Relationships of cigarette smoking and alcohol consumption to metabolic syndrome in Japanese men

BACKGROUND

Cigarette smoking is an important, aggravating factor in metabolic syndrome (MetS). In addition, some studies have reported that MetS is related to alcohol consumption irrespective of the amount consumed. However, the relationship of the combination of the 2 habits to MetS has not been fully described.

METHODS

In this cross-sectional survey, a questionnaire was used to collect information on cigarette smoking and alcohol consumption from 3904 Japanese men aged 20 years or older. MetS was defined according to Japanese criteria. Logistic regression analysis was used to analyze relationships of cigarette smoking and alcohol consumption with MetS, after adjustment for potential confounding factors.

RESULTS

Among the subjects, 581 (14.9%) had MetS. Daily cigarette and alcohol consumption were significantly associated with the prevalence of MetS (P < 0.0001, P = 0.030 for trend). The multivariate-adjusted odds ratio for the prevalence of MetS was 1.89 (95% confidence interval: 1.34-2.65) for subjects who smoked ≥30 cigarettes/day, as compared with nonsmokers; 1.54 (1.06-2.23) for those who consumed ≥69 grams of ethanol/day, as compared with nondrinkers; and 3.63 (1.91-6.90) for those who smoked ≥30 cigarettes/day and consumed ≥69 grams of ethanol/day, as compared with those who neither smoked nor drank. The interaction of smoking ≥30 cigarettes/day with drinking ≥69 grams/day was 2.03 (1.02-4.01, P = 0.043).

CONCLUSIONS

Cigarette smoking and alcohol drinking had independent relations to the prevalence of MetS. In addition, the prevalence of MetS was higher among Japanese men who smoked and drank heavily.

Incidence of metabolic syndrome according to combinations of lifestyle factors among middle-aged Japanese male workers

OBJECTIVE

To examine a combination of healthy lifestyles on the risk of metabolic syndrome (MetS) to inform future interventions.

METHODS

A total of 1897 men aged 35-60 years participated in an annual health check-up in 2002 and 2005. MetS was defined by AHA/NCEP criteria. Logistic regression analyses were used to estimate age- and BMI-adjusted odds ratios (ORs) of MetS incidence for each healthy lifestyle (regular physical activity, adherence to healthy eating behaviors, not current smoking, and maintaining a stable weight since one's mid-twenties), separately (Model 1) and simultaneously (Model 2). A points system was developed to derive 3-year risk of MetS incidence by assigning a specific point to each healthy lifestyle.

RESULTS

MetS developed in 285 (15.0%) subjects after the follow-up. The ORs of MetS for each healthy lifestyle ranged from 0.42 to 0.64 (Model 2). Three-year risk of MetS incidence was predicted to differ from 1% to 60% according to the individual point total of the points system. The population-attributable fraction of MetS in subjects whose point total was not in the highest quartile was 71%.

CONCLUSION

Adherence to healthy lifestyles was associated with a lower risk of MetS among apparently healthy middle-aged Japanese male workers.

Anthropometric measures and their relation to incident primary open-angle glaucoma

PURPOSE

To assess the relation between anthropometric measures and incident primary open-angle glaucoma (POAG).

DESIGN

Prospective cohort study.

PARTICIPANTS

Included were 78,777 women in the Nurses' Health Study and 41,352 men in the Health Professionals Follow-up Study.

METHODS

Females and male health professionals were followed prospectively from 1980 through 2004 and 1986 through 2004, respectively. Eligible participants were 40 years of age or older, did not have POAG at baseline, and reported undergoing eye examinations during follow-up. Information regarding anthropometric measures, potential confounders, and ophthalmic status was updated using biennial questionnaires. During follow-up, 980 POAG cases were identified.

MAIN OUTCOME MEASURES

Multivariate rate ratios (MVRR) of POAG and their 95% confidence intervals (CIs).

RESULTS

There was no significant relation between cumulatively averaged body mass index (BMI) in kilograms per meter squared and POAG overall (P = 0.06, for trend). However, in relation to POAG with intraocular pressure (IOP) of 22 mmHg or less at diagnosis, each unit increase in BMI was associated with a 6% reduced risk in women (MVRR, 0.94; 95% CI, 0.91-0.98; P = 0.01), but not for men (MVRR, 1.02; 95% CI, 0.96-1.09; P = 0.57); this gender difference was significant (P = 0.03, for heterogeneity). In multivariate analyses to explore the independent effects of height and weight, weight (as height-adjusted weight residuals; P = 0.002, for trend), but not height (P = 0.10, for trend) seemed to account for most of the inverse association between BMI and POAG with IOP of 21 mmHg or less at diagnosis in women. There was no association between BMI and POAG with IOP of more than 21 mmHg at diagnosis for either gender (P> or =0.26, for trend). Among women, analyses found that the relations between anthropometric parameters and both POAG subtypes (POAG with IOP< or =21 mmHg vs. POAG with IOP >21 mmHg when diagnosed) were significantly different (P< or =0.0001).

CONCLUSIONS

Among women, higher BMI was associated with a lower risk of POAG with IOP of 21 mmHg or less at diagnosis. The factors contributing to this tendency may yield insight into the pathogenesis of POAG.

Long-term changes in gut hormones, appetite and food intake 1 year after subtotal gastrectomy with normal body weight

BACKGROUND/OBJECTIVES

No prospective study on the long-term effects of gastric resection on gastrointestinal hormonal changes in patients with normal body weight has been reported. The aim of this study was to evaluate the 1-year effect of subtotal gastrectomy on ghrelin and peptide YY (PYY)(3-36) levels.

SUBJECTS/METHODS

Eighteen patients with early gastric cancer underwent subtotal gastrectomy with Billroth I reconstruction. We assessed appetite, food intake, body composition, and ghrelin and PYY(3-36) levels preoperatively and 1 year after surgery.

RESULTS

There were no significant difference in the preoperative daily food intake and 1 year after subtotal gastrectomy. Weight loss occurred in all study subjects; 11.7% (n=2), 55.5% (n=10) and 33.3% (n=6) of the patients lost <5%, 5-10% and >10% of their preoperative body weight, respectively. Body mass index, waist circumference and body fat significantly decreased 1 year after subtotal gastrectomy. There were no significant differences in the appetite visual analogue scale preoperatively and 1 year after subtotal gastrectomy. The plasma ghrelin concentration decreased significantly (P=0.006), whereas PYY(3-36) did not show a significant change 1 year after subtotal gastrectomy.

CONCLUSIONS

Ghrelin levels and body fat decreased significantly, whereas PYY(3-36) levels as well as appetite and food intake did not change significantly 1 year after subtotal gastrectomy with normal body weight. These findings suggest that decreased ghrelin might contribute directly to reduced body fat.

Prevalence of neck pain in subjects with metabolic syndrome--a cross-sectional population-based study

BACKGROUND

Metabolic syndrome (MetS) is increasingly common. Obesity has been suggested to associate with neck pain but prevalence of neck pain in subjects with MetS has not been studied. Aim of this study was to analyse the association between MetS and neck pain.

METHODS

The study population consisted of 1294 middle-aged subjects in Pieksämäki, Finland. A total of 399 males and 500 females participated (69%). The mean age of both males and females was 46 years. Clinical and biochemical measurements were taken. The participants filled out a standard questionnaire. Psychological distress was assessed with the 12-item General Health Questionnaire (GHQ-12). Neck pain was defined as neck pain perceived daily. MetS was defined using National Cholesterol Education Program (NCEP) criteria. Statistical comparisons between the groups were performed using a bootstrap-type t-test or Chi-Square test. Risk ratios of having neck pain were calculated using generalised linear models with age, smoking, alcohol use, exercise and GHQ-12 score as covariates.

