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Podzolkov VI, Bragina AE, Osadchiy KK, Rodionova JN, Bayutina DA. Pararenalfat Tissue: Rate of Pararenal Obesity and Relation with Anthropometric Indices of Obesity. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-09-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aim. To study a rate of excessive pararenal fat tissue (PRFT) thickness and its relationship with anthropometric obesity indices.Material and methods. 372 patients (152 men and 220 women) were included in the study, the average age was 63.5±13.3 years. There were measured: height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), WC/height ratio, sagittal abdominal diameter (SAD), body fat percentage (BFP), body surface area (BSA), body adiposity index (BAI) and visceral obesity index (VAI). All subjects underwent abdominal multispiral computed tomography. PRFT thickness was detected on a single slice at the level of the left renal vein.Results. 27% of the examined group had BMI<25 kg/m2, 28% – excessive body mass, 45% – obesity. The median PRFT thickness was 1.61 (1.03; 2.46) cm. There were correlations between PRFT thickness and glucose (r=0,64, p<0,05) and uric acid (r=0,46, p<0,05) levels. The threshold of referential PRFT thickness was 1,91cm. The rate of pararenal obesity was 9,9% among those with normal body mass, 29,3% in excessive body mass, 66,1% – in 1 class obesity, 67,7% – in 2 class, and 90,1% – in 3 class. The correlation analysis revealed a significant positive correlation between the PRFT thickness and obesity indices with exception of VAI and BAI: with BMI (r=0.43, p<0.05), WC (r=0.57, p<0.05), SAD (r=0.58, p<0.05), BFP (r=0.48, p<0.05), WC/height ratio (r=0.46, p<0.05), and BSA (r=0.58, p<0.05).Conclusion. Excessive PRFT may be detected isolated without any external anthropometric signs of obesity, wherein it is an active component of metabolic disorders typical for obesity. The most significant indices for the detection of pararenal obesity may be WC, SAD, and BSA.
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Affiliation(s)
- V. I. Podzolkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. E. Bragina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - K. K. Osadchiy
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - J. N. Rodionova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - D. A. Bayutina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Al- Ahmadi J, Enani S, Bahijri S, Al-Raddadi R, Jambi H, Eldakhakhny B, Borai A, Ajabnoor G, Tuomilehto J. Association between anthropometric indices and non-anthropometric components of the metabolic syndrome in Saudi adults. J Endocr Soc 2022; 6:bvac055. [PMID: 35592514 PMCID: PMC9113350 DOI: 10.1210/jendso/bvac055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Context Waist circumference (WC) is used in screening for metabolic syndrome (MetS) based on its association with cardiometabolic risk. This might apply differently in ethnically different populations. Associations with other measures are also unclear. Objective This work aimed to investigate the association between neck circumference (NC), WC, WC:hip circumference, WC:height (WC:Ht), NC:Ht, fat percentage, body mass index (BMI), conicity index, abdominal volume index, and weight-adjusted waist index with nonanthropometric components of MetS in nondiabetic Saudi adults. Methods This cross-sectional study took place in public health centers in Jeddah, comprising 1365 Saudi adults (772 men and 593 women) aged 18 years or older not previously diagnosed with diabetes. Main outcome measures included the presence of 2 or more nonanthropometric components of the MetS were used to define clinical metabolic abnormality (CMA). The predictive ability of studied anthropometric indices for CMA was determined using the area under receiver operating characteristics (AUC) curve and binary logistic regression. Results A total of 157 men and 83 women had CMA. NC and NC:Ht had the highest predictive ability for CMA in men (odds ratio [OR]NC = 1.79, P < .001 and ORNC:Ht = 1.68, P < .001; AUCNC = 0.69 [95% CI, 0.64-0.74] and AUCNC:Ht = 0.69 [95% CI, 0.64-0.73]). In women, WC had the highest predictive ability ORWC = 1.81, P < .001; AUCWC = 0.75 [95% CI, 0.69-0.80]). Conclusion Upper-body anthropometric indicators that were associated with subcutaneous fat had the highest predictive ability for CMA in men whereas abdominal obesity indictors had the best predictive ability in women, suggesting that fat distribution might contribute to CMA in a sex-specific manner.
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Affiliation(s)
- Jawaher Al- Ahmadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Sumia Enani
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Suhad Bahijri
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Rajaa Al-Raddadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hanan Jambi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Basmah Eldakhakhny
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Anwar Borai
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), College of Medicine, King Saud Bin Abdulaziz, University for Health Sciences (KSAU-HS), Jeddah 22384, Saudi Arabia
| | - Ghada Ajabnoor
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, king Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Jaakko Tuomilehto
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia
- Department of Public Health, University of Helsinki, FI-00014 Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland
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Kornej J, Lin H, Trinquart L, Jackson CR, Ko D, Benjamin EJ, Preis SR. Neck Circumference and Risk of Incident Atrial Fibrillation in the Framingham Heart Study. J Am Heart Assoc 2022; 11:e022340. [PMID: 35156385 PMCID: PMC9245798 DOI: 10.1161/jaha.121.022340] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Increased neck circumference, a proxy for upper‐body subcutaneous fat, is associated with cardiovascular risk and metabolic risk factors, accounting for body mass index (BMI) and waist circumference. The association between neck circumference and incident atrial fibrillation (AF) is unclear. The aim of current study was to evaluate the association between neck circumference and incident AF. Methods and Results We selected participants from the Framingham Heart Study aged ≥55 years without diagnosed AF and with available neck circumference, BMI, and waist circumference measurements. We defined high neck circumference as ≥14 inches in women and ≥17 inches in men on the basis of the Contal and O’Quigley changepoint method. We used Fine‐Gray models to estimate subdistribution hazards ratios (sHRs) for the association between neck circumference and incident AF accounting for the competing risk of death. We adjusted models for clinical risk factors. We then additionally adjusted separately for BMI, waist circumference, and height/weight. The study sample included 4093 participants (mean age 64±7 years, 55% female). During 11.2±5.7 mean years of follow‐up, incident AF occurred in 571 participants. High neck circumference was associated with incident AF (sHR for high versus low: 1.58; 95% CI, 1.32–1.90, P<0.0001). The association remained significant after adjustment for BMI (sHR, 1.51; 95% CI, 1.21–1.89; P=0.0003), waist circumference (sHR, 1.47; 95% CI, 1.18–1.83; P<0.0001), and height/weight (sHR, 1.37; 95% CI, 1.09–1.72; P=0.007). Conclusions High neck circumference was associated with incident AF adjusting for traditional adiposity measures such as BMI and waist circumference.
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Affiliation(s)
- Jelena Kornej
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Section of Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA
| | - Honghuang Lin
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Section of Computational Biomedicine Department of Medicine Boston University School of Medicine Boston MA
| | - Ludovic Trinquart
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Department of Biostatistics Boston University School of Public Health Boston MA
| | | | - Darae Ko
- Section of Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA
| | - Emelia J. Benjamin
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Section of Cardiovascular Medicine Department of Medicine Boston University School of Medicine Boston MA
- Department of Epidemiology Boston University School of Public Health Boston MA
| | - Sarah R. Preis
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study Framingham MA
- Department of Biostatistics Boston University School of Public Health Boston MA
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Brady RP, Shah AS, Jensen ET, Stafford JM, D’Agostino RB, Dolan LM, Knight L, Imperatore G, Turley CB, Liese AD, Urbina EM, Lawrence JM, Pihoker C, Marcovina S, Dabelea D. Glycemic control is associated with dyslipidemia over time in youth with type 2 diabetes: The SEARCH for diabetes in youth study. Pediatr Diabetes 2021; 22:951-959. [PMID: 34363298 PMCID: PMC8530941 DOI: 10.1111/pedi.13253] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/03/2021] [Accepted: 07/28/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Dyslipidemia has been documented in youth with type 2 diabetes. There is a paucity of studies examining dyslipidemia over time in youth with type 2 diabetes and associated risk factors. OBJECTIVE To evaluate lipids at baseline and follow-up and associated risk factors in youth with type 2 diabetes. METHODS We studied 212 youth with type 2 diabetes at baseline and after an average of 7 years of follow-up in the SEARCH for Diabetes in Youth Study. Abnormal lipids were defined as high-density lipoprotein cholesterol (HDL-C) < 35, low-density lipoprotein cholesterol (LDL-C) > 100, or triglycerides >150 (all mg/dl). We evaluated participants for progression to abnormal lipids (normal lipids at baseline and abnormal at follow-up), regression (abnormal lipids at baseline and normal at follow-up), stable normal, and stable abnormal lipids over time for HDL-C, LDL-C, and triglycerides. Associations between hemoglobin A1c (HbA1c) and adiposity over time (area under the curve [AUC]) with progression and stable abnormal lipids were evaluated. RESULTS HDL-C progressed, regressed, was stable normal, and stable abnormal in 12.3%, 11.3%, 62.3%, and 14.2% of participants, respectively. Corresponding LDL-C percentages were 15.6%, 12.7%, 42.9%, and 28.8% and triglycerides were 17.5%, 10.8%, 55.7%, and 16.0%. Each 1% increase in HbA1c AUC was associated with a 13% higher risk of progression and stable abnormal triglycerides and a 20% higher risk of progression and stable abnormal LDL-C. Higher adiposity AUC was marginally (p = 0.049) associated with abnormal HDL-C. CONCLUSIONS Progression and stable abnormal LDL-C and triglycerides occur in youth with type 2 diabetes and are associated with higher HbA1c.
