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

The co-ordinated regulation of food intake and energy expenditure takes place in the hypothalamic regions of the brain. Current understanding of the systems involved in this regulation suggests that, in the hypothalamus, there are two major groups of neuropeptides involved in orexigenic and anorexic processes. The orexigenic neuropeptides are neuropeptide Y (NPY) and agouti-related peptide (AgRP) and the anorexic neuropeptides are alpha-melanocyte-stimulating hormone (alpha-MSH) and cocaine and amphetamine-related transcript (CART). Theneurons expressing these neuropeptides interact with each other and with signals from the periphery (such as leptin, insulin, ghrelin and glucocorticoids) to regulate feeding behaviour, energy expenditure and various endocrine axes. Although direct evidence is limited, there are examples of genetic obesity in humans which suggest that the balance between orexigenic and anorexic pathways in the hypothalamus is also pivotally important in the maintenance of energy homeostasis in humans.
Best Pract Res Clin Endocrinol Metab 2002 Dec
PMID:Hypothalamic regulation of energy homeostasis. 1246 11

The adipocyte-derived hormone, leptin, regulates food intake and systemic fuel metabolism; ob /ob mice, which lack functional leptin, exhibit an obesity syndrome that is similar to morbid obesity in humans. Leptin receptors are expressed most abundantly in the brain but are also present in several peripheral tissues. The role of leptin in controlling energy homeostasis has thus far focused on brain receptors and neuroendocrine pathways that regulate feeding behaviour and sympathetic nervous system activity. This chapter focuses on mounting evidence that leptin's effects on energy balance are also mediated by direct peripheral actions on key metabolic organs such as skeletal muscle, liver, pancreas and adipose tissue. Strong evidence indicates that peripheral leptin receptors regulate cellular lipid balance, favouring beta-oxidation over triacylglycerol storage. There are data to indicate that peripheral leptin also modulates glucose metabolism and insulin action; however, its precise role in controlling gluco-regulatory pathways remains uncertain and requires further investigation.
Best Pract Res Clin Endocrinol Metab 2002 Dec
PMID:Peripheral metabolic actions of leptin. 1246 13

Regular physical exercise is of the utmost importance in the treatment of obesity because exercise is one of the factors determining long-term weight maintenance in weight reduction programmes and because exercise has been associated with a reduced risk for developing type 2 diabetes mellitus and cardiovascular disease. Obesity is associated with an impaired utilization of fat as a fuel during post-absorptive conditions, during beta-adrenergic stimulation and possibly during exercise, although the latter data are controversial. One of the underlying mechanisms for the positive effect of exercise training in obesity may be related to its effects on fat utilization because exercise training has been shown to increase basal fat oxidation and exercise fat oxidation in lean volunteers. Data on the effect of aerobic exercise training on exercise fat oxidation are controversial, whereas the available data indicate that exercise training may not be able to increase resting fat oxidation or 24-hour fat oxidation in obese subjects. Because disturbed muscle fat oxidation may be a primary event in the aetiology of obesity it is of the utmost importance to obtain more information on how and whether exercise training may be able to compensate for these impairments.
Best Pract Res Clin Endocrinol Metab 2002 Dec
PMID:Substrate oxidation, obesity and exercise training. 1246 14

Non-exercise activity thermogenesis (NEAT) is the energy expended for everything we do that is not sleeping, eating or sports-like exercise. It ranges from the energy expended walking to work, typing, performing yard work, undertaking agricultural tasks and fidgeting. Even trivial physical activities increase metabolic rate substantially and it is the cumulative impact of a multitude of exothermic actions that culminate in an individual's daily NEAT. It is, therefore, not surprising that NEAT explains a vast majority of an individual's non-resting energy needs. Epidemiological studies highlight the importance of culture in promoting and quashing NEAT. Agricultural and manual workers have high NEAT, whereas wealth and industrialization appear to decrease NEAT. Physiological studies demonstrate, intriguingly, that NEAT is modulated with changes in energy balance; NEAT increases with overfeeding and decreases with underfeeding. Thus, NEAT could be a critical component in how we maintain our body weight and/or develop obesity or lose weight. The mechanism that regulates NEAT is unknown. However, hypothalamic factors have been identified that specifically and directly increase NEAT in animals. By understanding how NEAT is regulated we may come to appreciate that spontaneous physical activity is not spontaneous at all but carefully programmed.
Best Pract Res Clin Endocrinol Metab 2002 Dec
PMID:Non-exercise activity thermogenesis (NEAT). 1246 15

