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

The rapid weight decrease at the beginning of strict slimming regimens leads often to an inconsiderate shortening of these cures. Our long-term experience with a slimming regimen lasting 13 days based on diet (3.7 MJ) and 4 hours of supervised exercise of low to moderate intensity was omitted by the organizers. They shortened the cure to 8 days. We checked therefore a group of obese women on the first, eight and twelfth day in the course of this regimen. A statistically significant decrease of serum insulin, growth hormone, triiodothyronine and cholesterol was observed on the twelfth day. These trends were not significant on the eighth day. On the other hand, the step-test revealed on the eighth day a reduction of the heart rate during recovery. Nevertheless, a higher level of significance was obtained after 12 days. No significant response to the regimen was obtained in the case of blood glucose, thyroxine, cortisol, uric acid, AST and ALT. The advantages of the 12-day regimen are discussed--especially the decrease of insulinemia, because hyperinsulinemia is responsible for several complications of obesity. The importance of the decrease of cholesterolaemia and the modification of heart rate after a load was also stressed. These favourable effects are not depreciated by a smaller weight loss in the second week due to an enhanced protein synthesis, stimulated by exercise and supported by a decrease of T3 which protects the organism against energy deficit.
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PMID:Hormonal, metabolic and cardiovascular response to the duration of a combined slimming regimen. 180 33

The rapid weight decrease at the beginning of strict slimming regimens leads often to an inconsiderate shortening of these cures. Our long-termed experience with a slimming regimen lasting 13 days and based on diet (3.7 MJ) and 4 hours of supervised exercise of low to moderate intensity was omitted by the organizers. They shortened the cure to 8 days. We checked therefore a group of obese women on the first, eighth and twelfth day in the course of this regimen. A statistically significant decrease of serum insulin, growth hormone, triiodothyronine and cholesterol was observed on the twelfth day. These trends were not significant on the eighth day. On the other hand, the step-test has shown on the eighth day a reduction of the heart rate during recovery. Nevertheless, a higher level of significance was obtained after a cure of 12 days. No significant response to the regimen was obtained in the case of blood glucose, thyroxine, cortisol, uric acid, AST and ALT. The advantages of the 12 day regimen were discussed--especially the decrease of insulinemia, because hyperinsulinemia is responsible for several complications of obesity. The importance of the decrease of cholesterolemia and the modification of heart rate after a load was also stressed. These favourable effects should not be depreciated by a smaller weight decrease on the second week due to an enhanced synthesis of proteins, stimulated by exercise and supported by a decrease of T3 which brings a protection against energy defficiency.
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PMID:[The effect of the duration of a weight reduction regimen on the hormonal, metabolic and cardiovascular response]. 224 39

The effect of a four-week experiment on ten fa/fa Zucker rats (aged seven weeks at the beginning) fed on a lipid-rich diet (HL: 31 per cent w/w lipids, 45.6 per cent starch) was compared to that of a control diet (C: 10 per cent lipids, 66 per cent starch) on control Fa/- rats using a special pair-feeding apparatus that made it possible to obtain an identical intake rhythm. Energy level of the intake was significantly higher for the HL diet than for the C diet. At the end of the experiment, fa/fa rats remained obese and hyperlipemic, and still showed liver steatosis. With equal energy levels ingested, the obesity of fa/fa rats was comparable for both diets; hypertriglyceridemia and hypercholesterolemia were identical for both diets. When compared to the C diet, the HL diet modified neither their obesity nor their hyperlipemia. Obese rat liver on the HL diet showed lower levels for triacylglycerols, cholesterol, GGT, ALT, LDH and aldolase activities, while hepatic glycerol kinase and AST activities were higher than and comparable to, respectively, the C diet. Thus the HL diet led to a decreased liver steatosis for fa/fa rats as compared to the C diet.
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PMID:Influence of diet composition on obesity, hyperlipemia and liver steatosis in Zucker fa/fa rats pair-fed with Zucker Fa/- rats. 637 17

To determine whether the aminopyrine breath test reflects the presence of increased pericentral fibrosis, steatonecrosis, and cirrhosis following jejunoileal bypass, 21 patients were evaluated with liver biopsies, liver chemistry tests, 45-min bromosulfothalein retention tests, and aminopyrine breath tests prior to bypass and at 3, 6, and 12 months thereafter. Following bypass, 15 biopsies demonstrated increased pericentral fibrosis, steatonecrosis, or cirrhosis, and 35 biopsies revealed increased fatty infiltration alone. Although the aminopyrine breath test results were significantly lower in patients with increased pericentral fibrosis, steatonecrosis, and cirrhosis at 6 and 12 months following bypass (P less than 0.05), this test had a positive predictability of only 0.67. An abnormal AST had a positive predictability of 0.87. Other liver function tests were less reliable in identifying patients with potentially progressive lesions following bypass. Thus, the AST is more useful than the aminopyrine breath test in reflecting increased pericentral fibrosis, steatonecrosis, and cirrhosis following jejunoileal bypass. The nonspecific effects of obesity and increased fatty infiltration of the liver following jejunoileal bypass may account for the low predictability of the aminopyrine breath test.
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PMID:Aminopyrine breath test. Prospective comparison with liver histology and liver chemistry tests following jejunoileal bypass performed for refractory obesity. 683 4

