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

Long-term studies are needed to establish obesity itself as a risk factor for cardiovascular disease, even though other well-known risk factors are prevalent in obese persons. It is possible that the risk for cardiovascular disease is found in a subgroup of the total obesity population. Cross-sectional studies have shown abdominal obesity to be strongly associated with risk factors for cardiovascular disease. Prospective epidemiologic studies in men and women have shown that abdominal obesity is associated with increased risk for ischemic heart disease, stroke, and death independent of the total degree of obesity. Even limited abdominal obesity should be treated and patients examined carefully for complicating conditions.
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PMID:Regional patterns of fat distribution. 406 32

The distribution of adipose tissue thickness, fat cell weight (FCW), and number (FCN) were studied in four regions in randomly selected middle-aged men and women and in 930 obese individuals. Both the obese and the randomly selected men were found to have the largest adipose tissue thickness in the abdominal region. Women, however, showed a relative preponderance for the gluteal and femoral regions. FCW increased with expanding body fat up to a maximal size of approximately 0.7-0.8 micrograms/cell in each region. After this increase in FCW, a more rapid increase in FCN was found. For the same degree of relative overweight, men had higher triglyceride, fasting glucose, and insulin levels; higher sums of glucose and insulin levels during an oral glucose tolerance test; and higher blood pressure. Furthermore, elevated fasting glucose levels (greater than 7.4 mM) occurred twice as often in the males. These differences between males and females persisted even after body fat matching. A male risk profile was seen in women characterized by abdominal obesity (high waist/hip circumference ratio) as compared to women with the typical peripheral obesity. Stepwise multiple regression analyses in both women and men showed the obesity complications to be associated in a first step to waist/hip circumference or body fat and in a second to abdominal fat cell size. It may thus be concluded that: (a) In both obese and nonobese subjects, regional differences exist between the sexes with regard to adipose tissue distribution. (b) Moderate expansion of body fat is mainly due to FCW enlargement, which is subsequently followed by increased FCN. (c) Men and women with a male abdominal type of obesity are more susceptible to the effect of excess body fat on lipid and carbohydrate metabolism.
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PMID:Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. 635 Mar 64

To quantify the fat distribution pattern in central obesity, truncal (neck, chest, and abdomen) and peripheral (bilateral upper part of the arms, thighs, and lower part of the legs) circumferences of the body were measured in Japanese women. Central obesity index (COI) was calculated as follows: sum of the truncal circumferences divided by sum of the bilateral peripheral circumferences. The mean COI of six women with Cushing's syndrome (1.028 +/- 0.056 [SD] ) far exceeded that of 56 female controls (0.875 +/- 0.054), including 14 obese women (0.877 +/- 0.060) and 13 diabetic women (0.922 +/- 0.028). During the postoperative follow-up of the patients with Cushing's syndrome, the COIs decreased considerably. Because there is no requirement for special instruments or techniques, the measurement of COI is expected to be useful in the screening of Japanese women for Cushing's syndrome and as an indicator of response after treatment.
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PMID:A body measurement to evaluate the pattern of fat distribution in central obesity. A screening and monitoring technique for Cushing's syndrome. 664 7

The effect of obesity as a factor limiting exercise tolerance is described and can be attributed to three mechanisms: (a) the increased metabolic and therefore ventilatory requirement to perform a given work task; (b) the increased metabolic cost of breathing because of interfering chest wall and abdominal obesity and high breathing frequency; and (c) pulmonary insufficiency in response to the high breathing work and lung atelectasis. The role of support and posture minimizing the effect of obesity should be considered when attempting to improve the work tolerance of obese patients. One cannot predict accurately the O2 cost of exercise in the obese patient from the ergometer load because of uncertainties of distribution of the adipose tissue, the uncertain effects on breathing work, and often reduced motor efficiency or skill. The metabolic cost of exercise in the obese patient, therefore, needs to be directly measured; only then can one establish the degree of normality of the physiologic responses to exercise, e.g., heart rate, blood pressure, cardiac output, and minute ventilation.
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PMID:The ventilatory stress of exercise in obesity. 669 51

