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Query: UMLS:C0028754 (
obesity
)
124,988
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Obesity
is defined as BMI (calculated as weight in kg divided by height in m2) more than 30, and overweight is defined as BMI of 25-29.9.
Obesity
has been considered as a risk factor for pancreatic diseases, including pancreatitis and pancreatic cancer. Severe
acute pancreatitis
is significantly more frequent in obese patients. Furthermore, obese patients develop systemic and local complications of
acute pancreatitis
more frequently. The underlying mechanisms are increased inflammation and necrosis from increased amount of intra- and peri-pancreatic fat. In addition,
obesity
is a poor prognostic factor in
acute pancreatitis
, and overweight before disease onset appears to be a risk factor for chronic pancreatitis. Overweight and/or
obesity
are associated with greater risk of pancreatic cancer and younger age of onset. Physical activity appears to decrease the risk of pancreatic cancer, especially among those who are overweight. Long-standing diabetes increases the risk of pancreatic cancer. The pathogenic mechanism is that
obesity
and physical inactivity increase insulin resistance. In a state of hypersinulinemia, increased circulating level of insulin-like growth factor-1 induces cellular proliferation of pancreatic cancer.
Obesity
is associated with negative prognostic factor and increased mortality in pancreatic cancer. However, there are controversies regarding the effects of
obesity
on long-term post-operative results in the patient with pancreatic cancer.
...
PMID:[Obesity and pancreatic diseases]. 2228 52
Obesity
increases severity of
acute pancreatitis
and risk of pancreatic cancer. Pancreatitis and
obesity
are associated with elevated IL-6, a cytokine involved in inflammation and tumorigenesis. We studied the role of IL-6 in the response of lean and obese mice to pancreatitis induced by IL-12 + IL-18. Lean and diet-induced obese (DIO) WT and IL-6 KO mice and ob/ob mice pretreated with anti-IL-6 antibodies were evaluated at Days 1, 7, and 15 after induction of pancreatitis. Prolonged elevation of IL-6 in serum and visceral adipose tissue was observed in DIO versus lean WT mice, whereas circulating sIL-6R declined in DIO but not lean mice with pancreatitis. The severe inflammation and lethality of DIO mice were also observed in IL-6 KO mice. However, the delayed resolution of neutrophil infiltration; sustained production of CXCL1, CXCL2, and CCL2; prolonged activation of STAT-3; and induction of MMP-7 in the pancreas, as well as heightened induction of serum amylase A of DIO mice, were blunted significantly in DIO IL-6 KO mice. In DIO mice, production of OPN and TIMP-1 was increased for a prolonged period, and this was mediated by IL-6 in the liver but not the pancreas. Results obtained in IL-6 KO mice were confirmed in ob/ob mice pretreated with anti-IL-6 antibodies. In conclusion, IL-6 does not contribute to the increased severity of pancreatitis of obese mice but participates in delayed recovery from acute inflammation and may favor development of a protumorigenic environment through prolonged activation of STAT-3, induction of MMP-7, and sustained production of chemokines.
...
PMID:Role of IL-6 in the resolution of pancreatitis in obese mice. 2242 81
Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. However, it may lead to diseases of the bilio-pancreatic tract. We evaluated transgastric endoscopic retrograde cholangiopancreatography (ERCP) for managing common biliary tract diseases in patients that underwent RYGB treatment for
obesity
. This prospective study was conducted between 2003 and 2010 at three medical institutions. We included 23 patients with a mean body mass index of 28.2 kg/m(2) after RYGB treatment. ERCP was performed in all patients to manage biliary tract diseases within 9 to 27 months (mean 16.3 months) of RYGB surgery. The gastrotomy was conducted through the anterior wall of the greater curve of the excluded stomach. A duodenoscope was introduced in the direction of the ostomy to perform the ERCP with sphincterotomy. All patients underwent an ERCP and papillotomy without incident. Ten patients underwent simultaneous cholecystectomy. A total of 17 gallstones were removed. The average gastrotomy duration was 92.69 min; the average hospital stay was 2 days. One patient had mild
acute pancreatitis
that resolved clinically. There was no mortality. Laparoscopy-assisted transgastric ERCP was feasible and safe for patients after RYGB. The necessary equipment is available in most bariatric surgery centers.
...
