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

Thirty-four patients were studied 2--6 years after jejunoileal bypass for morbid obesity. The serum concentration of 25-hydroxyvitamin D (25-OHD) were reduced and related to the frequency fo stools and to the weight reduction. Fifteen patients were not able to normalize serum 25-OHD following a long-term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3--6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25-OHD should be measured in order to monitor the effect of therapy.
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PMID:Impairment of vitamin D and bone metabolism in patients with bypass operation for obesity. 28 17

Five years following jejunoileal intestinal bypass surgery for obesity, a patient developed debilitating weakness and muscle pain. Osteomalacia was suspected clinically by radiographic and laboratory abnormalities and confirmed by bone biopsy. Malabsorption was documented as well as secondary hyperparathyroidism. Successful treatment of this syndrome with vitamin D and calcium identified a medically reversible disorder which obviated the need for surgical reanastomosis.
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PMID:Osteomalacia and weakness complicating jejunoileal bypass. 43 11

Nutrient requirements do not change markedly with advancing age, but life style, socioeconomic status, psychologic changes, and the presence of chronic disease alter nutrient intake in the elderly. It is important to recognize and deal with these factors in attempting to correct malnutrition and in prescribing dietary treatment. Malnutrition includes a variety of disorders: undernutrition, nutrient deficiencies and imbalances, and obesity. Frequent small feedings, with nutritional supplements for patients with profound weight loss, are the initial treatment for undernutrition. Iron supplements and a diet of foods rich in iron and in promoting iron absorption are required in treating iron deficiency anemia. Management of macrocytic anemia should include specific nutrient therapy plus improvement of diet to include leafy vegetables and animal foodstuffs. Diet is an important adjunct in treating chronic diseases. Maturity-onset diabetes mellitus often can be managed by diet alone, with attention to correct proportions of fat, carbohydrate, and protein and to the decreased caloric requirements of elderly patients. The importance of continuing dietary modifications in hyperlipidemia and hypertension is well known. Although dietary manipulation in osteoporosis is not curative, a diet high in calcium and containing adequate floride and vitamin D affords maximum dietary protection against progress of the disease.
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PMID:Guidelines for maintaining adequate nutrition in old age. 64 78

Circulating levels of 25-OH vitamin D were measured in 44 patients who had undergone small intestinal bypass for obesity. Sixty-one percent had low circulating levels of the metabolite, which tended to normalize with time. This adaptive response also occurred for circulating total calcium, magnesium, albumin, and alkaline phosphatase. Serum concentrations of 25-OH vitamin D were directly related to total serum calcium and albumin. Impaired intestinal absorption of 25-OH vitamin D was seen in two patients. Following correction of total serum calcium for attendant hypoalbuminemia, 27% of patients remained hypocalcemic. The bone densities of two of 32 patients were low. In addition, skeletal biopsies of three of six patients were abnormal. It is concluded that small intestinal bypass results in at least transient deficits of circulating 25-OH vitamin D. As this operation may be associated with abnormal bone morphology, clinically significant skeletal disease may become apparent with long-term follow-up.
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PMID:Abnormalities of circulating 25-OH vitamin D after jejunal-lleal bypass for obesity: evidence of an adaptive response. 84 87

In an effort to determine if structural variation in proteins important in bone metabolism might influence bone mineral density (BMD) and thus be a determinant of susceptibility to osteoporosis in older women, the authors typed a group of 258 non-Black women (age 65-90) participating in the Study of Osteoporotic Fractures (SOF) for two polymorphic bone-related proteins, group specific component (Gc), also known as vitamin D-binding protein, and alpha 2HS glycoprotein (AHSG). These two proteins exhibit common structural variation in populations that can be detected by isoelectric focusing/immunoblotting of serum. An important function of Gc is the binding, solubilization, and transport of vitamin D sterols in the bloodstream while AHSG is a glycoprotein constituent of calcified cortical bone matrix. There are six common phenotypes of Gc and four of AHSG. Using Gc or AHSG phenotypes as categorical variables, statistical analyses were done to determine if bone mineral density of the proximal or distal radius or calcaneus differed by phenotype. Neither Gc nor AHSG phenotype demonstrated a statistically significant relationship with BMD at any site. Adjustments for age and degree of obesity did not substantively affect these results. Subsequent analyses to determine if phenotype of either of these proteins was associated with variables related to skeletal size showed an association of AHSG with height (P less than .02). This may indicate that AHSG phenotype is related to postmenopausal loss of height, or it may be a chance statistical finding.
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PMID:Genetic variation in two bone-related proteins: is there an association with bone mineral density or skeletal size in postmenopausal women? 152 79

