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Drew JE. Cellular defense system gene expression profiling of human whole blood: opportunities to predict health benefits in response to diet. Adv Nutr 2012; 3:499-505. [PMID: 22797985 PMCID: PMC3649718 DOI: 10.3945/an.112.002121] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Diet is a critical factor in the maintenance of human cellular defense systems, immunity, inflammation, redox regulation, metabolism, and DNA repair that ensure optimal health and reduce disease risk. Assessment of dietary modulation of cellular defense systems in humans has been limited due to difficulties in accessing target tissues. Notably, peripheral blood gene expression profiles associated with nonhematologic disease are detectable. Coupled with recent innovations in gene expression technologies, gene expression profiling of human blood to determine predictive markers associated with health status and dietary modulation is now a feasible prospect for nutrition scientists. This review focuses on cellular defense system gene expression profiling of human whole blood and the opportunities this presents, using recent technological advances, to predict health status and benefits conferred by diet.
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102
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Epstein NU, Xie H, Ruland SD, Pandey DK. Vascular risk factors and cardiovascular outcomes in the Alzheimer's disease neuroimaging initiative. Am J Alzheimers Dis Other Demen 2012; 27:275-9. [PMID: 22739032 PMCID: PMC10697362 DOI: 10.1177/1533317512449730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND Vascular disease and medical factors are associated with cognitive decline and cardiovascular events. We examined the association between vascular risk factors and events in the Alzheimer's Disease Neuroimaging Initiative cohort. METHODS The association between vascular risk factors and cardiovascular events in a cohort of 810 participants, including 400 with mild cognitive impairment, 184 with Alzheimer's, and 226 controls was investigated using a longitudinal hazard model. RESULTS There were 31 events including 11 strokes, 7 myocardial infarctions, 5 revascularizations, and 8 deaths during an average follow-up of 31 months. Longitudinal cardiovascular event rates were low and similar between diagnostic groups. CONCLUSIONS All baseline vascular risk factors that were expected to be associated with longitudinal cardiovascular events were, or were trending toward, associating with cardiovascular events except atrial fibrillation, depression, and apolipoprotein E genotype. Despite differences in baseline vascular risk factors, longitudinal cardiovascular event rates were similar between diagnostic groups.
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Affiliation(s)
- Noam U. Epstein
- Department of Neurology and Rehabilitation, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Hui Xie
- Department of Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, Illinois, USA
| | - Sean D. Ruland
- Department of Neurology and Rehabilitation, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Dilip K. Pandey
- Department of Neurology and Rehabilitation, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
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Mikkola I, Keinänen-Kiukaanniemi S, Jokelainen J, Peitso A, Härkönen P, Timonen M, Ikäheimo T. Aerobic performance and body composition changes during military service. Scand J Prim Health Care 2012; 30:95-100. [PMID: 22643154 PMCID: PMC3378011 DOI: 10.3109/02813432.2012.649631] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the association between aerobic performance and body composition changes by body mass index (BMI). DESIGN 6-12 months' follow-up during military service. SETTING Conscripts entering military service in 2005 in Sodankylä Jaeger Brigade (Finland). SUBJECTS 945 men (19 years, SD 1 years). MAIN OUTCOME MEASURES Height, weight, waist circumference, BMI, and aerobic performance (Cooper test) were recorded. Body composition was measured by bioelectrical impedance analysis (BIA). The measured parameters were fat mass (FM), fat free mass (FFM), and visceral fat area (VFA). All the measurements were performed at the beginning and end of service. RESULTS On average, the military training period improved the running distance by 6.8% (169 m, p < 0.001) and the improvements were more pronounced in overweight (223.9 m/9.5%, p < 0.001) and obese (273.3 m/13.6%, p < 0.001) conscripts. A strong inverse correlation between aerobic performance and body composition changes was observed, especially for weight (r = -0.305, p < 0.001) and VFA (r = -0.465, p < 0.001). A significant association between aerobic performance and changes in weight (p < 0.001), waist circumference (p < 0.001), FM (p < 0.001), and VFA (p < 0.001) by BMI was detected. The associated decrease in weight, waist circumference, FM, and VFA with improved aerobic performance was more substantial between overweight and obese compared with normal-weight subjects. CONCLUSIONS Favourable changes in body composition are associated with improved aerobic performance during a physical training period such as military service. These findings are pronounced among overweight and obese men and can be applied at the population level in reducing obesity and co-morbidities.
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Affiliation(s)
- Ilona Mikkola
- Institute of Health Sciences, University of Oulu, Finland.
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Sánchez-López M, Ortega FB, Moya-Martínez P, López-Martínez S, Ortiz-Galeano I, Gómez-Marcos MA, Sjöström M, Martínez-Vizcaíno V. Leg fat might be more protective than arm fat in relation to lipid profile. Eur J Nutr 2012; 52:489-95. [PMID: 22484387 DOI: 10.1007/s00394-012-0350-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 03/20/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE The objective of this study was to determine the independent relationships of trunk fat, leg fat and arm fat to cardiovascular (CVD) risk factors, after controlling for relevant confounders such as fat mass index, cardiorespiratory fitness and objectively measured physical activity. METHODS This is a cross-sectional study involving 683 university students, aged 18-30 years. Total and regional body fat distribution was measured using dual-energy X-ray absorptiometry. The associations of trunk, leg and arm fat with CVD risk factors (triglycerides-TG-, high-density lipoprotein cholesterol-HDL-c-, TG/HDL-c ratio, HOMA(IR), mean arterial pressure, C-reactive protein) were examined using regression linear models, controlling for age, sex, fat mass index [total body fat(kg)/height(m(2))], maximal oxygen consumption and physical activity by accelerometer. RESULTS After controlling for fat mass index, and other confounders, higher levels of trunk fat were found to be associated with a poorer lipid profile, while higher levels of leg fat were found to be associated with a better lipid profile. We did not find any association between arm fat and lipid profile after controlling for total fatness and other confounders. Neither trunk, leg or arm fat was found to be related to insulin resistance, blood pressure or inflammation markers. CONCLUSIONS Our data suggest that the region where fat is accumulated might have a differential effect on lipid profile: trunk fat has an adverse effect, leg fat has a protective effect, and arm fat has no effect. The differences observed between upper- and lower-body peripheral fat depots should be further explored.
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Affiliation(s)
- M Sánchez-López
- Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain.
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Topsakal S, Yerlikaya E, Akin F, Kaptanoglu B, Erürker T. Relation with HOMA-IR and thyroid hormones in obese Turkish women with metabolic syndrome. Eat Weight Disord 2012; 17:e57-61. [PMID: 22751273 DOI: 10.1007/bf03325329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to investigate the relationship between insulin resistance and thyroid function in obese pre- and postmenopausal women with or without metabolic syndrome (MetS). 141 obese women were divided into two groups, HOMA-IR<2.7 and HOMA-IR>2.7, to evaluate relation with HOMA-IR and fatness, hormone and blood parameters. They were then divided into four groups as pre- and postmenopausal with or without MetS. Various fatness, hormone and blood parameters were examined. Statistically significant difference was found in weight, body mass index (BMI), waist circumference, fat%, fasting insulin, TSH, FT3, FT4, FSH, Anti-microsomal antibody (ANTIM) and triglycerides levels in HOMA-IR<2.7 and HOMA-IR>2.7 obese Turkish women. This study showed that age, weight, BMI, waist circumference, fat%, fasting insulin, FT3, ANTIM, FSH, LH, total cholesterol, triglycerides, HDL, HOMA-IR, systolic and diastolic blood pressure levels were related in preand post menopausal status in obese women with or without MetS. Obesity may influence the levels of thyroid hormones and increases the risk of MetS in women. Postmenopausal status with MetS is associated with an increased TSH, FT3 and FT4 levels and HOMA-IR in obese women. Strong relation was observed with MetS and TSH and FT3 levels.
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Affiliation(s)
- S Topsakal
- Pamukkale University, Faculty of Medicine, Department of Endocrinology and Metabolism, Denizli, 20070, Turkey.
