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

Schizophrenia is associated with several chronic medical illnesses and a reduced life expectancy. This paper summarizes findings and recommendations from "The Mount Sinai Conference," held at the Mount Sinai School of Medicine in New York on October 17-18, 2002, and discusses the implications for improving medical monitoring of patients with schizophrenia who are managed in outpatient settings from the initiation of treatment. The Mount Sinai Conference involved a diverse panel of experts, including specialists on schizophrenia, obesity, diabetes, cardiology, endocrinology, and ophthalmology. Consensus recommendations included baseline measurement and regular monitoring of body mass index, blood glucose, lipid profiles, signs of prolactin elevation or sexual dysfunction, and movement disorders. Information from such measurements should be considered when selecting or switching antipsychotic agents and should trigger an evaluation of medication when abnormalities are detected.
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PMID:Health monitoring for patients who have schizophrenia. Summary of the Mount Sinai Conference recommendations. 1712 58

Intensive efforts have been made to develop potent and selective ligands for certain human melanocortin receptors as possible treatments for obesity and sexual dysfunction due to the role of these receptors in feeding behavior, energy homeostasis, sexual function, etc. A number of novel alpha-MSH analogues were designed and synthesized primarily on the basis of our previous MTII NMR structure. In these peptide analogues, a disulfide or lactam bridge between residues at positions 5 and 8 was used as a conformational constraint to enhance the beta-turn spanning His6 and D-Phe7, while the pharmacophore group in Arg8 was mimicked via Nalpha-alkylation of residues 8 or 9 with the guanidinylbutyl group. Biological assays for binding affinities and adenylate cyclase activities for the hMC1R, hMC3R, hMC4R, and hMC5R showed that three analogues have good binding affinity for the hMC4R (0.7-4.1 nM), but have no binding affinity up to 10 microM at the other three melanocortin receptors. Interestingly, the three hMC4R selective analogues display only 50% binding efficiency, suggesting there is allosteric modulation of the melanocortin-4 receptor. These analogues were found to act as antagonists of the hMC4R. This result represents a discovery of very selective peptide-based antagonists for the hMC4R. The high selectivity may be due to the strong conformational constraint via ring contraction as compared to MTII, and the rigid conformation preferred by these new ligands allows them to recognize only the hMC4R, but not to activate the second messenger. The MTII NMR structure-based design thus not only examined the structural model of melanocortin ligands, but also yielded new biologically unique alpha-MSH analogues.
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PMID:Design, synthesis, and biological evaluation of new cyclic melanotropin peptide analogues selective for the human melanocortin-4 receptor. 1715 18

Sexual difficulties in women appear to be widespread in society; the relationship between female sexual function and obesity is unclear. This study aimed to investigate the relationship between body weight, the distribution of body fat and sexual function in women. Fifty-two, otherwise healthy women with abnormal values of female sexual function index (FSFI) score (< or =23) were compared with 66 control women (FSFI >23), matched for age and menopausal status. All women were free from diseases known to affect sexual function. FSFI strongly correlated with body mass index (BMI) (r=-0.72, P=0.0001), but not with waist-to-hip ratio (r=-0.09, P=0.48), in women with sexual dysfunction. Of the six sexual function parameters, desire and pain did not correlate with BMI, while arousal (r=-0.75), lubrication (r=-0.66), orgasm (r=-0.56) and satisfaction (r=-0.56, all P<0.001) did. FSFI score was significantly lower in overweight women as compared with normal weight women, while cholesterol and triglyceride levels were higher. On multivariate analysis, both age and BMI explained about 68% of FSFI variance, with a primacy of BMI over age (ratio 4:1). In conclusion, obesity affects several aspects of sexuality in otherwise healthy women with sexual dysfunction.
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PMID:Association of body weight with sexual function in women. 1728 32

We performed a cross-sectional analysis of factors associated with negative body image among 550 older men with or at-risk for HIV infection, including demographics, depression, illicit drug use, and antiretroviral therapy adherence. Overall, 31 per cent of participants reported negative body image, which was independently associated with increased BMI, self-rated fair/poor health, depression, and erectile dysfunction, but not HIV status. Screening for and treating depression, sexual dysfunction, and obesity in older men should be considered.
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PMID:Body image in older men with or at-risk for HIV infection. 1736 4

Erectile dysfunction is an important cause of decreased quality of life in men. It is estimated that approximately 30 million men in the US and 100 million worldwide may have erectile dysfunction. Data from epidemiological studies indicate a higher prevalence of impotence in obese men. Obesity may be a risk factor for sexual dysfunction in both sexes; data for the metabolic syndrome are very preliminary and need to be confirmed in larger epidemiological studies. The high prevalence of erectile dysfunction in patients with cardiovascular risk factors suggests that abnormalities of the vasodilator system of penile arteries play an important role in the pathophysiology of erectile dysfunction. Nitric oxide released during non-adrenergic, non-cholinergic neurotransmission and from the endothelium is probably the principal neurotransmitter mediating penile erection. It has been shown that chloroquine administration was associated with an increase in nitric oxide synthesis. Chloroquine was also postulated to enhance insulin sensitivity, which suggests potential benefit in treating the metabolic syndrome-related erectile dysfunction.
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PMID:Chloroquine-induced nitric oxide as a potential treatment of erectile dysfunction associated with the metabolic syndrome: the science and the fiction. 1760 95

