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

Obesity has become an important problem of public health in all developed countries. It has slightly different connotations in women because, apart from its greater prevalence, low socio-economic level is a risk factor solely for women. As well as a cardiovascular risk factor in women, it is associated with an increased risk of breast cancer, cancer of the endometrium, ovarian polycystosis and infertility. Weight control in women has a large aesthetic motivation and eating has considerable emotional components. On the other hand, women consume more drugs (contraceptives, painkillers, migraine treatments, anxiolytics, anti-depressants) which seem to favour obesity. The role played in the pathogenesis of obesity by cyclical hormonal changes, pregnancy, the consumption of oral contraceptives and the menopause remains to be clarified. The effect of replacement hormone therapy as a cause of weight gain is doubtful.
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PMID:[Obesity in women]. 1459 30

The aim of this paper is to assess the clinical effectiveness of orlistat used for the management of obesity. Nineteen electronic databases were searched for randomized controlled trials evaluating the effectiveness of orlistat for weight loss or maintenance of weight loss in overweight or obese patients. Each included trial was assessed for methodological quality. Statistical pooling was performed when trials were considered to be sufficiently similar. Twenty-three trials were eligible for inclusion. Placebo-controlled trials recruiting patients with uncomplicated obesity reported statistically significant differences in favour of orlistat for weight loss and changes in obesity-related risk factors at all time points. Trials in obese patients with defined risk factors at baseline showed similar results, however, smaller effect sizes were observed in patients with type 2 diabetes. The effectiveness of orlistat relative to other anti-obesity drugs is currently unclear. When orlistat was added to simvastatin, this proved to be more effective for weight loss than either drug used individually. Orlistat use is associated with a higher incidence of gastrointestinal adverse events compared with placebo. In conclusion, orlistat is more effective than placebo in promoting weight loss, maintenance of weight loss, and improving cardiovascular risk factor profiles. Baseline parameters of patients seen in clinical practice should be taken into account when considering treatment.
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PMID:A systematic review of the clinical effectiveness of orlistat used for the management of obesity. 1496 7

A low level of high-density lipoprotein cholesterol (HDL-C) is an important cardiovascular risk factor. Dietary measures and pharmacological agents are often not sufficient to reach the HDL-C target level of 40 mg/dl in patients with low baseline HDL-C. This study assesses the association between lipid levels and age, gender, body mass index (BMI), glycemia, diabetes and smoking and focuses on the parameters influencing HDL-C. In the town of Lede (Belgium) all patients aged between 45 and 64 years were invited during 1999 for a free of charge health check-up and blood test. Blood pressure, weight, length and smoking habits were recorded. Serum levels for glycemia and lipoproteins were determined. In total, 629 subjects attended for the check-up. In a logistic regression analysis age above 50 years was correlated with low HDL-C (OR = 2.27 CI = 1.10-4.68). Male gender was correlated with low HDL-C (OR = 3.85 CI = 1.77-8.43) and with high triglycerides (TG) (OR = 1.94 CI = 1.14-3.30). From the level of 90 mg/dl glycemia was correlated with low HDL-C (OR = 2.56 CI = 1.02-6.39) and high TG (OR = 2.12 CI = 1.16-4.06). Obesity was correlated with low HDL-C (OR = 2.36 CI = 1.18-4.71) and high TG (OR = 2.17 CI = 1.88-5.23). This study provides some evidence to sharpen the target levels for glycemia and BMI among patients with low HDL-C and high TG. For these patients, the target glycemia should be around 90 mg/dl and BMI around 25 kg/m2. Physical activity and diet are also important in the achievement of these target levels.
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PMID:Correlations between lipid levels and age, gender, glycemia, obesity, diabetes, and smoking. 1509 22