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Khunti K, Taub N, Webb D, Srinivasan B, Stockman J, Griffin SJ, Simmons RK, Davies MJ. Validity of self-assessed waist circumference in a multi-ethnic UK population. Diabet Med 2012; 29:404-9. [PMID: 21988535 DOI: 10.1111/j.1464-5491.2011.03478.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS To investigate validity of waist circumference measurements obtained by self-report and self-measurement with non-verbal pictorial instructions among a multi-ethnic population. METHODS Five hundred and twenty-six individuals aged 40-75 years (91 South Asian, 430 White European and five other), who attended a screening programme for Type 2 diabetes, estimated their waist circumference and measured their waist with a paper tape measure. Participants were also provided with simple pictorial instructions for measurement of waist circumference in their preferred language and remeasured their waist circumference. We calculated 95% limits of agreement with measures undertaken by a healthcare professional unaware of prior measures. RESULTS Mean age was 56.8 years (sd 9.0), mean BMI 30.0 kg/m(2) (sd 5.6) and mean waist circumference 98.4 cm (sd 14.1). Seventy-nine per cent had high waist circumference according to International Diabetes Federation criteria. The mean of participants' self-reported value was 6.8 cm lower than the healthcare professional measure (sd 8.8; 95% limits of agreement -10.4 to 24.0 cm), with significant differences by sex and ethnicity (South Asian men 7.5 cm, South Asian women 0.1 cm, White European men 7.8 cm, White European women 7.0 cm, P < 0.001). Compared with healthcare professional measures, mean self-measured waist circumference was very similar, both with instructions (0.4 cm higher; sd 5.5 cm; -11.1 to 10.4 cm) and without instructions (0.5 cm lower; sd 5.6; -10.4 to 11.4 cm), but with significant differences by sex and ethnicity (P < 0.001). CONCLUSIONS There was systematic underestimation of self-reported waist circumference in this multi-ethnic UK population. The magnitude of underestimation might reduce the performance of risk scores; however, this can be corrected through self-measurement with pictorial instructions.
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Affiliation(s)
- K Khunti
- Department of Health Sciences, University of Leicester, Leicester, UK.
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Windham BG, Fumagalli S, Ble A, Sollers JJ, Thayer JF, Najjar SS, Griswold ME, Ferrucci L. The Relationship between Heart Rate Variability and Adiposity Differs for Central and Overall Adiposity. J Obes 2012; 2012:149516. [PMID: 22649714 PMCID: PMC3357556 DOI: 10.1155/2012/149516] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 02/23/2012] [Accepted: 02/23/2012] [Indexed: 12/31/2022] Open
Abstract
While frank obesity is associated with reduced HRV, indicative of poorer autonomic nervous system (ANS) function, the association between body mass index (BMI) and HRV is less clear. We hypothesized that effects of adiposity on ANS are mostly mediated by visceral fat and less by subcutaneous fat; therefore, centrally distributed adipose tissue, that is, waist circumference (WC), should be more strongly associated with HRV than overall adiposity (BMI). To examine this hypothesis, we used data collected in a subset of the Baltimore Longitudinal Study of Aging to compare strength of association between HRV and WC to that of HRV and BMI. Time domain HRV variables SDNN (standard deviation of successive differences in normal-to-normal (N-N) intervals) and RMSSD (root mean square of successive differences in N-N intervals) were calculated from 24-hour Holter recordings in 159 participants (29-96 years). Increasing WC was associated with decreasing SDNN and RMSSD in younger but not older participants (P value for WC-by-age interaction = 0.003). BMI was not associated with either SDNN or RMSSD at any age. In conclusion, central adiposity may contribute to sympathetic and parasympathetic ANS declines early in life.
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Affiliation(s)
- B. Gwen Windham
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Stefano Fumagalli
- Unit of Geriatrics, Department of Critical Care Medicine and Surgery, University of Florence and AOU Careggi, 50134 Florence, Italy
| | - Alessandro Ble
- Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21225-1290, USA
| | - John J. Sollers
- Department of Psychological Medicine, Faculty of Medical & Health Science, The University of Auckland, Auckland 1142, New Zealand
| | - Julian F. Thayer
- The Ohio State University, Columbus, OH 43210, USA
- *Julian F. Thayer:
| | - Samar S. Najjar
- Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21225-1290, USA
- Laboratory of Cardiovascular Science, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Michael E. Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21225-1290, USA
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Physical, Social and Cultural, and Global Influences. SPRINGER TEXTS IN BUSINESS AND ECONOMICS 2012. [PMCID: PMC7120848 DOI: 10.1007/978-1-4614-3169-5_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In Chap. 5, we examined the technological environment of the health care policy-making system. Specifically, we examined the classification, evolution, and diffusion of medical technology; the effects of medical technology on medical training and the practice of medicine; effects on medical costs, quality of care, and quality of life; effects on access to care; the ethical concerns raised by medical technology; and the practice of technology assessment. We concluded the chapter by observing that the growth of technology, as well as other human endeavors, affects other important aspects of our lives, most notably, the air we breathe, the food we eat, the generation of radioactive by-products and toxic chemicals, the manufacture of illicit drugs, and the generation of natural and man-made hazards. In other words, in addition to their effects on the health care system, technology and other human activities affect many other aspects of our lives that are associated with health.
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110
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Jensky NE, Criqui MH, Wright CM, Wassel CL, Alcaraz JE, Allison MA. The association between abdominal body composition and vascular calcification. Obesity (Silver Spring) 2011; 19:2418-24. [PMID: 21475146 DOI: 10.1038/oby.2011.70] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Subclinical cardiovascular disease (CVD) may be associated with both adipose and skeletal muscle tissues in the abdomen. Accordingly, we examined whether subcutaneous, intermuscular, and visceral adipose tissue, as well as abdominal lean muscle, were associated with the presence and extent of vascular calcification in multiple vascular beds. Three hundred and ninety four patients (58.1% men) underwent electron beam computed tomography (EBCT) scans as part of routine health maintenance screening. The coronary and carotid calcium scores were analyzed at the time of the scan, whereas the other calcium scores, as well as the body composition analyses, were analyzed retrospectively. Mean age was 55.2 ± 11.1 years and BMI was 26.9 ± 4.2. The prevalence of any calcification in the carotids, coronaries, thoracic aorta, abdominal aorta, and iliacs was 30.1, 60.1, 39.8, 55.7, and 56.8%, respectively. Compared to those with calcification in different vascular beds, those without vascular calcification generally had significantly more lean muscle and less adipose tissue. In separate multivariable logistic models, a 1 s.d. increment in the ratio of abdominal and visceral fat to total area of each corresponding compartments was significantly associated with an increased odds for the presence of thoracic aortic calcium (odds ratio (OR) = 1.6, 1.5, respectively; P = 0.01 for both). Conversely, increases in abdominal lean muscle were associated with significantly decreased odds of thoracic aortic calcification (OR = 0.34; P ≤ 0.01). A similar pattern of associations existed among the other vascular beds. Also, the association between lean muscle and vascular calcification was independent of visceral adipose tissue. In conclusion, adipose tissue was positively and lean body mass inversely associated with prevalent aortic calcification.
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Affiliation(s)
- Nicole E Jensky
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California, USA.
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111
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Maturana MA, Moreira RMC, Spritzer PM. Lipid accumulation product (LAP) is related to androgenicity and cardiovascular risk factors in postmenopausal women. Maturitas 2011; 70:395-9. [PMID: 22018728 DOI: 10.1016/j.maturitas.2011.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 09/09/2011] [Accepted: 09/27/2011] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To investigate whether lipid accumulation product (LAP) is related to androgen and sex hormone binding globulin (SHBG) levels and to cardiovascular risk factors in postmenopausal women with no evidence of established cardiovascular disease. STUDY DESIGN Cross-sectional study. MAIN OUTCOME MEASURES LAP (waist-58 × triglycerides [nmol/L]), LAP ≥ arbitrary cutoff point of 34.5, serum testosterone, SHBG, ultrasensitive C-reactive protein (us-CRP). RESULTS Forty-nine women (mean age 55±5 years; median amenorrhea time 5.5 years [3-8]) were studied: 14% had the metabolic syndrome and 24.5% were hypertensive. Compared with LAP<34.5, LAP ≥ 34.5 (n=29, 59%) was associated with higher testosterone (p=0.021) and free androgen index (FAI) (p=0.003) and lower SHBG levels (p=0.013). Us-CRP (p=0.012), total cholesterol (p=0.041), glucose (p=0.020) and homeostasis model assessment (HOMA) (p=0.019) were higher, and high-density lipoprotein cholesterol (HDL-C) (p=0.001) was lower with LAP ≥ 34.5. LAP was positively correlated with total testosterone (r=0.349, p=0.014), FAI (rs=0.470, p=0.001), us-CRP (r=0.315, p=0.042), systolic (r=0.318, p=0.028) and diastolic (r=0.327, p=0.023) blood pressure, total cholesterol (r=0.498, p<0.001) and glucose (rs=0.319, p=0.026). LAP was negatively correlated with SHBG (rs=-0.430, p=0.003) and HDL-C (r=-0.319, p=0.026). CONCLUSIONS LAP index seems to be associated with androgens and SHBG and with cardiovascular risk factors in postmenopausal women. Also, LAP seems to be a suitable method to screen for cardiovascular risk in postmenopause.
