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Query: UMLS:C0028754 (obesity)
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The relationship between hypertension, glucose metabolism, fibrinogen and plasminogen activator inhibitor of endothelial cell type (PAI-1) was studied under conditions in which the influence of obesity and adipose tissue distribution (waist/hip ratio) were controlled. Twenty-two non-obese, middle-aged men with normal blood pressure (n = 11) and untreated mild hypertension (n = 11), respectively, participated in the study. Cholesterol, triglyceride and insulin levels were higher in hypertensive men than in the control group. Glucose disposal was studied as an indicator of insulin sensitivity using the euglycaemic clamp technique. The insulin effect tended to be less marked in men with hypertension. PAI-1 was higher in hypertensive men compared to the controls. A strong positive correlation was observed between PAI-1 and insulin levels as well as blood pressure. PAI-1 and fibrinogen levels correlated negatively with the rate of glucose disposal. Thus, even in these non-obese and mildly hypertensive individuals, an enhanced metabolic risk factor profile for cardiovascular disease was found. The metabolic aberrations were related to elevated fibrinogen and PAI-1 levels which, in turn, increase the risk of thrombus formation.
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PMID:Elevated fibrinogen and plasminogen activator inhibitor (PAI-1) in hypertension are related to metabolic risk factors for cardiovascular disease. 232 74

Coronary heart disease is the leading cause of death among patients with non-insulin-dependent diabetes mellitus (NIDDM). NIDDM patients have a high frequency of dyslipidemia, which along with obesity, hypertension, and hyperglycemia may contribute significantly to accelerated coronary atherosclerosis. Because risk factors for coronary heart disease are additive and perhaps multiplicative, even mild degrees of dyslipidemia may enhance coronary heart disease risk. Therefore, therapeutic strategies for management of NIDDM should give equal emphasis to controlling hyperglycemia and dyslipidemia. The National Cholesterol Education Program recently issued guidelines for treatment of hyperlipidemia in adults including diabetic patients. Because of the unique features of diabetic dyslipidemia, however, we suggest that certain modifications in these guidelines be made to meet specific needs of diabetic patients. For example, therapeutic goals for serum cholesterol reduction should be lower in diabetic patients than in nondiabetic subjects. Particular emphasis should be given to weight reduction in NIDDM patients. In some diabetic patients, monounsaturated fatty acids may be a better replacement for saturated fatty acids than carbohydrates. The target for cholesterol lowering should include both very-low-density lipoprotein and low-density lipoprotein (LDL) (non-high-density lipoprotein) rather than LDL alone. To obtain a substantial reduction of cholesterol levels, drug therapy may be required in many patients. However, first-line drugs for nondiabetic patients (nicotinic acid and bile acid sequestrants) may be less desirable in NIDDM patients than hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors and even fibric acids. In fact, HMG CoA reductase inhibitors may be the drugs of choice for NIDDM patients with elevated LDL cholesterol and borderline hypertriglyceridemia, whereas gemfibrozil appears preferable for NIDDM patients with severe hypertriglyceridemia.
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PMID:Management of dyslipidemia in NIDDM. 219 Jul 70

Screening for dyslipoproteinemias should be undertaken in all individuals older than 20 years of age at least once every 5 years. The initial screening, as recommended by the Adult Treatment Guidelines Panel of the National Cholesterol Education Program, is to determine the concentration of total blood cholesterol. This initial determination can be made on blood obtained in the nonfasting state. Further evaluation of the patient's lipoprotein concentrations is dependent upon the presence of other cardiovascular risk factors. in the absence of definite coronary heart disease, hypertension, diabetes mellitus, a family history of coronary artery disease, cigarette smoking, or severe obesity, the patient with a total blood cholesterol concentration less than 200 mg/dL requires no specific instruction and should have a repeated screening performed within 5 years. Patients with blood cholesterol concentrations greater than 200 mg/dL should have their lipoprotein profiles determined if they have atherosclerotic cardiovascular disease or two other cardiovascular disease risk factors. The lipoprotein profile includes the determination of fasting cholesterol and triglyceride and HDL cholesterol concentrations. From these values, the LDL cholesterol concentration can be calculated. This LDL cholesterol concentration is central in selecting the appropriate therapy. HDL cholesterol concentrations may be useful in evaluating patients with ischemic heart disease. Concentrations of HDL cholesterol less than 35 mg/dL are associated with increased risk for coronary artery disease. Although there is currently no convincing evidence that support the specific treatment of depressed HDL cholesterol concentrations, therapy directed to modulating lipoprotein metabolism in patients with heart disease and low HDL concentrations may be of benefit. Patients with recurrent abdominal pain, pancreatitis, and eruptive xanthomatosis frequently have fasting hypertriglyceridemia concentrations exceeding 1000 mg/dL. These patients should be identified in order to effectively reduce their triglyceride concentrations, which can prevent these complications.
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PMID:Detection and evaluation of dyslipoproteinemia. 219 76

