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

Cholesterol gallstones are a significant cause of morbidity in the U.S. Methods used to treat gallstones include cholecystectomy or medical dissolution. The primary drugs used for the dissolution of cholesterol gallstones are two bile acids, chenodeoxycholic acid and ursodeoxycholic acid. Complete or partial gallstone dissolution rates using chenodeoxycholic acid have ranged from 30 to 80 percent. Factors affecting gallstone dissolution using the bile acids include the dosage and administration schedule, obesity, the stone characteristics, diet, and the duration of therapy. The adverse effects of chenodeoxycholic acid include gastrointestinal complaints, hepatotoxicity, and increased serum cholesterol. Ursodeoxycholic acid, which is investigational, differs from chenodeoxycholic acid in its mechanism of action. Ursodeoxycholic acid has similar efficacy with chenodeoxycholic acid, at a lower daily dosage, with less gastrointestinal and hepatic adverse effects. If appropriate patient selection is used, the response rate to medical therapy can range from 50 to 80 percent.
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PMID:Medical management of cholesterol gallstones. 351 22

In contrast to the usual 2:1 female:male ratio for the presence of gallstones, we found that the 12 patients with symptomatic gallstones under age 30 in this study were all female. This prompted a retrospective study of clinicopathologic findings in these 12 women with gallstones. Chemical analyses of the gallstones confirmed that all were cholesterol stones. Obesity and pregnancy proved to be the outstanding risk factors. The mechanism of obesity and pregnancy as lithogenic factors are reviewed and discussed.
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PMID:Gallstones in women younger than thirty. 355 16

The examination and treatment of 547 patients with alimentary obesity revealed in them significant impairments of myocardial contractility, manifest hemodynamic disorders (in 65.5% of patients), marked changes in lipid metabolism (hypercholesterolemia, hypertriglyceridemia, hyperlipacidemia, hyperlipoproteinemia type IIa in 26,5%, type IIb in 14,5%, type IV in 32,5% of patients), as well as reduced activity of the T-immunity system, all these changes being prerequisites for the development of atherosclerosis, ischemic heart disease and essential hypertension. During examination of the patients' liver, fatty hepatosis was detected in 91.4%, chronic nonalcoholic steatohepatitis in 14% of patients, manifest shifts were found in their bile biochemical composition, leading to the development of cholelithiasis. The incretory dysfunction of the pancreas led to carbohydrate imbalance in 43%, and to diabetes mellitus in 7.5% of patients. Under the effect of the treatment (diet, exercise therapy, oxygenotherapy, hydrotherapy) conducted in the alimentary obesity patients, lessening of the pathologic process was observed in the heart, liver and pancreas, their functions being significantly improved. It has been concluded that normalization of the body weight in obese subjects is a measure preventing atherosclerosis, ischemic heart disease, essential hypertension, fatty hepatosis, steatohepatitis, cholelithiasis and diabetes mellitus.
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PMID:[Role of modern diet therapy in the prevention of visceral complications in patients with dietary obesity]. 356 80

106 IUD user, parous women (1.9-2.2 births) with an average age of 29.8 years and findings of triglyceridemia of 1.65 mmol/1 and cholesterolemia of 5.9 mmol/1 were studied. The control group consisted of 114 parous women (2.1 children) nonusers with an average age of 26.7 years and findings of triglyceridemia of 1.72 mmol/1 and cholesterolemia of 6 mmol/1. The IUD users were divided into 4 groups according to duration of use: 1-12 months, 13-24 months, 23-36 months, and 36 months. 45 women used Norbiogest, 34 used Neogest, 19 used Ovidon, 26 used Yermonil, 15 used Biogest, and 3 used Nonovlon. The incidence of cholelithiasis, measured by the 3.5 mHZ linear cholecystic sound of the SAL-22A ultrasonographic device made by Toshiba, was 13.2% in 106 IUD users vs. 10.5% in 114 nonusers, a finding without statistical significance. The rate of cholelithiasis was 20% in those who used IUDs for 36 months (average of 51 months) which was statistically significant when compared to the first group (10.9% rate) or controls (10.5%). The rate of longterm IUD users was similar to those who had had 3 pregnancies in their anamnesis (21.5%). Prolonged use of IUDs exceeding 3 years was associated with increased risk of developing cholelithiasis, but the levels of triglycerides and cholesterol were not different in the 2 groups. The following risk factors of the disease have to be considered for judging pathogenic potential: family history, prior birth, and obesity.
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PMID:[Do oral contraceptives increase the risk of developing cholelithiasis?]. 366 52