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Affiliation(s)
- Maria Augusta Maturana
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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112
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Meyer MR, Clegg DJ, Prossnitz ER, Barton M. Obesity, insulin resistance and diabetes: sex differences and role of oestrogen receptors. Acta Physiol (Oxf) 2011; 203:259-69. [PMID: 21281456 DOI: 10.1111/j.1748-1716.2010.02237.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Obesity increases the risk of coronary artery disease through insulin resistance, diabetes, arterial hypertension and dyslipidemia. The prevalence of obesity has increased worldwide and is particularly high among middle-aged women and men. After menopause, women are at an increased risk to develop visceral obesity due to the loss of endogenous ovarian hormone production. Effects of oestrogens are classically mediated by the two nuclear oestrogen receptors (ERs) α and β. In addition, more recent research has shown that the intracellular transmembrane G-protein-coupled oestrogen receptor (GPER) originally designated as GPR30 also mediates some of the actions attributed to oestrogens. Oestrogen and its receptors are important regulators of body weight and insulin sensitivity not only in women but also in men as demonstrated by ER mutations in rodents and humans. This article reviews the role of sex hormones and ERs in the context of obesity, insulin sensitivity and diabetes as well as the related clinical issues in women and men.
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Affiliation(s)
- M R Meyer
- Molecular Internal Medicine, University of Zurich, Switzerland
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113
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Dhara R, Dhar P, Ghosh M. Dietary effects of diacylglycerol rich mustard oil on lipid profile of normocholesterolemic and hypercholesterolemic rats. Journal of Food Science and Technology 2011; 50:678-86. [PMID: 24425969 DOI: 10.1007/s13197-011-0388-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 04/07/2011] [Accepted: 04/19/2011] [Indexed: 11/26/2022]
Abstract
Several recent studies have established that diacylglycerol (DAG) rich oils significantly reduce the body weight. The present study was conducted to evaluate the dietary effects of DAG- rich mustard oil on normal and hypercholesterolemic rats. DAG- rich mustard oil (45.5% DAG) was prepared in the laboratory by enzymatic glycerolysis process. For the feeding experiment, 32 rats were taken and divided into four groups (average body weight 130 g) and body weight gain, food efficiency ratio, lipid profile of plasma, liver, mesentery and erythrocytes membrane (EM), HMG Co-A reductase activity and plasma leptin content were measured and compared with the normal TAG-rich diet. The dietary DAG rich mustard oil significantly decreased body weight and FER compared to TAG rich mustard oil both in normal and hypercholesterolemic rats. The total cholesterol content was decreased with significant increase in HDL- cholesterol by feeding DAG rich diet. Total lipid and TAG content of both liver and mesentery were significantly decreased in DAG diet group compared to control group. Liver HMG CoA: mevalonate ratio was also found to be significantly decreased in the DAG group. Blood leptin level significantly reduced with DAG rich diet compared to the TAG rich dietary groups.
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Affiliation(s)
- Rupali Dhara
- Dept. of Chemical Technology, University of Calcutta, Kolkata, India
| | - Pubali Dhar
- Dept. of Home Science, University of Calcutta, Kolkata, India
| | - Mahua Ghosh
- Dept. of Chemical Technology, University of Calcutta, Kolkata, India ; Oil Technology Division, Department of Chemical Technology, University of Calcutta, 92, Acharyya Prafulla Chandra Road, Kolkata, 700009 India
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Abstract
Late-onset hypogonadism is a clinical and biological syndrome associated with advancing age and characterized by typical symptoms and a deficiency in serum testosterone levels. It is a common condition but often underdiagnosed and undertreated. The main symptoms of hypogonadism are reduced libido/erectile dysfunction, reduced muscle mass and strength, increased adiposity, osteoporosis/low bone mass, depressed mood, and fatigue. Testosterone replacement therapy is only warranted in the presence of both clinical symptoms suggesting hormone deficiency and decreased hormone levels. It improves libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life, and cardiovascular disease.
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Affiliation(s)
- Nazem Bassil
- Department of Medicine, Saint George Hospital Medical Center, Balamand University, Youssef Sursock Street, PO Box 166378, Achrafieh, Beirut 1100 2807, Lebanon.
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115
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Azar Sharabiani MT, Vermeulen R, Scoccianti C, Hosnijeh FS, Minelli L, Sacerdote C, Palli D, Krogh V, Tumino R, Chiodini P, Panico S, Vineis P. Immunologic profile of excessive body weight. Biomarkers 2011; 16:243-51. [DOI: 10.3109/1354750x.2010.547948] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | | | | | | | | | | | | | | | | | | | - Paolo Vineis
- MRC/HPA Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Imperial College, London, UK
- HuGeF Foundation, Torino, Italy
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Plasma leptin levels and digital pulse volume in obese patients without metabolic syndrome--a pilot study. Clin Chim Acta 2011; 412:730-4. [PMID: 21195702 DOI: 10.1016/j.cca.2010.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 12/22/2010] [Accepted: 12/23/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND The mechanism of obesity leading to endothelial function is complex, and involves many adipokines and inflammatory cytokines. The data is especially lacking in obese patients without metabolic syndrome. We assessed the relationship among endothelial dysfunction, anthropometric indices, adipokines and inflammatory cytokines in this population. METHODS Obese patients without metabolic syndrome were included in this study. The plasma resistin, leptin, retinol-binding-protein 4 and inflammatory cytokines were examined. Endothelial function was assessed by a fingertip peripheral arterial tonometry (PAT) device. Data are expressed as the natural logarithm (ln) of the PAT ratio. Endothelial dysfunction was defined by a ln (PAT ratio) <0.30. RESULTS A total of 35 patients were enrolled, 11 of whom were with endothelial dysfunction. There was a significant difference of ln leptin (p=0.007), ln [leptin/visceral fat thickness] (p=0.004) and ln [leptin/subcutaneous fat thickness] (p<0.001) between patients with and without endothelial dysfunction. Multivariate linear regression analyses showed that ln [leptin/subcutaneous fat thickness] was significantly related to the ln (PAT ratio) (p=0.002). Using ln [leptin/subcutaneous fat thickness] to detect endothelial dysfunction, the area of receiver operating characteristic curves was 0.843 (p=0.002). Using 6.10 as a cutoff point, the sensitivity and specificity to determine endothelial dysfunction were 91% and 78%, respectively. CONCLUSION Abnormal digital vascular function occurs in obese patients without metabolic syndrome. Low plasma leptin/subcutaneous fat ratio is associated with endothelial dysfunction in this population.
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Afsar B, Elsurer R, Güner E, Kirkpantur A. Which anthropometric parameter is best related with urinary albumin excretion and creatinine clearance in type 2 diabetes: body mass index, waist circumference, waist-to-hip ratio, or conicity index? J Ren Nutr 2011; 21:472-8. [PMID: 21454092 DOI: 10.1053/j.jrn.2010.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 12/17/2010] [Accepted: 12/20/2010] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE We analyzed the relationships between body mass index (BMI), waist circumference (WC), waist-to-hip ratio, and conicity index and 24-hour urinary albumin excretion rate (UAER) and creatinine clearance. DESIGN Cross-sectional study. SETTING Patients presenting to a state hospital. PATIENTS Study involved patients with type 2 diabetes. METHODS Study participants underwent medical history examination, measurement of office blood pressure (BP), measurement of anthropometric factors and calculations (including BMI, WC, waist-to-hip ratio, and conicity index), physical examination, biochemical analysis, and 24-hour urine specimen collection to determine creatinine clearance and UAER. RESULTS In all, 202 patients with type 2 diabetes (male/female: 91/111, aged: 58.4 ± 10.1 years) were included. It was found that 24-hour UAER correlated with WC (rho: +0.176, P = .012), serum albumin (rho: -0.324, P < .0001), and systolic BP (rho: +0.153, P = .029), whereas creatinine clearance correlated with age (rho: -0.152, P = .031), BMI (rho: +0.191, P = .007), albumin level (rho: +0.365, P < .0001), and uric acid level (rho: -0.369, P < .0001). The stepwise linear regression analysis revealed that WC (P = .012), glycosylated hemoglobin (P = .018), and systolic BP (P = .043) were found to be independently related to logarithmically converted 24-hour UAER, whereas creatinine clearance was found to be related to duration of diabetes (P = .001), BMI (P = .008), presence of peripheral arterial disease (P = .021), fasting serum glucose level (P = .003), and uric acid level (P < .0001). However, after correction for body surface area, BMI was no longer associated with creatinine clearance. CONCLUSION Among the anthropometric parameters, only an increase in WC was found to be independently related to 24-hour UAER. Although BMI was associated with creatinine clearance, this association was lost after creatinine clearance was corrected for body surface area.
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Affiliation(s)
- Baris Afsar
- Department of Nephrology, Zonguldak Atatürk State Hospital, Turkey.