Osteomalacia is characterized by large osteoid seams and a preserved volume of bone trabeculae. The mineralization of newly formed bone requires adequate concentrations of calcium and phosphate: the Ca.P product has been regarded as a useful, empirical diagnostic test of osteomalacia. It decreases in patients with osteomalacia mainly because they have very low plasma phosphate levels. At present total body bone mineral and total body bone density can be directly measured by whole body absorptiometry, which indicates the lowest total mineral content of the skeleton which can increase quickly after adequate treatment. The main symptoms of osteomalacia are: bone pain; muscular weakness (commonly as pelvic girdle myopathy); Looser-Milkman pseudofractures or more often a pattern of generalized demineralization at X-ray. The main biochemical parameters in osteomalacia include: defective calcium absorption with hypocalcemia and hypocalciuria; defective intestinal phosphate absorption with hypophosphatemia; there is often increased renal phosphate clearance due to hypocalcemia and secondary hyperparathyroidism; elevated alkaline phosphatase and osteocalcin levels; high bone turnover confirmed by kinetic studies carried out with radiocalcium or 99mTc-MDP. An etiological classification of the osteomalacias includes: 1) nutritional osteomalacia: a) inadequate exposure to sunlight and/or insufficient vitamin D intake; b) defective intestinal absorption of vitamin D because of malabsorption syndromes (e.g. jejuno-ileal bypass for obesity).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The osteomalacias. 166 41

In winter 1988/1989, a total of 435 randomly selected men and women aged 70-75 years and living in the city of Roskilde were invited to participate in a diet and health study. Nutritional status was assessed through a dietary interview, antropometric and biochemical measurements on 188 of the invited elderly. Assessed in relation to dietary recommendations, the average fat intake was found to be high (41% energy), whereas intakes of vitamin B6 and D were found to be below recommended levels in 22-26% of the subjects. The prevalences of obesity (12% had BMI over 30 kg/m2) and elevated levels of serum cholesterol (16% had serum levels over 7.5 mmol/l) were relatively high, the percentages being higher for females than for males. Many of the elderly had low levels of 25-hydroxy-vitamin D in plasma (30% under 30 nmol/l) indicating a marginal status. The prevalences of low blood levels of vitamin B6 (40% under 30 mmol/l) and betacarotene (26% under 0.3 mumol/l) were also high among the elderly. The prevalence of anaemia was 3%. It is concluded that osteoporosis-related parameters and risk factors for cardiovascular diseases are prevalent among the elderly in Denmark. The origin of these risk factors have to be studied in more detail, and consequences of any changes occurring must be monitored.
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PMID:A dietary study of the elderly in the City of Roskilde 1988/1989 (II). A nutritional risk assessment. 180 28

Bearing in mind the reports which clearly document the constant dissociation between daily calorie intake from diet, obesity and the positive effects of the mechanical load on bone trophism, the possible correlation between total daily calorie intake of some nutrients (Ca, P and vitamin D) on the one hand, and bone mineral density (BMD) on the other was evaluated in 61 obese women. The results appear to indicate that the higher BMD in obese compared to normal weight subjects may largely depend on the presence of notoriously high estrogen levels which allow a better efficacy and use of dietary calcium.
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PMID:[Caloric intake and bone mineral content in obese and normal weight subjects]. 210 34

Established risk factors for osteoporosis and associated fractures are increasing age, female sex, white race, removal of the ovaries at an early age, prolonged immobility, and prolonged use of corticosteroids. Obesity and use of estrogen replacement therapy are protective. Factors that probably or possibly increase risk in postmenopausal white women include a low calcium intake, cigarette smoking, and, at least for hip fractures, use of long half-life psychotrophic drugs and heavy alcohol consumption. Factors probably or possibly associated with a decreased risk include ingestion of vitamin D and its metabolites, fluoride levels of 2 ppm or more in drinking water, moderate physical activity, pregnancies and breast feeding, use of thiazide diuretics, and progestogens. Some evidence suggests that calcium intake and physical activity at young ages may be important determinants of peak bone mass. Few studies have been undertaken in males and blacks, although at least some risk factors in males may be similar to those in females. Preventive efforts may be aimed at increasing peak bone mass at young ages, preventing bone loss in postmenopausal women, and preventing fractures and their adverse consequences in older people with osteoporosis.
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PMID:Risk factors for osteoporosis and associated fractures. 251 95

We have studied the effects of diet-induced obesity on thyroidal calcitonin, plasma calcitonin, calcium and phosphorus in rats. Twelve 9-week-old female rats were randomly divided into two groups. One group was fed a low-fat diet while the other was fed a high-fat diet. Both diets had 0.76% Ca, 0.56% P and 2.2 U/g vitamin D; however, the high-fat diet had hydrogenated vegetable oil added at 405 g/kg. All rats were pair-fed and consumed 11 g/day per rat for 27 weeks at which time the rats were fasted overnight and exsanguinated. The rats on the high-fat diet weighted 406 +/- 21 g (mean +/- SEM) versus 292 +/- 13 g for controls and had higher levels of serum calcitonin (104 +/- 12 versus 57 +/- 9 pg/ml). The obese rats also had increased thyroidal calcitonin by radioimmunoassay and increased thyroidal C-cells by immunohistology. The increased calcitonin levels occurred without a concomitant increase in calcium levels. These data indicate that a high-fat diet in rats stimulates C-cell growth and calcitonin secretion.
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PMID:A high-fat diet increases calcitonin secretion in the rat. 278 30


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