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

Twenty-eight patients (19 females, 9 males) were evaluated pre- and posttransplant to determine the frequency and find predictors of excessive weight gain after orthotopic liver transplant. Posttransplant, 21 patients gained and 7 patients lost weight as compared with their pretransplant dry weight. The majority of weight gain occurred between 2 and 16 months; 64.3% of patients (18/28 pts.) became overweight. All patients overweight prior to transplant (11 pts.) were more overweight posttransplant (P less than 0.005). Overweight and nonoverweight patients were similar in age, female predominance, etiology of liver disease, hypercholesterolemia, and hypertriglyceridemia pretransplant, as well as diabetes mellitus and medications including prednisone posttransplant. Overweight patients more commonly had a family history of diabetes mellitus, arteriosclerotic heart disease, and hypertension. They also had more hypertension, hypercholesterolemia, hypertriglyceridemia, abnormal physical findings related to the liver, and abnormal results of hepatic tests posttransplant. Mean rate of weight gain for overweight patients compared with nonoverweight ones during the first 16 months after transplant was 1.5 kg/month +/- 0.9 vs 0.4 kg/month +/- 0.4 for those not overweight. After 16 months mean rate of increase was slower for overweight patients (0.3 kg/month +/- 0.3), whereas weight appeared to stabilize in the nonoverweight ones. We conclude that excessive weight gain after liver transplant is common and occurs early. Since obesity may contribute to, as well as be a separate cause, of hepatic abnormalities, confusion may result when interpreting abnormal results of hepatic tests. Obesity prior to transplant predicts excessive weight gain posttransplant, although all patients may be at risk.
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PMID:Excessive weight gain after liver transplantation. 201 32

The effects of first generation sulphonylurea compounds carbutamide, gliclazide and tolbutamide as well as second generation compounds glibenclamide and glipizide on the cardiovascular system were investigated in dogs. Six dogs received each compound intravenously at cumulative dose levels of 74, 296, 1184 mumol/kg of carbutamide and tolbutamide, 0.4, 2.0, 10.0 mumol/kg of glibenclamide and glipizide, and 16, 48 and 144 mumol/kg of gliclazide. Mean arterial blood pressure, myocardial contractile force, cardiac output and heart rate were measured. The rate of change of myocardial contractile force development (positive dF/dt), as well as of myocardial relaxation (negative dF/dt) were measured. The first generation sulphonylureas were found, in dogs, to exert a positive inotropic effect in contrast to second generation compounds. The clinical importance of our findings may be in the potential for the malfunction of the cardiovascular system (based on cardiopathy, neuropathy, atherosclerosis, and obesity), developing in diabetes, to be further impaired by the first generation sulphonylureas. Therefore, second generation sulphonylureas should be preferred in the therapy of type 2 diabetics, if satisfactory metabolic control cannot be achieved by dietary management alone and sulphonylurea treatment becomes necessary.
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PMID:Direct effect of hypoglycemic sulphonylureas on the cardiovascular system of dogs. 201 35

To evaluate the relationship between maximum venous outflow (MVO) of the leg and development of deep vein thrombosis (DVT), venous occlusion plethysmography (VOP) using a Mercury strain gauge was carried out in 56 unilateral DVT patients. The data from these patients were compared with those obtained from several control groups. Then, the relationship between plethysmographic and 9 clinical variables was statistically analysed in the normal legs of these patients. The mean MVO of the normal legs of these patients was significantly higher than that of the affected legs, but it was significantly lower than those of normal controls and patients with mild congestive heart disease. However, it was similar to those in patients with lymphedema and obese men. A decrease in the MVO of the normal legs of these patients was noted in older females with femoral vein obstruction of the left leg, with a shorter number of days from the onset of symptoms or with higher values for the obesity index and calf circumference. Significant correlations between the MVO and the obesity index (r = -0.59), venous capacitance (VC, r = 0.49) and the number of days from the onset of symptoms (r = 0.40) were found in the normal right legs of these patients (n = 40). In the normal left legs (n = 16), on the other hand, significant correlations were found between the MVO and the VC (r = 0.65) and the MVO and age (r = -0.65).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Maximum venous outflow and development of deep vein thrombosis. 203 May 45