PMID:Transgastric endoscopic retrograde cholangiopancreatography for the management of biliary tract disease after Roux-en-Y gastric bypass treatment for obesity. 2246 May 51
Case reports have indicated an increased risk of
acute pancreatitis
during use of selective serotonin reuptake inhibitors (SSRIs), an association not found in a few epidemiological studies. We studied the use of SSRI in relation to risk of
acute pancreatitis
in a population-based case-control study of people aged 40 to 84 years between 2006 and 2008 in Sweden. The Patient Register was used to identify 6161 cases of first-episode
acute pancreatitis
. The Register of the Total Population was used to randomly select 61,637 control subjects from the general population using frequency-based density sampling, matched for age, sex, and calendar year. Use of SSRI was defined as "current," "recent," "past," or "former" if the drug had been dispensed 1 to 114 days, 115 to 180 days, 181 to 365 days, or 1 to 3.5 years before a given index date, respectively. Logistic regression with adjustment for potential confounding factors was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs). The OR for
acute pancreatitis
, adjusted for matching variables, was increased among present users of SSRI (OR, 1.5; 95% CI, 1.4-1.7). After adjusting for diseases or medications related to alcohol overconsumption, tobacco smoking, diabetes, ischemic heart disease,
obesity
, and severe pain together with educational level and marital status, the corresponding OR was 1.1 (95% CI, 1.0-1.3). After adjusting for the number of distinct medications, a proxy for comorbidity, the corresponding OR was 1.0 (95% CI, 0.9-1.1). The OR for antidepressant use other than SSRI showed a similar pattern. In conclusion, no increased risk of
acute pancreatitis
remained among users of SSRI after adjusting for confounding factors.
...
PMID:Selective serotonin reuptake inhibitors and the risk of acute pancreatitis: a Swedish population-based case-control study. 2254 14
The interactions between
obesity
and infectious diseases have recently received increasing recognition as emerging data have indicated an association between
obesity
and poor outcome in pandemic H1N1 influenza infection.
Obesity
is an established risk factor for surgical-site infections, nosocomial infections, periodontitis and skin infections. Several studies indicate that
acute pancreatitis
is more severe in the obese. Data are controversial and limited as regards the association between
obesity
and the risk and outcome of community-acquired infections such as pneumonia, bacteremia and sepsis and
obesity
and the course of HIV infection. As the cause-effect relationship between
obesity
and infection remains obscure in many infectious diseases, further studies are warranted. The consequences of
obesity
may have substantial effects on the global burden of infectious diseases.
...
PMID:Obesity and the risk and outcome of infection. 2254 72
Obesity
increases severity of
acute pancreatitis
(AP) by unclear mechanisms. We investigated the effect of the PPAR-gamma agonist rosiglitazone (RGZ, 0.01% in the diet) on severity of AP induced by administration of IL-12+ IL-18 in male C57BL6 mice fed a low fat (LFD) or high fat diet (HFD), under the hypothesis that RGZ would reduce disease severity in HFD-fed obese animals. In both LFD and HFD mice without AP, RGZ significantly increased body weight and % fat mass, with significant upregulation of adiponectin and suppression of erythropoiesis. In HFD mice with AP, RGZ significantly increased survival and hastened recovery from pancreatic inflammation, as evaluated by significantly improved pancreatic histology, reduced saponification of visceral adipose tissue and less severe suppression of erythropoiesis at Day 7 post-AP. This was associated with significantly lower circulating and pancreas-associated levels of IL-6, Galectin-3, osteopontin and TIMP-1 in HFD + RGZ mice, particularly at Day 7 post-AP. In LFD mice with AP, RGZ significantly worsened the degree of intrapancreatic acinar and fat necrosis as well as visceral fat saponification, without affecting other parameters of disease severity or inflammation. Induction of AP lead to major suppression of adiponectin levels at Day 7 in both HFD and HFD + RGZ mice. In conclusion, RGZ prevents development of severe AP in obese mice even though it significantly increases adiposity, indicating that
obesity
can be dissociated from AP severity by improving the metabolic and inflammatory milieu. However, RGZ worsens selective parameters of AP severity in LFD mice.
...
PMID:Rosiglitazone improves survival and hastens recovery from pancreatic inflammation in obese mice. 2281 75
Obesity
is associated with systemic low-grade inflammation and is a risk factor for non-alcoholic fatty pancreas disease (NAFPD), but the molecular mechanisms of these associations are not clear. Interleukin (IL)-10, a potent anti-inflammatory cytokine, is released during
acute pancreatitis
and is known to limit inflammatory responses by downregulating the release of proinflammatory mediators. The origin of IL-10 that suppresses pancreatitis has not been investigated. Since
obesity
is known to reduce expression of proinflammatory cytokines in the spleen, we examined whether spleen-derived IL-10 regulates NAFPD caused by high-fat (HF) diet-induced
obesity
. The following investigations were performed: 1) IL-10 induction from spleen was examined in male mice fed a HF diet; 2) triglyceride content, expression of pro- and anti-inflammatory cytokines and infiltration of M1 and M2 macrophages were determined to evaluate ectopic fat accumulation and inflammatory responses in the pancreas of splenectomy (SPX)-treated mice fed HF diet; 3) exogenous IL-10 was systemically administered to SPX-treated obese mice and the resulting pathogenesis caused by SPX was assessed; and 4) IL-10 knockout (IL-10KO) mice were treated with SPX and ectopic fat deposition and inflammatory conditions in the pancreas were investigated.
