 2 diabetes mellitus, associated with severe hypertriglyceridemia, was admitted to a local hospital complaining of abdominal pain. Although the abdominal pain worsened, his serum amylase level remained normal with persistent severe hypertriglyceridemia until the second day of hospitalization. The next day, computed tomography showed severe acute pancreatitis (AP) with serum amylase elevation, while the patient's triglyceride level decreased to 558 mg/dL. He was transferred to our hospital and recovered after intensive care. AP accompanied by diabetic ketoacidosis is not rare but an early diagnosis can be difficult to make due to normal amylase levels in the presence of severe hypertriglyceridemia.

  2. Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin resistance in overweight children and adolescents: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Agarwalla Vipin

    2007-02-01

    Full Text Available Abstract Background The rising prevalence of obesity and metabolic syndrome (MetS has received increased attention since both place individuals at risk for Type II diabetes and cardiovascular disease. Insulin resistance (IR has been implicated in the pathogenesis of obesity and MetS in both children and adults and is a known independent cardiovascular risk factor. However measures of IR are not routinely performed in children while MetS or severe obesity when present, are considered as clinical markers for IR. Objective The study was undertaken to assess the utility of ATPIII defined metabolic syndrome (MetS and severe obesity as predictors of insulin resistance (IR in a group of 576 overweight children and adolescents attending a pediatric obesity clinic in Brooklyn. Methods Inclusion criteria were children ages 3–19, and body mass index > 95th percentile for age. MetS was defined using ATP III criteria, modified for age. IR was defined as upper tertile of homeostasis model assessment (HOMA within 3 age groups (3–8, n = 122; 9–11, n = 164; 12–19, n = 290. Sensitivity, specificity, positive predictive values and odds ratios (OR with 95% confidence intervals (CI were calculated within age groups for predicting IR using MetS and severe obesity respectively. Results MetS was present in 45%, 48% and 42% of the respective age groups and significantly predicted IR only in the oldest group (OR = 2.0, 95% CI 1.2, 3.4; p = .006. Sensitivities were Conclusion The expression of IR in overweight children and adolescents is heterogeneous and MetS or severe obesity may not be sufficiently sensitive and specific indicators of insulin resistance. In addition to screening for MetS in overweight children markers for IR should be routinely performed. Further research is needed to establish threshold values of insulin measures in overweight children who may be at greater associated risk of adverse outcomes whether or not MetS is present.

  3. Effect of GLP-1 receptor agonist treatment on body weight in obese antipsychotic-treated patients with schizophrenia: a randomized, placebo-controlled trial.

    Science.gov (United States)

    Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V; Bak, Nikolaj; Andersen, Ulrik B; Jørgensen, Niklas R; Holst, Jens J; Glenthøj, Birte Y; Ebdrup, Bjørn H

    2017-02-01

    Schizophrenia is associated with cardiovascular co-morbidity and a reduced life-expectancy of up to 20 years. Antipsychotics are dopamine D 2 receptor antagonists and are the standard of medical care in schizophrenia, but the drugs are associated with severe metabolic side effects such as obesity and diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are registered for treatment of both obesity and type 2 diabetes. We investigated metabolic effects of the GLP-1RA, exenatide once-weekly, in non-diabetic, antipsychotic-treated, obese patients with schizophrenia. Antipsychotic-treated, obese, non-diabetic, schizophrenia spectrum patients were randomized to double-blinded adjunctive treatment with once-weekly subcutaneous exenatide (n = 23) or placebo (n = 22) injections for 3 months. The primary outcome was loss of body weight after treatment and repeated measures analysis of variance was used as statistical analysis. Between March 2013 and June 2015, 40 patients completed the trial. At baseline, mean body weight was 118.3 ± 16.0 kg in the exenatide group and 111.7 ± 18.0 kg in the placebo group, with no group differences ( P = .23). The exenatide and placebo groups experienced significant ( P = .004), however similar ( P = .98), weight losses of 2.24 ± 3.3 and 2.23 ± 4.4 kg, respectively, after 3 months of treatment. Treatment with exenatide once-weekly did not promote weight loss in obese, antipsychotic-treated patients with schizophrenia compared to placebo. Our results could suggest that the body weight-lowering effect of GLP-1RAs involves dopaminergic signaling, but blockade of other receptor systems may also play a role. Nevertheless, anti-obesity regimens effective in the general population may not be readily implemented in antipsychotic-treated patients with schizophrenia. © 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  4. Health-Related Quality of Life in Children and Adolescents with Severe Obesity after Intensive Lifestyle Treatment and at 1-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Meeke Hoedjes

    2018-04-01

    Full Text Available Objective: To examine changes in generic and weight-related, health-related quality of life (HRQoL in children and adolescents with severe obesity participating in intensive lifestyle treatment, and to examine whether changes in SDS-BMI were associated with changes in HRQoL. Methods: In this prospective observational study, a referred sample of 120 children and adolescents (8-19 years with severe obesity (SDS-BMI ≥ 3.0, or ≥ 2.3 in combination with obesity-related comorbidity received an intensive 1-year lifestyle treatment with an inpatient period in a specialized childhood obesity center. A weight-related (IWQOL-Kids and three generic (KIDSCREEN-52, PedsQL 4.0, and EuroQol HRQoL questionnaires were administered at baseline (T0, after treatment (T1, and 1 year later (T2. Generalized Linear Mixed Models and partial correlations were used to analyze changes in HRQoL and associations with changes in SDS-BMI. Results: Statistically significant improvements in generic and weight-related HRQoL overall and domain scores were observed at T1and at T2 in comparison with T0, despite partial weight regain from T1 to T2. Larger weight loss at T2 was correlated with larger improvements in physical HRQoL domains. Conclusion: Children and adolescents with severe obesity experienced long-term improvements in generic and weight-related HRQoL after participating in intensive lifestyle treatment, despite partial weight regain.

  5. Prevalence and intensity of hyperglycemia in non-diabetic patients undergoing coronary artery bypass graft surgery with and without cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Azarfarin, R.; Asl, Azin A.

    2008-01-01

    Objective was to study the prevalence and severity of hyperglycemia in nondiabetic patients undergoing cardiac operation. In an observational prospective study, 282 non-diabetic patients underwent elective off-pump (n=101) or non on-pump (n=181) coronary artery bypass grafting (CABG) surgery from March 2006 to July 2007 in Madani Heart Hospital, Tabriz, Iran. Blood glucose (BG) levels were measured during and 24 hours after operation. Frequencies of hyperglycemia (BG>-126 mg/dl) and severe hyperglycemia (BG>-180 mg/dl) and postoperative complications were compared in the 2 study groups. Prevalence of at least one episode of severe hyperglycemia was 54.6% (154/282) in our patients during and 24 hours after operation. Intra-operative hyperglycemia was slightly higher in on-pumping group. Frequency of post-operative hyperglycemia was higher, although not significantly different between the two groups. The 2 study groups were not significantly different in frequency of severe hyperglycemia during operation, although were different within 24 hours postoperative period. Prevalence of hyperglycemia especially severe hyperglycemia was high during, and after operation in both off-pump and on-pump CABG in non-diabetic patients. There was a borderline difference in blood glucose level between on-pump and off-pump CABG patients. It may be prudent to consider glycemic control protocols in these patients especially in early post-operative period. (author)

  6. Nutritional status and birth outcomes of the diabetic and non-diabetic pregnant women.

    Science.gov (United States)

    Begum, S; Huda, S N; Musarrat, N; Ahmed, S; Banu, L A; Ali, S M Keramat

    2002-12-01

    This cross sectional study compares the nutritional status and birth outcomes of 357 diabetic and non-diabetic pregnant women (203 DM and 154 NDM as control). Uncomplicated diabetic and non-diabetic pregnant women of singleton pregnancies with age range of 19-35 years were enrolled at term in BIRDEM hospital. Maternal anthropometry and neonatal anthropometric measurements were taken following standard techniques. Educational level was significantly different between the groups. The diabetic mothers were found significantly less educated (phemoglobin concentration (p values for all: 29.0), on the other hand most of the NDM pregnant mothers were within normal range (BMI: 19.8-26.0). DM pregnant mothers were found more anemic (45.8% vs. 23.4%; pnutritional status. The DM group experienced more anemia and preterm deliveries and macrosomic babies were born only in them.

  7. Body fat related to daily physical activity and insulin concentrations in non-diabetic children

    DEFF Research Database (Denmark)

    Dencker, Magnus; Thorsson, Ola; Karlsson, Magnus K

    2007-01-01

    This study explored the associations between body fat versus daily physical activity and insulin concentrations in non-diabetic young children in a cross-sectional study of 172 children (93 boys and 79 girls) aged 8-11 years. Blood samples were analysed for serum insulin and daily physical activity......%). Body fat distribution was calculated as AFM/TBF. Body fat distribution was independently linked to both insulin concentrations and physical activity. In contrast, TBF, AFM, and BF% were linked to physical activity only and not to insulin concentrations. In conclusion in this population of non-diabetic...... was measured by accelerometers. Time spent performing vigorous activity was estimated from accelerometer data by using established cut-off points. Dual-energy x-ray absorptiometry (DXA) was used to quantify abdominal fat mass (AFM) and total body fat (TBF), also calculated as percentage of body weight (BF...

  8. Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis

    Directory of Open Access Journals (Sweden)

    Jennifer Mancio

    2017-10-01

    Full Text Available Abstract Background Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC and poor outcomes in aortic stenosis (AS. However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. Aims To determine the association of body mass index (BMI and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR. Methods This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Results Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05. At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1–4.9; p = 0.021 and HR with obese/high VAF was 2.5 (95% CI 1.1–5.8; p = 0.031 compared with obese/low VAF patients. Conclusions In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

  9. Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis.

    Science.gov (United States)

    Mancio, Jennifer; Fonseca, Paulo; Figueiredo, Bruno; Ferreira, Wilson; Carvalho, Monica; Ferreira, Nuno; Braga, Pedro; Rodrigues, Alberto; Barros, Antonio; Falcao-Pires, Ines; Leite-Moreira, Adelino; Ribeiro, Vasco Gama; Bettencourt, Nuno

    2017-01-01

    Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF) and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05). At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1-4.9; p = 0.021) and HR with obese/high VAF was 2.5 (95% CI 1.1-5.8; p = 0.031) compared with obese/low VAF patients. In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

  10. Status Oral Higiene Dan Periodontal Pada Pasien Diabetes Melitus Dan Non- Diabetes Di RSUD Dr. Pirngadi

    OpenAIRE

    Butar-Butar, Mardiah Rizqo

    2014-01-01

    Diabetes melitus adalah penyakit gangguan metabolisme ditandai dengan meningkatnya kadar gula darah yang terjadi karena kelainan sekresi insulin, kerja insulin, atau kedua-duanya. Diabetes melitus merupakan salah satu penyakit sistemik yang berperan sebagai faktor risiko penyakit periodontal. Penelitian ini bertujuan untuk mengetahui status oral higiene dan periodontal dan odd rasio periodontitis pada pasien Diabetes melitus dan non-Diabetes. Rancangan penelitian adalah case-control. Popul...

  11. Maternal and fetal cocaine- and amphetamine-regulated transcript in diabetic and non-diabetic pregnancy.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-09-01

    Cocaine- and amphetamine-regulated transcript (CART) is a leptin-regulated anorectic neuropeptide. Increased levels of leptin in cord blood of diabetic mothers have previously been described. The aim of this study was to quantify maternal and fetal serum CART levels in type 1 diabetes mellitus (T1DM, n = 10) and non-diabetic pregnancy (n = 10). Matched maternal serum samples (n = 20) were obtained at 36-weeks gestation and cord samples from the umbilical vein at delivery (n = 20), CART was quantified using a competitive enzyme immunoassay. Statistical analysis was performed using Spearmans correlation and t test. There was no difference in maternal CART levels at 36-weeks gestation between T1DM (mean = 331.13 pg\\/ml, Standard Error of the Mean (SEM) = 114.54) and non-diabetic pregnancy (mean = 195.01 pg\\/ml SEM = 29.37) (p = 0.106). Fetal CART levels in the umbilical vein were similar in T1DM (mean = 199.27 pg\\/ml, SEM = 39.81) and non-diabetic pregnancy (mean = 149.76 pg\\/ml, SEM = 26.08) (p = 0.143). Maternal serum CART levels measured at 36-weeks gestation correlated with maternal BMI at booking (Spearmans ρ = 0.332) (p = 0.001) irrespective of diabetes. Serum CART can be detected in both diabetic and non-diabetic human pregnancy and may play an important role in body mass regulation in pregnancy.

  12. Presentation of frozen shoulder among diabetic and non-diabetic patients☆

    Science.gov (United States)

    Uddin, Mohammad Moin; Khan, Aminuddin A.; Haig, Andrew J.; Uddin, Mohammad Kafil

    2014-01-01

    Objective The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. Design This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Results Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). Conclusions No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes. PMID:25983497

  13. Presentation of frozen shoulder among diabetic and non-diabetic patients.

    Science.gov (United States)

    Uddin, Mohammad Moin; Khan, Aminuddin A; Haig, Andrew J; Uddin, Mohammad Kafil

    2014-12-01

    The literature is inconsistent regarding the level of pain and disability in frozen shoulder patients with or without diabetes mellitus. The aim of this study is to evaluate some demographic features of frozen shoulder patients and to look into the disparity of information by comparing the level of pain and disability due to frozen shoulder between diabetic and non-diabetic people. This is a prospective comparative study. People with frozen shoulder attending an outpatient department were selected by consecutive sampling. Disability levels were assessed by the Shoulder Pain & Disability Index (SPADI). Means of pain and disability scores were compared using unpaired t-test. Among 140 persons with shoulder pain 99 (71.4%) had frozen shoulder. From the participating 40 frozen shoulder patients, 26 (65%) were males and 14 (35%) were females. Seventeen participants (42.5%) were diabetic, two (5%) had impaired glucose tolerance and 21 (52.5%) patients were non-diabetic. Mean disability scores (SPADI) were 51 ± 15.5 in diabetic and 57 ± 16 in non-diabetic persons. The differences in pain and disability level were not statistically significance (respectively, p = 0.24 and p = 0.13 at 95% confidence interval). No difference was found in level of pain and disability level between frozen shoulder patients with and without diabetes.

  14. Differences in Urinary Arsenic Metabolites between Diabetic and Non-Diabetic Subjects in Bangladesh

    Directory of Open Access Journals (Sweden)

    Tamie Nakajima

    2013-03-01

    Full Text Available Ingestion of inorganic arsenic (iAs is considered to be related to the development of diabetes mellitus. In order to clarify the possible differences in the metabolism in diabetics, we measured urinary iAs metabolites in diabetic cases and non-diabetic control subjects in Faridpur, an arsenic-contaminated area in Bangladesh. Physician-diagnosed type 2 diabetic cases (140 persons and non-diabetic controls (180 persons were recruited. Drinking water and spot urine samples were collected. Mean concentrations of total arsenic in drinking water did not differ between cases (85.1 μg/L and controls (85.8 μg/L. The percentage of urinary iAs (iAs% was significantly lower in cases (8.6% than in controls (10.4%, while that of dimethylarsinic acid (DMA% was higher in cases (82.6% than in controls (79.9%. This may have been due to the higher secondary methylation index (SMI in the former (11.6 rather than the latter (10.0. Adjusting for matching factors (sex and unions, and the additional other covariates (age and water arsenic significantly attenuated the differences in iAs%, SMI, and DMA%, respectively, though the difference in monomethylarsonic acid% was newly significant in the latter adjustment. Our study did not suggest any significant differences in urinary arsenic metabolites between diabetic and non-diabetic subjects.

  15. Assessment of lipid profile in Saudi type 2 diabetic and non-diabetic periodontal patients

    International Nuclear Information System (INIS)

    Al-Otaibi, Dalal H.; Babay, Nadir A.; Habib, Syed S.; Almas, K.

    2008-01-01

    Objective was to study the extent of periodontal disease in diabetic and non-diabetic periodontitis patients and to investigate the relationship of dyslipidemia and periodontal disease, in diabetic and non-diabetic periodontitis patients. This is a cross-sectional study at the Department of Preventive Dental Sciences College of Dentistry and Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2003 to June 2004. A total of 90 patients was recruited and divided into 3 equal groups of 30 subjects, with age and gender matched, and divided as follows: group 1 healthy group: periodontally and systemically healthy subjects, group 2 periodontitis group: chronic periodontitis patients with no systemic disease, group 3 diabetic group: chronic periodontitis patients with chronic type 2 diabetes mellitus. Plaque index, bleeding on probing, probing pocket depth PPD, and clinical attachment level CAL were measured at the time of initial examination. The glycated hemoglobin, total cholesterol, low density lipoprotein LDL, triglyceride, high density lipoprotein were also measured. Periodontal parameters PPD and CAL were of significantly higher value in the diabetic patients, when compared to the periodontitis patients p<0.05. The total cholesterol, LDL, and triglyceride were also found to be significantly higher among the periodontitis patients than the healthy subjects p<0.05. This study indicated that type 2 diabetic patients had a higher risk to developed advanced periodontal disease hat the non-diabetic subjects. It also highlighted the association of dyslipidemia in periodontitis patients. (author)

  16. [Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group].

    Science.gov (United States)

    García-Humbría, Leila; Richard-Yegres, Nicole; Pérez-Blanco, Maigualida; Yegres, Francisco; Mendoza, Mireya; Acosta, Arnaldo; Hernández, Rosaura; Zárraga, Eluz

    2005-03-01

    Superficial mycoses are considered to affect more frequently patients with type 2 diabetes mellitus (DM-2), specially onychomycosis and Tinea pedis. The purpose of this study was to compare the dermatophytoses, candidiasis and Pitiriasis versicolor frequency between 40 patients with DM-2 and 40 healthy persons of either sex, 40 years old or more. Clinical, metabolic, mycologic and inmunologic studies against Candida albicans, were carried out. Both diabetics 75% (30/40) and controls 65% (26/40) presented a high frequency of superficial mycoses (no significant difference p = 0.329). Pitiriasis versicolor was not detected in diabetic patients. They presented Tinea unguium, concomitant with Tinea pedis, with a higher frequency. The predominant dermatophyte was Trichophyton rubrum 18/23 (78%) in diabetics and 8/16 (50%) in non diabetics. Candida was isolated as commensal from oral mucous: 23/40 (58%) in diabetics and 21/40 (52%) in non diabetics (serotipo A was the more frequent), and from onychomycosis: 11/40 (28%) in diabetics and 12/40 (30%) in non diabetics. The immunological response was the same in both groups: celular 100%, humoral 20%. No statistical correlation among superficial mycoses, blood glucose level, glycosylated hemoglobin values or the time suffering the disease was observed. The high susceptibility to dermatophytes and Candida sp. infection showed to be associated with age and no with the diabetic type 2 condition in those patients.

  17. Comparison of blood electrolytes and glucose during cardiopulmonary bypass in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Golamreza Maasoumi

    2013-01-01

    Full Text Available Background: Cardiopulmonary bypass (CPB during coronary artery bypass grafting is thought to contribute significantly to increased blood glucose level and altered blood electrolytes balance during the operation. In this (CABG study, blood electrolytes and glucose during CPB in insulin-dependent diabetic and non-diabetic patients were assessed with special emphasis on the trend of the changes. Materials and Methods: Blood glucose and electrolytes were assessed in 30 insulin-dependent diabetic and 30 non-diabetic patients, classified as class II and III American Society of Anesthesiologist, before, during, and after CPB. Repeated-measures analysis of variance (ANOVA was used to compare the trend of the changes during CPB for the two groups. Results: The trend in blood glucose level did not show any significant difference between two groups ( P = 0.59. For other blood factors, no significant between-group difference was detected except for PaCO 2 ( P = 0.002. Conclusion: The study suggested that the changes in blood electrolytes and the increase in blood glucose level do not differ between insulin dependent diabetic and non-diabetic patients.

  18. Assessment of lipid profile in Saudi type 2 diabetic and non-diabetic periodontal patients

    Energy Technology Data Exchange (ETDEWEB)

    Al-Otaibi, Dalal H; Babay, Nadir A [Dept. of Preventive Dental Services, Coll. of Dentistry, King Saud Univ., Riyadh (Saudi Arabia); Habib, Syed S [Dept. of Physiology, Habib Coll. of Medicine, King Khalid Univ. Hospital, Riyadh (Saudi Arabia); Almas, K [Dept. of Periodontology, Univ. of Connecticut (United States)

    2008-07-01

    Objective was to study the extent of periodontal disease in diabetic and non-diabetic periodontitis patients and to investigate the relationship of dyslipidemia and periodontal disease, in diabetic and non-diabetic periodontitis patients. This is a cross-sectional study at the Department of Preventive Dental Sciences College of Dentistry and Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2003 to June 2004. A total of 90 patients was recruited and divided into 3 equal groups of 30 subjects, with age and gender matched, and divided as follows: group 1 healthy group: periodontally and systemically healthy subjects, group 2 periodontitis group: chronic periodontitis patients with no systemic disease, group 3 diabetic group: chronic periodontitis patients with chronic type 2 diabetes mellitus. Plaque index, bleeding on probing, probing pocket depth PPD, and clinical attachment level CAL were measured at the time of initial examination. The glycated hemoglobin, total cholesterol, low density lipoprotein LDL, triglyceride, high density lipoprotein were also measured. Periodontal parameters PPD and CAL were of significantly higher value in the diabetic patients, when compared to the periodontitis patients p<0.05. The total cholesterol, LDL, and triglyceride were also found to be significantly higher among the periodontitis patients than the healthy subjects p<0.05. This study indicated that type 2 diabetic patients had a higher risk to developed advanced periodontal disease hat the non-diabetic subjects. It also highlighted the association of dyslipidemia in periodontitis patients. (author)

  19. Intensive lifestyle intervention provides rapid reduction of serum fatty acid levels in women with severe obesity without lowering omega?3 to unhealthy levels?

    OpenAIRE

    Lin, C.; Andersen, J. R.; V?ge, V.; Rajalahti, T.; Mj?s, S. A.; Kvalheim, O. M.

    2016-01-01

    Summary Serum fatty acid (FA) levels were monitored in women with severe obesity during intensive lifestyle intervention. At baseline, total FA levels and most individual FAs were elevated compared to a matching cohort of normal and overweight women (healthy controls). After 3 weeks of intensive lifestyle intervention, total level was only 11?12% higher than in the healthy controls and with almost all FAs being significantly lower than at baseline, but with levels of omega?3 being similar to ...

  20. Laparoscopic Surgical Treatment of Severe Obesity Combined with Gastroesophageal Reflux Disease: A Pilot Randomized Two-Arm Controlled Clinical Study

    Science.gov (United States)

    Ospanov, Oral B.; Orekeshova, Akzhunis M.; Fursov, Roman A.; Yelemesov, Aset A.

    2016-01-01

    Obesity and gastroesophageal reflux disease (GERD) are serious medical, social, and economic problems of modern society. A pilot randomized two-arm controlled clinical study was conducted to compare laparoscopic plication of the greater gastric curvature combined with Nissen fundoplication (LFN+LGP) versus only Nissen fundoplication (LFN). The…

  1. Comparison of Oral Manifestations of Diabetic and Non-Diabetic Uremic Patients Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Seyed Javad Kia

    2014-06-01

    Full Text Available Background & Objectives: Chronic renal failure (CRF, also known as chronic kidney disease, caused by devastated nephron mass of the kidney results in uremia. Hypertension, diabetes mellitus and glomerulonephritis are common etiologic factors of CRF. This condition causes miscellaneous oral manifestations especially in diabetic patients. The aim of this study was to comparison oral manifestations of diabetic and non-diabetic uremic patients undergoing hemodialysis.   Methods: A total of 95 patients who undergoing hemodialysis in Razi hospital in Rasht city participated in this descriptive analytical study. Patients were divided into two diabetic and non- diabetic groups. Oral cavity examinations were done by latex gloves and single use mirror. Objective and subjective oral manifestations such as xerostomia, bad taste, mucosal pain, uremic odor, coating tongue, petechial, purpura, pale oral mucosa, ulcer, dental erosion and candida infection were recorded in questionnaire. After gathering of information, the data were analyzed by SPSS 15 software using t-test and chi square statistical test.   Results: About 60% of patients (57 person were men and 40 % (38 person were women. The mean age of patients was 48 years (range of 20 -76 years. Common subjective oral manifestation in both groups was xerostomia and most common objective oral manifestations were pale oral mucosa, uremic odor and coating tongue respectively. The DMFT index in diabetic group was significantly higher (17.3±7.63 than non-diabetic patients (12.4±8.26. There was no significant statistical correlation between the time of dialysis, number of dialysis appointment during the week and objective and subjective oral manifestations in two groups.   Conclusion: Although, the present study has shown an increase in oral manifestations in diabetic patients undergoing hemodialysis relative to non-diabetic group, but this increase was not statistically significant. On the other hand

  2. The DSM-5 effect: psychological characteristics of new patients affected by Binge Eating Disorder following the criteria of the DSM-5 in a sample of severe obese patients.

    Science.gov (United States)

    Vinai, Piergiuseppe; Da Ros, Annalisa; Cardetti, Silvia; Casey, Halpern; Studt, Stacia; Gentile, Nicola; Tagliabue, Anna; Vinai, Luisa; Vinai, Paolo; Bruno, Cecilia; Mansueto, Giovanni; Palmieri, Sara; Speciale, Maurizio

    2016-03-01

    The current study evaluated whether or not there were significant differences in psychopathological traits between three groups of individuals. The first was a group of patients seeking bariatric surgery diagnosed as being affected by Binge Eating Disorder (BED), according to the new criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. This group (NEW BED group) did not meet BED diagnosis following the previous criteria listed in the DSM-IV-TR. The second group of individuals was composed of severely obese patients seeking bariatric surgery not affected by an eating disorder, according to the diagnostic criteria of the DSM-5 (OB group). The third group was composed of individuals within a healthy weight range (Control group). 94 severely obese patients (33 in the NEW BED group and 61 in the OB group) were compared to the Control group including 41 participants on depression, anxiety and eating habits. The NEW BED scored significantly higher than the OB group on the Beck Depression Inventory, both the subscales of the State Trait Anxiety Inventory, on disinhibition and hunger subscales of the Three-Factor Eating Questionnaire and on many subscales of the Eating Disorders Inventory. The new, less restrictive diagnostic criteria for BED of the DSM-5 are useful in identifying obese patients affected by severe psychopathology and dysfunctional eating habits.