Obese donkeys are susceptible to a hyperlipaemic crisis characterised by high plasma triglyceride concentrations. In this study, the relationships between the body condition of 24 donkeys and their basal lipid metabolism were investigated. Plasma cholesterol, triglyceride and lipoprotein cholesterol concentrations were measured in healthy donkeys classified according to their body condition as thin, ideal or obese. There were significant differences between the groups in the concentrations of triglyceride and very low density lipoprotein (VLDL), which increased in concentration with body condition (P less than 0.05). Cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) concentrations were similar in all the groups. Triglyceride and VLDL concentrations were positively correlated with body weight (r = 0.82) and plasma free fatty acid concentration (r = 0.48). There were no significant differences in basal plasma concentrations of insulin or cortisol. These results suggest that obesity in donkeys is associated with changes in lipid and lipoprotein metabolism that might predispose the animals to hyperlipaemia.
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PMID:An investigation of the relationships between body condition and plasma lipid and lipoprotein concentrations in 24 donkeys. 227 89

1. Risk factors for coronary heart disease include age, sex, family history, high cholesterol, blood pressure, smoking, and severe obesity. The last four risk factors can be modified with lifestyle changes. 2. Occupational health nurses who provide primary care to workers can assist employees in detecting and treating their elevated cholesterol. Cholesterol screening at the workplace is an effective means for employees to learn their cholesterol level or monitor their dietary progress in lowering their cholesterol. 3. Employees can modify their eating behaviors by developing the skills to make wise dietary choices. Simple dietary self assessment and self monitoring tools will aid employees in monitoring and evaluating their efforts. 4. To successfully implement a cholesterol education program and counsel employees, occupational health nurses need to increase their knowledge of nutrition, specifically the composition of a diet that will help reduce the risks associated with heart disease.
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PMID:Cholesterol education at the worksite. 233 Dec 50

The principal goal of dietary prevention and treatment of atherosclerotic coronary heart disease is the achievement of physiological levels of the plasma total and LDL cholesterol, triglyceride, and VLDL. These goals have been well delineated by the National Cholesterol Education Program of the National Heart, Lung and Blood Institute and the American Heart Association. Dietary treatment is first accomplished by enhancing LDL receptor activity and at the same time depressing liver synthesis of cholesterol and triglyceride. Both dietary cholesterol and saturated fat decrease LDL receptor activity and inhibit the removal of LDL from the plasma by the liver. Saturated fat decreases LDL receptor activity, especially when cholesterol is concurrently present in the diet. The total amount of dietary fat is of importance also. The greater the flux of chylomicron remnants is into the liver, the greater is the influx of cholesterol ester. In addition, factors that affect VLDL and LDL synthesis could be important. These include excessive calories (obesity), which enhance triglyceride and VLDL and hence LDL synthesis. Weight loss and omega-3 fatty acids from fish oil depress synthesis of both VLDL and triglyceride in the liver. The optimal diet for the treatment of children and adults to prevent coronary disease has the following characteristics: cholesterol (100 mg/day), total fat (20% of calories, 6% saturated with the balance from omega-3 and omega-6 polyunsaturated and monounsaturated fat), carbohydrate (65% of calories, two thirds from starch including 11 to 15 gm of soluble fiber), and protein (15% of calories). This low-fat, high-carbohydrate diet can lower the plasma cholesterol 18% to 21%. This diet is also an antithrombotic diet, thrombosis being another major consideration in preventing coronary heart disease. Dietary therapy is the mainstay of the prevention and treatment of coronary heart disease through the control of plasma lipid and lipoprotein levels. The exact place of the omega-3 fatty acids from fish and fish oil remains to be defined. However, this much seems certain. Fish provides an excellent substitute for meat in the diet. Fish is lower in fat, especially saturated fat, and contains the omega-3 fatty acids. Fish oil may have promise as a therapeutic agent in certain hyperlipidemic states, especially the chylomicronemia of type V hyperlipidemia. Fish oil has logical and well-defined antithrombotic and anti-atherosclerotic activities since it depresses thromboxane A2 production and inhibits cellular proliferation responsible for the progression of atherosclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Diet, atherosclerosis, and fish oil. 240 91

Epidemiologic studies have established that elevated low-density lipoprotein (LDL) cholesterol values and decreased levels of high-density lipoprotein (HDL) cholesterol are risk factors for coronary artery disease (CAD). Results from clinical trials indicate that reduction in LDL cholesterol decreases the incidence of and reduces the risk of CAD. The National Cholesterol Education Program recently developed guidelines for the evaluation of plasma cholesterol in adults. Initial classification is categorized and based on the following values: less than 200 mg/dl is "desirable" blood cholesterol; from 200 through 239 mg/dl is classified as "moderate-high" blood cholesterol; and greater than or equal to 240 mg/dl is "high" blood cholesterol. Decision-making regarding therapeutic intervention is influenced by the presence of other lipoprotein risk factors, such as reduced HDL cholesterol and elevated lipoprotein (a), and nonlipid factors, including age, sex, hypertension, obesity, smoking, diabetes mellitus, and family or patient history of CAD. Persons with borderline-high blood cholesterol and established CAD or 2 other risk factors as well as those with high blood cholesterol should undergo lipoprotein analysis. LDL cholesterol is the primary lipoprotein to consider when determining treatment goals. Patients with LDL cholesterol levels greater than 160 mg/dl without CAD or 2 other risk factors and those patients with LDL cholesterol greater than 130 mg/dl with CAD or 2 other risk factors are initially managed with dietary therapy. The goal of treatment of hyperlipidemia is to reduce LDL cholesterol to less than 160 mg/dl or to less than 130 mg/dl in patients with established CAD or with 2 other risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical significance of plasma lipid levels. 267 28

