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

Patients on maintenance hemodialysis (MHD) often show substantial reductions in quality of life (QoL). The SF36 (Short Form with 36 questions), a well-documented, self-administered QoL scoring system that includes eight independent scales and two main dimensions, has been widely used and validated. In 65 adult outpatients on MHD, the SF36 and its scales and dimensions, scored as a number between 0 and 100, and the nutritional and inflammatory state measured by subjective global assessment, near-infrared (NIR) body fat, body mass index (BMI), and pertinent laboratory values, including hemoglobin, albumin, and C-reactive protein were assessed. Twelve-month prospective hospitalization rates and mortality were used as the clinical outcomes. Multivariate (case-mix) adjusted correlation coefficients were statistically significant between SF36 scores and serum albumin and hemoglobin concentrations. There were significant inverse correlations between SF36 scores and the BMI and NIR body fat percentage. Hypoalbuminemic, anemic, and obese patients on MHD had a worse QoL. Prospective hospitalizations correlated significantly with the SF36 total score and its two main dimensions (r between -0.28 and -0.40). The Cox proportional regression relative risk of death for each 10 unit decrease in SF36 was 2.07 (95% CI, 1.08 to 3.98; P = 0.02). Of the eight components and two dimensions of the SF36, the Mental Health dimension and the SF36 total score had the strongest predictive value for mortality. Thus, in patients on MHD the SF36 appears to have significant associations with measures of nutritional status, anemia, and clinical outcomes, including prospective hospitalization and mortality. Even though obesity, unlike undernutrition, is not generally an indicator of poor outcome in MHD, the SF36 may detect obese patients on MHD at higher risk for morbidity and mortality.
 ...
PMID:Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. 1172 50

Obesity, which has reached epidemic proportions in the United States and other western countries, may be complicated by hypertension, an increased incidence of renal cancer or proteinuria. Patients with obesity-associated proteinuria show focal glomerulosclerosis and glomerulomegaly on biopsy, usually have minimal clinical edema and relatively normal levels of serum albumin, cholesterol and blood pressure, and can progress to end-stage renal disease. Severe obesity may also be an additive risk factor in patients with preexisting nephropathy or reduced renal mass. The pathophysiology of obesity-associated proteinuria is unclear but may include hyperfiltration, increased renal venous pressure, glomerular hypertrophy, hyperlipidemia and increased synthesis of vasoactive and fibrogenic substances, including angiotensin II, insulin, leptin and transforming growth factor-beta1. These substances may individually or interactively affect glomerular hyperfiltration, mesangial cell hypertrophy and matrix production, and the production of collagen, fibronectin, transforming growth factor-beta and other fibrogenic mediators of change. Although angiotensin-converting enzyme inhibition has proven to have an impact, perhaps temporarily, on obesity-associated proteinuria in humans, weight reduction early in the course of the disease would appear the most important therapeutic approach.
 ...
PMID:Obesity and renal disease. 1198 Dec 64

To investigate the relationship between obesity, small-solute clearances, and nutrition in continuous peritoneal dialysis (CPD), we compared clearances and nutrition indices between 270 obese and 502 normal-weight CPD patients. Degree of obesity was classified by the ratio of body weight (W) to desired weight (DW) at the first clearance study. The DWs were obtained from the tables of the Metropolitan Life Insurance Company, assuming a medium skeletal frame. The obese patients (group I) had W/DW > 1.2 (1.38 +/- 0.17), and the normal-weight patients (group II) had 0.9 < or = W/DW < or = 1.2 (1.05 +/- 0.08). Nutrition indices derived from urea nitrogen and creatinine excretion were normalized by both W and DW. The following variables differed between group I (first value) and group II: sex (women: 48.2% vs. 33.9%), W (87.6 +/- 14.4 kg vs. 68.2 +/- 8.7 kg), body surface area (1.95 +/- 0.22 m2 vs. 1.77 +/- 0.16 m2), body water by method of Watson (41.2 +/- 7.7 L vs. 36.3 +/- 5.5 L), body mass index (31.8 +/- 3.9 vs 24.3 +/- 2.0), protein nitrogen appearance (PNA: 62.9 +/- 17.6 kg in 24 h vs. 57.7 +/- 15.7 kg in 24 h), PNA normalized to DW (1.08 +/- 0.29 g/kg in 24 h vs. 0.96 +/- 0.26 g/kg in 24 h), creatinine excretion (CrEx: 1111 +/- 396 mg in 24 h vs. 991 +/- 348 mg in 24 h), CrEx/W (12.6 +/- 3.7 g/kg in 24 h vs. 15.4 +/- 4.5 g/kg in 24 h), CrEx/DW (17.3 +/- 5.3 g/kg in 24 h vs. 15.1 +/- 4.8 g/kg in 24 h), lean body mass (LBM: 49.3 +/- 13.8 kg vs. 43.6 +/- 11.9 kg), LBM/W (0.56 +/- 0.12 vs. 0.64 +/- 0.15), and LBM/DW (0.77 +/- 0.18 vs 0.67 +/- 0.16), all at p < or = 0.034. Marginal differences (0.10 > p > 0.05) were found in the diabetes prevalence (53.0% vs. 40.8%), height (165.9 +/- 11.7 cm vs. 167.4 +/- 9.8 cm), and serum albumin (3.64 +/- 0.55 g/dL vs. 3.53 +/- 0.62 g/dL). No differences were found in age, duration of CPD until the first clearance study, percent of subjects with anuria, Kt/V urea, creatinine clearance, blood urea nitrogen, serum creatinine, and PNA normalized to W. Obese CPD patients tend to have better nutrition indices than do normal-weight CPD patients with similar small-solute clearances. In obese subjects, normalization by W creates inappropriately low values for nutrition indices derived from urea nitrogen and creatinine excretion. Normalization of those indices by DW appears preferable.
 ...
PMID:Small solute clearances and nutrition indices in obese patients on continuous peritoneal dialysis. 1240 84

