Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous studies have reported high rates of gallbladder disease and gallbladder cancer among all American Indians. Data from the New Mexico Tumor Registry confirm these findings, specifically showing high rates for New Mexico's American Indians, as well as for the state's Spanish population. This review explores several risk factors, including parity, obesity, age, cholesterol level, and genetic factors. From the available evidence, genetic factors appear to be the most important, with parity a contributing factor.
 ...
PMID:Gallbladder disease and gallbladder cancer among American Indians in tricultural New Mexico. 71 24

The epidemiological patterns for pancreatic and biliary cancers reveal more differences than similarities. Pancreatic carcinoma is common in western countries, although 2 Polynesian groups (New Zealand Maoris and native Hawaiians) have the highest rates internationally. In the United States the disease is rising in frequency, predominating in males and in blacks. The rates are elevated in urban areas, but geographic analysis uncovered no clustering of contiguous counties except in southern Louisiana. The origin of pancreatic cancer is obsure, but a twofold increased risk has been documented for cigarette smokers and diabetic patients. Alcohol, occupational agents, and dietary fat have been suspected, but not proven to be risk factors. Except for the rare hereditary form of pancreatitis, there are few clues to genetic predisposition. In contrast, the reported incidence of biliary tract cancer is highest in Latin American populations and American Indians. The tumor predominates in females around the world, except for Chinese and Japanese who show a male excess. In the United States the rates are higher in whites than blacks, and clusters of high-risk counties have been found in the north central region, the southwest, and Appalachia. The distribution of biliary tumors parallels that of cholesterol gallstones, the major risk factor for biliary cancer. Insights into biliary carcinogenesis depend upon clarification of lithogenic influences, such as pregnancy, obesity, and hyperlipoproteinemia, exogenous estrogens, familial tendencies, and ethnic-geographic factors that may reflect dietary habits. Noncalculous risk factors for biliary cancer include ulcerative colitis, clonorchiasis, Gardner's syndrome, and probably certain industrial exposures. Within the biliary tract, tumors of the gallbladder and bile duct show epidemiological distinctions. In contrast to gallbladder cancer, bile duct neoplasms predominate in males; they are less often associated with stones and more often with other risk factors. In some respects, bile duct and pancreatic tumors are alike. The male predominance of both tumors, an association between cholecystectomy and pancreatic cancer, and other considerations have prompted the notion that the same biliary carcinogens may affect the bile duct, ampulla of Vater, or, by reflux, the pancreatic duct. Various epidemiological and interdisciplinary approaches are needed to further clarify the origins of biliary tract and pancreatic cancers, but nutritional studies hold special promise in laying the groundwork for prevention of these tumors.
 ...
PMID:Cancers of the pancreas and biliary tract: epidemiological considerations. 110 53

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
 ...
PMID:Symptoms of gallstone disease. 148 6

Among the Cree-Ojibwa Indians in the subarctic boreal forest of northern Manitoba and Ontario, a high prevalence of clinical gallbladder disease (18.5% among women aged 20-64) was observed. Of a variety of sociodemographic, physiological, anthropometric, and lifestyle factors, increased age and serum triglycerides, and reduced total cholesterol were found to be independent associated factors on multivariate analysis whereas diabetic status, obesity, and a central fat distribution were not. Previous studies in this population have indicated that the Indians also suffer from a high burden of obesity, diabetes, and gallbladder cancer, thus lending support to the hypothesis that genetic predisposition to a constellation of metabolic disorders is perhaps universal among New World aboriginal peoples.
 ...
PMID:Factors associated with clinical gallbladder disease in a Canadian Indian population. 235 72

A case-control study of biliary tract cancer was conducted in Niigata prefecture where the mortality of the cancer is the highest in Japan. The cases were 109 patients with gallbladder cancer and 84 with bile duct cancer, and the controls were 386 sex- and age-matched neighborhood controls. For gallbladder cancer, a past history of biliary tract disease, a positive family history of cholelithiasis and a taste for oily foods were high risk factors. Intakes of animal proteins and fats such as fish, eggs, meat, etc., ingestion of vegetables and fruits, and taking snacks were low risk factors for gallbladder cancer. For bile duct cancer, a past history of biliary tract disease, a family history of cerebral vascular accident, a thin constitution and taking a small amount of foods were high risk factors, and a family history of heart disease, obesity, intakes of alcohol, animal proteins and fats, or frequent intakes of vegetables and fruits were low risk factors.
 ...
PMID:A case-control study of biliary tract cancer in Niigata Prefecture, Japan. 251 77

Primary cancer of the gallbladder is uncommon but not rare, being in Italy the fourth cause of death for gastrointestinal cancer in females over 65 years old. Two centuries after the first description, this tumor remains characterized by an unfavorable prognosis due to the silent progression of the clinical course and the frequent unresectability at the time of surgery. Early diagnosis, aggressive surgical approach and chemotherapy are the basis for longer post-operative survival rates; in fact, despite the advances in ultrasonography and computer-assisted imaging devices, the prevention of gallbladder cancer remains a problem. In the statistical terms, the risks of an indiscriminate surgical prophylaxis would outweigh the advantages of cancer prevention; in this optic, a recognition of the patients "at major risk" appears to be essential. With this aim we have undertaken a review of current knowledge of the "risk factors" involved in the epidemiology and etiology of gallbladder cancer, deduced from Literature and our surgical experience. It is reasonable to assume that the etiology of this cancer is based on the correlationship between factors with a wide and different penetration in racial-ethnic areas: genetic, systemic and local risk-factors. A genetic influence can be highly suspected in the familiar cases, in the non-carcinoma tumors and in the geographic predominance of the tumor. None of the systemic factors suggested as risk factors (age, sex, obesity, occupational and chemical carcinogens, drugs, etc.) appear to be directly involved; moreover, the main factors, such as female sex and age, are probably mediated through cholelithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Risk factors and etiopathogenesis of cancer of the gallbladder]. 269 81