The metabolic cardiovascular disease (CVD) risk factors of women with self-reported oligomenorrhea and/or hirsutism, which are symptoms of polycystic ovary syndrome (PCOS), were investigated in a general population-based Northern Finland Birth Cohort 1966 Study to determine whether women with PCOS symptoms at 31 yr would be distinguishable from asymptomatic controls in terms of CVD risk factors. A total of 518 cases with oligomenorrhea and/or hirsutism and 1036 randomly selected controls were analyzed. C-Reactive protein (CRP; median, 0.70 vs. 0.60 mg/liter; P = 0.026), triglycerides (mean, 0.97 vs. 0.91 mmol/liter; P = 0.039), body mass index (BMI; mean, 25.1 vs. 24.2 kg/m(2); P < 0.001), and waist/hip ratio (mean, 0.82 vs. 0.81; P = 0.001) were significantly higher, and high-density lipoprotein cholesterol levels were lower (mean, 1.60 vs. 1.66 mmol/liter; P = 0.002) in the cases compared with the controls. Total cholesterol, low-density lipoprotein cholesterol, and blood pressure showed no statistically significant differences between the cases and the controls. In terms of metabolic CVD risk factors, women reporting hirsutism alone were indistinguishable from the control group, and those who reported both oligomenorrhea and hirsutism had the most severe changes in risk factor profiles. Because obesity is strongly related to PCOS symptoms, the analyses were stratified by BMI. After stratification into normal weight (BMI, <25 kg/m(2)), overweight (25 kg/m(2) <or= BMI <30 kg/m(2)), and obese (BMI, >or=30 kg/m(2)) groups, the waist/hip ratio was significantly higher among the overweight cases (mean, 0.84 vs. 0.83; P = 0.04). Among the obese women, high-density lipoprotein cholesterol was significantly lower (mean, 1.32 vs. 1.48 mmol/liter; P = 0.002) among the cases, and triglycerides tended to be higher (mean, 1.43 vs. 1.27 mmol/liter; P = 0.068) than in controls. In conclusion, these results indicate that self-reported symptoms of oligomenorrhea and/or hirsutism, particularly in the presence of both symptoms, may be helpful to identify women with metabolic cardiovascular risk factor accumulation associated with PCOS.
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PMID:Metabolic cardiovascular disease risk factors in women with self-reported symptoms of oligomenorrhea and/or hirsutism: Northern Finland Birth Cohort 1966 Study. 1512 28

To better understand obesity and overweight among urban African American women, the authors examined sociodemographic, behavioral, and psychological factors within body mass index (BMI) categories. A total of 496 women were recruited for cardiovascular risk factor screening from 20 urban African American churches. Study participants had a mean age of 52.8 years, 13.5 years of education, and an average BMI of 32 kg/m2. Bivariate analyses showed increased overall energy intake and decreased physical performance on a walk test, and general well-being declined as the BMI class increased; obese women had the lowest physical performance and well-being levels and the highest energy intake levels. There was no difference by BMI category, however, in social variables such as educational attainment, employment, marital status, or household income. This study suggests that although women with increasing BMI have some physical and well-being concerns, the major social variables are not differentially distributed by BMI in this sample of women.
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PMID:Sociodemographic, behavioral, and psychological correlates of current overweight and obesity in older, urban african american women. 1529 92

BACKGROUND: There is increasing interest in monitoring cardiovascular risk factor levels and their treatment. We decided to study this in patients discharged from Divisions of Internal Medicine. METHODS: In three studies conducted in 1996, 1999, and 2002, data was collected on diagnoses of cardiovascular diseases and cardiovascular risk factor levels and treatment in 5904, 7476, and 9649 patients, respectively, aged 35 years or older, who were discharged within a week from 235, 345, and 517 Divisions of Internal Medicine in Italy. RESULTS: Between the first and third surveys, a relative decrease in atherosclerotic cardiovascular diseases was recorded, but heart failure showed a definite increase, reaching 11% of all cases. Mean levels of most cardiovascular risk factors decreased significant; only obesity did not. The proportion of treated hypertensives increased slightly (from 65% to 83% among men, and from 69% to 85% among women). The proportion of controlled hypertensives also rose, reaching around 37%. The proportion of treated dyslipidemics increased from 10% to 28% in men and from 12% to 25% in women, due to an increase in the use of statins. CONCLUSIONS: It is essential to focus attention on cardiovascular risk factors in order to optimize their treatment and to reduce cardiovascular disease.
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PMID:Time trends in three triennial surveys of cardiovascular risk factors and their treatment among patients discharged from divisions of internal medicine The FAPOI-1, FADOI-2, and FADOI-3 studies. 1545 Sep 87

Obesity is a multifactorial, chronic disorder that has reached epidemic proportions in most industrialized countries and is threatening to become a global epidemic. Obese patients are at higher risk from coronary artery disease, hypertension, hyperlipidemia, diabetes mellitus, cancers, cerebrovascular accidents, osteoarthritis, restrictive pulmonary disease, and sleep apnoea. In particular, visceral fat accumulation is usually accompanied by insulin resistance or type 2 diabetes mellitus, hypertension, hypertriglyceridemia, high uremic acid levels, low high density lipoprotein (HDL) cholesterol to define a variously named syndrome or metabolic syndrome. Metabolic syndrome is now considered a major cardiovascular risk factor in a large percentage of population in worldwide. Both obesity and metabolic syndrome are particularly challenging clinical conditions to treat because of their complex pathophysiological basis. Indeed, body weight represents the integration of many biological and environmental components and relationships among fat and glucose tolerance or blood pressure are not completely understood. Efforts to develop innovative anti-obesity drugs, with benefits for metabolic syndrome, have been recently intensified. In general two distinct strategies can be adopted: first, to reduce energy intake; second, to increase energy expenditure. Here we review some among the most promising avenues in these two fields of drug therapy of obesity and, consequently, of metabolic syndrome.
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PMID:Emerging aspects of pharmacotherapy for obesity and metabolic syndrome. 1545 65

