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

Diabetes mellitus is the most frequent endogenous cause of fat metabolism-disorder. In diabetics the risk for arteriosclerosis is significantly higher and the clinical significance of hyperlipidemia should be estimated more serious as in non-diabetics. The predominant abnormality of fat metabolism in diabetes is hypertriglyceridemia due to an increase of triglyceride-carrying lipoproteins, the chylomicrons and the very-low-density lipoproteins. In type I-diabetics the decisive pathogenetic factor for hypertriglyceridemia is the impaired degradation of VLDL and the reduced chylomicron-clearance, caused by decreased activity of the lipoproteinlipase. In ketoacidosis there is an additional increase in hepatic VLDL-triglyceride-production due to increased lipolysis with elevated free-fatty-acid flux. Total cholesterol in type I-diabetics is only significantly elevated when metabolic control is poor, low-density lipoprotein (LDL-)-cholesterol-levels can be increased and high-density lipoprotein (HDL-)cholesterol decreased in dependence on the metabolic control. In type II-diabetics the decisive pathogenetic factor for hypertriglyceridemia is increased VLDL-triglyceride-synthesis in the liver especially due to augmented free-fatty-acid flux. Additionally the activity of the lipoproteinlipase can be reduced. Usually in non-insulin-dependent diabetics LDL-cholesterol-levels can be seen elevated and HDL-cholesterol-concentration decreased in correlation with the metabolic control. Primary hyperlipoproteinemia appears frequently in diabetics, but this can be explained by the association with obesity in type II-diabetics.
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PMID:[Disorders of lipid metabolism in diabetes mellitus]. 269 31

Obesity continues as before to be a widespread condition. Obesity is defined as a body weight of over 120% of the ideal weight, corresponding roughly to the 85th percentile of the weight distribution. According to the "Build Study" (1979), the ideal weight is assumed to be rather higher than formerly; in men it is 8%, in women 6% less than the so-called normal weight. The latter corresponds roughly to the average weight and is defined as: height (cm) minus 100 in kg. In obese subjects both somatic and psychological complications arise; these are related exponentially to the degree of overweight. More recent findings in the Framingham Study show that obesity leads to coronary heart disease and premature death independently of the classical risk factors. Evaluation of the patient should include a personal and familial history of the obesity, together with individual eating habits and the degree of physical activity indulged in. As assessment should be made of the body fat distribution (android or gynoid obesity); android obesity carries a relatively high risk. Complications should be looked for, together with other risk factors for arteriosclerosis. Treatment depends on the severity of the condition and on the motivation. In general, it should consist of a moderate reduction in the caloric value of the food intake together with advice on eating habits and an increase in bodily activity. Group therapy often gives good results on account of the dynamic interactions within groups. Patients with morbid obesity will profit from a very hypocaloric, "ketogenic" diet (ca. 600-700 kcal/day). One of the author's own studies showed that a very hypocaloric diet resulted in mood elevation and a reduction in the need for sleep. Conservative measures such dietary weight reduction, changes in eating habits and encouragement of bodily activity are to be preferred to surgical treatment (eg, gastric stapling). Weight reductions in hospital do not lead to a change in eating habits and are therefore of doubtful value; drug therapy as a form of long-term treatment is likewise of questionable usefulness.
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PMID:[Evaluation and treatment of obesity in clinical practice]. 274 Nov 31