Gallbladder cancer, although rare in most Caucasian populations, is among the most frequently observed cancers in native populations of North and South America, and in the Maori population of New Zealand. In all populations, there is a strong correlation between gallstones and gallbladder cancer: the risk of gallbladder cancer is approximately 4-5 times higher in patients with gallstones, than in patients without gallstones. In those populations where the onset of gallstone disease occurs in the first few decades, the risk is much higher. Obesity, which is also a risk factor for gallstones, increases the risk of gallbladder cancer, as does the consumption of diets high in fats and calories. Other risk factors, such as increased parity, also increase the frequency of gallbladder cancer, most probably explained by the association between gallstones and parity. Prophylactic cholecystectomy for asymptomatic gallstones cannot be justified for the control of gallbladder cancer, but the increasing frequency of this procedure in many countries, secondary to the widespread use of laparoscopic surgical techniques, will clearly lower the incidence and mortality rates for this lethal disease.
 ...
PMID:Epidemiology of gallbladder cancer. 1043 Feb 89

Cancer of the gallbladder is a rare cancer with a poor prognosis. Most patients die within 1 year. The incidence shows large geographic variation and is higher in females and in certain ethnic groups. Gallstones are closely related to this type of cancer. Studying risk factors such as lifestyle is hampered by the generally small size of the case-series. Nevertheless, the studies conducted so far provide some indication that cigarette smoking, alcohol consumption, obesity and specific dietary habits might affect the risk. In women, reproductive history seems to affect the risk as well. Incidence may be lowered by identifying high risk groups and offering preventive measures. Although gallstones are associated with higher risk, most people with untreated gallstones are at low risk of developing the cancer. Moreover, the cancer occurs at such an old age that prophylactic removal of a stone-containing gallbladder is not an appropriate measure for the prevention of gallbladder cancer. Probably at a higher risk are those who are exposed to stones for longer periods. An indicator of duration of exposure is not presently available; whether stone size can be such an indicator in specific conditions and populations needs to be studied further.
 ...
PMID:The epidemiology of gallbladder cancer: lifestyle related risk factors and limited surgical possibilities for prevention. 1043 Feb 90

Obese patients are at an increased risk for developing many medical problems, including insulin resistance and type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, stroke, sleep apnea, gallbladder disease, hyperuricemia and gout, and osteoarthritis. Certain cancers are also associated with obesity, including colorectal and prostate cancer in men and endometrial, breast, and gallbladder cancer in women (1-6). Excess body weight is also associated with substantial increases in mortality from all causes, in particular, cardiovascular disease. More than 5% of the national health expenditure in the United States is directed at medical costs associated with obesity (7). In addition, certain psychologic problems, including binge-eating disorder and depression, are more common among obese persons than they are in the general population (8.9). Finally, obese individuals may suffer from social stigmatization and discrimination, and severely obese people may experience greater risk of impaired psychosocial and physical functioning, causing a negative impact on their quality of life (10).
 ...
PMID:Obesity and its comorbid conditions. 1069 82

Gallbladder cancer is usually associated with gallstone disease, late diagnosis, unsatisfactory treatment, and poor prognosis. We report here the worldwide geographical distribution of gallbladder cancer, review the main etiologic hypotheses, and provide some comments on perspectives for prevention. The highest incidence rate of gallbladder cancer is found among populations of the Andean area, North American Indians, and Mexican Americans. Gallbladder cancer is up to three times higher among women than men in all populations. The highest incidence rates in Europe are found in Poland, the Czech Republic, and Slovakia. Incidence rates in other regions of the world are relatively low. The highest mortality rates are also reported from South America, 3.5-15.5 per 100,000 among Chilean Mapuche Indians, Bolivians, and Chilean Hispanics. Intermediate rates, 3.7 to 9.1 per 100,000, are reported from Peru, Ecuador, Colombia, and Brazil. Mortality rates are low in North America, with the exception of high rates among American Indians in New Mexico (11.3 per 100,000) and among Mexican Americans. The main associated risk factors identified so far include cholelithiasis (especially untreated chronic symptomatic gallstones), obesity, reproductive factors, chronic infections of the gallbladder, and environmental exposure to specific chemicals. These suspected factors likely represent promoters of carcinogenesis. The main limitations of epidemiologic studies on gallbladder cancer are the small sample sizes and specific problems in quantifying exposure to putative risk factors. The natural history of gallbladder disease should be characterized to support the allocation of more resources for early treatment of symptomatic gallbladder disease in high-risk populations. Secondary prevention of gallbladder cancer could be effective if supported by cost-effective studies of prophylactic cholecystectomy among asymptomatic gallstone patients in high-risk areas.
 ...
PMID:Epidemiology and molecular pathology of gallbladder cancer. 1176 May 69


1 2 3 4 Next >>