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

The prevalence of obesity is particularly high in Black and Latino pediatric populations. A limited number of metabolic studies suggest that race plays a role in the development of obesity-related co-morbidities. We evaluated clinical and metabolic characteristics of 428 obese (mean BMI z-score 2.63) children and adolescents ranging in age from 2-20 years, of primarily Dominican ancestry attending the obesity clinic at Children's Hospital of New York Presbyterian over a 5-year period (1998-2003). Of 193 patients available for detailed metabolic analysis, abnormalities were found for elevated systolic blood pressure (19%), diastolic blood pressure (11%), total cholesterol (18%), LDL (12%), triglycerides (10%), AST (<1%), ALT (4%), low HDL (47%), impaired fasting glucose (5%), impaired glucose tolerance 7%, diabetes mellitus by fasting criteria(<1%), and metabolic syndrome (14%). Despite extraordinary family histories of obesity and diabetes mellitus, the metabolic syndrome and abnormalities of glucose regulation were relatively infrequent compared to studies of obese, pediatric Latino patients of primarily Mexican and Puerto Rican ancestry. This finding suggests that Latinos from different areas of origin may have different risks of obesity-related conditions.
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PMID:Clinical and metabolic characteristics of an obese, Dominican, pediatric population. 1645 52

The authors conducted this study to evaluate the efficacy of a health check-up program and the health status of health care workers at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. The authors reviewed all yearly-check up charts of personnel who worked at Srinagarind Hospital from 2002 to 2003 including history taking, physical examination, and laboratory testings. There were 606 office workers and 1,024 nursing staff enrolled The mean ages of both groups were 38.9 and 36.5 years old, respectively. The office workers visited physicians significantly more often than the nursing staff (553 of 606 vs 271 of 1,024; p-value = 0.00). Obesity was found much more in office workers (127 of 472 versus 129 of 749). There were significant differences between the groups on impaired fasting plasma glucose, DM, HT, high cholesterol level, high triglyceride level, and significant elevation of ALT or AST (all p-value = 0.00). In the obese group, there was also a significantly higher number of cases who had high blood pressure, defined as IFG or DM, high cholesterol level, and high triglyceride level (p-value = 0.00) except the significant elevation of ALT or AST level. Cases of obesity with significant elevation of hepatic enzyme had many atherosclerotic risk factors. Therefore, metabolic derangements are the important problem for health care workers.
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PMID:Health status of health care workers at Srinagarind Hospital: experience from the Annual Health Check-up Program. 1647 Nov 10

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease that has been shown to progress to cirrhosis and hepatocellular carcinoma. This article reviews the prevalence of NAFLD and the factors associated this disorder, and with the more advanced stages of NAFLD, including nonalcoholic steatohepatitis (NASH) and fibrosis. In the general population, the estimated prevalence ranges from 3% to 24%, with most estimates in the 6% to 14% range. NAFLD is extremely common among patients undergoing bariatric surgery, ranging from 84% to 96%. In these patients, 25% to 55% have NASH, 34% to 47% have fibrosis, and 2% to 12% have bridging fibrosis or cirrhosis. NAFLD appears to be most strongly associated with obesity, and insulin resistance states including diabetes and with other features of the metabolic syndrome, such as high triglycerides and low HDL. It appears to be more common in men, and it increases with increasing age and after menopause. Some data suggest that Mexican Americans are more likely to have NAFLD and blacks are less likely compared with non-Hispanic whites. More advanced stages of NAFLD are associated with older age, higher body mass index, diabetes, hypertension, high triglycerides, and/or insulin resistance. An AST/ALT ratio greater >1 may also indicate more severe disease. Although hepatocellular carcinoma can occur in the setting of NAFLD, the risk factors for hepatocellular carcinoma in the setting of NAFLD have not been established. More prospective studies are needed to determine the true risk factors for the development and progression of NAFLD to help identify patients at highest risk who might benefit from treatment trials.
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PMID:The epidemiology of nonalcoholic fatty liver disease in adults. 1654 Jul 68