RESULTS

The prevalence of MetS was 33% in males and 29% in females. Neck pain was present in 11% (N = 42) of males and 19% (N = 93) of females (P < 0.001). The prevalence of neck pain was 7.9% (95% CI, 4.9% to 12%) among male subjects without MetS and 16% (95% CI, 10% to 23%) among those with MetS. The respective proportions among females were 16% (95% CI, 12% to 20%) and 25% (95% CI, 18% to 33%). The multivariate analysis showed an increased risk of neck pain in males with MetS (RR 2.1, 95% CI, 1.2 to 3.7, P = 0.010) and in females with MetS (RR 1.5, 95% CI, 1.0 to 2.1, P = 0.040).

CONCLUSIONS

MetS was associated with neck pain. This association was stronger in males, but the prevalence of neck pain was higher in females. Prospective studies should explore the potential causal association between neck pain and MetS and the potential common background factors of neck pain and MetS.

Optimal cutoff values of waist circumference and the discriminatory performance of other anthropometric indices to detect the clustering of cardiovascular risk factors for metabolic syndrome in Japanese men and women

OBJECTIVE

To evaluate the pertinent cutoffs of waist circumference (WC) and the discriminatory performance of other anthropometric indices to detect clustering cardiovascular risk factors for metabolic syndrome (MetS) in Japan, where the current WC cutoffs for MetS (85 cm for men and 90 cm for women) remain controversial.

METHODS

We analyzed the baseline data from 844 subjects (330 men and 514 women) aged 40-69 years who participated in a cohort study in Saga city, Japan, between November 2005 and December 2007. Receiver operating characteristic (ROC) analyses were performed to find an appropriate cutoff (defined as the point nearest to the upper left corner of the ROC curve) of each anthropometric index for the presence of multiple risk factors among dyslipidemia, hypertension, and hyperglycemia [which was defined as hemoglobin A1c (HbA1c) levels at and above 5.2, 5.5, or 5.8%, values approximately corresponding to fasting plasma glucose levels of 100, 110, and 120 mg/dL, respectively].

RESULTS

The optimal WC cutoff was 88 cm (sensitivity 60%, specificity 70%) for men and 82 cm (sensitivity 78%, specificity 62%) for women; changing the HbA1c cutoff affected the results in women only (~85 cm). For the currently defined WC cutoffs in Japan, specificity was low (53-57%) in men, whereas sensitivity was very low (32-42%) in women. Body mass index, proportion of body fat, waist-to-height ratio, and waist-to-hip ratio showed area under the curve values similar to that of WC.

CONCLUSION

The current Japanese criteria of WC for MetS may be low for men and too high and insensitive for women in our study population. Other anthropometric indices such as waist-to-height ratio did not confer an improved discriminatory performance compared with WC.

Relationship between serum uric Acid levels, metabolic syndrome, and arterial stiffness in korean

Background and Objectives

Associations have been reported between the serum uric acid (SUA) level, metabolic syndrome (MS), and atherosclerosis. We have determined the relationship between the SUA level, MS, and arterial stiffness in Korean.

Subjects and Methods

Cross-sectional data from 1,276 adults who underwent routine laboratory tests and pulse wave velocity (PWV) measurements during a health check-up were analyzed in a gender-specific manner. None of the participants had atherosclerotic cardiovascular disease, diabetes, renal disease, or systemic disease, or were under treatment which would affect SUA levels, or taking medications for hypertension or dyslipidemia.

Results

After adjustment for age, smoking status, total cholesterol (TC), and creatinine, the odds ratios (ORs, 95% confidence interval) of gender-specific quartiles of SUA for MS were 1.0, 1.28 (0.66-2.47), 1.46 (0.76-2.82), and 2.21 (1.15-4.26) in females, and 1.0, 1.33 (0.82-2.17), 1.60 (0.96-2.66), and 2.03 (1.21-3.40) in males. However, after adjustment for waist circumference, there were no significant differences in the ORs among the SUA quartile groups in females and males (both, p=NS). The Pearson's correlation coefficients for the relationship between SUA levels and heart-femoral (hf) PWVs or brachial-ankle (ba) PWVs were not significant in females and males (r=0.054 and r=0.015, respectively, in females; r=-0.036 and r=-0.015, respectively, in males; all, p=NS).

Conclusion

An elevated SUA level is associated with abdominal obesity among the MS components, but the SUA level is not associated with PWV in females or males.

Optimal cut-off values and population means of waist circumference in different populations

Abdominal obesity is a risk factor for cardiometabolic disease, and has become a major public health problem in the world. Waist circumference is generally used as a simple surrogate marker to define abdominal obesity for population screening. An increasing number of publications solely rely on the method that maximises sensitivity and specificity to define ‘optimal’ cut-off values. It is well documented that the optimal cut-off values of waist circumference vary across different ethnicities. However, it is not clear if the variation in cut-off values is a true biological phenomenon or an artifact of the method for identifying optimal cut-off points. The objective of the present review was to assess the relationship between optimal cut-offs and population waist circumference levels. Among sixty-one research papers, optimal cut-off values ranged from 65·5 to 101·2 cm for women and 72·5 to 103·0 cm for men. Reported optimal cut-off values were highly correlated with population means (correlation coefficient: 0·91 for men and 0·93 for women). Such a strong association was independent of waist circumference measurement techniques or the health outcomes (dyslipidaemia, hypertension or hyperglycaemia), and existed in some homogeneous populations such as the Chinese and Japanese. Our findings raised some concerns about applying the sensitivity and specificity approach to determine cut-off values. Further research is needed to understand whether the differences among populations in waist circumference were genetically or environmentally determined, and to understand whether using region-specific cut-off points can identify individuals with the same absolute risk levels of metabolic and cardiovascular outcomes among different populations.

Dietary determinants of changes in waist circumference adjusted for body mass index - a proxy measure of visceral adiposity

BACKGROUND

Given the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype "waist circumference for a given body mass index (WC(BMI))", a proxy measure of visceral adiposity, is deemed necessary. Hence, the objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by changes in the phenotype WC(BMI).

METHODS AND FINDINGS

We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WC(BMI) was defined as the residuals of waist circumference regressed on body mass index, and annual change in WC(BMI) (DeltaWC(BMI), cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between energy, energy density (ED), macronutrients, alcohol, glycemic index (GI), glycemic load (GL), fibre and DeltaWC(BMI) was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Men and women with higher ED and GI diets showed significant increases in their WC(BMI), compared to those with lower ED and GI [1 kcal/g greater ED predicted a DeltaWC(BMI) of 0.09 cm (95% CI 0.05 to 0.13) in men and 0.15 cm (95% CI 0.09 to 0.21) in women; 10 units greater GI predicted a DeltaWC(BMI) of 0.07 cm (95% CI 0.03 to 0.12) in men and 0.06 cm (95% CI 0.03 to 0.10) in women]. Among women, lower fibre intake, higher GL, and higher alcohol consumption also predicted a higher DeltaWC(BMI).

CONCLUSIONS

Results of this study suggest that a diet with low GI and ED may prevent visceral adiposity, defined as the prospective changes in WC(BMI). Additional effects may be obtained among women of low alcohol, low GL, and high fibre intake.

Optimal waist circumference cutoff value reflecting insulin resistance as a diagnostic criterion of metabolic syndrome in a nondiabetic Korean population aged 40 years and over: the Chungju Metabolic Disease Cohort (CMC) study

PURPOSE

We aimed at determining the cutoff value of waist circumference with respect to its ability to reflect insulin resistance in a Korean population.

MATERIALS AND METHODS

A total of 8,817 subjects aged 40 years and over were analyzed. Insulin resistant individuals were defined as those who had the highest quartile value of the homeostasis model assessment of insulin resistance (HOMA-IR) in a non-diabetic population. Receiver operating characteristic (ROC) curve analysis and multiple logistic regression analysis were applied.