  3. Serum vaspin level as a predictive indicator in the amelioration of fatty liver and metabolic disturbance in patients with severe obesity after laparoscopic vertical banded gastroplasty.

    Science.gov (United States)

    Wang, Yong; Yu, Zong-Fan; Cheng, Yun-Sheng; Jia, Ben-Li; Yu, Gang; Yin, Xiao-Qiang; Wang, Yang

    2017-07-01

    This study is all about predicting the value of serum vaspin level in the amelioration of fatty liver and metabolic disturbance in patients with severe obesity after laparoscopic vertical banded gastroplasty (LVBG). A total of 164 patients (from January 2012 to May 2015) with severe obesity were chosen and performed LVBG. Enzyme-linked immunosorbent assay was performed to detect the serum vaspin level. The patients were given a biochemical automatic analyzer to measure the biochemical indicators. Homeostasis model assessment (HOMA) helps in the calculation of fasting insulin level (FINS) and insulin resistance (IR). The changes in fatty liver were examined by computed tomography (CT). Receiver operating characteristic curve is used to increase the predictive value of serum vaspin level in the amelioration of liver function and disturbances in the metabolism. Weight, BMI, waist circumference, serum vaspin level, and triglyceride (TG) decreased, but CT value of liver increased at 4th, 7th, and 12th month after surgery. After the 7th and 12th month period of surgery, the alanine aminotransferase, aspartate aminotransferase, FINS, and HOMA-IR reduced in the patients (P fatty liver and metabolic disturbance. This study proves that the serum vaspin level serves as a predictive indicator in the amelioration of fatty liver and metabolic disturbance in patients with severe obesity after LVBG.

  4. Development of a group therapy to enhance treatment motivation and decision making in severely obese patients with a comorbid mental disorder.

    Science.gov (United States)

    Wild, Beate; Herzog, Wolfgang; Wesche, Daniela; Niehoff, Dorothea; Müller, Beat; Hain, Bernhard

    2011-05-01

    The prevalence rate of mental disorders in severely obese patients appears to be high. In the Department of Psychosomatic Medicine, Heidelberg, we established a short outpatient group intervention for severely obese patients with an affective, anxiety, and/or eating disorder who either are not able to make a clear decision for an intensive weight loss program or who have already decided to undergo bariatric surgery but are advised to attend a support group before surgery. The aim of the group intervention was to reduce depressive symptoms and, in indecisive patients, to enhance the motivation of the patients for engagement in further intensive treatment programs, including bariatric surgery. Descriptive data of the first two intervention groups are provided. The treatment program and topics of the group sessions are explained. Time series analysis methods are used to investigate the development of a single patient during the intervention program. Initially, 16 patients joined the group program; ten of these attended the group therapy to completion. The remaining ten patients showed clinically relevant reduction in depression levels and improvement in mental quality of life. Results of the single-case time series analysis indicate that the temporal relationship between eating behavior and depression changed during treatment. The group program, as outlined, could be a useful intervention for severely obese patients with comorbid depression, anxiety, or eating disorder. A gap in the health care system is thus bridged by this short intervention that can encourage further treatment decisions such as bariatric surgery.

  5. A 2-Week Course of Enteral Treatment with a Very Low-Calorie Protein-Based Formula for the Management of Severe Obesity

    Directory of Open Access Journals (Sweden)

    Giuseppe Castaldo

    2015-01-01

    Full Text Available Background. Multiple weight loss failures among obese patients suggest the design of new therapeutic strategies. We investigated the role of 2-week course of enteral treatment with a very low-calorie protein-based formula in the management of severe obesity. Methods. We evaluated the feasibility, safety, and efficacy of 2-week continuous administration of a protein-based formula (1.2 g/kg of ideal body weight/day by nasogastric tube in severely obese adults (body mass index (BMI ≥ 40 kg/m2. Results. In total, 364 patients (59% women; BMI = 46.6±7.2 kg/m2 were recruited. The intervention was discontinued within 48 hours in 26 patients, due to nasogastric tube intolerance. No serious adverse events occurred. During the first and the second week, 65% and 80% patients, respectively, reported no side effects. All biochemical safety parameters were affected by the intervention, particularly uric acid (+45% and aminotransferases (+48%. In the other cases the change was negligible. We observed significant weight loss (5.7±2.3% and improvement in blood pressure and glucose and lipid metabolism parameters (P<0.001. Conclusions. A 2-week course of enteral treatment with a very low-calorie protein-based formula appeared a feasible, likely safe, and efficacious therapeutic option to be considered for inclusion into a composite weight loss program for the management of severe obesity. This trial is registered with ClinicalTrials.gov Identifier: NCT01965990.

  6. Inflammatory status is different in relationship to insulin resistance in severely obese people and changes after bariatric surgery or diet-induced weight loss.

    Science.gov (United States)

    Ballesteros-Pomar, M D; Calleja, S; Díez-Rodríguez, R; Calleja-Fernández, A; Vidal-Casariego, A; Nuñez-Alonso, A; Cano-Rodríguez, I; Olcoz-Goñi, J L

    2014-11-01

    To assess if insulin resistance is related to a different inflammatory status (especially lymphocyte subpopulations) in severely obese people and to evaluate changes after weight loss either following a very-low calorie diet (VLCD) or bariatric surgery. Severely obese patients were consecutively recruited in our Obesity Unit. Blood lymphocyte subpopulations and inflammatory parameters were measured baseline, after a VLCD during 6 weeks and one year after biliopancreatic diversion. Insulin resistance was evaluated by Homeostasis Model Assessment (HOMA) index. After excluding diabetic patients, 58 patients were studied. HOMA index classified 63.8% of them as insulin resistant (IR). Serum baseline levels of inflammatory cytokines were not significantly different between IR and insulinsensitive (IS) patients but, regarding lymphocyte subpopulations, Natural Killer (NK) cells were higher in IR patients [(305.0 (136.7) vs. 235.0 (80.7) cells/µL, p=0.047]. NK cells showed a significant positive correlation with HOMA index (r=0.484, p=0.000) and with the carbohydrate content of the diet (r=0.420, p=0.001). After VLCD, NK cells significantly decreased, but only in IR patients and in those losing more than 10% of their initial weight. After biliopancreatic diversion, total and CD8 T Lymphocytes, B lymphocytes and NK cells also decreased but only in IR individuals. NK cells are significantly increased in IR severely obese people in respect to IS, suggesting a slightly different immune status in these patients with a probable dietary relationship. Weight loss could reverse this increase either after VLCD or after bariatric surgery. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  7. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

    International Nuclear Information System (INIS)

    Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M.; Nevitt, M.C.; Lynch, J.; McCulloch, C.E.

    2012-01-01

    To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI 2 , n = 38), overweight (BMI 25-29.9 kg/m 2 , n = 37), and obese (BMI ≥ 30 kg/m 2 , n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

  8. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M. [University of California San Francisco, Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, M.C.; Lynch, J.; McCulloch, C.E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

    2012-06-15

    To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI < 25 kg/m{sup 2}, n = 38), overweight (BMI 25-29.9 kg/m{sup 2}, n = 37), and obese (BMI {>=} 30 kg/m{sup 2}, n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

  9. Changes in Functional Mobility and Musculoskeletal Pain After Bariatric Surgery in Teens With Severe Obesity: Teen-Longitudinal Assessment of Bariatric Surgery (LABS) Study.

    Science.gov (United States)

    Ryder, Justin R; Edwards, Nicholas M; Gupta, Resmi; Khoury, Jane; Jenkins, Todd M; Bout-Tabaku, Sharon; Michalsky, Marc P; Harmon, Carroll M; Inge, Thomas H; Kelly, Aaron S

    2016-09-01

    Severe obesity is associated with mobility limitations and higher incidence of multijoint musculoskeletal pain. It is unknown whether substantial weight loss improves these important outcomes in adolescents with severe obesity. To examine the association of bariatric surgery with functional mobility and musculoskeletal pain in adolescents with severe obesity up to 2 years after surgery. The Teen-Longitudinal Assessment of Bariatric Surgery Study is a prospective, multicenter, observational study, which enrolled 242 adolescents (≤19 years of age) who were undergoing bariatric surgery from March 2007 through February 2012 at 5 US adolescent bariatric surgery centers. This analysis was conducted in November 2015. Roux-en-Y gastric bypass (n = 161), sleeve gastrectomy (n = 67), or laparoscopic adjustable gastric band (n = 14). Participants completed a 400-m walk test prior to bariatric surgery (n = 206) and at 6 months (n = 195), 12 months (n = 176), and 24 months (n = 149) after surgery. Time to completion, resting heart rate (HR), immediate posttest HR, and HR difference (resting HR minus posttest HR) were measured and musculoskeletal pain concerns, during and after the test, were documented. Data were adjusted for age, sex, race/ethnicity, baseline body mass index (calculated as weight in kilograms divided by height in meters squared), and surgical center (posttest HR and HR difference were further adjusted for changes in time to completion). Of the 206 adolescents with severe obesity included in the study, 156 were female (75.7%), the mean (SD) age was 17.1 (1.6) years, and the mean (SD) body mass index was 51.7 (8.5). Compared with baseline, significant improvements were observed at 6 months for the walk test time to completion (mean, 376 seconds; 95% CI, 365-388 to 347 seconds; 95% CI, 340-358; P concerns at all points. These data provide evidence that bariatric surgery in adolescents with severe obesity is associated with

  10. Cost-effectiveness of intensive inpatient treatments for severely obese children and adolescents in the Netherlands; a randomized controlled trial (HELIOS

    Directory of Open Access Journals (Sweden)

    van der Baan-Slootweg Olga H

    2011-06-01

    Full Text Available Abstract Background Intensive combined lifestyle interventions are the recommended treatment for severely obese children and adolescents, but there is a lack of studies and their cost-effectiveness. The objective of this study is to compare the cost-effectiveness of two intensive one-year inpatient treatments and usual care for severely obese children and adolescents. Methods/Design Participants are 40 children aged 8-13 and 40 adolescents aged 13-18 with severe obesity (SDS-BMI ≥ 3.0 or SDS-BMI ≥ 2.3 with obesity related co-morbidity. They will be randomized into two groups that will receive a comprehensive treatment program of 12 months that focuses on nutrition, physical activity and behavior change of the participant and their parents. The two programs are the same in total duration (12 months, but differ in inpatient treatment duration. Group A will participate in a 6 month intensive inpatient treatment program during weekdays, followed by six monthly return visits of 2 days. Group B will participate in a 2 month intensive inpatient treatment program during weekdays, followed by biweekly return visits of 2 days during the next four months, followed by six monthly return visits of 2 days. Several different health care professionals are involved, such as pediatricians, dieticians, psychologists, social workers, nurses and physiotherapists. Results will also be compared to a control group that receives usual care. The primary outcome is SDS-BMI. Secondary outcomes include quality of life using the EQ-5D and cardiovascular risk factors. Data will be collected at baseline and after 6, 12 and 24 months. An economic evaluation will be conducted alongside this study. Healthcare consumption will be based on actual resource use, using prospective data collection during 2 years through cost diaries. Quality Adjusted Life Years (QALYs will be calculated using the EQ-5D. Discussion This study will provide useful information on the effectiveness and

  11. Clearance of glucoregulatory peptide hormones during haemodialysis and haemodiafiltration in non-diabetic end-stage renal disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Morten B; Idorn, Thomas; Knop, Filip K

    2015-01-01

    BACKGROUND: Patients with end-stage renal disease (ESRD) have increased fasting concentrations and disturbed postprandial responses of several glucoregulatory hormones. We aimed to evaluate the impact of high-flux haemodialysis (HD) and high-volume haemodiafiltration (HDF) on fasting and postpran......BACKGROUND: Patients with end-stage renal disease (ESRD) have increased fasting concentrations and disturbed postprandial responses of several glucoregulatory hormones. We aimed to evaluate the impact of high-flux haemodialysis (HD) and high-volume haemodiafiltration (HDF) on fasting...... and postprandial plasma levels of glucoregulatory pancreatic and gut peptide hormones in ESRD patients. METHODS: Ten non-diabetic HD-treated ESRD patients were included to undergo a 3-h standardized liquid mixed meal test 1 h into an HD and an HDF, respectively. On a third, optional, examination day, the meal test...... during HDF and four completed the optional meal test without dialysis. All plasma hormone concentrations declined significantly during the first fasting hour of dialysis with no differences between HD and HDF. Significant clearance of the investigated hormones was observed for both dialysis modalities...

  12. Traditional and cyberbullying victimization as correlates of psychosocial distress and barriers to a healthy lifestyle among severely obese adolescents – a matched case–control study on prevalence and results from a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background Obese youth are at increased risk for peer victimization, which may heighten their risk of psychosocial problems and physical activity avoidance, and lower the effectiveness of professional and lifestyle weight-loss initiatives. Little is known about obese adolescents’ risk for victimization from cyber-bullying and how this relates to psychosocial functioning and healthy lifestyle barriers. The purpose of the study was to assess traditional and cyber-victimization among adolescents with severe obesity and its relation to psychosocial distress and barriers to healthy lifestyles. Methods A sample of 102 obese adolescents (mean age = 15.32 ±1.71) in residential treatment was matched with 102 normal-weight youngsters from the Health Behavior in School-aged Children (HBSC) study (mean age = 15.30 ±1.73). Results Adolescents with obesity were significantly more often cyber-victimized than normal-weight peers. Obese youth victimized by traditional bullying experienced lower quality of life, lower motivation for physical activity and higher avoidance and emotional coping towards healthy lifestyles than those non-victimized. Obese cyber-victims experienced significantly higher suicidal ideation. Conclusions Traditional and cyber-victimization may hinder treatment effectiveness and healthy lifestyle change in adolescents with obesity. Health professionals should pro-actively address peer victimization and psychosocial functioning during multidisciplinary obesity treatment. Schools could contribute to a better physical and psychosocial health of obese youth by implementing multi-behavioral health-promotion programs. PMID:24593118

  13. Traditional and cyberbullying victimization as correlates of psychosocial distress and barriers to a healthy lifestyle among severely obese adolescents--a matched case-control study on prevalence and results from a cross-sectional study.

    Science.gov (United States)

    DeSmet, Ann; Deforche, Benedicte; Hublet, Anne; Tanghe, Ann; Stremersch, Evi; De Bourdeaudhuij, Ilse

    2014-03-05

    Obese youth are at increased risk for peer victimization, which may heighten their risk of psychosocial problems and physical activity avoidance, and lower the effectiveness of professional and lifestyle weight-loss initiatives. Little is known about obese adolescents' risk for victimization from cyber-bullying and how this relates to psychosocial functioning and healthy lifestyle barriers. The purpose of the study was to assess traditional and cyber-victimization among adolescents with severe obesity and its relation to psychosocial distress and barriers to healthy lifestyles. A sample of 102 obese adolescents (mean age=15.32±1.71) in residential treatment was matched with 102 normal-weight youngsters from the Health Behavior in School-aged Children (HBSC) study (mean age=15.30±1.73). Adolescents with obesity were significantly more often cyber-victimized than normal-weight peers. Obese youth victimized by traditional bullying experienced lower quality of life, lower motivation for physical activity and higher avoidance and emotional coping towards healthy lifestyles than those non-victimized. Obese cyber-victims experienced significantly higher suicidal ideation. Traditional and cyber-victimization may hinder treatment effectiveness and healthy lifestyle change in adolescents with obesity. Health professionals should pro-actively address peer victimization and psychosocial functioning during multidisciplinary obesity treatment. Schools could contribute to a better physical and psychosocial health of obese youth by implementing multi-behavioral health-promotion programs.

  14. Association between circulating irisin and insulin resistance in non-diabetic adults: A meta-analysis.

    Science.gov (United States)

    Qiu, Shanhu; Cai, Xue; Yin, Han; Zügel, Martina; Sun, Zilin; Steinacker, Jürgen Michael; Schumann, Uwe

    2016-06-01

    Exogenous administration of recombinant irisin improves glucose metabolism. However, the association of endogenous circulating (plasma/serum) irisin with insulin resistance remains poorly delineated. This study was aimed to examine this association by meta-analyzing the current evidence without study design restriction in non-diabetic adults. Peer-reviewed studies written in English from 3 databases were searched to December 2015. Studies that reported the association between circulating irisin and insulin resistance (or its reverse, insulin sensitivity) in non-diabetic non-pregnant adults (mean ages ≥18years) were included. The pooled correlation coefficient (r) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses and meta-regression were performed to explore potential sources of heterogeneity. Of the 195 identified publications, 17 studies from 15 articles enrolling 1912 participants reported the association between circulating irisin and insulin resistance. The pooled effect size was 0.15 (95% CI: 0.07 to 0.22) with a substantial heterogeneity (I(2)=55.5%). This association seemed to be modified by glycemic status (fasting blood glucose ≥6.1mmol/L versus insulin sensitivity (6 studies; r=-0.17, 95% CI: -0.25 to -0.09). Circulating irisin is directly and positively associated with insulin resistance in non-diabetic adults. However, this association is rather small and requires further clarification, in particular by well-designed large epidemiological studies with overall, race-, and sex-specific analyses. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Acute effect of different antidepressants on glycemia in diabetic and non-diabetic rats

    Directory of Open Access Journals (Sweden)

    Gomez R.

    2001-01-01

    Full Text Available Diabetic patients have a 20% higher risk of depression than the general population. Treatment with antidepressant drugs can directly interfere with blood glucose levels or may interact with hypoglycemic agents. The treatment of depression in diabetic patients must take into account variations of glycemic levels at different times and a comparison of the available antidepressant agents is important. In the present study we evaluated the interference of antidepressants with blood glucose levels of diabetic and non-diabetic rats. In a first experiment, male adult Wistar rats were fasted for 12 h. Imipramine (5 mg/kg, moclobemide (30 mg/kg, clonazepam (0.25 mg/kg, fluoxetine (20 mg/kg sertraline (30 mg/kg or vehicle was administered. After 30 min, fasting glycemia was measured. An oral glucose overload of 1 ml of a 50% glucose solution was given to rats and blood glucose was determined after 30, 60 and 90 min. Imipramine and clonazepam did not change fasting or overload glycemia. Fluoxetine and moclobemide increased blood glucose at different times after the glucose overload. Sertraline neutralized the increase of glycemia induced by oral glucose overload. In the second experiment, non-diabetic and streptozotocin-induced diabetic rats were fasted, and the same procedures were followed for estimation of glucose tolerance 30 min after glucose overload. Again, sertraline neutralized the increase in glycemia after glucose overload both in diabetic and non-diabetic rats. These data raise the question of whether sertraline is the best choice for prolonged use for diabetic individuals, because of its antihyperglycemic effects. Clonazepam would be useful in cases with potential risk of hypoglycemia.

  16. Comparison of Quality of Life and Coping Strategies in Diabetic and Non Diabetic People

    Directory of Open Access Journals (Sweden)

    J Babapour Kheirodin

    2013-01-01

    Full Text Available Introduction: Diabetic patients face with different physical and psychological challenging factors which impress their quality of life. The major problem of these patients, which has made their life circumstances more complicated, is coping and adapting styles with the illness. So, this study aimed to determine quality of life and also different kinds of coping strategies in patients with type 2 diabetes and also to compare it with those of healthy people. Methods: In this study, sixty diabetic patients (30 male, 30 female, were chosen by available sampling method from the people who referred to Sina Diabetes center in Tabriz and were compared with sixty non diabetic people (30 male, 30 female. Data were collected by two questionnaires including the short form health survey (SF-36 and coping style Inventories. MANOVA method was used to analyze the research data. Results: The study results showed that non diabetics were significantly higher than diabetic patients in regard to quality of life and its dimensions (p<0.001. Also results revealed that non diabetic people used the problem–oriented styles (p<0.001, however diabetic patients used emotional-oriented coping and avoidance strategies more (p<0.05. In this study (in both groups, females in comparison with males had lower score in quality of life and used more emotion-oriented coping styles and less problem-oriented styles. Conclusion: The results indicated that individuals’ quality of life was affected by their coping style with different affairs. Emotional-oriented coping and avoidance strategies were related with decrease of quality of life in diabetic patients whereas problem-oriented styles enhanced it. Therefore, it is necessary to perform interventions for teaching problem solving coping in order to improve these patients' quality of life.

  17. Benazepril slows progression of renal dysfunction in patients with non-diabetic renal disease.

    Science.gov (United States)

    Ishimitsu, Toshihiko; Akashiba, Akira; Kameda, Tomoko; Takahashi, Toshiaki; Ohta, Satoshi; Yoshii, Masayoshi; Minami, Junichi; Ono, Hidehiko; Numabe, Atsushi; Matsuoka, Hiroaki

    2007-06-01

    The present study examined the effects of benazepril, an angiotensin-converting enzyme inhibitor, on the progression of renal insufficiency in patients with non-diabetic renal disease. Fifteen patients with non-diabetic renal disease whose serum creatinine (Cr) ranged from 1.5 to 3.0 mg/dL were given either benazepril (2.5-5 mg) or placebo once daily for 1 year in a random crossover manner. In both periods, antihypertensive medications were increased if blood pressure was greater than 130/85 mmHg. Blood sampling and urinalysis were performed bimonthly throughout the study period. Blood pressure was similar when comparing the benazepril and the placebo periods (128+/-12/83+/-6 vs 129+/-10/83+/-7 mmHg). Serum Cr significantly increased from 1.62+/-0.18 to 1.72+/-0.30 mg/dL (P=0.036) during the placebo period, while there was no statistically significant increase in serum Cr during the benazepril period (from 1.67+/-0.17 to 1.71+/-0.27 mg/dL). The slope of decrease of the reciprocal of serum Cr was steeper in the placebo period than in the benazepril period (-0.073+/-0.067 vs-0.025+/-0.096/year, P=0.014). Urinary protein excretion was lower during the benazepril period than during the placebo period (0.57+/-0.60 vs 1.00+/-0.85 g/gCr, P=0.006). Serum K was significantly higher in the benazepril period than in the placebo period (4.4+/-0.5 vs 4.2+/-0.5 mEq/L, Pbenazepril therapy as a result of hyperkalemia. Long-term benazepril treatment decreased the progression of renal dysfunction in patients with non-diabetic renal disease by a mechanism that is independent of blood pressure reduction.

  18. Candida colonization on the denture of diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Lotfi-Kamran

    2009-01-01

    Full Text Available Background: Oral candidiasis is a common opportunistic infection in diabetic patients. Presence of denture in the oral cavity of diabetic patients can promote Candida colonization and results in the higher incidence of oral and systemic candidiasis. The general purpose of the present study was to evaluate and compare Candida colonization in denture of diabetic patients and non-diabetic control group. Methods: In current case-control study, samples for mycological examinations were collected from the palatal impression surface of maxillary dentures from 92 edentulous patients including 46 dia-betic and 46 non-diabetic denture wearers. All samples were cultured directly on sabouraud agar me-dium and isolated colonies were counted and identified based on specific tests. Data were statistically analyzed using Mann-Whitney and Spearman correlation tests. Results: The higher density of isolated colonies was seen in diabetic group in compare with control group (P = 0.0001. There was a statistically significant correlation between the blood glucose level (P = 0.0001 and the duration of denture usage (P = 0.022 with the colonization of Candida on den-ture of diabetic patients. C. albicans was the most common isolated Candida species in both groups, though diabetic patients with dentures had more non-albicans Candida isolated from their dentures compared to non-diabetic patients. Conclusions: Mycological findings from the present study revealed that diabetes mellitus can in-crease colonization of Candida in denture and mouth. By elimination of local and systemic factors in diabetic patients and improving their oral health care, Candida colonization and the risk of oral and systemic candidiasis will be decreased.

  19. Comparison of Dry Eye Parameters between Diabetics and Non-Diabetics in District of Kuantan, Pahang.

    Science.gov (United States)

    Aljarousha, Mohammed; Badarudin, Noor Ezailina; Che Azemin, Mohd Zulfaezal

    2016-05-01

    Diabetes may affect the human body's systems and organs, including the eye. Diabetic retinopathy is the 5th leading cause of blindness globally. Diabetic subjects demonstrated dry eye symptoms that were also supported by the low values of the clinical tests. This study aimed to compare the dry eye symptoms and signs between diabetics and non-diabetics and tear functions between diabetic subjects with and without dry eye. This retrospective study was based on the observation of 643 medical files. Using a convenience sampling method, 88 subjects were found to report diabetes mellitus. The information extracted from the files included: date of first examination, age at first visit, gender, past ocular history, systemic disease, symptoms of dry eye disease and details of clinical diagnostic signs. Non-contact lens wearers were excluded. A group of 88, age and gender matched, control subjects were included for this comparison study. The percentage of dry eye symptoms was higher in diabetic subjects (15.9%) compared with non-diabetic subjects (13.6%; p<0.001). The percentage of dry eye symptoms was also higher in diabetics with dry eye (63%) than in diabetics without dry eye (36.9%; p<0.001). Tear break up time was significantly different between diabetics and non-diabetics (p<0.001) and between diabetics with and without dry eye (p=0.046). The corneal staining was significantly different between diabetic subjects with and without dry eye (p=0.028). Dry eye symptoms were significantly associated with diabetics. Tear break up time was significantly shorter in diabetics with dry eye compared to diabetics without dry eye.