Endothelin-1 (ET-1) is known to play an important role in hepatic fibrosis. ET-1 is also a mediator that is elevated in conditions such as insulin resistance, hyperglycemia, oxidative stress, and endothelial cell dysfunction. In this study, we investigated whether ET-1 has a role in determining the severity of liver fibrosis in NASH. Also, the relation between ALT levels, obesity, diabetes, and AST/ALT ratio and fibrosis and ET-1 level was sought. A total of 92 patients were enrolled in the study. The patients were categorized into three groups: group 1, patients with elevated transaminase levels who were diagnosed as NASH by liver biopsy (n=40); group II, patients with only hepatosteatosis determined by biopsy but having elevated transaminase levels (n=12); and group III, patients with hepatosteatosis observed by ultrasonography, having normal transaminase levels (n=40). The serum ET-1 level was measured by an appropriate ELISA kit for all patients. Mean serum ET-1 level was statistically significantly higher in the NASH group compared to the other two groups (15.56+/-4.63 vs 6.75+/-2.46 and 5.74+/-2.34 micromol/L; P < 0.01). Mean serum ET-1 levels in NASH patients with grade I, grade II, and grade IV fibrosis were 14.06+/-0.92, 17.70+/-2.32, and 20.40+/-1.40 micromol/L, respectively. None of the patients were identified as grade III fibrosis. It was found that the serum ET-1 level showed a statistically significant increase as fibrosis severity increased in NASH patients (P < 0.05). In conclusion, the serum ET-1 level is higher in NASH patients compared to patients having only steatosis. There appears to be a correlation between severity of fibrosis and serum ET-1 level in NASH patients. It has been found that NASH patients having a twofold increase in their ALT levels had higher ET-1 levels and a more severe grade of fibrosis.
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PMID:The serum endothelin-1 level in steatosis and NASH, and its relation with severity of liver fibrosis. 1742 33

Obesity is considered to be epidemic worldwide. Stopping further progression interdisciplinary, outpatient intervention therapy programs for obese children have become increasingly important. FITOC (Freiburg Intervention Trial for Obese Children) consists of a combination of organized sports, behavioral therapy and nutritional advice. The effectiveness of the therapy is determined on the basis of anthropometrical and physical performance data. The purpose of this report is to give a differentiated view of the motor abilities of obese children and to describe changes in the course of the therapy program FITOC. Data were collected on n = 49 obese children (BMI > 97th percentile) aged 8 - 12 in a pretest at the beginning and posttest at the end of the intensive phase of the therapy. These data were compared with an age-matched German reference group. Besides the General Sports-Motor Test (Allgemeiner Sportmotorischer Test [AST]), the BMI-SDS values, the body fat mass (FM %) and the aerobic capacity (Watt/kg body weight) were recorded. In the pretest, the running exercise results and the aerobic capacity checked ranged significantly below the values of the reference group. The performance in the coordinative tests of the AST was differentiated. The medicine-ball toss was significantly above average of the reference group. In the posttest, the BMI-SDS values and the body fat mass (% FM) decreased (p < 0.001) and the aerobic capacity improved (p < 0.001). Performance in all motor abilities tests improved and the difference between the strength of the obese children and the strength of the reference group decreased. This study demonstrates that in obese children weight-bearing activities are below average but not all motor abilities.
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PMID:Motor abilities and aerobic fitness of obese children. 1749 79

The occurrence of liver disease and raised liver enzymes is common in Type 2 diabetes, and may be multifactorial in origin. Very few studies are available on the exact prevalence of the phenomenon, however. We carried out an observational point-prevalence study of elevated liver enzymes in eight hospital-based Italian diabetes units. Data of 9621 consecutive Type 2 diabetes patients (males, 52.4%; median age, 65 yr) were analyzed, and alanine and aspartate aminotransferase (ALT, AST) and gamma-glutamyltransferase (GGT) levels were related to body mass index (BMI), metabolic control and the presence of the metabolic syndrome. ALT, AST, and GGT levels exceeding the upper limit of normal were present in 16.0%, 8.8%, 23.1%, respectively, the prevalence being higher in males, increasing with obesity class and poor metabolic control, and decreasing with age. Elevated enzymes were systematically associated with most parameters of the metabolic syndrome. After correction for age, gender, BMI, and differences across centers, elevated triglyceride levels/fibrate treatment [odds ratio (OR), 1.57; 95% confidence interval (CI), 1.34- 1.84] and an enlarged waist circumference (OR, 1.47; 95% CI, 1.17-1.85) were the only parameters independently associated with high ALT. In a separate analysis, the presence of metabolic syndrome (Adult Treatment Panel III criteria) was highly predictive of raised liver enzymes. After exclusion of hepatitis B and C positive cases, tested in 2 centers, the prevalence of raised enzymes decreased by approximately 4%, but the association with the metabolic syndrome did not change significantly. In conclusion, the high prevalence of elevated liver enzymes in Type 2 diabetes is in keeping with the well-demonstrated risk of progressive liver disease. A large amount of diabetes patients may require a thorough clinical, laboratory and histological investigation.
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PMID:Prevalence of elevated liver enzymes in Type 2 diabetes mellitus and its association with the metabolic syndrome. 1836 6