RESULTS

The cutoff value of waist circumference reflecting insulin resistance from the ROC analysis was 84.4 cm for men and 80.6 cm for women. Sensitivity and specificity were 70.0% and 54.2% in men and 71.1% and 59.3% in women, respectively. After being controlled for other covariates, the odds ratio for the risk of insulin resistance using < 70 cm of waist circumference as a reference increased significantly in the category of 85.0-89.9 cm for men and 80.0-84.9 cm for women. In addition, statistically significant associations were consistently observed over the category of 85.0-89.9 cm for men and 80.0-84.9 cm for women.

CONCLUSION

The optimal cutoff value for waist circumference reflecting insulin resistance is considered to be 85 cm for men and 80 cm for women, suggesting that the Asian criterion of abdominal obesity (90 cm for men and 80 cm for women) as a component of metabolic syndrome (MetS) might not be applicable for middle-aged to older men in Korea.

Functional impact of transposable elements using bioinformatic analysis and a comparative genomic approach

A dual coding event, which is the translation of different isoforms from a single gene, is one of the special patterns among the alternative splicing events. This is an important mechanism for the regulation of protein diversity in human and mouse genomes. Although the regulation for dual coding events has been characterized in a few genes, the individual mechanism remains unclear. Numerous studies have described the exonization of transposable elements, which is the splicing mediated insertion of transposable element sequence fragments into mature mRNAs. Therefore, in this study, we investigated the number of transposable element (TE)-derived dual coding genes in human, chimpanzee and mouse genomes. TE fusion exons appeared in the dual coding regions of 309 human genes. Functional protein domain alterations by TE-derived dual coding events were observed in 129 human genes. Comparative TE-derived dual coding events were also analyzed in chimpanzee and mouse orthologs. Seventy chimpanzee orthologs had TE-derived dual coding events, but mouse orthologs did not have any TE-derived dual coding events. Taken together, our analyses listed the number of TE-derived dual coding genes which could be investigated by experimental analysis and suggested that TE-derived dual coding events were major sources for the functional diversity of human genes, but not mouse genes.

Effects of a 6-month lifestyle modification intervention on the cardiometabolic risk factors and health-related qualities of life in women with metabolic syndrome

Although therapeutic lifestyle modification (TLM) has been recommended as a cornerstone treatment of metabolic syndrome (MetS), little is known about the biobehavioral effects of a TLM program for patients in a community. The purpose of this study was to examine the effects of a 6-month TLM program on MetS risk factors and health-related qualities of life (HRQOL) among middle-aged and older women in a community in Korea. Fifty-two women (mean age, 62.7 +/- 9.0 years) with MetS were recruited from 3 community health centers and were randomly assigned to the intervention (n = 31) or control (n = 21) groups. The patients in the intervention group participated in supervised TLM sessions for 6 months. The TLM program included health monitoring, counseling, health education, exercise, and dieting. Metabolic risk factors and HRQOL were measured at baseline, during the study (month 3), at completion (month 6), and post completion (month 12) of the TLM program. Compared with the control group, the TLM group showed significantly greater reductions in body weight (P < .001) and waist circumference (P < .001); these effects were sustained for 6 months after intervention. With regard to HRQOL, the TLM group showed greater improvements in physical function (P = .017), general health (P < .001), vitality (P = .008), and mental health (P = .027). These improvements, however, were not sustained after the intervention. The results indicate that a nurse-led systematic TLM program may be an effective strategy for managing middle-aged and older women with MetS at a community level.

Intraocular pressure and aqueous humor flow during a euglycemic-hyperinsulinemic clamp in patients with type 1 diabetes and microvascular complications

BACKGROUND

Microvascular complications, including retinopathy and nephropathy are seen with type 1 diabetes. It is unknown whether functional changes in aqueous humor flow or intraocular pressure (IOP) develop in parallel with these complications. This study was designed to test the hypothesis that clinical markers of microvascular complications coexist with the alteration in aqueous humor flow and IOP.

METHODS

Ten patients with type 1 diabetes and ten healthy age- and weight-matched controls were studied. Aqueous flow was measured by fluorophotometry during a hyperinsulinemic-euglycemic clamp (insulin 2 mU/kg/min). Intraocular pressure was measured by tonometry at -10, 90 and 240 minutes from the start of the clamp, and outflow facility was measured by tonography at 240 minutes.

RESULTS

During conditions of identical glucose and insulin concentrations, mean aqueous flow was lower by 0.58 microl/min in the diabetes group compared to controls (2.58 +/- 0.65 versus 3.16 +/- 0.66 microl/min, respectively, mean +/- SD, p = 0.07) but statistical significance was not reached. Before the clamp, IOP was higher in the diabetes group (22.6 +/- 3.0 mm Hg) than in the control group (19.3 +/- 1.8 mm Hg, p = 0.01) but at 90 minutes into the clamp, and for the remainder of the study, IOP was reduced in the diabetes group to the level of the control group. Ocular pulse amplitude and outflow facility were not different between groups. Systolic blood pressure was significantly higher in the diabetes group, but diastolic and mean arterial pressures were not different.

CONCLUSIONS

We conclude that compared to healthy participants, patients with type 1 diabetes having microalbuminuria and retinopathy have higher IOPs that are normalized by hyperinsulinemia. During the clamp, a reduction in aqueous flow was not statistically significant.

Cardiovascular risk factors, nonalcoholic fatty liver disease, and carotid artery intima-media thickness in an adolescent population in southern Italy

The objective of this study was to determine, in an adolescent population, the prevalence of nonalcoholic fatty liver disease (NAFLD) and the association of NAFLD and cardiovascular risk factors with carotid artery intima-media thickness (IMT), a marker of subclinical atherosclerosis. The authors conducted a population-based study among 642 randomly selected adolescents aged 11-13 years in Reggio Calabria, southern Italy, between November 2007 and October 2008. Prevalences of overweight and obesity were 30.5% and 13.5%, respectively. The overall prevalence of NAFLD was 12.5%, increasing to 23.0% in overweight/obese adolescents. In univariate analysis, increased IMT was positively associated with the presence of NAFLD, body mass index (BMI), waist circumference, systolic blood pressure (all P's < 0.001), diastolic blood pressure (P = 0.006), gamma-glutamyl transpeptidase (P = 0.006), alanine aminotransferase (P = 0.007), and C-reactive protein (P = 0.008) and was inversely associated with high density lipoprotein cholesterol (P < 0.001). In multivariate analysis, NAFLD (P = 0.002), BMI (P = 0.004), waist circumference (P = 0.003), and systolic blood pressure (P = 0.005) retained significant associations. The authors conclude that NAFLD, BMI, waist circumference, and systolic blood pressure are independent markers of increased IMT in a random sample of adolescents.

Optimal cut-off point of waist circumference for the diagnosis of metabolic syndrome in Japanese subjects

Metabolic syndrome (MetS) has been redefined by a new criterion in Japan, in which waist circumference cut-off points, that is 85 cm for men and 90 cm for women, are used; however, objections are rising against this criterion. The present study examined the criterion for waist circumference to predict the accumulation of the components of MetS. In the present study, we used data for 5972 Japanese people who received annual health examinations, and 621 men (16.3%) and 51 women (2.4%) were diagnosed as having MetS. A cut-off point as a predictor for two or more components of MetS was evaluated by the sensitivity/specificity and a receiver operating characteristic analysis. The optimal point of waist circumference was estimated as being approximately 84 cm for men and 80 cm for women. We therefore recommend revising the cut-off value for the criterion of MetS in women according to our results and studies from other investigators. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.00020.x, 2010).

