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

Serum protein and lipid concentrations as well as the serum protein binding of propranolol, diazepam and phenytoin were measured in normal weight and obese volunteers. Concentrations of alpha 1-acid glycoprotein (AAG) in the obese subjects were double that of the lean controls. Conversely, concentrations of high density lipoproteins (HDL) were decreased in the obese group. The serum binding of propranolol was increased in the obese subjects and correlated with serum AAG concentrations. Diazepam binding was slightly decreased in the obese as a result of lower serum albumin concentrations and elevated free fatty acids. The binding of phenytoin was comparable in all of the volunteers. These findings point out some of the complex pathophysiologic changes associated with obesity which may in turn influence drug disposition and hence drug therapy in the obese patient.
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PMID:Serum protein binding and the role of increased alpha 1-acid glycoprotein in moderately obese male subjects. 652 34

Although clinically relevant, drug-protein interactions in the morbidly obese population have not been studied thoroughly. The objective of this study was to evaluate serum chemistry profiles and the degree of serum protein binding of propranolol, diazepam and phenytoin in the serum of four female, morbidly obese (greater than 190% of ideal body weight) and eight control female subjects. Serum triglyceride concentrations were higher and high-density lipoproteins were lower in the obese subjects than in the control group. Serum albumin and total protein concentrations in the obese were not different from controls. Unexpectedly, alpha 1-acid glycoprotein concentrations were doubled in the obese subjects (mean obese value 121 mg/100 ml vs 62.9 mg/100 ml for the control subjects). Obese subjects had a mean fraction unbound (fu) for propranolol of 0.086, which was significantly different from the controls (fu = 0.123). The binding of diazepam was decreased slightly in the obese subjects. The binding of phenytoin was similar in both groups. The altered serum chemistry of obesity may play a significant role in the drug management of the obese patient by altering drug-protein interactions.
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PMID:Serum alpha 1-acid glycoprotein and the binding of drugs in obesity. 666 65

Prospectively studied were 520 patients undergoing elective thoracic, upper abdominal and lower abdominal surgeries to analyze risk factors for postoperative pneumonias. Over-all, pneumonias developed in 91 of the 520 patients studied (17.5 percent). The acquisition of pneumonia was highly associated with preoperative markers of the severity of underlying diseases such as low serum albumin concentrations on admission (P less than 0.005) and high American Society of Anesthesiologists pre-anesthesia physical status classification (P less than 0.0001). History of smoking (P less than 0.001), longer preoperative stays (P less than 0.0001), longer operative procedures (P less than 0.0001) and thoracic or upper abdominal sites of surgery (P less than 0.0001) were also significant risk factors for postoperative pneumonias. Although massive obesity, old age and male sex were also associated with increased incidences of pneumonia, statistical significance was lost when these variables were controlled for site or duration of surgery. We were able to identify risk factors for pneumonia and to define a subpopulation of patients in which the risk of pneumonia was negligible. The acquisition of pneumonia by a low-risk patient should alert the physician to the possibility of a potentially preventable nosocomial infection.
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PMID:Risk factors for postoperative pneumonia. 721

This study was conducted to determine the nutritional status of elderly subjects participating in a congregate meals program. Twenty-four-hour recalls, anthropometric measurements, and biochemical determinations were the criteria used to determine nutritional status of the 30 volunteers. Information regarding use of dietary supplements was also obtained. Ninety-three percent of the participants consumed diets providing at least 70 percent of the RDA for the 13 nutrients calculated. Seven percent consumed diets rated as "poor," but none of the participants consumed diets supplying less than 54 percent of the RDA. Twenty-seven percent of the sample reported daily use of dietary supplements. Height, weight, mid-arm circumference, triceps skinfold, and abdominal circumference were measured. The incidence of obesity was high, with 42 percent of the women and 78 percent of the men being over 119 percent of ideal body weight. Mid-arm circumference, triceps skinfold, and abdominal circumference data agreed with the weight-for-height data. The incidence of obesity was greater in this study than in other studies cited, and, as was not the case in other studies, the incidence of obesity was greater in men. Biochemical determinations included hemoglobin, hematocrit, serum albumin, serum folate, ascorbic acid, and vitamins A, B6, and B12. Comparison of biochemical data with accepted standards indicated that the nutritional status of the participants was adequate.
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PMID:Nutritional status of elderly participants in a congregate meals program. 721 86