This study was designed to evaluate coagulation and fibrinolysis activity and their relationship with left ventricular function in young obese subjects with central fat distribution. We assessed coagulation and fibrinolysis activity by evaluation of factor VII activity, fibrinogen and plasminogen, plasminogen activator inhibitor (PAI), and tissue plasminogen activator antigen basally (tPA1) and after venous occlusion (tPA2). These measures were evaluated in young (< 40 years) obese subjects with central fat distribution (n = 19) and in comparable lean subjects (n = 20). Blood glucose, triglycerides, total and high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) A1 and apo B, fasting immunoreactive insulin, and lipoprotein(a) levels were also measured by current methods. Left ventricular ejection fraction (LVEF) and peak filling rate (PFR) determined by radionuclide angiocardiography and left ventricular mass (LVM) and LVM indexed for body height (LVM/H) determined by echocardiographic study were calculated. Central obesity was evaluated by the waist to hip ratio (WHR) according to the criteria of the Italian Consensus Conference of Obesity. Factor VII (P < .001), fibrinogen (P < .001), plasminogen (P < .001), PAI activity (P < .001), tPA1 (P < .02), fasting blood glucose (P < .01), apo B (P < .02), and immunoreactive insulin (P < .01) were significantly higher in obese than in lean subjects. In contrast, HDL cholesterol (P < .01), tPA2 (P < .01), LVEF (P < .001), and PFR (P < .02) were significantly lower in obese than in lean subjects. In all subjects, WHR correlated directly with fibrinogen and inversely with tPA2; LVEF correlated inversely with tPA1, PAI, and fibrinogen; and PFR correlated inversely with factor VII activity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hemostatic function in young subjects with central obesity: relationship with left ventricular function. 747 28

Recent research has indicated that visceral obesity is associated with multiple endocrine disturbances. Insulin resistance, as well as visceral fat accumulation, may be consequences of these abnormalities. The complex endocrine aberrations are probably of central origin, and suggest a neuroendocrine background with a "hypothalamic arousal" syndrome. Such a syndrome has been found after excess alcohol intake, tobacco smoking, and certain types of stress reactions. Subjects with visceral obesity might be characterized by a high prevalence of such factors, although only indirect evidence is available for the stress component, maybe caused by a poor socioeconomic and psychosocial situation. In primate experiments, a submissive stress reaction is followed by a syndrome essentially identical to that seen in humans with visceral obesity, including visceral fat accumulation. These observations strongly support a similar chain of events in humans. Recent studies have indicated several abnormalities in cerebrospinal fluid (CSF) concentrations of catecholamines and neuropeptides. In particular, serotonin metabolites and corticotropin-releasing factor (CRF) concentrations are apparently lower than normal. In women with visceral obesity, these low concentrations are associated with food choices that indicate a preference for carbohydrates. This finding emphasizes the importance of serotonin agonists in the treatment of human obesity. It seems possible that such drugs may have effects on metabolic and other symptoms particularly prevalent in abdominal obesity, and that these effects might be independent of the decrease in energy intake. It would seem highly desirable to explore these possibilities further. Such observations may also provide a link between the abnormalities of low serotonin and CRF concentrations in the central nervous system on one hand and peripheral metabolic and other abnormalities on the other.
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PMID:Neuroendocrine abnormalities in human obesity. 753 80

Considerable evidence indicates that obesity, and in particular abdominal obesity, is a risk factor for both heart disease and non-insulin dependent diabetes mellitus. In spite of this, little is known of the regulation of triacylglycerol synthesis in adipose tissue other than by insulin. Acylation stimulating protein (ASP), a human plasma protein, stimulates triacylglycerol synthesis in adipose tissue and is also produced by human adipocytes. ASP may play a physiological role in the regulation of efficiency of adipose tissue fat storage and affect clearance of triglycerides from plasma.
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PMID:The acylation stimulating protein-adipsin system. 755 May 36