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118
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Hsu HS, Liu CS, Pi-Sunyer FX, Lin CH, Li CI, Lin CC, Li TC, Lin WY. The associations of different measurements of obesity with cardiovascular risk factors in Chinese. Eur J Clin Invest 2011; 41:393-404. [PMID: 21114491 DOI: 10.1111/j.1365-2362.2010.02421.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Obesity increases the risks of cardiovascular diseases (CVD). This study examined the optimal cut-off values for overweight and obesity for CVD risks using different anthropometric indices in middle-aged Taiwanese. MATERIALS AND METHODS A total of 2359 subjects aged 40 and over were recruited in 2004 in Taiwan. Body mass index (BMI) was divided into four groups using three different definitions. Waist circumference (WC), waist-to-hip ratio (WC/HC) and waist-to-height ratio (WC/H) were divided into quartiles. The receiver operating characteristic analysis was used to compare their predictive validity and to find out their optimal cut-off values. RESULTS Men were older and had greater height, weight, BMI, WC, WC/HC, WC/H, blood pressure (BP), fasting glucose, uric acid and triglycerides than women. In all BMI definitions, subjects in higher BMI groups had higher BP, fasting glucose, triglycerides, uric acid and WC than subjects in lower BMI groups. Compared to quartile I of WC, WC/HC and WC/H, the odds ratios of having CVD risk factors increased in higher quartiles of WC, WC/HC and WC/H. The optimal cut-off values for overweight/obesity in middle-aged Taiwanese in men and women were as follows: BMI of 23·7 and 22·4 kg m(-2), WC of 82·5 and 72·5 cm, WC/HC of 0·87 and 0·79 and WC/H of 0·50 and 0·46. WC/H is the best indicator for predicting CVD risks. CONCLUSIONS Obesity, presenting with higher BMI, WC, WC/HC and WC/H, is closely related to CVD risk factors. WC/H is the best predictor of CVD risk factors in middle-aged Taiwanese.
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Affiliation(s)
- Hua-Shui Hsu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Menezes AMB, Hallal PC, Dumith SC, Matijasevich AM, Araújo CLP, Yudkin J, Osmond C, Barros FC, Victora CG. Adolescent blood pressure, body mass index and skin folds: sorting out the effects of early weight and length gains. J Epidemiol Community Health 2011; 66:149-54. [PMID: 21325148 PMCID: PMC3245895 DOI: 10.1136/jech.2010.124842] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Although there is longstanding evidence of the short-term benefits of promoting rapid growth for young children in low-income settings, more recent studies suggest that early weight gain can also increase the risk of chronic diseases in adults. This paper attempts to separate the effects of early life weight and length/height gains on blood pressure, body mass index (BMI), sum of skin folds and subscapular/triceps skin fold ratio at 14-15 years of age. METHODS The sample comprised 833 members of a prospective population-based birth cohort from Brazil. Conditional size (weight or height) analyses were used to express the difference between observed size at a given age and expected size based on a regression, including all previous measures of the same anthropometric index. A positive conditional weight or height indicates growing faster than expected given prior size. RESULTS Conditional weights at all age ranges were positively associated with most outcomes; each z-score of conditional weight at 4 years was associated with an increase of 6.1 mm in the sum of skin folds (95% CI 4.5 to 7.6) in adolescence after adjustment for conditional length/height. Associations of the outcomes with conditional length/height were mostly negative or non-significant-each z-score was associated with a reduction of 2.4 mm (95% CI -3.8 to -1.1) in the sum of skin folds after adjustment for conditional weight. No associations were found with the skin fold ratio. CONCLUSION The promotion of rapid length/height gain without excessive weight gain seems to be beneficial for long-term outcomes, but this requires confirmation from other studies.
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120
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Piazza N, Wessells RJ. Drosophila models of cardiac disease. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2011; 100:155-210. [PMID: 21377627 PMCID: PMC3551295 DOI: 10.1016/b978-0-12-384878-9.00005-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The fruit fly Drosophila melanogaster has emerged as a useful model for cardiac diseases, both developmental abnormalities and adult functional impairment. Using the tools of both classical and molecular genetics, the study of the developing fly heart has been instrumental in identifying the major signaling events of cardiac field formation, cardiomyocyte specification, and the formation of the functioning heart tube. The larval stage of fly cardiac development has become an important model system for testing isolated preparations of living hearts for the effects of biological and pharmacological compounds on cardiac activity. Meanwhile, the recent development of effective techniques to study adult cardiac performance in the fly has opened new uses for the Drosophila model system. The fly system is now being used to study long-term alterations in adult performance caused by factors such as diet, exercise, and normal aging. The fly is a unique and valuable system for the study of such complex, long-term interactions, as it is the only invertebrate genetic model system with a working heart developmentally homologous to the vertebrate heart. Thus, the fly model combines the advantages of invertebrate genetics (such as large populations, facile molecular genetic techniques, and short lifespan) with physiological measurement techniques that allow meaningful comparisons with data from vertebrate model systems. As such, the fly model is well situated to make important contributions to the understanding of complicated interactions between environmental factors and genetics in the long-term regulation of cardiac performance.
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Affiliation(s)
- Nicole Piazza
- University of Michigan Medical School, Ann Arbor, MI, USA
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121
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Affiliation(s)
- Myoungseok Han
- Department of Obstetrics and Gynecology, Dong-A University College of Medicine, Busan, Korea
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122
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Saad F, Gooren LJ. The role of testosterone in the etiology and treatment of obesity, the metabolic syndrome, and diabetes mellitus type 2. J Obes 2011; 2011:471584. [PMID: 20847893 PMCID: PMC2931403 DOI: 10.1155/2011/471584] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 07/06/2010] [Indexed: 12/12/2022] Open
Abstract
Obesity has become a major health problem. Testosterone plays a significant role in obesity, glucose homeostasis, and lipid metabolism. The metabolic syndrome is a clustering of risk factors predisposing to diabetes mellitus type 2, atherosclerosis, and cardiovascular morbidity and mortality. The main components of the syndrome are visceral obesity, insulin resistance, glucose intolerance, raised blood pressure and dyslipidemia (elevated triglycerides, low levels of high-density lipoprotein cholesterol), and a proinflammatory and thrombogenic state. Cross-sectional epidemiological studies have reported a direct correlation between plasma testosterone and insulin sensitivity, and low testosterone levels are associated with an increased risk of type 2 diabetes mellitus, dramatically illustrated by androgen deprivation in men with prostate carcinoma. Lower total testosterone and sex hormone-binding globulin (SHBG) predict a higher incidence of the metabolic syndrome. Administration of testosterone to hypogonadal men reverses part of the unfavorable risk profile for the development of diabetes and atherosclerosis.
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Affiliation(s)
- Farid Saad
- Bayer Schering Pharma AG, Scientific Affairs Men's Healthcare, D-13342 Berlin, Germany
- Gulf Medical University School of Medicine, Ajman, UAE
- *Farid Saad:
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Yim JY, Kim D, Lim SH, Park MJ, Choi SH, Lee CH, Kim SS, Cho SH. Sagittal abdominal diameter is a strong anthropometric measure of visceral adipose tissue in the Asian general population. Diabetes Care 2010; 33:2665-70. [PMID: 20843976 PMCID: PMC2992209 DOI: 10.2337/dc10-0606] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Finding the anthropometric measure of visceral obesity is essential to clinical practice, because it predicts cardiovascular and metabolic risks. Sagittal abdominal diameter (SAD) has been proposed as an estimate of visceral adipose tissue (VAT). The aim of the present study was to evaluate the usefulness of SAD in predicting visceral obesity by comparing SAD to other anthropometric measures. RESEARCH DESIGN AND METHODS Estimation of subcutaneous and visceral adipose tissue and measurement of SAD and transverse abdominal diameter using computed tomography at the umbilical level were obtained in 5,257 men and women who were enrolled in a health checkup program in Korea. To compare SAD to other anthropometric measures, linear regression analyses were used to determine correlations between anthropometrics and visceral obesity. RESULTS SAD showed a stronger correlation to VAT than waist circumference, BMI, and transverse abdominal diameter in the both sexes (men: r = 0.804, women: r = 0.724). Waist circumference showed generally stronger associations to subcutaneous adipose tissue (SAT) than to VAT (men: r = 0.789 vs. 0.705, women: r = 0.820 vs. 0.636). Even after subdividing according to age or BMI in both sexes and analyzing multiple regressions, SAD showed the strongest correlation to VAT. CONCLUSIONS SAD showed the strongest correlation to VAT irrespective of age, sex, and the degree of obesity compared with other anthropometric measures, whereas waist circumference may have a stronger correlation to SAT than to VAT. The clinical use of SAD has advantages over other anthropometric measures in predicting VAT.