  20. Relationship between glycaemic levels and arterial stiffness in non-diabetic adults.

    Science.gov (United States)

    Cavero-Redondo, Iván; Martínez-Vizcaíno, Vicente; Álvarez-Bueno, Celia; Recio-Rodríguez, José Ignacio; Gómez-Marcos, Manuel Ángel; García-Ortiz, Luis

    2018-01-23

    To examine, in a non-diabetic population, whether the association between arterial stiffness and glycaemic levels depends on the test used as a glycaemic indicator, fasting plasma glucose (FPG) or glycated haemoglobin A1c (HbA1c). A cross-sectional analysis of a 220 non-diabetic subsample from the EVIDENT II study in which FPG, HbA1c and arterial stiffness-related parameters (pulse wave velocity, radial and central augmentation index, and central pulse pressure) were determined. Mean differences in arterial stiffness-related parameters by HbA1c and FPG tertiles were tested using analysis of covariance. All means of arterial stiffness-related parameters increased by HbA1c tertiles, although mean differences were only statistically significant in pulse wave velocity (p ≤.001), even after controlling for potential confounders (HbA1c <5.30% = 6.88 m/s; HbA1c 5.30%-5.59% = 7.06 m/s; and HbA1c ≥5.60% = 8.16 m/s, p =.004). Conversely, mean differences in pulse wave velocity by FPG tertiles did not reach statistically significant differences after controlling for potential confounders (FPG 4.44 mmol/l = 7.18 m/s; FPG 4.44 mmol/l-4.87 mmol/l = 7.26 m/s; and FPG ≥4.88 mmol/l = 7.93 m/s, p =.066). Glucose levels in a non-diabetic population were associated with arterial stiffness but better when levels were determined using HbA1c. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. Pixel Statistical Analysis of Diabetic vs. Non-diabetic Foot-Sole Spectral Terahertz Reflection Images

    Science.gov (United States)

    Hernandez-Cardoso, G. G.; Alfaro-Gomez, M.; Rojas-Landeros, S. C.; Salas-Gutierrez, I.; Castro-Camus, E.

    2018-03-01

    In this article, we present a series of hydration mapping images of the foot soles of diabetic and non-diabetic subjects measured by terahertz reflectance. In addition to the hydration images, we present a series of RYG-color-coded (red yellow green) images where pixels are assigned one of the three colors in order to easily identify areas in risk of ulceration. We also present the statistics of the number of pixels with each color as a potential quantitative indicator for diabetic foot-syndrome deterioration.

  2. Does weight loss improve semen quality and reproductive hormones? results from a cohort of severely obese men

    Directory of Open Access Journals (Sweden)

    Ernst Emil

    2011-08-01

    Full Text Available Abstract Background A high body mass index (BMI has been associated with reduced semen quality and male subfecundity, but no studies following obese men losing weight have yet been published. We examined semen quality and reproductive hormones among morbidly obese men and studied if weight loss improved the reproductive indicators. Methods In this pilot cohort study, 43 men with BMI > 33 kg/m2 were followed through a 14 week residential weight loss program. The participants provided semen samples and had blood samples drawn, filled in questionnaires, and had clinical examinations before and after the intervention. Conventional semen characteristics as well as sperm DNA integrity, analysed by the sperm chromatin structure assay (SCSA were obtained. Serum levels of testosterone, estradiol, sex hormone-binding globulin (SHBG, luteinizing hormone (LH, follicle-stimulating hormone (FSH, anti-Müllerian hormone (AMH and inhibin B (Inh-B were measured. Results Participants were from 20 to 59 years of age (median = 32 with BMI ranging from 33 to 61 kg/m2. At baseline, after adjustment for potential confounders, BMI was inversely associated with sperm concentration (p = 0.02, total sperm count (p = 0.02, sperm morphology (p = 0.04, and motile sperm (p = 0.005 as well as testosterone (p = 0.04 and Inh-B (p = 0.04 and positively associated to estradiol (p Conclusion This study found obesity to be associated with poor semen quality and altered reproductive hormonal profile. Weight loss may potentially lead to improvement in semen quality. Whether the improvement is a result of the reduction in body weight per se or improved lifestyles remains unknown.

  3. Obesity and fracture risk

    OpenAIRE

    Gonnelli, Stefano; Caffarelli, Carla; Nuti, Ranuccio

    2014-01-01

    Obesity and osteoporosis are two common diseases with an increasing prevalence and a high impact on morbidity and mortality. Obese women have always been considered protected against osteoporosis and osteoporotic fractures. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures.

  4. Hypoadiponectinemia in obese subjects with type II diabetes: A close association with central obesity indices

    Directory of Open Access Journals (Sweden)

    Ghorban Mohammadzadeh

    2011-01-01

    Full Text Available Background: Adiponectin is an adipocyte secreted protein with important biological functions Hypoadiponectinemia is associated with obesity, insulin resistance, and type II diabetes This study aimed to evaluate serum adiponectin level in obese subjects with type II diabetes and its correlation with metabolic parameters Methods: This cross-sectional study was performed on 40 obese subjects with type II diabetes and 40 non-diabetic obese control subjects Fasting lipid profile was measured by the enzymatic methods The NycoCard HbA1c protocol was used to measure HbAlc The Serum adiponectin, insulin and glucose levels were measured using an enzyme immunoassay and glucose oxidase methods respectively Results: Type II diabetes was associated with hypoadiponectinemia, in both men and women Serum adiponectin level in non-diabetic subjects (6.44 ± 2.47 μg/ml was significantly higher than diabetics (4.55 ± 1.88 μg/ml Furthermore, serum adiponectin concentration in females was significantly higher than males in non-diabetics (7.18 ± 2.68 vs 5.61 ± 0.57 and diabetic groups (5.18 ± 2.08 vs 3.99 ± 1.5 There was a negative and significant correlation between serum adiponectin level with waist (r = -0.451, p = 0.003, waist to hip ratio (r = -0.404, p = 0.01 and BMI (r = - 0.322, p = 0.042 and a positive correlation with HDL (r = 0.337, p = 0.034 in non-diabetic group In diabetic group, there was only found a negative correlation between adiponectin and waist size (r = -0.317, p = 0.046 Conclusions: Obesity and type II diabetes are associated with low serum adiponectin concentration

  5. Indications and limitations of bariatric intervention in severely obese children and adolescents with and without nonalcoholic steatohepatitis: ESPGHAN Hepatology Committee Position Statement.

    Science.gov (United States)

    Nobili, Valerio; Vajro, Pietro; Dezsofi, Antal; Fischler, Bjorn; Hadzic, Nedim; Jahnel, Joerg; Lamireau, Thierry; McKiernan, Patrick; McLin, Valerie; Socha, Piotr; Tizzard, Sarah; Baumann, Ulrich

    2015-04-01

    Morbid obesity is strongly associated with nonalcoholic fatty liver disease (NAFLD), which is one of the most common causes of chronic liver disease worldwide. The present best treatment for NAFLD and nonalcoholic steatohepatitis (NASH) is weight reduction through lifestyle modification. Because of frustrating inefficiency of such a therapeutic approach, bariatric surgery is increasingly performed in adolescents as an alternative option for weight reduction. Standards of care and consensus for indications are, however, scarce. We explore the indications and limitations of bariatric surgery in children with severe obesity with and without NASH and aim to provide guidance for the exceptional indications for adolescents with extreme obesity with major comorbidity that may benefit from these controversial interventions. Present evidence suggests that bariatric surgery can decrease the grade of steatosis, hepatic inflammation, and fibrosis in NASH. Uncomplicated NAFLD is not an indication for bariatric surgery. Roux-en-Y gastric bypass is considered a safe and effective option for adolescents with extreme obesity, as long as an appropriate long-term follow-up is provided. Laparoscopic adjustable gastric banding has not been approved by the Food and Drug Administration for use in adolescents and therefore should be considered investigational. Finally, sleeve gastrectomy and other types of weight loss surgery that have grown increasingly common in adults, still need to be considered investigational. Temporary devices may be increasingly being used in pediatrics; however, future studies, including a long-term risk analysis of patients who undergo surgery, are much needed to clarify the exact indications for bariatric surgery in adolescents.

  6. [Benefit from bio-enteric Intra-gastric balloon (BIB) to modify lifestyle and eating habits in severely obese patients eligible for bariatric surgery].

    Science.gov (United States)

    Zago, S; Kornmuller, A M; Agagliati, D; Saber, B; Ferrari, D; Maffeis, P; Labate, M; Bauducco, E; Manghisi, L; Martignone, L; Spanu, M; Rovera, G M

    2006-02-01

    The therapeutic model for severe obesity includes bariatric surgery, representing the safest way to keep weight down and to prevent relapses. The selection of patients for the most suitable type of surgery implies multidisciplinary approach (nutritionist, dietist, clinical psychologist and surgeon). The intragastric balloon may represent a relatively invasive method to help the medical team to select and prepare severely obese patients for restrictive bariatric surgery. In our study we considered 48 severely obese patients: initial weight 111+/-14.8 kg, BMI 43+/-5.02, excess weight 77.47+/-16.14%. These patients have been treated with intragastric balloon (BIB) filled to a volume of 500 cc for 6 months. We considered variations induced by BIB treatment on a number of parameters--clinical, anthropometric, food intake, partition of nourishing elements and psychological and psychometric data. At the end of the treatment the patients showed significant reductions of excess weight (67.35+/-20.19%), of weight (103.4+/-16.72 kg) and food intake, without modification of the items in the EDI2 test, but with important motivational support for a change in life style between the beginning and the end of the treatment, clearly resulting from the medical, dietist and clinical-psychological follow-up. BIB is a relatively invasive means capable of modifying eating habits in the short term; it induces weight loss, may help to reduce the anaesthesiological risk and to foster a change in the patient's behaviour. In our experience treatment with BIB is useful from the educational point of view and can be used to select patients for bariatric surgery only within a multidisciplinary team. Further clinical studies are necessary.

  7. Surgical Site Infection in Diabetic and Non-Diabetic Patients Undergoing Laparoscopic Cholecystectomy

    International Nuclear Information System (INIS)

    Butt, U. I.; Khan, A.; Nawaz, A.; Mansoor, R.; Malik, A. A.; Sher, F.; Ayyaz, M.

    2016-01-01

    Objective: To compare the frequency of surgical site infections in patients with type II diabetes undergoing laparoscopic cholecystectomy as compared with non-diabetic patients. Study Design: Cohort study. Place and Duration of Study: Surgical Unit 2, Services Hospital, Lahore, from May to October 2012. Methodology: Patients were divided into two groups of 60 each, undergoing laparoscopic cholecystectomy. Group A comprised non-diabetic patients and group B comprised type II diabetic patients. Patients were followed postoperatively upto one month for the development of SSIs. Proportion of patients with surgical site infections or otherwise was compared between the groups using chi-square test with significance of p < 0.05. Results: In group A, 35 patients were above the age of 40 years. In group B, 38 patients were above the age of 40 years. Four patients in group A developed a surgical site infection. Seven patients in group B developed SSIs (p = 0.07). Conclusion: Presence of diabetes mellitus did not significantly affect the onset of surgical site infection in patients undergoing laparoscopic cholecystectomy. (author)

  8. Clinical and bacteriological characteristics of pyogenic liver abscess in non-diabetic patients.

    Science.gov (United States)

    Chuang, Han-Chuan; Chen, Te-Li; Chiang, Dung-Hung; Lee, Yi-Tzu; Huang, Ling-Ju; Wang, Fu-Der; Fung, Chang-Phone; Liu, Cheng-Yi

    2009-10-01

    Diabetes mellitus is an important risk factor for Klebsiella pneumoniae liver abscess, but many patients with pyogenic liver abscess (PLA) do not have diabetes. This study was conducted to compare the clinical characteristics and prognostic factors of K. pneumoniae PLA with that caused by other organisms in non-diabetic patients. The medical charts of patients with a diagnosis of PLA were retrospectively reviewed from January 2005 to December 2007. The clinical symptoms and signs, laboratory data, and risk factors were analyzed. There were 50 patients in the K. pneumoniae group and 34 patients in the non-K. pneumoniae group. The clinical presentations did not differ between the 2 groups. The patients in the non-K. pneumoniae group had a higher prevalence of malignant disease than those in the K. pneumoniae group (58.8% vs 6.0%; p factors included chronic renal failure (p = 0.005), abscess rupture (p = 0.036), and right lower lung infiltration (p = 0.049). Hepatobiliary malignancy and newly diagnosed malignancy were risk factors for non-K. pneumoniae liver abscess in non-diabetic patients. Physicians should ascertain the presence of underlying malignancy in patients with non-K. pneumoniae PLA.

  9. Metformin prevents and reverses inflammation in a non-diabetic mouse model of nonalcoholic steatohepatitis.

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    Yuki Kita

    Full Text Available BACKGROUND: Optimal treatment for nonalcoholic steatohepatitis (NASH has not yet been established, particularly for individuals without diabetes. We examined the effects of metformin, commonly used to treat patients with type 2 diabetes, on liver pathology in a non-diabetic NASH mouse model. METHODOLOGY/PRINCIPAL FINDINGS: Eight-week-old C57BL/6 mice were fed a methionine- and choline-deficient plus high fat (MCD+HF diet with or without 0.1% metformin for 8 weeks. Co-administration of metformin significantly decreased fasting plasma glucose levels, but did not affect glucose tolerance or peripheral insulin sensitivity. Metformin ameliorated MCD+HF diet-induced hepatic steatosis, inflammation, and fibrosis. Furthermore, metformin significantly reversed hepatic steatosis and inflammation when administered after the development of experimental NASH. CONCLUSIONS/SIGNIFICANCE: These histological changes were accompanied by reduced hepatic triglyceride content, suppressed hepatic stellate cell activation, and the downregulation of genes involved in fatty acid metabolism, inflammation, and fibrogenesis. Metformin prevented and reversed steatosis and inflammation of NASH in an experimental non-diabetic model without affecting peripheral insulin resistance.

  10. Predictors of Long-Term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass in Severely Obese Patients.

    Science.gov (United States)

    de Oliveira, Vanessa Lopes Preto; Martins, Gianluca P; Mottin, Cláudio C; Rizzolli, Jacqueline; Friedman, Rogério

    2018-01-01

    Diabetes remission is not observed in all obese patients with type 2 diabetes submitted to bariatric surgery. Relapses occur in patients in whom remission is achieved. We investigated the factors associated with long-term (≥3 years) remission and relapse of type 2 diabetes after Roux-en-Y gastric bypass (RYGB) in these patients. By a retrospective review, we analyzed data from 254 patients with type 2 diabetes who had undergone RYGB from May 2000 to November 2011 and had at least 3 years of follow-up. The criteria for remission and relapse of type 2 diabetes followed the current American Diabetes Association recommendations. Remission was achieved in almost 82% of participants (69.7% complete, and 12.2% partial remission). Of these, 12% relapsed within a mean follow-up of 5.1 ± 2.0 years after surgery. Predictors of complete remission were younger age, better preoperative glycemic control, and shorter diabetes duration. Preoperative insulin use was associated with a ninefold increase in the relapse hazard (HR = 9.1 (95% CI: 3.3-25.4)). Use of two or more oral anti-diabetic agents increased the relapse hazard sixfold (HR = 6.1 (95% CI: 1.8-20.6)). Eighteen point one percent of patients did not achieve any remission during follow-up. However, they exhibited significant improvements in glycemic control. These data indicate that RYGB should not be delayed when remission of type 2 diabetes is a therapeutic goal, and also suggest that the best possible metabolic control should be sought in obese patients who may eventually be candidates for RYGB.

  11. Prevalence and Predictors of Self-Reported Sexual Abuse in Severely Obese Patients in a Population-Based Bariatric Program

    Directory of Open Access Journals (Sweden)

    Danielle L. Gabert

    2013-01-01

    Full Text Available Background. Sexual abuse may be associated with poorer weight loss outcomes following bariatric treatment. Identifying predictors of abuse would enable focused screening and may increase weight management success. Methods. We analyzed data from 500 consecutively recruited obese subjects from a population-based, regional bariatric program. The prevalence of self-reported sexual abuse was ascertained using a single interview question. Health status was measured using a visual analogue scale (VAS. Multivariable logistic regression was performed to identify sexual abuse predictors. Results. The mean age was 43.7 y (SD 9.6, 441 (88.2% were females, 458 (91.8% were white, and the mean body mass index (BMI was 47.9 kg/m2 (SD 8.1. The self-reported prevalence of past abuse was 21.8% (95% CI 18.4–25.4%. Abused subjects had worse health status (VAS score 53.1 (SD 21.2 versus 58.0 (SD 20.1, P=0.03. BMI was not associated with abuse (P>0.5. Age, sex, BMI, and covariate-adjusted independent predictors of abuse included alcohol addiction (adjusted odds ratio 15.8; 95% CI 4.0–62.8, posttraumatic stress disorder (4.9; 2.5–9.5, borderline personality (3.8; 1.0–13.8, depression (2.4; 1.3–4.3, and lower household income (3.4; 1.6–7.0. Conclusions. Abuse was common amongst obese patients managed in a population-based bariatric program; alcohol addiction, psychiatric comorbidities, and low-income status were highly associated with sexual abuse.

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

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    Anne-Laure Borel

    Full Text Available 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.

  13. Prognostic Value of Negative Coronary CT Angiography in Severely Obese Patients Prior to Bariatric Surgery: a Follow-Up After 6 Years.

    Science.gov (United States)

    Messerli, Michael; Maywald, Céline; Wälti, Stephan; Warschkow, René; Wildermuth, Simon; Alkadhi, Hatem; Leschka, Sebastian; Schiesser, Marc

    2017-08-01

    This study aims to determine the long-term prognostic value of coronary CT angiography (CCTA) prior to bariatric surgery in severely obese patients with a body mass index (BMI) ≥35 kg/m 2 . Seventy consecutive patients undergoing cardiac CT for coronary assessment prior to bariatric surgery were prospectively included. Images were analysed for the presence of coronary calcification and for non-obstructive (50% stenosis) coronary artery disease (CAD). A median clinical follow-up of 6.1 years in 54 patients was obtained for major adverse cardiovascular events (MACEs), defined as death, non-fatal myocardial infarction or coronary revascularisation. Weight loss and BMI decrease following bariatric surgery were recorded. The median BMI prior to surgery was 46.9 kg/m 2 . The median percentage of excess BMI loss after surgery was 75%. CT showed coronary calcification in 26 (48%) patients, whereas 28 (52%) patients had no calcification. CCTA revealed normal coronaries in 47 (87%) and non-obstructive CAD in 7 (13%) patients. No obstructive CAD was found. All patients successfully underwent bariatric surgery, and no MACE occurred neither perioperatively nor in the follow-up period. The negative predictive value of CCTA was 100% (95% confidence interval of 90.1-100.0%). In severely obese patients, the absence of obstructive CAD in cardiac CT prior to bariatric surgery with subsequently marked weight reduction has strong long-term prognostic implications for ruling out major adverse cardiac events in the postoperative period.

  14. Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

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    Stefano Lai

    Full Text Available To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status.Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4-14 years were enrolled. The diabetic children were divided: a 20 children in good metabolic control (Hb1ac≤7.5 and b 48 children in bad metabolic control (Hb1ac>7.5. Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse.Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively and in subjects in bad metabolic control (p = 0.03 and p<0.01, respectively. Oral hygiene habits were similar, except for the use of fluoridated adjuvants, higher in non-diabetic children (p = 0.04. No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (p<0.01. Significant difference for the main cariogenic bacteria was found between diabetic and non-diabetic subjects (p<0.05. The pH values showed statistically significant differences between diabetic and non-diabetic subjects and between diabetic subjects in good and bad metabolic control (p<0.01.Diabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

  15. The relationship between regional abdominal fat distribution and both insulin resistance and subclinical chronic inflammation in non-diabetic adults

    Science.gov (United States)

    2014-01-01

    Objective Obesity is associated with a high risk of insulin resistance (IR) and its metabolic complications. It is still debated that distributions of adipose tissue relate to an excess risk of IR and chronic inflammation in different race. This study was designed to examine the relation between insulin sensitivity, chronic inflammation and central fat distribution in non-diabetic volunteers in Taiwanese. Methods There were 328 volunteers without family history of diabetes mellitus and with normal oral glucose tolerance test enrolled. Total body fat and abdominal fat were measured. Abdominal fat was categorized into intraperitoneal (IP), retroperitoneal (RP) and subcutaneous (SC) fat. The IR index was estimated by homeostatic model assessment. Five inflammatory markers: adiponectin, leptin, tumor necrosing factor-α (TNF-α), resistin and high sensitive CRP (hs-CRP) were measured. Results IR was related to IP fat (r = 0.23, p fat, SC fat or total body fat. After correcting for age and sex, IP fat was the only significant predictor of IR (r2 = 58%, p = 0.001). Leptin showed the strongest relationship with all fat compartments (IP fat: r = 0.44, p = 0.001; RP fat: r = 0.36, p = 0.005, SC fat: r = 0.54, p fat: r = 0.61, p fat (r = 0.29, p = 0.004; r = -0.29, p = 0.005, respectively), but not RP, or SC fat. TNF-α and resistin were not correlated to any fat compartment. After correcting for age and sex, leptin variance was mostly explained by SC fat (41.3%), followed by IP fat (33.6%) and RP fat (25.3%). The hs-CRP and adiponectin variance were mostly explained by IP fat (40% and 49% respectively). Conclusions IP fat is better predictors of IR and subclinical chronic inflammation in Taiwanese adults. A disproportionate accumulation of abdominal fat is associated with increased risk of cardiovascular diseases. PMID:24684833

  16. ACE and SGLT2 inhibitors: the future for non-diabetic and diabetic proteinuric renal disease.

    Science.gov (United States)

    Perico, Norberto; Ruggenenti, Piero; Remuzzi, Giuseppe

    2017-04-01

    Most chronic nephropathies progress relentlessly to end-stage kidney disease. Research in animals and humans has helped our understanding of the mechanisms of chronic kidney disease progression. Current therapeutic strategies to prevent or revert renal disease progression focus on reduction of urinary protein excretion and blood pressure control. Blockade of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors and/or angiotensin II type 1 receptor blockers is the most effective treatment to achieve these purposes in non-diabetic and diabetic proteinuric renal diseases. For those individuals in which nephroprotection by RAS blockade is only partial, sodium-glucose linked cotransporter-2 (SGLT2) inhibitors could be a promising new class of drugs to provide further renoprotective benefit when added on to RAS blockers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Evaluation of Plasma Lipoprotein (A Levels in Diabetic and Non Diabetic Indiviuals

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    BA Jalai

    2005-01-01

    Full Text Available Introduction: Lipoprotein (a is a particle rich in cholesterol in human plasma and it is known as an independent risk factor for coronary artery disease. In addition to genetic background, other factors such as diabetes affect the plasma concentration of this lipoprotein as a risk factor. The aim of this study was evaluation and comparison of plasma concentration of Lp(a in type II diabetics and non diabetic individuals. Material and Methods: The study population included 180 diabetic patients who had referred to the Diabetic Research center of Yazd and 180 non diabetic individuals who were matched according to age and sex with the patient group. Blood samples were collected from the study groups in fasting condition. Glycated hemoglobin, glucose, lipids and lipoproteins were measured by routine laboratory methods and Lp(a assay was carried out by electro immunodiffusion. Results were analyzed with the use of SPSS program. Statistical tests included variance analysis, t-test for comparing lipids and lipoproteins, U-test for comparing Lp(a in the two groups and Pearson Correlation for determining of the variables with Lp(a. Results: Mean plasma concentratin of Lp(a in diabetic patients (Mean + SD 41.98+ 34.63 mg/dl was significantly higher than that of the control group (26.6 + 20.2 mg/dl (P<0.001. Mean concentration of cholesterol, triglyceride and LDL cholesterol in the patient group was higher but mean HDL cholesterol in control group was higher than patient group. However, no significant correlation was found between Lp(a and other variables in the patient and control groups. Conclusion: Plasma concentration of Lp(a in Diabetes Mellitus is increased independently. In diabetic patients, the risk of coronary artery disease may increase with increase in Lp(a.

  18. The effect of non-diabetic chronic renal failure on olfactory function.

    Science.gov (United States)

    Koseoglu, S; Derin, S; Huddam, B; Sahan, M

    2017-05-01

    In chronic renal failure (CRF), deterioration of glomerular filtration results in accumulation of metabolites in the body which affect all organs. This study was performed to investigate the olfactory functions, and determine if hemodialysis or peritoneal dialysis improves olfactory function in non-diabetic CRF patients. The olfactory functions were analyzed in CRF patients not on a dialysis program and had a creatinine level≥2mg/dL, in CRF patients on hemodialysis or peritoneal dialysis, and in healthy controls. Diabetic patients were excluded since diabetes alone is a cause of olfactory dysfunction. The study group consisted of a total of 107 individuals including 38CRF patients on a hemodialysis program, 15 CRF patients on peritoneal dialysis, 30 patients with a creatinine level ≥ 2mg/dL without any need for dialysis, and 24 healthy controls with normal renal functions. Olfactory functions were analyzed with "Sniffin' sticks" test, and the groups were compared for the test results. All test parameters were impaired in patients with CRF. The median TDI scores of the patients with CRF and the healthy subjects were 24.75 (13-36) and 32.5 (27.75-37.75), respectively, with a statistically significant difference in between (P<0.001). The olfactory functions for the dialysis patients were better than those for the CRF patients not on a dialysis program (P=0.020). Non-diabetic CRF affects olfactory functions negatively. Dialysis improves olfactory functions in those patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Intensive lifestyle intervention provides rapid reduction of serum fatty acid levels in women with severe obesity without lowering omega-3 to unhealthy levels.

    Science.gov (United States)

    Lin, C; Andersen, J R; Våge, V; Rajalahti, T; Mjøs, S A; Kvalheim, O M

    2016-08-01

    Serum fatty acid (FA) levels were monitored in women with severe obesity during intensive lifestyle intervention. At baseline, total FA levels and most individual FAs were elevated compared to a matching cohort of normal and overweight women (healthy controls). After 3 weeks of intensive lifestyle intervention, total level was only 11-12% higher than in the healthy controls and with almost all FAs being significantly lower than at baseline, but with levels of omega-3 being similar to the healthy controls. This is contrary to observations for patients subjected to bariatric surgery where omega-3 levels dropped to levels significantly lower than in the lifestyle patients and healthy controls. During the next 3 weeks of treatment, the FA levels in lifestyle patients were unchanged, while the weight loss continued at almost the same rate as in the first 3 weeks. Multivariate analysis revealed that weight loss and change of serum FA patterns were unrelated outcomes of the intervention for lifestyle patients. For bariatric patients, these processes were associated probably due to reduced dietary input and increased input from the patients' own fat deposits, causing a higher rate of weight loss and simultaneous reduction of the ratio of serum eicosapentaenoic to arachidonic acid. © 2016 World Obesity.

  20. Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort study in Sweden.

