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

Type 2 diabetes is the most common form of hyperglycemia. The disease exists in all populations, but in developed societies, the prevalence has risen as the population ages and above all becomes more obese. In the prediabetic state, type 2 diabetes involves two defects, peripheral insulin resistance and hyperinsulinemia, which is followed by the failure of insulin secretion to compensate for the insulin resistance. As with nearly any disease, it is likely that multiple environmental and genetic factors are involved in the development of insulin resistance. An acquired pathogenic factor is obesity, particularly visceral obesity. Compelling evidence suggests that progressive dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, with elevated levels of circulating cortisol, is implicated in the development of visceral obesity. The HPA axis perturbations associated with visceral obesity can be accounted for, in part, by increased environmental stress that destabilizes the hypothalamic-pituitary system in individuals with genetic susceptibility.
Med Sci Monit 2003 Feb
PMID:Stress induced disturbances of the HPA axis: a pathway to Type 2 diabetes? 1260 4

Adiponectin and resistin are recently described secretory products of adipose tissue. Adiponectin is secreted by fat cells and circulates in the blood. Plasma adiponectin concentration is reduced in obese animals and humans and in patients with type 2 diabetes mellitus. Adiponectin stimulates fatty acids oxidation, decreases plasma triglycerides, and improves glucose metabolism by increasing insulin sensitivity. In addition, adiponectin inhibits the inflammatory process and possibly atherogenesis by suppressing the migration of monocytes/macrophages and their transformation into foam cells. Plasma adiponectin is lower in patients with ischemic heart disease than in body mass index-matched healthy individuals. Hypoadiponectinemia may contribute to insulin resistance and accelerated atherogenesis associated with obesity. Resistin/FIZZ3 is a member of the newly discovered cysteine-reach secretory protein family, referred to as 'resistin-like molecules' (RELM) or 'found in inflammatory zone' (FIZZ), together with FIZZ1/RELMalpha and FIZZ2/RELMbeta. Each of these has unique tissue distribution. Both resistin and FIZZ1/RELMalpha are expressed in adipose tissue. Initial studies in rodents suggested that resistin is upregulated in obesity and may be involved in the development of insulin resistance. Later studies failed to confirm this hypothesis and demonstrated reduced resistin expression in adipose tissue of obese animals. In human adipose tissue resistin is detectable at a very low level, and there is no relationship between resistin expression and obesity. Although the role of resistin in linking human obesity with type 2 diabetes is thus questionable, this protein is detected in peripheral blood monocytes,
Med Sci Monit 2003 Feb
PMID:Adiponectin and resistin--new hormones of white adipose tissue. 1458 85

Heart failure (HF) is an important cause of morbidity and mortality. Obesity is an increasingly prevalent condition that has been associated with increased cardiovascular risk, including increased risk of developing HF. Based on the associations of obesity with cardiac structural and hemodynamic alterations, as well as case reports of reversal of cardiomyopathy with weight loss, obesity has been presumed to have a deleterious effect in patients with HF. However, several recent studies have shown that in patients with established HF, obesity is not associated with increased mortality, but rather is associated with improved survival. Potential mechanisms for cardioprotection in obesity include a diminished activation of the neurohumoral system, an enhanced protection against endotoxin/inflammatory cytokines, and an increased nutritional and metabolic reserve. Further investigations into the relationship between obesity and the progression of HF are necessary. Ultimately, clinical trials are needed to provide definitive guidance to the management of obese and overweight HF patients.
Heart Fail Monit 2002
PMID:The impact of obesity on survival in patients with heart failure. 1263 83

Archival reports demonstrate that black females are in the minority of reported breast cancer cases, yet are given a significantly poorer prognosis than their white counterparts. Numerous studies have been conducted in an attempt to explain this discrepancy. In the past, socio-economic variables such as economic status and access to adequate health care have been the focus of attention. More recently there has been a shift to understanding the racial differences in genotype, as well as hormones related to tumor growth. In the present report, we explore the effects of increased estrogen levels as a precursor to the detrimental effects of breast cancer in African American women when compared to Caucasian women. Furthermore we will explore the effects of increased estrogen levels on the apoptotic events of p53 and Bcl-2 proteins. We conclude with a discussion regarding the antagonistic behavior of varying isoforms of estrogen receptors, and their relationship to nitric oxide (NO) as a free radical. The main focus of this paper is to address the many carcinogenic pathways that are instigated by estrogen and those which may be linked to obesity. By determining the relative concentration of estrogen and related proteins within black and white populations we hope to better understand the above mentioned disparity.
Med Sci Monit 2003 Jun
PMID:Risk factors for breast cancer and the prognosis of African American women: estrogen's role. 1282 61