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Affiliation(s)
- Jeong Yoon Yim
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
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Brown LM, Clegg DJ. Central effects of estradiol in the regulation of food intake, body weight, and adiposity. J Steroid Biochem Mol Biol 2010; 122:65-73. [PMID: 20035866 PMCID: PMC2889220 DOI: 10.1016/j.jsbmb.2009.12.005] [Citation(s) in RCA: 224] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Revised: 11/19/2009] [Accepted: 12/15/2009] [Indexed: 12/14/2022]
Abstract
In recent years, obesity and its associated health disorders and costs have increased. Accumulation of adipose tissue, or fat, in the intra-abdominal adipose depot is associated with an increased risk of developing cardiovascular problems, type-2 diabetes mellitus, certain cancers, and other disorders like the metabolic syndrome. Males and females differ in terms of how and where their body fat is stored, in their hormonal secretions, and in their neural responses to signals regulating weight and body fat distribution. Men and post-menopausal women accumulate more fat in their intra-abdominal depots than pre-menopausal women, resulting in a greater risk of developing complications associated with obesity. The goal of this review is to discuss the current literature on sexual dimorphisms in body weight regulation, adipose tissue accrual and deposition.
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Affiliation(s)
- LM Brown
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC 27412
| | - DJ Clegg
- Department of Internal Medicine, Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, TX 75390-8854
- Corresponding author at: Deborah J. Clegg, RD, PhD, Assistant Professor, Department of Internal Medicine, Touchstone Diabetes Center, UT Southwestern Medical Center, 5323 Harry Hines Blvd., K5.252, Dallas, TX 75390-8854, Tel: 214-648-3401, Fax: 214-648-8720, (D. Clegg)
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Knopman DS, Roberts R. Vascular risk factors: imaging and neuropathologic correlates. J Alzheimers Dis 2010; 20:699-709. [PMID: 20182020 DOI: 10.3233/jad-2010-091555] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Cerebrovascular disease plays an important role in cognitive disorders in the elderly. Cerebrovascular disease and Alzheimer's disease interact on several levels, with one important level being the overlap in risk factors. The major vascular risk factors such as diabetes and impaired glycemic control, hypertension, obesity, and hyper- or dyslipidemia have been associated both with Alzheimer's disease and vascular dementia. The purpose of this review is to consider the context in which vascular dementia is diagnosed, place the pathophysiological consequences of cerebrovascular disease on cognition in the context of clinical and pathological Alzheimer's disease, and then to consider the evidence for the role of major vascular risk factors in late-life cognitive impairment, changes in brain imaging and neuropathological changes. Midlife diabetes mellitus, hypertension, and obesity are established risk factors for clinically defined Alzheimer's disease as well as vascular dementia. The basis for these relationships could either be that the risk factors lead to microvascular brain disease, promote Alzheimer pathology or both. The associations of late-life onset diabetes mellitus, hypertension, and obesity with cognitive impairment are either attenuated or reversed. The role of vascular risk factors in midlife should be the focus of public health efforts to reduce the burden of late-life cognitive impairment.
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Affiliation(s)
- David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
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Abstract
Increased longevity and population aging will increase the number of men with late-onset hypogonadism, a common condition that is often under diagnosed and under treated. The indication of testosterone replacement therapy (TRT) treatment requires the presence of low testosterone level and symptoms and signs of hypogonadism. Although there is a lack of large-scale, long-term studies assessing the benefits and risks of TRT in men with hypogonadism, reports indicate that TRT may produce a wide range of benefits that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life, and cardiovascular disease. Perhaps the most controversial area is the issue of risk, especially the possible stimulation of prostate cancer by testosterone, even though there is no evidence to support this risk. Other possible risks include worsening symptoms of benign prostatic hypertrophy, liver toxicity, hyperviscosity, erythrocytosis, worsening untreated sleep apnea, or severe heart failure. Despite this controversy, testosterone supplementation in the United States has increased substantially in the past several years. The physician should discuss with the patient the potential benefits and risks of TRT. This review discusses the benefits and risks of TRT.
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Affiliation(s)
- Nazem Bassil
- Division of Geriatric Psychiatry, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St Louis, MO 63104, USA
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Meydani M, Hasan ST. Dietary polyphenols and obesity. Nutrients 2010; 2:737-51. [PMID: 22254051 PMCID: PMC3257683 DOI: 10.3390/nu2070737] [Citation(s) in RCA: 237] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 07/01/2010] [Accepted: 07/07/2010] [Indexed: 12/19/2022] Open
Abstract
The prevalence of overweight and obesity and their associated metabolic disorders are considered a major threat to the public’s health. While several diet and exercise programs are available for weight loss and prevention of weight regain, progress is often slow and disappointing. Recently, natural bioactive phytochemicals present in foods have been discovered for their potential health benefit effects on the prevention of chronic disorders such as cancer, cardiovascular disease, inflammatory and metabolic diseases including obesity. Polyphenols are a class of naturally-occurring phytochemicals, of which some such as catechins, anthocynines, resveratrol and curcumin have been shown to modulate physiological and molecular pathways that are involved in energy metabolism, adiposity, and obesity. The potential in vivo, beneficial effects of these polyphenols on adiposity and obesity as complementary agents in the up-regulation of energy expenditure have emerged by investigating these compounds in cell cultures, animal models of obesity and in some human clinical and epidemiological studies. In this brief review, the efficacy of the above-named polyphenols and their potential efficacy to modulate obesity and some associated disorders are discussed.
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Affiliation(s)
- Mohsen Meydani
- Author to whom correspondence should be addressed: Tel.: 617-556-3126; Fax: 617-556-3224
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Rouen PA, Lukacs JL, Reame NE. Adipokine concentrations in nonobese women: a study of reproductive aging, body mass index, and menstrual cycle effects. Biol Res Nurs 2010; 12:54-61. [PMID: 20453025 PMCID: PMC3128347 DOI: 10.1177/1099800410365368] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore the influence of reproductive aging, body mass index (BMI), and the menstrual cycle on adiponectin (AD) and leptin concentrations. DESIGN Cross-sectional comparison in age- and BMI-matched nonobese volunteers with regular cycles (CO, n = 19) or in early postmenopause (EPM, n = 19), aged 40-52 years, and a young cycling group (CY, n = 21), aged 20-30 years. MEASURES Sex steroids, fasting AD, leptin, insulin, glucose, AD/leptin (A/L) ratio, and insulin resistance (IR) by homeostasis model assessment (HOMA-IR). In ovulatory women, AD, estradiol (E(2)), and progesterone were assessed weekly across the same menstrual cycle. RESULTS Insulin, glucose, HOMA-IR, A/L ratio, and leptin values were similar across the three study groups. AD differed, with the highest concentrations in the EPM group (CY: 13.0 +/- 0.9 microg/ml vs. CO: 14.0 +/- 1.1 microg/ml vs. EPM: 17.7 +/- 1.5 microg/ml; p = .05). Values among cycling women were similar. When the cycling groups were combined into a premenopausal (PRE) group and compared to EPM women by BMI (> or CONCLUSION Nonobese, midlife women experience minimal adverse effects from reproductive aging on insulin sensitivity and adipokine secretion. The menstrual cycle is not a key mediator of AD. Early menopause has differential, BMI-dependent effects on adipokine secretion.
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Affiliation(s)
- Patricia A. Rouen
- McAuley School of Nursing, University of Detroit Mercy, 4001 W. McNichols Road., Detroit, MI 48221, , Phone: (313) 993-1739 Fax: (313) 993-1271
| | - Jane L. Lukacs
- School of Nursing, University of Michigan, Ann Arbor, MI
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Lombardi M, Mercuro G, Fini M, Rosano GM. Gender-specific aspects of treatment of cardiovascular risk factors in primary and secondary prevention. Fundam Clin Pharmacol 2010; 24:699-705. [DOI: 10.1111/j.1472-8206.2010.00834.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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130
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Kaya A, Uzunhasan I, Baskurt M, Ozkan A, Ataoglu E, Okcun B, Yigit Z. Oxidative status and lipid profile in metabolic syndrome: gender differences. Metab Syndr Relat Disord 2010; 8:53-8. [PMID: 19958158 DOI: 10.1089/met.2009.0004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome is associated with cardiovascular disease and oxidative stress. The aim of this study was to investigate the differences of novel oxidative stress parameters and lipid profiles in men and women with metabolic syndrome. METHODS The study population included 88 patients with metabolic syndrome, consisting of 48 postmenauposal women (group I) and 40 men (group II). Premenauposal women were excluded. Plasma levels of total antioxidant status (TAS) and total oxidative status (TOS) were determined by using the Erel automated measurement method, and oxidative stress index (OSI) was calculated. To perform the calculation, the resulting unit of TAS, mmol Trolox equivalent/L, was converted to micromol equivalent/L and the OSI value was calculated as: OSI = [(TOS, micromol/L)/(TAS, mmol Trolox equivalent/L) x 100]. The Student t-test, Mann-Whitney-U test, and chi-squared test were used for statistical analysis; the Pearson correlation coefficient and Spearman rank test were used for correlation analysis. P < or = 0.05 was considered to be statistically significant. RESULTS Both women and men had similar properties regarding demographic characteristics and biochemical work up. Group II had significantly lower levels of antioxidant levels of TAS and lower levels of TOS and OSI compared with group I (P = 0.0001, P = 0.0035, and P = 0,0001). Apolipoprotein A (ApoA) levels were significantly higher in group I compared with group II. CONCLUSIONS Our findings indicate that women with metabolic syndrome have a better antioxidant status and higher ApoA levels compared with men. Our findings suggest the existence of a higher oxidative stress index in men with metabolic syndrome. Considering the higher risk of atherosclerosis associated with men, these novel oxidative stress parameters may be valuable in the evaluation of patients with metabolic sydrome.
