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

The complications of cadaveric renal transplantation in a group of 10-year survivors are presented. Fifty-two (44%) of 119 graft recipients survived more than 10 years, 48 with their original allograft. The major causes of death in the others were bacterial (24%) and other (10%) infections, cerebral (12%) and myocardial (7.5%) vascular disease. Serious morbidity in the survivors included infectious episodes (55%), skin cancer (40%), vascular disease (30%), cataracts (45%) and aseptic necrosis of bone (13%). Only six (12%) patients had no complications. Although complications were frequent, 34 patients (72%) were fully rehabilitated to work or household duties. Several recipients have become parents. Prevention of the late complications of transplantation must be aimed at reducing the known risk factors early in the course of renal failure. These include hypertension, obesity, cigarette smoking and sun exposure.
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PMID:Delayed complications of renal transplantation and their prevention. 675 92

Although hepatic transplantation is now a well-accepted treatment modality for end-stage liver diseases there are little detailed data on the clinical profile of patients who survive beyond 1 year following transplantation. The aim of this study was to develop a cross-sectional profile on 53 adults who have survived beyond 2 years following liver transplantation. These patients have been followed for a mean of 43.5 months (range 24-84) since the time of transplant. Nineteen patients had persisting liver enzyme abnormalities, 11 due to chronic viral hepatitis (seven hepatitis C virus, three hepatitis B virus), four due to biliary disease. Two had post severe rejection, one steatosis secondary to obesity while in one the aetiology was unclear. Nineteen (36%) of patients required anti-hypertensive medications. The median doses of Prednisone, Cyclosporin and Imuran were 7.5, 300 and 50 mg daily, respectively. The mean serum creatinine was 117 +/- 27 mumol/L. However 22 (41%) had an elevated serum creatinine (> 120 mumol/L) but in only seven was the serum creatinine > 150 mumol/L. Fourteen (26%) of patients were obese (body mass index > 30) whilst 46% had a higher than recommended serum cholesterol (mean level 5.6 +/- 1.5 mumol/L). There has only been one case of internal malignancy (lymphoma) although 19 patients attend regular dermatological review for skin cancer surveillance. Forty-eight patients had a Karnofsky Score > 80. In conclusion, the vast majority of these patients have excellent clinical function but some caution is required with respect to renal function, hypertension, obesity and mild hypercholesterolaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A follow up of 53 adult patients alive beyond 2 years following liver transplantation. 828 Aug 46

Half the targets in The Health of the Nation have already been, or are set to be, achieved by the specified date. Deaths from strokes, smoking, fat consumption, and accidents among elderly people are all falling-but not fast enough to meet targets. Obesity, drinking, skin cancer and smoking among 11 to 15-year-olds are all increasing.
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PMID:Health promotion. Feelgood factors. 1016 42

Obesity is related to cardiovascular disease (CVD) morbidity and mortality, however, the mechanisms for the development of obesity-induced CVD risk remain unclear. Hyperinsulinemia and insulin resistance are considered key components in the metabolic cardiovascular syndrome and as independent risk factors for CVD. Plasma leptin and tumor necrosis factor-alpha (TNF-alpha), two adipocyte products, are also proposed to be associated with the development of CVD risk. The purpose of this study is to evaluate the association of plasma leptin, soluble TNF receptors (sTNF-R), and insulin levels as possible mediators of the effect of obesity on atherogenic and thrombogenic CVD risk factors among men. From the Health Professionals Follow-up Study (HPFS), we selected 268 men, aged 47--83 years, who were free of CVD, diabetes, and cancer (except non-melanoma skin cancer), and who had provided a fasting blood sample in 1994. We measured plasma insulin and leptin levels by radioimmunoassay and sTNF-R levels by ELISA. Men in the highest quintile of body mass index (BMI, mean=30.5 kg/m(2)) were less physically active and had a more adverse cardiovascular lipid and homeostatic profile, as indicated by levels of insulin, triglyceride (TG), tissue plasminogen activator (t-PA) antigen levels, and apolipoprotein A1 (Apo-A1). In a multivariate regression model controlling for age, smoking, alcohol intake, physical activity and diet, BMI was inversely associated with HDL-cholesterol (HDL-C) and Apo-A1 and positively associated with TG, Apo-B and t-PA antigen levels. The associations between BMI and these CVD risk factors were only slightly changed after adjusting for leptin and/or sTNF-R; but were substantially attenuated after controlling for insulin levels. These data suggest that the association between obesity and biological predictors of CVD may be mediated through changes in plasma insulin, rather than leptin or sTNF-R levels. However, plasma leptin may still play a role in CVD through independent effects on lipid metabolism.
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PMID:Plasma insulin, leptin, and soluble TNF receptors levels in relation to obesity-related atherogenic and thrombogenic cardiovascular disease risk factors among men. 1147 52