Forty-nine consecutive patient admissions to a rehabilitation unit were evaluated by a nutritional assessment team. Measured parameters included serum albumin, height, weight, 24-hour protein and calorie intake, and response to 4 antigens (purified protein derivative, streptokinase/streptodornase, trichophyton, candida) administered by intradermal injections. Patients were classified normal (albumin greater than or equal to 3.5 gm%, positive skin tests, normal weight), Kwashiorkor (albumin less than 3.5gm%, anergic skin tests, no weight loss), marasmus (albumin greater than or equal to 3.5gm%, anergic skin tests, weight loss greater than 101lb (4.54kg) or obesity (greater than 130% ideal body weight). Protein-calories malnutrition (marasmus or kwashiorkor) was found in 34 (67%) of the patients. Only 15 patients (33%) satisfied criteria for normal nutritional status at the time of admission. Four subjects satisfied the criteria for both obesity and kwashiorkor. Because of the increased morbidity and mortality associated with protein-calorie malnutrition, all patients admitted to a rehabilitation unit should have a nutritional assessment. If the assessment demonstrates malnutrition, a program of metabolic support should be initiated to increase protein levels and restore immune competence.
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PMID:Nutritional assessment in a rehabilitation unit. 723 22

This experiment was designed to study in rats the implications of the dietary type of fat at two levels of vitamin E on the life span as well as on several biochemical and anatomopathological age-related changes. For this purpose, six different isoenergetic diets containing 15% coconut oil (SFD), safflower oil (UFD) or a combination of both (CFD) with 2 or 200 mg% of dl-alpha-tocopherol were offered ad libitum to outbred Wistar male rats from weaning to senescence. The results indicated that up to 9--12 months the body weights of rats consuming the CFD or the UFD increased generally faster than those fed the SFD, and that all rats developed moderate degrees of obesity. Age-dependent changes in organ weights (kidneys, testes, spleen, brain, liver and heart) were unaffected by diet. Serum levels of vitamin E generally reflected the corresponding dietary levels, but were also influenced by the type of dietary fat. Serum cholesterol levels were not significantly affected by the type of diet or by age. Only transient hypotriglyceridemic and hypophospholipidemic effects of the UFD were observed and, while the levels of triglycerides decreased with age up to the 18th month followed by an increase at 24 months, the levels of serum phospholipids remained unchanged. Neither diet nor age modified the serum albumin/globulin ratios. While no differences in maximum life span were found between dietary groups, the 50% survival time of rats fed the UFD at high level of vitamin E was significantly longer than in all the other groups. This beneficial effect was related to postponement of the onset and reduction of incidence of malignant neoplasms, but was apparently not related to any particular influence on the incidence or severity of chronic nephropathy which practically developed in all rats. Various neoplastic, degenerative and inflammatory diseases encountered in rats dying during the course of the experiment were tabulated and compared with similar findings reported by others in different strains of rats. Pituitary and adrenocortical adenomas as well as adrenocortical and renal carcinomas were the most frequent tumors found in this study. All the pathological changes provided useful baseline information for the evaluation of data presented in this and subsequent communications of this series of studies.
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PMID:Effects of the type of dietary fat at two levels of vitamin E in Wistar male rats during development and aging. I. Life span, serum biochemical parameters and pathological changes. 741 19

Serum albumin levels decrease during pregnancy while the concentration of most other maternal serum proteins of hepatic origin remain stable or increase. In a study of 289 women, most maternal characteristics such as race, age, smoking, a history of previous low birth-weight, infant sex and gestational age at delivery were not related to maternal serum albumin levels at 18 or 30 weeks' gestational age. The degree of maternal obesity significantly correlated with the concentration of albumin. There was a significant negative correlation in individual women between maternal serum levels of albumin and alpha-fetoprotein, with high levels of maternal serum alpha-fetoprotein predicting lower levels of albumin. We hypothesize that there may be a negative feedback effect of alpha-fetoprotein of fetal origin on the maternal production of albumin during pregnancy.
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PMID:Albumin levels in pregnancy: a hypothesis--decreased levels of albumin are related to increased levels of alpha-fetoprotein. 750 40