Obesity
impaired the ability of the spleen to synthesize cytokines, including IL-10. SPX aggravated fat accumulation and inflammatory responses in the pancreas of HF diet-induced obese mice and these effects were inhibited by systemic administration of IL-10. Moreover, SPX had little effect on fat deposition and inflammatory responses in the pancreas of IL-10KO mice. Our findings indicate that
obesity
reduces IL-10 production by the spleen and that spleen-derived IL-10 may protect against the development of NAFPD.
...
PMID:Spleen-derived interleukin-10 downregulates the severity of high-fat diet-induced non-alcoholic fatty pancreas disease. 2328 60
Hypertriglyceridemia is reported as cause of 1 to 4% of the episodes of
acute pancreatitis
. We report the case of a 42-year-old woman with a history of
obesity
, type 2 diabetes mellitus, hypertriglyceridemia and hypercholesterolemia, with triglycerides of 9365 mg/dl, total cholesterol of 1822 mg/dl, one month prior to the consultation. She presented at the emergency unit with a 5 day history of abdominal pain, which progressed in intensity in the last 48 hours. Abdominal computed tomography revealed pancreatic and peripancreatic inflammation. Thirty-six hours after admission, a first session of plasmapheresis was conducted with a plasma triglyceride and cholesterol reduction of 25 and 30%, respectively. A second session was performed the next day, with a further reduction of triglycerides to 996 mg/dl and cholesterol to 238 mg/dl. During hospitalization the patient presented fever and Klebsiella pneumoniae bacteremia with no pancreatic collection or necrosis in tomography and, later on, nosocomial pneumonia, both infections with adequate response to antibiotic therapy. At the time of discharge, triglycerides and cholesterol levels were 652 mg/dl and 167 mg/dl respectively, no abdominal pain was present and the patient resumed oral nutrition. We observed a 90% reduction of triglycerides and 87% of cholesterol after 2 sessions of plasmapheresis, compared to 70% in average of reduction in most of the studies reviewed. We did not find the presence of bacteremia or nosocomial pneumonia as complications in the reported cases.
...
PMID:[Use of plasmapheresis in hypertriglyceridemic pancreatitis]. 2456 42
The influence of neonatal administration of hyperosmolar sodium chloride and sodium glutamate on the exocrine function of the pancreas in rats has been investigated. It was observed the development of
acute pancreatitis
under experimental
obesity
. The cross-section area of acini reduced by 12%, the cross-section area of acinocytes nuclei increased by 10%, the length between the lobes of the gland has grown by 48%. The level of amylase was increased by 43%, the levels of pancreatic amylase and lipase were increased by 68% and 24%, respectively.
...
PMID:[Exocrine function of the pancreas in rats with experimental obesity]. 2480 73
Over the past decades, the incidence and the number of hospital admissions for
acute pancreatitis
have increased in the Western countries. The two most common etiological factors of
acute pancreatitis
are gallstones (including small gallstones or microlithiasis) and alcohol abuse.
Acute pancreatitis
is associated with a significant mortality (4-10%) and 25% in case of pancreatic necrosis, especially. Edematous pancreatitis is benign and oral feeding can be restarted once abdominal pain is decreasing and inflammatory markers are improving. Enteral tube feeding should be the primary therapy in patients with predicted severe
acute pancreatitis
who require nutritional support. Enteral nutrition in
acute pancreatitis
can be administered via either the nasojejunal or nasogastric route. In case of necrosis, preventive antibiotics are not recommended. The single indication is infected necrosis confirmed by fine needle aspiration. The incidence trends of
acute pancreatitis
possibly reflect a change in the prevalence of main etiological factors (e.g. gallstones and alcohol consumption) and cofactors such as tobacco,
obesity
and genetic susceptibility. Priority is to search for associated causes, especially in cases with atypical symptoms. In case of first
acute pancreatitis
in patients older than 50 years, the presence of a tumor (benign or malignant) has to be specifically ruled out, using CT-scan, MRI and endoscopic ultrasound.
...
PMID:[Acute pancreatitis: an overview of the management]. 2483 48
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