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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our review focuses on low density lipoprotein (LD lipoprotein) and very low density lipoprotein (VLD lipoprotein) in their roles as transporters of cholesterol and triglyceride and as factors contributing to premature arteriovascular disease. We describe the clinical manifestations of the common, primary hyperlipoproteinemias--that is, hyper-beta-lipoproteinemia, combined hyperlipoproteinemia, hyper-pre-beta-lipoproteinemia, and sporadic hyperlipoproteinemia--and discuss the variations in lipoprotein structure and metabolism that occur in these diseases. Based on an understanding of the physiologic control of lipoprotein metabolism, it is possible for the physician to alter the concentrations of LD lipoprotein and VLD lipoprotein by selecting a course of therapy appropriate to the specific disease. We describe the effects of obesity, diet, insulin, ethanol, estrogens, and the drugs clofibrate, nicotinic acid, and cholestyramine.
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PMID:The common hyperlipoproteinemias: an understanding of disease mechanisms and their control. 18 30

Perimenopausal and postmenopausal substitutive estrogen treatment is valuable if prescribed according to proper indications and in the proper manner. Studies have shown a correlation between menopausal estrogen treatment and endometrial cancer. Siiteri hypothesized that estrone was the estrogen with a specific carcinogenic effect. A study undertaken in California indicates, however, that conjugated estrogens are associated with a lower risk of endometrial cancer. There is also strong indications that certain factors predispose a woman to endometrial cancer during menopausal estrogen treatment: obesity, the Stein-Leventhal syndrone, the Turner syndrome, hirsuitism caused by increased androgen activity, and family history of endometrial cancer. Menopausal estrogen treatment is prescribed in cases of menstrual disturbances, neurovegetative or vaso-motor disturbances, psychological disturbances, atrophy of the urogenital tract, or cases of calcium or fat metabolism disturbances which could lead to osteoporosis or arteriosclerosis.
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PMID:[Estrogen substitution and endometrial carcinoma]. 21 33

The prevalence of clinical and sub-clinical occlusive arterial disease and of risk factors implicated in the pathogenesis of arteriosclerosis was assessed in 21 patients with chronic renal failure, 27 on maintenance haemodialysis and 51 renal allograft recipients. Clinical occlusive arterial disease was present in 27 patients, and sub-clinical arterial disease in 34. Myocardial infarction, cerebral thrombosis and lower limb arterial thrombosis had occurred only in the transplant recipients; these patients had, however, been followed for a longer period of time than the other two groups. In the allograft recipients, the cumulative incidence of any occlusive arterial disease was 416 per 1000, and that of coronary heart disease was 267 per 1000 at six years. Hypertension was present in 76 per cent of patients prior to renal replacement therapy. Following institution of definitive therapy, hypertension was of shorter duration and less common in haemodialysis patients than in renal transplant recipients. Uraemic and haemodialysis patients with occlusive arterial disease had required antihypertensive medication for significantly longer than those free of arterial disease. Transplant recipients with hypertension had a greater mean serum creatinine, were receiving a larger maintenance dosage of corticosteroids and less frequently had undergone prior bilateral nephrectomy than those transplant patients without hypertension. Serum lipid levels were elevated in 62 per cent of patients. In the uraemic and haemodialysis patients hypertriglyceridaemia was the predominant abnormality while in the transplant recipients combined hypertriglyceridaemia/hypercholesterolaemia was more frequent. Despite regular aluminium hydroxide therapy 81 per cent of uraemic and haemodialysis patients had a calcium X phosphate product higher than normal. Arterial and/or soft tissue calcification as demonstrable in 20-38 per cent of patients within each group, but could not be related to the calcium X phosphate product of radiographic evidence of hyperparathyroidism. Glucose intolerance was present in 71 per cent of the uraemic and haemodialysis patients and 33 per cent of the transplant recipients. Hyperuricaemia, cigarette smoking, obesity and a sedentary existence were also prevalent. The majority of patients had several risk factors implicated in the pathogenesis of arteriosclerosis. Occlusive arterial disease is a major problem in patients with end stage renal disease, being no less common after transplantation than with long-term maintenance dialysis. The aetiology is multifactorial.
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PMID:Occlusive arterial disease in uraemic and haemodialysis patients and renal transplant recipients. A study of the incidence of arterial disease and of the prevalence of risk factors implicated in the pathogenesis of arteriosclerosis. 32 93

The therapy of gout is discussed taking into consideration the concomitant diseases occurring significantly frequently in patients with gout: Hypertension, uric acid-nephrolithiasis, hyperlipoproteinaemia, obesity, premature arteriosclerosis as well as diabetes mellitus. In contrast to other opinions the authors are of the opinion that the dietetic treatment is furthermore of essential importance. It is referred to the still allowed sufficiently great number in the supply of nourishment, in which cases, however, the limitations in the supply of calories, protein or purin bodies, respectively, lipid and carbohydrate do not remain unmentioned. The propositions for the medicamentous treatment essentially correspond to the central therapeutic recommendations. For the acute attack of gout, however, following to the international experiences, the colchicine therapy is more emphasized again. The medicamentous therapy of the asymptomatic hyperuricaemia is to be included into the considerations after full exhaustion of all dietetic and other possibilities in constant increase of the serum-uric acid-level more than 8 mg/dl.
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PMID:[Therapy of gout]. 33 84