Non-alcoholic steatohepatitis (NASH) is a disease of emerging identity and importance. It is frequently associated with obesity, especially visceral fat, and is intimately related to fatty liver and markers of the insulin resistance syndrome. Both the prevalence and the severity of liver steatosis are related to body mass index, waist circumference, hyperinsulinaemia, hypertriglyceridaemia and impaired glucose tolerance or type 2 diabetes. The identification of obese patients who may progress from steatosis to NASH and from NASH to fibrosis/cirrhosis is an important clinical challenge. Substantial weight loss is accompanied by a marked attenuation of insulin resistance and related metabolic syndrome and, concomitantly, by a remarkable regression of liver steatosis in most patients, although increased inflammation may be detected in some subjects. Thus, NASH may be considered as another disease of affluence, as is the insulin resistance syndrome, and perhaps being part of it, especially in obese patients.
Best Pract Res Clin Endocrinol Metab 2002 Dec
PMID:Obesity and liver disease. 1246 16

The growing recognition of the health risks of obesity coupled with the difficulties in treating it successfully by lifestyle modification predicates a need for effective drug treatment. The history of drug treatment in the second half of the 20th century is, however, one of disappointment and concern over drug toxicity. However, the advances in our understanding of the mechanism of weight control, together with improved ways of evaluating anti-obesity drugs, has resulted in two effective compounds, sibutramine and orlistat, becoming available for clinical use. Sibutramine has actions on both energy intake and expenditure and had been shown to enhance weight loss and weight maintenance achieved by diet, in simple obesity as well as when accompanied by complications of diabetes or hypertension. About 50-80% of patients can achieve a >5% loss, significantly more than if patients receive the same lifestyle intervention with placebo. Orlistat, which acts peripherally to block the absorption of dietary fat, has had similar results in clinical trials; a recent study (XENDOS) has just reported results which show that the enhanced, albeit modest, weight loss achieved with orlistat delays the development of diabetes over a 4-year period. A number of other compounds are expected to complete or enter clinical trials over the next decade. There is considerable optimism that we will soon have the pharmacological tools needed to make the treatment of obesity feasible.
Best Pract Res Clin Endocrinol Metab 2002 Dec
PMID:Pharmacotherapy of obesity. 1246 17

Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. There is some evidence that it may have been brought from North America to Europe during the 18th century. Its arrival in rural parts of the developing world is still more recent. The incidence and prevalence of RA appear to have fallen in Europe, North America and Japan in the last 50 years. During this time the peak age of onset has risen. Risk factors for the development of RA include genetic factors, an adverse pregnancy outcome, smoking, obesity and recent infections. The oral contraceptive pill and some dietary constituents may be protective. Older age and female gender are risk factors both for the development of RA and for a worse outcome. This risk factor profile offers some opportunities for primary and secondary prevention. However, treatment is the greatest determinant of RA outcome.
Best Pract Res Clin Rheumatol 2002 Dec
PMID:Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. 1247 69

During the Third Heelsum International Workshop, Nutrition Guidance of Family Doctors Towards Best Practice, December 10-12, 2001, Heelsum, the Netherlands, 17 papers were presented. Each paper was discussed by all the participants at the workshop. These discussions were tape-recorded, transcribed, rearranged into topics, and summarized here. There are situations that call for nutrition advice to be given by general practitioners (GPs). GPs are trusted, they are not selling any particular food, and patients accept that their GPs may talk to them about diet. Compared with dietitians, GPs have much less time to advise about diet, so they must condense information. It is easier for a GP to give dietary advice if the patient is registered on the practice's list and if the GP can be paid for preventive work. Six topics seemed to be particularly new and challenging in our changing world: (1) Use of dietary supplements, herbal preparations, and functional foods; (2) patients as partners; (3) computers in practices; (4) evidence-based medicine; (5) the Internet; and (6) the obesity epidemic. These topics were reported as problems and then discussed as opportunities. The aim of the Heelsum Collaboration on General Practice Nutrition was to facilitate the nutrition work of GPs in their practices by researching the problems and barriers and by testing solutions. In line with this aim, some suggestions for research are provided.
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PMID:Nutrition guidance by family doctors in a changing world: problems, opportunities, and future possibilities. 1266 23