Potential mechanisms of endogenous retroviral-mediated genomic instability in human cancer

Malignancy results from a complex combination of genetic and epigenetic changes, the full effects of which are still largely unknown. Here we summarize current knowledge of the origin, retrotranspositional activity, epigenetic state, and transcription of human endogenous retroviruses (HERVs), and then discuss the potential effects of their deregulation in cancer. Evidence suggests that cancer-associated epigenetic changes most likely underlie potential HERV-mediated effects on genome and transcriptome instability and may play a role in malignancy. Despite our currently limited understanding of the importance of HERVs or other transposable elements in cancer development, we believe that the emerging era of high-throughput sequencing of cancer genomes, epigenomes, and transcriptomes will provide unprecedented opportunities to investigate these roles in the future.

Alu-derived cis-element regulates tumorigenesis-dependent gastric expression of GASDERMIN B (GSDMB)

GASDERMIN B (GSDMB) belongs to the novel gene family GASDERMIN (GSDM). All GSDM family members are located in amplicons, genomic regions often amplified during cancer development. Given that GSDMB is highly expressed in cancerous cells and the locus resides in an amplicon, GSDMB may be involved in cancer development and/or progression. However, only limited information is available on GSDMB expression in tissues, normal and cancerous, from cancer patients. Furthermore, the molecular mechanisms that regulate GSDMB expression in gastric tissues are poorly understood. We investigated the spatiotemporal expression patterns of GSDMB in gastric cancer patients and the 5' regulatory sequences upstream of GSDMB. GSDMB was not expressed in the majority of normal gastric-tissue samples, and the expression level was very low in the few normal samples with GSDMB expression. Most pre-cancer samples showed moderate GSDMB expression, and most cancerous samples showed augmented GSDMB expression. Analysis of genome sequences revealed that an Alu element resides in the 5' region upstream of GSDMB. Reporter assays using intact, deleted, and mutated Alu elements clearly showed that this Alu element positively regulates GSDMB expression and that a putative IKZF binding motif in this element is crucial to upregulate GSDMB expression.

Metabolic risk profiles and associated risk factors among Vietnamese adults in Ho Chi Minh City

BACKGROUND

A clustering of metabolic risk factors increases the likelihood of cardiovascular diseases. This study reports the metabolic risk profiles and the prevalence of metabolic risk factors and associated factors among Vietnamese adults in Ho Chi Minh City.

METHODS

A cross-sectional study was carried out in a representative sample of adults aged 25-64 years in Ho Chi Minh City in 2005. Metabolic risk factors, including central obesity, elevated fasting glucose, elevated total cholesterol, and raised blood pressure, were collected to estimate their prevalence and association with socioeconomic and health-related behavioral risk factors. Multivariate logistic models were performed to examine the associations between socioeconomic and behavioral risk factors and the odds of having metabolic risk factors.

RESULTS

The prevalence of individual risk components was: 28.9% high blood pressure, 18.3% central obesity, 16.8% high total cholesterol, and 6.4% high fasting glucose. There were significant gender differences in central obesity and high blood pressure. The prevalence of metabolic risk cluster (two or more risk factors) was 17.0% in men and 17.6% in women. The metabolic risk cluster appeared earlier in men, but women showed higher rates at older ages. Increasing age and household wealth were associated with the metabolic risk cluster across both genders, but additional risk factors in men were smoking in the past and in women education level and sitting and reclining time.

CONCLUSIONS

Strategies to prevent metabolic risk factors through the prevention of abdominal obesity must be established for young adults and should include promoting physical activity, healthy eating, and preventing alcohol abuse and tobacco use.

The association of metabolic syndrome with periodontal disease is confounded by age and smoking in a Korean population: the Shiwha-Banwol Environmental Health Study

AIM

Because metabolic syndrome (MS) is pro-inflammatory and periodontitis is inflammatory, we issued the hypothesis that MS (the explanatory variable) is associated with periodontitis (the outcome variable). This study aimed to examine the link between MS and periodontitis among Koreans.

MATERIALS AND METHODS

From the Shiwha-Banwol Environmental Health Study, 1046 subjects aged 18 years or older were cross-sectionally surveyed. All participants underwent comprehensive dental and medical health examinations. The community periodontal index was used to assess periodontitis. Age, gender, monthly family income, smoking, drinking, frequency of daily teeth brushing, and physical activity were evaluated as confounders.

RESULTS

MS was strongly associated with periodontitis [odds ratio (OR): 1.7, 95% confidence interval (CI): 1.22-2.37], and MS with more components had a higher association. The association was higher for elders aged 65 years or more, males, and smokers. MS including both high glucose and hypertension had a higher association with the OR of 2.19 (95% CI: 1.23-3.90) comparing with other types of MS.

CONCLUSIONS

Our results suggested that MS might be associated with periodontitis and the association was confounded by age, gender, and smoking. MS with high glucose and hypertension showed the higher impact on this link.

Current status of liver disease in Korea: nonalcoholic fatty liver disease

Recently, obesity (BMI>or=25 kg/m2) and type II diabetes mellitus have reached epidemic proportions in Korea, and rates of nonalcoholic fatty liver disease (NAFLD) are between 10% and 25% of the general population. NAFLD in Korea is as closely associated with several components of metabolic syndrome including, obesity, hypertension, diabetes and dyslipidemia as it is in Western countries. Insulin resistance and hyperinsulinemia may play a role in the pathogenesis of fatty liver in patients with normal body weight as well as in patients with obesity. And, obesity induced accumulation of fat in the adipose tissue leads to an imbalance in the regulation of adipokines, such as downregulation of adiponectin and upregulation of retinol-binding protein 4 (RBP4) and ghrelin. High BMI, the AST/ALT ratio, and ALT levels could be used to distinguish NASH from simple steatosis in Korean patients. In large number of NAFLD patients who underwent a voluntary medical checkup, even a small weight reduction was associated with improvements in their hepatic steatosis grade on ultrasonography, serum aminotransferase levels, and related metabolic abnormalities. Subjects with fatty liver disease should be advised to lose weight through lifestyle modifications. Small animal and human studies of treatment with PPAR agonists and betaine have been reported in the Korean literature. It is now acknowledged that NAFLD is the most common liver disease in Korea, largely due to the considerable increase in metabolic abnormalities such as obesity and diabetes. Future studies should continue to focus both on the pathogenesis and the treatment of NAFLD in order to accumulate more of our own data.

Sex differences in the association of regional fat distribution with the severity of obstructive sleep apnea

STUDY OBJECTIVES

To describe sex differences in the associations between severity of obstructive sleep apnea (OSA) and measures of obesity in body regions defined using both dual-energy absorptiometry and traditional anthropometric measures in a sleep-clinic sample.

DESIGN

A prospective case-series observational study.

SETTING

The Western Australian Sleep Health Study operating out of the Sir Charles Gairdner Hospital Sleep Clinic, Perth, Western Australia.

PARTICIPANTS

Newly referred clinic patients (60 men, 36 women) suspected of having OSA.

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

Obstructive sleep apnea severity was defined by apnea-hypopnoea index from laboratory-based overnight polysomnography. Body mass index, neck, waist and hip circumference, neck-to-waist ratio, and waist-to-hip ratio were measured. Dual energy absorptiometry measurements included percentage fat and lean tissue. Multivariate regression models for each sex were developed. In women, percentage of fat in the neck region and body mass index together explained 33% of the variance in apnea-hypopnea index. In men, percentage of fat in the abdominal region and neck-to-waist ratio together accounted for 37% of the variance in apnea-hypopnea index.

CONCLUSIONS

Regional obesity is associated with obstructive sleep apnea severity, although differently in men and women. In women, a direct influence of neck fat on the upper airway patency is implicated. In men, abdominal obesity appears to be the predominant influence. The apnea-hypopnea index was best predicted by a combination of Dual Energy Absorptiometry-measured mass and traditional anthropometric measurements.