Impaired glucose tolerance (IGT) constitutes two-thirds of all glucose intolerance in the United States and is a major risk factor for diabetes. Despite these findings, the clinical and epidemiological significance of IGT has not been well investigated. The Second National Health and Nutrition Examination Survey, a cross-sectional study in which 75-g 2-h oral glucose tolerance tests (OGTTs) were performed, has provided an opportunity to examine the characteristics of IGT in the U.S. population. Data from the survey have been extrapolated to represent all U.S. residents. The findings indicate that approximately 11.2% of Americans aged 20-74 yr have IGT compared to 6.6% with diabetes. Rates of IGT increased with age for White men and women and Black men but declined for Black women greater than 54 yr of age, possibly because greater obesity in Black women precipitated earlier conversion of IGT to diabetes. The distribution of 2-h glucose values showed IGT to be part of a continuum of glucose intolerance extending from normal to diabetes. Individuals with IGT had rates of risk factors for non-insulin-dependent diabetes (age, plasma glucose, past obesity, family history of diabetes, physical inactivity) that were intermediate between those of individuals with normal glucose tolerance and those with diabetes, although current obesity was similar for IGT and diabetes. The proportion of people with medical histories of diabetes-related conditions did not differ between IGT and normal glucose tolerance. However, several cardiovascular findings were more prevalent in individuals with IGT than in those with normal glucose tolerance, including hypertension, serum cholesterol, angina, abnormal heart findings, and medical history of arteriosclerosis and stroke. Both obesity and reported family history of diabetes were associated with higher rates of IGT, with the effect of weight gain on the prevalence of IGT occurring at lower levels than for diabetes.
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PMID:Impaired glucose tolerance in the U.S. population. 275 51

One-year changes in low density lipoprotein (LDL) peak flotation (Sf) rate and serum mass concentrations of LDL of Sf 0 to 7 (small LDL), LDL of Sf 7 to 12 (large LDL), intermediate density lipoprotein (IDL) of Sf 12 to 20, and very low density lipoprotein (VLDL) of Sf 20 to 400 were compared between men assigned at random to a 1-year exercise program (N = 48) or to a sedentary control condition (N = 31). Distance run among exercisers varied substantially (mean +/- SD: 12.7 +/- 8.9 km/week). Mean changes were not significantly different between the exercise and control groups for any of the low to very low density lipoprotein measurements. However, within the exercise group: 1) distance run correlated negatively with changes in the mass concentrations of small LDL; and 2) weight loss and reduced upper body obesity correlated positively with changes in small LDL, IDL, and VLDL mass and negatively with change in LDL peak flotation rate. Analyses with partial correlations suggest that weight loss may primarily affect LDL mass distributions through metabolic processes associated with high density lipoprotein2 or small VLDL (Sf 20 to 60). The decrease in small LDL concentrations and the increase in LDL peak flotation rate suggest that exercise-induced weight loss may be effective in reducing coronary heart disease risk in persons genetically predisposed to a high-risk lipoprotein profile.
Arteriosclerosis
PMID:Effects of exercise-induced weight loss on low density lipoprotein subfractions in healthy men. 278 76

Recent evidence indicates that measurement of apoproteins may enhance evaluation of coronary heart disease risk. The purpose of the present study was to identify factors associated with interindividual variation in apoproteins (apo) A-I, A-II, and B and lipoprotein lipid levels in 541 healthy premenopausal women, a random sample ages 42 to 50 taken from driver's license lists. The results of multivariate analyses that included alcohol intake, obesity, smoking, exercise, and age as predictor variables showed alcohol consumption to be strongly, positively related to apo A-I and A-II and smoking and obesity to have modest lowering effects on apo A-I. Concentration of the high density lipoprotein subfraction, HDL2c, however, was highly negatively related to body mass index, with alcohol intake and smoking each contributing about 5% to the variation. HDL3c had a similar relationship to obesity, alcohol, and smoking, but the magnitude of effect was much smaller than that for HDL2c. Thus, the concentration of cholesterol relative to protein found in HDL, particularly HDL2, was lower in overweight women and higher in women who reported alcohol intake. About 10% of variation in low density lipoprotein cholesterol (LDLc) was explained jointly by smoking, obesity, and alcohol intake compared with 15% of variation in apo B associated primarily with obesity (8%) and, to a lesser extent, with age and smoking. Physical activity was not independently associated with any of the lipoprotein lipid or apoprotein measures. In sum, results show that obese women exhibited reduced HDLc per mole of protein and that alcohol intake was linked to increased HDL particle number.(ABSTRACT TRUNCATED AT 250 WORDS)
Arteriosclerosis
PMID:Characteristics associated with apoprotein and lipoprotein lipid levels in middle-aged women. 314 51