At present, obesity is considered one of the major health problems. It is a predisposing factor of several chronic diseases including non-insulin dependent diabetes mellitus (NIDDM) and coronary heart disease (CHD). Leptin levels in humans have been found to be highly correlated with total adiposity. We performed statistic analysis in order to identify linkage between leptin levels and anthropometric parameters in a group of 285 Czech obese children (152 girls and 133 boys) aged 7 to 18 years. The children were measured using the standard anthropometric technique according to Martin and Saller [16] at the beginning and end of a five-week therapeutic weight reduction programme. The skin fold thickness at 14 sites was assessed by means of Best calliper. The body composition was evaluated using Matiegka's technique. The leptin levels were investigated on the beginning and end of the reduction programme by direct enzyme linked immunosorbent assay (ELISA). For the evaluation of the grade of obesity, body weight, BMI (body mass index), RI (Rohrer's index), FMI (fat mass index) and normalized body weight, normalized BMI and RI were plotted. Correlation analysis shows relation between leptin concentration and FMI to be the most significant. As to ponderal indexes, normalized RI shows the most significant positive correlation. Leptin concentrations are negatively correlated with the proportion of the weight of skeletal muscles by Matiegka both in girls and boys. Intersexual differences in correlations between leptin concentrations and normalized circumferences are observed, as well as in correlations between leptin and particular skin fold thickness. We also tested relations between the magnitude of leptin decreases and magnitude of decreases of anthropometric parameters. There is a strong endorsement both in girls and boys of positive correlation between decrease of leptin concentration and fat reduction. Interestingly, differences between boys and girls in relations between leptin decrease and change in lean body mass had been observed.
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PMID:[Correlation of leptin and anthropometric parameters during weight reduction therapy in obese children]. 1268 63

Uncouplers of oxidative phosphorylation have relevance to bioenergetics and obesity. The mechanisms of action of chemical uncouplers of oxidative phosphorylation on biological systems were evaluated using differential gene expression. The transcriptional response in human rhabdomyosarcoma cell line (RD), was elucidated following treatment with carbonyl cyanide p-(trifluoromethoxy) phenylhydrazone (FCCP), a classical uncoupling agent. Changes in mitochondrial membrane potential were used as the biological dosimeter. There was an increase in membrane depolarization with increasing concentrations of FCCP. The concentration at 75% uncoupling (20 microM) was chosen to study gene expression changes, using cDNA-based large-scale differential gene expression (LSDGE) platforms. At the above concentration, subtle light microscopic and clear gene expression changes were observed at 1, 2, and 10 h. Statistically significant transcriptional changes were largely associated with protein synthesis, cell cycle regulation, cytoskeletal proteins, energy metabolism, apoptosis, and inflammatory mediators. Bromodeoxyuridine (BrdU) and propidium iodide (PI) assays revealed cell cycle arrest to occur in the G1 and S phases. There was a significant initial decrease in the intracellular adenosine triphosphate (ATP) concentrations. The following seven genes were selected as potential molecular markers for chemical uncouplers: seryl-tRNA synthetase (Ser-tRS), glutamine-hydrolyzing asparagine synthetase (Glut-HAS), mitochondrial bifunctional methylenetetrahydrofolate dehydrogenase (Mit BMD), mitochondrial heat shock 10-kDa protein (Mit HSP 10), proliferating cyclic nuclear antigen (PCNA), cytoplasmic beta-actin (Act B), and growth arrest and DNA damage-inducible protein 153 (GADD153). Transcriptional changes of all seven genes were later confirmed with reverse transcription-polymerase chain reaction (RT-PCR). These results suggest that gene expression changes may provide a sensitive indicator of uncoupling in response to chemical exposure.
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PMID:Effects of minimally toxic levels of carbonyl cyanide P-(trifluoromethoxy) phenylhydrazone (FCCP), elucidated through differential gene expression with biochemical and morphological correlations. 1270 Apr


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