Effects by daily long term provision of ghrelin to unselected weight-losing cancer patients: a randomized double-blind study

BACKGROUND

The short-term provision of ghrelin to patients with cancer indicates that there may be benefits from long-term provision of ghrelin for the palliative treatment of weight-losing cancer patients. This hypothesis was evaluated in a randomized, double-blind, phase 2 study.

METHODS

Weight-losing cancer patients with solid gastrointestinal tumors were randomized to receive either high-dose ghrelin treatment (13 microg/kg daily; n = 17 patients) or low-dose ghrelin treatment (0.7 microg/kg daily; n = 14 patients) for 8 weeks as a once-daily, subcutaneous injections. Appetite was scored on a visual analog scale; and food intake, resting energy expenditure, and body composition (dual x-ray absorpitometry) were measured before the start of treatment and during follow-up. Serum levels of ghrelin, insulin, insulin-like growth factor 1, growth hormone (GH), triglycerides, free fatty acids, and glucose were measured. Health-related quality of life, anxiety, and depression were assessed by using standardized methods (the 36-item Short Form Health Survey and the Hospital Anxiety and Depression Scale). Physical activity, rest, and sleep were measured by using a multisensor body monitor.

RESULTS

Treatment groups were comparable at inclusion. Appetite scores were increased significantly by high-dose ghrelin analyzed both on an intent-to-treat basis and according to the protocol. High-dose ghrelin reduced the loss of whole body fat (P < .04) and serum GH (P < .05). There was a trend for high-dose ghrelin to improve energy balance (P < .07; per protocol). Otherwise, no statistically significant differences in outcome variables were observed between the high-dose and low-dose groups. Adverse effects were not observed by high-dose ghrelin, such as serum levels of tumor markers (cancer antigen 125 [CA 125], carcinoembryonic antigen, and CA 19-9).

CONCLUSIONS

The current results suggested that daily, long-term provision of ghrelin to weight-losing cancer patients with solid tumors supports host metabolism, improves appetite, and attenuates catabolism.

Obesity and gastrointestinal cancer

BACKGROUND

There is emerging evidence of a strong association between obesity and gastrointestinal cancer. This review summarizes the evidence from an epidemiological and pathophysiological perspective.

METHODS

Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles were identified. Selection of articles was based on peer review, journal and relevance.

RESULTS

Numerous epidemiological studies consistently identified an increased risk of developing oesophageal adenocarcinoma and colorectal carcinoma in the obese. The association between obesity and other gastrointestinal malignancies was less robust. Sex seems important with respect to cancer risk. Adipose tissue, particularly viscerally located fat, is metabolically active and exerts systemic endocrine effects. Putative pathophysiological mechanisms linking obesity and carcinogenesis include the insulin-like growth factor axis, adipocytokines and sex steroids.

CONCLUSION

A better understanding of the mechanisms that link obesity and cancer may uncover targets for intervention. Tackling obesity may result in a reduction in the incidence in addition to mortality of certain cancers in future.

Reliability of the Semmes Weinstein Monofilaments to measure coetaneous sensibility in the feet of healthy subjects

PURPOSE

To determine the intrarater-reliability, interrater-reliability and normal reference scores of the Semmes Weinstein Monofilament test (SWM) of the feet of healthy subjects. In addition, the stability of the SWM for prospective use was assessed by determining systematic changes in sensory thresholds.

METHODS

Interrater-reliability was assessed on five locations of the plantar side of both feet using monofilaments 1.65, 2.36, 2.44, 2.83, 3.22, 3.61, 3.84, 4.08, 4.31, 5.56, 6.65 in 60 healthy subjects by two or three investigators (test day 1). Intrarater-reliability and systematic changes in sensory thresholds were assessed 3 weeks later (test day 22) by one investigator.

RESULTS

Median interrater-reliability for the five test locations for both feet was poor to moderate. Median intrarater-reliability was good for the left foot and poor to moderate for the right foot. Significantly lower median sensory thresholds were found for the first SWM measurement at test day 22 compared to the first and second measurement of test day 1. Given the observed reliability of the SWM, a normal sensory score for the feet was situated between monofilament 3.22 and 4.08.

CONCLUSIONS

The SWM are reliable when measured by one researcher. Systematic changes in sensory thresholds were observed; therefore, the stability of the SWM for use in prospective studies could not be verified.

Association between alcohol intake amount and prevalence of metabolic syndrome in Korean rural male population

Moderate alcohol consumption is known to be associated with a reduced risk of cardiovascular disease and mortality. However, few studies reported that long-term alcohol drinking may increase the prevalence of central obesity, and cardiovascular disease. We examined the association between metabolic syndrome, nutritional factors and alcohol intake amount in Korean male rural population. We performed a cross-sectional analysis on data from Korean Rural Genomic Cohort (KRGC) study. We used multiple logistic regression analysis to estimate the adjusted odds ratio of metabolic syndrome according to alcohol intake amount categories (never, 0-16 g/day, 16-40 g/day, and >40 g/day). The age adjusted odds ratio for the prevalence of metabolic syndrome was significantly increased in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group (1.33; C.I., 1.11-1.59). These results were similar in the high energy intake group, but not in the low energy intake group. Waist circumference, blood pressure, and serum triglyceride levels were significantly higher in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group. These results suggest that large alcohol consumption is associated with metabolic syndrome and may be a modifiable risk factor of metabolic syndrome especially in subjects with high calorie intake.

Influence of leptin, adiponectin, and resistin on the association between abdominal adiposity and arterial stiffness

BACKGROUND

Adiposity is associated with arterial stiffness, and both adiposity and arterial stiffness independently predict morbidity and mortality. Because adipocytes account for most adipokine production, the objectives of this study were to examine the influence of adipokines such as leptin, adiponectin, and resistin on the relationship between abdominal adiposity and arterial stiffness.

METHODS

This is a cross-sectional analysis of data from the Baltimore Longitudinal Study of Aging (BLSA). Adiposity was measured as kilograms of abdominal adipose tissue using dual-energy X-ray absorptiometry (DXA). Arterial stiffness was assessed as carotid-femoral pulse wave velocity (PWV). Leptin, adiponectin, and resistin were assayed in fasting serum samples. The influence of adipokines on the relationship between adiposity and arterial stiffness by adipokines was examined using standard mediation pathway analysis.

RESULTS

Among 749 participants ages 26-96 years (mean age 67, 52% men, 27% black), abdominal adiposity was positively associated with PWV (relative ratio (RR) = 1.04, P = 0.02), after adjusting for potential confounders but was attenuated and no longer significant after adjusting for leptin (RR = 0.99, P = 0.77). The relationship between adiposity and PWV was not substantially influenced by adiponectin (RR = 1.03, P = 0.06) or resistin (RR = 1.05, P = 0.010). Leptin (RR = 1.02, P < 0.001), resistin (RR = 0.92, P < 0.0001), and adiponectin (RR = 0.97, P = 0.004), but not abdominal adiposity (RR = 1.00, P = 0.94), retained significant associations with PWV when adjusting for each other and confounders.

CONCLUSIONS

Our findings are consistent with the hypothesis that leptin explains, in part, the observed relationship between abdominal adiposity and arterial stiffness. Adiponectin, leptin, and resistin are independent correlates of PWV.

Abdominal visceral adipose tissue predicts risk of colorectal adenoma in both sexes

BACKGROUND & AIMS

Small studies have shown inconsistent results regarding the association between abdominal visceral adipose tissue and colorectal adenomas. We evaluated the effects of visceral adipose tissue volume on the development and growth of colorectal adenomas.

METHODS

A total of 3922 participants underwent colonoscopy and computed tomography from February to November 2008. The associations between waist circumference, visceral adipose tissue volume, and colorectal adenomas were estimated with adjusted odds ratios and 95% confidence intervals (CIs). In addition, the association between characteristics of colorectal adenomas and visceral adipose tissue volume was evaluated.