We investigated the prevalence of carotid atherosclerosis and its association with serum lipoprotein cholesterol fractions in 412 Eastern Finnish men ages 42, 48, 54, or 60 years who were examined between February and December 1987 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Of the participants, 37% had thickening of the intimal or medial layer of the arterial wall, 10% had plaques, 2% had stenosis in the right or left common carotid artery or in the carotid bifurcation, and only 51% were free of any detectable carotid atherosclerosis. The prevalence of atherosclerosis was 14.1%, 32.0%, 67.7%, and 81.9% in the four age groups, respectively. The mean age-adjusted serum low density lipoprotein (LDL) cholesterol concentration was 3.67 mmol/l (142 mg/dl) in men free of carotid atherosclerosis and 4.02 mmol/l (155 mg/dl) in those with at least intimal thickening (p = 0.003 for difference). The mean age-adjusted serum cholesterol concentration in the high density lipoprotein (HDL) fraction was 1.34 mmol/l (52 mg/dl) in the atherosclerosis-free and 1.27 mmol/l (49 mg/dl) in the atherosclerotic men (p = 0.029 for difference). There was a similar difference in both the serum HDL2 and the HDL3 cholesterol levels. Serum LDL and HDL (inverse) cholesterol were significant determinants of severity of carotid atherosclerosis in a multivariate regression model adjusting for age, obesity, plasma fibrinogen, cigarette-years, and duration of hypertension. Our data reveal the high prevalence of atherosclerosis in middle-aged Eastern Finnish men and provide further evidence of the roles of LDL and HDL cholesterol in atherosclerosis.
Arteriosclerosis
PMID:Prevalence of carotid atherosclerosis and serum cholesterol levels in eastern Finland. 319 22

Plasma very low density lipoprotein (VLDL) cholesterol and triglyceride, low density lipoprotein (LDL) cholesterol and triglyceridea, high density lipoprotein (HDL) cholesterol, glucose and insulin response (sums of 1- and 2-hour postload oral glucose levels), body mass index (BMI), and blood pressure were determined in a representative sample (n = 542) of the adult Israeli Jewish population. Persons with diabetes or on antihypertensive medications were excluded. Total VLDL and LDL fractions were estimated from their cholesterol and triglyceride subfraction levels that were standardized relative to the mean of the reference group (participants free of glucose intolerance, obesity, and hypertension--the GOH conditions). Hyperinsulinemia and disturbed levels of VLDL and LDL were defined as levels equal to or greater than the 75th percentile and those of HDL, equal to or less than the 25th percentile of their respective reference group distributions. When VLDL was disturbed jointly with LDL and HDL, the mean insulin response adjusted for age, gender, glucose response, BMI, blood pressure, and smoking was high compared to the reference group (166.0 vs. 122.5, p less than 0.001). With isolated disturbed VLDL, or disturbed LDL and HDL but normal VLDL, the mean insulin response resembled the reference group. The adjusted risk ratio for this jointly disturbed lipoprotein profile among hyperinsulinemic individuals was 3.4 (95% confidence limits 2.6 to 4.4, p less than 0.001) with no further association with the GOH conditions. We conclude that hyperinsulinemia is characterized by an atherogenic lipoprotein profile.
Arteriosclerosis
PMID:Hyperinsulinemia is characterized by jointly disturbed plasma VLDL, LDL, and HDL levels. A population-based study. 328 21

