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

Hyperinsulinemia, hypertension, hypertriglyceridemia and obesity are all risk factors for atherosclerosis. The clustering of these risk factors in the same individual greatly increases the risk for atherosclerosis and has been termed 'Syndrome X' or 'The Deadly Quartet' The purpose of the present study was to investigate the effects of diet on these risk factors in inbred, female Fischer 344 rats. Animals were raised on ad lib diets consisting of high-fat, sucrose (HFS) or low-fat, complex-carbohydrate (LFCC). After 2 years, the HFS rats were obese (38% +/- 1% vs. 15% +/- 1% body fat), hypertensive (140 +/- 3 vs. 123 +/- 3 mmHg), hyperinsulinemic (439 +/- 118 vs. 98 +/- 10 pmol/l), and hypertriglyceridemic (1.1 +/- 0.2 vs. 0.4 +/- 0.07 mmol/l). The HFS rats also exhibited enhanced clotting and impaired fibrinolytic response to streptokinase. All these differences between the two groups were statistically significant (P < 0.05). Insulin was significantly correlated with body weight (r = 0.71), triglycerides (r = 0.48), and systolic blood pressure (r = 0.70). Total cholesterol was slightly, but not significantly higher, in the HFS group (2.8 +/- 0.3 vs 2.2 +/- 0.1 mmol/l) while HDL-cholesterol was unchanged. These results show that many risk factors for atherosclerosis can be induced in inbred rats by feeding a HFS diet. Aggregation of risk factors was found in the HFS group but not in the LFCC group. In fact, most of the rats on the LFCC diet developed no risk factors after 2 years, indicating that the development of risk factors is not an aging phenomenon.
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PMID:Effects of a high-fat, sucrose diet on serum insulin and related atherosclerotic risk factors in rats. 835 55

We have previously demonstrated that women who had given birth to large infants had a six-fold increased risk of developing Type 2 (non-insulin-dependent) diabetes mellitus compared with a control group matched for age and parity. However, the patients were extremely obese which explained, in part, the increased risk. In the present investigation we studied whether the delivery of large infants correlated with risk factors for atherosclerotic vascular disease other than obesity and diabetes, and therefore could serve as early markers for syndrome X. The study consisted of 73 women who 20-27 years earlier had given birth to large infants weighing 4,500 g or more. Another group of 73 women matched for age, parity and BMI who had delivered infants weighing less than 4,500 g within a 3-month period served as a control group. Of these 73 patient/control pairs, 48 (66%) were able to participate in the investigation. Mean age was 52.2 years (range 40-66 years). No differences were noted for family history of diabetes and medication prescribed for vascular disease between the groups. An oral glucose tolerance test was performed and glucose, insulin and C-peptide at 0 and 2 h were estimated. Triglycerides, cholesterol, LDL and HDL cholesterol were analysed at baseline. We found no tendency towards hyperinsulinaemia and hyperglycaemia in the patients and both groups had the same relative increase in levels of insulin and C-peptide. No difference between the groups regarding manifest symptoms of vascular disease, either in blood pressure or in proteinuria were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Can the birth of a large infant predict risk for atherosclerotic vascular disease in the mother? 845 25

The metabolic syndrome (syndrome X) is characterized by elevated insulin levels, obesity of the android type, disturbed lipid metabolism with increased triglycerides (VLDL elevated, HDL decreased) and an association with hypertension. The cause of this syndrome appears to be an insulin resistance of the skeletal muscle. The molecular mechanism leading to skeletal muscle insulin resistance is not understood, however an abnormality of signal transduction from the insulin receptor to glycogen synthase is suggested. It is believed that this syndrome represents a potentially prediabetic situation. Furthermore it is believed that this syndrome gives rise to cardiovascular complications in certain predisposed populations.
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PMID:[Metabolic syndrome--bridge to type II diabetes]. 847 32