The Honolulu Heart Program (HHP) is a prospective study of heart disease and stroke in Japanese-American men in Hawaii. Body weight, height, and subscapular and triceps skinfold thicknesses were measured by using standard methods at the baseline exam held in 1965-1968. The relationship of measures of body fatness to the 20-y follow-up for coronary heart disease (CHD) and stroke of these men was explored. Body mass index (BMI), subscapular skinfold thicknesses, and centrality index (subscapular skinfold thickness/triceps skinfold thickness) were predictors of CHD in this population, even after other risk factors were added to a multivariate model, indicating an independent contribution of body fat to CHD risk. Neither BMI nor centrality index was related to stroke. However, subscapular skinfold thickness was an independent predictor of stroke. The implications of these findings are that lifestyle changes that lead to an increase in obesity of Japanese men in Hawaii may increase risk for cardiovascular disease.
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PMID:Body fat, coronary heart disease, and stroke in Japanese men. 203 94

Crude estimation of the selection probability ratio (SPR), described previously, was extended to stratified and multivariate estimation and used to assess selection bias in a case-control study of renal adenocarcinoma. It was shown that the directly pooled estimate of the SPR, using the same weights as the directly pooled estimate of the exposure odds ratio (OR) from the case-control study (assuming the OR and SPR are common to all strata and data are abundant), can be multiplied with the OR to yield an adjusted OR that is free from selection bias. Medical records of 548 interviewed cases were compared with 640 noninterviewed cases, and interviews of 640 controls were compared with mailed questionnaires from 272 (60%) of the noninterviewed controls. Age-sex-adjusted point estimates of SPRs ranged from 0.65 to 1.4. Multivariate estimates from binomial regression ranged from 0.34 to 2.0. Higher socioeconomic status and history of renal stones were predictors of participation by both cases and controls. Obesity in women, hypertension, and nonsmoking were predictors in cases only. Heart disease was associated with control participation and case nonparticipation. This study cast doubt on the OR for obesity in women and hypertension in the case-control risk analysis.
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PMID:Analysis of selection bias in a case-control study of renal adenocarcinoma. 209 Feb 81

Screening for dyslipoproteinemias should be undertaken in all individuals older than 20 years of age at least once every 5 years. The initial screening, as recommended by the Adult Treatment Guidelines Panel of the National Cholesterol Education Program, is to determine the concentration of total blood cholesterol. This initial determination can be made on blood obtained in the nonfasting state. Further evaluation of the patient's lipoprotein concentrations is dependent upon the presence of other cardiovascular risk factors. in the absence of definite coronary heart disease, hypertension, diabetes mellitus, a family history of coronary artery disease, cigarette smoking, or severe obesity, the patient with a total blood cholesterol concentration less than 200 mg/dL requires no specific instruction and should have a repeated screening performed within 5 years. Patients with blood cholesterol concentrations greater than 200 mg/dL should have their lipoprotein profiles determined if they have atherosclerotic cardiovascular disease or two other cardiovascular disease risk factors. The lipoprotein profile includes the determination of fasting cholesterol and triglyceride and HDL cholesterol concentrations. From these values, the LDL cholesterol concentration can be calculated. This LDL cholesterol concentration is central in selecting the appropriate therapy. HDL cholesterol concentrations may be useful in evaluating patients with ischemic heart disease. Concentrations of HDL cholesterol less than 35 mg/dL are associated with increased risk for coronary artery disease. Although there is currently no convincing evidence that support the specific treatment of depressed HDL cholesterol concentrations, therapy directed to modulating lipoprotein metabolism in patients with heart disease and low HDL concentrations may be of benefit. Patients with recurrent abdominal pain, pancreatitis, and eruptive xanthomatosis frequently have fasting hypertriglyceridemia concentrations exceeding 1000 mg/dL. These patients should be identified in order to effectively reduce their triglyceride concentrations, which can prevent these complications.
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PMID:Detection and evaluation of dyslipoproteinemia. 219 76