Interaction of advanced glycation end products (AGE) with AGE receptors induces several cellular phenomena potentially relating to diabetic complications. We here show that AGE-modified bovine serum albumin (BSA) is endocytosed by adipocytes via CD36. Upon differentiation, 3T3-L1 and human subcutaneous adipose cells showed marked increases in endocytic uptake and subsequent degradation of [(125)I]AGE-BSA, which were inhibited effectively by the anti-CD36 antibody. Ligand specificity of CD36 for modified BSAs was compared with that of LOX-1 and scavenger receptor class A. Effect of fucoidan on [(125)I]AGE-BSA binding showed a sharp contrast to that on [(125)I]-oxidized low density lipoprotein. These results implicate that CD36-mediated interaction of AGE-modified proteins with adipocytes might play a pathological role in obesity or insulin-resistance.
 ...
PMID:CD36-mediated endocytic uptake of advanced glycation end products (AGE) in mouse 3T3-L1 and human subcutaneous adipocytes. 1260 36

Variations of circulating C-reactive protein (CRP) levels are supposed to reflect chronic inflammatory process of the cardiovascular system. In particular, it has been reported that high-sensitivity CRP (hsCRP) is a promising marker of coronary heart disease. In the present study, we assessed the relationship between hsCRP and classic cardiovascular risk factors, such as age, blood pressure, smoking habit and serum lipids. Plasma hsCRP was measured by ELISA in 908 subjects, aged 30-79 years, who entered our health-check program. Plasma hsCRP level was 0.54+/-0.02 mg/l in 566 subjects without any disease currently treated. The level was significantly higher in patients treated for hypertension (0.74+/-0.06 mg/l, P=0.002), diabetes mellitus (0.77+/-0.09 mg/l, P=0.016) or coronary artery disease (0.99+/-0.16 mg/l, P=0.008) than in subjects without diseases. In a simple regression analyses of the 566 subjects without diseases, plasma hsCRP positively correlated with male gender, smoking, body mass index, systolic blood pressure, white blood cell count, blood hemoglobin, fasting blood glucose, serum gamma-GTP, uric acid and triglycerides, and inversely correlated with serum albumin and HDL-cholesterol. In multiple regression analysis, white blood cell count (r=0.276, P<0.001), body mass index (r=0.246, P<0.001), age (r=0.122, P=0.001) and smoking (r=0.112, P=0.009) showed independent correlations with plasma hsCRP. It is suggested that variation of circulating hsCRP, even within normal range, is involved in the interrelation of cardiovascular risk factors, such as age, smoking, obesity, high blood pressure and dyslipidemia, which are supposed to promote atherosclerosis and ultimately provoke cardiovascular diseases, such as coronary artery disease.
 ...
PMID:Relations of plasma high-sensitivity C-reactive protein to traditional cardiovascular risk factors. 1261 70

Because obesity is thought to play a key role in atherosclerosis through the low-grade chronic inflammation, the present study was designed to investigate associations of body mass index (BMI), body fat, and weight gain with optimized inflammation markers in 1,053 residents who were 40 years of age and older from a rural community (total population = 3,940 in 2000) in Japan. People reporting having a cold and those who did not undergo blood examinations were excluded. C-reactive protein (CRP), fibrinogen, serum albumin, and white blood cell (WBC) count were used as the markers for inflammation, body fat was calculated by a conventional method, and weight change since the age of 20 was assessed. The BMI and body fat significantly increased with CRP quartile, and its correlation coefficients to BMI or body fat were relatively high. Similar associations were found for fibrinogen, serum albumin and WBC. Multivariate-adjusted analysis found a high concentration of CRP was significantly associated with obesity, but attenuated the association in other markers. In an analysis restricted to people aged 40-69 years, body fat levels were more strongly associated with CRP and fibrinogen than with BMI only. Furthermore, only CRP concentrations were significantly elevated according to weight gain. Strong associations of CRP concentration with BMI, body fat, and weight gain were found among elderly Japanese, but not with fibrinogen, serum albumin or WBC.
 ...
PMID:Association of body mass index, body fat, and weight gain with inflammation markers among rural residents in Japan. 1265 63

