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

The prevalence of and the risk factors for fatty liver have not undergone a formal evaluation in a representative sample of the general population. We therefore performed a cross-sectional study in the town of Campogalliano (Modena, Italy), within the context of the Dionysos Project. Of 5,780 eligible persons aged 18 to 75 years, 3,345 (58%) agreed to participate in the study. Subjects with suspected liver disease (SLD), defined on the basis of elevated serum alanine aminotransferase (ALT) and gamma-glutamyl-transferase (GGT) activity, hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV)-RNA positivity, were matched with randomly selected subjects of the same age and sex without SLD. A total of 311 subjects with and 287 without SLD underwent a detailed clinical, laboratory, and anthropometrical evaluation. Fatty liver was diagnosed by ultrasonography, and alcohol intake was assessed by using a 7-day diary. Multinomial logistic regression was used to detect risk factors for normal liver versus nonalcoholic fatty liver disease (NAFLD) and for alcoholic fatty liver (AFLD) versus NAFLD. The prevalence of NAFLD was similar in subjects with and without SLD (25 vs. 20%, P = .203). At multivariable analysis, normal liver was more likely than NAFLD in older subjects and less likely in the presence of obesity, hyperglycemia, hyperinsulinemia, hypertriglyceridemia, and systolic hypertension; AFLD was more likely than NAFLD in older subjects, males, and in the presence of elevated GGT and hypertriglyceridemia, and less likely in the presence of obesity and hyperglycemia. In conclusion, NAFLD is highly prevalent in the general population, is not associated with SLD, but is associated with many features of the metabolic syndrome.
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PMID:Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. 1589 1

Despite the high cardiovascular risk of diabetic patients, there is a paucity of data on isolated systolic hypertension (ISH) in diabetic patients. In this cross-sectional study, we examined the risk of ISH and its associated factors in Chinese type 2 diabetic patients. Isolated systolic hypertension was defined as systolic blood pressure (SBP) > or =140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg. The mean value of two BP measurements taken 1 min apart was used. There were 1048 type 2 diabetic patients recruited from the Prince of Wales Hospital Diabetes Clinic. Another 1043 age- and sex-matched non-diabetic subjects were recruited from the community. The mean age of the 2091 subjects was 40.6 +/- 7.6 years (median: 40 years, range: 16-69 years). Diabetic patients had an increased risk of ISH compared to non-diabetic subjects (7.6% vs. 3.4%, p < 0.001) with an odd ratio of 2.38. On multivariate analysis, age, body mass index, total cholesterol and duration of diabetes in diabetic subjects while age and waist-hip ratio (WHR) in non-diabetic subjects were independently associated with ISH. In conclusion, Chinese type 2 diabetic patients had increased risk to develop ISH than non-diabetic subjects. Age, obesity, lipid and duration of diabetes were independent associated with ISH. These findings suggest that control of body weight and metabolic profile might have beneficial effects on ISH.
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PMID:Effects of body mass index, plasma glucose and cholesterol levels on isolated systolic hypertension. 1590 11

Actual condition of alcohol intake was investigated in forty four thousand one hundred and twenty six individuals who visited the Tokai University Hospital Health Checkup Center from 1989 to 2003. Effects of alcohol intake were also examined in relation to several risk factors for lifestyle-related diseases. The male drinkers who took more than 1 gou of sake per a day were recognized in 53.0% from 1989 to 1991, and decreased to 46.3% from 2001 to 2003. The female drinkers were found in approximately 10%, and remained unchanged during the 15-year survey period. When examined by age, the frequency of habitual drinking among males was 34.4% in the age of 20 years, and then increased to 45% in the 30 years, leading to the peak (54.1%) in the 40 years. In females, the frequency was 27.5% in the age of 20 years, but decreased to 10.9% in the 30 years. The prevalence of systolic hypertension, diastolic hypertension, hyperuricemia, high levels of HbAlc, and hypertriglyceridemia was significantly (P < 0.0001) increased with an increase in alcohol intake. The prevalence of obesity, fatty liver and hyperglycemia at fasting was markedly (P < 0.0001) increased in the drinkers whose intake was more than 2 gou per a day. These findings indicate that habitual drinking may be associated with risk factors for lifestyle-related diseases, such as obesity, fatty liver, hypertension, hypertriglyceridemia and hyperuricemia.
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PMID:[Actual condition of alcohol intake and its effects on lifestyle-related disease in health checkup]. 1603 25