    Science.gov (United States)

    Persson, Martina; Johansson, Stefan; Villamor, Eduardo; Cnattingius, Sven

    2014-05-01

    Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI) in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks). A nation-wide Swedish cohort study based on data from the Medical Birth Register included all live singleton term births in Sweden between 1992 and 2010. Logistic regression analyses were used to obtain odds ratios (ORs) with 95% CIs for Apgar scores between 0 and 3 at 5 and 10 minutes, meconium aspiration syndrome, and neonatal seizures, adjusted for maternal height, maternal age, parity, mother's smoking habits, education, country of birth, and year of infant birth. Among 1,764,403 term births, 86% had data on early pregnancy BMI and Apgar scores. There were 1,380 infants who had Apgar score 0-3 at 5 minutes (absolute risk  = 0.8 per 1,000) and 894 had Apgar score 0-3 at 10 minutes (absolute risk  = 0.5 per 1,000). Compared with infants of mothers with normal BMI (18.5-24.9), the adjusted ORs (95% CI) for Apgar scores 0-3 at 10 minutes were as follows: BMI 25-29.9: 1.32 (1.10-1.58); BMI 30-34.9: 1.57 (1.20-2.07); BMI 35-39.9: 1.80 (1.15-2.82); and BMI ≥40: 3.41 (1.91-6.09). The ORs for Apgar scores 0-3 at 5 minutes, meconium aspiration, and neonatal seizures increased similarly with maternal BMI. A study limitation was lack of data on effects of obstetric interventions and neonatal resuscitation efforts. Risks of severe asphyxia-related outcomes in term infants increase with maternal overweight and obesity. Given the high prevalence of the exposure and the severity of the outcomes studied, the results are of potential public health relevance and should be confirmed in other populations. Prevention of overweight and obesity in women of reproductive age is important to improve perinatal health.

  1. Experience of severe desaturation during anesthetic induction period in an obese adult patient with Prader-Willi syndrome -A case report-.

    Science.gov (United States)

    Choi, Joon Woo; Kim, Eun-Ju; Min, Byung Woo; Ban, Jong Seouk; Lee, Sang Gon; Lee, Ji-Hyang

    2012-02-01

    Prader-Willi syndrome is characterized by infantile hypotonia, childhood-onset obesity, short stature, mental retardation, hyperphagia, hypogonadism. After infantile hypotonia phase, patient is prone to morbid obesity due to hyperphagia. Complications associated with morbid obesity are recognized as the main risk factors for death the lifespan of patients with Prader-Willi syndrome. We experienced desaturation and bronchospasm during arteriovenous fistula surgery in an obese adult with Prader-Willi syndrome.

  2. The effects of diabetes and low blood sugar levels on driving behaviour : Comparison of diabetics and non-diabetics

    NARCIS (Netherlands)

    Martens, M.; Janssen, W.H.; Stork, A.

    2001-01-01

    Under contract with the University Medical Centre, Utrecht, TNO Human Factors has conducted research to investigate the effect of diabetes on driving behaviour. In a driving simulator experiment, patients with diabetes and non-diabetics were confronted with various trafßc situations. The subject

  3. Sedation using 5% lidocaine patches, midazolam and propofol in a combative, obese adolescent with severe autistic disorder undergoing brain magnetic resonance imaging: a case report.

    Science.gov (United States)

    Seo, Kwon Hui; Jung, Hong Soo; Kang, Eu Gene; Kim, Change Jae; Rhee, Ho Young; Jeon, Yeon Soo

    2014-12-01

    We present a 17-year-old man who underwent brain magnetic resonance imaging and laboratory exams for uncontrolled seizure. Patients with an autistic disorder require deep sedation or, occasionally, general anesthesia even for radiologic exams or simple procedures. The anesthetic management of an obese, violent patient with a severe autistic disorder and mental retardation can be challenging to anesthesiologists and requires a more careful approach in selecting adequate anesthetics and doses. This case emphasizes the importance of having a detailed plan to ensure the smooth process of premedication, anesthetic induction, maintenance, emergence and safe discharge of incorporated patients in the event of unexpected situations. A 5% lidocaine patch to relieve the pain from the intramuscular injection and intravenous cannulation, intramuscular midazolam as premedication, and propofol for the maintenance of sedation can be a good sedation protocol in incorporated patients.

  4. Interleukin-6 stimulates Akt and p38 MAPK phosphorylation and fibroblast migration in non-diabetic but not diabetic mice.

    Directory of Open Access Journals (Sweden)

    Tsubame Nishikai-Yan Shen

    Full Text Available Persistent inflammatory environment and abnormal macrophage activation are characteristics of chronic diabetic wounds. Here, we attempted to characterize the differences in macrophage activation and temporal variations in cytokine expression in diabetic and non-diabetic wounds, with a focus on interleukin (IL-6 mRNA expression and the p38 MAPK and PI3K/Akt signaling pathways. Cutaneous wound closure, CD68- and arginase-1 (Arg-1-expressing macrophages, and cytokine mRNA expression were examined in non-diabetic and streptozotocin-induced type 1 diabetic mice at different time points after injury. The effect of IL-6 on p38 MAPK and Akt phosphorylation was investigated, and an in vitro scratch assay was performed to determine the role of IL-6 in primary skin fibroblast migration. Before injury, mRNA expression levels of the inflammatory markers iNOS, IL-6, and TNF-α were higher in diabetic mice; however, IL-6 expression was significantly lower 6 h post injury in diabetic wounds than that in non-diabetic wounds. Non-diabetic wounds exhibited increased p38 MAPK and Akt phosphorylation; however, no such increase was found in diabetic wounds. In fibroblasts from non-diabetic mice, IL-6 increased the phosphorylation of p38 MAPK and levels of its downstream factor CREB, and also significantly increased Akt phosphorylation and levels of its upstream factor P13K. These effects of IL-6 were not detected in fibroblasts derived from the diabetic mice. In scratch assays, IL-6 stimulated the migration of primary cultured skin fibroblasts from the non-diabetic mice, and the inhibition of p38 MAPK was found to markedly suppress IL-6-stimulated fibroblast migration. These findings underscore the critical differences between diabetic and non-diabetic wounds in terms of macrophage activation, cytokine mRNA expression profile, and involvement of the IL-6-stimulated p38 MAPK-Akt signaling pathway. Aberrant macrophage activation and abnormalities in the cytokine m

  5. Prevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry.

    Science.gov (United States)

    Lydia Rajakumari, M; Saravana Kumari, P

    2016-12-01

    The aim of the present study was to determine the prevalence of Candida in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry, India and to analyse the antifungal susceptibility profile of the selected isolates. A total of 400 buccal samples, 200 each from diabetic and non-diabetic healthy individuals were included in the study. Sabouraud's dextrose agar was used for isolation of Candida species. Identification was performed through microscopy, germ tube test, sugar fermentation test, sugar assimilation test and by using Hichrome agar. Distinct and phenotypically representative colonies were selected and subjected to ITS analysis. In vitro antifungal susceptibility testing for the isolated Candida species was performed using E-test. Results revealed that the prevalence of Candida species in diabetic individuals was higher when compared with non-diabetic healthy individuals. The most predominantly isolated species in diabetic and non-diabetic individuals from buccal cavity was Candida albicans. C. tropicalis was predominant among the non-albicans Candida isolated from both diabetic and non-diabetic individuals. Among denture wearers C. glabrata was predominant. In vitro antifungal susceptibility testing shows that ketoconazole, fluconazole and itraconazole were effective against the isolated Candida species. The rate of candidal carriage in diabetic individuals is higher. Different species of Candida are present in the oral cavity of diabetic individuals. There may be a positive correlation between glycemic control and candidal colonization. In vitro antifungal susceptibility testing of Candia species are required for proper management and treatment of candidal infections. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Acute differential effects of milk-derived dietary proteins on postprandial lipaemia in obese non-diabetic subjects

    DEFF Research Database (Denmark)

    Holmer-Jensen, Jens; Hartvigsen, Merete; Mortensen, L.S.

    2012-01-01

    Postprandial lipaemia is an established risk factor for atherosclerosis. To investigate the acute effect of four milk-derived dietary proteins (alpha-lactalbumin, whey isolate, caseinoglycomacropeptide and whey hydrolysate) on postprandial lipaemia, we have conducted a randomized, acute, single...

  7. Renal Replacement Therapy: Purifying Efficiency of Automated Peritoneal Dialysis in Diabetic versus Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Nicanor Vega-Diaz

    2015-07-01

    Full Text Available Background: In order to reduce the cardiovascular risk, morbidity and mortality of peritoneal dialysis (PD, a minimal level of small-solute clearances as well as a sodium and water balance are needed. The peritoneal dialysis solutions used in combination have reduced the complications and allow for a long-time function of the peritoneal membrane, and the preservation of residual renal function (RRF in patients on peritoneal dialysis (PD is crucial for the maintenance of life quality and long-term survival. This retrospective cohort study reviews our experience in automatic peritoneal dialysis (APD patients, with end-stage renal disease (ESRD secondary to diabetic nephropathy (DN in comparison to non-diabetic nephropathy (NDN, using different PD solutions in combination. Design: Fifty-two patients, 29 diabetic and 23 non-diabetic, were included. The follow-up period was 24 months, thus serving as their own control. Results: The fraction of renal urea clearance (Kt relative to distribution volume (V (or total body water (Kt/V, or creatinine clearance relative to the total Kt/V or creatinine clearance (CrCl decreases according to loss of RRF. The loss of the slope of RRF is more pronounced in DN than in NDN patients, especially at baseline time interval to 12 months (loss of 0.29 mL/month vs. 0.13 mL/month, respectively, and is attenuated in the range from 12 to 24 months (loss of 0.13 mL/month vs. 0.09 mL/month, respectively. Diabetic patients also experienced a greater decrease in urine output compared to non-diabetic, starting from a higher baseline urine output. The net water balance was adequate in both groups during the follow up period. Regarding the balance sodium, no inter-group differences in sodium excretion over follow up period was observed. In addition, the removal of sodium in the urine output decreases with loss of renal function. The average concentration of glucose increase in the cycler in both groups (DN: baseline 1.44 ± 0

  8. Dissociated incretin hormone response to protein versus fat ingestion in obese subjects

    DEFF Research Database (Denmark)

    Lindgren, O; Carr, RD; Holst, Jens Juul

    2011-01-01

    kcal/kg) fat (olive oil) or protein (whey protein) was ingested by non-diabetic obese male volunteers [body mass index (BMI) >30 kg/m(2) ; n = 12] and plasma GIP and GLP-1 were determined. We found no difference in the early GIP or GLP-1 responses to fat versus protein. However, the total 300-min GIP...

  9. Sex and muscle structural lipids in obese subjects - an impact on insulin action?

    DEFF Research Database (Denmark)

    Haugaard, SB; Vaag, A.; Høy, Carl-Erik

    2008-01-01

    BACKGROUND: Long-chain polyunsaturated fatty acid (LCPUFA) especially the n-3-FA of skeletal muscle phospholipids may facilitate insulin action, whereas saturated and trans-FA act oppositely. Community studies show that non-diabetic weight matched obese men and women display similar insulin resis...

  10. Pioglitazone improves insulin sensitivity, reduces visceral fat and stimulates lipolysis in non diabetic dialyzed patients

    Directory of Open Access Journals (Sweden)

    Anne Zanchi

    2012-06-01

    Full Text Available Insulin resistance is common in dialyzed patients and is associated with increased mortality and protein-energy wasting. The aim of this study was to investigate the effect of pioglitazone (PIO, a powerful insulin sensitizer, on insulin sensitivity, body composition and adipose tissue metabolism, in dialyzed patients. A double blind randomized cross-over study was performed in non diabetic dialysis patients. Each patient followed 2 treatment phases of 16 weeks, starting either with oral PIO 45 mg/d or placebo (PL, and then switched to the other phase. At the end of each phase, patients underwent hyperinsulinemic euglycemic clamps, dual energy X-ray absorptiometry, an abdominal CT, and extensive plasma biochemical analysis. Twelve patients including 8 HD (59.6±4.4 y and 4 PD patients (43.5±3.6 y were recruited. Nine patients completed both phases and 3 patients dropped out (renal transplantation/2 HD and peritonitis/1 PD. PIO was safe and well tolerated. Under PIO, insulin sensitivity improved, as assessed by increased total glucose disposal rate (1.98±0.24 for PIO versus 1.58±0.12 umol/kg/min for PL, p<0.05, and reduced glucose endogenous hepatic production. PIO did not affect post-dialysis body weight, total fat and lean body mass, but significantly reduced visceral adipose tissue (VAT area and the VAT/SAT (subcutaneous adipose tissue ratio. HDL-cholesterol significantly increased. PIO decreased CRP (3.96±1.44 mg/l vs 7.88±2.56, p<0.05, plasma leptin, and dramatically reduced leptin/adiponectin ratio. Glycerol turnover, circulating glycerol and non esterified fatty acids were paradoxically increased. In conclusion, the improvement in insulin sensitivity by PIO, in non diabetic dialyzed patients, was associated with favorable metabolic effects, reduction in inflammation and body fat redistribution. The stimulation of systemic lipolysis was a surprising finding which may reflect adipose tissue remodeling and/or a paradoxical lypolitic

  11. Diagnostic Performance of MR Elastography and Vibration-controlled Transient Elastography in the Detection of Hepatic Fibrosis in Patients with Severe to Morbid Obesity.

    Science.gov (United States)

    Chen, Jun; Yin, Meng; Talwalkar, Jayant A; Oudry, Jennifer; Glaser, Kevin J; Smyrk, Thomas C; Miette, Véronique; Sandrin, Laurent; Ehman, Richard L

    2017-05-01

    Purpose To evaluate the diagnostic performance and examination success rate of magnetic resonance (MR) elastography and vibration-controlled transient elastography (VCTE) in the detection of hepatic fibrosis in patients with severe to morbid obesity. Materials and Methods This prospective and HIPAA-compliant study was approved by the institutional review board. A total of 111 patients (71 women, 40 men) participated. Written informed consent was obtained from all patients. Patients underwent MR elastography with two readers and VCTE with three observers to acquire liver stiffness measurements for liver fibrosis assessment. The results were compared with those from liver biopsy. Each pathology specimen was evaluated by two hepatopathologists according to the METAVIR scoring system or Brunt classification when appropriate. All imaging observers were blinded to the biopsy results, and all hepatopathologists were blinded to the imaging results. Examination success rate, interobserver agreement, and diagnostic accuracy for fibrosis detection were assessed. Results In this obese patient population (mean body mass index = 40.3 kg/m 2 ; 95% confidence interval [CI]: 38.7 kg/m 2 , 41.8 kg/m 2 ]), the examination success rate was 95.8% (92 of 96 patients) for MR elastography and 81.3% (78 of 96 patients) or 88.5% (85 of 96 patients) for VCTE. Interobserver agreement was higher with MR elastography than with biopsy (intraclass correlation coefficient, 0.95 vs 0.89). In patients with successful MR elastography and VCTE examinations (excluding unreliable VCTE examinations), both MR elastography and VCTE had excellent diagnostic accuracy in the detection of clinically significant hepatic fibrosis (stage F2-F4) (mean area under the curve: 0.93 [95% CI: 0.85, 0.97] vs 0.91 [95% CI: 0.83, 0.96]; P = .551). Conclusion In this obese patient population, both MR elastography and VCTE had excellent diagnostic performance for assessing hepatic fibrosis; MR elastography was more

  12. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  13. Effect of GLP-1 receptor agonist treatment on body weight in obese antipsychotic-treated patients with schizophrenia

    DEFF Research Database (Denmark)

    Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V

    2017-01-01

    and placebo groups experienced significant ( P  = .004), however similar ( P  = .98), weight losses of 2.24 ± 3.3 and 2.23 ± 4.4 kg, respectively, after 3 months of treatment. CONCLUSIONS: Treatment with exenatide once-weekly did not promote weight loss in obese, antipsychotic-treated patients......AIMS: Schizophrenia is associated with cardiovascular co-morbidity and a reduced life-expectancy of up to 20 years. Antipsychotics are dopamine D2 receptor antagonists and are the standard of medical care in schizophrenia, but the drugs are associated with severe metabolic side effects...... such as obesity and diabetes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are registered for treatment of both obesity and type 2 diabetes. We investigated metabolic effects of the GLP-1RA, exenatide once-weekly, in non-diabetic, antipsychotic-treated, obese patients with schizophrenia. MATERIAL...

  14. Cardiac and metabolic changes in long-term high fructose-fat fed rats with severe obesity and extensive intramyocardial lipid accumulation.

    Science.gov (United States)

    Axelsen, Lene N; Lademann, Jacob B; Petersen, Jørgen S; Holstein-Rathlou, Niels-Henrik; Ploug, Thorkil; Prats, Clara; Pedersen, Henrik D; Kjølbye, Anne Louise

    2010-06-01

    Metabolic syndrome and obesity-related diseases are affecting more and more people in the Western world. The basis for an effective treatment of these patients is a better understanding of the underlying pathophysiology. Here, we characterize fructose- and fat-fed rats (FFFRs) as a new animal model of metabolic syndrome. Sprague-Dawley rats were fed a 60 kcal/100 kcal fat diet with 10% fructose in the drinking water. After 6, 12, 18, 24, 36, and 48 wk of feeding, blood pressure, glucose tolerance, plasma insulin, glucose, and lipid levels were measured. Cardiac function was examined by in vivo pressure volume measurements, and intramyocardial lipid accumulation was analyzed by confocal microscopy. Cardiac AMP-activated kinase (AMPK) and hepatic phosphoenolpyruvate carboxykinase (PEPCK) levels were measured by Western blotting. Finally, an ischemia-reperfusion study was performed after 56 wk of feeding. FFFRs developed severe obesity, decreased glucose tolerance, increased serum insulin and triglyceride levels, and an initial increased fasting glucose, which returned to control levels after 24 wk of feeding. The diet had no effect on blood pressure but decreased hepatic PEPCK levels. FFFRs showed significant intramyocardial lipid accumulation, and cardiac hypertrophy became pronounced between 24 and 36 wk of feeding. FFFRs showed no signs of cardiac dysfunction during unstressed conditions, but their hearts were much more vulnerable to ischemia-reperfusion and had a decreased level of phosphorylated AMPK at 6 wk of feeding. This study characterizes a new animal model of the metabolic syndrome that could be beneficial in future studies of metabolic syndrome and cardiac complications.

  15. Association between insulin resistance and plasma amino acid profile in non-diabetic Japanese subjects

    OpenAIRE

    Yamada, Chizumi; Kondo, Masumi; Kishimoto, Noriaki; Shibata, Takeo; Nagai, Yoko; Imanishi, Tadashi; Oroguchi, Takashige; Ishii, Naoaki; Nishizaki, Yasuhiro

    2015-01-01

    Aims/Introduction Elevation of the branched-chain amino acids (BCAAs), valine, leucine and isoleucine; and the aromatic amino acids, tyrosine and phenylalanine, has been observed in obesity-related insulin resistance. However, there have been few studies on Asians, who are generally less obese and less insulin-resistant than Caucasian or African-Americans. In the present study, we investigated the relationship between homeostasis model assessment of insulin resistance (HOMA-IR) and plasma ami...

  16. Non-diabetic renal disease in patients with type 2 diabetes: a single centre study.

    Science.gov (United States)

    Fan, Jian-Zhen; Wang, Rong

    2018-04-01

    Non-diabetic renal disease (NDRD) has been widely known in diabetic patients. The clinical differentiation between diabetic nephropathy (DN) and NDRD is still not so clear and effective. To analyse the pathological characteristics and distribution of renal injury in selected type 2 diabetic patients. Comparison between DN and NDRD in clinical characteristics, to find important predictors for NDRD. To conduct retrospective analysis of clinical, laboratory and pathohistological data of type 2 diabetic patients in whom renal biopsies were performed from March 2010 to September 2014 in Shandong Provincial Hospital affiliated to Shandong University (n = 88). According to the findings of renal biopsy, the incidences of DN, NDRD and DN complicated with NDRD were 20.46, 72.73 and 6.82% respectively. The most common NDRD found were: membranous nephropathy, followed by IgA nephropathy and focal segmental glomerulosclerosis. In multivariate logistic-analysis, fasting blood glucose (odds ratio (OR) 0.714; 95% confidence interval (CI) = 0.543-0.939; P = 0.016) and absence of diabetic retinopathy (OR 18.602; 95% CI = 2.176-159.018; P = 0.003) were independent predictors of NDRD. This study confirmed a considerably high prevalence of NDRD in type 2 diabetic patients with renal injury. As some cases of NDRD are readily treatable or remittable, we should consider renal biopsy in selected diabetic patients with renal involvement, especially in those with effective blood glucose control and the absence of diabetic retinopathy. © 2017 Royal Australasian College of Physicians.

  17. Short term outcome of Percutanous Coronary Intervention in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Nouzari Y

    2007-05-01

    Full Text Available Background: Despite recent improvement in coronary intervention, there are many controversies about it’s results in diabetic patients. The goal of this study is comparison of in hospital outcome of diabetics after coronary intervention with nondiabetics. Methods: In this study 115 diabetic and 115non diabetic patients who admitted for coronary intervention in our center during 1383&84 were entered in an analytic study of Cohort type. Datas about clinical, aniographic, procedural and post procedural (24hours characteristics were entered in each patient’s form. Independent T test,chi-square and Fisher’s exact test were used for analyzing datas. Results: The Diabetic Patients were most often older men, and they had higher angina class, more co-risk factors and lower ejection fractions. Diabetic’s lesions were longer and more located in proximal portion of vessels. But success rate, major complication (death, revascularization, Q Wave MI and CVA, and minor complications (coronary/peripheral arteries complication, pulmonary edema, ischemic ECG had no significant differences between two groups. Conclusion: Diabetes mellitus does not affect short outcomes of coronary intervention as an independent factor. So intervention could be done in these patients with considering favorable outcomes.

  18. Helicobacter pylori in Diabetic and Non-Diabetic Patients with Dyspepsia

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Hashemi

    2012-05-01

    Full Text Available Helicobacter pylori (H. pylori is one of the most common chronic infections in patients with gastrointestinal disorders. Recent reports suggested that H. pylori might have high prevalence among patients with diabetes. The aim of this cross-sectional study was to assess the prevalence of H. pylori infection in diabetes mellitus and to study the relationship between histological findings and H. pylori infection in diabetic patients. Eighty patients with dyspepsia that were referred to our gastrointestinal department between May 2007 and May 2008 were included in our study. We checked fasting blood sugar for all of the study samples. All of patients underwent upper endoscopy and biopsy specimens were obtained from the antrum and the corpus. The specimens for the presence of H. pylori were colored by Giemsa stains. A single pathologist evaluated the histology slides. We found that prevalence of H. pylori infection was significantly higher in diabetics than in non-diabetics (P=0.001. Indeed, the prevalence of gastritis did differ significantly between the two groups (P=0.001. According to our results diabetes mellitus is one of the risk factor that must be considered in evaluation of H. pylori infection in diabetic patients with dyspepsia.

  19. Carbohydrate metabolism of lymphocytes: modified methodology and comparisons of diabetics with non-diabetics

    International Nuclear Information System (INIS)

    Glassman, A.B.; Bennett, C.E.

    1980-01-01

    Changes in the hexose monophosphate shunt (HMPS) and Krebs cycle activity during lymphocyte blast transformation are reported in 50 patients with diabetes mellitus and 50 non-diabetics. A modified technique using 12 X 75 mm sterile tubes and micropipette tips stuffed with filter paper was used. The filter paper, soaked with hyamine hydroxide, absorbed radioactively labeled CO 2 produced from [ 14 C]- labeled glucose incorporated by cells. [ 14 C]CO 2 from glucose labeled at the C-1 position measured the activity of the HMPS. [ 14 C]CO 2 from glucose labeled at the C-2 position measured the HMPS activity associated with the feedback of pentose sugars. [ 14 C]-labeled CO 2 from glucose labeled at the C-6 position was used to measure Krebs cycle activity. A statistically significant decrease in HMPS activity was found in diabetic cells exposed to the mitogens phytohemagglutinin-P (PHA-P), concanavalin-A (CON-A) and pokeweed mitogen (PWM) (P<0.01). This decrease in HMPS activity and its relation to lymphocyte blast transformation may be related to the increased incidence of infection known to occur in patients with diabetes mellitus. (Auth.)

  20. Rosuvastatin and Atorvastatin: Comparative Effects on Glucose Metabolism in Non-Diabetic Patients with Dyslipidaemia

    Directory of Open Access Journals (Sweden)

    Ahmed Abbas

    2012-01-01

    Full Text Available The ever increasing interventional CVD outcome studies have resulted in statins being an essential factor of cardiovascular prevention strategies. The JUPITER study in 2008, despite reducing CVD and overall mortality, highlighted an increase in new onset diabetes in the rosuvastatin treated arm. Since then there have been many meta-analyses of the RCTs and the largest carried out by Sattar et al showed a significant increase in the incidence of diabetes during the trials. The findings from the individual studies when comparing the different statins were less clear. A higher statin dosage and risk factors associated with diabetes appeared to predict this phenomenon. There have been many studies investigating the effects of statins on glycaemic control, but again no clear conclusion is apparent. Despite the increase in new onset diabetes observed, the risk is clearly out-weighed by the CVD benefits observed in nearly all the statin trials. Thus, no change is required to any of the prevention guidelines regarding statins. However, it may be prudent to monitor glycaemic control after commencing statin therapy. This review will focus on atorvastatin which is the most widely used statin worldwide and rosuvastatin which is the most efficacious. This will be against a background of the effects of other statins on glucose metabolism in non-diabetic patients.

  1. Rosuvastatin and atorvastatin: comparative effects on glucose metabolism in non-diabetic patients with dyslipidaemia.

    Science.gov (United States)

    Abbas, Ahmed; Milles, John; Ramachandran, Sudarshan

    2012-01-01

    The ever increasing interventional CVD outcome studies have resulted in statins being an essential factor of cardiovascular prevention strategies. The JUPITER study in 2008, despite reducing CVD and overall mortality, highlighted an increase in new onset diabetes in the rosuvastatin treated arm. Since then there have been many meta-analyses of the RCTs and the largest carried out by Sattar et al showed a significant increase in the incidence of diabetes during the trials. The findings from the individual studies when comparing the different statins were less clear. A higher statin dosage and risk factors associated with diabetes appeared to predict this phenomenon. There have been many studies investigating the effects of statins on glycaemic control, but again no clear conclusion is apparent. Despite the increase in new onset diabetes observed, the risk is clearly out-weighed by the CVD benefits observed in nearly all the statin trials. Thus, no change is required to any of the prevention guidelines regarding statins. However, it may be prudent to monitor glycaemic control after commencing statin therapy. This review will focus on atorvastatin which is the most widely used statin worldwide and rosuvastatin which is the most efficacious. This will be against a background of the effects of other statins on glucose metabolism in non-diabetic patients.