Ghrelin is a peptydil hormone that has recently been discovered through an unusual reverse pharmacology pathway. Ghrelin is produced mainly in the stomach, but its expression has also been demonstrated in many other organs such as pituitary, hypothalamus, bowel, kidney, heart, pancreas, testis. It is active on the central nervous system, where it is involved in the regulation of GH secretion, mainly through a GHRH-independent mechanism and directly at the pituitary level. Furthermore, ghrelin controls energy balance, enhancing fat mass deposition and food intake through the activation of the hypothalamic nuclei and the promotion of NPY (neuropeptide Y) and AGRP (Agouti related protein) expression; since it stimulates weight gain, ghrelin is considered a possible important factor in the etiology of obesity. Besides these main actions, ghrelin is active in the cardiovascular, reproductive and endocrine systems, and displays antineoplastic activity. Even though most studies have been conducted in humans and rats, there is increasing interest in the role of ghrelin in domestic species. We have integrated the first studies on ghrelin action with recent data on its involvement in modulating several central and peripheral activities.
Med Sci Monit 2003 Sep
PMID:Ghrelin: central and peripheral effects of a novel peptydil hormone. 1296 Sep 36

To determine the frequency of type-2 diabetics who have target lipoprotein blood levels, to study these levels in patients with ischemic heart disease and cardiovascular disease risk factors, and to study the possible causes of poor control, we reviewed hyperlipdemic type-2 diabetics who were on regular follow up to the medical outpatient clinic of King Abdulaziz University Hospital from January 2000 to January 2001. A total of 202 patients were studied with mean age of 60 yr and equal male to female ratio. The mean duration of diabetes was 10 yr and it was 7 yr for hyperlipidemia. The mean level of LDL was 3.15 mmol/L and it was 1.0 mmol/L and 2.47 mmol/L for HDL and TG, respectively. Only 31% of patients had LDL < 2.6 mmol/L, 28% had HDL > 1.1 mmol/L, and 37% had TG < 1.7 mmol/L. No significant difference was found in the frequency of target level of LDL in patients with IHD and those without; 26% vs 34% (0.4). Similarly, no difference was found in those with hypertension, obesity, and patients with family history of IHD compared to those without these risk factors; 30%, 26%, 16% vs 34%, 36%, 33% (p = 0.2, 0.1, 0.4, respectively). Males were found to have a higher frequency of target LDL level compared to females; 38% vs 25% (p = 0.04). Poor diet restriction was found in 90% of patients' with poor control, lack of patients' knowledge in 62%, 70% have financial reasons, 86% of patients on multiple medications, and in 16% the treating physician took no proper action. In conclusion, a low frequency of type-2 diabetics have target levels of lipoproteins. Diabetics with IHD and CVD risk factors also have poor lipid control. Poor control was associated with poor diet compliance and use of multiple medications. Proper management and control of this disease is needed among elderly patients.
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PMID:Poor lipid control in type-2 diabetics with and without ischemic heart disease. 1451 4

In addition to their stimulatory action on neuronal differentiation and survival, the neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) improve glucose and lipid metabolism and control energy balance and feeding behavior. These latter activities are referred to here as the metabotrophic potential of neurotrophins. We recently reported that circulating NGF and BDNF levels are reduced in the metabolic syndrome and in acute coronary syndromes, and that the tissue content of NGF is reduced in atherosclerotic coronary arteries. Thus we hypothesize that a metabotrophic deficit due to reduction of neurotrophin availability may be implicated in the pathogenesis of obesity and related metabolic diseases, such as metabolic syndrome, type 2 diabetes, and atherosclerosis. The metabotrophic deficit hypothesis also considers metabolism-related beneficial effects exerted by other neurotrophic factors, particularly ciliary neurotrophic factor, leukemia inhibitory factor, and bone morphogenetic proteins.
Med Sci Monit 2003 Oct
PMID:Metabotrophic potential of neurotrophins:implication in obesity and related diseases? 1452 35