The prevalence of sludge and stones in the gallbladder of 298 women in the immediate post-partum period was ultrasonographically assessed. We have investigated some risk factors for the development of sludge or stones in these patients and followed up most of these patients by ultrasonography to detect the presence of sludge and/or stones in the year following their discovery. We found sludge in 80 (26.2%) and gallstones in 16 (5.2%) of these patients. Age, obesity and months of oral contraceptive use were risk factors only for the presence of gallstones. After 1 year of follow-up only 2 out of 45 patients with sludge but 13 out of 15 patients with gallstones still had abnormal ultrasonographic findings.
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PMID:Sludge and stones in gallbladder after pregnancy. Prevalence and risk factors. 369 66

Gallbladder emptying and filling was studied in eight diabetic and six normal control patients. None of the patients had gallstones. Cholescintigraphy was performed using [99mTc]disofenin, and gallbladder emptying was studied using a 45-min i.v. infusion of the octapeptide of cholecystokinin (OP-CCK) 20 ng/kg X hr. The peak filling rate was greater in diabetic than in normal subjects; however, emptying of the gallbladder in response to OP-CCK was significantly less in the diabetic subjects (51.6 +/- 10.4% compared with 77.2 +/- 4.9%). When the diabetic group was subdivided into obese and nonobese diabetics, the obese diabetics had a much lower percentage of emptying than the nonobese diabetics (30.0 +/- 10.4% compared with 73.1 +/- 9.3%). These findings suggest that obese diabetics may have impaired emptying of the gallbladder even in the absence of gallstones. The more rapid rate of gallbladder filling in obesity may indicate hypotonicity of the gallbladder. The combination of these abnormalities may predispose the obese diabetic to the development of gallstones.
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PMID:Gallbladder function in diabetic patients. 371 53

The prevalence of clinical gallbladder disease was determined in a cross-sectional survey of Mexican Americans and non-Hispanic whites. The study population was randomly selected from three urban neighborhoods representing different socioeconomic strata. Gallbladder disease was defined as a history of cholecystectomy, or of stones on cholecystography. Mexican American women had an age-standardized prevalence of 16.9%, vs 8.7% for non-Hispanic whites (p less than 0.0001). Prevalences in men were 4.2 and 3.4%, respectively. The ethnic differences in women persisted after stratification by age, parity, and body mass index. Gallbladder disease prevalence was inversely related to four measures of socioeconomic status. After controlling for age, obesity, parity, and ethnicity, the prevalence in women was inversely related to levels of education, income, occupational status, and neighborhood. These socioeconomic differences, if not the result of detection bias, suggest that environmental factors may play a role in gallstone pathogenesis. Identification of such factors may lead to the development of preventive strategies.
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PMID:Socioeconomic status and the prevalence of clinical gallbladder disease. 387 35

Gallbladder stasis has been implicated in gallstone formation. Gallbladder filling and emptying were quantitated by computer-assisted cholescintigraphy in 41 normal subjects versus 26 patients with gallstones. Gallbladder contraction was induced by low-dose (1.2 U/kg . h) cholecystokinin infusion. Gallstone patients exhibited normal gallbladder filling, but emptying was significantly (p less than 0.01) reduced compared with controls. On closer inspection, the patients fell into two subgroups, separated by t1/2, the time to empty 50% of gallbladder contents, 19.1 min (mean + 2 SD of control). Fifteen patients (57.7%) with a normal t1/2 (less than 19.1 min) exhibited both normal filling and normal emptying. The remaining 11 patients (43.3%) with t1/2 greater than 19.1 min had grossly abnormal gallbladder emptying, significantly (p less than 0.001) different from both the previous patient subgroup and the controls. There was no significant difference in age, sex, prevalence of obesity, presence or absence of biliary colic, and gallstone size, number, or calcification between these two subgroups. Thus, defective gallbladder emptying is evident in a subgroup of gallstone patients, and is independent of clinical features, stone size, and number. Impaired emptying should be considered when assessing pathogenesis or medical therapy.
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PMID:Abnormal gallbladder emptying in a subgroup of patients with gallstones. 396 10