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Affiliation(s)
- Ryan P Brady
- Department of Pediatrics, Cincinnati Children’s Hospital & University of Cincinnati, Cincinnati, OH USA 45229
| | - Amy S Shah
- Department of Pediatrics, Cincinnati Children’s Hospital & University of Cincinnati, Cincinnati, OH USA 45229
| | - Elizabeth T Jensen
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC USA 27157
| | - Jeanette M Stafford
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC USA 27157
| | - Ralph B D’Agostino
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC USA 27157
| | - Lawrence M Dolan
- Department of Pediatrics, Cincinnati Children’s Hospital & University of Cincinnati, Cincinnati, OH USA 45229
| | - Lisa Knight
- Department of Pediatrics, University of South Carolina School of Medicine, Columbia, SC USA 29203
| | - Giuseppina Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA USA 30341
| | - Christine B Turley
- Department of Pediatrics, University of South Carolina School of Medicine, Columbia, SC USA 29203
| | - Angela D. Liese
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC USA 29208
| | - Elaine M Urbina
- Department of Pediatrics, Cincinnati Children’s Hospital & University of Cincinnati, Cincinnati, OH USA 45229
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA USA 91101
| | - Catherine Pihoker
- Department of Pediatrics, University of Washington, Seattle, WA USA 98195
| | - Santica Marcovina
- Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA USA 98195
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO USA 80045
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Neck Circumference as a Predictor of Metabolic Syndrome in Koreans: A Cross-Sectional Study. Nutrients 2021; 13:nu13093029. [PMID: 34578907 PMCID: PMC8468211 DOI: 10.3390/nu13093029] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
Metabolic syndrome (MetS) is a complex metabolic disorder and a high-risk condition for type 2 diabetes and cardiovascular disease. Rapid screening of at-risk individuals using accurate and time-saving tools is effective in disease management. Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, we collected data from 2234 participants suitable for the study design, of which 974 (43.6%) were men and 1260 (56.4%) were women. We used receiver operating characteristic (ROC) curve analysis to estimate the optimal sex-specific neck circumference (NC) cut-off point to predict the MetS risk. To analyze the risk of MetS according to the estimated NC, logistic regression analysis was performed to identify the confounding factors. The result of the ROC analysis showed that the optimal neck cut-off points for predicting the risk of MetS were 38.25 cm (AUC: 0.759, 95% CI: 0.729–0.790) in men and 33.65 cm (AUC: 0.811, 95% CI: 0.782–0.840) in women. In the upper NC cut-off point compared to the lower NC cut-off point, NC was associated with an increased MetS risk by 2.014-fold (p = 0.010) in men and 3.650-fold (p < 0.001) in women, after adjustments. The current study supports NC as an effective anthropometric indicator for predicting the risk of MetS. It is suggested that more studies should be conducted to analyze the disease prediction effect of the combined application of anthropometric indicators currently in use and NC.
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Metabolic syndrome in type 2 diabetic patients: a review of current evidence. Porto Biomed J 2020; 5:e101. [PMID: 33299950 PMCID: PMC7721212 DOI: 10.1097/j.pbj.0000000000000101] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
The metabolic syndrome (MS) is a set of metabolic disturbances, represented by various cardiovascular risk factors which are generally associated with the central accumulation of fat and the resistance to insulin. Inadequate changes in eating behaviours and weight loss, which are associated to taking part in regular physical activity, are considered to be primary and first choice therapies for the treatment of MS, as they assist in the reduction of the abdominal girth and visceral fat, improve the sensibility to insulin and reduce the plasmatic concentrations of glucose and triglycerides, raise the values of high density lipoproteins and, consequently decrease the risk factors which contribute to the development of type 2 diabetes. The MS is a current discussion theme in the health field as it is related to illnesses/diseases, which not only cause a worldwide high mortality rate but show increasing incidence. Type 2 diabetes is characterised by a deregulation of the carbohydrates, lipids and proteins found in the metabolism and result in diminished secretion of insulin, resistance to insulin or a combination of both. Type 2 diabetes is the most form of diabetes of the first 3 types of diabetes, representing 90% of all cases. Diabetes is a chronic and complex disease which requires a strict medical follow-up so as to reduce the risks and obtain strategies for its control. The fast-epidemiological global evolution which has been registered in the last few years, leads to it being considered one of the pandemics of the 21st century. In this non-systematic and advanced review of the MS in type 2 diabetic patients, several articles were consulted, and some recently published studies were analysed.
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Petrenko AP, Castelo-Branco C, Marshalov DV, Kuligin AV, Mysovskaya YS, Shifman EM, Abdulaev AMR. Physiology of intra-abdominal volume during pregnancy. J OBSTET GYNAECOL 2020; 41:1016-1022. [PMID: 33251897 DOI: 10.1080/01443615.2020.1820470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A total of 580 pregnant and 50 puerperal women were included in this cross-sectional study to assess the physiological changes that allow women to adapt to a chronic increase in intra-abdominal pressure during pregnancy. The volume of the uterus, intra-abdominal volume (IAV), visceral and subcutaneous fat was calculated. During pregnancy, the IAV increases up to 1.5 times. Changes in IAV until 24 weeks present a linear relationship (5.2%); thereafter, changes become exponential and, at 40 weeks, IAV increases by 61%. This fact is exclusively related to the progressive growth of the foetus and to the increase in uterine size. At term, the IAV reserve is exhausted, becoming equal the anteroposterior and transverse diameters of the abdomen.In conclusion, the adaptive capabilities of IAV related to the foetal growth are limited by the IAV reserve. The reserve capacity of the IAV and tensile properties of the abdominal wall can be estimated by the dynamics of the anteroposterior and transverse abdominal diameters.IMPACT STATEMENTWhat is already known on this subject? A causal relationship between intra-abdominal hypertension and the development of adverse obstetric and perinatal outcomes has been suggested. Nevertheless, the role of this condition as a leading cause of systemic dysfunction during pregnancy remains unrecognised and underestimated.What do the results of this study add? This study assesses the dynamics of IAV in uncomplicated singleton pregnancies.What are the implications of these findings for clinical practice and/or further research? The study of abdominal pressure indicators such as intra-abdominal volume and compliance will help to a better understand the aetiology, pathophysiology, prognosis and treatment strategies for pregnant women with intra-abdominal hypertension.
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Affiliation(s)
- Aleksei Petrovich Petrenko
- Institut Clinic of Gynecology, Obstetrics and Neonatology, Faculty of Medicine-University of Barcelona, Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Emergency Anesthesiology-Resuscitation Care and Simulation Technologies in Medicine, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation.,City Clinical Hospital No. 1 named after Y.Ya. Gordeev, Saratov, Russian Federation
| | - Camil Castelo-Branco
- Institut Clinic of Gynecology, Obstetrics and Neonatology, Faculty of Medicine-University of Barcelona, Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Dimitry Vasilevich Marshalov
- Department of Emergency Anesthesiology-Resuscitation Care and Simulation Technologies in Medicine, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation.,City Clinical Hospital No. 1 named after Y.Ya. Gordeev, Saratov, Russian Federation
| | - Alexander Valerievich Kuligin
- Department of Emergency Anesthesiology-Resuscitation Care and Simulation Technologies in Medicine, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation
| | | | - Efim Munevich Shifman
- Department of Anesthesiology and Critical Care, State Budgetary Healthcare Institution of Moscow Region, M. F. Vladimirskiy Moscow's Regional Research Clinical Institute, Moscow, Russian Federation
| | - Adam Muhamed Rasulovich Abdulaev
- Department of Emergency Anesthesiology-Resuscitation Care and Simulation Technologies in Medicine, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation.,City Clinical Hospital No. 1 named after Y.Ya. Gordeev, Saratov, Russian Federation
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Song YM, Lee K. Comparison of the associations between appendicular lean mass adjustment methods and cardiometabolic factors. Nutr Metab Cardiovasc Dis 2020; 30:2271-2278. [PMID: 32980247 DOI: 10.1016/j.numecd.2020.07.036] [Citation(s) in RCA: 6] [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] [Received: 03/20/2020] [Revised: 06/28/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS To compare the cross-sectional and longitudinal associations between appendicular lean mass (ALM) and cardiometabolic risk factors according to body-size adjustment methods and the contributions of genetic and/or environmental factors to the correlations between those traits. METHODS AND RESULTS Regression coefficients per sex-specific 1 standard deviation in bodyweight (wt), body mass index (BMI), or height-squared (ht2) adjusted ALM (assessed using a dual-energy X-ray absorptiometer (DXA) and a bioelectrical impedance analyzer (BIA) at baseline)/changes in these indices (assessed using BIA) were compared in terms of their associations with blood pressure (BP), lipid profiles, and insulin resistance profiles in 2655 participants for cross-sectional analysis and 332 participants for longitudinal analysis (follow-up time, 32.2 ± 7.9 months). A bivariate genetic analysis of the genetic/environmental cross-trait correlations was conducted to determine their cross-sectional relationships. After adjusting for sociodemographic factors, health behaviors, and BMI in the analysis for ALM/ht2, ALM/wt and ALM/BMI had favorable associations with all cardiometabolic risk factors, while ALM/ht2 had favorable associations with some risk factors. In longitudinal associations, changes in ALM/wt and ALM/BMI had inverse associations with increments of lipid profiles, insulin, and homeostasis model assessment of insulin resistance (HOMA), while change in ALM/ht2 did not have associations with increments of cardiometabolic risk factors. ALM/ht2 had genetic correlations with seven of nine risk factors; ALM/wt and ALM/BMI had correlations with three and one risk factors, respectively. CONCLUSION ALM/wt and ALM/BMI are better indicators for cardiometabolic risk factors; genetic factors may contribute more to the correlations between ALM/ht2 and those traits.
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Affiliation(s)
- Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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Weight Loss After Sleeve Gastrectomy: Does Type 2 Diabetes Status Impact Weight and Body Composition Trajectories? Obes Surg 2020; 31:1046-1054. [PMID: 33146869 DOI: 10.1007/s11695-020-05075-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION/ PURPOSE Sleeve gastrectomy (SG), the most frequently performed bariatric procedure, induces marked weight-loss, but with high inter-individual variability. Since type 2 diabetes (T2D) negatively impacts weight-loss outcomes after Roux-en-Y gastric bypass (RYGB), we herein aimed to evaluate whether and how T2D status may influence weight-loss and body composition changes in individuals with or without T2D after SG. MATERIAL AND METHODS We retrospectively included individuals with obesity operated from SG and prospectively followed at our center: 373 patients including 152 with T2D (40%). All subjects' clinical characteristics were collected before and during 4 years of follow-up post-SG. Linear mixed models were applied to analyze weight-loss trajectories post-surgery. RESULTS Compared to individuals with obesity but no T2D, those with T2D before SG displayed lower weight-loss at 1 year (21 vs. 27% from baseline, p < 10-3). This difference was accentuated in patients with poorer glucose control (HbA1c > 7%) at baseline. Furthermore, patients with T2D underwent less favorable body composition changes at 1-year post-SG compared to individuals without T2D (% fat mass reduction: 28 vs. 37%, p < 10-3 respectively). CONCLUSION When undergoing SG, subjects with obesity and T2D who have poor pre-operative glycemic control display reduced weight-loss and less improvement in body composition compared to patients with obesity but without T2D. This result suggests that glycemic control prior to surgery is important to take into account for the outcome of bariatric surgery.