A prospective study of 21 patients with the diagnosis of non-alcoholic steatohepatitis (NASH) was carried out. All patients had hepatomegaly and in 10 (48%) image studies were consistent with steatosis and/or fibrosis. Biochemically, there was increase of AST, ALT and cholesterol in 48%, of GGT in 52% and of alkaline phosphatase in 38%. 18 patients were obese, 2 of them diabetic, 2 others had a history of exposure to drugs (amiodarone and isopropilic alcohol) and the last one presented hypothyroidism. Liver biopsies were studied using a semiquantitative scale to evaluate the degree of steatosis, inflammation and fibrosis in a scale from 1 to 3. Results showed a medium score of 2.6 for steatosis, 1.5 for inflammation and 1.8 for fibrosis. Four patients had cirrhosis and Mallory bodies were found in 11 cases (52%). NASH is an oligosymptomatic disease that can be found in different clinical conditions, mainly obesity, and is more frequent in women. It is histologically indistinguishable from alcoholic steatohepatitis. It is frequently underdiagnosed clinically and must be taken into account as a possible cause of cryptogenetic cirrhosis.
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PMID:[Non alcoholic steatohepatitis]. 765 98

The risk for developing acute liver failure after halothane exposition was calculated between 1:8,000 and 1:36,000. The case report given on a 22 year old man with halothane-induced hepatic failure is unusual, because the typical risk factors as age over 40, female sex, obesity, and previous exposure to halothane were not present. Two days after exposure to halothane the patient suffered acute liver failure with severe coagulopathy (factor V = 5% activity), and encephalopathy grade IV complicated by renal failure and respiratory insufficiency. Maximal increases of enzymes in blood were AST 3900 U/L, ALT 2570 U/L, LDH 10600 U/L. After six days the patient underwent liver transplantation with complete anuria and instable circulation. Explanted liver showed massive necrosis (70% of parenchyma) and fatty changes. The liver transplant had immediately a good function and renal failure resolved within three days. In the follow-up of 3 1/2 years the patient suffered no further complications. Culturing the patient's lymphocytes in the lymphocyte transformation test a strong reaction could be detected with a stimulatory index of 20. Maximal proliferation was observed when lymphocytes were incubated with plasma metabolites of a volunteer drawn 120 minutes after anesthesia with halothane was started.
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PMID:[Liver transplantation in halothane-induced liver necrosis]. 802 96

Nonalcoholic steatohepatitis (NASH) is the term used for a common form of fatty liver presenting in adults with varied clinical manifestations. The most common presentation is asymptomatic elevation of liver enzymes (AST or SGOT and ALT or SGPT), which can be discovered incidentally in the course of an annual checkup, life insurance examination, or as part of surrogate screening before blood donation. At the other end of the clinical spectrum is the patient with complications from cryptogenic cirrhosis, who also shows a lack of evidence of alcohol as an etiological factor in pathogenesis. Clinical associations of probable relevance include gender (female), obesity, diabetes, and hyperlipidemia, but many patients do not conform to any of these stereotypes (e.g., young men of normal weight with normal fasting glucose and lipid levels). Liver biopsy confirms the diagnosis of NASH, the association of steatosis with an inflammatory response being the sine qua non for the condition and "creeping fibrosis" being a variable but possibly sinister feature. Newer imaging techniques may provide convincing evidence of steatosis, but they give little insight into ongoing fibrosis, and liver biopsy therefore remains the gold standard. The mainstay of treatment remains judicious weight loss coupled with positive dietary advice, including the ingestion of adequate but not excessive vitamins. After initial encouraging data. the assessment of ursodeoxycholic acid currently being studied under randomized controlled conditions is eagerly awaited.
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PMID:Nonalcoholic fatty liver (NASH syndrome). 943 7