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Affiliation(s)
- Aysem Kaya
- Biochemistry Department, Institute of Cardiology, Istanbul University, Istanbul 34303, Turkey
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Brown LM, Gent L, Davis K, Clegg DJ. Metabolic impact of sex hormones on obesity. Brain Res 2010; 1350:77-85. [PMID: 20441773 DOI: 10.1016/j.brainres.2010.04.056] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Revised: 04/18/2010] [Accepted: 04/20/2010] [Indexed: 02/07/2023]
Abstract
Obesity and its associated health disorders and costs are increasing. Men and post-menopausal women have greater risk of developing complications of obesity than younger women. Within the brain, the hypothalamus is an important regulator of energy homeostasis. Two of its sub-areas, the ventrolateral portion of the ventral medial nucleus (VL VMN) and the arcuate (ARC) respond to hormones and other signals to control energy intake and expenditure. When large lesions are made in the hypothalamus which includes both the VL VMN and the ARC, animals eat more, have reduced energy expenditure, and become obese. The ARC and the VL VMN, in addition to other regions in the hypothalamus, have been demonstrated to contain estrogen receptors. There are two estrogen receptors, estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta). We and others have previously demonstrated that activation of ERalpha by estrogens reduces food intake and increases body weight. This review focuses on the relative contribution of activation of ERalpha by estrogens in the ARC and the VL VMN in the regulation of food intake and body weight. Additionally, estrogen receptors have been found in many peripheral tissues including adipose tissue. Estrogens are thought to have direct effects on adipose tissue and estrogens may provide anti-inflammatory properties both in the periphery and the in the central nervous system (CNS) which may protect women from diseases associated with inflammation. Understanding the mechanisms by which estrogens regulate body weight and inflammation will assist in determining potential therapeutic agents for menopausal women to decrease the propensity of diseases associated with obesity.
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Affiliation(s)
- Lynda M Brown
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC 27412, USA
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Post-exercise systolic blood pressure recovery and adiposity in adults. COMPARATIVE EXERCISE PHYSIOLOGY 2010. [DOI: 10.1017/s1755254010000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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133
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Molenaar EA, van Ameijden EJC, Vergouwe Y, Grobbee DE, Numans ME. Effect of nutritional counselling and nutritional plus exercise counselling in overweight adults: a randomized trial in multidisciplinary primary care practice. Fam Pract 2010; 27:143-50. [PMID: 20026554 DOI: 10.1093/fampra/cmp104] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To compare the effects of nutritional counselling with nutritional plus exercise counselling on body weight and waist circumference in overweight adults in a multidisciplinary primary care setting. METHODS One hundred and thirty-four overweight adults (body mass index 28-35) were randomly assigned to individual counselling sessions by a dietician (D) or counselling sessions by a dietician plus physiotherapist (D + E) during 6 months with one follow-up session at 12 months. Outcomes were assessed at baseline, 6 and 12 months. Difference in changes of outcome measures between groups were analysed using generalized estimating equations. RESULTS Weight reduced from baseline to 6 months in D [-2.2 (-3.1 to -1.4) kg] and D + E [-3.0 (-4.0 to -2.0) kg] and was sustained at 12 months [-2.0 (-3.1 to -1.4) kg and -3.1 (-4.5 to -1.6) kg, respectively]. The reduction in weight did not significantly differ between D and D + E (P = 0.48). In both groups, waist circumference decreased from baseline to 6 months [-2.1 (-3.3 to -0.8) cm for D; -3.7 (-5.1 to -2.3) cm for D + E] and was sustained at 12 months [-2.1 (-3.5 to -0.7) cm and -4.2 (-6.0 to -2.5) cm, respectively]. Participants in D + E tended to decrease their waist circumference more than those in D (P = 0.14). DISCUSSION Nutritional counselling by a dietician resulted in modest reductions in weight and waist circumference in overweight adults, which were sustained up to 12 months. Adding exercise counselling by a physiotherapist did not significantly enhance the effect on body weight. Exercise counselling may, however, further improve waist circumference.
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Affiliation(s)
- Esther A Molenaar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
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Abstract
PURPOSE OF REVIEW Octogenarians are the fastest growing stratum of the population and have the highest prevalence of coronary artery disease. In the past, physicians have been reluctant to provide these patients with optimal care. Seniors are frequently excluded from large randomized trials and generally not included in published guidelines. The purpose of this review is to revisit the demography and epidemiology of coronary artery disease in this population as well as therapeutic strategies used. RECENT FINDINGS Recent publications have shown significant advancement in medical and invasive treatment of coronary artery disease in elderly, with special focus on the potential benefit of off-pump coronary artery bypass (OPCAB) surgery. SUMMARY Although OPCAB surgery has gained popularity over the past 15 years, its benefit regarding operative mortality and major complications has not been clearly defined in the general population. There is a body of literature supporting its benefit in the elderly population. OPCAB surgery has the potential of decreasing operative mortality and major postoperative complications such as stroke, delirium, atrial fibrillation, and decline in neurocognitive functions in these patients. Off-pump surgery is technically more demanding and has been blamed for providing less complete revascularization and lower graft patency rate, especially in less experienced hands. However, with the upcoming demographic explosion of senior citizens in western societies, OPCAB surgery has definitely to be a part of the armamentarium of modern cardiac surgeons.
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Wang W, Kong J, Sun J, Wang CY, Chen HY, Jiang YF, Feng XW, He SM, Niu JQ. Epidemiological Investigation of Metabolic Syndrome and Analysis of Relevant Factors in North-Eastern China. J Int Med Res 2010; 38:150-9. [PMID: 20233524 DOI: 10.1177/147323001003800117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This epidemiological study was conducted to investigate the prevalence of metabolic syndrome and associated risk factors in Chinese subjects from Dehui in northeastern China. Using a random sampling method, a questionnaire was completed by 3785 permanent residents aged 18-72 years and relevant clinical data were collected from each subject. Binary multivariate logistic regression analysis was used to identify factors that were significantly associated with metabolic syndrome. Based on the International Diabetes Federation definition, the prevalence of metabolic syndrome was 22.4%, which is higher than that of the general Chinese population. Metabolic syndrome occurred more frequently in females and the prevalence gradually increased with age. Living in an urban setting and being female, > 50 years old, overweight, having total cholesterol ≥ 5.18 mmol/l, low-density lipoprotein cholesterol ≥ 3.1 mmol/l, and a fatty liver were significant risk factors associated with metabolic syndrome.
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Affiliation(s)
- W Wang
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - J Kong
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - J Sun
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - CY Wang
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - HY Chen
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - YF Jiang
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - XW Feng
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - SM He
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - JQ Niu
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
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137
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Vergouwe Y, Soedamah-Muthu SS, Zgibor J, Chaturvedi N, Forsblom C, Snell-Bergeon JK, Maahs DM, Groop PH, Rewers M, Orchard TJ, Fuller JH, Moons KGM. Progression to microalbuminuria in type 1 diabetes: development and validation of a prediction rule. Diabetologia 2010; 53:254-62. [PMID: 19908023 PMCID: PMC2797626 DOI: 10.1007/s00125-009-1585-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 09/23/2009] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Microalbuminuria is common in type 1 diabetes and is associated with an increased risk of renal and cardiovascular disease. We aimed to develop and validate a clinical prediction rule that estimates the absolute risk of microalbuminuria. METHODS Data from the European Diabetes Prospective Complications Study (n = 1115) were used to develop the prediction rule (development set). Multivariable logistic regression analysis was used to assess the association between potential predictors and progression to microalbuminuria within 7 years. The performance of the prediction rule was assessed with calibration and discrimination (concordance statistic [c-statistic]) measures. The rule was validated in three other diabetes studies (Pittsburgh Epidemiology of Diabetes Complications [EDC] study, Finnish Diabetic Nephropathy [FinnDiane] study and Coronary Artery Calcification in Type 1 Diabetes [CACTI] study). RESULTS Of patients in the development set, 13% were microalbuminuric after 7 years. Glycosylated haemoglobin, AER, WHR, BMI and ever smoking were found to be the most important predictors. A high-risk group (n = 87 [8%]) was identified with a risk of progression to microalbuminuria of 32%. Predictions showed reasonable discriminative ability, with c-statistic of 0.71. The rule showed good calibration and discrimination in EDC, FinnDiane and CACTI (c-statistic 0.71, 0.79 and 0.79, respectively). CONCLUSIONS/INTERPRETATION We developed and validated a clinical prediction rule that uses relatively easily obtainable patient characteristics to predict microalbuminuria in patients with type 1 diabetes. This rule can help clinicians to decide on more frequent check-ups for patients at high risk of microalbuminuria in order to prevent long-term chronic complications.