Dietary energy restriction (DER) has long been known to strikingly inhibit carcinogenesis in many animal models. The animal data has been corroborated by recent and ongoing epidemiological studies demonstrating the importance of energy balance, physical exercise and obesity in human cancer. Dr. Edward Bresnick provided key insights into this important area of research and pivotal direction for the author's research while he served as Director of the Eppley Institute for Research in Cancer, Omaha, NE. These insights moved this research toward demonstrating that DER reduced the expression of key protein kinase C isoforms in mouse skin. More recent studies have uncovered downstream events that are inhibited by DER including blockage of tumor promoter activation of Raf-1, ERK 1,2 and AP-1 expression. Parallel studies have demonstrated the DER inhibition of these key cellular signaling events in mouse skin carcinogenesis are dependent upon an intact adrenal gland because adrenalectomized mice fed DER diet did not have reduced tumor burden or inhibited signaling and blocked AP-1 activation as was observed in DER mice with intact adrenal glands. In addition, the DER inhibition of tumorigenesis and AP-1 signaling was restored in adrenalectomized mice that were given corticosterone in the drinking water. This showed that in mice in the chemical carcinogenesis protocol glucocorticoid hormone plays a major role in mediating DER prevention of cancer. Studies are ongoing to further assess the mechanism of DER modulation of skin cancer by assessing impacts on transcriptional regulation and expression of genes that are critical in skin carcinogenesis.
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PMID:Identification of molecular targets for dietary energy restriction prevention of skin carcinogenesis: an idea cultivated by Edward Bresnick. 1474 86

Prostate cancer is the most common non-skin cancer among men in most western populations, and it is the second leading cause of cancer death among U.S. men. Despite its high morbidity, the etiology of prostate cancer remains largely unknown. Advancing age, race, and a family history of prostate cancer are the only established risk factors. Many putative risk factors, including androgens, diet, physical activity, sexual factors, inflammation, and obesity, have been implicated, but their roles in prostate cancer etiology remain unclear. It is estimated that as much as 42% of the risk of prostate cancer may be accounted for by genetic influences, including individual and combined effects of rare, highly penetrant genes, more common weakly penetrant genes, and genes acting in concert with each other. Numerous genetic variants in the androgen biosynthesis/metabolism, carcinogen metabolism, DNA repair, and chronic inflammation pathways, have been explored, but the results are largely inconclusive. The pathogenesis of prostate cancer likely involves interplay between environmental and genetic factors. To unravel these complex relationships, large well-designed interdisciplinary epidemiologic studies are needed. With newly available molecular tools, a new generation of large-scale multidisciplinary population-based studies is beginning to investigate gene-gene and gene-environment interactions. Results of these studies may lead to better detection, treatment, and, ultimately, prevention of prostate cancer.
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PMID:Prostate cancer epidemiology. 1636 24

In general, long-term treatment of hypertension, diabetes, and obesity after liver transplantation is similar to that for the general population. Measure bone density within the first year after transplantation. Treat osteoporosis with standard agents. Joint replacement surgery appears safe in this group of patients. Resume standard screening for malignancy 2 to 3 years after transplantation, and repeat at intervals similar to that used with the general population. Given the high risk of skin cancer, transplant recipients should wear sunblock (SPF >40) and have routine dermatologic examinations. Patients should wait at least 2 years before considering pregnancy and use barrier-type methods in this period. Vaccinate patients against hepatitis A and B, influenza, and pneumococcus. Avoid live vaccines.
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PMID:The liver transplant recipient: what you need to know for long-term care. 1645 81