RESULTS

Compared with participants who had visceral adipose tissue volume of less than 500 cm(3), the odds ratio for colorectal adenoma was 1.09 (95% CI, 0.87-1.36) for a volume of 500 to 999 cm(3), 1.33 (95% CI, 1.04-1.69) for a volume of 1000 to 1499 cm(3), and 1.43 (95% CI, 1.06-1.94) for a volume of 1500 cm(3) or greater. The risk of colorectal adenomas increased with increasing visceral adipose tissue volume in both sexes (P trend = .004 in men and .009 in women). Waist circumference was associated with colorectal adenomas in men (P trend = .02), but not in women. High volume of visceral adipose tissue (>or=1000 cm(3)) had a positive association with larger adenomas (>or=10 mm) and multiple adenomas.

CONCLUSIONS

Abdominal visceral adipose tissue volume can contribute to the development and growth of colorectal adenomas, and it was a better predictor for risk of colorectal adenomas than body mass index or waist circumference in both sexes.

Optimal waist circumference cutoff values for metabolic syndrome diagnostic criteria in a Korean rural population

The Korean Society for the Study of Obesity (KSSO) has defined the waist circumference cutoff value of central obesity as 90 cm for men and 85 cm for women. The purpose of this investigation was to determine the corresponding waist circumference values. A total of 3,508 persons in the Korean Rural Genomic Cohort Study were enrolled in this survey. Receiver operating characteristic (ROC) curve analysis was used to find appropriate waist circumference cutoff values in relation to insulin resistance determined by homeostasis model assessment for insulin resistance (HOMA-IR), body mass index (BMI), and components of metabolic syndrome. The optimal waist circumference cutoff values were 87 cm for men and 83 cm for women by ROC analysis to HOMA-IR and 86 cm for men and 83 cm for women by ROC analysis to value with more than two components of metaobolic syndrome. By using a BMI > or =25 kg/m(2), 86 cm for men and 82 cm for women were optimal waist circumference cutoff values. In this study, we suggest that the most reasonable waist circumference cutoff values are 86-87 cm for men and 82-83 cm for women.

Implications of magnesium deficiency in type 2 diabetes: a review

Magnesium is the fourth most abundant cation in the body and plays an important physiological role in many of its functions. It plays a fundamental role as a cofactor in various enzymatic reactions involving energy metabolism. Magnesium is a cofactor of various enzymes in carbohydrate oxidation and plays an important role in glucose transporting mechanism of the cell membrane. It is also involved in insulin secretion, binding, and activity. Magnesium deficiency and hypomagnesemia can result from a wide variety of causes, including deficient magnesium intake, gastrointestinal, and renal losses. Chronic magnesium deficiency has been associated with the development of insulin resistance. The present review discusses the implications of magnesium deficiency in type 2 diabetes.

The role of orexigenic and anorexigenic factors in an interdisciplinary weight loss therapy for obese adolescents with symptoms of eating disorders

AIM

The aim of this study was to evaluate the role of orexigenic and anorexigenic factors in an interdisciplinary weight loss therapy for obese adolescents with symptoms of eating disorders.

METHODS

Thirty-seven post-pubertal, obese adolescents (14 to 19 years old) with symptoms of eating disorders were submitted to long-term interdisciplinary therapy (1 year). Bulimic and binge eating symptoms were measured using the Bulimic Investigatory Test, Edinburgh, and the Binge Eating Scale respectively. Neuropeptide Y, melanin-concentrating hormone, total ghrelin, alpha-melanocyte stimulating hormone and leptin were measured using radioimmunoassay.

RESULTS

After long-term interdisciplinary therapy, the adolescents showed significantly improved body composition, visceral and subcutaneous fat and reduced symptoms of bulimia and binge eating. Intriguingly, orexigenic peptides were up-regulated after short-term therapy and down-regulated at the end of therapy, whereas the anorexigenic pathway was improved with therapy. Furthermore, after long-term therapy, a negative correlation was observed between leptin concentration and melanin-concentrating hormone.

DISCUSSION

We suggest that long-term therapy promotes an intrinsic association between weight loss, improvement of eating disorder symptoms and a decrease in orexigenic factors. Together, these results represent a more effective course by which patients can normalise behaviours related to eating disorders as well the actions of hormones involved in energy balance, and thus advance obesity control.

CONCLUSION

Long-term interdisciplinary therapy was effective to improve anorexigenic and orexigenic factors that influence energy balance and avoid the development of eating disorders in obese adolescents. However, the associations between eating disorders and neuroendocrine factors need to be confirmed in future studies.

Ghrelin in diabetes and metabolic syndrome

Metabolic syndrome is a cluster of related risk factors for cardiovascular disease, type 2 diabetes and liver disease. Obesity, which has become a global public health problem, is one of the major risk factors for development of metabolic syndrome and type 2 diabetes. Obesity is a complex disease, caused by the interplay between environmental and genetic factors. Ghrelin is one of the circulating peptides, which stimulates appetite and regulates energy balance, and thus is one of the candidate genes for obesity and T2DM. During the last years both basic research and genetic association studies have revealed association between the ghrelin gene and obesity, metabolic syndrome or type 2 diabetes.

A survey of erectile dysfunction in Taiwan: use of the erection hardness score and quality of erection questionnaire

INTRODUCTION

There are currently no studies in the Asia-Pacific region using the erection hardness score (EHS) and Quality of Erection Questionnaire (QEQ) to assess erectile dysfunction (ED).

AIMS

To provide up-to-date data on the prevalence of ED in Taiwanese men and to validate the EHS and QEQ in this population.

METHODS

A representative sample of 1,060 men aged ≥ 30 years completed a telephone interview. ED status was confirmed via direct questioning and using the abridged five-item version of the 15-item International Index of Erectile Function (IIEF-5). Responses regarding EHS, QEQ, marital and sexual satisfaction, and attitude to treatment were also recorded.

MAIN OUTCOME MEASURES

IIEF, EHS, and QEQ.

RESULTS

The prevalence of ED, as defined by IIEF-5, was 27% among all respondents and 29% among those aged ≥ 40 years. Although, the prevalence of ED increased with age, men of all ages tended to underestimate their erectile problems. Among men who indicated that they did not have ED, 25% were found to have mild to moderate ED according to the IIEF-5 assessment. An EHS ≤ 3, indicating the presence of ED, was reported in 26% of men. The EHS was consistent with the QEQ: When the EHS was 4, the satisfaction of each domain of QEQ ranged from 85% to 90%. The QEQ score correlated well with the IIEF-5 score and significantly affected both sexual and marital satisfaction (P < 0.005).

CONCLUSIONS

These data indicate that EHS is a simple, practical tool for clinical use. QEQ scores appear to be independently associated with sexual and marital satisfaction, and may be of value in the assessment and monitoring of ED patients. While ED is a common health problem in Taiwan and the prevalence of ED increases with age, affected men lack awareness regarding the presence of erectile problems and the importance of initiating timely and effective treatment.

Metabolic or bariatric surgery? Long-term effects of malabsorptive vs restrictive bariatric techniques on body composition and cardiometabolic risk factors

BACKGROUND

Obesity is an increasing health problem and surgery seems to be the only treatment effective in achieving weight loss without relapse. Among bariatric techniques, many differences exist in terms of weight loss and resolution of comorbidities. Up to now, there are no prospective studies comparing long-term effects of malabsorptive vs restrictive techniques.

OBJECTIVE

In this study, cardiometabolic risk factors and body composition changes after malabsorptive biliointestinal bypass (BIBP) and restrictive laparoscopic adjustable gastric banding (LAGB) were compared during a 4-year follow-up.

DESIGN

Prospective, case-control and cohort study.