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Luis de Moraes Ferrari G, Kovalskys I, Fisberg M, Gomez G, Rigotti A, Sanabria LYC, García MCY, Torres RGP, Herrera-Cuenca M, Zimberg IZ, Guajardo V, Pratt M, Pires C, Solé D. Association of moderate-to-vigorous physical activity with neck circumference in eight Latin American countries. BMC Public Health 2019; 19:809. [PMID: 31234866 PMCID: PMC6591862 DOI: 10.1186/s12889-019-7153-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity is a cornerstone in the prevention and treatment of obesity. There are relatively few studies that explore the effect of accelerometer-determined moderate-to-vigorous physical activity (MVPA) on neck circumference (NC), most of them confined to single high-income countries. The present study investigated the association of accelerometer-determined MVPA with NC in adolescents and adults from eight Latin American countries, which are mostly upper-middle income countries. METHODS The sample consisted of 2370 participants (47.8% male) from the Latin American Study of Nutrition and Health, a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Times (min/day) in MVPA (defined as time accumulated at ≥1952 activity counts/min) was assessed by ActiGraph GT3X+ accelerometer over 7 days. NC for adolescent was categorized as abnormal if circumference was > 34.5 cm for boys and > 31.25 for girls, whereas for adults the cut-off points for abnormal were > 39 cm for men and > 35 cm women. Multilevel logistic models, including country and region as random effects and adjusted for sex, age, socioeconomic level, and educational level, were used to study the association between MVPA and NC. RESULTS The average time of MVPA was 34.88 min/day, ranging from 31.16 in Venezuela to 40.27 in Chile. Concerning NC, 37.0% of the sample was classified as having elevated NC. Chile was the country with the highest percentage of people with elevated NC (56.9%), and Colombia had the lowest percentage (24.8%). Overall, the MVPA (min/day) was associated with elevated NC (OR = 0.994, CI95% = 0.990-0.998). In Costa Rica and Peru, there were significant associations between MVPA and NC when analyzed by country. CONCLUSIONS The present study provided evidence of significant associations between MVPA and NC in adolescents and adults from Latin America, independent of sex, age, socioeconomic level, and educational level. This analysis of accelerometry data and NC represents the first examination of these associations in eight Latin America countries. Further research is required to understand the differences between countries in the observed associations. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Luis de Moraes Ferrari
- Centro de Investigación en Fisiologia del Ejercicio-CIFE, Universidad Mayor, José Toribio Medina, 29. Estacion Central, Santiago, Chile
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, da Universidade Federal de São Paulo, São Paulo, Brazil
| | - Irina Kovalskys
- Commitee of Nutrition and WellbeingInternational Life Science Institute, Buenos Aires, Argentina
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
- Departamento de Pediatria, da Universidade Federal de São Paulo, São Paulo, Brazil
| | - Georgina Gomez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | | | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela/Fundación Bengoa, Caracas, Venezuela
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Viviana Guajardo
- Commitee of Nutrition and WellbeingInternational Life Science Institute, Buenos Aires, Argentina
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, La Jolla, CA USA
| | - Carlos Pires
- Centre for Mathematics of the University of Trás-os-Montes e Alto Douro (CM-UTAD), Vila Real, Portugal
| | - Dirceu Solé
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria, da Universidade Federal de São Paulo, São Paulo, Brazil
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Tal S, Litovchik I, Klar MM, Maresky HS, Grysman N, Wiser I, Vitkon-Barkay I, Marcus G, Tzuman O, Pereg D, Rum V, Ziv-Baran T, Fuchs S, Minha S. The association between neck adiposity and long-term outcome. PLoS One 2019; 14:e0215538. [PMID: 31013323 PMCID: PMC6478301 DOI: 10.1371/journal.pone.0215538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/03/2019] [Indexed: 01/06/2023] Open
Abstract
Anthropometric indices of obesity (e.g. body mass index, waist circumference and neck circumference) are associated with poor long-term cardiovascular outcome. Prior studies have associated neck circumference and central body adiposity. We explored the association between neck fat volume (NFV) and long-term cardiovascular outcome. The study provides a retrospective analysis of all patients undergoing computerized tomography angiography for suspected cerebrovascular accident between January and December 2013. NFV was assessed by three dimensional reconstructions and was adjusted to height to account for differences in body sizes, thus yielding the NFV/height ratio (NHR). Univariate and multivariate analysis were utilized to explore the association between various indices including NHR and all-cause mortality. The analysis included 302 patients. The average age was 61.9±14.3 years, 60.6% of male gender. Diabetes mellitus, hypertension and cardiovascular disease were frequent in 31.5%, 69.9%, and 72.2% of patients, respectively. The median NHR was 492.53cm2 [IQR 393.93–607.82]. Median follow up time was 41.2 months, during which 40 patients (13.2%) died. Multivariate analysis adjusting for age, sex, and diabetes mellitus indicated an independent association between the upper quartile of NHR and all-cause mortality (hazard ratio = 2.279; 95% CI = 1.209–4.299; p = .011). NHR is a readily available anthropometric index which significantly correlated with poor long-term outcome. Following validation in larger scale studies, this index may serve a risk stratifying tool for cardiovascular disease and future outcome.
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Affiliation(s)
- Sigal Tal
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ilya Litovchik
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Miriam M. Klar
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Hillel S. Maresky
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Medical Imaging, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Noam Grysman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO, United States of America
| | - Itay Wiser
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Plastic and Reconstructive Surgery, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Itzhak Vitkon-Barkay
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Gil Marcus
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Oran Tzuman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assuta Medical Center, Ashdod, Israel
| | - David Pereg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| | - Victoria Rum
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventative Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shmuel Fuchs
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Sa’ar Minha
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
- * E-mail:
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12
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Albassam RS, Sabico S, Alnaami AM, Khattak MNK, Lei KY, Al-Daghri NM, Reginster JY, Alokail MS. Bone metabolism markers are associated with neck circumference in adult Arab women. Osteoporos Int 2019; 30:845-852. [PMID: 30613867 DOI: 10.1007/s00198-018-04830-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
UNLABELLED The study aimed to determine whether neck circumference is associated with bone metabolism markers among adult Arab women and found modest but significant associations with bone resorption markers, suggesting that neck circumference, a surrogate measure of upper subcutaneous fat, influences bone turnover expression among adult females. INTRODUCTION Body fat distribution is associated with decreased bone resorption and neck circumference (NC), a surrogate measure for upper body fat, has never been tested as a marker that can reflect bone turnover. This is the first study aimed to analyze the associations between NC and several bone biomarkers among adult Saudi women. METHODS This cross-sectional study included a total of 265 middle-aged Saudi women [86 non-obese (mean age 52.7 ± 8.1; mean BMI 26.9 ± 2.3) and 179 obese (mean age 50.6 ± 7.5; mean BMI 35.7 ± 4.5)] recruited from primary care centers in Riyadh, Saudi Arabia. Anthropometrics included BMI, NC, waist and hip circumferences, total body fat percentage (%), and blood pressure. Biochemical parameters included glucose and lipid profile which were measured routinely. Serum levels of 25(OH) D, parathyroid hormone, RANKl, sclerostin, C-terminal telopeptide of collagen I (CTX-I), Dkk1, IL1β, osteoprotegerin, osteopontin, and osteocalcin were measured using commercially available assays. RESULTS In all groups, NC was inversely associated with PTH (R = - 0.22; p < 0.05) and positively associated with osteoprotegerin (R = 0.20; p < 0.05) even after adjustments for age and BMI. Using all anthropometric indices as independent variables showed that only NC explained the variance perceived in CTX-I (p = 0.049). In the non-obese, waist-hip ratio (WHR) was significantly associated with sclerostin (R = 0.40; p < 0.05) and body fat was significantly associated with osteopontin (R = 0.42; p < 0.05). CONCLUSION NC is modestly but significantly associated with bone biomarkers, particularly the bone resorption markers, among adult Arab women. The present findings highlight the importance of NC as measure of upper body subcutaneous fat in influencing bone biomarker expression in adult females.
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Affiliation(s)
- R S Albassam
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, 20742, USA
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - S Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
| | - A M Alnaami
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
| | - M N K Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
| | - K Y Lei
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, 20742, USA
| | - N M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia.
| | - J-Y Reginster
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - M S Alokail
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
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13
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Qureshi NK, Hossain T, Hassan MI, Akter N, Rahman MM, Sultana MM, Ashrafuzzaman SM, Latif ZA. Neck Circumference as a Marker of Overweight and Obesity and Cutoff Values for Bangladeshi Adults. Indian J Endocrinol Metab 2017; 21:803-808. [PMID: 29285438 PMCID: PMC5729663 DOI: 10.4103/ijem.ijem_196_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE There are several methods of assessing overweight and obesity. Several studies conducted in different populations indicate that neck circumference (NC) can be used as a simple measure of overweight and obesity. This study was conducted to evaluate NC as a marker of overweight and obesity and to determine respective cutoff values for Bangladeshi male and female participants. RESEARCH DESIGN/MATERIALS AND METHODS This cross-sectional observational study was conducted with during July 2013-June 2014 among randomly selected 871 Bangladeshi participants (male = 496 [56.9%], female = 375 [43.1%], aged >18 years) who visited Outpatient Department of United Hospital, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic disorders, primary health-care centers located in Dhaka, Savar, Gazipur. NC of participants was taken in centimeter to the nearest 1 mm, using plastic tape measure. Main outcome included NC, waist circumferences (WC), body mass index (BMI), and waist: hip ratio (WHR). RESULTS Pearson's correlation coefficients indicated a significant association between NC and height (men, r = 0.33; women, r = 0.28; P < 0.0001), weight (men, r = 0.61; women, r = 0.55; P < 0.0001), BMI (men, r = 0.51; women, r = 0.41; P < 0.0001), WC (men, r = 0.61; women, r = 0.46; P < 0.0001), hip circumference (men, r = 0.61; women, r = 0.44; P < 0.0001), WHR (men, r = 0.22; women, r = 0.18; P < 0.0001). Receiver operating characteristic curve analysis showed that NC ≥34.75 cm in men (area under curve [AUC]: 0.77; P < 0.001) and ≥31.75 cm in women (AUC: 0.62; P < 0.001) were the best cutoff value for BMI ≥23 (overweight). NC ≥35.25 cm in men (AUC: 0.82; P < 0.001) and NC ≥34.25 cm in women (AUC: 0.76; P < 0.001) were the best cutoff value for BMI ≥27.5 (obesity). NC ≥35.25 cm in male (AUC: 0.83; P < 0.001) and NC ≥31.25 cm in women (AUC: 0.65; P < 0.001) were the best cutoff value for WC >90 cm in men and > 80 cm in women, respectively. NC ≥34.45 cm in male (AUC: 0.59; P = 0.001) and NC ≥31.25 cm in women (AUC: 0.66; P = 0.008) were the best cutoff value for WHR >0.9 in men and >0.8 in women, respectively. CONCLUSION NC measurement is a simple, convenient, inexpensive screening measure to identify overweight and obese participants. Men with NC ≥34.75 cm and women with NC ≥31.75 cm are to be considered overweight while men with NC ≥35.25 cm and women with NC ≥34.25 cm are to be considered obese. NC ≥35.25 cm in male and NC ≥31.25 cm in women were the best cutoff value for abdominal obesity.