Previous studies of leptin with cardiovascular disease (CVD) risk factors have been limited by clinical samples or lack of representation of the general population. This cross-sectional study, designed to examine whether leptin or insulin may mediate the endogenous relation of obesity with metabolic, inflammatory, and thrombogenic cardiovascular risk factors, included 522 men and 514 women aged >or=40 years who completed a physical examination during the third National Health and Nutrition Examination Survey. Participants were free of existing CVD, cancer (except non-melanoma skin cancer), diabetes, or respiratory disease. In multivariable analyses adjusted for race/ethnicity and lifestyle factors, waist circumference (WC) was positively associated with blood pressure, triglyceride, LDL cholesterol, total cholesterol:HDL ratio, apolipoprotein B, C-reactive protein (CRP), and fibrinogen concentrations, and negatively associated with HDL cholesterol and apolipoprotein A1 levels. The associations of WC with the metabolic CVD risk factors were largely attenuated after adjustment for insulin levels, while the associations of WC with the inflammatory and thrombogenic factors (CRP and fibrinogen, respectively) were largely explained by adjustment for leptin concentrations. However, leptin levels were not independently associated with CRP and fibrinogen in men and CRP in women when adjusted for WC. Positive associations of leptin and insulin with fibrinogen in women, independent of WC, were noted. These results suggest that insulin may be an important mediator of the association of obesity with metabolic but not inflammatory or thrombogenic CVD risk factors, while leptin does not appear to influence cardiovascular risk through a shared association with these risk factors. However, we cannot rule out the possibility that leptin and insulin influence cardiovascular risk in women through independent effects on fibrinogen concentrations.
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PMID:The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults. 1816 70

As outcomes after liver transplant surgery continue to improve, management of the long-term consequences of the procedure and the associated immunosuppression become increasingly important. Liver allograft recipients have, compared with age and sex-matched controls, increased risk for cardiovascular and cerebrovascular events and death, for bone disease, and for some cancers. Early recognition and treatment of modifiable risk factors, especially of hypertension (present in up to 77% recipients), diabetes (in up to 22%), obesity (up to 40%), renal impairment (in up to 50%), and hyperlipidemia (in up to 66%) are necessary to maintain prolonged and healthy survival. Early recognition of de novo cancers (which occur in up to 26% recipients) indicates the need for additional monitoring for skin cancer and lymphoproliferative disorders, as well as cancers of the lung, colon, and upper gastrointestinal track. Early recognition of bone disease and appropriate intervention will allow introduction of strategies to reduce bone fracture. In this article, we review the evidence for the extent and treatment of these modifiable conditions in the allograft recipient.
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PMID:Long-term care of the liver allograft recipient. 1923 63

NF-kappaB, a transcription factor first discovered in 1986, is now known to be closely connected to the process of tumorogenesis based on a multiplicity of evidence. (1) NF-kappaB is activated in response to tobacco, stress, dietary agents, obesity, alcohol, infectious agents, irradiation, and environmental stimuli that account for as much as 95% of all cancers. (2) The transcription factor has been linked with transformation of cells. (3) It is constitutively active in most tumor cells. (4) It has also been linked with the survival of cancer stem cells, an early progenitor cell that has acquired self-renewal potential. (5) NF-kappaB regulates the expression of most anti-apoptotic gene products associated with the survival of the tumor. (6) It also regulates the gene products linked with proliferation of tumors. (7) The transcription factor controls the expression of gene products linked with invasion, angiogenesis, and metastasis of cancer. (8) While most carcinogens activate NF-kappaB, most chemopreventive agents suppress its activation. These observations suggest that NF-kappaB is intimately intertwined with cancer growth and metastasis. The mechanism that leads to constitutive activation of NF-kappaB in hematological, gastrointestinal, genitourinary, gynecological, thoracic head and neck, breast, and skin cancers, and the ways NF-kappaB is activated are the topics of discussion in this review.
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PMID:NF-kappaB and cancer: how intimate is this relationship. 1982 71


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