Levels of high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apo A-I) may provide independent information concerning cardiovascular disease risk. Therefore, possible correlates of HDL-C and apo A-I levels were studied in 2827 5- to 17-year-olds from a biracial community, and the possible differences in these relationships were assessed. The characteristics examined included sexual maturation, plasma levels of glucose and insulin, obesity, reported oral contraceptive use, alcohol consumption, and cigarette smoking. In addition, levels of endogenous sex hormones (testosterone, estrogen, and progesterone) were measured in 515 adolescent males. HDL-C and apo A-I levels showed different (p less than 0.001) relationships with both obesity and oral contraceptive use. Increases in subscapular skinfold thickness corresponded more closely to decreases in HDL-C, rather than apo A-I, levels; the relationship with HDL-C was probably mediated by triglyceride levels. In contrast, oral contraceptive use was associated with increases in mean levels of apo A-I (8 mg/dl, whites; 16 mg/dl, blacks), but with only very small changes in HDL-C. (High-estrogen oral contraceptives were related most closely to increases in levels of both HDL-C and apo A-I). Levels of both HDL-C and apo A-I were similarly related to sexual maturation and levels of testosterone (negatively in boys), cigarette smoking (negatively), and alcohol intake (positively). Since levels of apo A-I independently of HDL-C may indicate an increased risk of cardiovascular disease, characteristics related to apo A-I levels should be further examined.
Arteriosclerosis
PMID:Correlates of high density lipoprotein cholesterol and apolipoprotein A-I levels in children. The Bogalusa Heart Study. 330 Jun 17

This paper reviews epidemiological studies on the relationship between diet and high density lipoproteins (HDL), with emphasis on the authors' studies of boys and men from different countries and with different dietary habits. Sera were collected from boys (ages 7 to 9 years) and men (ages 33 to 48 years) in 20 countries, and these were analyzed in one standardized laboratory. In boys, total and HDL cholesterol changed in parallel, from low values in populations in developing countries with low-fat, high-carbohydrate diets to high values in affluent populations. The correlation between HDL and total cholesterol was 0.90 (n = 16 populations). A similar trend was seen in groups of vegetarian and omnivorous boys within one region. Detailed analyses of individual diets of boys in five countries showed a negative relation between carbohydrate intake and HDL cholesterol both for group means (r = -0.99, n = 5) and for individual boys within one country (r = -0.26 to 0.04, n = 109 to 133 boys per country). In these boys, differences in obesity and physical activity were slight, and unrelated to differences in HDL. Total cholesterol rose with saturated fat intake (r = 0.87 for five population means; r = 0.07 to 0.26 within population groups). In adult men, total and HDL cholesterol also tended to rise simultaneously with affluence. However, the relation was much weaker (r = 0.60, n = 13 population groups).(ABSTRACT TRUNCATED AT 250 WORDS)
Arteriosclerosis
PMID:Total cholesterol and high density lipoprotein cholesterol levels in populations differing in fat and carbohydrate intake. 331 81

Relationships between diet and cardiovascular disease risk factors were studied in a cohort of infants in Bogalusa, Louisiana. The 24-hour dietary recalls and cardiovascular measurements were obtained on each child at age 6 months, yearly through age 4, and again at age 7 (cardiovascular measurements only). At ages 4 and 7, children with persistently high intakes of dietary cholesterol (three or more measurements in the upper tertile) had levels of serum total cholesterol approximately 14 mg/dl higher than children whose intakes of cholesterol were not persistently high. Children in the upper tertile for dietary cholesterol had levels of low density lipoprotein cholesterol (15 mg/dl at age 4 and 18 mg/dl at age 7) higher than children in the lower tertile for dietary cholesterol. Children with high intakes of animal fat were 2 to 6 kg heavier (p less than 0.05) than those with lower intakes. Changes in dietary cholesterol correlated significantly with changes in serum total cholesterol (r = 0.42) and low density lipoprotein cholesterol (r = 0.50) from 6 months to 4 years of age. Changes in subscapular skinfold measurements correlated significantly with changes in intake of total protein (r = 0.31), total fat (r = 0.25), starch (r = 0.31), and energy (r = 0.39) from ages 6 months to 4 years. Results indicate that tracking of dietary components and their relationships with cardiovascular disease risk factors can be detected at an early age. These findings may well be the groundwork for later studies of obesity and the early onset of hyperlipoproteinemia.
Arteriosclerosis
PMID:Dietary factors relate to cardiovascular risk factors in early life. Bogalusa Heart Study. 334 59


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