  2. Carbohydrate metabolism of lymphocytes: modified methodology and comparisons of diabetics with non-diabetics

    Energy Technology Data Exchange (ETDEWEB)

    Glassman, A B; Bennett, C E [Medical University of South Carolina, Charleston, SC, (USA). Department of Laboratory Medicine

    1980-10-01

    Changes in the hexose monophosphate shunt (HMPS) and Krebs cycle activity during lymphocyte blast transformation are reported in 50 patients with diabetes mellitus and 50 non-diabetics. A modified technique using 12 X 75 mm sterile tubes and micropipette tips stuffed with filter paper was used. The filter paper, soaked with hyamine hydroxide, absorbed radioactively labeled CO/sub 2/ produced from (/sup 14/C)- labeled glucose incorporated by cells. (/sup 14/C)CO/sub 2/ from glucose labeled at the C-1 position measured the activity of the HMPS. (/sup 14/C)CO/sub 2/ from glucose labeled at the C-2 position measured the HMPS activity associated with the feedback of pentose sugars. (/sup 14/C)-labeled CO/sub 2/ from glucose labeled at the C-6 position was used to measure Krebs cycle activity. A statistically significant decrease in HMPS activity was found in diabetic cells exposed to the mitogens phytohemagglutinin-P (PHA-P), concanavalin-A (CON-A) and pokeweed mitogen (PWM) (P<0.01). This decrease in HMPS activity and its relation to lymphocyte blast transformation may be related to the increased incidence of infection known to occur in patients with diabetes mellitus.

  3. A comparative study of risk factors for corneal infection in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Bin Wang

    2018-01-01

    Full Text Available AIM: To compare the clinical characteristics of infectious keratopathy in type 2 diabetes mellitus (T2DM and non-diabetes mellitus (NDM and to investigate risk factors for infectious keratopathy in T2DM patients. METHODS: Totally 230 patients with T2DM and 168 with NDM diagnosed as infectious keratopathy were hospitalized at Qingdao Eye Hospital from 2001 to 2015. Data including sex, age, occupation, season, smoking and alcohol consumption habits, duration between onset and treatments, duration of hospitalization were collected. Initially identified indicators were analyzed with a multivariate logistic regression. Glycosylated hemoglobin A1c (HbA1c in patients with T2DM was analyzed. The infectious keratopathies in the two groups were categorized and compared. RESULTS: The diabetic group consisted of 146 (63.5% males and 84 (36.5% females. The NDM group consisted of 111 (66.1% males and 57 (33.9% females. There was no signigicantly difference in sex distribution between the two groups (P>0.05. There were significant differences in age, occupation of patients, season of the onset of diseases, duration between onset and treatment, and durations of hospitalization between the two groups (P0.05. CONCLUSION: Advanced age and the summer and winter seasons are identified as risk factors for infectious keratopathy in T2DM patients, and T2DM patients are more prone to bacterial keratitis.

  4. Does Abdominal Obesity Accelerate the Effect of Hypertriglyceridemia on Impaired Fasting Glucose?

    OpenAIRE

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

    2010-01-01

    Purpose 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. Materials and Methods 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...

  5. A calorie-restriction diet supplemented with fish oil and high-protein powder is associated with reduced severity of metabolic syndrome in obese women.

    Science.gov (United States)

    Su, H-Y; Lee, H-C; Cheng, W-Y; Huang, S-Y

    2015-03-01

    The prevalence of metabolic syndrome (MetS) and obesity has increased worldwide, as well as in Taiwan, particularly in women aged>40 years. The purpose of this study was to elucidate the effects of a calorie-restriction diet (CR) supplemented with protein and n-3 polyunsaturated fatty acids (PUFAs) on women with MetS. A total of 143 eligible female participants were recruited and assigned to four dietary interventions such as 1500-kcal CR, calorie-restriction meal-replacement diet (CRMR), calorie-restriction diet with fish oil supplementation (CRF) and calorie-restriction meal-replacement diet with fish oil supplementation (CRMRF). The changes in anthropometric measures, metabolic profiles, inflammatory response and the Z-score of severity of MetS were evaluated. Among 143 female MetS patients enrolled, 136 patients completed the 12-week study. After the 12-week dietary interventions, we observed reductions in body weight (BW), body mass index (BMI) and waist circumference (WC) in all groups. BMI and triglyceride (TG) levels decreased significantly in the CRMR, CRF and CRMRF groups, but not in the CR group. The homeostasis model assessment of insulin resistance (HOMA-IR) had significantly improved in all four groups, and the levels of interleukin-6 (IL-6) and C-reactive protein (CRP) had significantly decreased in the CRF and CRMRF groups. Following the interventions, the changes in waist circumference (WC), mean arterial pressure (MAP), fasting blood glucose (FBG), TGs, HOMA-IR, CRP and IL-6 significantly correlated with the reductions in Z-score of MetS severity. Our study results indicate that a calorie-restriction dietary intervention combined with various macronutrients can reduce the severity of MetS in women and increase recovery from MetS by almost twofold in comparison with a CR alone.

  6. One-Anastomosis Jejunal Interposition with Gastric Remnant Resection (Branco-Zorron Switch) for Severe Recurrent Hyperinsulinemic Hypoglycemia after Gastric Bypass for Morbid Obesity.

    Science.gov (United States)

    Zorron, Ricardo; Branco, Alcides; Sampaio, Jose; Bothe, Claudia; Junghans, Tido; Rasim, Gyurdzhan; Pratschke, Johann; Guel-Klein, Safak

    2017-04-01

    The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch). Patients with severe symptomatic hyperinsulinemic hypoglycemia refractory to conservative therapy were treated using the technique. The procedure started with resection of the remnant stomach close to pylorus. The alimentary limb was sectioned at 20 cm from the gastrojejunal anastomosis, and the rest of the alimentary limb was resected until the Y-Roux anastomosis. A hand-sutured anastomosis was then performed with the proximal alimentary limb and the remnant antrum. Four patients were successfully submitted to the procedure with reversal of the symptomatology and normalization of insulin levels, postprandial glucose levels, and oral glucose tolerance test, with a mean follow-up of 24.3 months. Mean operative time was 188 min, and patients recovered without postoperative complications. Patients suffering from severe hyperinsulinemic hypoglycemia after gastric bypass may be efficiently treated by this innovative procedure, avoiding extreme surgical therapy such as pancreatectomy or restoring the gastric anatomy, while still maintaining sustained weight loss. Studies with larger series and longer follow-up are still needed to define the role of this therapy in managing this entity.

  7. Treatment of antipsychotic-associated obesity with a GLP-1 receptor agnoist: Protocol for an investigator-initiated prospective, randomised, placebo-controlled, double-blinded intervention study - the TAO study

    DEFF Research Database (Denmark)

    Ishøy, Pelle Lau; Knop, Filip Krag; Broberg, Brian Villumsen

    with a GLP-1 receptor agonist (exenatide once-weekly) is safe and facilitates weight loss in non-diabetic schizophrenia patients with antipsychotic-associated obesity. Materials and methods: Forty obese patients with schizophrenia or schizoaffective disorder treated with antipsychotic drugs...

  8. Treatment of antipsychotic-associated obesity with a GLP-1 receptor agonist: Protocol for an investigator-initiated prospective, randomised, placebo-controlled, double-blinded intervention study – the TAO study

    DEFF Research Database (Denmark)

    Ishøy, Pelle Lau; Knop, Filip Krag; Broberg, Brian Villumsen

    with a GLP-1 receptor agonist (exenatide once-weekly) is safe and facilitates weight loss in non-diabetic schizophrenia patients with antipsychotic-associated obesity. Methods and analysis: Forty obese patients with schizophrenia or schizoaffective disorder treated with antipsychotic drugs will be randomised...

  9. MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

    International Nuclear Information System (INIS)

    Pierre-Jerome, Claude; Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R.

    2012-01-01

    Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor

  10. Hemoglobin A1c Levels Predicts Acute Kidney Injury after Coronary Artery Bypass Surgery in Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Cevdet Ugur Kocogulları

    Full Text Available Abstract INTRODUCTION: Elevated hemoglobin A1c levels in patients with diabetes mellitus have been known as a risk factor for acute kidney injury after coronary artery bypass grafting. However, the relationship between hemoglobin A1c levels in non-diabetics and acute kidney injury is under debate. We aimed to investigate the association of preoperative hemoglobin A1c levels with acute kidney injury in non-diabetic patients undergoing isolated coronary artery bypass grafting. METHODS: 202 non-diabetic patients with normal renal function (serum creatinine <1.4 mg/dl who underwent isolated coronary bypass were analyzed. Hemoglobin A1c level was measured at the baseline examination. Patients were separated into two groups according to preoperative Hemoglobin A1c level. Group 1 consisted of patients with preoperative HbA1c levels of < 5.6% and Group 2 consisted of patients with preoperative HbA1c levels of ≥ 5.6%. Acute kidney injury diagnosis was made by comparing baseline and postoperative serum creatinine to determine the presence of predefined significant change based on the Kidney Disease Improving Global Outcomes (KDIGO definition. RESULTS: Acute kidney injury occurred in 19 (10.5% patients after surgery. The incidence of acute kidney injury was 3.6% in Group 1 and 16.7% in Group 2. Elevated baseline hemoglobin A1c level was found to be associated with acute kidney injury (P=0.0001. None of the patients became hemodialysis dependent. The cut off value for acute kidney injury in our group of patients was 5.75%. CONCLUSION: Our findings suggest that, in non-diabetics, elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. Prospective randomized studies in larger groups are needed to confirm these results.

  11. Plasma lipoprotein(a levels: a comparison between diabetic and non-diabetic patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Holanda Maurus Marques de Almeida

    2004-01-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate lipoprotein(a (Lp(a, total cholesterol, high density lipoprotein cholesterol (HDL, low density lipoprotein cholesterol (LDL, very low density lipoprotein cholesterol (VLDL , triglycerides , apolipoprotein A (apo A and B100 (apo B100, uric acid, glycaemic and insulin plasmatic concentrations in patients affected by acute stroke. In this group of patients, we have compared the variables between type 2 diabetic patients and non-diabetic patients. METHOD: We evaluate a total of 34 non-diabetic patients (22 males and 12 females; mean age 66.71 ± 10.83 years and a group of 26 type 2 diabetic patients (15 males and 11 females; mean age 66.35 ± 9.92 years in a cross-sectional study. RESULTS: Mean Lp(a concentration did not significantly differ between type 2 diabetic patients and non-diabetic subjects (29.49 ± 23.09 vs 44.81 ± 44.34 mg/dl. The distribution of Lp(alevels was highly skewed towards the higher levels in both groups, being over 30 mg/dl in 50%. Lp(a concentration was positively correlated with abdominal adiposity, using waist-hip ratio(WHR(p< 0.05. No association was found between Lp(a and others risk factors like sex, age, other lipidic parameters and the presence of stroke. CONCLUSIONS: Our results showed that there were no significant differences between diabetic and non-diabetic patients' serum Lp(a levels, which indicates that elevated Lp(a levels were associated with ischemic stroke, irrespective of the presence of type 2 diabetes mellitus (type 2 DM.

  12. MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Pierre-Jerome, Claude, E-mail: cpierr3@emory.edu [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States); Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R. [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States)

    2012-10-15

    Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor.

  13. Assessment of urinary tract infection and their resistance to antibiotics in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Nureen Zahra

    2016-09-01

    Full Text Available Diabetic patients are more susceptible to urinary tract infections (UTIs than non-diabetic patients and due to the development of multidrug resistant uropathogenic strains, the choice of antibacterial agents is being limited. The study was undertaken to determine the influence of diabetes mellitus on the uropathogens and antibiotic sensitivity pattern among patients with UTIs. A cross-sectional study was conducted in which total of 400 patients were studied out of which 150 were diabetics and 250 were non-diabetics. Patients with negative urine culture (n = 240 were excluded from the study and 160 patients with positive culture of UTIs of which 80 were diabetics and 80 were non-diabetics, included in this study. Clinical data were obtained from individual study participant with informed written consent using pre-tested questionnaire. According to the clean-catch procedure, midstream urine samples were collected and cultured for the diagnosis and susceptibility of bacteriuria. Out of 160 uropathogenic isolates, E. coli was found as a leading pathogen i.e. 46.25% followed by Candida spp. 30.62%, S. Faecalis 15.62%, P. aeruginosa 3.13%, Pneumococcus. 1.25%, MSSA 1.25%, MRSA 0.63%, Proteus spp. 0.63% and Vancomycin resistant enterococcus spp. 0.63%. The results indicated that prevalence of UTIs was significantly higher in diabetic patients than in non-diabetic subjects. E. coli was found to be the most common isolate. It was observed that UTIs in diabetic patients was more in female diabetic patients than in male patients. Investigation of bacteriuria in diabetic patients for UTIs is an important tool for the treatment and prevention of renal complications.

  14. Therapies for inter-relating diabetes and obesity - GLP-1 and obesity

    DEFF Research Database (Denmark)

    Iepsen, Eva Pers Winning; Torekov, Signe S; Holst, Jens Juul

    2014-01-01

    INTRODUCTION: The dramatic rise in the prevalence of obesity and type 2 diabetes mellitus (T2DM) is associated with increased mortality, morbidity as well as public health care expenses worldwide. The need for effective and long-lasting pharmaceutical treatment is obvious. The record of anti-obesity...... drugs has been poor so far and the only efficient treatment today is bariatric surgery. Research has indicated that appetite inhibiting hormones from the gut may have a therapeutic potential in obesity. The gut incretin hormone, glucagon-like peptide-1 (GLP-1), appears to be involved in both peripheral...... and central pathways mediating satiety. Clinical trials have shown that two GLP-1 receptor agonists exenatide and liraglutide have a weight-lowering potential in non-diabetic obese individuals. Furthermore, they may also hold a potential in preventing diabetes as compared to other weight loss agents. AREAS...

  15. Protective effects of sodium selenite on lead nitrate-induced hepatotoxicity in diabetic and non-diabetic rats.

    Science.gov (United States)

    Kalender, Suna; Apaydin, Fatma Gökçe; Baş, Hatice; Kalender, Yusuf

    2015-09-01

    In the present study, the effect of sodium selenite on lead induced toxicity was studied in Wistar rats. Sodium selenite and lead nitrate were administered orally for 28 days to streptozotocin induced diabetic and non-diabetic rats. Eight groups of rats were used in the study: control, sodium selenite, lead nitrate, lead nitrate+sodium selenite, streptozotocin-induced diabetic-control, diabetic-sodium selenite, diabetic-lead nitrate, diabetic-lead nitrate+sodium selenite groups. Serum biochemical parameters, lipid peroxidation, antioxidant enzymes and histopathological changes in liver tissues were investigated in all groups. There were statistically significant changes in liver function tests, antioxidant enzyme activities and lipid peroxidation levels in lead nitrate and sodium selenite+lead nitrate treated groups, also in diabetic and non-diabetic groups. Furthermore, histopathological alterations were demonstrated in same groups. In the present study we found that sodium selenite treatment did not show completely protective effect on diabetes mellitus caused damages, but diabetic rats are more susceptible to lead toxicity than non-diabetic rats. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Comparison of carotid and cerebrovascular disease between diabetic and non-diabetic patients using dual-source CT

    International Nuclear Information System (INIS)

    He Ci; Yang Zhigang; Chu Zhigang; Dong Zhihui; Li Yunming; Shao Heng; Deng Wen

    2011-01-01

    Purpose: To clarify the differences of the carotid and cerebrovascular disease between patients with and without type 2 diabetes using dual-source CT angiography. Materials and methods: Dual-source CT angiography of the carotid and cerebrovascular arteries was performed in 79 type 2 diabetic patients and 207 non-diabetic patients. The type, extent and distribution of plaques, and luminal stenosis were compared. Results: Compared with non-diabetic patients, diabetic patients had a higher overall incidence of plaque (p 0.05), as well as for the number of diseased segments and the distribution of plaques; both mainly involved the bilateral cavernous segment of the internal carotid artery. As for the stenosis, non-obstructive lesions were more common in diabetic patients (p 0.05). Conclusion: Diabetes is associated with a higher incidence of plaque and non-obstructive stenosis. However, no significant differences were observed in the type, extent and distribution of involved plaques between diabetic and non-diabetic patients.

  17. Detection of Mogibacterium timidum in subgingival biofilm of aggressive and non-diabetic and diabetic chronic periodontitis patients

    Directory of Open Access Journals (Sweden)

    Renato Corrêa Viana Casarin

    2012-09-01

    Full Text Available The aim of the present study was to evaluate the frequency of detection of Mogibacterium timidum in subgingival samples of subjects with generalized aggressive periodontitis (GAgP and uncontrolled diabetic and non-diabetic subjects with generalized chronic periodontitis (GChP. 48 patients with GAgP, 50 non-diabetic and 39 uncontrolled (glycated hemoglobin >7% type 2 diabetic subjects with GChP were enrolled in this study. Subgingival biofilm were collected from deep pockets (probing depth > 7 mm. After DNA extraction, M. timidum was detected by Nested Polymerase Chain Reaction and chi-square test was used to data analysis (p>0.05. There were no differences in the frequency of detection of M. timidum between subjects with GAgP (35% and non-diabetic subjects with GChP (40% (p>0.05. The frequency of detection of M. timidum was significantly higher in deep pockets of diabetic subjects with GChP (56% when compared to GAgP (p0.05. The frequency of detection of M. timidum was higher in subjects GChP presenting uncontrolled type 2 diabetes mellitus, when compared to GAgP subjects.

  18. Detection of Mogibacterium timidum in subgingival biofilm of aggressive and non-diabetic and diabetic chronic periodontitis patients.

    Science.gov (United States)

    Casarin, Renato Corrêa Viana; Saito, Daniel; Santos, Vanessa Renata; Pimentel, Suzana Peres; Duarte, Poliana Mendes; Casati, Márcio Zaffalon; Gonçalves, Reginaldo Bruno

    2012-07-01

    The aim of the present study was to evaluate the frequency of detection of Mogibacterium timidum in subgingival samples of subjects with generalized aggressive periodontitis (GAgP) and uncontrolled diabetic and non-diabetic subjects with generalized chronic periodontitis (GChP). 48 patients with GAgP, 50 non-diabetic and 39 uncontrolled (glycated hemoglobin >7%) type 2 diabetic subjects with GChP were enrolled in this study. Subgingival biofilm were collected from deep pockets (probing depth > 7 mm). After DNA extraction, M. timidum was detected by Nested Polymerase Chain Reaction and chi-square test was used to data analysis (p>0.05). There were no differences in the frequency of detection of M. timidum between subjects with GAgP (35%) and non-diabetic subjects with GChP (40%) (p>0.05). The frequency of detection of M. timidum was significantly higher in deep pockets of diabetic subjects with GChP (56%) when compared to GAgP (pGChP (p>0.05). The frequency of detection of M. timidum was higher in subjects GChP presenting uncontrolled type 2 diabetes mellitus, when compared to GAgP subjects.

  19. Ultrasonic Measurement of Common Carotid Intima-Media Thickness in Type 2 Diabetic and Non-Diabetic Patients

    International Nuclear Information System (INIS)

    Alizadeh, Ahmad; Roudbari, Ali; Heidarzadeh, Abtin; Babaei Jandaghi, Ali; Bani Jamali, Maryam

    2012-01-01

    Diabetes mellitus is a widespread disease. Its vascular complications can be characterized by arteriosclerosis formation in carotid arteries. Due to its delayed diagnosis resulting in more complications in Iran, it seems that screening diabetic patients is mandatory. The aim of this study was to compare the intima-media thickness (IMT) of carotid artery in diabetic and non-diabetic patients. This is a cross-sectional study, which included 80 participants (40 diabetics and 40 non-diabetics). By using ultrasound, bilateral IMTs of the distal carotid were measured and the data were analyzed using ANOVA and multivariate regression tests in SPSS 14. The mean IMT was 0.97 in diabetic patients and 0.63 in non-diabetics (P < 0.001). Age and gender had significant positive effects on the increase of IMT (P < 0.05 and P < 0.005, respectively for age and gender). Past medical history of coronary heart disease (CHD) and cerebrovascular accident (CVA) in diabetes is associated significantly with an increase in IMT (P =0.019 and 0.027 respectively). Other confounding variables such as smoking, history of hypertension (HTN) and hyperlipoproteinemia (HLP) in diabetic patients showed no significant relationship with the increase of IMT. Although measuring the IMT of the carotid artery by sonography is a useful tool for screening diabetic patients, more studies are needed for determining how to use these measurements in promoting the patients outcomes

  20. Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

    Science.gov (United States)

    Lai, Stefano; Cagetti, Maria Grazia; Cocco, Fabio; Cossellu, Dina; Meloni, Gianfranco; Campus, Guglielmo; Lingström, Peter

    2017-01-01

    To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status. Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4-14 years) were enrolled. The diabetic children were divided: a) 20 children in good metabolic control (Hb1ac≤7.5) and b) 48 children in bad metabolic control (Hb1ac>7.5). Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse. Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively) and in subjects in bad metabolic control (p = 0.03 and pgood metabolic control (pgood and bad metabolic control (pgood metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

  1. Distinct roles of urinary liver-type fatty acid-binding protein in non-diabetic patients with anemia.

    Directory of Open Access Journals (Sweden)

    Naohiko Imai

    Full Text Available Various stresses including ischemia are known to up-regulate renal L-FABP gene expression and increase the urinary excretion of L-FABP. In diabetic patients with anemia, the urinary excretion of L-FABP is significantly increased. We studied the clinical significance of urinary L-FABP and its relationship with anemia in non-diabetic patients.A total of 156 patients were studied in this retrospective cross-sectional analysis. The associations between anemia and urinary L-FABP levels, and the predictors of urinary L-FABP levels in non-diabetic patients were evaluated.Urinary L-FABP levels were significantly higher in patients with anemia compared to those in patients without anemia. Similarly, the urinary L-FABP levels were significantly higher in patients with albuminuria compared to those in patients without albuminuria. Urinary L-FABP levels correlated with urinary albumin-to-creatinine ratios, estimated glomerular filtration rates, body mass index, and hemoglobin levels. Multivariate linear regression analysis determined that hemoglobin levels (β = -0.249, P = 0.001 and urinary albumin-to-creatinine ratios (β = 0.349, P < 0.001 were significant predictors of urinary L-FABP levels.Urinary L-FABP is strongly associated with anemia in non-diabetic patients.

  2. Furan induced ovarian damage in non-diabetic and diabetic rats and cellular protective role of lycopene.

    Science.gov (United States)

    Uçar, Semra; Pandir, Dilek

    2017-11-01

    In our work, furan, lycopene, and furan + lycopene treatments were applied to non-diabetic and diabetic female rats via gavage. Ovarian tissue alterations with histopathology, immunohistochemistry, malondialdehyde levels, oxidative stress parameters such as superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase and harmful effect on ovarian tissue DNA were evaluated in all groups for 28 days. Furan caused the changes histological, ovarian cell's DNA structure, malondialdehyde levels, antioxidant enzymes activities as in a statistically significant manner in each group. Useful effect of lycopene was determined both in non-diabetic and diabetic treatment groups against furan according to the used experimental parameters. Although some histopathological alterations were seen in diabetic and non-diabetic/diabetic plus furan-treated group's ovarians, lycopene restored these variations near to normal levels in furan + lycopene treated groups for in 28 days. Additionally, the results of our immunohistochemical analysis and alterations of the oxidative stress parameters results also supported these findings. Our result confirms that lycopene has protective effect and significantly altered diabetes and furan-induced toxicity in the rat ovarian tissue.

  3. A preliminary study of levels of selected nutrients for neonates born to diabetic and non-diabetic mothers in Bangladesh

    International Nuclear Information System (INIS)

    Alam, A.M.S.; Chhowdhury, S.A.; Rahman, M.A.; Ali, S.M.K.; Huda, A.S.N.

    2006-01-01

    To investigate some selected nutrients status in the neonates born to diabetic and non-diabetic mothers a prospective study was carried out. From the Obstetric Unit of Bangladesh Institute of Rehabilitation in Diabetes, Endocrine and Metabolic disorder (BIRDEM) Hospital, Dhaka, Bangladesh, 236 newborns were recruited; 74 from diabetic, 59 from gestational diabetic and 103 from non-diabetic mothers group for this study. Cord-serum levels of Cu, Zn, Fe, Mg, Ca and ascorbic acid were investigated, and some anthropometric measurements were recorded to correlate with the nutrient levels. Fe was found significantly higher (p<0.05) whereas, ascorbic acid was found significantly lower (p<0.05) in diabetic group compared with other two groups. However, Mg and Ca levels were found significantly higher (p<0.05) in non-diabetic group. There was no significant difference observed in Cu, Zn levels for the 3 groups. Ca level was significantly correlated with birth weight and length of the neonates. These data suggests that diabetes has some effects on fetal growth and its nutritional status that also reflect the socio-economical status of the families of the neonates. (author)

  4. Comparison of the clinical parameters of benign prostate hyperplasia in diabetic and non diabetic patients

    Directory of Open Access Journals (Sweden)

    Levent Ozcan

    2017-03-01

    Full Text Available Objective: We evaluated the correlation between benign prostate hyperplasia (BPH measures and diabetes mellitus in men with benign prostate hyperplasia in a prospective study. Materials and methods: Between 2008-2012, 100 diabetic and 200 non diabetic patients undergoing surgery due to benign prostate hyperplasia were enrolled in the study. The parameters evaluated for each patients included prostate volume, fasting blood glucose, HbA1c, total testosterone, total prostatic specific antigen (T-PSA, triglicerides, total cholesterol and body mass index (BMI. A questionnaire including international prostate symptom score (IPSS was sdministered and uroflow test measuring the peak urinary flow rate was performed to appreciate the complaints of the patients objectively. Results: Diabetic patients are more likely to have larger prostate volume. The symptom score evaluated by IPSS and post micturition residual volume were also significantly higher in diabetic groups. The other statistically significant different parameter between two groups was total testosterone that diabetic patients tend to have lower levels. Diabetic counterparts were established to have higher BMI. No statistically significant differentiation was observed about trigliceryde and total cholesterol levels and uroflow rates. Conclusions: Our study suggests a positive correlation between high prostate volume and diagnosis of diabetes mellitus in patients with benign prostatic hyperplasia. We also observed a positive correlation between symptom scores and post micturion residual volumes and diagnosis of diabetes mellitus suggesting that the presence of diabetes is related to both static and dynamic components of benign prostate hyperplasia. Additionally testosterone levels were lower in diabetic patients. Further studies need to confirm these relationship in a larger population.