PATIENTS

In all, 80 obese subjects, matched for weight and age. Altogether, 40 patients underwent BIBP and 40 underwent LAGB.

MEASUREMENTS

Weight, body composition, fasting and post-loading plasma glucose and insulin, homeostatic model assessment index (HOMA-I), lipid profile, blood pressure (BP), erythrocyte sedimentation rate and fibrinogen were monitored at baseline, 12 and 48 months.

RESULTS

At 12 months after surgery, a significant reduction in body mass index, total fat mass (FM), trunk FM (trFM), trFM/legs FM (lFM) ratio (trFM/lFM), triglycerides, BP and inflammation markers was observed in both groups. BIBP patients showed a significant reduction in total cholesterol (Tot-C), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), whereas the LAGB group showed a significant increase of HDL-C. A further improvement of all the parameters evaluated was seen in the BIBP group at 48 months after surgery.

CONCLUSIONS

Both bariatric procedures exerted positive effects on cardiometabolic risk factors and on weight loss in the population studied, but on the long-term period, HOMA-I, Tot-C/HDL-C ratio and body composition improvements were more evident after BIBP. We conclude that malabsorptive BIBP seems to be more effective than LAGB in treating visceral obesity and its metabolic complications.

[Ultrasound in the diagnostics of fatty liver in obesity]

Chronic diffuse liver diseases produce a characteristic ultrasound image called bright liver. On the basis of liver attenuation, two major appearances can be observed: low and high attenuation types. It is proved that high attenuation is associated with fatty liver and subcutaneous fat thickness correlates with attenuation. Cut-off value of attenuation and subcutaneous fat thickness was searched for differentiation of the two attenuation types and that of the normal livers. 441 patients (proved by histology) were examined by ultrasound. 132 normal livers, 176 low and 133 high attenuation type bright livers were found. Cut-off level of attenuation, determined by frequency distribution analysis was defined as 1.1 dB/cm/MHz, between fatty liver and low attenuation type bright liver and normal liver. Cut-off value for subcutaneous fat thickness could not be determined. It is concluded, that above the cut-off point of attenuation, the diagnosis of fatty liver can be established without liver biopsy. Subcutaneous fat thickness values give additive confirmative data.

Normal range of alanine aminotransferase concentration is associated with carotid atherosclerosis

OBJECTIVE

To investigate whether alanine aminotransferase (ALT), even within the reference range, is associated with atherosclerotic burden in apparently healthy adults.

METHODS

This was an observational study performed on 830 healthy individuals with normal ALT concentration (<or=40U/L). Atherosclerotic burden was assessed by carotid arterial intima-media thickness (IMT). All subjects were divided according to the quartile based on their ALT concentrations.

RESULTS

Despite all subjects having a normal ALT concentration, ultrasonographic liver steatosis was observed in 48.4% and 36.7% of men and women, respectively. In both genders, subjects in the highest quartile of ALT concentration had a significantly higher waist circumference, triglyceride concentration, HOMA-IR, a higher prevalence of metabolic syndrome, and a greater severity of ultrasonographic liver steatosis than did those in the lower quartiles. In women, the carotid IMT increased significantly with increasing quartiles of ALT concentration (0.62+/-0.14mm, 0.66+/-0.15mm, 0.69+/-0.15mm, vs. 0.72+/-0.24mm; P for trend<0.001). Based on multivariate regression analysis, the serum ALT, even within the normal range, was associated with the carotid IMT in both men and women, and independently of traditional cardiovascular risk factors.

CONCLUSIONS

ALT concentrations, albeit within the reference range, were associated with atherosclerotic burden in healthy adults.

The effects of exercise-induced weight loss on appetite-related peptides and motivation to eat

CONTEXT

The magnitude of exercise-induced weight loss depends on the extent of compensatory responses. An increase in energy intake is likely to result from changes in the appetite control system toward an orexigenic environment; however, few studies have measured how exercise impacts on both orexigenic and anorexigenic peptides.

OBJECTIVE

The aim of the study was to investigate the effects of medium-term exercise on fasting/postprandial levels of appetite-related hormones and subjective appetite sensations in overweight/obese individuals.

DESIGN AND SETTING

We conducted a longitudinal study in a university research center.

PARTICIPANTS AND INTERVENTION

Twenty-two sedentary overweight/obese individuals (age, 36.9 +/- 8.3 yr; body mass index, 31.3 +/- 3.3 kg/m(2)) took part in a 12-wk supervised exercise programme (five times per week, 75% maximal heart rate) and were requested not to change their food intake during the study.

MAIN OUTCOME MEASURES

We measured changes in body weight and fasting/postprandial plasma levels of glucose, insulin, total ghrelin, acylated ghrelin (AG), peptide YY, and glucagon-like peptide-1 and feelings of appetite.

RESULTS

Exercise resulted in a significant reduction in body weight and fasting insulin and an increase in AG plasma levels and fasting hunger sensations. A significant reduction in postprandial insulin plasma levels and a tendency toward an increase in the delayed release of glucagon-like peptide-1 (90-180 min) were also observed after exercise, as well as a significant increase (127%) in the suppression of AG postprandially.

CONCLUSIONS

Exercise-induced weight loss is associated with physiological and biopsychological changes toward an increased drive to eat in the fasting state. However, this seems to be balanced by an improved satiety response to a meal and improved sensitivity of the appetite control system.

Repressive coping style and its relation to psychosocial distress in males with erectile dysfunction

INTRODUCTION

There is evidence that repressive coping adversely affects medical conditions such as coronary heart disease, hypertension, and bronchial asthma. Erectile dysfunction (ED) is known to have a severe and lasting negative impact on health, quality of life, and partnership. Although ED may be eminently threatening for the self-image of affected men, a repressive coping style and its consequences for their mental health and partnership has not yet been investigated.

AIM

Based on the presumption that the male self-image is threatened by ED, we expected men with repressive coping strategies-although reporting the same degree of impairments regarding their sexual function-to describe themselves as more satisfied with: (i) their sexual relationship, to report (ii) a better quality of their partnership; and (iii) less distress (depression and physical complaints) as compared with those who do not use such strategies.

METHODS

Fifty-nine patients with ED from the outpatient unit of the Clinic of Urology, Pediatric Urology and Andrology of the University of Giessen were examined using standardized German versions of international questionnaires. Coping style was determined using a combination of the State Trait Anxiety Inventory (STAI) and the Marlowe Crown Social Desirability Scale (SDS-CM) measuring defensiveness.

MAIN OUTCOME MEASURES

Questionnaires measuring anxiety (STAI), depression (Center for Epidemiological Studies Depression Scale), social desirability (SDS-CM), quality of partnership (Partnership Questionnaire), and physical complaints (Complaint List) were administered.

RESULTS

Repressors did not differ from nonrepressors with regard to their self-reported sexual function (International Index of Erectile Function). However, they described themselves as less distressed (depression, physical complaints) and rated the quality of their partnership as higher.

CONCLUSION

Repressors tend to report their complaints in a manner that protects their self-worth. Clinicians therefore might have difficulties deciding whether and which treatment is necessary. Additional clinical information (e.g., interview together with the female partner) or questionnaires might prove useful sources of information on patients' coping style.

Associations between weight perceptions, weight control and body fatness in a multiethnic sample of adolescent girls

Objective

The purpose of the present study was to examine the interactions between weight perceptions, weight control behaviours and body fatness in a multiethnic sample of adolescent girls.

Design

A cross-sectional study.

Setting

Girls from European (37·7 %), Pacific Island (21·6 %), East Asian (15·8 %), Maori (10·2 %) and South Asian (9·6 %) populations and from other ethnicities (5·0 %).

Subjects

A sample of 954 girls aged 11–15 years participated in the study. BMI was derived from height and weight, whereas body fat (BF) was determined from hand-to-foot bioimpedance measurements. Weight perceptions, weight control behaviours and pubertal stage were assessed by questionnaire.