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Affiliation(s)
- Y Vergouwe
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Str 6.131, PO Box 85500, 3508 GA, Utrecht, the Netherlands.
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Mikkola I, Jokelainen JJ, Timonen MJ, Härkönen PK, Saastamoinen E, Laakso MA, Peitso AJ, Juuti AK, Keinänen-Kiukaanniemi SM, Mäkinen TM. Physical activity and body composition changes during military service. Med Sci Sports Exerc 2009; 41:1735-42. [PMID: 19657297 DOI: 10.1249/mss.0b013e31819fcd3c] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To examine how body composition changes in different body mass index (BMI) categories among young Finnish men during military service, which is associated with marked changes in diet and physical activity. In addition, this study examined how reported previous physical activity affected the body composition changes. METHODS Altogether 1003 men (19 yr) were followed throughout their military service (6-12 months). Height, weight, BMI, waist circumference, and waist-to-hip ratio (WHR) were recorded. Previous physical activity was assessed at the beginning of the service by a questionnaire. Body composition was measured by bioelectrical impedance assessments (BIA) at the beginning and at the end of the service. The measured parameters were fat mass (FM), fat percentage (fat %), fat-free mass (FFM), visceral fat area (VFA), lean body mass (LBM), and skeletal muscle mass (SMM). RESULTS On average, military training decreased weight by 0.7%, FM by 9.7%, fat % by 6.6%, and VFA by 43.4%. FFM increased by 1.3%, LBM by 1.2%, and SMM by 1.7%. The group of underweight and normal-weight men gained weight, FM, and FFM, whereas overweight and obese men lost weight and FM and gained FFM. FM was most reduced in the groups of overweight (20.8%) and obese (24.9%) men. The amount of VFA was reduced in all BMI groups (38%-44%). Among overweight men who reported being inactive previous to the military service, more beneficial changes in body composition were observed compared with those who reported being physically active. CONCLUSIONS The lifestyle changes associated with military service markedly reduce fat tissue and increase the amount of lean tissue. These beneficial changes are prominent among previously inactive subjects with high BMI.
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Affiliation(s)
- Ilona Mikkola
- Institute of Health Sciences, University of Oulu, Finland.
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139
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Rogliani P, Curradi G, Mura M, Lauro D, Federici M, Galli A, Saltini C, Cazzola M. Metabolic syndrome and risk of pulmonary involvement. Respir Med 2009; 104:47-51. [PMID: 19800211 DOI: 10.1016/j.rmed.2009.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 08/05/2009] [Accepted: 08/22/2009] [Indexed: 01/02/2023]
Abstract
Metabolic syndrome (MS) is a complex disorder recognized clinically by the findings of abdominal obesity, elevated triglycerides, atherogenic dyslipidaemia, elevated blood pressure, high blood glucose and/or insulin resistance. It is associated with a pro-thrombotic and a pro-inflammatory state. A growing body of evidence suggests that individuals in the community with moderate airflow limitation may have co-existing systemic inflammation with this background. Therefore, we examined a population of 237 patients with metabolic disorder for the concomitant presence of functional pulmonary involvement, as assessed by FEV(1) and FVC impairment. Criteria for the identification of the MS included 3 or more of the following: waist circumference: (>102 cm in men, >88 cm in women), triglycerides levels (> or =150 mg/dl), high-density lipoprotein cholesterol levels (<40 mg/dl in men, <50 mg/dl in women), blood pressure (> or =135/> or =85 mmHg), and fasting glucose levels (>100 mg/dl). 119 subjects were diagnosed MS. Non-smokers patients suffering from MS presented lower spirometric values, with a trend to ventilatory restrictive more than obstructive pattern. Also in smokers patients with MS there was a trend to harmonic decrease in FEV(1) and FVC but not in FEV(1)/FVC ratio, although the changes did not reach statistical significance. Mainly abdominal circumference, and also insulin resistance were retained as independent predictors of both FEV(1) and FVC changes. However, HDL-C was the strongest predictor of FEV(1) and FVC changes, with an inverse association.
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Affiliation(s)
- Paola Rogliani
- Department of Internal Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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140
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Laimer MW, Engl J, Tschoner A, Kaser S, Ritsch A, Tatarczyk T, Rauchenzauner M, Weiss H, Aigner F, Patsch JR, Ebenbichler CF. Effects of Weight Loss on Lipid Transfer Proteins in Morbidly Obese Women. Lipids 2009; 44:1125-30. [DOI: 10.1007/s11745-009-3349-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 09/10/2009] [Indexed: 11/28/2022]
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141
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Jou HJ, Huang HT. Metabolic Syndrome: Menopausal Women and the Health Care Challenge. Taiwan J Obstet Gynecol 2009; 48:205-9. [DOI: 10.1016/s1028-4559(09)60291-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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142
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Effect of metformin on weight gain during antihypertensive treatment with a beta-blocker in Chinese patients. Am J Hypertens 2009; 22:884-90. [PMID: 19574961 DOI: 10.1038/ajh.2009.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Overweight and obesity are associated with cardiovascular disease (CVD). This study was designed to investigate whether combined use of nitrendipine and atenolol has any effect on body weight (BW) and whether metformin can prevent antihypertensive medication-induced weight gain and has any effect on blood glucose (BG). METHODS Included in the present study were 94 hypertensive patients with a body mass index (BMI) > or =25 kg/m(2), of whom 45 patients were treated with nitrendipine plus atenolol (N/A group), and the remaining 49 patients were treated with nitrendipine, atenolol, and metformin (N/A/M group). The mean follow-up duration was 14 months. BW and glucose tolerance were measured. RESULTS In N/A group, BW and fasting BG significantly increased from 73.5 +/- 9.6 kg to 74.2 +/- 9.7 kg (P < 0.05) and from 94.2 +/- 10.5 mg/dl to 97.9 +/- 11.3 mg/dl (P < 0.01), respectively, whereas postprandial BG did not change significantly. In N/A/M group, BW slightly decreased from 72.7 +/- 10.1 kg to 72.3 +/- 10.2 kg (P = 0.30), and fasting BG did not change significantly (93.5 +/- 10.4 mg/dl vs. 92.7 +/- 10.2 mg/dl, P = 0.59), whereas 2-h postprandial BG significantly decreased from 133.7 +/- 30.5 mg/dl to 124.0 +/- 29.6 mg/dl (P < 0.05). Furthermore, a significant difference was observed in difference value of BW before and after treatment between the two groups (0.7 (95% confidence interval, 0.1-1.3) kg in N/A group vs. -0.4 (95% confidence interval, -1.3 to 0.4) kg in N/A/M group, P < 0.05). CONCLUSIONS Combination therapy of nitrendipine and atenolol may significantly increase BW and fasting BG in overweight or obese patients with hypertension. Metformin may prevent BW gain and improve BG levels in hypertensive patients who received combination therapy of nitrendipine and atenolol.
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143
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Horwitz S, Yogo J, Juma E, Ice GH. Caregiving and cardiovascular disease risk factors in male and female Luo elders from Kenya. Ann Hum Biol 2009; 36:400-10. [DOI: 10.1080/03014460902845720] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shawn Horwitz
- Department of Social Medicine, Ohio University College of Osteopathic Medicine, , Athens, Ohio, USA
| | - Jaja Yogo
- Department of Social Medicine, Ohio University College of Osteopathic Medicine, , Athens, Ohio, USA
| | | | - Gillian H. Ice
- Department of Social Medicine, Ohio University College of Osteopathic Medicine, , Athens, Ohio, USA
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144
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Srikanthan P, Seeman TE, Karlamangla AS. Waist-hip-ratio as a predictor of all-cause mortality in high-functioning older adults. Ann Epidemiol 2009; 19:724-31. [PMID: 19596204 DOI: 10.1016/j.annepidem.2009.05.003] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 05/06/2009] [Accepted: 05/10/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE The relationship between obesity and mortality in older adults is debated, with concern that body mass index (BMI) may be an imperfect measure of obesity in this age group. We assessed the relationship between three measures of obesity and all-cause mortality in a group of healthy older adults. METHODS We analyzed data from the MacArthur Successful Aging Study, a longitudinal study of high-functioning men and women, ages 70-79 years at baseline. We examined 12-year, all-cause mortality risk by BMI, waist circumference, and waist-to-hip circumference ratio (WHR). Proportional hazards regression was used to adjust for gender, race, baseline age, and smoking status. We tested for obesity interactions with gender, race, and smoking status and conducted stratified analyses based on the results of interaction testing. RESULTS There was no association between all-cause mortality and BMI or waist circumference in either unadjusted or adjusted analyses. In contrast, all-cause mortality increased with WHR. There was an interaction with sex, so that there was a graded relationship between WHR and mortality in women (relative hazard, 1.28 per 0.1 increase in WHR; 95% confidence interval, 1.05-1.55) and a threshold relationship in men (relative hazard 1.75 for WHR>1.0 compared to WHR< or =1.0; 95% confidence interval, 1.06-2.91). CONCLUSION WHR rather than BMI appears to be the more appropriate yardstick for risk stratification of high-functioning older adults.