  5. Gender differences in factors influencing insulin resistance in elderly hyperlipemic non-diabetic subjects

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    Hrebícek Jirí

    2002-10-01

    Full Text Available Abstract Background The increase in the prevalence of insulin resistance-related metabolic syndrome, a disorder that greatly increases the risk of diabetes, heart attack and stroke, is alarming. One of the most frequent and early symptoms of metabolic syndrome is hypertriglyceridemia. We examined the gender differences between various metabolic factors related to insulin resistance in elderly non-diabetic men and postmenopausal women of comparable age suffering from hypertriglyceridemia, and compared them with healthy subjects of equal age. Results The indexes of insulin resistance HOMA IR and QUICKI were significantly higher in both hyperlipemic men and women than in controls; 95% confidence limits of hyperlipemic subjects did not overlap with controls. In both normolipemic and hyperlipemic men and women serum leptin correlated significantly with insulin resistance, while HDL-cholesterol correlated inversely with HOMA-IR only in women (both normo- and hyperlipemic, and serum tumor necrosis factor α (TNFα only in hyperlipemic women. According to results of multiple regression analysis with HOMA-IR as a dependent variable, leptin played a significant role in determining insulin resistance in both genders, but – aside from leptin – triglycerides, TNFα and decreased HDL-cholesterol were significant determinants in women, while body mass index and decreased HDL-cholesterol were significant determinants in men. The coefficient of determination (R2 of HOMA IR by above mentioned metabolic variables was in women above 60%, in men only about 40%. Conclusion The significant role of serum leptin in determination of insulin resistance in both elderly men and postmenopausal women of equal age was confirmed. However, the study also revealed significant gender differences : in women a strong influence of triglycerides, TNFα and decreased HDL-cholesterol, in men only a mild role of BMI and decreased HDL-cholesterol.

  6. Obesity Prevention and Screening.

    Science.gov (United States)

    Mackey, Eleanor R; Olson, Alexandra; DiFazio, Marc; Cassidy, Omni

    2016-03-01

    Obesity is widespread, associated with several physical and psychosocial comorbidities, and is difficult to treat. Prevention of obesity across the lifespan is critical to improving the health of individuals and society. Screening and prevention efforts in primary care are an important step in addressing the obesity epidemic. Each period of human development is associated with unique risks, challenges, and opportunities for prevention and intervention. Screening tools for overweight/obesity, although imperfect, are quick and easy to administer. Screening should be conducted at every primary care visit and tracked longitudinally. Screening tools and cutoffs for overweight and obesity vary by age group. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Visceral obesity is associated with increased soluble CD163 concentration in men with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Sørensen, Lars Peter; Parkner, Tina; Søndergaard, Esben

    2015-01-01

    individuals. The objective was to examine the effect of male overweight/obesity and type 2 diabetes mellitus (T2DM) on associations between adiposity parameters and sCD163. A total of 23 overweight/obese non-diabetic men, 16 overweight/obese men with T2DM, and a control group of 20 normal-weight healthy men...... multiple linear regression analysis. In the normal-weight healthy men, there was no significant association between adiposity parameters and sCD163, whereas in the overweight/obese non-diabetic men, measures of general and regional adiposity were positively associated with sCD163. In the overweight/obese......-body fat, adjusted for BMI and age, VAT remained a significant predictor of sCD163 in the overweight/obese T2DM men, but not in the overweight/obese non-diabetic men. Our results indicate that VAT inflammation is exaggerated in men with T2DM, and that propensity to store excess body fat viscerally...

  8. Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography

    DEFF Research Database (Denmark)

    Gudbergsen, H.; Boesen, M.; Lohmander, L. S.

    2012-01-01

    With an increasing prevalence of older and obese citizens, the problems of knee osteoarthritis (KOA) will escalate. Weight loss is recommended for obese KOA patients and in a majority of cases this leads to symptomatic relief. We hypothesized that pre-treatment structural status of the knee joint......, assessed by radiographs, 1.5 T magnetic resonance imaging (MRI) and knee-joint alignment, may influence the symptomatic changes following a significant weight reduction....

  9. Obesity and respiratory diseases

    Directory of Open Access Journals (Sweden)

    Christopher Zammit

    2010-10-01

    Full Text Available Christopher Zammit, Helen Liddicoat, Ian Moonsie, Himender MakkerSleep and Ventilation Unit, Department of Respiratory Medicine, North Middlesex University Hospital, London, UKAbstract: The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ producing systemic inflammation and effecting central respiratory control. Obesity plays a key role in the development of obstructive sleep apnea and obesity hypoventilation syndrome. Asthma is more common and often harder to treat in the obese population, and in this study, we review the effects of obesity on airway inflammation and respiratory mechanics. We also discuss the compounding effects of obesity on chronic obstructive pulmonary disease (COPD and the paradoxical interaction of body mass index and COPD severity. Many practical challenges exist in caring for obese patients, and we highlight the complications faced by patients undergoing surgical procedures, especially given the increased use of bariatric surgery. Ultimately, a greater understanding of the effects of obesity on the respiratory disease and the provision of adequate health care resources is vital in order to care for this increasingly important patient population.Keywords: obesity, lung function, obstructive sleep apnea, obesity hypoventilation syndrome, anesthesia

  10. Non-diabetic renal disease in patients with type-2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sonia Yaqub

    2012-01-01

    Full Text Available Diabetic nephropathy (DN is the leading cause of end-stage renal disease in diabetics worldwide, yet most patients with type-2 diabetes mellitus are not formally evaluated with a renal biopsy. The diagnosis is almost always based on clinical grounds. A wide spectrum of non-diabetic renal disease (NDRD is reported to occur in patients with type-2 diabetes. It has been estimated that up to one-third of all diabetic patients who present with proteinuria are suffering from NDRD. The aim of this analysis was to evaluate the prevalence and etiology of NDRD in patients with type-2 diabetes. We retrospectively reviewed the medical records of patients with type-2 diabetes who underwent kidney biopsy on clinical suspicion of NDRD (absence of diabetic retinopathy and/or neuropathy; short duration of diabetes, i.e. less than five years from January 2003 through December 2007 at the Aga Khan University Hospital, Karachi. Based on the biopsy findings, patients were grouped as Group-I, isolated NDRD; Group-II, NDRD with underlying DN; and Group-III, isolated DN. Of 68 patients studied, 75% were males and the mean age was 56 years. The mean duration of diabetes was nine years. Group-I included 34 patients (52%, Group-II included 11 patients (17% and Group-III included 23 patients (31%. Among the Group-I patients, the mean age was 56 years (41-77 years. The most common NDRDs were acute interstitial nephritis (32%, diffuse proliferative glomerulonephritis (17%; membranous nephropathy (12% and crescentic glomerulonephritis (12%. Among Group-II, the mean age was 60 years (46-71 years, and the most common lesion was interstitial nephritis superimposed on underlying DN (63% cases. Among Group-III, the mean age was 53 years (42- 80 years. The mean proteinuria was 5, 6.3 and 7.3 g/24 h of urine collection in Groups I, II and III, respectively (P = NS. The mean duration of diabetes was 7.3, 11.7 and 10.7 years in Groups I, II and III, respectively. The duration of

  11. Gastric bypass surgery reveals independency of obesity and diabetes melitus type 2

    DEFF Research Database (Denmark)

    Fenger, Mogens; Hansen, Dorte Lindqvist; Worm, Dorte

    2016-01-01

    BACKGROUND: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change...... in metabolic status is poorly understood, but the observation may suggest that the fate obesity and diabetes is only partly linked after surgery. METHODS: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects with and without diabetes were evaluated. Evaluation...... was performed on three groups: 1) subjects that were non-diabetic before and after surgery; 2) subjects that were diabetics before surgery but non-diabetics after surgery; and 3) subjects that were diabetics before surgery and remained diabetics after surgery. The diabetic state was established at HbA1c above...

  12. HOMA-IR Values are Associated With Glycemic Control in Japanese Subjects Without Diabetes or Obesity: The KOBE Study.

    Science.gov (United States)

    Hirata, Takumi; Higashiyama, Aya; Kubota, Yoshimi; Nishimura, Kunihiro; Sugiyama, Daisuke; Kadota, Aya; Nishida, Yoko; Imano, Hironori; Nishikawa, Tomofumi; Miyamatsu, Naomi; Miyamoto, Yoshihiro; Okamura, Tomonori

    2015-01-01

    Several studies have reported that insulin resistance was a major risk factor for the onset of type 2 diabetes mellitus in individuals without diabetes or obesity. We aimed to clarify the association between insulin resistance and glycemic control in Japanese subjects without diabetes or obesity. We conducted a community-based cross-sectional study including 1083 healthy subjects (323 men and 760 women) in an urban area. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders. Compared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: β = 1.83, P = 0.001; FPG: β = 0.49, P HOMA-IR values was inversely associated with 1,5-AG levels compared with the lowest tertile (β = -18.42, P = 0.009) only in men. HOMA-IR values were associated with markers of glycemic control in Japanese subjects without diabetes or obesity. Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population.

  13. Severe Maternal Stress Exposure Due to Bereavement before, during and after Pregnancy and Risk of Overweight and Obesity in Young Adult Men

    DEFF Research Database (Denmark)

    Hohwü, Lena; Li, Jiong; Olsen, Jørn

    2014-01-01

    BACKGROUND: Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men. METHODS: A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military...... service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group). Median body mass index (BMI) and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25...... kg/m2) and obesity (BMI≥30 kg/m2) were estimated by logistic regression analysis adjusted for maternal educational level. RESULTS: Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02) and obesity (9.8% versus 8.5%, p = 0...

  14. Effects of an in-patient treatment program based on regular exercise and a balanced diet on high molecular weight adiponectin, resistin levels, and insulin resistance in adolescents with severe obesity.

    Science.gov (United States)

    Gueugnon, Carine; Mougin, Fabienne; Simon-Rigaud, Marie-Laure; Regnard, Jacques; Nègre, Véronique; Dumoulin, Gilles

    2012-08-01

    Adiponectin, the most abundant hormone produced by adipose tissue, circulates in 3 isoforms, including high molecular weight (HMW) adiponectin. The latter has been suggested to be a better predictor of metabolic disturbances and insulin resistance associated with obesity. This study investigated changes in total and HMW adiponectin, resistin, and homeostasis model assessment (HOMA) during a 9-month in-patient treatment program based on physical exercise and a balanced diet in 32 severely obese adolescents. Total and HMW adiponectin, resistin, and HOMA were measured at baseline (month 0) and during the program (months 3, 6, 9). In addition, a control group of 15 teenagers served as a reference for the baseline assessments. At baseline, HMW adiponectin was more markedly decreased in obese adolescents than total adiponectin, and both were lower than in controls. Conversely, resistin and HOMA were higher in obese adolescents. During the program, there was a significant change in body composition and improved insulin sensitivity among obese teenagers. In addition, HMW adiponectin and the ratio of HMW-to-total adiponectin increased throughout the study, whereas total adiponectin only increased up until the sixth month. On the contrary, resistin did not show any significant change. In obese adolescents, a long-term combination of aerobic exercise and a balanced diet, inducing change in body composition and improved insulin sensitivity, markedly increased HMW adiponectin compared with total adiponectin, without any change in resistin concentrations. Our results thus suggest that the determination of HMW adiponectin could be more useful than measurement of total adiponectin in clinical settings.

  15. Correlation between Stress Hyperglycemia and Short-Term Prognosis in non Diabetic Patients with Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Rafighdoust Amirhossein

    2009-03-01

    Full Text Available Background: Abnormal hyperglycemia is a common finding in early phase of acute myocardial infarction that is named as stress hyperglycemia. In this study we have evaluated primary blood sugar of non-diabetic patients with acute myocardial infarction at the time of admission to compare the early complications between patients with high or normal blood sugar. We aimed to find any relation between primary blood sugar and post MI complication rate. Materials and Methods: One hundred non-diabetic patients with acute myocardial infarction who were referred to heart emergency ward of Imam Reza Hospital (Mashhad, Iran were included in this study. According to primary blood glucose level, 50 patients with blood glucose > 126 mg/dl were compared with 50 patients with normal blood glucose level. All patients were evaluated during hospitalization and daily clinical examinations laboratory tests, and routine non-invasive assessments were done. The results were analyzed by SPSS software and the level of signification difference was described as p<0.05.Results: Sinus tachycardia, atrial fibrillation, bundle branch block, ventricular extrasystole, prolonged PR-interval and heart failure according to Klip classification and also according to echocardiographic index (EF<50 were statistically significant and more common in hyperglycemic patients (P<0.05. Thromboembolic and mechanical complications (papillary muscle dysfunction, pericarditis, phlebitis and angina were also more common in hyperglycemic group although the differences were not significant statistically. Conclusion: It seems that high rate of early complications in non-diabetic patients with acute myocardial infarction is directly related to primary hyperglycemia (stress hyperglycemia.

  16. Outcome of Diabetic and Non-Diabetic Patients Undergoing Successful Percutaneous Coronary Intervention of Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    Bahram Sohrabi

    2011-05-01

    Full Text Available Introduction: Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention (PCI. The prognosis of patients with diabetes mellitus and chronic total occlusion (CTO treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. Methods: One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15±3 months, were evaluated for the occurrence of major adverse cardiac events (MACE comprising death, acute myocardial infarction, and need for repeat revascularization.Results: No differences were found in baseline clinical and procedural variables between patients with (n=34 and without diabetes (n=129, unless for hypertension (p=0.03. Hospitalization period after PCI in diabetics (3.26±0.61 days and non-diabetics (2.86±0.52 days was similar. In-hospital MACE occurred in 8 (23.5% individuals of diabetics and 10 (7.8% individuals of non-diabetics (p=0.02, among them revascularization was significantly higher in diabetics (20.6% vs. 7%, p=0.04. Follow-up events in diabetic and non-diabetic groups were 12 (35.3% and 37 (28.5%, respectively (p was not significant. Conclusion: In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients.

  17. The Effect of Trans-Chalcone on Amylase Activity, Blood Glucose and Lipid Levels in Diabetic and Non Diabetic Rats

    Directory of Open Access Journals (Sweden)

    M Najafian

    2011-04-01

    Full Text Available Introduction & Objective: Alpha amylase is the most important decomposing enzyme in starch. Digestion and absorption of starch in the intestine can be prevented and also the blood sugar levels can be controlled by restrain and control of alpha amylase. The aim of this study was to evaluate the effect of trans-chalcone on amylase activity, blood glucose and lipid levels in diabetic and non diabetic rats. Materials & Methods: This experimental study was conducted in 1388 at Tehran University of Medical Sciences. Sixty rats were randomly divided to ten equal groups: non diabetic control, diabetic control, four non diabetic experiments and four diabetic experiments. Control groups received grape seed oil and experimental groups received 2, 8,16 and 32 mg/kg of body weight in a period of 24 days with a gastric cannula. Blood sugar, every two days, serum insulin levels in days 0,12, and 24 and at the end of the experiment, lipoproteins and alpha amylase activity were measured.The data were analyzed by one way analysis of variance, ANOVA, followed by Turkey,s test with SPSS soft ware . Results: On average Chalcone reduced 25.5% of blood sugar in normal and diabetic rats. IT also decreased the serum insulin level. On average, chalcone decreased 34.9% of alpha amylase activity in normal and diabetic rats. Following disturbances in lipids metabolism caused by diabetes, this drug improved lipoproteins metabolism and reduced water, food and urine volume. Conclusion: This study shows that trans-Chalcone reduces blood sugar and body weight via inhibition of alpha amylas. Moreover, improvement of lipoprotein metabolism may happen via the inhibitory effect of this drug on hydroxyl methyl glutaryl -COA reductase and phosphodiesterase.

  18. Intra-Hospital Outcomes in ST Elevation Myocardial Infarction: Comparison of Diabetic and Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Toba Kazemi

    2015-12-01

    Full Text Available We read the interesting article entitled “the Effect of Diabetes Mellitus on Short Term Mortality and Morbidity after Isolated Coronary Artery Bypass Grafting Surgery” (1. We performed a study on intra-hospital complications in diabetic and non-diabetic patients with Acute Myocardial Infarction (AMI in Birjand, east of Iran in 2012. In our study, 479 patients with AMI (243 diabetics and 236 non-diabetics were assessed. The subjects’ mean age was 61.95 ± 13.18 years. Assessment of intra-hospital complications in the two groups revealed that recurrent angina and mortality were significantly higher in the diabetics compared to the non-diabetics (52.5% vs. 39.3%, P = 0.009; 11.2% vs. 2.6%, P = 0.012, respectively. Besides, the mean Ejection Fraction (EF was lower in the diabetics in comparison to the non-diabetics (45.26 ± 11.37% vs. 49.98 ± 10.39%, P = 0.014. Moreover, the incidence rates of intra-hospital mortality and heart failure were higher in the diabetics with AMI. This can be due to the higher prevalence of the associated risk factors, such as hypertension, dyslipidemia, and hyperglycemia, in diabetic patients and their effects on the heart. Hyperglycemia occurring after AMI is a strong and independent prognostic marker of post-MI complications. Stress, which occurs following AMI, increases insulin resistance and hyperglycemia and decreases glucose tolerance. Un-controlled diabetes in patients having AMI is accompanied by an unfavorable prognosis and may increase the risk of life-threatening complications (2. The increased risk of complications can be a possible explanation for the increase in intra-hospital mortality after AMI is diabetic patients. Various studies have indicated that initial hyperglycemia associated with failure of ST segment resolution after streptokinase infusion is followed by more extensive infarction revealed in Single-Photon Emission Computerized Tomography (SPECT, less blood flow in coronary arteries in

  19. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    International Nuclear Information System (INIS)

    Maseeh-uz-Zaman; Fatima, N.; Samad, A.; Rasheed, S.Z.; Ishaq, M.; Rehman, K.; Wali, A.

    2009-01-01

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

  20. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    Energy Technology Data Exchange (ETDEWEB)

    Maseeh-uz-Zaman,; Fatima, N; Samad, A; Rasheed, S Z; Ishaq, M; Rehman, K; Wali, A [Karachi, Inst. of Heart Diseases, Karachi (Pakistan)

    2009-07-15

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

  1. Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults.

    LENUS (Irish Health Repository)

    Crowe, Catherine

    2015-08-01

    Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme.

  2. Treatment of antipsychotic-associated obesity with a GLP-1 receptor agonist--protocol for an investigator-initiated prospective, randomised, placebo-controlled, double-blinded intervention study

    DEFF Research Database (Denmark)

    Ishøy, Pelle L; Knop, Filip K; Broberg, Brian V

    2014-01-01

    -associated obesity are limited and insufficient. Glucagon-like peptide-1 (GLP-1) receptor agonists are approved for the treatment of type 2 diabetes, but their bodyweight-lowering effects have also been recognised in patients with non-diabetes. The primary endpoint of this trial is weight loss after 3 months...... of treatment with a GLP-1 receptor agonist (exenatide once weekly) in patients with non-diabetic schizophrenia with antipsychotic-associated obesity. Secondary endpoints include physiological and metabolic measurements, various psychopathological and cognitive measures, and structural and functional brain MRI....

  3. Could inherited predisposition drive non-obese fatty liver disease? Results from German tertiary referral centers.

    Science.gov (United States)

    Krawczyk, Marcin; Bantel, Heike; Rau, Monika; Schattenberg, Jörn M; Grünhage, Frank; Pathil, Anita; Demir, Münevver; Kluwe, Johannes; Boettler, Tobias; Weber, Susanne N; Geier, Andreas; Lammert, Frank

    2018-05-01

    Non-alcoholic fatty liver disease (NAFLD) is frequent among obese individuals with metabolic syndrome. Variants PNPLA3 p.I148M, TM6SF2 p.E167K and MBOAT7 rs641738 are associated with higher liver fat contents. Here we analyzed 63 biopsied non-obese, non-diabetic patients with NAFLD (39 men, age: 20-72 years) recruited within the German NAFLD CSG program. The frequencies of the PNPLA3, TM6SF2 and MBOAT7 polymorphisms were compared with the remaining patients in the NAFLD CSG cohort and with a control population (n = 174). Serum CK18-M30 was measured by ELISA. In non-obese NAFLD patients, the frequency of the PNPLA3 p.I148M allele (74.6%), but not of the TM6SF2 or MBOAT7 polymorphisms, was significantly (P < 0.05) higher as compared to the other patients in the NAFLD CSG cohort (54.9%) or controls (40.2%). The presence of the minor PNPLA3 p.I148M risk allele increased the risk of developing NAFLD (OR = 3.29, P < 0.001) and was associated with higher steatosis, fibrosis, and serum CK18-M30 levels (all P < 0.05). According to the population attributable fraction (PAF), 49.8% of NAFLD cases could be eliminated if the PNPLA3 mutation was absent. The MBOAT7 polymorphism was more frequent (P = 0.019) in patients with severe hepatic steatosis. In conclusion, PNPLA3, and to a lesser extent, MBOAT7 variants are associated with NAFLD risk and modulate liver injury in non-obese patients without diabetes.

  4. Obesity and Asthma

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is more prevalent in obese compared with normal weight subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy.Several studies have shown that overweight and obesity is associated with more severe asthma...... and impaired quality of life compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency...... department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index (BMI) on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy with regard...

  5. Effect of stress hyperglycemia and intensive rehabilitation therapy in non-diabetic hemorrhagic stroke: Korean Stroke Cohort for Functioning and Rehabilitation.

    Science.gov (United States)

    Yoon, J A; Kim, D Y; Sohn, M K; Lee, J; Lee, S-G; Lee, Y-S; Han, E Y; Joo, M C; Oh, G-J; Han, J; Lee, S W; Park, M; Chang, W H; Shin, Y-I; Kim, Y-H

    2016-11-01

    We investigated the effect of stress hyperglycemia on the functional outcomes of non-diabetic hemorrhagic stroke. In addition, we investigated the usefulness of intensive rehabilitation for improving functional outcomes in patients with stress hyperglycemia. Non-diabetic hemorrhagic stroke patients were recruited and divided into two groups: intracerebral hemorrhage (ICH) (n = 165) and subarachnoid hemorrhage (SAH) (n = 156). Each group was divided into non-diabetics with or without stress hyperglycemia. Functional assessments were performed at 7 days and 3, 6 and 12 months after stroke onset. The non-diabetic with stress hyperglycemia groups were again divided into two groups who either received or did not receive intensive rehabilitation treatment. Serial functional outcome was compared between groups. For the ICH group, patients with stress hyperglycemia had worse modified Rankin Scale, National Institutes of Health Stroke Scale, Functional Ambulatory Category and Korean Mini-Mental State Examination scores than patients without stress hyperglycemia. For the SAH group, patients with stress hyperglycemia had worse scores on all functional assessments than patients without stress hyperglycemia at all time-points. After intensive rehabilitation treatment of patients with stress hyperglycemia, the ICH group had better scores on Functional Ambulatory Category and the SAH group had better scores on all functional assessments than patients without intensive rehabilitation treatment. Stress hyperglycemia affects the long-term prognosis of non-diabetic hemorrhagic stroke patients. Among stress hyperglycemia patients, intensive rehabilitation can enhance functional improvement after stroke. © 2016 EAN.

  6. Obesity attenuates gender differences in cardiovascular mortality.

    Science.gov (United States)

    Song, Xin; Tabák, Adam G; Zethelius, Björn; Yudkin, John S; Söderberg, Stefan; Laatikainen, Tiina; Stehouwer, Coen D A; Dankner, Rachel; Jousilahti, Pekka; Onat, Altan; Nilsson, Peter M; Satman, Ilhan; Vaccaro, Olga; Tuomilehto, Jaakko; Qiao, Qing

    2014-10-19

    To estimate cardiovascular disease (CVD) mortality in relation to obesity and gender. Data from 11 prospective cohorts from four European countries including 23 629 men and 21 965 women, aged 24 to 99 years, with a median follow-up of 7.9 years were analyzed. Hazards ratios (HR) for CVD mortality in relation to baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated using Cox proportional hazards models with age as the timescale. Men had higher CVD mortality than women in all four BMI categories (obesity defined by WC, WHR or WHtR. The gender difference was slightly smaller in obese than in non-obese individuals; but the interaction was statistically significant only between gender and WC (p = 0.02), and WHtR (p = 0.01). None of the interaction terms was significant among non-diabetic individuals. Men had higher CVD mortality than women across categories of anthropometric measures of obesity. The gender difference was attenuated in obese individuals, which warrants further investigation.

  7. Obesity: A Bibliographic Review

    Science.gov (United States)

    McGowan, Beth

    2012-01-01

    The study of obesity is a relatively new interdisciplinary academic field. The community college library shelves should contain two types of resources. First, several kinds of reference materials, and second, a host of broader materials that place the discussion of obesity within a cultural framework. This overview is divided into two major…

  8. DGAT inhibitors for obesity.

    Science.gov (United States)

    Matsuda, Daisuke; Tomoda, Hiroshi

    2007-10-01

    Obesity is characterized by the accumulation of triacylglycerol in adipocytes. Diacylglycerol acyltransferase (DGAT) catalyzes the final reaction of triacylgycerol synthesis. Two isozymes of DGAT, DGAT1 and DGAT2, have been reported. Increased DGAT2 activity has a role in steatosis, while DGAT1 plays a role in very (V)LDL synthesis; increased plasma VLDL concentrations may promote obesity and thus DGAT1 is considered a potential therapeutic target of inhibition for obesity control. Several DGAT inhibitors of natural and synthetic origin have been reported, and their future prospect as anti-obesity drugs is discussed in this review.