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Affiliation(s)
- Nazmul Kabir Qureshi
- Department of Endocrinology and Diabetes, National Healthcare Network, Dhaka, Bangladesh
| | - Tanjina Hossain
- Department of Medicine, Green Life Medical College and Hospital, Dhaka, Bangladesh
| | | | - Nazma Akter
- Department of Medicine, MARKS Medical College and Hospital, Dhaka, Bangladesh
| | - Md Mubinur Rahman
- Department of Medicine, Sapporo Dental College and General Hospital, Dhaka, Bangladesh
| | | | - S. M. Ashrafuzzaman
- Department of Endocrinology, Ibrahim Medical College and BIRDEM General Hospital, Dhaka, Bangladesh
| | - Zafar Ahmed Latif
- Department of Endocrinology and BIRDEM Academy, Ibrahim Medical College and BIRDEM General Hospital, Dhaka, Bangladesh
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Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev 2017; 18:715-723. [PMID: 28489290 DOI: 10.1111/obr.12551] [Citation(s) in RCA: 725] [Impact Index Per Article: 103.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 03/20/2017] [Indexed: 02/06/2023]
Abstract
This paper considers the argument for obesity as a chronic relapsing disease process. Obesity is viewed from an epidemiological model, with an agent affecting the host and producing disease. Food is the primary agent, particularly foods that are high in energy density such as fat, or in sugar-sweetened beverages. An abundance of food, low physical activity and several other environmental factors interact with the genetic susceptibility of the host to produce positive energy balance. The majority of this excess energy is stored as fat in enlarged, and often more numerous fat cells, but some lipid may infiltrate other organs such as the liver (ectopic fat). The enlarged fat cells and ectopic fat produce and secrete a variety of metabolic, hormonal and inflammatory products that produce damage in organs such as the arteries, heart, liver, muscle and pancreas. The magnitude of the obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host. Thus, obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe. Reversing obesity will prevent most of its detrimental effects.
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Affiliation(s)
- G A Bray
- Pennington Biomedical Research Center of Louisiana State University, Baton Rouge, Louisiana, USA
| | - K K Kim
- National University of Korea, Seoul, Korea
| | - J P H Wilding
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK
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15
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Assyov Y, Gateva A, Tsakova A, Kamenov Z. A comparison of the clinical usefulness of neck circumference and waist circumference in individuals with severe obesity. Endocr Res 2017; 42:6-14. [PMID: 27050332 DOI: 10.3109/07435800.2016.1155598] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
UNLABELLED Purpose/Aim: Neck circumference (NC) is an emerging anthropometric parameter that has been proposed to reflect metabolic health. The aim of the current study was to compare its clinical usefulness to waist circumference (WC) in the assessment of individuals with severe obesity. MATERIALS AND METHODS A total of 255 subjects participated in the study. All anthropometric measurements were done by a single medical professional. Biochemical measurements included oral glucose-tolerance tests (OGTTs), fasting insulin, lipids, and hepatic enzymes. RESULTS The mean age of the participants was 49 ± 12 years with the mean body mass index (BMI) of 36.9 ± 6.2 kg/m2. Correlation analyses revealed that while WC was better associated with adiposity parameters, it was of little use in comparison to NC with regard to metabolic outcomes. In men, NC was positively associated with fasting plasma glucose, fasting insulin, FINDRISC scores. ROC analyses showed NC was better in distinguishing type 2 diabetes (AUC = 0.758; p < 0.001), insulin resistance (AUC = 0.757; p = 0.001), metabolic syndrome (AUC = 0.724; p < 0.001), and hypertension (AUC = 0.763; p = 0.001). Similar correlations were observed in women. Using binary logistic regression, we determined that a NC of ≥35 cm in women and ≥38 cm in men are valuable cut-off values to use in the everyday practice. CONCLUSION In individuals with severe obesity, NC performs better than WC in the assessment of metabolic health.
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Affiliation(s)
- Yavor Assyov
- a Clinic of Endocrinology , University Hospital "Alexandrovska", Medical University - Sofia , Bulgaria
| | - Antoaneta Gateva
- a Clinic of Endocrinology , University Hospital "Alexandrovska", Medical University - Sofia , Bulgaria
| | - Adelina Tsakova
- b Central Clinical Laboratory , University Hospital "Alexandrovska", Medical University - Sofia , Bulgaria
| | - Zdravko Kamenov
- a Clinic of Endocrinology , University Hospital "Alexandrovska", Medical University - Sofia , Bulgaria
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Selvan C, Dutta D, Thukral A, Nargis T, Kumar M, Mukhopadhyay S, Chowdhury S. Neck height ratio is an important predictor of metabolic syndrome among Asian Indians. Indian J Endocrinol Metab 2016; 20:831-837. [PMID: 27867888 PMCID: PMC5105569 DOI: 10.4103/2230-8210.192927] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND AIMS The predictive potential of neck circumference (NC) based indices (a measure of upper body fat distribution) for predicting metabolic syndrome (MetS) and its components among Indians is not known. This study aimed to evaluate the role of NC and neck height ratio (NHtR) as independent predictors of MetS and its components as compared to traditional anthropometric indices. MATERIALS AND METHODS A total of 451 individuals from 867 screened individuals, 30-80 years age, without any co-morbid state who gave informed written consent underwent clinical, anthropometric, and biochemical assessment. RESULTS Patients with MetS in both the sexes had significantly higher NC, NHtR, glycated hemoglobin, fasting glucose, and dyslipidemia (higher triglycerides, total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, low-density lipoprotein cholesterol/HDL-C ratio, and lower HDL-C). In both sexes, individuals in the highest tertile of NC had significantly greater central and generalized obesity, lower HDL-C, and significantly higher MetS. Receiver operating characteristic analysis revealed waist circumference (WC) to have the largest area under the curve for predicting MetS in both sexes, followed by NHtR, NC, and body mass index. NC and NHtR of >34.9 cm (sensitivity 78.6%; specificity 59.3%) and >21.17 cm/m (sensitivity 80.7% and specificity 64.6%) respectively for men and >31.25 cm (sensitivity 72.3%; specificity 64.4%) and >20.48 cm/m (sensitivity 80.4% and specificity 60%) respectively for women were the best values for identifying MetS. Increased NC and NHtR had odds ratio of 1.52 (95% confidence interval [CI]: 1.37-1.68; P < 0.001) and 1.96 (95% CI: 1.67-2.29; P < 0.001) respectively in identifying MetS. CONCLUSION NC and NHtR are good predictors of MetS and cardiovascular risk factors in Asian Indians. NHtR is reliable and perhaps an even better index than NC with regards to cardiovascular risk prediction.
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Affiliation(s)
- Chitra Selvan
- Department of Endocrinology, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Deep Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Anubhav Thukral
- Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Titli Nargis
- PhD Scholar, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Manoj Kumar
- Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Satinath Mukhopadhyay
- Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Institute of Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
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Abstract
Diet influences many modifiable risk factors for cardiovascular diseases (CVDs). Considering this, moderation of total dietary fat, particularly trans and saturated fats, as well as cholesterol is recommended. Dietary fats should come mainly from plants and fatty fish, providing monounsaturated and polyunsaturated (including omega-3) fatty acids. Carbohydrate sources to emphasize include whole grains, legumes, vegetables, fruits, and other fiber-rich sources, rather than sugars. Although vitamins such as E, C, and some B vitamins are associated with reduced CVD risk, data do not support the use of supplements, but foods rich in these nutrients are advocated. Dietary minerals such as potassium, magnesium, and calcium may be beneficial to heart health, while reduction of dietary sodium decreases risk of hypertension. A large variety of phytonutrients are also associated with reduced CVD risk. Other dietary factors receiving research attention regarding CVD risk. Other dietary factors receiving research attention regarding CVD risk include caffeine, alcobol, and meal frequency, although more work is needed in these areas. In contrast, data are quite robust to support the importance of healthy body weight management in cardiovascular health. In general, diets based on a variety of less processed foods, mainly of plant origin, in the context of an active lifestyle, are conducive to heart health.
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Affiliation(s)
- Kathleen J. Melanson
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston,
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18
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Mondal N, Sen J, Bose K, Timungpi R, Kathar M, Hanse S. Neck circumference as a screening measure of overweight/obesity among Indian adults. ANTHROPOLOGICAL REVIEW 2016. [DOI: 10.1515/anre-2016-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Neck circumference (NC) is an anthropometric measurement of differentiating body fat distributions and a marker of upper subcutaneous adiposity. The present study highlights the association and importance of NC as a suitable proxy screening measure of overweight/obesity as compared to the conventional anthropometric variables used among Indian adults. The present community based cross-sectional study was undertaken among 1169 Karbi adults (males: 625; females: 544) residing in Karbi Anglong district of Assam, Northeast India, who were selected through a multistage stratified random sampling method. Height, weight, waist circumference (WC), hip circumference (HC) and NC were recorded using standard procedures. The body mass index (BMI) was calculated and prevalence of overweight/obesity was assessed using standard cut-offs. The prevalence of obesity using BMI (≥25.00 kg m-2) was 15.52% and 15.26% among males and females, respectively (p≥0.05).The prevalence of obesity using NC was observed to be significantly higher among males (48.80%) than females (19.12%) (p<0.01). The binary logistic regression analysis showed that NC predicted obesity over the conventional anthropometric variables with reasonable accuracy (p<0.01). The ROC-AUC analysis showed a relatively greater significant association between BMI, WC and HC and NC for obesity (p<0.01). Thus, NC appears to be a potentially simple, easyto- use screening measure for predicting obesity among adults. Further studies are required to validate its use for screening of obesity among other ethnic populations in India.