Obesity is usually defined on the basis of body composition measurements. Body composition can be assessed using elaborate methods or anthropometry. Obese children are characterized by increased serum total cholesterol and triglycerides, reduced high-density-lipoprotein(HDL)-cholesterol concentrations, and hyperinsulinemia. Such a metabolic profile may create favorable conditions for atherogenesis and cardiovascular disease later in life. In fourty obese children aged 6-14 years were evaluated plasma insulin after OGTT, serum lipids and body composition. The correlation analysis between insulin, lipids and fat mass (%), based on skinfold measurements was not significative. These results are possible because with skinfold measurements are not separated the subcutaneous and intraabdominal compartments; infarct, only abdominal obesity is associated with the increased risk factors (hyperinsulinemia, hyperlipidemia, ecc.).
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PMID:[The lipid status, insulinemia and fat mass in 40 children with essential obesity]. 756 42

To determine whether the combination of obesity and hypertension results in additive defects in oxidative and nonoxidative glucose metabolism and the association of these changes with altered hemodynamic actions of insulin, we studied 11 abdominally obese hypertensive, 6 abdominally obese normotensive, and 7 lean normotensive nondiabetic subjects. Endogenous glucose production and glucose metabolized were calculated from a euglycemic clamp at 72 and 287 pmol insulin/m2 per minute. Glucose metabolized divided by insulin was lower at 72 pmol/m2 per minute in both obese groups than in lean normotensive subjects, at 148 +/- 14, 144 +/- 33, and 373 +/- 69 (mumol/m2 per minute)/(pmol/L), respectively (P < .01). Similar results were obtained during the higher insulin dose. Nonoxidative and oxidative glucose disposals by indirect calorimetry were lower in both abdominally obese groups (P < .05). Hepatic glucose production was completely suppressed in lean subjects at the lower insulin dose and in all three groups at the higher insulin dose. Hemodynamic responses during the clamp were not significantly different among the three groups. Abdominal obesity is associated with defects in insulin-regulated oxidative and nonoxidative glucose disposal as well as in insulin suppression of hepatic glucose production. Mild hypertension does not exacerbate these defects. Whereas the global impairment in glucose metabolism suggests the presence of an early defect or defects, including reduced tissue perfusion, systemic and regional hemodynamic responses to insulin were not altered. These findings do not support a direct role for insulin resistance in the pathogenesis of the hypertension associated with abdominal obesity.
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PMID:Glucose metabolism in abdominally obese hypertensive and normotensive subjects. 760 22

Central obesity in association with insulin resistance is a strong predictor of coronary artery disease (CAD) in South Asians; however the prevalence of central obesity and insulin resistance in Indians are unknown. Anthropometric measurements, dietary intakes, physical activity and prevalence of risk factors and CAD were obtained in 152 adults between 26-65 years of age (80 males, 72 females) selected by random sampling from urban population of Moradabad. The overall prevalence of central obesity was 539 per 1000 adults including 56.2% in males and 51.3% in females. The prevalence of glucose intolerance, diabetes mellitus, hypertension, hypertriglyceridemia and CAD were significantly higher in the higher quintiles of WHR above 0.88 compared to lower quintiles. Fasting and postprandial glucose, plasma insulin and triglycerides as well s total cholesterol and blood pressure were significantly higher in each of the upper quintile of WHR with increase in WHR compared to lowest quintile of WHR below 0.81. These findings indicate the existence of a modest degree of insulin resistance with a modest tendency to central obesity in the urban population of North India. The prevalence of CAD was significantly (p < 0.01) higher among subjects with central obesity than in non-obese subjects (21.5 vs 3.2%). Underlying these findings, the prevalence of central obesity was significantly greater among sedentary and mild activity group compared to moderate and heavy activity group and per day energy expenditure during activity in the upper quintiles with WHR > 0.88 was significantly less compared to energy expenditure in lower quintiles of WHR. Similarly dietary fat intake in the upper quintiles of WHR was also significantly higher than in the lower quintiles of WHR. These findings suggest that populations with higher prevalence of central obesity and CAD may be benefited with an aim to decrease central obesity.
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PMID:Epidemiologic study of central obesity, insulin resistance and associated disturbances in the urban population of North India. 767 61


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