  9. The association between obesity and severe disability among adults aged 50 or over in nine high-income, middle-income and low-income countries: a cross-sectional study

    Science.gov (United States)

    Moneta, Maria Victoria; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Chatterji, Somnath; Leonardi, Matilde; Sainio, Päivi; Galas, Aleksander; Haro, Josep Maria

    2015-01-01

    Objective The association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was to assess this association in nine countries using nationally-representative data from the Collaborative Research on Ageing in Europe (COURAGE) study and the WHO's Study on global AGEing and Adult Health (SAGE). Design Population-based cross-sectional study Setting The survey was conducted in China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa and Spain between 2007 and 2012. Participants 42 116 individuals 50 years and older. The institutionalised and those with limited cognition were excluded. Primary outcome measure Disability was defined as severe or extreme difficulty in conducting at least one of six types of basic activities of daily living (ADL). Results The mean body mass index (BMI) ranged from 20.4 kg/m2 in India to 30.7 kg/m2 in South Africa. Compared to normal BMI (18.5–24.9 kg/m2), BMI≥35 kg/m2 was associated with significantly higher odds for ADL disability in Finland (OR 4.64), Poland (OR 2.77), South Africa (OR 2.19) and Spain (OR 2.42). Interaction analysis showed that obese individuals in high-income countries were more likely to have ADL limitations than those in low-income or middle-income countries. Conclusions The higher odds for disability among obese individuals in high-income countries may imply longer life lived with disability due to factors such as the decline in cardiovascular disease mortality. In South Africa, this may have been due to the exceptionally high prevalence of class III obesity. These findings underscore the importance of obesity prevention to reduce the disability burden among older adults. PMID:25838510

  10. Assessing the effect of interaction between an FTO variant (rs9939609) and physical activity on obesity in 15,925 Swedish and 2,511 Finnish adults

    DEFF Research Database (Denmark)

    Jonsson, Anna Elisabet; Renström, F; Lyssenko, V

    2009-01-01

    Recent reports have suggested that genotypes at the FTO locus interact with physical activity to modify levels of obesity-related traits. We tested this hypothesis in two non-diabetic population-based cohorts, the first from southern Sweden and the second from the Botnia region of western Finland....

  11. Psychosocial aspects of obesity.

    Science.gov (United States)

    Vaidya, Varsha

    2006-01-01

    Obese patients have many physical limitations and much psychiatric burden to overcome. Several studies have shown that the prevalence of psychiatric morbidity in the obese is similar to those with normal weight. However, in obese patients seeking treatment there is an increased prevalence (40-60%) of psychiatric morbidity, most commonly depression. It is difficult to separate the effects of depression on obesity and, on the contrary, the neuroendocrine changes associated with stress and depression may cause metabolic changes that predispose and perpetuate obesity. The stigma associated with obesity causes bullying in school as well as childhood psychiatric morbidity. Prejudice is not limited to the general public but exists among health professionals too. This chapter discusses the treatment of depression in obesity and the psychiatric evaluation of the pre-bariatric surgery patient. Education of society, starting with schools and including healthcare professionals will reduce bias and stigma as well as assist this vulnerable group of patients to seek help for their obesity and the many problems that come with it. Given that by the year 2025 obesity will be the world's number one health problem with the US leading the way, it is very important that we pursue preventive measures as well as encourage research for treatments of obesity.

  12. Gastrointestinal Complications of Obesity

    Science.gov (United States)

    Camilleri, Michael; Malhi, Harmeet; Acosta, Andres

    2017-01-01

    Obesity usually is associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause (eg, nonalcoholic fatty liver disease) or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease, erosive esophagitis, Barrett’s esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer. Gastroenterologists are uniquely poised to participate in the multidisciplinary management of obesity as physicians caring for people with obesity-related diseases, in addition to their expertise in nutrition and endoscopic interventions. PMID:28192107

  13. Obesity in show cats.

    Science.gov (United States)

    Corbee, R J

    2014-12-01

    Obesity is an important disease with a high prevalence in cats. Because obesity is related to several other diseases, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain cat breeds has been suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of obesity in certain breeds to the official standards of that breed. To this end, 268 cats of 22 different breeds investigated by determining their body condition score (BCS) on a nine-point scale by inspection and palpation, at two different cat shows. Overall, 45.5% of the show cats had a BCS > 5, and 4.5% of the show cats had a BCS > 7. There were significant differences between breeds, which could be related to the breed standards. Most overweight and obese cats were in the neutered group. It warrants firm discussions with breeders and cat show judges to come to different interpretations of the standards in order to prevent overweight conditions in certain breeds from being the standard of beauty. Neutering predisposes for obesity and requires early nutritional intervention to prevent obese conditions. Journal of Animal Physiology and Animal Nutrition © 2014 Blackwell Verlag GmbH.

  14. [Is cancer incidence different between type 2 diabetes patients compared to non-diabetics in hemodialysis? A study from the REIN registry].

    Science.gov (United States)

    Le Guillou, Aurélie; Pladys, Adelaide; Kihal, Wahida; Siebert, Muriel; Haddj-Elmrabet, Atman; Cernon, Charlotte; Bernard, Anne; Charasse, Christophe; Mandart, Lise; Hamel, Didier; Tanquerel, Tugdual; Strullu, Bernard; Richer, Christine; Siohan, Pascale; Sawadogo, Théophile; Baleynaud, Juliette; Baluta, Simona; Bayat, Sahar; Vigneau, Cécile

    2018-05-01

    In France, diabetes mellitus is now the second cause of end stage renal disease. In a large previous French national study, we observed that dialyzed diabetics have a significant lower risk of death by cancer. This first study was focused on cancer death but did not investigate cancer incidence. In this context, the aim of this second study was to compare the incidence of cancer in diabetic dialyzed patients compared to non-diabetic dialyzed patients in a French region. This epidemiologic multicentric study included 588 diabetic and non-diabetic patients starting hemodialysis between 2002 and 2007 in Bretagne. Data were issued from REIN registry and cancer incidence were individually collected from medical records. Diabetics and non-diabetics were matched one by one on age, sex and year of dialysis initiation. During the follow-up, we observed 28 cancers (9.4%) in diabetic patients and 26 cancers (8.9%) in non-diabetics patients. The cumulative incidence to develop a cancer 2 years after the dialysis start was approximately 6% in both diabetics and non-diabetics patients. In univariate Fine and Gray analysis, BMI, hemoglobin, statin use had P-value<0.2. However, in the adjusted model, these variables were not significantly associated with cancer incidence. This study lead on a little number of dialyzed patients did not show any significant difference on cancer incidence between diabetic and non-diabetic patients after hemodialysis start. Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.

  15. Asthma and obesity

    DEFF Research Database (Denmark)

    Ulrik, Charlotte S

    2016-01-01

    PURPOSE OF REVIEW: Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. RECENT FINDINGS: Clinical studies have shown that weight...... reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness...... reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma....

  16. Altered Resting and Exercise Respiratory Physiology in Obesity

    OpenAIRE

    Sood, Akshay

    2009-01-01

    Obesity, particularly severe obesity, affects both resting and exercise-related respiratory physiology. Severe obesity classically produces a restrictive ventilatory abnormality, characterized by reduced expiratory reserve volume. However, obstructive ventilatory abnormality may also be associated with abdominal obesity. Decreased peak work rates are usually seen among obese subjects in a setting of normal or decreased ventilatory reserve and normal cardiovascular response to exercise. Weight...

  17. comparative study of glucose homeostasis, lipids and lipoproteins, HDL functionality, and cardiometabolic parameters in modestly severely obese African Americans and White Americans with prediabetes: implications for the metabolic paradoxes.

    Science.gov (United States)

    Healy, Sara J; Osei, Kwame; Gaillard, Trudy

    2015-02-01

    To determine whether modestly severe obesity modifies glucose homeostasis, levels of cardiometabolic markers, and HDL function in African Americans (AAs) and white Americans (WAs) with prediabetes. We studied 145 subjects with prediabetes (N = 61 WAs, N = 84 AAs, mean age 46.5 ± 11.2 years, mean BMI 37.8 ± 6.3 kg/m(2)). We measured fasting levels of lipids, lipoproteins, and an inflammatory marker (C-reactive protein [CRP]); HDL functionality (i.e., levels of paraoxonase 1 [PON1]); and levels of oxidized LDL, adiponectin, and interleukin-6 (IL-6). We measured serum levels of glucose, insulin, and C-peptide during an oral glucose tolerance test. Values for insulin sensitivity index (Si), glucose effectiveness index (Sg), glucose effectiveness at zero insulin (GEZI), and acute insulin response to glucose (AIRg) were derived using a frequently sampled intravenous glucose tolerance test (using MINMOD software). Mean levels of fasting and incremental serum glucose, insulin, and C-peptide tended to be higher in WAs versus AAs. The mean Si was not different in WAs versus AAs (2.6 ± 2.3 vs. 2.9 ± 3.0 × 10(-4) × min(-1) [μU/mL](-1)). Mean values for AIRg and disposition index as well as Sg and GEZI were lower in WAs than AAs. WAs had higher serum triglyceride levels than AAs (116.1 ± 55.5 vs. 82.7 ± 44.2 mg/dL, P = 0.0002). Mean levels of apolipoprotein (apo) A1, HDL cholesterol, PON1, oxidized LDL, CRP, adiponectin, and IL-6 were not significantly different in obese AAs versus WAs with prediabetes. Modestly severe obesity attenuated the ethnic differences in Si, but not in Sg and triglyceride levels in WAs and AAs with prediabetes. Despite the lower Si and PON1 values, AAs preserved paradoxical relationships between the Si and HDL/apoA1/triglyceride ratios. We conclude that modestly severe obesity has differential effects on the pathogenic mechanisms underlying glucose homeostasis and atherogenesis in obese AAs and WAs with prediabetes. © 2015 by the American

  18. Left ventricular dysfunction with reduced functional cardiac reserve in diabetic and non-diabetic LDL-receptor deficient apolipoprotein B100-only mice

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    Bosch Fatima

    2011-06-01

    Full Text Available Abstract Background Lack of suitable mouse models has hindered the studying of diabetic macrovascular complications. We examined the effects of type 2 diabetes on coronary artery disease and cardiac function in hypercholesterolemic low-density lipoprotein receptor-deficient apolipoprotein B100-only mice (LDLR-/-ApoB100/100. Methods and results 18-month-old LDLR-/-ApoB100/100 (n = 12, diabetic LDLR-/-ApoB100/100 mice overexpressing insulin-like growth factor-II (IGF-II in pancreatic beta cells (IGF-II/LDLR-/-ApoB100/100, n = 14 and age-matched C57Bl/6 mice (n = 15 were studied after three months of high-fat Western diet. Compared to LDLR-/-ApoB100/100 mice, diabetic IGF-II/LDLR-/-ApoB100/100 mice demonstrated more calcified atherosclerotic lesions in aorta. However, compensatory vascular enlargement was similar in both diabetic and non-diabetic mice with equal atherosclerosis (cross-sectional lesion area ~60% and consequently the lumen area was preserved. In coronary arteries, both hypercholesterolemic models showed significant stenosis (~80% despite positive remodeling. Echocardiography revealed severe left ventricular systolic dysfunction and anteroapical akinesia in both LDLR-/-ApoB100/100 and IGF-II/LDLR-/-ApoB100/100 mice. Myocardial scarring was not detected, cardiac reserve after dobutamine challenge was preserved and ultrasructural changes revealed ischemic yet viable myocardium, which together with coronary artery stenosis and slightly impaired myocardial perfusion suggest myocardial hibernation resulting from chronic hypoperfusion. Conclusions LDLR-/-ApoB100/100 mice develop significant coronary atherosclerosis, severe left ventricular dysfunction with preserved but diminished cardiac reserve and signs of chronic myocardial hibernation. However, the cardiac outcome is not worsened by type 2 diabetes, despite more advanced aortic atherosclerosis in diabetic animals.

  19. Novel risk factors for premature peripheral arterial occlusive disease in non-diabetic patients: a case-control study.

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    Annie M Bérard

    Full Text Available BACKGROUND: This study aimed to determine the prevalence of genetic and environmental vascular risk factors in non diabetic patients with premature peripheral arterial disease, either peripheral arterial occlusive disease or thromboangiitis obliterans, the two main entities of peripheral arterial disease, and to established whether some of them are specifically associated with one or another of the premature peripheral arterial disease subgroups. METHODS AND RESULTS: This study included 113 non diabetic patients with premature peripheral arterial disease (diagnosis <45-year old presenting either a peripheral arterial occlusive disease (N = 64 or a thromboangiitis obliterans (N = 49, and 241 controls matched for age and gender. Both patient groups demonstrated common traits including cigarette smoking, low physical activity, decreased levels of HDL-cholesterol, apolipoprotein A-I, pyridoxal 5'-phosphate (active form of B6 vitamin and zinc. Premature peripheral arterial occlusive disease was characterized by the presence of a family history of peripheral arterial and carotid artery diseases (OR 2.3 and 5.8 respectively, 95% CI, high lipoprotein (a levels above 300 mg/L (OR 2.3, 95% CI, the presence of the factor V Leiden (OR 5.1, 95% CI and the glycoprotein Ia(807T,837T,873A allele (OR 2.3, 95% CI. In thromboangiitis obliterans group, more patients were regular consumers of cannabis (OR 3.5, 95% CI and higher levels in plasma copper has been shown (OR 6.5, 95% CI. CONCLUSIONS: According to our results from a non exhaustive list of study parameters, we might hypothesize for 1 a genetic basis for premature peripheral arterial occlusive disease development and 2 the prevalence of environmental factors in the development of thromboangiitis obliterans (tobacco and cannabis. Moreover, for the first time, we demonstrated that the 807T/837T/873A allele of platelet glycoprotein Ia may confer an additional risk for development of peripheral

  20. Myths about diabetes mellitus among non-diabetic individuals attending primary health care centers of karachi suburbs

    International Nuclear Information System (INIS)

    Nisar, N.; Khan, I.A.; Qadri, M.H.; Sher, A.

    2007-01-01

    To determine the myths and misconception about diabetes mellitus among non-diabetics attending primary health care centers of Gadap town, Karachi. Data was collected from four primary health care centers, located at Gadap Town, Karachi, and about 198 non-diabetic patients, above 18 years of age, and resident of Gadap Town, coming consecutively during the month of July 2005, were interviewed after taking the informed consent by using a semi-structured pre-tested questionnaire regarding prevailing myths about diabetes mellitus. The data collected was entered and analyzed by using a statistical package SPSS 11.0. Myths are defined as stories shared by a group, as part of the cultural identity. There were 198 participants in the study. Mean age of study participants was 40 years with standard deviation of 13, while approximately two thirds, 62.6%, were females. About 39% had history of type II diabetes mellitus in family. Overall myths related to diabetes mellitus were common among the individuals, males reported myths pre-dominantly contagiousness of diabetes (p= <0.03), diabetics becoming more ill (p=<0.009) and belief in spiritual treatment for permanent cure of diabetes (p=<0.006). People having 5- 16 years of education were less misconceived as compared to illiterates. The variables that showed significant difference were overeating, causing diabetes (p= <0.006), diabetics falling ill more than others (p=<0.04), eating less starch (p=< 0.0006) and alternative treatment like spiritual treatment (p=<0.00001). Family history of diabetes was also found significantly associated with reporting myths. Frequency of reporting myths was significantly high in this study with preponderance of males, family history of diabetes mellitus and educational status. Education serves as protective factor, hence efforts should be made to promote education and health awareness regarding the disease, with more emphasis on addressing myths regarding diabetes mellitus. (author)

  1. Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance.

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    Andrea R Zammit

    Full Text Available The aims of the study were to examine the association between CKD and the metabolic syndrome (MetS and its components in older adults. We also explored two possible pathways linking the metabolic syndrome with CKD: inflammation as measured by high sensitivity C-Reactive Protein (hsCRP and insulin resistance as measured by HOMA-IR.Community-dwelling non-diabetic 70+ adults from the Einstein Aging Study participated in the study. We defined CKD as eGFR below 60mL/min/1.73m2. MetS was defined according to recent guidelines from the National Cholesterol Education Program. Binary logistic regressions were used to assess the association between the metabolic syndrome, its components and CKD with adjustments for demographics, HOMA-IR and hsCRP.Of 616 participants (mean age = 79.3 years, 65.5% female, 25% had MetS and 26.5% had CKD. Participants with CKD had a significantly higher prevalence of the MetS than individuals without CKD (34.4% vs. 24.3%. Binary logistic regression models showed that CKD was associated with MetS (OR = 1.72, 95%CI = 1.13-2.61. The association was unaltered by adjustment for hsCRP but altered by adjustment for HOMA-IR. As the number of MetS components increased the relative odds of CKD also increased. None of the individual components was independently associated with CKD.MetS is associated with CKD in non-diabetic older adults. Results showed that as the number of MetS components increased so did the odds for CKD. HOMA-IR seems to be in the casual pathway linking MetS to CKD.

  2. The impact of a 600-mg loading dose of clopidogrel in diabetic and non-diabetic patients undergoing elective PCI.

    Science.gov (United States)

    Mohareb, Mina W; Abd Elghany, Mohamed; Sabry, Nirmeen A; Farid, Samar F

    2016-08-01

    High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in type 1 and 2 diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to determine the effect of diabetes mellitus on clopidogrel activity in cardiac patients undergoing PCI. This is an observational study. Patients were categorized according to DM status into diabetic group (N.=30) and non-diabetic group (N.=33). All patients received clopidogrel in a loading dose of 600 mg before PCI. Platelet function was assessed using light transmittance aggregometry (LTA) technique at baseline (before clopidogrel administration), 24 hour after clopidogrel loading dose administration and 7-10 days after PCI. All patients were followed up for at least one year after PCI for recurrence of acute cardiac events. There was no statistically significant difference between the two groups with respect to 10 µm adenosine diphosphate (ADP)-induced platelet aggregation measured at baseline (P=0.64), 24 hours after PCI (P=0.874), and 7-10 days after PCI (0.643). Diabetics were not significantly different from non-diabetics in terms of post-PCI acute stent thrombosis (P=0.945), sub-acute stent thrombosis (P=0.945), unstable angina (P=0.29) and cardiac death (P=0.64). There was a statistically significant difference between patients with and without post-PCI acute events regarding ADP aggregation measured 24 hours and 7-10 days after PCI. The use of a high loading dose of clopidogrel (600 mg) in patients undergoing elective PCI can overcome the significant increase in post-PCI platelet aggregation and rate of acute cardiac events induced by diabetes mellitus as co-morbidity in those patients.

  3. Sex, race, and the adverse effects of social stigma vs. other quality of life factors among primary care patients with moderate to severe obesity.

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    Wee, Christina C; Davis, Roger B; Chiodi, Sarah; Huskey, Karen W; Hamel, Mary B

    2015-02-01

    Patients with obesity face widespread social bias, but the importance of this social stigma to patients relative to other quality of life (QOL) factors is unclear. Our aim was to examine the importance of obesity-related social stigma relative to other QOL factors on reducing patients' overall well-being. We used a cross-sectional telephone interview. The study was conducted at four diverse primary care practices in Greater Boston. Three hundred and thirty-seven primary care patients aged 18-65 years and with a body mass index (BMI) of 35 kg/m(2) or higher participated in the study. Patients' health utility (preference-based QOL measure) was determined via responses to a series of standard gamble scenarios assessing willingness to risk death to lose various amounts of weight or to achieve perfect health. We used the Impact of Weight on Quality of Life-lite instrument to assess QOL domains specific to obesity (physical function, self-esteem, sexual life, public distress or social stigma, and work), and we examined variation in utility explained by these domains. Depending on patients' race/ethnicity, mean health utilities ranged from 0.92 to 0.99 among men and from 0.89 to 0.93 among women. After adjustment for race, BMI, and education, none of the QOL domains explained much of the variation in utility among men, except for work function among Hispanic men. In contrast, social stigma was the leading QOL contributor to utility for Caucasian women (explaining 6 % of the marginal variation beyond demographics and BMI). In contrast, sexual function was the most important contributor among African American women (3 % marginal variation), and work life was most important among Hispanic women (> 20 % in variation). Lower scores in one domain did not always translate into lower well-being. Moreover, QOL summary scores often explained less of the variation than some individual domains. Obesity-related social stigma had disproportionate adverse effects on Caucasian women

  4. Epigenetics and human obesity.

    Science.gov (United States)

    van Dijk, S J; Molloy, P L; Varinli, H; Morrison, J L; Muhlhausler, B S

    2015-01-01

    Recent technological advances in epigenome profiling have led to an increasing number of studies investigating the role of the epigenome in obesity. There is also evidence that environmental exposures during early life can induce persistent alterations in the epigenome, which may lead to an increased risk of obesity later in life. This paper provides a systematic review of studies investigating the association between obesity and either global, site-specific or genome-wide methylation of DNA. Studies on the impact of pre- and postnatal interventions on methylation and obesity are also reviewed. We discuss outstanding questions, and introduce EpiSCOPE, a multidisciplinary research program aimed at increasing the understanding of epigenetic changes in emergence of obesity. An electronic search for relevant articles, published between September 2008 and September 2013 was performed. From the 319 articles identified, 46 studies were included and reviewed. The studies provided no consistent evidence for a relationship between global methylation and obesity. The studies did identify multiple obesity-associated differentially methylated sites, mainly in blood cells. Extensive, but small, alterations in methylation at specific sites were observed in weight loss intervention studies, and several associations between methylation marks at birth and later life obesity were found. Overall, significant progress has been made in the field of epigenetics and obesity and the first potential epigenetic markers for obesity that could be detected at birth have been identified. Eventually this may help in predicting an individual's obesity risk at a young age and opens possibilities for introducing targeted prevention strategies. It has also become clear that several epigenetic marks are modifiable, by changing the exposure in utero, but also by lifestyle changes in adult life, which implies that there is the potential for interventions to be introduced in postnatal life to modify

  5. Chronic Latent Magnesium Deficiency in Obesity Decreases Positive Effects of Vitamin D on Cardiometabolic Risk Indicators.

    Science.gov (United States)

    Stokic, Edita; Romani, Andrea; Ilincic, Branislava; Kupusinac, Aleksandar; Stosic, Zoran; Isenovic, Esma R

    2017-08-21

    Obesity and micronutrient deficiencies contribute to the risk of cardiometabolic diseases such are type 2 diabetes mellitus and cardiovascular disease (CVD). We examined the frequency of concomitant deficit of magnesium (Mg) and vitamin D in obese patients and evaluated the connection of these combined deficiencies with indicators of cardiometabolic risk in non-diabetic subjects. Non-diabetic middle aged adults (n = 80; mean age 36 ± 4 years, 52% women) were recruited based on weight/adiposity parameters [i.e. body mass index (BMI) and body fat percentage (FAT%)]. Cardiometabolic risk indicators [insulin resistance (Homeostatic Model Assessment for insulin resistance (HOMA-IR)) and CVD risk (Framingham risk score for predicting 10-year CVD)], Mg status [i.e. total serum Mg concentration (TMg), chronic latent Mg deficiency (CLMD) - 0.75-0.85 mmol/L], vitamin D status [i.e. serum concentration of 25-hydroxyvitamin D (25(OH)D), vitamin D deficiency <50 nmol/l] were assessed. Among obese subjects 36% presented a combination of vitamin D deficiency and CLMD. In all studied patients, 25(OH)D and TMg levels both, individually and combined, showed a negative linear correlation with HOMA-IR and CVD risk. In subjects with CLMD (TMg ˂0.85 mmol/L), a negative linear coefficient was found between 25(OH)D and, HOMA-IR and CVD risk, compared with subjects with normal TMg status (TMg ≥0.85 mmol/L). CLMD and vitamin D deficiency may commonly be present in obese non-diabetic subjects. Individually and combined, both deficiencies predispose non-diabetic patients to increased risk of cardiometabolic diseases. Maintaining normal Mg status may improve the beneficial effects of vitamin D on cardiometabolic risk indicators. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Obesity Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Simona Ianosi Edith

    2015-12-01

    Full Text Available Obesity is a disease with severe health consequences and increased risk of mortality. The most commonly used criteria to assess the presence and the severity of obesity are body mass index, waist circumference, waist-to-height ratio and the presence of the health conditions caused or worsened by obesity. Worldwide obesity has more than doubled in the last 4 decades. Obesity is the second of the leading preventable causes of death worldwide (after smoking. Obesity has a plurifactorial pathogenesis. The central perturbation consists in the imbalance between calories intake and calories consumption (by inappropriate diet and sedentary lifestyle. Identification of all the ethiological factors is important for treatment and prophylaxis. Weight loss benefits are multiple and important: improvement in glicemic control and in plasma lipid levels, blood presure control, obstructiv sleep apneea reduction, improvement in management of daily activities and profesional performances, increase quality of life, reduction in mortality. Overweight or obese patient will complete a diagnostic and a treatment program. Treatment of obesity claims a targeted multidimensional therapy: weight and lifestyle management, diet, sustained physical activity in daily life, exercise, decrease life stressors, smoking cessation, drug therapy, bariatric surgery psichological, familial and social suport. Weight loss program must be carefully planned, adapted to the patient’s abilities and comorbidities and supervised by a nutritionist and a physiotherapist.

  7. Bias in estimating the cross-sectional smoking, alcohol, obesity and diabetes associations with moderate-severe periodontitis in the Atherosclerosis Risk in Communities study: comparison of full versus partial-mouth estimates.

    Science.gov (United States)

    Akinkugbe, Aderonke A; Saraiya, Veeral M; Preisser, John S; Offenbacher, Steven; Beck, James D

    2015-07-01

    To assess whether partial-mouth protocols (PRPs) result in biased estimates of the associations between smoking, alcohol, obesity and diabetes with periodontitis. Using a sample (n = 6129) of the 1996-1998 Atherosclerosis Risk in Communities study, we used measures of probing pocket depth and clinical attachment level to identify moderate-severe periodontitis. Adjusting for confounders, unconditional binary logistic regression estimated prevalence odds ratios (POR) and 95% confidence limits. Specifically, we compared POR for smoking, alcohol, obesity and diabetes with periodontitis derived from full-mouth to those derived from 4-PRPs (Ramfjörd, National Health and Nutrition Examination survey-III, modified-NHANES-IV and 42-site-Random-site selection-method). Finally, we conducted a simple sensitivity analysis of periodontitis misclassification by changing the case definition threshold for each PRP. In comparison to full-mouth PORs, PRP PORs were biased in terms of magnitude and direction. Holding the full-mouth case definition at moderate-severe periodontitis and setting it at mild-moderate-severe for the PRPs did not consistently produce POR estimates that were either biased towards or away from the null in comparison to full-mouth estimates. Partial-mouth protocols result in misclassification of periodontitis and may bias epidemiologic measures of association. The magnitude and direction of this bias depends on choice of PRP and case definition threshold used. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Relationship of serum resistin with insulin resistance and obesity

    International Nuclear Information System (INIS)

    Zaidi, S.I.Z.