The administration of human serum albumin has been reported to prevent severe ovarian hyperstimulation syndrome (OHSS) while undergoing ovarian stimulation protocols for in-vitro fertilization (IVF). This prospective, randomized study investigated the effectiveness of a single dose of human serum albumin (20 g) administered i.v. immediately after oocyte retrieval. Women enrolled in the IVF programme were treated with long gonadotrophin-releasing hormone agonist, triptorelin, and an individually-adjusted human menopausal gonadotrophin protocol. The criteria for inclusion in the study were young age, non-obesity, oestradiol concentration > 9200 pmol/l on the day of human chorionic gonadotrophin administration and > 20 follicles > 14 mm diameter as observed by transvaginal sonography. The treatment group (n = 22) received albumin while the control group (n = 18) did not. Patients were followed-up using ultrasound every 3 days. There was a significantly higher number of severe OHSS cases in the control group (n = 4) than in the treatment group (n = 0) (P = 0.035). Where the data base was restricted to patients with an oestradiol concentration > 15,000 pmol/l, the difference between control and treatment groups was highly significant (P = 0.008). These findings support the use of i.v. albumin in preventing severe OHSS during IVF treatment.
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PMID:Decreased incidence of severe ovarian hyperstimulation syndrome in high risk in-vitro fertilization patients receiving intravenous albumin: a prospective study. 759 99

Obesity is a major health problem in the United States today. Traditionally, management of obese hospitalized patients has not differed from that of normal-weight patients, with calorie and protein needs based on current body weight and weight loss postponed until the acute illness has subsided. This study was undertaken to determine whether obese hospitalized patients (> 130% ideal body weight) requiring total parenteral nutrition and given hypocaloric (HC) feedings with adequate protein intake could achieve nitrogen balance comparable with that of controls (C) given isonitrogenous normocaloric formulas. Sixteen obese patients (HC = 9, C = 7) were randomized to either HC (50% resting metabolic energy expenditure, plus protein; calories:nitrogen = 75:1) or C (100% resting metabolic energy expenditure, plus protein; calories:nitrogen = 150:1) formulas. Resting metabolic energy expenditure was determined by indirect calorimetry on day 0 and weekly, and nitrogen balance was determined daily. The two groups were similar in Harris-Benedict predicted energy expenditure and metabolic energy expenditure, initial and final serum albumin, total iron-binding capacity, and weight loss. Total daily calorie and nonprotein calorie intake per kilogram body weight were 14 +/- 4.1 (HC) vs 25 +/- 4 (C) and 7 +/- 1.9 (HC) vs 20 +/- 3 (C), respectively. Protein intake was 1.23 +/- 0.4 (HC) vs 1.31 +/- 0.2 (C) g/kg per day. Initial respiratory quotients were similar and consistent with fasting (HC = 0.7 +/- 0.09 vs C = 0.66 +/- 0.09); final respiratory quotients in C patients reflected mixed fuel use (C = 0.82 +/- 0.11 vs HC = 0.7 +/- 0.12).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy of hypocaloric total parenteral nutrition in hospitalized obese patients: a prospective, double-blind randomized trial. 855 59

In recent years, the rate of decrease of the number of new patients with tuberculosis has slowed down. The aging of the Japanese population partially accounts for the increase in the number of patients with tuberculosis. The disease is often transmitted from these aged patients to those who were uninfected. Since it is well-known that a poor nutritional condition lowers the immunological resistance to tuberculosis, we used Onodera's PNI (Prognostic Nutritional Index; 10 x serum albumin concentration + 0.005 x peripheral lymphocyte count) as a parameter to check the nutritional condition and immunological deficiency in patients suffering from tuberculosis. We examined a total of 451 patients with tuberculosis who were admitted to our hospital from 1987 to 1991. The PNI value decreased with age and was low in patients with extensive lesions on chest X-ray as well as in those with complications, PNI was also low in patients showing negative tuberculin skin reaction, and increased with the intensification of the positive reaction. In patients showing negative conversion of bacilli during treatment, PNI value on admission increased significantly immediately before discharge. Patients with percent ideal body weight (IBW, calculated by the Broca's method modified by Katsura) on admission less than 90% accounted for 48.6% of all patients. There was a positive correlation between PNI and an obesity index (P < 0.01, r = 0.24). After admission, in patients showing negative conversion of bacilli, there was a positive correlation between the increase in PNI and the gain of body weight (P < 0.01, r = 0.30).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A nutritional and immunological investigation of patients with tuberculosis]. 806 84


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