Results

Body size and fatness varied significantly across ethnic groups. Although few differences in weight perceptions were observed between BMI and %BF percentile groups, a relatively high degree of weight misclassification was evident across all BF categories. The number of girls trying to lose weight exceeded those who perceived themselves as being overweight, with the magnitude of the difference dependent on ethnicity. Of the girls trying to lose weight, the combination of dieting and exercise was the most common weight loss practice; however, a substantial proportion reported neither exercise nor dieting. Weight status perception was a stronger predictor of weight loss intent than actual BF when controlling for all other factors.

Conclusions

Interventions and educational campaigns that assist girls in recognising a state of excess BF are a priority for all ethnic groups to increase the likelihood that behavioural changes necessary to combat widespread overweight and obesity are adopted.

Environmental tobacco use and indicators of metabolic syndrome in Chinese adults

INTRODUCTION

Exposure to environmental tobacco smoke (ETS) is a widespread source of nicotine exposure, and an estimated 540 million Chinese are exposed to ETS in mainland China. We aimed to investigate associations of ETS exposure and metabolic syndrome (MetS) as well as its individual components independent of active smoking status in Chinese adults.

METHODS

A cross-sectional data of 304 randomly selected Chinese households with fourth (elementary school) and seventh (middle school) graders in Qingdao city was used. Assessments of fat mass, metabolic biomarkers, personal history of illness, and health behaviors were conducted.

RESULTS

Proportions of current smokers were 3% in women and 60.5% in men, and more men reported exposure to ETS 5-7 days per week than women (60.8% vs. 48.1%). Exposure to ETS was significantly associated with enhanced risks of MetS (odds ratio [OR] = 2.8, p = .01), hypertriglyceridemia (OR = 2.1, p = .02), and central obesity (OR = 2.7, p < .001) and reduced levels of high-density lipoprotein cholesterol (OR = 1.9, p = .02) and elevated mean levels of fasting insulin (p < .01). These observed associations were independent of active smoking status and were successfully replicated in female never-smokers.

CONCLUSIONS

Results of our study support the hypothesis that ETS exposure is independently associated with MetS and its individual components. Further large-scale studies with longitudinal design and objective assessment of ETS exposure are needed to elucidate the underlying mechanisms and the causal effects of passive smoking on MetS. Findings of this work emphasize the importance of developing community intervention to reduce smoking, ETS, and promote healthy lifestyle.

Colonic complications of obesity

Obesity is a risk factor for colorectal cancer and adenomatous polyps. The increased prevalence of neoplasia coupled with the observation that obesity may be associated with a suboptimal bowel preparation may diminish the adequate detection of adenomas for obese who undergo colonoscopy. The colonic complications of obesity are reviewed in this article.

Metabolic syndrome as a risk factor for high-ocular tension

OBJECTIVE

To investigate the relationship between the metabolic syndrome and intraocular pressure (IOP).

METHODS

An observational study was conducted in a medical health checkup program at a general hospital. This study involved 14 003 apparently healthy Japanese men and women, 18-83 years of age, with a mean IOP of 14.8 (3.0) mm Hg. IOP was examined by noncontact tonometer. High-ocular tension was defined as IOP >21 mm Hg without optic-disc abnormalities or history of receiving any anti-glaucoma therapy. Modified criteria of the revised National Cholesterol Education Program Adult Treatment Panel III (rATPIII), the new International Diabetes Federation definition, and the Japan Society for The Study of Obesity definition were used to characterize the metabolic syndrome. Air temperature was assessed from the Gifu Meteorological Observatory, Gifu, Japan.

RESULTS

In the male and female subjects, mean IOP and the prevalence of high-ocular tension became high in direct correlation with the increased number of metabolic syndrome components. To analyze by logistic regression, the metabolic syndrome defined by rATPIII was positively and maximum temperature was negatively correlated with high-ocular tension in males (adjusted odds ratio: 2.0 [95% confidence interval, CI, 1.43-2.78] and 0.63 [95% CI, 0.54-0.73], respectively) and in females (adjusted odds ratio: 7.09 [95% CI, 3.74-13.43] and 0.67 [95% CI, 0.53-0.87], respectively). Three of five metabolic syndrome components (fasting plasma glucose, blood pressure, and triglycerides) were related to high-ocular tension.

CONCLUSION

The metabolic syndrome is a risk factor for high-ocular tension.

Plasma adipokine and inflammatory marker concentrations are altered in obese, as opposed to non-obese, type 2 diabetes patients

Elevated plasma free fatty acid (FFA), inflammatory marker, and altered adipokine concentrations have been observed in obese type 2 diabetes patients. It remains unclear whether these altered plasma concentrations are related to the diabetic state or presence of obesity. In this cross-sectional observational study, we compare basal plasma FFA, inflammatory marker, and adipokine concentrations between obese and non-obese type 2 diabetes patients and healthy, non-obese controls. A total of 20 healthy, normoglycemic males (BMI <30 kg/m²), 20 non-obese (BMI <30 kg/m²) and 20 obese (BMI >35 kg/m²) type 2 diabetes patients were selected to participate in this study. Groups were matched for age and habitual physical activity level. Body composition, glycemic control, and exercise performance capacity were assessed. Basal blood samples were collected to determine plasma leptin, adiponectin, resistin, tumor necrosis factor α (TNFα), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and FFA concentrations. Plasma FFA, inflammatory marker (hsCRP, IL-6, TNFα), adipokine (adiponectin, resistin, leptin), and triglyceride concentrations did not differ between non-obese diabetes patients and healthy, normoglycemic controls. Plasma FFA, IL-6, hsCRP, leptin, and triglyceride levels were significantly higher in the obese diabetes patients when compared with the healthy normoglycemic controls (P < 0.05). Furthermore, plasma hsCRP and leptin levels were significantly higher in the obese versus non-obese diabetes patients (P < 0.05). Significant correlations between plasma parameters and glycemic control were observed, but disappeared after adjusting for trunk adipose tissue mass. Elevated plasma leptin, hsCRP, IL-6, and FFA concentrations are associated with obesity and not necessarily with the type 2 diabetic state.

Ghrelin, des-acyl ghrelin and nesfatin-1 in gastric X/A-like cells: role as regulators of food intake and body weight

Numerous peptides released from endocrine cells in the intestinal mucosa were established early on to be involved in the physiological regulation of food intake with a prominent role in termination of food ingestion when nutrients pass along the intestinal tract. Recently, peptides released from X/A-like endocrine cells of the gastric oxyntic mucosa were recognized as additional key players in the regulation of feeding and energy expenditure. Gastric X/A-like cells release the octanoylated peptide, ghrelin, the only known peripherally produced hormone stimulating food intake through interaction with growth hormone secretagogue 1a receptor (GHS-R1a). Additionally, non-octanoylated (des-acyl) ghrelin present in the circulation at higher levels than ghrelin is currently discussed as potential modulator of food intake by opposing ghrelin's action independent from GHS-R1a although the functional significance remains to be established. Obestatin, a ghrelin-associated peptide was initially reported as anorexigenic modulator of ghrelin's orexigenic action. However, subsequent reports did not support this contention. Interesting is the recent identification of nesfatin-1, a peptide derived from the nucleobindin2 gene prominently expressed in gastric X/A-like cells in different vesicles than ghrelin. Circulating nesfatin-1 levels vary with metabolic state and peripheral or central injection inhibits dark phase feeding in rodents. Overall, these data point to an important role of gastric X/A-like cells in food intake regulation through the expression of the orexigenic peptide ghrelin along with des-acyl ghrelin and nesfatin-1 capable of reducing food intake upon exogenous injection although their mechanisms of action and functional significance remain to be established.