Hypertension is a major cardiovascular risk factor in the metabolic syndrome (MS) in which the presence of insulin resistance, glucose intolerance, abnormal lipoprotein metabolism, and central obesity all confer an increased risk. Because essential hypertension (EHT), insulinemia, and visceral fat are associated with sympathetic hyperactivity, which is itself known to increase cardiovascular risk, the aim of this study was to see if MS is a state of sympathetic nerve hyperactivity and if the additional presence of EHT intensifies this hyperactivity. In 69 closely matched subjects, comprising hypertensive MS (MS+EHT, 18), normotensive MS (MS-EHT, 17), hypertensives without MS (EHT, 16), and normotensive controls without MS (NC, 18), we measured resting muscle sympathetic nerve activity (MSNA) as assessed from multiunit discharges and from single units with defined vasoconstrictor properties (s-MSNA). The s-MSNA in MS+EHT (76+/-3.1 impulses/100 beats) was greater (at least P<0.01) than in MS-EHT (62+/-3.2 impulses/100 beats) and in EHT (60+/-2.3 impulses/100 beats), and all these were significantly greater (at least P<0.01) than in NC (46+/-2.7 impulse/100 beats). The multi-unit MSNA followed a similar trend. These findings suggest that MS is a state of sympathetic nerve hyperactivity and that the additional presence of hypertension further intensifies this hyperactivity. The degree of sympathetic hyperactivity seen in this study could be argued at least partly to contribute to the higher cardiovascular risk and metabolic abnormalities seen in MS+EHT patients.
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PMID:Sympathetic neural activation in nondiabetic metabolic syndrome and its further augmentation by hypertension. 1552 Mar 3

The aim of the study was to evaluate the level of habitual physical activity in Croatian physical education (PE) teachers, as well as the existence of some other risk factors for the development of cardiovascular diseases (CVD). The sample consisted of 191 PE teachers aged 24 to 59 years (122 men, mean age 42.6+/-8.76 and 69 women, mean age 40.3+/-8.84;p=0.09). In order to assess the level of habitual physical activity, the teachers were asked to fill in Baecke's questionnaire. The questionnaire comprises 16 items testing physical loads at work, during sport activity and during leisure time. The questionnaire also contains 8 items, each of them representing a certain cardiovascular risk factor. In comparison to average adult employed population, PE teachers have a significantly higher level of sport and leisure time activity, which could have a favorable impact on the incidence of particular risk factors, such as overweight/obesity, systolic hypertension and blood cholesterol level. This is more obvious in females PE teachers who pay more attention to the principles of healthy life style: optimal body weight regulation, low fat diet and higher amount of leisure time physical activity (significantly higher than in male teachers). Female PE teachers who have maintained their active life style decrease the risk of CVD, particularly after the age of 55. Although it is necessary to keep in mind all the limitations of a questionnaire study, this preliminary report leads to the conclusion that male PE teachers, although physically active at job, have still kept sedentary habits, often have maintained heavy smoking habits, are slightly overweight, thus minimizing the positive effects of their demanding workplace. Consequently, average male PE teachers' risk for CVD development corresponds to the risk of general male population.
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PMID:Gender differences in cardiovascular diseases risk for physical education teachers. 1557 Oct 98

The aim of this study was to evaluate the frequency of Internet use among African-Americans at risk of cardiovascular disease and to determine the feasibility of developing Webbased, culturally relevant health information programs to reduce cardiovascular disease in the African American faith community. A cross-sectional survey was used to investigate the association of Internet use with the risk of cardiovascular disease (CVD) among members of African Methodist Episcopal churches in South Carolina. A telephone survey including questions on demographic factors, medical history, diet, and exercise was administered to a sample of 208 adult church members. A preventable CVD risk factor was defined as having any of the following: hypertension, obesity, diabetes, high cholesterol, cigarette use, and not participating in moderate physical activity. A logistic regression determined the relationship of having a preventable CVD risk factor with Internet use while controlling for potential confounding variables. Among respondents, 47% used the Internet with most (65%) using it for 1 month or less. Most (87%) have at least one preventable CVD risk factor. Both higher education and younger age were significantly associated with Internet use. Results of the logistic regression indicate that individuals with a cardiovascular risk factor were not significantly less likely to use the Internet when controlling for age and education. Use of the Internet has potential to reach large populations, however, more work needs to be done to increase access to the Internet by older African-Americans at greatest risk of CVD before this approach can be effective.
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PMID:Use of the internet for health information by African-Americans with modifiable risk factors for cardiovascular disease. 1565 May 25


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