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Formisano A, Bammann K, Fraterman A, Hadjigeorgiou C, Herrmann D, Iacoviello L, Marild S, Moreno LA, Nagy P, Van Den Bussche K, Veidebaum T, Lauria F, Siani A. Efficacy of neck circumference to identify metabolic syndrome in 3-10 year-old European children: Results from IDEFICS study. Nutr Metab Cardiovasc Dis 2016; 26:510-516. [PMID: 27089975 DOI: 10.1016/j.numecd.2016.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Several studies demonstrated that larger neck circumference (NC) in children and adolescents may help to identify obesity and cardio-metabolic abnormalities. We aimed to evaluate the correlation between NC and metabolic syndrome (MetS) risk factors and to determine the utility of this anthropometric index to identify MetS in European children. METHODS AND RESULTS The present cross-sectional analysis includes 15,673 children (3-10 years) participating in the IDEFICS study. A continuous MetS (cMetS) score was calculated summing age and sex standardized z-scores of specific MetS risk factors. Receiver Operating Characteristic analysis, stratified by one-year age groups, was used to determine the ability of NC to identify children with unfavorable metabolic profile, corresponding to cMetS score ≥ 90th percentile. The areas under the curve values for NC associated with cMetS score values ≥ 90th percentile were significantly greater in girls than in boys (p < 0.001), except for 5 < 6 years group. For boys, optimal NC cut-off values ranged from 26.2 cm for the lowest age group (3 < 4 years), up to 30.9 cm for the highest age group (9 < 10 years). In girls, corresponding values varied from 24.9 cm to 29.6 cm. CONCLUSION The study demonstrated the efficacy of NC in identifying European children with an unfavorable metabolic profile.
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Affiliation(s)
- A Formisano
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - K Bammann
- Institute for Public Health and Nursing Science, Bremen University, Bremen, Germany; Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany
| | - A Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany
| | - C Hadjigeorgiou
- Child Health research and educational institute, Strovolos, Cyprus
| | - D Herrmann
- Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH, Bremen, Germany
| | - L Iacoviello
- Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Mediterranean Neurological Institute Neuromed, Pozzilli, Italy
| | - S Marild
- Department of Pediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Sweden
| | - L A Moreno
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - P Nagy
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | | | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - F Lauria
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - A Siani
- Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy.
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Atef A, Ibrahim A, Hassan NE, Elmasry SA, Elashry GI. Neck circumference as a novel screening method for estimating fat distribution and metabolic complications in obese children. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2015. [DOI: 10.1016/j.epag.2015.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Arjmand G, Shidfar F, Molavi Nojoomi M, Amirfarhangi A. Anthropometric Indices and Their Relationship With Coronary Artery Diseases. HEALTH SCOPE 2015. [DOI: 10.17795/jhealthscope-25120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Sarker A, Meek CL, Park A. Biochemical consequences of bariatric surgery for extreme clinical obesity. Ann Clin Biochem 2015; 53:21-31. [DOI: 10.1177/0004563215588116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 01/01/2023]
Abstract
Obesity, defined as a body mass index over 30 kg/m2 for adults, poses a major healthcare challenge with important economic, personal and social consequences. Although public health measures, lifestyle change and pharmacological therapies have an important role in the management of obesity, patients with established morbid obesity (body mass index over 40 kg/m2) may also require bariatric surgery. Bariatric or metabolic surgery is associated with effective and enduring weight loss but is also known to improve glucose homeostasis, blood pressure and dyslipidaemia. Patients who have bariatric surgery need lifelong clinical follow-up to identify and prevent nutritional deficiencies and other complications. Clinical biochemistry laboratories have an important role in the nutritional assessment of obese patients and in the identification of complications following bariatric surgery. The aim of this article is to review the different bariatric procedures available and to summarize their complications, especially nutrient deficiencies and those of particular relevance to clinical biochemistry laboratories.
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Affiliation(s)
- Anita Sarker
- Department of Clinical Biochemistry and Immunology, Cambridge Universities NHS foundation trust, Addenbrooke’s Hospital, Cambridge, UK
| | - Claire L Meek
- Department of Clinical Biochemistry and Immunology, Cambridge Universities NHS foundation trust, Addenbrooke’s Hospital, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Adrian Park
- Department of Clinical Biochemistry and Immunology, Cambridge Universities NHS foundation trust, Addenbrooke’s Hospital, Cambridge, UK
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The role of physical activity in preventing obesity in midlife women. MENOPAUSE REVIEW 2015; 14:13-9. [PMID: 26327883 PMCID: PMC4440193 DOI: 10.5114/pm.2015.49252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/05/2014] [Accepted: 12/08/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Obesity is one of the most common nutrition-related disorders worldwide and one of the major health problems in menopausal women, which significantly worsens the quality of life and can lead to severe diseases or even premature death. The aim of the study was to evaluate the relation between physical activity in different domains undertaken by menopausal women while performing daily activities and their body mass index (BMI). MATERIAL AND METHODS The study was conducted on a random sample of 400 healthy Polish women aged 45-55. The questionnaire contained questions concerning the respondents' socio-economic status, medical history and the long format of the International Physical Activity Questionnaire was used. RESULTS Fifty-one percent (50.6%) of women had normal body mass, 43.75% of respondents were overweighed and 5.65% of women were obese. A moderate physical activity level was presented by most midlife women in domestic and garden domain, active transportation and leisure time. Pearson's correlation showed that such factors as age, education and physical activity level in different domains have a significant correlation with BMI. CONCLUSIONS Most respondents presented a moderate physical activity level in all domains except work, where the respondents had a high physical activity (PA) level. A high PA level especially at work (r = -0.5788) and during leisure time (r = -0.5175) strongly correlate with lower BMI.
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Pereira DCR, de Araújo MFM, de Freitas RWJF, Teixeira CRDS, Zanetti ML, Damasceno MMC. Neck circumference as a potential marker of metabolic syndrome among college students. Rev Lat Am Enfermagem 2014; 22:973-9. [PMID: 25591092 PMCID: PMC4309232 DOI: 10.1590/0104-1169.3565.2505] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 07/10/2014] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE to relate neck circumference with metabolic syndrome and its criteria among college students. METHOD cross-sectional study conducted with 702 college students in Fortaleza, CE, Brazil from September 2010 to June 2011. Socio-demographic data, waist circumference and neck circumference were collected together with blood pressure, fasting blood sugar, triglyceride levels, and HDL-C. RESULTS 1.7% of the studied sample presented metabolic syndrome. Of these, 58.3% presented altered neck circumference (p<0.006). As neck circumference decreases, pressure levels improve (p<0.001). Additionally, college students with high fasting blood sugar (p=0.003) and high triglyceride levels (p<0.001) presented higher values of neck circumference. CONCLUSION neck circumference is a potential predictive marker in the detection of metabolic syndrome and its components among college students.
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Affiliation(s)
| | - Márcio Flávio Moura de Araújo
- PhD, Adjunct Professor, Instituto de Ciências da Saúde, Universidade da
Integração Internacional da Lusofonia Afro Brasileira, Redenção, CE,
Brasil
| | | | - Carla Regina de Souza Teixeira
- PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto,
Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development,
Ribeirão Preto, SP, Brazil
| | - Maria Lúcia Zanetti
- PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto,
Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development,
Ribeirão Preto, SP, Brazil
| | - Marta Maria Coelho Damasceno
- PhD, Adjunct Professor, Faculdade de Farmácia Odontologia e Enfermagem,
Universidade Federal do Ceará, Fortaleza, CE, Brazil
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Bespalova ID, Ryazantseva NV, Kalyuzhin VV, Osikhov IA, Murashev BY, Medyantsev YA, Rudnitsky VA. GENDER FEATURES OF INTERACTION HORMONAL ACTIVITY ADIPOSE TISSUE AND PROINFLAMMATORY STATUS IN HYPERTENSION WITH METABOLIC SYNDROME. BULLETIN OF SIBERIAN MEDICINE 2014. [DOI: 10.20538/1682-0363-2014-5-12-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | | | | | - Yu. A. Medyantsev
- Municipal Healthcare Institution “Tomsk Central Regional Hospital”, Tomsk
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Bespalova ID, Bychkov VA, Kalyuzhin VV, Ryazantseva NV, Medyantsev YA, Osikhov IA, Murashev BY. QUALITY OF LIFE IN HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME: INTERRELATION WITH MARKERS OF SYSTEMIC INFLAMMATION. BULLETIN OF SIBERIAN MEDICINE 2013. [DOI: 10.20538/1682-0363-2013-6-5-11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Object of research: to study the interrelation of activity of systemic inflammatory response and quality of life (QOL) and evidence of metabolic disorders in hypertensive patients with metabolic syndrome (MS).Material and methods.We carried out a study of 86 patients with hypertensive disease of II stage in combination with MS and 18 volunteers, who formed the control group. Along with a complete clinical, laboratory and instrumental examination, taken in a specialized cardiology clinic, the study of QOL using the MOS SF-36 questionnaire was carried out, as well as the research of activity of systemic inflammato-ry response.Results.We determined the reverse correlative interrelation of QOL indicators with all MS components, such as abdominal obesity, hyperglycemia, hypertriglyceridemia, the degree of arterial hypertension, but also with the level of markers of systemic inflammation (C-reactive protein, neopterin and fibrinogen), hyperinsulinemia and hyperleptinemia. It was found out that physical functioning (PF) has the strongest interrelations with the maximum number of clinical and laboratory indicators of MS and all the studied markers of systemic inflammation.