A comprehensive study of the sternoclavicular joints (SCG) of 120 autopsy cases comprising both sexes and all age groups has proved that this non-weight-bearing joint turns arthritic with increasing age. The degenerative lesions set on already from the 3rd decade; between 40 and 50 years of age, 84% of the joints are arthrotic, and over 70, all patients show an osteoarthrosis. Statistically significant relationships could further be demonstrated between SCG-arthrosis, aging, obesity, fatty degeneration of the liver, and severe arteriosclerosis.
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PMID:[Arthrosis of the sternoclavicular joint]. 41 85

A 46 year old woman who used oral contraceptives (OCs) for 10 years developed severe arteriosclerosis of the base of the brain and renally fixed hypertension. She subsequently died of cerebral hemorrhage. The relationship between o.c. use and hypertension is discussed. A thorough family and personal anamnesis must be taken for women who want to use o.c.s; hypertension, kidney ailments, obesity, or diabetes mellitus require particular attention. Blood pressure should be checked for the first 3 months of o.c. use and every 6 months thereafter. Weight gain during o.c. use may serve as a warning symptom. Hypertension or several other difficulties require discontinuation of o.c. use to determine whether they may be caused by o.c.s.
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PMID:[The problem of hypertension and ovulation inhibitors]. 47 16

Issuing from the present state of the influence of the basic nutritive substances (protein, fat, carbohydrates) and various nutritive factors discussed again and again (cholesterol, erucaic acid, sodium, calcium/magnesium quotient, pressor amines) on the development of the arteriosclerosis, the indididual factors of influence are critically evaluated. The investigations are getting under way, so that ascertained results are standing beside insufficiently claified or open problems, From the abundance of the observations conclusions are drawn which are of significance for practice. Unfavourable influences of nutrition on the factors of risk (hyperlipoproteinaemia, disturbance of the carbohydrate tolerance, hyperuricaemia, hyperalimentation) and on the manifest diseases (hypertension, diabetes mellitus, uric arthritis, obesity) of the metabolic syndrome which finally contribute to the development of arteriosclerosis are emphasized. In front of this background a clinically and ambulatorily tested basic metabolic diet is described. About 20% of the energy content (kcal or kJ) of this diet are protein, 35% fat and 45% are carbohydrates. The saturated fatty acids lie below 30%, the manifold saturated fatty acids, however, above 20% of the total fat proportion. The cholesterol content is below 400 mg, the purin-nitrogen below 200 mg, and the sodium content is about 2g per day. This diet can be produced for the treatment of persons with normal weight and overweight in different energetic degradations.
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PMID:[Nutrition and arteriosclerosis]. 70

With the world-wide increase of the number of ischemic heart diseases the significance of the so-called factors of risk which initiate an arteriosclerosis or can deteriorate it, respectively, has increased. In the Dresden study concerning the most important factors of risk we found the following frequencies: obesity 8.2%, hyperlipoproteinemia 7.4%, hyperuricemia 3.8%, diabetes mellitus 2.0%, hypertension 17.2% and smoking 30.3%. From the investigations results the great significance of the combination of factors of risk which has a potentiating effect. The hyperlipoproteinemias of type III-V most frequently show a disturbed carbohydrate tolerance and hypertension. In them also the most frequent severe changes of the ECG appear. Myocardial infarctions concerned above all type II-IV. Apparantly concerning the vascular system patients with the combination hyperlipoproteinemia and carbohydrate metabolism are particularly endangered. The "metabolic syndrome" (obesity, diabetes mellitus, hyperlipoproteinemia, hyperuricemia, steatosis hepatis) with the increase of the viscosity of blood and plasma as well as disturbances of coagulation together with other factors of risk further the development of arteriosclerosis or has a directing influence on it. Nevertheless, the concept of the significance of the factors of risk is not able to predict the risk in every case. With the help of the apoproteins the metabolic risk is to be more exactly estimated by the determination of the lipid values in the individual classes of lipids or by classification.
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PMID:[Epidermiology and associated risk factors of hyperlipoproteinemia]. 88 54

Total starvation is effective for acute weight reduction in obesity. However, in 200 patients, most of whom also had internal diseases, 8% exhibited sometimes severe complications, i.e. reversible cerebral ischemia in 3 hypertensive patients when the blood pressure was lowered to the normal range by natriuresis of fasting; breakdown of water and electrolyte homeostasis with circulatory collapse, vomiting and vertigo; acute crises of paroxysmal nocturnal hemoglobinuria and porphyria respectively and increase of transaminases up to 200 mu/ml, or cardiac arrhythmias. Relative (?) contraindications for total fasting appear to be clinical sings of arteriosclerosis such as vascular bruits, angina pectoris and intermittent claudication. In case of doubt, the method should only be used in hospital.
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PMID:[Complications in null-diet]. 91 86

In elderly patients thromboses are especially important because of their frequency and consequences (invalidity) often demanding measures of rehabilitation. In thrombophilia there are prophylactic measures necessary founding upon new perceptions on pathogenesis (vascular wall factors; rheologic and microcirculatory factors and factors of hemostasis: increasing of factor VIII; decreasing of antithrombin III; hypofibrinolysis; increased aggregation of thrombocytes). In prophylaxis you should influence the predisposing factors (hypertension, diabetes, arteriosclerosis, adipositas), use dietetic and hygienic measures and also from the pharmalogical point medicines with complex effect, which not only act on one factor (blood coagulation) like the anticoagulants, but also on other pre-disposing factors; and at the same time activate the fibrinolysis and stop the aggregation of thrombocytes. Thrombolytica should be used in elderly patients with precaution. In hemorrhages in the age especially capillary protecting medicaments should be used to correct the increased fragility of capillaries. Of there is at the some time a arteriosclerosis, hypertension, diabetes mellitus, obesity.
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PMID:[Thromboses and haemorrhages in geriatrics (author's transl)]. 101 38


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