The determination of aminotranferases levels is very useful in the diagnosis of hepatopathies. In recent years, an elevated serum ALT level in blood donors has been associated with an increased risk of post-transfusion hepatitis (PTH). The purpose of the study was to research the factors associated with elevated ALT levels in a cohort of voluntary blood donors and to evaluate the relationship between increased ALT levels and the development of hepatitis C (HCV) infection. 166 volunteer blood donors with elevated ALT at the time of their first donation were studied. All of the donors were questioned about previous hepatopathies, exposure to hepatitis, exposure to chemicals, use of medication or drugs, sexual behaviour, contact with blood or secretions and their intake of alcohol. Every three months, the serum levels of AST, ALT, alkaline phosphatase, gamma glutamyl transpeptidase, cholesterol, triglyceride and glycemia are assessed over a two year follow-up. The serum thyroid hormone levels as well as the presence of auto-antibodies were also measured. Abdominal ultrasound was performed in all patients with persistently elevated ALT or AST levels. A needle biopsy of liver was performed in 9 donors without definite diagnostic after medical investigation. The presence of anti-HCV antibodies in 116 donors were assayed again the first clinical evaluation. At the end of follow-up period (2 years later) 71 donors were tested again for the presence of anti-HCV antibodies. None of donors resulted positive for hepatitis B or hepatitis C markers during the follow-up. Of the 116 donors, 101 (87%) had persistently elevated ALT serum levels during the follow-up. Obesity and alcoholism were the principal conditions related to elevated ALT serum levels in 91/101 (90.1%) donors. Hypertriglyceridemia, hypercholesterolemia, hypothyroidism and diabetes mellitus also were associated with increased ALT levels. Only 1/101 (0.9%) had mild chronic active non A-G viral hepatitis and 3/101 (2.9%) had liver biopsy with non-specific reactive hepatitis. The determination of ALT levels was not useful to detect donors infected with HCV at donation in Brazil, including the initial seronegative anti-HCV phase.
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PMID:Elevated alanine aminotransferase (ALT) in blood donors: an assessment of the main associated conditions and its relationship to the development of hepatitis C. 987 34

Sixty-six rheumatoid arthritis (RA) patients were analyzed retrospectively to assess the incidence and risk factors for elevation of serum hepatic aminotransferases during methotrexate (MTX) therapy. The effect of folate supplementation on serum ALT and RA activity was evaluated prospectively in 14 patients who showed a sustained high serum level of ALT. The frequency of elevation of serum AST or ALT was 4-5 times greater than in patients taking other DMARDs. Multivariate linear regression analysis demonstrated that elevation of ALT was independently associated with sex (female), obesity, baseline ALT, MTX dose, and gastrointestinal side effects. Folate supplementation caused ALT levels to decrease in all patients within 3 months. Eleven patients showed no change of RA activity, but 3 patients dropped out of the study because of the exacerbation of RA. These results suggest that careful monitoring of serum hepatic aminotransferases is necessary in patients with predisposing factors, especially those receiving more than 0.15 mg/kg of MTX weekly. Folate supplementation can reverse the sustained elevation of ALT, but might cause exacerbation of RA in some patients.
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PMID:Elevation of serum hepatic aminotransferases during treatment of rheumatoid arthritis with low-dose methotrexate. Risk factors and response to folic acid. 1056 23

Nonalcoholic steatohepatitis (NASH) may present with increased hepatic fibrosis progressing to end-stage liver disease. No factors that determine increasing fibrosis and histologically advanced disease have been recognized, thus, liver biopsy is recommended in all patients for diagnosis and prognosis. Our aim was to identify independent predictors of severe hepatic fibrosis in patients with NASH. One hundred and forty-four patients were studied. All patients underwent liver biopsy. Clinical and biochemical variables were examined with univariate and multivariate analysis. Thirty-seven (26%) patients had no abnormal fibrosis, 53 (37%) had mild fibrosis, 15 (10%) had moderate fibrosis, 14 (10%) had bridging fibrosis, and 25 (17%) had cirrhosis. In multivariate analysis, older age (P =. 001), obesity (P =.002), diabetes mellitus (P =.009), and aspartate transaminase/alanine transaminase (AST/ALT) ratio greater than 1 (P =.03) were significant predictors of severe liver fibrosis (bridging/cirrhosis). Body mass index (P =.003) was the only independent predictor of the degree of fat infiltration. Increased transferrin saturation correlated positively with the severity of fibrosis (P =.02) in univariate analysis, and there was a trend for more female patients among those with more advanced fibrosis (P =. 09). However, iron studies or gender were not significant when controlled for age, obesity, diabetes, and AST/ALT ratio. In conclusion, older age, obesity, and presence of diabetes mellitus help identify those NASH patients who might have severe liver fibrosis. This is the subgroup of patients with NASH who would be expected to derive the most benefit from having a liver biopsy and considering investigational therapies.
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PMID:Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. 1057 11


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