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145
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Christian AH, Mochari H, Mosca LJ. Waist circumference, body mass index, and their association with cardiometabolic and global risk. ACTA ACUST UNITED AC 2009; 4:12-9. [PMID: 19245511 DOI: 10.1111/j.1559-4572.2008.00029.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Total body fat and adipose tissue distribution are associated with cardiometabolic risk, yet there are conflicting data as to whether waist circumference (WC) or body mass index (BMI) is a better predictor of cardiovascular risk. To determine whether WC or BMI was more strongly associated with cardiometabolic risk, family members of patients with cardiac disease were studied (N=501; mean age, 48 years; 66% female; 36% nonwhite). Height, weight, WC, BMI, blood pressure, high-density lipoprotein cholesterol, triglycerides, glucose, high-sensitivity C-reactive protein, and lipoprotein-associated phospholipase A(2) were systematically measured. Global risk was calculated using the Framingham function. Increased WC and BMI were equally strong predictors of cardiometabolic and global risk. The prevalence of cardiometabolic risk factors and their correlation with WC and BMI varied by race/ethnicity. Our data support inclusion of WC and BMI in screening guidelines for diverse populations to identify individuals at increased cardiometabolic risk.
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146
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Koziel S, Ulijaszek SJ, Szklarska A, Bielicki T. The effects of fatness and fat distribution on respiratory functions. Ann Hum Biol 2009; 34:123-31. [PMID: 17536761 DOI: 10.1080/03014460601121795] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Inverse relationships between respiratory function and indices of obesity and fat distribution have been reported, but it remains unclear which measure of obesity shows the strongest relationship with lung function. AIM The study assessed the effect of fatness and fat distribution on respiratory function. SUBJECTS AND METHODS A sample of 423 males and 509 females aged 40-50 years were examined in the Silesian Centre for Preventive Medicine, DOLMED, in Wrocław in 1995. The strength of influence of height, body mass index (BMI), wait-to-hip ratio (WHR) and abdominal and subscapular skinfolds upon forced vital capacity (FVC) and forced expiratory volume in a 1-s expiration (FEV1) was assessed by multiple regression analysis. RESULTS In males, FVC was strongly positively associated with height and BMI, but negatively associated with subscapular and abdominal skinfolds, WHR, and smoking. FEV1 showed a positive relationship with height, BMI and WHR. In females, both FVC and FEV1 showed significant positive associations with height, negative ones with subscapular skinfold, and no association with either WHR or abdominal skinfold. In males, respiratory function is affected to a similar extent by fat in the abdominal region and by fatness of the chest. In females, fatness of the thorax has the strongest relationship with respiratory function. CONCLUSION Fatness tends to impair respiratory function in both sexes but these effects show a different pattern in males and females. In males, respiratory functions are significantly, and to a similar extant, affected by fatness in the abdominal region, both subcutaneous and visceral, and by fatness on the chest. In females, it is primarily subcutaneous fat on the upper thorax that affects respiratory functions, while visceral and subcutaneous abdominal fatness play little or no role.
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Affiliation(s)
- Slawomir Koziel
- Institute of Anthropology, Polish Academy of Sciences, Kuznicza 35, 50-951 Wroclaw, Poland.
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147
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148
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Cutoff values for central obesity in Chinese based on mesenteric fat thickness. Clin Nutr 2009; 28:679-83. [PMID: 19560238 DOI: 10.1016/j.clnu.2009.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 03/05/2009] [Accepted: 05/28/2009] [Indexed: 11/22/2022]
Abstract
AIMS Sonographic measurement of mesenteric fat thickness (MFT) is a novel, accurate and simple tool to evaluate regional distribution of obesity. We used MFT to determine the optimal waist circumference (WC) values and associated risk factors for cardiovascular disease (CVD). METHODS 282 healthy Chinese (age 41.8+/-7.4 years, BMI 23.8+/-3.3 kg/m(2)) was assessed. High MFT was defined as mean+1 SD of the cohort. We compared the CVD risks including fatty liver amongst subjects with normal waist, central pre-obesity and central obesity. RESULTS WC of 84.6 cm in men and 75.7 cm in women were the optimal cutoff values to predict high MFT with ROC analysis. Using WC cutoff values > or =85-90 cm and > or =90 cm to define central pre-obesity and obesity in men (> or =75-80 cm and > or =80 cm in women), both central obesity and pre-obesity had higher MFT and CVD risk than those with normal waist. The frequencies of fatty liver in these 3 categories were 15.9%, 56.7% and 96.7% in men and 6.9%. 17.9% and 63.2% in women (p<0.001 for trend). CONCLUSION In addition to central obesity, "central pre-obesity" identifies subjects who harbor high CVD risks, fatty liver and excess visceral fat.
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149
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Bassil N, Alkaade S, Morley JE. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag 2009; 5:427-48. [PMID: 19707253 PMCID: PMC2701485 DOI: 10.2147/tcrm.s3025] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Indexed: 12/13/2022] Open
Abstract
Increased longevity and population aging will increase the number of men with late onset hypogonadism. It is a common condition, but often underdiagnosed and undertreated. The indication of testosterone-replacement therapy (TRT) treatment requires the presence of low testosterone level, and symptoms and signs of hypogonadism. Although controversy remains regarding indications for testosterone supplementation in aging men due to lack of large-scale, long-term studies assessing the benefits and risks of testosterone-replacement therapy in men, reports indicate that TRT may produce a wide range of benefits for men with hypogonadism that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease. Perhaps the most controversial area is the issue of risk, especially possible stimulation of prostate cancer by testosterone, even though no evidence to support this risk exists. Other possible risks include worsening symptoms of benign prostatic hypertrophy, liver toxicity, hyperviscosity, erythrocytosis, worsening untreated sleep apnea or severe heart failure. Despite this controversy, testosterone supplementation in the United States has increased substantially over the past several years. The physician should discuss with the patient the potential benefits and risks of TRT. The purpose of this review is to discuss what is known and not known regarding the benefits and risks of TRT.
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Affiliation(s)
| | - Saad Alkaade
- Internal Medicine, Saint Louis University Health Sciences Center, St. Louis, Missouri, USA
| | - John E Morley
- Division of Geriatric Medicine
- GRECC, VA Medical Center, St. Louis, Missouri, USA
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150
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Janssen I. Influence of age on the relation between waist circumference and cardiometabolic risk markers. Nutr Metab Cardiovasc Dis 2009; 19:163-169. [PMID: 18809302 DOI: 10.1016/j.numecd.2008.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 06/26/2008] [Accepted: 06/30/2008] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS To determine whether the relation between waist circumference (WC) and cardiometabolic risk markers is attenuated with advancing age. METHODS AND RESULTS The study population consisted of 5222 adults from the 1999 to 2004 U.S. National Health and Nutrition Examination Survey, a nationally representative cross-sectional study. Study variables were assessed in a clinical exam. Subjects were grouped into low, moderate, and high sex-specific WC tertiles. The cardiometabolic risk markers examined consisted of insulin resistance (HOMA method), high C-reactive protein, hypertension, and high LDL-cholesterol. Logistic regression was used to determine and compare the association between WC categories with high-risk cardiometabolic risk marker values within young (20-39 years), middle-aged (40-59 years), and older (60+ years) adults. With few exceptions, within each of the three age categories, individuals with a moderate and high WC were significantly more likely to have elevated cardiometabolic risk markers than individuals with a low WC. There was a significant interaction between age and WC indicating that the relation between WC with insulin resistance, high CRP, and hypertension was attenuated in older adults. For example, the odds ratio for hypertension in those with a high relative to low WC was 11.07 (95% CI: 6.13-20.00) in young adults, 3.67 (2.47-5.46) in middle-aged adults, and 2.68 (2.00-3.59) in older adults. Similar observations were made for BMI to those reported for WC. CONCLUSIONS A high WC was associated with elevated cardiometabolic risk markers irrespective of age. However, the association between WC and cardiometabolic risk markers was greatly attenuated with advancing age.
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Affiliation(s)
- I Janssen
- School of Kinesiology and Health Studies, and Department of Community Health and Epidemiology, Queen's University, 69 Union Street, Kingston, Ontario K7L 3N6, Canada.
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