Time and feeding influences on cholesterol, triglyceride, glucose and insulin levels, and serum cholinesterase activity were assessed in a genetically-hyperlipidemic hyperphagic obese rat model, and compared with its lean litter-mate. Following a 28-day acclimation to a 12-hr light/dark cycle, blood samples were obtained every 2 hr from rats via tail bleed for a 24-hr period. Synchronization with other animal studies was established by endogenous serum cortisol levels [acrophase 18-20 hr after light onset (HALO) in both groups]. Triglycerides cholesterol, insulin and glucose levels were significantly elevated in obese versus lean rats. Obese rats were observed to feed throughout the 24-hr cycle, whereas lean litter-mates ate only during the dark cycle. No circadian rhythmicity was found in glucose levels with either rat group. Insulin levels were not correlated. Although triglyceride levels peaks at 13 HALO in lean rats, no pattern was observed in obese rats. Cholesterol levels were unchanged with time in either group. Cholinesterase activity followed a circadian rhythm in the lean, but not obese, rats with an acrophase estimated at 8 HALO. In contrast to previous reports, enzyme activity was not correlated with triglyceride levels in either rat group. Circadian similarities in insulin levels between rat groups suggest changes in insulin metabolism and/or secretion which are likely to be independent of feeding or activity. Conversely, triglyceride levels remained elevated throughout the 24-hr period in obese rats, whereas significant increases were observed in lean rats during the dark active cycle. These data suggest that triglyceride levels, and not insulin and cholesterol levels, are most likely dependent on feeding patterns.
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PMID:Circadian assessment of lipids in the hyperphagic obese rat compared with lean litter-mates. 268 Jan 23

A random sample of 20% of people taking part in the free health check-ups provided by the city of Vienna in 1986 (707 men and 1022 women), aged 20 to 79 years (mean age men 48.1 +/- 15.8, women 49.6 +/- 15.1 respectively) were retrospectively evaluated to determine coronary heart disease risk according to the recommendations of the Austrian Cholesterol Consensus Conference. Age-standardized mean total-cholesterol is 230.0 mg/dl in men and 235.8 mg/dl in women. Age-standardized percentage of normal lipid levels (i.e. total-cholesterol below 200 mg/dl) is 29.7% in men, 25.7% in women respectively. The high-risk group (i.e. total-cholesterol more than 250 mg/dl) has an age-standardized prevalence of 28.5% in men and 35.8% in women. The age-standardized percentage of obesity according to the guidelines of the National Institutes of Health is 14.2 in men, 17.2 in women respectively. The comparison of age-standardized men-values of total-cholesterol, LDL-cholesterol, triglycerides and Quetelet-index, as well as normal lipid levels according to the Austrian recommendations and percentage of obesity, in the age groups 20 to 39, 40 to 59 and 60 to 79 years shows a statistical significant difference of each parameter between age-group 20 to 39 and age-group 40 to 59 in men, but no significant difference in any parameter between age-group 40 to 59 and 60 to 79 in men. On the contrary in women differences are significant between age-group 20 to 39 and 40 to 59, as well as between age-group 40 to 59 and 60 to 79 in each parameter.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The prevalence of hyperlipidemia and obesity in Vienna health examinations 1986]. 278 30

One hundred nine 19-year-old female students were surveyed as to academic test marks; salt detection and recognition thresholds; serum cholesterol, serum uric acid, serum cortisol, and other biochemical indices in serum; urinary sodium/creatinine and potassium/creatinine, as well as number of complaints based on the Cornell Medical Index (CMI) and personality based on the Yatabe-Guilford (Y-G) test. The salt recognition threshold showed a high negative correlation with serum uric acid concentration and a slight correlation with CMI complaint number, academic test marks, blood pressure, obesity, and serum cholesterol. The subjects with high salt thresholds had relatively passive personalities. Cholesterol, uric acid, hemoglobin, ferritin, and glucose levels in the serum were higher in the group with higher academic marks. These students also had fewer complaints and more of them were type B individuals based on the Y-G test. They also seemed to be under greater stress. In regression analysis, the partial regression coefficient between academic test marks and serum cholesterol was 60 percent higher than that between academic test marks and serum uric acid. Students who lived on campus had 24.8 milligrams per deciliter (15.7 percent) more serum cholesterol and 3.8 micrograms per deciliter (37.7 percent) more serum cortisol than those who commuted from home.
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PMID:An epidemiologic study on the correlation between salt threshold, academic test marks, biochemical data, number of complaints, and personality in women college students. 345 2


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