Post-hysterectomy vaginal vault prolapse is a common disorder which generally manifests as a protrusion of the vagina through the genital hiatus, sometimes accompanied by urinary and gastrointestinal symptoms as well as sexual dysfunction. Risk factors for this condition include vaginal deliveries, obesity and previous hysterectomy, although genetic predisposition leading to reduced connective tissue and muscle strength may also play a role. Surgical correction of this disorder can be performed through either the abdominal or transvaginal approaches. Two prospective randomized trials have compared these approaches demonstrating better anatomic success rates for the abdominal approach as opposed to faster recovery and lower morbidity for the transvaginal approach. Laparoscopic and other transvaginal minimal access techniques for vaginal vault suspension have recently been advocated utilizing synthetic or biological adjuvant grafts. These techniques have been associated with high success rates albeit substantial graft complications such as erosion, contraction and dyspareunia. Suspension of the vaginal apex to the uterosacral ligaments (McCall culdoplasty) or to the sacrospinous ligaments at the time of vaginal hysterectomy is the mainstay for prevention of post hysterectomy vaginal vault prolapse. Our knowledge of the pathophysiology of post hysterectomy vaginal vault prolapse is quickly being refined, leading to more efficient surgical therapies for prevention and treatment of this disorder.
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PMID:[Post hysterectomy vaginal vault prolapse: diagnosis prevention and treatment]. 1877 Sep 62

The metabolic syndrome (MS) is comprised of various medical conditions that confer increased risk of diabetes and cardiovascular disease. The pathophysiologic components of MS include glucose abnormality, obesity or increased waist circumference, increased blood pressure, and hyperlipidemia. There is an increased risk of hypogonadism in men with MS and its individual components, including insulin resistance, considered by some to be at the core of MS. Hypogonadism may even predict MS. These factors are interwoven and impact overall health, including sexual dysfunction. One interesting and important question is whether treating hypogonadism with testosterone replacement will ameliorate the pathological components of MS.
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PMID:The emerging link between hypogonadism and metabolic syndrome. 1877 86

Recent work shows a high prevalence of low testosterone and inappropriately low LH and FSH concentrations in type 2 diabetes. This syndrome of hypogonadotrophic hypogonadism (HH) is associated with obesity, and other features of the metabolic syndrome (obesity and overweight, hypertension and hyperlipidemia) in patients with type 2 diabetes. However, the duration of diabetes or HbA1c were not related to HH. Furthermore, recent data show that HH is also observed frequently in patients with the metabolic syndrome without diabetes but is not associated with type 1 diabetes. Thus, HH appears be related to the two major conditions associated with insulin resistance: type 2 diabetes and the metabolic syndrome. CRP concentrations have been shown to be elevated in patients with HH and are inversely related to plasma testosterone concentrations. This inverse relationship between plasma free testosterone and CRP concentrations in patients with type 2 diabetes suggests that inflammation may play an important role in the pathogenesis of this syndrome. This is of interest since inflammatory mechanisms may have a cardinal role in the pathogenesis of insulin resistance. It is relevant that in the mouse, deletion of the insulin receptor in neurons leads to HH in addition to a state of systemic insulin resistance. It has also been shown that insulin facilitates the secretion of gonadotrophin releasing hormone (GnRH) from neuronal cell cultures. Thus, HH may be the result of insulin resistance at the level of the GnRH secreting neuron. Low testosterone concentrations in type 2 diabetic men have also been related to a significantly lower hematocrit and thus to an increased frequency of mild anemia. Low testosterone concentrations are also related to an increase in total and regional adiposity, and to lower bone density. This review discusses these issues and attempts to make the syndrome relevant as a clinical entity. Clinical trials are required to determine whether testosterone replacement alleviates symptoms related to sexual dysfunction, and features of the metabolic syndrome, insulin resistance and inflammation.
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PMID:Hypogonadotrophic hypogonadism in type 2 diabetes, obesity and the metabolic syndrome. 1907 78

The number of patients with metabolic disorders, obesity, type 2 diabetes and hypertension is increasing worldwide. The increase in body weight as a consequence of genetic, environmental, and nutritional factors contributes to these disorders, playing a significant role in their disease course. In 1994 the obesity gene (ob) which encodes a protein named leptin, considered an important molecule in regulation of body weight, was described Body weight gain has been generally correlated with high plasma levels of leptin, generating a state of leptin-resistance. Because of its association with obesity, leptin has also been connected with type 2 diabetes and insulin-resistance, an essential characteristic of this disease. Leptin has also been linked with other disorders such as dyslipidaemia, and cardiovascular disease (conditions that together are known as metabolic syndrome), as well as cancer, psychological deficits, sexual dysfunction, etc. We describe some important biochemical and molecular aspects associated with the physiology of leptin, emphasizing the pathological consequences associated with obesity and diabetes.
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PMID:[Leptin and its association with obesity and type 2 diabetes]. 1911 26

Metabolic syndrome (MetS) is a diagnostic category, based on a cluster of risk factors (hyperglycemia/diabetes, abdominal obesity, hypertriglyceridaemia, low HDL cholesterol and hypertension), which identifies subjects at high risk for forthcoming type 2 diabetes mellitus and cardiovascular (CV) diseases. Recently, a close association between MetS, erectile dysfunction (ED) and male hypogonadism has been reported. In patients with MetS, hypogonadism can exacerbate sexual dysfunction and arteriogenic ED because of its typical symptoms, such as decreased sexual desire and mood disturbances. On the other hand, hypogonadism per se has been associated with an increased risk of CV and overall mortality. Obesity and in particular central obesity is nowadays considered the most important determinant of MetS-induced hypogonadism whereas hypertension and diabetes play a major role in ED associated with MetS. This review analyses the current literature regarding the relationship between ED, MetS and hypogonadism emphasising the epidemiological and psychopathological aspects and stressing the concept that ED subjects are 'lucky', because ED offers a unique chance to undergo medical examination and therefore to improve not only their sexual but, most importantly, their overall health.
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PMID:Why can patients with erectile dysfunction be considered lucky? The association with testosterone deficiency and metabolic syndrome. 1917 51


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