High plasma level of triglycerides (TGs) is a common feature in atherosclerosis, obesity, diabetes, alcoholism, stress, and infection. Since mitochondria have been implicated in cell death under a variety of metabolic disorders, we examined liver mitochondrial functions in hypertriglyceridemic transgenic mice. Hypertriglyceridemia increased resting respiration and predisposed to mitochondrial permeability transition (MPT). Ciprofibrate therapy reduced plasma TG levels, normalized respiration, and prevented MPT. The higher resting respiration in transgenic mitochondria remained in the presence of the adenine nucleotide carrier inhibitor, carboxyatractyloside, bovine serum albumin, and the uncoupling proteins (UCPs) inhibitor, GDP. UCP2 content was similar in both control and transgenic mitochondria. We propose that faster resting respiration represents a regulated adaptation to oxidize excess free fatty acid in the transgenic mice.
 ...
PMID:Hypertriglyceridemia increases mitochondrial resting respiration and susceptibility to permeability transition. 1474 Aug 93

A protective effect of obesity on the mortality of end-stage renal failure patients has been observed in several studies. Most of these studies have been based on prevalent dialysis population. The aim of the present study was to evaluate if obesity has beneficial effects on the survival of advanced chronic renal failure patients. The study group consisted of 376 patients (mean age 63 +/- 15 years) with advanced chronic renal failure not yet on dialysis. Obesity was defined as a body mass index (BMI) > or = 30 kg/m2. Grade of comorbidity was quantified by the method devised by Davies. Survival was analyzed as time from the referral to the predialysis outpatient clinic to patient death, censoring from contributing additional survival data to the analysis following transplantation. Kaplan-Meier analysis was used to test survival differences according to quartiles of BMI, and between obese and nonobese patients. Further analysis were performed, stratifying survival curves by comorbid scores, lean body mass, age, and sex. Cox proportional hazard regression models were used to investigate the best determinants of mortality, and the role of obesity adjusted for other covariates. Median survival time was 1,453 days. During the follow-up time, 158 patients (42%) died. Survival differences among quartiles of BMI were statistically significant (Breslow = 10.7, p = 0.017). Patients within the lowest and the highest quartiles of BMI had higher mortality than the rest of patients. Survival curves between obese and non-obese patients did not differ significantly. However, when patients without comorbidity were studied apart, those with obesity showed worse survival than the rest of patients (log-rank = 7.42, p = 0.0064). Since the effect of obesity on mortality did not follow a proportional hazard pattern throughout the study period, multivariable analysis for mortality was stratified by 18 months intervals. The variables which fitted the best model were: age (Hazard Ratio: 1.04), comorbid score (HR: 2.17), serum albumin (HR: 0.62), GFR at the study entry (HR: 0.91), male gender (HR: 1.48), and obesity (HR: 1.51). In conclusion, obesity had no survival benefit in patients with advanced chronic renal failure. Obesity had a noteworthy impact on early mortality of advanced chronic kidney disease patients without comorbidities.
 ...
PMID:[Obesity and mortality in advanced chronic renal failure patients]. 1564 3

Cardiovascular disease is the leading cause of death among dialysis patients. The relative risk of mortality increases as serum albumin concentration and body mass index decline. While these are generally associated with nutritional status, inflammation causes sarcopenia and decreased albumin concentration by reducing synthesis of proteins and increasing their catabolic rate. While inflammation can arise from atherosclerotic blood vessels, systemic inflammation from any source can alter the vascular endothelium and plasma protein composition in ways that promotes vascular injury. High-density lipoprotein synthesis is decreased and the high-density lipoprotein present is less capable of reducing inflammation. Activation of neutrophils favors lipoprotein oxidation. Surprisingly, while obesity is associated with cytokine production in patients without renal failure, as well as among dialysis patients, increased body mass index, whether reflecting muscle mass or adipose tissue, is associated with a decline in mortality rates.
 ...
PMID:Association between inflammation and malnutrition as risk factors of cardiovascular disease. 1636 41

Hepatitis B and C are diseases characterized by a high global prevalence, complex clinical course and limited efficacy of currently available antiviral therapy. Hepatitis B: local factors have a significant influence not only on the disease prevalence but also on the disease course. Vertical transmission of the infection in the areas of high prevalence results in perinatal infection, which universaly leads to the development of chronic disease. Factors associated with an increased risk of cirrhosis are older age, persistent viremia, coinfection with HCV, HDV and HIV, and consumption of alcohol, while the role of viral genotype is uncertain. Predictors of HCC development in cirrhotic liver are older age, male sex, alcohol abuse, exposure to aflatoxin, coinfection with HCV and HDV, continuously active inflammation, and potentially viral genotype. Survival predictors in cirrhotic patients are age, serum albumin, platelet count and splenomegaly as a reflection of portal hypertension. Hepatitis C: the risk of cirrhosis is low. Risk factors for cirrhosis are infection in older age, alcohol abuse, and coinfection with HBV and HIV. Obesity has negative impact on treatment efficacy.
 ...
PMID:[Factors influencing clinical course of viral hepatitis]. 1638 Dec 33


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>