Insulin resistance is associated with increased cardiovascular morbidity and mortality. The mechanism(s) underlying this association are poorly understood. Increased arterial stiffness is the main cause of the most prevalent form of hypertension, systolic hypertension. Hypertension is also commonly observed in individuals with insulin resistance. In cross-sectional epidemiological studies such as the Atherosclerosis Risk in Communities study, hyperinsulinemia was independently associated with increased arterial stiffness. Recent mechanistic studies performed in humans in vivo have suggested that increased stiffness could be yet another facet of insulin resistance. Insulin, at physiological concentrations, acutely diminishes wave reflection in the aorta in vivo. This action of insulin precedes any changes in peripheral blood flow, vascular resistance, ejection duration or heart rate, and therefore implies that insulin acutely diminishes stiffness in arteries greater than those controlling peripheral vascular resistance. This effect is blunted in insulin-resistant conditions such as obesity and type 1 diabetes. These data suggest that the inability of insulin to normally diminish arterial stiffness could provide a mechanistic link between insulin resistance and systolic hypertension.
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PMID:Arterial stiffness and insulin resistance. 1622 7

The worldwide epidemic of metabolic syndrome correlates with an elevation in serum uric acid as well as a marked increase in total fructose intake (in the form of table sugar and high-fructose corn syrup). Fructose raises uric acid, and the latter inhibits nitric oxide bioavailability. Because insulin requires nitric oxide to stimulate glucose uptake, we hypothesized that fructose-induced hyperuricemia may have a pathogenic role in metabolic syndrome. Four sets of experiments were performed. First, pair-feeding studies showed that fructose, and not dextrose, induced features (hyperinsulinemia, hypertriglyceridemia, and hyperuricemia) of metabolic syndrome. Second, in rats receiving a high-fructose diet, the lowering of uric acid with either allopurinol (a xanthine oxidase inhibitor) or benzbromarone (a uricosuric agent) was able to prevent or reverse features of metabolic syndrome. In particular, the administration of allopurinol prophylactically prevented fructose-induced hyperinsulinemia (272.3 vs.160.8 pmol/l, P < 0.05), systolic hypertension (142 vs. 133 mmHg, P < 0.05), hypertriglyceridemia (233.7 vs. 65.4 mg/dl, P < 0.01), and weight gain (455 vs. 425 g, P < 0.05) at 8 wk. Neither allopurinol nor benzbromarone affected dietary intake of control diet in rats. Finally, uric acid dose dependently inhibited endothelial function as manifested by a reduced vasodilatory response of aortic artery rings to acetylcholine. These data provide the first evidence that uric acid may be a cause of metabolic syndrome, possibly due to its ability to inhibit endothelial function. Fructose may have a major role in the epidemic of metabolic syndrome and obesity due to its ability to raise uric acid.
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PMID:A causal role for uric acid in fructose-induced metabolic syndrome. 1623 13

Research studies on hypertension have, so far, generally focused on vascular resistance and small arteries. The high prevalence of systolic hypertension in patients older than 50 years and the development of noninvasive Doppler and echotracking techniques have made it possible to determine large-artery stiffness with a high degree of reproducibility. Increased arterial stiffness and disturbed wave reflections are the basis for understanding reduced aortic elasticity and systolic hypertension, particularly in older people. This hemodynamic pattern results from mechanical factors and other pressure-independent risk factors, such as diabetes mellitus, renal failure, obesity and severe atherosclerosis. Distinct phenotypes of arterial stiffness and pulse pressure result from specific gene polymorphisms, such as those related to the renin-angiotensin system. The roles of arterial stiffness and wave reflections in hypertension have been elucidated by modern interpretations of the blood-pressure curve in relation to its propagation, mechanisms of systolic-blood-pressure amplification, and the pulse-pressure amplitude. New predictors of cardiovascular risk have been identified, such as increased pulse pressure and pulse-wave velocity, and disturbed wave reflections, all of which are independent predictors of cardiovascular risk that are more powerful than either systolic or diastolic blood pressure alone. Therapeutic trials are investigating ways to reduce stiffness, and thereby allow the selective reduction of systolic and pulse pressure in hypertensive patients with or without advanced renal failure. Modern pharmacologic agents need to be identified, which could reduce systolic hypertension in patients older than 50 years. Here we discuss the structural and functional factors that influence arterial stiffness, wave reflections and pulse pressure in hypertension, as well as their related roles in cardiovascular risk.
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PMID:Large-artery stiffness, hypertension and cardiovascular risk in older patients. 1626 85

Pulse pressure is calculated as the difference between the systolic and diastolic components of arterial blood pressure. Epidemiological studies have demonstrated that pulse pressure elevation directly correlates with cardiovascular mortality and morbidity, as well as with target organ damage. From a pathophysiological point of view, pulse pressure can be considered a marker of the rigidity of large arteries, especially aorta. Loss of elastic properties of these large arteries is crucial in the development of isolated systolic hypertension, prevalent in the majority of the elderly, and in difficulties in organ perfusion. Some recent data suggest that both sedentary life and obesity enhance this loss of arterial elasticity. Pulse pressure reduction by antihypertensive treatment in subjects with elevation of this parameter (isolated systolic hypertensives) protects against cardiovascular disease. Nevertheless, the independence of this protection regarding other blood pressure components or the existence of clear differences between antihypertensive drug classes on pulse pressure reduction are still unknown.
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PMID:[Value of pulse pressure as a cardiovascular risk marker]. 1675 Jan 30