The prevalence of hypertension in diabetes is significantly higher than in non-diabetics, perhaps twice as common. The excess is related to diabetic nephropathy, mainly in type 1 diabetes, to obesity, mainly in type 2 diabetes, but also to increased sympathetic activity. Furthermore, the increased prevalence of hypertension may relate to insulin resistance and its sequelae. Insulin resistance leads to hyperinsulinemia, relates to increased LDL and reduced HDL levels, causes the development of impaired glucose tolerance and type 2 diabetes and might also be causally related to the onset of hypertension. Syndrome X has relevant therapeutic implications in the management of hypertension. Hypertension is a major risk factor for large vessel disease in diabetics and also a risk factor for microangiopathy, particularly nephropathy. The incidence of atherosclerotic disease is dramatically increased in both type 1 and type 2 diabetics and is the major cause of morbidity and premature death mainly in patients with raised urinary albumin excretion. Thus, diabetics show a two-fold increased risk of coronary heart disease, 2-6 fold increased risk of stroke and a several-fold increased risk of peripheral vessel disease. Some evidence suggests that hypertension may be a risk factor for retinopathy, particularly its progression, but surely hypertension is a significant risk factor for nephropathy, accelerating its progression and perhaps even causing the onset of the glomerulopathy. The mechanisms by which hypertension might contribute to the evolution of both large vessel as well as small vessel disease is still unknown, although increased capillary leakage and vascular endothelium alterations might be important factors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hypertension and diabetes]. 856 58

In this paper we presented characteristics of insulin resistance syndrome (IRS), also known as metabolic syndrome and syndrome X, with an emphasis on insulin resistance in hyperandrogenemic women. The aim features of IRS are obesity, hypertension, dyslipidemia-hypertriglyceridemia and decreased HDL cholesterol, impaired glucose tolerance with hyperinsulinemia and higher cardiovascular morbidity. It is considered typical that in hyperandrogenemia, especially in PCO syndrome, insulin resistance and hyperinsulinemia without other characteristics of IRS are expressed.
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PMID:[Androgen excess in women and the metabolic syndrome (syndrome X)]. 875 4

Recent trends in the American lifestyle, such as a high-fat diet and inactivity, have promoted the emergence of a metabolic disorder titled syndrome X. Although originally linked to non-insulin-dependent diabetes mellitus (NIDDM) and characterized by insulin resistance, syndrome X is now better described as a cascade of disorders encompassing not only NIDDM, but also hypertension, atherosclerosis, centrally distributed obesity, and dyslipidemia. Further pathology has been linked to syndrome X, such as polycystic ovary disease, microvascular angin, and the presence of acanthosis nigricans. Recognition and appropriate management of syndrome X will prevent deleterious patient outcomes that might occur without continuity of care in treating associated disorders. Pharmacological management of syndrome X includes the use of insulin-sparing antihyperglycemic agents and/or combination therapy and avoidance of several frequently prescribed medications. Clinicians need to initiate renewed efforts to provide lifestyle counselling to promote ideal body weight, since interpretation of research data concerning syndrome X reinforces that serious health consequences will result from obesity and inactivity.
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PMID:Syndrome X. Recognition and management of this metabolic disorder in primary care. 878 76

Excess activity of the sympathetic nervous system (SNS) is linked to human obese hypertension and to salt-sensitive hypertension. Paradoxically, reduced SNS activity has been implicated as a contributor to obesity, particularly in animal models, and salt loading usually inhibits SNS activity. We have investigated the relationship between SNS activity, diet, and hypertension in the obese spontaneously hypertensive rat (SHROB), a model with a recessive obesity trait superimposed on a hypertensive background with multiple metabolic abnormalities resembling human syndrome X. We examined the role of SNS overactivity in the adverse impact of excess dietary salt and the possible beneficial effects of sympatholytic therapy. Mean blood pressure (MBP) was increased in SHROB and SHR fed a 4% NaCl diet. The pressor effect of dietary salt was abolished by ganglionic blockade, suggesting that increased SNS activity contributed to the pressor effect of the high-salt diet. Moxonidine, a second-generation central antihypertensive, controlled hypertension in both SHROB and SHR. Kidney damage in SHROB was accelerated by dietary salt and was reduced by moxonidine. Moxonidine elicited progressive weight loss in SHROB but not in SHR. Food intake in SHROB was reduced to the level of lean SHR. SHROB and SHR treated with moxonidine showed improved glucose tolerance. Additionally, SHROB showed reduced levels of triglycerides, cholesterol, and insulin following moxonidine therapy. Inhibition of the SNS, as with moxonidine therapy, may ameliorate multiple abnormalities and have therapeutic advantages in obese hypertensive syndromes.
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PMID:Sympathetic nervous system in salt-sensitive and obese hypertension: amelioration of multiple abnormalities by a central sympatholytic agent. 882 50