    2015-01-01

    Background: Adipokines have been implicated in the modulation of insulin sensitivity and glucose tolerance and have thus gained importance in the study of Type 2 diabetes mellitus (T2DM). Resistin, a unique signalling molecule, is being proposed as a significant factor in the pathogenesis of obesity-related insulin resistance. However, its relevance to human diabetes mellitus remains uncertain and controversial. This study was therefore planned to compare and correlate the potential role of resistin in obese patients with T2DM and obese non-diabetic controls and also to evaluate the correlation between resistin and marker of obesity and glycaemic parameters. Method: Fasting serum resistin, glucose and insulin were measured in forty obese diabetics (mean±SD BMI 35±5 kg/m2) and forty obese non-diabetics (mean±SD BMI 33±3 kg/m2). Insulin resistance was assessed using the HOMA-IR formula derived from fasting insulin and glucose levels. Results: Serum resistin levels (38±8 ng/ml) were significantly higher in type 2 diabetic patients as compared with the controls. Fasting blood glucose (164±46 mg/dl), serum insulin (37±7 μU/ml) and insulin resistance (19±8), were considerably higher among the studied diabetics than in the controls. Pearson's correlation analysis revealed positive correlation between serum resistin and BMI (p=0.001) and HOMA-IR (p=0.561) in diabetic subjects. Similarly, a correlation also existed between serum resistin and BMI (p=0.016) and HOMA-IR (p=0.307) in control obese subjects. However, it was highly significant in diabetics as compared to non-diabetic controls. Conclusion: A significant BMI-dependent association exists between resistin and insulin resistance in patients with T2DM. It appears that resistin may play a role in the pathogenesis of obesity and insulin resistance and that both of these may contribute to the development of T2DM. (author)

  9. Clinical spectrum of non-alcoholic fatty liver disease in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    George Boon-Bee Goh

    2015-06-01

    Conclusion: Patients with DM have more severe NAFLD based on histology. However, NASH and advanced fibrosis also occur in a considerable proportion of NAFLD patients without DM. The lower utility of the NFS in NAFLD patients without DM emphasises the heterogeneous nature of the NAFLD phenotype.

  10. biochemical and hormonal studies in obese cases

    International Nuclear Information System (INIS)

    Issa, G.I.

    1993-01-01

    The present study was carried out on a total number of 116 obese and 23 non-obese control females. Obesity was assessed mainly by body mass index (BMI). Other skinfold thickness e.g. triceps, subscapular, suprailiac, as parameters of obesity assessment were determined in some obese patients. The degree of obesity was assessed by BMI and categorized as follows: i- Mild obesity, BMI=25-30 Kg/m 2 . ii-Moderate obesity, BMI=31-35 kg/m 2 . iii-severe obesity, BMI= above 35 kg/m 2 . Type of fat distribution was assessed by waist/hip circumference ratio (w/H) as :- i-gynoid (lower body segment obesity). (≤ 0.81) i i- android (upper body segment obesity). (≥0.82)

  11. Serum Levels of Visfatin and Interleukin-6 in Non-Obese Versus Obese Men with Coronary Artery Disease

    International Nuclear Information System (INIS)

    Naz, S.; Sandhu, Q. S.; Akhtar, A.; Zafar, U.; Khalid, A.; Saeed, M.

    2017-01-01

    Objective: To evaluate and compare the serum levels of visfatin, interleukin-6 and lipid profile in non-obese and obese male patients with coronary artery disease. Study Design: Observational, comparative study. Place and Duration of Study: Punjab Institute of Cardiology and Lahore General Hospital, Lahore, from July to December 2013. Methodology: The participants included 20 non-obese group I with coronary artery disease (CAD) and 20 obese males group II with coronary artery disease (angiographically confirmed). All the participants were in the age group of 35 - 55 years being non-smokers and non-diabetic. Serum visfatin and interleukin-6 levels were analysed by Enzyme Linked Immunosorbent Assay (ELISA). Lipid profile was also evaluated. Results were compared with T-test and Mann Whitney U test. The values were considered significant at 0.05 level of significance. Results: Serum visfatin 9.05 versus 3.9 ng/ml and interleukin-6 12.80 versus 0.60 pg/ml levels were significantly (p-value < 0.001 of both) raised in the obese CAD group as compared to non-obese with CAD. Lipid profile also showed raised levels of total serum cholesterol, low density lipoproteins, triglycerides, very low density lipoproteins and low levels of high density lipoproteins in obese group. Conclusion: Significantly raised levels of serum visfatin and interleukin-6 indicate adipose tissue as an imperative source of these adipocytokines involved in inflammation in CAD. Altered lipid profile also seen in obese patients with CAD. (author)

  12. Obesity and Cardiovascular Disease.

    Science.gov (United States)

    Ortega, Francisco B; Lavie, Carl J; Blair, Steven N

    2016-05-27

    The prevalence of obesity has increased worldwide over the past few decades. In 2013, the prevalence of obesity exceeded the 50% of the adult population in some countries from Oceania, North Africa, and Middle East. Lower but still alarmingly high prevalence was observed in North America (≈30%) and in Western Europe (≈20%). These figures are of serious concern because of the strong link between obesity and disease. In the present review, we summarize the current evidence on the relationship of obesity with cardiovascular disease (CVD), discussing how both the degree and the duration of obesity affect CVD. Although in the general population, obesity and, especially, severe obesity are consistently and strongly related with higher risk of CVD incidence and mortality, the one-size-fits-all approach should not be used with obesity. There are relevant factors largely affecting the CVD prognosis of obese individuals. In this context, we thoroughly discuss important concepts such as the fat-but-fit paradigm, the metabolically healthy but obese (MHO) phenotype and the obesity paradox in patients with CVD. About the MHO phenotype and its CVD prognosis, available data have provided mixed findings, what could be partially because of the adjustment or not for key confounders such as cardiorespiratory fitness, and to the lack of consensus on the MHO definition. In the present review, we propose a scientifically based harmonized definition of MHO, which will hopefully contribute to more comparable data in the future and a better understanding on the MHO subgroup and its CVD prognosis. © 2016 American Heart Association, Inc.

  13. Fasting insulin, insulin resistance, and risk of cardiovascular or all-cause mortality in non-diabetic adults: a meta-analysis.

    Science.gov (United States)

    Zhang, Xiaohong; Li, Jun; Zheng, Shuiping; Luo, Qiuyun; Zhou, Chunmei; Wang, Chaoyang

    2017-10-31

    Studies on elevated fasting insulin or insulin resistance (IR) and cardiovascular or all-cause mortality risk in non-diabetic individuals have yielded conflicting results. This meta-analysis aimed to evaluate the association of elevated fasting insulin levels or IR as defined by homeostasis model assessment of IR (HOMA-IR) with cardiovascular or all-cause mortality in non-diabetic adults. We searched for relevant studies in PubMed and Emabse databases until November 2016. Only prospective observational studies investigating the association of elevated fasting insulin levels or HOMA-IR with cardiovascular or all-cause mortality risk in non-diabetic adults were included. Risk ratio (RR) with its 95% confidence intervals (CIs) was pooled for the highest compared with the lowest category of fasting insulin levels or HOMA-IR. Seven articles involving 26976 non-diabetic adults were included. The pooled, adjusted RR of all-cause mortality comparing the highest with the lowest category was 1.13 (95% CI: 1.00-1.27; P =0.058) for fasting insulin levels and 1.34 (95% CI: 1.11-1.62; P =0.002) for HOMA-IR, respectively. When comparing the highest with the lowest category, the pooled adjusted RR of cardiovascular mortality was 2.11 (95% CI: 1.01-4.41; P =0.048) for HOMA-IR in two studies and 1.40 (95% CI: 0.49-3.96; P =0.526) for fasting insulin levels in one study. IR as measured by HOMA-IR but not fasting insulin appears to be independently associated with greater risk of cardiovascular or all-cause mortality in non-diabetic adults. However, the association of fasting insulin and HOMA-IR with cardiovascular mortality may be unreliable due to the small number of articles included. © 2017 The Author(s).

  14. Obesity and kidney protection.

    Science.gov (United States)

    Chandra, Aravind; Biersmith, Michael; Tolouian, Ramin

    2014-07-01

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

  15. [Obesity and colorectal cancer].

    Science.gov (United States)

    Na, Soo-Young; Myung, Seung-Jae

    2012-01-01

    Obesity worldwide is constantly increasing. Obesity acts as an independent significant risk factor for malignant tumors of various organs including colorectal cancer. Visceral adipose tissue is physiologically more important than subcutaneous adipose tissue. The relative risk of colorectal cancer of obese patients is about 1.5 times higher than the normal-weight individuals, and obesity is also associated with premalignant colorectal adenoma. The colorectal cancer incidence of obese patients has gender-specific and site-specific characteristics that it is higher in men than women and in the colon than rectum. Obesity acts as a risk factor of colorectal carcinogenesis by several mechanisms. Isulin, insulin-like growth factor, leptin, adiponectin, microbiome, and cytokines of chronic inflammation etc. have been understood as its potential mechanisms. In addition, obesity in patients with colorectal cancer negatively affects the disease progression and response of chemotherapy. Although the evidence is not clear yet, there are some reports that weight loss as well as life-modification such as dietary change and physical activity can reduce the risk of colorectal cancer. It is very important knowledge in the point that obesity is a potentially modifiable risk factor that can alter the incidence and outcome of the colorectal cancer.

  16. PPARs, Obesity, and Inflammation

    Directory of Open Access Journals (Sweden)

    Rinke Stienstra

    2007-01-01

    Full Text Available The worldwide prevalence of obesity and related metabolic disorders is rising rapidly, increasing the burden on our healthcare system. Obesity is often accompanied by excess fat storage in tissues other than adipose tissue, including liver and skeletal muscle, which may lead to local insulin resistance and may stimulate inflammation, as in steatohepatitis. In addition, obesity changes the morphology and composition of adipose tissue, leading to changes in protein production and secretion. Some of these secreted proteins, including several proinflammatory mediators, may be produced by macrophages resident in the adipose tissue. The changes in inflammatory status of adipose tissue and liver with obesity feed a growing recognition that obesity represents a state of chronic low-level inflammation. Various molecular mechanisms have been implicated in obesity-induced inflammation, some of which are modulated by the peroxisome proliferator-activated receptors (PPARs. PPARs are ligand-activated transcription factors involved in the regulation of numerous biological processes, including lipid and glucose metabolism, and overall energy homeostasis. Importantly, PPARs also modulate the inflammatory response, which makes them an interesting therapeutic target to mitigate obesity-induced inflammation and its consequences. This review will address the role of PPARs in obesity-induced inflammation specifically in adipose tissue, liver, and the vascular wall.

  17. Gastric bypass surgery reveals independency of obesity and diabetes melitus type 2.

    Science.gov (United States)

    Fenger, Mogens; Hansen, Dorte Lindqvist; Worm, Dorte; Hvolris, Lisbeth; Kristiansen, Viggo B; Carlsson, Elin Rebecka; Madsbad, Sten

    2016-11-09

    Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but the observation may suggest that the fate obesity and diabetes is only partly linked after surgery. The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects with and without diabetes were evaluated. Evaluation was performed on three groups: 1) subjects that were non-diabetic before and after surgery; 2) subjects that were diabetics before surgery but non-diabetics after surgery; and 3) subjects that were diabetics before surgery and remained diabetics after surgery. The diabetic state was established at HbA1c above 48 mmol/mol. The trajectories differ significantly between groups and any sub-populations of groups, the latter identified by the distance between individual trajectories using a k-means procedure. The results suggest that different domains in the enormous genetic network governing basic metabolism are perturbed in obesity and diabetes, and in fact some of the patients are affected by two distinct diseases: obesity and diabetes mellitus type 2. Although RYGB "normalized" many glycaemic parameters in some of the diabetic subjects apparently converting to a non-diabetics state, other diabetic subjects stay diabetic in the context of the new gut anatomy after surgery. Thus, the obesity part of the glycaemic derangement may have been ameliorated, but some defects of the diabetic state had not.

  18. Psoriasis and Obesity

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone

    2017-01-01

    Psoriasis is a common chronic inflammatory skin disease with a complex pathogenesis consisting of a genetic component, immune dysfunction, and environmental factors. It is associated with numerous comorbidities including psoriatic arthritis, cardiovascular disease, metabolic syndrome, and obesity....... Evidence suggests that obesity is a risk factor for incident psoriasis, aggravates existing psoriasis, and that weight reduction may improve the severity of psoriasis in overweight individuals. Excess body weight may interfere with the medical treatment used in psoriasis and adds to the cardiovascular risk...... profile in these patients, which underscores the importance of effective weight control regimens. In this review we examine the current literature with regard to the association between obesity and psoriasis....

  19. Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults.

    Science.gov (United States)

    Crowe, Catherine; Gibson, Irene; Cunningham, Katie; Kerins, Claire; Costello, Caroline; Windle, Jane; O Shea, Paula M; Hynes, Mary; McGuire, Brian; Kilkelly, Katriona; Griffin, Helena; O Brien, Tim; Jones, Jenni; Finucane, Francis M

    2015-08-01

    Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme. We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) ≥ 40 kgm(-2) (or ≥ 35 kgm(-2) with significant co-morbidity) who were attending a regional bariatric service and who completed a single centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol analyses. Of 183 bariatric patients enrolled, 150 (81.9%) completed the programme. Mean age of completers was 47.9 ± 1.2 years. 34.7% were male. There were statistically significant reductions in weight (129.6 ± 25.9 v 126.9 ± 26.1 kg, p triglyceride levels, with an increase in functional capacity (5.9 ± 1.7 v 6.8 ± 2.1 metabolic equivalents of thermogenesis (METS), p structured lifestyle programme had improved adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this programme in a pragmatic randomised controlled trial seems warranted.

  20. Self-regulatory skills usage strengthens the relations of self-efficacy for improved eating, exercise, and weight in the severely obese: toward an explanatory model.

    Science.gov (United States)

    Annesi, James J

    2011-07-01

    Lack of success with behavioral weight-management treatments indicates a need for a better understanding of modifiable psychological correlates. Adults with class 2 and 3 obesity (N = 183; Mean(BMI) = 42.0 kg/m(2)) volunteered for a 26-week nutrition and exercise treatment, based on social cognitive theory, that focused on self-efficacy and self-regulation applied to increasing cardiovascular exercise and fruit and vegetable consumption. Improved self-efficacy for controlled eating significantly predicted increased fruit and vegetable consumption (R(2) = .15). Improved self-efficacy for exercise significantly predicted increased exercise (R(2) = .46). When changes in self-regulatory skill usage were stepped into the 2 previous equations, the variances accounted for significantly increased. Increases in fruit and vegetable consumption and exercise significantly predicted weight loss (R(2) = .38). Findings suggest that behavioral theory should guide research on weight-loss treatment, and a focus on self-efficacy and self-regulatory skills applied to specific nutrition and exercise behaviors is warranted.

  1. Childhood Obesity

    Science.gov (United States)

    Yuca, Sevil Ari, Ed.

    2012-01-01

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

  2. Comprehensive metabolic characterization of serum osteocalcin action in a large non-diabetic sample.

    Directory of Open Access Journals (Sweden)

    Lukas Entenmann

    Full Text Available Recent research suggested a metabolic implication of osteocalcin (OCN in e.g. insulin sensitivity or steroid production. We used an untargeted metabolomics approach by analyzing plasma and urine samples of 931 participants using mass spectrometry to reveal further metabolic actions of OCN. Several detected relations between OCN and metabolites were strongly linked to renal function, however, a number of associations remained significant after adjustment for renal function. Intermediates of proline catabolism were associated with OCN reflecting the implication in bone metabolism. The association to kynurenine points towards a pro-inflammatory state with increasing OCN. Inverse relations with intermediates of branch-chained amino acid metabolism suggest a link to energy metabolism. Finally, urinary surrogate markers of smoking highlight its adverse effect on OCN metabolism. In conclusion, the present study provides a read-out of metabolic actions of OCN. However, most of the associations were weak arguing for a limited role of OCN in whole-body metabolism.

  3. Comprehensive metabolic characterization of serum osteocalcin action in a large non-diabetic sample.

    Science.gov (United States)

    Entenmann, Lukas; Pietzner, Maik; Artati, Anna; Hannemann, Anke; Henning, Ann-Kristin; Kastenmüller, Gabi; Völzke, Henry; Nauck, Matthias; Adamski, Jerzy; Wallaschofski, Henri; Friedrich, Nele

    2017-01-01

    Recent research suggested a metabolic implication of osteocalcin (OCN) in e.g. insulin sensitivity or steroid production. We used an untargeted metabolomics approach by analyzing plasma and urine samples of 931 participants using mass spectrometry to reveal further metabolic actions of OCN. Several detected relations between OCN and metabolites were strongly linked to renal function, however, a number of associations remained significant after adjustment for renal function. Intermediates of proline catabolism were associated with OCN reflecting the implication in bone metabolism. The association to kynurenine points towards a pro-inflammatory state with increasing OCN. Inverse relations with intermediates of branch-chained amino acid metabolism suggest a link to energy metabolism. Finally, urinary surrogate markers of smoking highlight its adverse effect on OCN metabolism. In conclusion, the present study provides a read-out of metabolic actions of OCN. However, most of the associations were weak arguing for a limited role of OCN in whole-body metabolism.

  4. Elevated circulating lipasin/betatrophin in human type 2 diabetes and obesity

    OpenAIRE

    Zhiyao Fu; Feven Berhane; Alemu Fite; Berhane Seyoum; Abdul B. Abou-Samra; Ren Zhang

    2014-01-01

    Lipasin (also known as C19ORF80, RIFL, ANGPTL8 and betatrophin) is a newly discovered circulating factor that regulates lipid metabolism and promotes pancreatic ?-cell proliferation. Whether circulating levels of lipasin in humans are altered in a) type 2 diabetes; b) obesity and c) the postprandial state, however, is unknown. The current study aimed to compare serum lipasin levels in those who were a) non-diabetic (N = 15) or diabetic (BMI- and age-matched; N = 14); b) lean or obese (N = 53 ...

  5. Is there a place for incretin therapies in obesity and prediabetes?

    DEFF Research Database (Denmark)

    Holst, Jens Juul; Deacon, Carolyn F

    2013-01-01

    the incretin hormones in the body. Both drug classes improve metabolic control in type 2 diabetes (T2DM), with GLP-1 receptor agonists also lowering body weight. Pharmacotherapy using DPP-4 inhibitors has few side effects and is weight neutral. Animal studies support their use in prediabetes; however, human...... data are scarce. GLP-1 receptor agonist effects are also apparent in non-diabetic obese individuals. Therefore, incretin-based therapies, if safe, may be effective in preventing progression of prediabetes; and GLP-1 receptor agonists may have potential for use in the treatment of obesity....

  6. Evaluation of Smoking, Diabetes Mellitus and Obesity associations with Degenerative Lumbar Spinal Stenosis in Elderly

    Directory of Open Access Journals (Sweden)

    Laith Thamer Al-Ameri

    2018-05-01

    Full Text Available Background: Degenerative lumbar spinal stenosis (LSS is a common condition affecting mainly old age group with high incidence and prevalence, and is associated with many factors. Aim: Our study aimed to evaluate smoking, diabetes mellitus and obesity associations with degenerative LSS. Patients and methods: A comparative crosssectional study with participants aged 60 years or older. Participants suffering from degenerative LSS were enrolled as the diseased group after diagnosis with MRI, healthy persons (age and gender matched were considered as control group. Smoking, diabetes mellitus and obesity variables were collected and analyzed using chi-square and odds ratio. Results: Around 162 participants enrolled the study, 62 were considered as degenerative LSS group, whereas 100 were considered as the control group. In LSS group, a picture obtained was of 20:42 smokers to non-smoker, 22:20 diabetic to non-diabetic, 37:25 obese to non-obese. While in the controlled group a picture was obtained with 18:82 smokers to non-smoker, 18-82 diabetic to non-diabetic, 34:66 obese to non-obese. Chi-square p-value was of 0.037, 0.012 and 0.001 for smoking, diabetes mellitus, and obesity, respectively. The odd ratio was 2.17, 2.5 and 2.87 for smoking, diabetes mellitus, and obesity, respectively. All above results were significant. Conclusion: Each of smoking, diabetes mellitus, and obesity has a great association with the development of degenerative LSS in elderly age group. Obesity shows the highest association among them

  7. [Obesity-hypoventilation syndrome].

    Science.gov (United States)

    Weitzenblum, E; Kessler, R; Canuet, M; Chaouat, A

    2008-04-01

    The obesity-hypoventilation syndrome (OHS), or alveolar hypoventilation in the obese, has been described initially as the "Pickwickian syndrome". It is defined as chronic alveolar hypoventilation (PaO2 or =45 mmHg) in obese patients (body mass index>30 kg/m2) who have no other respiratory disease explaining the hypoxemia-hypercapnia. The large majority of obese subjects are not hypercapnic, even in case of severe obesity (>40 kg/m2). There are three principal causes, which can be associated, explaining alveolar hypoventilation in obese subjects: high cost of respiration and weakness of the respiratory muscles (probably the major cause), dysfunction of the respiratory centers with diminished chemosensitivity, long-term effects of the repeated episodes of obstructive sleep apneas observed in some patients. The role of leptin (hormone produced by adipocytes) in the pathogenesis of this syndrome, has been recently advocated. OHS is generally observed in subjects over 50 years. Its prevalence has markedly increased in recent years, probably due to the present "epidemic" of obesity. The diagnosis is often made after an episode of severe respiratory failure. Comorbidities, favored by obesity, are very frequent: systemic hypertension, left heart diseases, diabetes. OHS must be distinguished from obstructive sleep apnea syndrome (OSAS) even if the two conditions are often associated. OSAS may be absent in certain patients with OHS (20% of the patients in our experience). On the other hand obesity may be absent in certain patients with OSAS. Losing weight is the "ideal" treatment of OHS but in fact it cannot be obtained in most patients. Nocturnal ventilation (continuous positive airway pressure and mainly bilevel non invasive ventilation) is presently the best treatment of OHS and excellent short and long-term results on symptoms and arterial blood gases have been recently reported.

  8. Obesity Prevalence Maps

    Science.gov (United States)

    ... Obesity Causes & Consequences CDC Reports Improvement in Childhood Obesity among Young Children Participating in WIC Data & Statistics Adult Obesity Facts Childhood Obesity Facts Data, Trends and ...

  9. [Postmenopausal osteoporosis in obese women].

    Science.gov (United States)

    Izmozherova, N V; Popov, A A

    2008-01-01

    assessment of frequency of obesity and comorbidities in women with postmenopausal osteoporosis (OP). cross-sectional study included 243 postmenopausal symptomatic women with OP diagnosed by dual energy lumbar spine absorptiometry. normal body mass was found in 74 women (30.5%), 105 persons (43.2%) had overweight and 64 patients (26.3%) were obese. Obese OP patients had significantly higherfrequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than those with normal body mass. Obese persons also had more severe menopausal symptoms than women with normal body mass. There was no difference in non-traumatic fractures between obese, overweight and slim patients. Thus, postmenopausal OP in obese women was associated with numerous comorbidities and more severe menopausal symptoms.

  10. Treatment of adolescent obesity.

    Science.gov (United States)

    Steinbeck, Katharine S; Lister, Natalie B; Gow, Megan L; Baur, Louise A

    2018-04-13

    The increased prevalence of adolescent obesity and associated short-term and long-term complications emphasize the need for effective treatment. In this Review, we aim to describe the evidence for, and elements of, behaviour management and adjunctive therapies and highlight the opportunities and challenges presented by obesity management in adolescence. The broad principles of treatment include management of obesity-associated complications; a developmentally appropriate approach; long-term behaviour modification (dietary change, increased physical activity, decreased sedentary behaviours and improved sleep patterns); long-term weight maintenance strategies; and consideration of the use of pharmacotherapy, more intensive dietary therapies and bariatric surgery. Bariatric surgery should be considered in those with severe obesity and be undertaken by skilled bariatric surgeons affiliated with teams experienced in the medical and psychosocial management of adolescents. Adolescent obesity management strategies are more reliant on active participation than those for childhood obesity and should recognize the emerging autonomy of the patient. The challenges in adolescent obesity relate primarily to the often competing demands of developing autonomy and not yet having attained neurocognitive maturity.

  11. [Eating disorders and obesity].

    Science.gov (United States)

    Wolf, L M; Houdent, C

    1989-02-16

    In most cases, obesity does not stem from a specific psychologic disturbance. Some obese people overeat, as do their family or their socio-professional peers, and this cannot be considered a pathologic behaviour. Many obese patients increase their energy intake when frustrated, anxious, or tired, like many normal individuals who enjoy a better weight regulation. But when obesity increases suddenly and/or severely in these circumstances, and in gross obesity, abnormal feeding behaviour is usually responsible: prandial or, more often extraprandial overeating (nibbling, gorging, binge eating, night eating, excess alcohol, carbohydrate craving). Serotoninergic mechanisms of the latter have focused wide interest. Conflicting situations and/or anxiety are usually a factor in child obesity. Deppreciated self-image and feelings of culpability, partly secondary to obesity itself and dietary failures often contribute to feeding disturbances, sometimes surreptitious, carrying a risk of vicious circle. But weight reduction itself, while improving self image, carries a risk of unmasking depressive tendencies, especially when too quick. Hence the importance of careful and comprehensive management.

  12. Obesity and infection: reciprocal causality.

    Science.gov (United States)

    Hainer, V; Zamrazilová, H; Kunešová, M; Bendlová, B; Aldhoon-Hainerová, I

    2015-01-01

    Associations between different infectious agents and obesity have been reported in humans fo