Relation between obesity in young adulthood and risk of non-insulin-dependent diabetes mellitus

Urolithiasis and obesity: metabolic and technical considerations

PURPOSE OF REVIEW

The increasing prevalence of obesity poses a challenge to urologists in the diagnosis and treatment of urolithiasis. This review summarizes the new evidence linking obesity and urolithiasis, and the technical considerations and modifications necessary in the diagnosis and treatment of stone disease in obese patients.

RECENT FINDINGS

Recent studies have confirmed the epidemiological link between obesity and urolithiasis, and have provided some possible explanations for its underlying cause. New clinical series have demonstrated that flexible ureterorenoscopy and adapted percutaneous nephrolithotomy techniques can result in similar stone clearance rates and morbidity to the non-obese patient. New data, however, suggest that obesity may be an independent predictor of extracorporeal shock wave lithotripsy treatment failure for ureteric stones. Evidence of the efficacy of dietary modification and medical treatment of metabolic abnormalities has been reported in obese stone formers.

SUMMARY

Urolithiasis can be safely and effectively managed in obese patients with minor modifications to the established surgical techniques. Increased understanding of the underlying metabolic abnormalities in obese patients with urolithiasis may improve prevention strategies in the future.

Childhood weight, stature, and body mass index among never overweight, early-onset overweight, and late-onset overweight groups

OBJECTIVE

To determine the effects of timing of onset of overweight (OW) on childhood anthropometric adiposity levels using long-term serial data from the Fels Longitudinal Study.

CLASSIFICATION

OW was defined as body mass index (BMI; kg/m(2)) >25, and the age at first measurement of BMI >25 was the age of onset of OW. Early onset of OW (early-OW) and late onset of OW (late-OW) were defined as having onset of OW before and after 25 years of age, respectively, whereas never OW (never-OW) was defined as never having a BMI >25.

SUBJECTS

Subjects consisted of 67 males and 47 females in early-OW groups, 62 males and 48 females in late-OW groups, and 80 males and 114 females in never-OW groups.

RESULTS

Levels of weight and BMI in early-OW males and females were significantly greater than those in never-OW and late-OW males and females beginning at the time of adiposity rebound, which generally occurs between 4 and 8 years of age. Median BMI and weight patterns between never-OW and late-OW males were similar throughout childhood. However, significant differences in median levels of BMI for never-OW and late-OW females began at 11 years of age, although onset of OW was not until >25 years of age in the latter group.

CONCLUSIONS

For both males and females, adiposity rebound is likely an effective time in a child's development to detect and initiate prevention for childhood and early adulthood onset of OW. Although later-onset OW needs additional study, puberty seems to be a critical phase in the development of later adult onset of OW in females.