The triglyceride, cholesterol, and phospholipid contents of heart papillary muscle were measured in groups of obviously healthy and diseased females and males on whom either routine or forensic necropsies were performed. In healthy men the triglyceride content was 1.77 +/- 1.30 mg/g of wet weight and in women 1.25 +/- 0.48 mg/g wet weight. The corresponding values for cholesterol were 1.07 +/- 0.24 mg/g and 1.21 +/- 0.22 mg/g and those for phospholipids 17.70 +/- 5.15 mg/g and 19.65 +/- 10.21 mg/g. The differences between the sexes were not significant. The hypertensive or cardiac hypertrophy group had about the same or slightly lower means for lipid content. In the cholelithiasis group, women had significantly high triglyceride values (3.38 +/- 2.36 mg/g). The cholesterol values were not significantly elevated in either men or women. In the diabetic group, triglycerides were significantly increased both in men (mean 8.12 +/- 0.54 mg/g) and in women (6.85 +/- 5.66 mg/g). The cholesterol mean values were also high in both sexes, but the rise was not significant because of the great variation. In the coronary atheroma group, both male and female hospital cases had high triglyceride contents (mean 4.48 +/- 4.25 mg/g and 3.65 +/- 3.94 mg/g) whereas the forensic cases had only slightly elevated or normal values. Cholesterol assays paralleled the triglyceride ones, but phospholipids showed an inverse trend. The results showed that the lipid content of papillary muscle was increased in diseases where disturbances of lipid metabolism are evident, as in diabetes and cholelithiasis. In coronary atheroma only those cases with advanced obstruction of the arteries were associated with abnormal values of papillary lipids. No increase of the lipid content with age alone was found, nor was there any correlation with obesity.
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PMID:Triglycerides, cholesterol, and phospholipids in normal heart papillary muscle and in patients suffering from diabetes, cholelithiasis, hypertension, and coronary atheroma. 426 65

Hepatic secretions of biliary lipids were estimated in 43 patients with and without cholesterol gallstones. Studies were carried out by a marker dilution technique employing duodenal intubation with a three-lumen tube. Hourly secretion rates of cholesterol, bile acids, and phospholipids were determined during constant infusion with liquid formula. In 17 American Indian women with gallstones, hourly outputs of biliary bile acids were significantly less than those in 7 Indian men and 12 Caucasian women without gallstones. These findings suggest that a decreased hepatic secretion of bile acids contributes significantly to the production of a lithogenic bile in Indian women. However, in Indian women with gallstones, secretion of biliary cholesterol was also significantly increased, as compared with Caucasian women without stones. Therefore, lithogenic bile in Indian women was, in most cases, due to a combined decrease in bile acid output and increase in cholesterol secretion. In an attempt to determine the mechanisms for these abnormalities, cholesterol balance studies were done in Indian women with gallstones and normal Indian men. Balance data were compared with results reported previously in non-Indian patients studied by the same techniques, and in general, Indian women showed a slight increase in fecal excretion of bile acids. Since bile acids in the enterohepatic circulation were relatively depleted in Indian women, these patients had a reduced fractional reabsorption. However, previous studies have shown that Caucasians can rapidly replenish bile acid pools in the presence of much greater intestinal losses, and it is suggested that among Indian women with gallstones, reduced secretion rates of bile acids are primarily the result of defective homeostatic regulation of bile acid synthesis. In Indian women with gallstones, at least two factors may have contributed to an increased availability of cholesterol in the liver for secretion into bile. First, cholesterol was inadequately converted into bile acids, and secondly, an increased amount of cholesterol was synthesized, as shown by the balance technique. This enhanced production of cholesterol can partially be explained by obesity, but other factors may also play a role.
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PMID:Mechanisms of lithogenic bile formation in American Indian women with cholesterol gallstones. 464 Sep 46


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