Aging is associated with an increased incidence of hypertension, noninsulin-dependent diabetes mellitus, and coronary heart disease. Because these conditions often cluster in the same individuals, there has been speculation that a common mechanism is responsible for all of these pathological states. Both epidemiological and clinical research has shown that insulin resistance and/or hyperinsulinemia are associated with glucose intolerance, dyslipidemia (high plasma triglyceride and low high-density lipoprotein-cholesterol levels), and higher systolic and diastolic blood pressures. Therefore, insulin resistance and hyperinsulinemia have been proposed as the causal link among the elements of the cluster mentioned above, now most commonly referred to as the insulin resistance syndrome, syndrome X, or the metabolic syndrome. The elderly are more glucose intolerant and insulin-resistant, but it remains controversial whether this decrease in function is an inevitable consequence of "biological aging" or the result of what might be referred to as environmental or lifestyle variables: increased obesity, a detrimental pattern of fat distribution, or physical inactivity that usually accompany age. All of these modifiable environmental factors have also been shown to result in increases in insulin resistance and hyperinsulinemia and are risk factors for the development of the diseases of the metabolic syndrome. Recent interventional studies that have attempted to reverse these conditions in the elderly have shown improved insulin sensitivity, and glucose tolerance. Insulin secretion, on the other hand, seems to decrease with age even after adjustments for differences in adiposity, fat distribution, and physical activity. This may be responsible for the glucose intolerance in the very old even after improvements have been made in their lifestyle variables.
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PMID:The effect of age on insulin resistance and secretion: a review. 882 67

Coronary heart disease (CHD) is the most important cause of death and disability among older women. A 50-year-old woman has a 46% risk of having CHD and a 31% risk of dying from it. Female CHD patients have a distinct clinical presentation, which includes more severe thromboembolic disease without coronary arteriosclerosis. Syndrome X also appears to be more prevalent in women. Oestrogen deficiency may be a trigger for this syndrome. The magnitude of the effect of various risk factors may also differ between women and men. In addition, there are risk factors unique to women. Lipid profiles differ between men and women. After menopause, the lipid profile changes unfavourably, with increasing levels of LDL cholesterol and decreasing levels of HDL cholesterol. Cigarette smoking, hypertension, diabetes mellitus, and obesity are all recognised risk factors for CHD in women. It is important to recognise that risk factors for CHD differ between men and women. Advising women to quit cigarette smoking, avoid obesity, increase physical activity, and prevent and treat hypertension and hyperlipidaemia will result in a reduction in CHD risk. Additional studies are needed to further contribute to our understanding of the complex risk factors underlying the development of CHD in women.
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PMID:Risk factors for cardiovascular disease in women: assessment and management. 886 75

Obesity is commonly associated with insulin resistance. The etiology of insulin resistance syndrome such as syndrome X or deadly quartet is not clear. We have proposed visceral fat syndrome, in which fat accumulation is predominant in the intra-abdominal cavity, frequently accompanied by disorders of glucose and lipid metabolism, and also hypertension. Excess free fatty acid of the portal circulation may cause the enhancement of lipid synthesis and gluconeogenesis as well as insulin resistance, resulting in hyperlipidemia, glucose intolerance and hypertension and finally atherosclerosis. Enhanced production of PAI-1 by increased visceral fat may be partly responsible for the development of cardiovascular disease in patient with visceral fat assmulation.
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PMID:[Obesity and insulin resistance syndrome]. 891 27


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