The study was made to evaluate the rate of application of different diagnostic methods in patients with stable effort angina (SEA) treated in the cardiological department; influence of various factors (social, demographic, risk factors, clinical course of ischemic heart disease, associated diseases, internal picture of the disease) on choice by the attending physician of the diagnostic policy. The trial included 49 patients (44 male and 5 female aged 42-73 years, median 63 years) without contraindications to stress tests and without mental diseases. Choice of diagnostic tests (bicycle exercise only, Holter ECG monitoring only, bicycle exercise + ECG monitoring, none of the two) was made by attending physicians. Information on social, demographic, risk factors, clinical features of IHD and associated diseases was obtained in the course of semistructured interview 2-5 days before the discharge from the hospital. The internal picture of the disease was studied by psychometric testing using "Reaction to the Disease Questionnaire". The results were the following: only bicycle exercise, only Holter ECG monitoring were performed in 15 (30.6%) and 19 (38.8%) patients, respectively (95% confidence interval was 17.2-44.0% and 24.6-52.9%, respectively). None of the tests was made in 15 (30.6%) patients (95% confidence interval was 17.2-44.0%). The choice of the physician was significantly influenced by two factors: obesity and internal picture of the disease. The physicians preferred to avoid bicycle exercise conduction in obese patients and patients with hypernosognosia who consider ischemic heart disease a catastrophe and suffer of vital fear and helplessness.
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PMID:[Factors influencing policy of examination of patients with stable angina pectoris]. 1510 6

Though multiple risk factors are commonly observed in patients with ischemic heart disease and associated with an increased risk of developing IHD, it has not yet been proven that risk factors actually occur in combination more frequently than by chance alone. We tested the hypothesis that if some risk factors occur in combination, the actual incidences will be higher than the predicted ones which were calculated on the assumption that each risk factor occurs independently and in combination as a result of coincidence. One hundred consecutive patients were included in this study. All had significant stenosis or occlusion of a coronary artery. The ages ranged from 50 to 69 years and only males were studied. From the incidences of the well-established risk factors in IHD: hypertension, impaired glucose tolerance or diabetes mellitus, hypertriglyceridemia, obesity and hypercholesterolemia, we determined the actual incidences of combinations of risk factors and compared these with the predicted incidences, which were the probability calculated from each risk factor. Some of the combinations of 2 to 4 risk factors were found significantly more often than the predicted ones. Though not significant, the reverse was the case in the actual incidence of patients having no risk factors. Some combinations of well-known risk factors were found more often than the predicted risk factors from the probability and showed a tendency to cluster in coronary artery disease patients. Some linking factor must be involved in this type of occurrence of risk factors.
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PMID:Excess accumulation of risk factors in ischemic heart disease. 1555 14

Obstructive sleep apnea syndrome (OSAS) is usually associated with conditions known to increase insulin resistance and cardiovascular risk, such as hypertension, obesity, and diabetes. Thus, investigating whether obstructive sleep apnea itself is an independent risk factor for increased insulin resistance and whether continuous positive airway pressure treatment (CPAP) might improve insulin sensitivity brings up considerable methodological problems. Even if insulin sensitivity improves, it is hard to distinguish between an effect of CPAP treatment, e.g. in the reduction of nocturnal sympathetic activity caused by the sleep disturbance, and concomitant factors, such as weight loss. Two recent investigations were able to prove that OSAS is an independent risk factor for insulin resistance: one study in a statistical approach, the other by demonstrating a significant improvement of insulin sensitivity already two days after onset of CPAP therapy, thus clearly ruling out such confounding factors as changes in lifestyle or weight loss. However, it is still not clear if this improvement in insulin sensitivity is accompanied by an improvement in the usually elevated cardiovascular risk of patients with OSAS. Since a decrease in elevated markers of subclinical inflammation--nowadays regarded as the main culprit of cardiovascular complications and atherosclerosis--such as Interleukin-6 and C-reactive protein has been reported during CPAP therapy, and since an improvement in left ventricular function and a decrease in blood pressure were also reported under CPAP treatment, there are several good reasons to assume an improvement in metabolical function in OSAS patients due to CPAP treatment.
Med Sci Monit 2005 Mar
PMID:Insulin resistance and other metabolic aspects of the obstructive sleep apnea syndrome. 1573 78


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