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Luconi M, Samavat J, Seghieri G, Iannuzzi G, Lucchese M, Rotella C, Forti G, Maggi M, Mannucci E. Determinants of testosterone recovery after bariatric surgery: is it only a matter of reduction of body mass index? Fertil Steril 2013; 99:1872-9.e1. [DOI: 10.1016/j.fertnstert.2013.02.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 02/20/2013] [Accepted: 02/20/2013] [Indexed: 10/27/2022]
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Bray GA. Why do we need drugs to treat the patient with obesity? Obesity (Silver Spring) 2013; 21:893-9. [PMID: 23520198 DOI: 10.1002/oby.20394] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 01/14/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Obesity is a public health problem, which increases the risk of chronic diseases and mortality. Weight loss can reduce mortality and improve most of the detrimental health consequences of obesity. DESIGN AND METHODS This paper was developed from two presentations to the US Food and Drug Administration (FDA), which has responsibility for reviewing and approving drugs to treat obesity. RESULTS A weight loss of 5% or more is sufficient to significantly reduce health risks in individuals with impaired glucose tolerance, hypertension, or nonalcoholic fatty liver disease. Slightly more weight loss (16% on average, achieved by surgery) reduces mortality. The goal of medicating for obesity is to help more patients achieve more weight loss. A barrier to drug approval has been the concern that weight loss medications might be used by individuals with little or no health risks, thus mandating a low side effect profile for approval of any drug. This limits the options for patients who have obesity-related health problems that could improve with weight loss. Recently the FDA signaled interest in identifying health benefits in higher risk patients that might justify medications with higher risk; however, the potential impact on a large segment of the population has led the FDA to consider requiring a cardiovascular outcome trial for all obesity medications, either prior to or after approval. CONCLUSION This review argues that drugs are needed for obesity because they enhance behaviorally induced weight loss and that new medications for obesity are needed in the approval process.
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Affiliation(s)
- George A Bray
- Pennington Biomedical Research Center Baton Rouge, LA, USA.
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Lira FS, De Souza CT. Inflammatory status in obesity: emergent predictors. Int J Clin Pract 2013; 67:193-4. [PMID: 23409686 DOI: 10.1111/ijcp.12073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Peters S, Bird L, Ashraf H, Ahmed S, McNamee P, Ng C, Hart J. Medical undergraduates' use of behaviour change talk: the example of facilitating weight management. BMC MEDICAL EDUCATION 2013; 13:7. [PMID: 23347344 PMCID: PMC3626629 DOI: 10.1186/1472-6920-13-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 01/15/2013] [Indexed: 05/11/2023]
Abstract
BACKGROUND Obesity, an increasing problem worldwide, is a leading cause of morbidity and mortality. Management principally requires lifestyle (i.e. behavioural) changes. An evidence-base exists of behaviour change techniques for weight loss; however, in routine practice doctors are often unsure about effective treatments and commonly use theoretically-unfounded communication strategies (e.g. information-giving). It is not known if communication skills teaching during undergraduate training adequately prepares future doctors to engage in effective behaviour change talk with patients. The aim of the study was to examine which behaviour change techniques medical undergraduates use to facilitate lifestyle adjustments in obese patients. METHODS Forty-eight medical trainees in their clinical years of a UK medical school conducted two simulated consultations each. Both consultations involved an obese patient scenario where weight loss was indicated. Use of simulated patients (SPs) ensured standardisation of key variables (e.g. barriers to behaviour change). Presentation of scenario order was counterbalanced. Following each consultation, students assessed the techniques they perceived themselves to have used. SPs rated the extent to which they intended to make behavioural changes and why. Anonymised transcripts of the audiotaped consultations were coded by independent assessors, blind to student and SP ratings, using a validated behaviour change taxonomy. RESULTS Students reported using a wide range of evidence-based techniques. In contrast, codings of observed communication behaviours were limited. SPs behavioural intention varied and a range of helpful elements of student's communication were revealed. CONCLUSIONS Current skills-based communication programmes do not adequately prepare future doctors for the growing task of facilitating weight management. Students are able to generalise some communication skills to these encounters, but are over confident and have limited ability to use evidence-based theoretically informed techniques. They recognise this as a learning need. Educators will need to tackle the challenges of integrating theoretically informed and evidence based behaviour change talk within medical training.
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Affiliation(s)
- Sarah Peters
- Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Louisa Bird
- North Western Deanery, Greater Manchester, UK
| | - Hamaira Ashraf
- Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Sehar Ahmed
- Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Philip McNamee
- Medical School, University of Manchester, Manchester, UK
| | - Cassandra Ng
- Medical School, University of Manchester, Manchester, UK
| | - Jo Hart
- Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK
- Medical School, University of Manchester, Manchester, UK
- UHSM Academy, Education and Research Centre, University Hospital of South Manchester, Southmoor Rd, Wyhenshawe Hospital, Manchester, M23 9LT, UK
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Vallianou NG, Evangelopoulos AA, Bountziouka V, Vogiatzakis ED, Bonou MS, Barbetseas J, Avgerinos PC, Panagiotakos DB. Neck circumference is correlated with triglycerides and inversely related with HDL cholesterol beyond BMI and waist circumference. Diabetes Metab Res Rev 2013; 29:90-7. [PMID: 23135790 DOI: 10.1002/dmrr.2369] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 08/31/2012] [Accepted: 10/23/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Neck circumference, beyond a measure of obesity, is a unique fat depot with increasing significance. This study aimed to investigate the association between neck circumference and biomarkers, indicators of cardiovascular risk. METHODS During 2009, 490 volunteers (46 ± 16 years, 40% men) were consecutively enrolled to the study (participation rate 85%). Biochemical analyses were performed through established procedures, and after 12-h fasting and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, cystatin C, uric acid and high-sensitivity C-reactive protein were measured. Anthropometric, lifestyle and dietary characteristics were also recorded to account for potential confounders. Additive linear and logistic regression models were used to evaluate the association between neck circumference and biomarkers of cardiometabolic risk. RESULTS A positive association between neck circumference and systolic and diastolic blood pressure, glucose, triglycerides, uric acid and high-sensitivity C-reactive protein, and a negative association with high-density lipoprotein cholesterol were revealed (all ps < 0.05); models were adjusted for age, gender, years of school, smoking, physical activity status, MedDietScore and alcohol intake. The relationship between neck circumference and high-density lipoprotein cholesterol, glucose, triglycerides and uric acid remained significant when models were further stratified by body mass index class and abnormal waist circumference. CONCLUSION Neck circumference was found to be a powerful indicator of atherogenic dyslipidaemia above and beyond central obesity indicators.
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Olivier M. Body fat distribution, lipoprotein metabolism, and insulin resistance: A lifetime of research on the pathophysiology of the human metabolic syndrome. J Clin Lipidol 2012; 6:601-3. [DOI: 10.1016/j.jacl.2012.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 08/23/2012] [Indexed: 11/28/2022]
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Mercado DL, Stefan M, Liu X. Bariatric Surgery. Perioper Med (Lond) 2012. [DOI: 10.1002/9781118375372.ch25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kurtoglu S, Hatipoglu N, Mazicioglu MM, Kondolot M. Neck circumference as a novel parameter to determine metabolic risk factors in obese children. Eur J Clin Invest 2012; 42:623-30. [PMID: 22129208 DOI: 10.1111/j.1365-2362.2011.02627.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND To establish the association between neck circumference and cardiometabolic risk factors and to determine the utility of the neck circumference as a parameter in predicting children at cardiometabolic risk. MATERIALS AND METHODS Five - hundred and eighty-one children (461: overweight/obese, 120: normal body mass index) aged between 5 and 18 years were enrolled. Neck circumference, waist circumference, blood pressure and fasting plasma glucose, insulin, total cholesterol, triglyceride and high-density lipoprotein (HDL) cholesterol were recorded, and the homeostasis model assessment for insulin resistance score was calculated. RESULTS Neck circumference was negatively correlated with HDL cholesterol and positively correlated with all other parameters, with the exception of fasting plasma glucose in pubertal boys and girls and total cholesterol in pubertal girls. Linear regression analysis by designating neck circumference as a dependent variable revealed that insulin and TG levels in prepubertal boys and blood pressure and TG levels in pubertal boys were positively correlated with neck circumference. We found that diastolic blood pressure and insulin were positively correlated, while HDL levels were negatively correlated with neck circumference in prepubertal girls. Systolic blood pressure and insulin were positively correlated with neck circumference in pubertal girls. The cut-off value for neck circumference, as an indicator for metabolic syndrome (MS), was calculated as 36 cm in boys and 35 cm in girls. CONCLUSIONS Neck circumference measurement was shown to be associated with cardiometabolic risk factors in children. We suggest the use of neck circumference as a novel, simple, practical and reliable anthropometric index in predicting children at risk for cardiometabolic diseases.
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Affiliation(s)
- Selim Kurtoglu
- Department of Pediatric Endocrinology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Proimos E, Kiagiadaki D, Kaprana A, Chimona TS, Maroudias NJ, Papadakis CE. Clinical Application of Subjective Measurements for OSAS Assessment: Predictive Factors of Syndrome Severity. ACTA ACUST UNITED AC 2012; 74:240-5. [DOI: 10.1159/000342278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 07/02/2012] [Indexed: 12/24/2022]
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Murr M, Rafiei A, Ajami H, Fakhry TK. Overview of emerging concepts in metabolic surgery. Perm J 2011; 14:57-62. [PMID: 20844706 DOI: 10.7812/tpp/10-037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, Hill JO, Brancati FL, Peters A, Wagenknecht L. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 2011; 34:1481-6. [PMID: 21593294 PMCID: PMC3120182 DOI: 10.2337/dc10-2415] [Citation(s) in RCA: 1159] [Impact Index Per Article: 89.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Overweight and obese individuals are encouraged to lose 5-10% of their body weight to improve cardiovascular disease (CVD) risk, but data supporting this recommendation are limited, particularly for individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted an observational analysis of participants in the Look AHEAD (Action For Health in Diabetes) study (n=5,145, 40.5% male, 37% from ethnic/racial minorities) and examined the association between the magnitude of weight loss and changes in CVD risk factors at 1 year and the odds of meeting predefined criteria for clinically significant improvements in risk factors in individuals with type 2 diabetes. RESULTS The magnitude of weight loss at 1 year was strongly (P<0.0001) associated with improvements in glycemia, blood pressure, triglycerides, and HDL cholesterol but not with LDL cholesterol (P=0.79). Compared with weight-stable participants, those who lost 5 to <10% ([means±SD] 7.25±2.1 kg) of their body weight had increased odds of achieving a 0.5% point reduction in HbA1c (odds ratio 3.52 [95% CI 2.81-4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20-1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27-1.91]), a 5 mg/dL increase in HDL cholesterol (1.69 [1.37-2.07]), and a 40 mg/dL decrease in triglycerides (2.20 [1.71-2.83]). The odds of clinically significant improvements in most risk factors were even greater in those who lost 10-15% of their body weight. CONCLUSIONS Modest weight losses of 5 to <10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.