Activation of peroxisome proliferator-activated receptor (PPAR)-alpha by natural and synthetic chemicals induces hepatic hypertrophy. An aqueous extract of Salacia oblonga root (SOW) is an Ayurvedic medicine with anti-diabetic and anti-obesity properties. In the present study, it was found that SOW (100, 300 and 900mg/kg, once daily by oral gavage over a 28 day period) elicited dose-related increases in liver weight (LW) by 1.6%, 13.4% and 42.5%, respectively, and in the ratio of LW to body weight by 8.8%, 16.7% and 40.2%, respectively, in male rats. These effects were less pronounced in females. SOW selectively increased liver mass in male rats but Sudan red staining was not different, which indicates that hepatic lipid accumulation was similar in both genders. However, SOW even at the highest dosage did not influence serum ALT and AST activities in male or female rats. Moreover, SOW was found to activate PPAR-alpha in human hepatoma-derived HepG2 cells, as evidenced by the upregulation of PPAR-alpha and acyl-CoA oxidase mRNA expression. Thus, SOW-dependent PPAR-alpha activation may precede the development of the gender difference in hepatic hypertrophy; this process may be influenced by sex hormone status.
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PMID:An aqueous extract of Salacia oblonga root, a herb-derived peroxisome proliferator-activated receptor-alpha activator, by oral gavage over 28 days induces gender-dependent hepatic hypertrophy in rats. 1839 19

The inhibitory effect of the MeOH extract of Citri unshii pericarpium (CU) and its fractions were tested in hyperlipemic rats using for animal models induced by high cholesterol-diet. We measured plasma levels of triglyceride, total cholesterol, low-density lipoprotein (LDL)-cholesterol and high-density lipoprotein (HDL)-cholesterol as measures of its hyperlipemic effects. We demonstrated that CU decreases plasma levels of triglyceride, total cholesterol and LDL cholesterol. There was also no elevation of plasma ALT and AST levels, which indicate CU did not cause liver injury. These results indicate that CU is a good candidate for the treatment on high cholesterol diet-induced blood circulatory disorders, obesity and hyperlipidemia.
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PMID:Lipid lowering activity of Citri unshii pericarpium in hyperlipemic rats. 1868 99

Obesity with insulin resistance and alcohol are the most frequent causes of steatohepatitis. This work investigates the contribution of bioactive TNF and Th1 type cytokines in a mouse model of steatohepatitis induced by FAT alone or FAT+EtOH and endotoxin. The extent of liver injury and cytokine activation induced by endotoxin in chronic FAT-fed mice, FAT+EtOH-fed mice, or mice fed standard chow were analyzed. Endotoxin administration to either FAT-fed or FAT+EtOH-fed mice increased serum ALT and AST compared to standard chow mice. Immunoreactive TNF was strongly activated by LPS in FAT-fed and FAT+EtOH-fed mice which presented the highest levels, but low levels were found in standard chow mice. In contrast, bioactive TNF was only present in serum of FAT-fed and in particular the highest levels were found in FAT+EtOH-fed mice. Moreover, soluble TNFR2 but not TNFR1 was found in lower amounts in serum of FAT+EtOH-fed mice compared to FAT-fed mice. Steatohepatitis was associated with increased IL-6, IFN-gamma, and iNOS mRNA and proteins. Data show that a moderately FAT diet and low-dose EtOH concur to generate steatohepatitis and TNF liver expression after LPS. In this model, changes in the regulation of TNF are associated with increased expression of IL-6, IFN-gamma, and iNOS.
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PMID:Fat diet and alcohol-induced steatohepatitis after LPS challenge in mice: role of bioactive TNF and Th1 type cytokines. 1872 87

We examined the relationship between moderate obesity and glucose metabolism, insulin sensitivity and suspected fatty liver in children. We measured body mass index (BMI), z-score BMI, caliper skinfold thickness, waist and hip circumference in 94 participants (mean age 9.7 +/-2.2 years). Fasting blood glucose, insulin, HOMA score, lipid profile and transaminases (ALT, AST) were measured. Fatty liver and skinfold thickness were evaluated by means of ultrasound. The z-score BMI was 2.01 +/-0.39 (mean +/- SD), and the duration of obesity was 4.3+/-3.03 years. A positive correlation was found between caliper and US skinfold thickness for tricipital (r= 0.33; p= 0.003) and sovrailiac skinfold (r= 0.34; p=0.003). Fatty liver was diagnosed in 64% of children and it was positively related to anthropometric measurements. The three sub-groups--group 0 (normal US liver and normal transaminases); group 1 (US fatty liver and normal transaminases); group 2 (US fatty liver and elevated transaminases)--showed a difference concerning z-score BMI, insulin and HOMA parameters (Tukey test: z score BMI group 1 vs group 0 and 2 vs group 0; serum insulin: group 2 vs group 1 and group 2 vs group 0; HOMA IR: group 2 vs group 1 and group 2 vs group 0). Moderately obese children with steatosis exhibited a clear increase of insulin and insulin resistance which represents indices of a future metabolic syndrome. In addition, it is important to perform a liver ultrasound since transaminases seems to be not adequate for the diagnosis of fatty liver.
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PMID:Relationship among fatty liver, adipose tissue distribution and metabolic profile in moderately obese children: an ultrasonographic study. 1899 88


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