Non-drinkers and heavy drinkers tend to have higher total and cardiovascular mortality rates than light or moderate drinkers. The finding is not disputed; it is the interpretation of this U-shaped curve that is controversial, and in particular the belief that light and moderate drinking protects against coronary heart disease. The British Regional Heart Study of middle-aged British men has shown that 70% of non-drinkers are ex-drinkers. Those ex-drinkers have high rates of doctor-diagnosed illnesses including heart disease, hypertension, diabetes and bronchitis as well as high prevalence rates of measured hypertension, obesity, current smoking and regular medical treatment. Over a five-year period men who were diagnosed as having heart disease, had multiple diagnoses or were put on regular medication had an increased likelihood of becoming non-drinkers or occasional drinkers. The study suggests a downward drift from heavy and moderate drinking towards non-drinking under the influence of accumulating ill health. The data strongly suggest that the observed alcohol-mortality relationships in prospective studies are produced by symptoms and disease present at the time of screening, and by the prior movement of men with such disorders into non-drinking or occasional drinking categories. The concept of a protective effect on mortality which ignores the dynamic relationship between ill health and drinking behaviour is likely to be ill-founded. A review of the major prospective studies reveals an inadequate exploration of the nature of non-drinkers, who are clearly unsuitable for use as a baseline in studies of the effects of alcohol on health.
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PMID:Alcohol and mortality: a review of prospective studies. 205 31

A large cross sectional study, the Scottish Heart Health Study, of 10,359 men and women from 22 districts of Scotland was undertaken to try to explain the geographical variation of coronary heart disease mortality. Analysis by district showed that of the classic risk factors only cigarette smoking was strongly associated with heart disease mortality among both men and women. Mean diastolic blood pressure was weakly associated with rates among men and high density lipoprotein cholesterol showed a strong negative association among women. Total cholesterol showed a weak negative association with heart disease mortality, but, because the serum concentrations of cholesterol were uniformly high in all districts, a strong association with mortality would not be expected. In both men and women many dietary factors showed moderate or strong associations with mortality from coronary heart disease in a district--of these a low consumption of vitamin C was most notable. Other factors associated with heart disease included alcohol consumption and serum triglycerides among men, and obesity, physical activity, and serum triglycerides among women. Many factors associated with heart disease showed strong intercorrelations. Clustering of risk factors (including smoking, alcohol, and diet among men, and smoking, diet, and obesity among women) was associated with much of the regional variation in heart disease mortality in Scotland.
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PMID:Geographical clustering of risk factors and lifestyle for coronary heart disease in the Scottish Heart Health Study. 220 12

Based on postmortem records at the Wayne County Medical Examiners' Office from 1982 to 1986, autopsy results indicated that the deaths of 129 persons aged 20-34 resulted from heart disease: 51 of these deaths were attributed to atherosclerotic cardiovascular disease (ASCVD), 29 to hypertensive cardiovascular disease, 28 to cardiomyopathy, and 21 to other cardiac causes. The majority of the deaths due to ASCVD occurred among men, both black and white, followed by black women, and the incidence increased with age. All of these deaths due to ASCVD were sudden and accounted for all deaths due to ischemic heart disease in this age group among Wayne County residents. Diabetes mellitus, left ventricular hypertrophy, a history of seizures, and the recent ingestion of alcohol were all found to be associated with sudden death from ASCVD in this group. Obesity did not seem to be a significant factor. These data suggest that ASCVD is not rare as a cause of death in young adults and some of the risk factors identified in older subjects also operate in this age group.
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PMID:Atherosclerotic cardiovascular disease and sudden deaths among young adults in Wayne County. 222 Jul 3

Risk factors for coronary heart disease were compared in fifth year boys (15-16 years old) from two schools that were chosen from localities with a fourfold difference in adult mortality from coronary heart disease. One school was in an underprivileged urban locality in the area of increased incidence of heart disease ('high risk') and the other in a semi-rural affluent locality with an incidence of heart disease similar to the national average ('low risk'). Smoking, hypertension, hypercholesterolaemia, obesity, physical fitness, and inactivity were evaluated as risk factors for coronary heart disease. Smoking, increased body fat, poor diet, and physical inactivity were found increased among pupils from the school in the high risk area compared with those in the low risk area. Lipids, maximum oxygen uptake, and hypertension were similar in both schools. The risk of coronary heart disease seems to reflect the adult mortality rates in the area. To reduce the overall incidence of coronary heart disease, health education should be directed towards prevention of smoking, improving diets, and increasing amounts of activity among school children, with special attention directed toward children in regions where there is a high mortality from coronary heart disease among adults.
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PMID:Association between risk factors for coronary heart disease in schoolboys and adult mortality rates in the same localities. 230 87


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