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Affiliation(s)
- Rena R Wing
- Department of Psychiatry and Human Behavior, Brown Medical School, The Miriam Hospital, Providence, Rhode Island, USA.
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Blood profiling of proteins and steroids during weight maintenance with manipulation of dietary protein level and glycaemic index. Br J Nutr 2011; 107:106-19. [PMID: 21733334 DOI: 10.1017/s0007114511002583] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Weight regain after weight loss is common. In the Diogenes dietary intervention study, a high-protein and low-glycaemic index (GI) diet improved weight maintenance. The objective of the present study was to identify (1) blood profiles associated with continued weight loss and weight regain (2) blood biomarkers of dietary protein and GI levels during the weight-maintenance phase. Blood samples were collected at baseline, after 8 weeks of low-energy diet-induced weight loss and after a 6-month dietary intervention period from female continued weight losers (n 48) and weight regainers (n 48), evenly selected from four dietary groups that varied in protein and GI levels. The blood concentrations of twenty-nine proteins and three steroid hormones were measured. The changes in analytes during weight maintenance largely correlated negatively with the changes during weight loss, with some differences between continued weight losers and weight regainers. Increases in leptin (LEP) and C-reactive protein (CRP) were significantly associated with weight regain (P < 0·001 and P = 0·005, respectively), and these relationships were influenced by the diet. Consuming a high-protein and high-GI diet dissociated the positive relationship between the change in LEP concentration and weight regain. CRP increased during the weight-maintenance period only in weight regainers with a high-protein diet (P < 0·001). In addition, testosterone, luteinising hormone, angiotensinogen, plasminogen activator inhibitor-1, resistin, retinol-binding protein 4, insulin, glucagon, haptoglobin and growth hormone were also affected by the dietary intervention. The blood profile reflects not only the weight change during the maintenance period, but also the macronutrient composition of the dietary intervention, especially the protein level.
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Targeting 5-HT receptors for the treatment of obesity. Curr Opin Pharmacol 2011; 11:52-8. [DOI: 10.1016/j.coph.2011.01.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 01/24/2011] [Accepted: 01/25/2011] [Indexed: 01/09/2023]
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Benatti FB, Lira FS, Oyama LM, do Nascimento CMDPO, Lancha AH. Strategies for reducing body fat mass: effects of liposuction and exercise on cardiovascular risk factors and adiposity. Diabetes Metab Syndr Obes 2011; 4:141-54. [PMID: 21779146 PMCID: PMC3138146 DOI: 10.2147/dmso.s12143] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Indexed: 11/26/2022] Open
Abstract
Liposuction is the most popular aesthetic surgery performed in Brazil and worldwide. Evidence showing that adipose tissue is a metabolically active tissue has led to the suggestion that liposuction could be a viable method for improving metabolic profile through the immediate loss of adipose tissue. However, the immediate liposuction-induced increase in the proportion of visceral to subcutaneous adipose tissue could be detrimental to metabolism, because a high proportion of visceral to subcutaneous adipose tissue is associated with risk factors for cardiovascular disease. The results of studies investigating the effects of liposuction on the metabolic profile are inconsistent, however, with most studies reporting either no change or improvements in one or more cardiovascular risk factors. In addition, animal studies have demonstrated a compensatory growth of intact adipose tissue in response to lipectomy, although studies with humans have reported inconsistent results. Exercise training improves insulin sensitivity, inflammatory balance, lipid oxidation, and adipose tissue distribution; increases or preserves the fat-free mass; and increases total energy expenditure. Thus, liposuction and exercise appear to directly affect metabolism in similar ways, which suggests a possible interaction between these two strategies. To our knowledge, no studies have reported the associated effects of liposuction and exercise in humans. Nonetheless, one could suggest that exercise training associated with liposuction could attenuate or even block the possible compensatory fat deposition in intact depots or regrowth of the fat mass and exert an additive or even a synergistic effect to liposuction on improving insulin sensitivity and the inflammatory balance, resulting in an improvement of cardiovascular risk factors. Consequently, one could suggest that liposuction and exercise appear to be safe and effective strategies for either the treatment of metabolic disorders or aesthetic purposes.
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Affiliation(s)
- Fabiana Braga Benatti
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
- Correspondence: Fabiana Braga Benatti, Av. Professor Mello Moraes, 65, CEP 05508-030, Sao Paulo, SP, Brazil, Tel +55 11 3091 3096, Fax +55 11 3813 5921, Email
| | - Fábio Santos Lira
- Department of Physiology, Division of Nutrition Physiology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Lila Missae Oyama
- Department of Physiology, Division of Nutrition Physiology, Federal University of Sao Paulo, Sao Paulo, Brazil
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Surman MD, Freeman EE, Grabowski JF, Hadden M, Henderson AJ, Jiang G, Jiang X(M, Luche M, Khmelnitsky Y, Vickers S, Viggers J, Cheetham S, Guzzo PR. 5-(Pyridinon-1-yl)indazoles and 5-(furopyridinon-5-yl)indazoles as MCH-1 antagonists. Bioorg Med Chem Lett 2010; 20:7015-9. [DOI: 10.1016/j.bmcl.2010.09.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 09/03/2010] [Accepted: 09/08/2010] [Indexed: 11/26/2022]
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Delling L, Karason K, Olbers T, Sjöström D, Wahlstrand B, Carlsson B, Carlsson L, Narbro K, Karlsson J, Behre CJ, Sjöström L, Stenlöf K. Feasibility of bariatric surgery as a strategy for secondary prevention in cardiovascular disease: a report from the Swedish obese subjects trial. J Obes 2010; 2010:102341. [PMID: 20847932 PMCID: PMC2931372 DOI: 10.1155/2010/102341] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 06/08/2010] [Indexed: 01/14/2023] Open
Abstract
Aims. Evaluation of bariatric surgery as secondary prevention in obese patients with ischemic heart disease (IHD). Methods. Analysis of data from 4047 subjects in the Swedish Obese Subjects (SOSs) study. Thirty-five patients with IHD are treated with bariatric surgery (n = 21) or conventional treatment (n = 14). Mean follow-up is 10.8 years. Results. Bariatric surgery resulted in sustained weight loss during the study period. After 2 years, the surgery group displayed significant reductions in cardiovascular risk factors, relief from cardiorespiratory symptoms, increments in physical activity, and improved quality of life. After 10 years, recovery from hypertension, diabetes, physical inactivity, and depression was still more common in the surgery group. There were no signs of increased cardiovascular morbidity or mortality in the surgery group. Conclusion. Bariatric surgery appears to be a safe and feasible treatment to achieve long-term weight loss and improvement in cardiovascular risk factors, symptoms, and quality of life in obese subjects with IHD.
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Affiliation(s)
- Lotta Delling
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
- *Lotta Delling:
| | - Kristjan Karason
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Torsten Olbers
- Department of Surgery, The Sahlgrenska Academy, University of Gothenburg, SE-413 45 Göteborg, Sweden
| | - David Sjöström
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Björn Wahlstrand
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Björn Carlsson
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Lena Carlsson
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Kristina Narbro
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
- Department of Health Care, Regional Secretariat, Västra Götaland Region, SE-405 44 Göteborg, Sweden
| | - Jan Karlsson
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Carl Johan Behre
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Lars Sjöström
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
| | - Kaj Stenlöf
- Department of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45 Göteborg, Sweden
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Risérus U, de Faire U, Berglund L, Hellénius ML. Sagittal abdominal diameter as a screening tool in clinical research: cutoffs for cardiometabolic risk. J Obes 2010; 2010:757939. [PMID: 20798888 PMCID: PMC2925288 DOI: 10.1155/2010/757939] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 12/27/2009] [Accepted: 02/03/2010] [Indexed: 11/17/2022] Open
Abstract
Background. Waist girth and BMI are commonly used as markers of cardiometabolic risk. Accumulating data however suggest that sagittal abdominal diameter (SAD) or "abdominal height" may be a better marker of intra-abdominal adiposity and cardiometabolic risk. We aimed to identify cutoffs for SAD using a cardiometabolic risk score. Design. A population-based cross-sectional study. Methods. In 4032 subjects (1936 men and 2096 women) at age 60, different anthropometric variables (SAD, BMI, waist girth, and waist-to-hip ratio) were measured and cardiometabolic risk score calculated. ROC curves were used to assess cutoffs. Results. Among men SAD showed the strongest correlations to the majority of the individual risk factors; whereas in women SAD was equal to that of waist girth. In the whole sample, the area under the ROC curve was highest for SAD. The optimal SAD cutoff for an elevated cardiometabolic risk score in men was approximately 22 cm (95%CI; 21.6 to 22.8) and in women approximately 20 cm (95%CI; 19.4 to 20.8). These cutoffs were similar if the Framingham risk score was used. Conclusions. These cutoffs may be used in research and screening to identify "metabolically obese" men who would benefit from lifestyle and pharmacological interventions. These results need to be verified in younger age groups.