Childhood obesity is directly related to cardiovascular disease (CVD) risk factors, but there is limited information on their relation in Korean children and adolescents. The authors investigated the association between obesity and CVD risk factors among 2,272 Korean boys and girls aged 10-18 years, who participated in the Korean National Health and Nutrition Examination Survey in 1998 and 2001. Obesity was defined by body mass index cutoff points provided by the US Centers for Disease Control and Prevention. The prevalence of obesity increased significantly from 5.4% in 1998 to 11.3% in 2001 (p < 0.0001). Korean obese children and adolescents in 1998 and 2001 had 4.6- and 4.9-fold risks for systolic hypertension, 4.2- and 2.8-fold risks for high levels of total cholesterol, 9.4- and 2.7-fold risks for high levels of low density lipoprotein cholesterol, 4.1- and 3.7-fold risks for low levels of high density lipoprotein cholesterol, and 5.3- and 2.8-fold risks for high levels of triglycerides, compared with their normal-weight counterparts (p < 0.05 in all). Approximately 60% of Korean obese children and adolescents had at least one CVD risk factor. These findings suggest that Korean obese children and adolescents have an increased risk of CVD.
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PMID:Obesity and cardiovascular risk factors in Korean children and adolescents aged 10-18 years from the Korean National Health and Nutrition Examination Survey, 1998 and 2001. 1684 May 21

We evaluate in this study the factors associated with the effect of age on blood pressure in more than 4800 patients. Their physicians referred them to evaluate for secondary causes for their hypertension. Factors studied included history and physical examination, serum sodium, potassium and creatinine, a stimulated plasma renin and catecholamine. We also studied the blood pressure response to infusion of either saralasin (an angiotensin II analogue) or enalapril (an angiotensin converting enzyme inhibitor), and plasma aldosterone and cortisol after infusion of saline. We measured serum thyroxin and thyroid stimulating hormone concentrations on 1061 consecutive patients in this series. The results of our study show that increased age is associated with a significant increase in the prevalence of hypertension and especially of systolic hypertension after age 60 years. Increased obesity between age 30-50 years is associated with significant increases in diastolic blood pressure and this trend is also seen in African-Americans who are heavier than whites. Increased age is associated with an increased prevalence of secondary forms of hypertension including atherosclerotic renovascular hypertension, renal insufficiency and primary hypothyroidism.
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PMID:Effect of age on hypertension: analysis of over 4,800 referred hypertensive patients. 1821 39

In hypertensive patients with left ventricular hypertrophy, antihypertensive treatment induces changes in left ventricular structure and function. However, less is known about gender differences in this response. Baseline and annual echocardiograms until the end of study or a primary end point occurred were assessed in 863 hypertensive patients with electrocardiographic left ventricular hypertrophy aged 55 to 80 years (mean: 66 years) during 4.8 years of randomized losartan- or atenolol-based treatment in the Losartan Intervention for Endpoint Reduction in Hypertension Echocardiography substudy. Left ventricular hypertrophy was diagnosed as left ventricular mass divided by height(2.7) >or=46.7 g/m(2.7) and 49.2 g/m(2.7) in women and men, respectively, and systolic function as ejection fraction and stress-corrected midwall fractional shortening. Women included more patients with obesity, isolated systolic hypertension, and mitral regurgitation (all P<0.01). Ejection fraction, stress-corrected midwall shortening, and prevalence of left ventricular hypertrophy were higher in women at baseline and at the end of study (all P<0.01). In particular, more women had residual eccentric hypertrophy (47% versus 32%; P<0.01) in spite of similar in-treatment reduction in mean blood pressure. In logistic regression, left ventricular hypertrophy at study end was more common in women (odds ratio: 1.61; 95% CI: 1.16 to 2.26; P<0.01) independent of other significant covariates. In linear regression analyses, female gender also predicted 2% higher mean in-treatment ejection fraction and 2% higher mean stress-corrected midwall shortening (both beta=0.07; P<0.01). Hypertensive women in this study retained higher left ventricular ejection fraction and stress-corrected midwall shortening in spite of less hypertrophy regression during long-term antihypertensive treatment.
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PMID:Gender differences in left ventricular structure and function during antihypertensive treatment: the Losartan Intervention for Endpoint Reduction in Hypertension Study. 1825 11


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