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Affiliation(s)
- U. Risérus
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, 75185 Uppsala, Sweden
- *U. Risérus:
| | - U. de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institute and Department of Cardiology, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - L. Berglund
- Uppsala Clinical Research Center (UCR), Uppsala University, 75183 Uppsala, Sweden
| | - M. -L. Hellénius
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, 17176 Stockholm, Sweden
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Pereira MA, Kottke TE, Jordan C, O’Connor PJ, Pronk NP, Carreón R. Preventing and managing cardiometabolic risk: the logic for intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2568-84. [PMID: 20054455 PMCID: PMC2790093 DOI: 10.3390/ijerph6102568] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 09/29/2009] [Indexed: 02/07/2023]
Abstract
Cardiometabolic risk (CMR), also known as metabolic syndrome or insulin resistance syndrome, comprises obesity (particularly central or abdominal obesity), high triglycerides, low HDL, elevated blood pressure, and elevated plasma glucose. Leading to death from diabetes, heart disease, and stroke, the root cause of CMR is inadequate physical activity, a Western diet identified primarily by low intake of fruits, vegetables, and whole grains, and high in saturated fat, as well as a number of yet-to-be-identified genetic factors. While the pathophysiological pathways related to CMR are complex, the universal need for adequate physical activity and a diet that emphasizes fruits and vegetables and whole grains, while minimizing food high in added sugars and saturated fat suggests that these behaviors are the appropriate focus of intervention.
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Affiliation(s)
- Mark A. Pereira
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454-1015, USA; E-Mails:
(M.A.P.);
(C.J.)
| | - Thomas E. Kottke
- HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA; E-Mails:
(P.J.O’C.);
(N.P.P.)
- JourneyWell, Minneapolis, MN 55425, USA
| | - Courtney Jordan
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454-1015, USA; E-Mails:
(M.A.P.);
(C.J.)
| | - Patrick J. O’Connor
- HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA; E-Mails:
(P.J.O’C.);
(N.P.P.)
| | - Nicolaas P. Pronk
- HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA; E-Mails:
(P.J.O’C.);
(N.P.P.)
- JourneyWell, Minneapolis, MN 55425, USA
| | - Rita Carreón
- America’s Health Insurance Plans, Washington, DC 20004, USA; E-Mail:
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Onat A, Hergenç G, Yüksel H, Can G, Ayhan E, Kaya Z, Dursunoğlu D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr 2008; 28:46-51. [PMID: 19010573 DOI: 10.1016/j.clnu.2008.10.006] [Citation(s) in RCA: 182] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 09/29/2008] [Accepted: 10/07/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS To investigate the relationship of neck circumference (NC) to metabolic syndrome (MetS) and obstructive sleep apnea syndrome (OSAS) and whether it adds information to that provided by waist circumference. METHODS Cross-sectional analysis of a population sample of 1,912 men and women, aged 55.1 +/- 12 years, representative of Turkish adults. MetS was identified based on modified criteria of the ATP-III, OSAS when habitual snoring and episodes of apnea were combined with another relevant symptom. RESULTS NC measured 36.7 (+/- 3.5) cm in the total sample. It was significantly correlated with numerous risk factors, above all body mass index and waist girth (r > or = 0.6), homeostatic model-assessed insulin resistance, blood pressure and, inversely, with smoking status and sex hormone-binding globulin. Sex- and age-adjusted NC was associated significantly with MetS, at a 2-3-fold increased likelihood for 1 standard deviation (SD) increment. After further adjustment for waist circumference and smoking status, a significant residual odds ratio (OR, 1.13 [95% CI 1.08; 1.19]) persisted, corresponding to ORs of 1.53 and 1.27 in males and females, respectively, for 1 SD increment. Even when adjusted for all MetS components, a residual OR (1.08 [95% CI 1.000; 1.17]) remained. Sex- and age-adjusted NC was associated significantly also with OSAS in genders combined, independent of waist girth, yielding an added OR of 1.3 for 1 SD increment. CONCLUSIONS NC contributes to MetS likelihood beyond waist circumference and the MetS components. Regarding association with OSAS, NC is of greater value than WC among Turkish men, not women.
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Affiliation(s)
- Altan Onat
- Turkish Society of Cardiology, Istanbul University, Istanbul, Turkey.
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Abstract
UNLABELLED Prediabetes mellitus (PDM) is defined as a state of abnormal glucose homeostasis in which deficiency or resistance to insulin is the hallmark. PDM precedes the development of overt type 2 DM. It is associated with increased mortality and morbidity and thus fits well with the criteria of a disease condition. Framing PDM as a disease and not a risk or a 'pre' stage for diabetes is needed to facilitate early management. AIM This review aims therefore to increase awareness of PDM as a disease state. METHODS To do so, we shall preview guidelines for its diagnosis. Its prevalence and hazards will be then discussed. Finally, we shall elaborate on the current treatment guidelines. RESULT Enough evidence support the notion that PDM is a curable disease state. CONCLUSIONS The current recommendations for the treatment of PDM should be adhered. In addition, there is a room for the use of other pharmacological agents.
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Affiliation(s)
- W Shehab Eldin
- Department of Medicine, University of Saskatchewan, Royal University Hospital, Saskatoon, Canada
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Andersson K, Karlström B, Fredén S, Petersson H, Öhrvall M, Zethelius B. A two-year clinical lifestyle intervention program for weight loss in obesity. Food Nutr Res 2008; 52:1656. [PMID: 19109657 PMCID: PMC2596731 DOI: 10.3402/fnr.v52i0.1656] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Revised: 02/18/2008] [Accepted: 02/20/2008] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In recent randomised prospective studies, lifestyle intervention induced a weight loss of approximately 5%. OBJECTIVE To describe and evaluate a 2-year on-going group intervention program in clinical practice in terms of weight loss and changes in metabolic risk factors, i.e. sagital abdominal diameter (SAD), triglycerides, fasting blood glucose and blood pressure. DESIGN The aim of the intervention program was to motivate lifestyle changes concerning food intake and physical activity. The emphasis was on lifestyle modification, followed up at regular visits during 2 years. Subjects evaluated were 100 women with mean BMI 37.6 kg/m(2) and 26 men with mean BMI 36.5 kg/m(2). RESULTS One hundred of 151 enrolled women and 26 of 36 men completed the program. Mean weight decreased by 3.8 kg in women (from 103.5 to 99.7, p<0.001) and 4.4 kg in men (from 116.5 to 112.1, p<0.05), respectively. SAD decreased by 5% (p=0.001 in women, p=0.01 in men), and triglycerides by 16% in women (p=0.01) and 24% in men (p=0.001), however systolic and diastolic blood pressure increased slightly but significantly. CONCLUSION It is possible to perform a clinical lifestyle intervention program for outpatients on an ongoing basis with weight loss, lowered SAD and triglycerides, and a similar or lower dropout rate compared to clinical trials.
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Affiliation(s)
- Karin Andersson
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Brita Karlström
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Susanne Fredén
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Helena Petersson
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Margareta Öhrvall
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Björn Zethelius
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
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Vajda I, Mészáros J, Mészáros Z, Prókai A, Sziva A, Photiou A, Zsidegh P. Effects of 3 hours a week of physical activity on body fat and cardio-respiratory parameters in obese boys. ACTA ACUST UNITED AC 2007; 94:191-8. [PMID: 17853771 DOI: 10.1556/aphysiol.94.2007.3.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The prevalence of overweight or fat children and adolescents has markedly increased in Hungary during the past three decades. Among the possible factors insufficient physical activity and a relative or absolute excess of calorie intake associated to it can be regarded as the most important ones. The aim of the study was to analyse the effects of a 20-week aerobic exercise on body composition and on the exercise tested cardio-respiratory functions in 10-year-old obese boys. Obesity was defined by a BMI greater than the cut-off value reported by Cole and co-workers (5) and a relative body fat content above 30% (13). Of the study group 21 volunteer children completed the program; the contrast group contained 28 obese boys. Mean calendar age was 10.03 +/- 0.26 in the study group (S) and 9.88 +/- 0.29 in the control group (C). The members of group S had two curricular physical education (PE) classes a week and three extracurricular aerobic physical activity sessions of 60 min net time in the afternoon, on Mondays (swimming and water games), Wednesdays (folk dance) and Fridays (soccer). Group C had only 2 PE classes a week. Anthropometric and spiroergometric data were collected in the middle of January and June of 2004. Relative body fat content and BMI did not increase during the observation period in contrast to the significant increase of both in the control group. Peak minute ventilation, aerobic power, oxygen pulse, and running distance (performed on a treadmill) increased in group S, and did not change in group C. The program was considered successful despite that the changes in the observed physiological and physical indicators appeared to be slight. However, the 5-month elevated level of physical activity brought about such development in the physical status of the obese subjects that might be an appropriate basis for regular training. Fortunately, the cardio-respiratory functions of the investigated boys were not affected yet by obesity, consequently the really dramatic change in their further lifestyle exclusively depends on their decision.
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Affiliation(s)
- I Vajda
- Faculty of Physical Education and Sports Sciences, Semmelweis University, Alkotás u. 44, H-1123 Budapest, Hungary
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Abstract
Obesity and impaired glucose tolerance are associated with a greater risk for a number of conditions, including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, coagulation abnormalities, inflammatory markers, and coronary heart disease. Lifestyle changes can delay or prevent the development of type 2 diabetes in patients with obesity and impaired glucose tolerance. The risks improve with weight loss and increased physical activity. A decrease of 7% to 10% or more from baseline weight can have a significant effect. This has now been documented in a number of randomized, controlled studies.
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Affiliation(s)
- F Xavier Pi-Sunyer
- Columbia University, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025, USA.
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50
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Abstract
The prevalence of obesity has reached epidemic proportions in many countries. Although its impact on overall health is well documented, less is known about the ocular manifestations of obesity. Among different eye diseases, obesity has been linked with age-related cataract, glaucoma, age-related maculopathy, and diabetic retinopathy. Numerous population-based and prospective studies support an association between obesity and risk of age-related cataract. However, the nature and strength of these associations, particularly with the different cataract subtypes, remains to be determined. There is strong evidence that obesity is associated with elevated intraocular pressure, but there is no convincing data to support a more direct association between obesity and glaucomatous optic neuropathy. Studies to date have not found a consistent pattern of association between obesity and risk of age-related maculopathy or diabetic retinopathy. Thus, although obesity may be a risk factor for many ocular conditions, the present literature is inadequate to establish any convincing associations. Furthermore, whether weight loss reduces the risk of eye diseases remains unresolved. Because of the potential public health impact of obesity, there is a greater need to understand its ocular effects.
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Affiliation(s)
- Ning Cheung
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Royal Melbourne Hospital, Victoria, Australia
| | - Tien Y. Wong
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Singapore Eye Research Institute, National University of Singapore, Singapore
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