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

Hyperlipidemia is an important risk factor of arteriosclerotic diseases. In Japan, as heart disease and cerebrovascular disorders rank second and third as the causes of death, demand has intensified for measures to prevent these diseases. In the U.S., the National Cholesterol Education Program (NCEP) was initiated as a means to prevent CHD by reducing th prevalence of hypercholesterolemia. Since 1988, this program has demonstrated effectiveness in this regard. In Japan, there are no consistent guidelines for the management of hyperlipidemia such as are espoused by the NCEP. In this study, in an endeavor to resolve this problem, a worksite population (1343 adult males) was classified according to the NCEP guidelines and the role and effectiveness of NCEP in this population were studied. A questionnaire concerning life-style and some biochemical findings were also used to classify the subjects according to the NCEP guidelines. Of the subjects, 22.8% were classified as hypercholesterolemic (> or = 240 mg/dl) and another 34.9% as being borderline high risk (> or = 200 < 240 mg/dl). Twenty-five percent of subjects required diet or drug therapy. The percentage of subjects requiring therapeutic intervention increased with age. The therapy group subjects tended to have a larger number of risk factors compared to the normal group. They also featured a significantly high age-adjusted odds ratios for hypertension, diabetes mellitus, obesity, and elevated serum triglyceride. This study suggests that in the health management of those in the therapy group, educational instruction on coronary risk factors is required.
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PMID:[Classification of hyperlipidemia in a worksite population in Japan using criteria of the U.S. National Cholesterol Education Program]. 804 15

Cardiovascular risk factors in a population of adults with mental retardation were examined. The subjects resided in three types of settings (16+ bed facility, group home, and natural family) and were measured on the following parameters: blood lipids, obesity, and smoking. The data were compared to a nonretarded population and to the guidelines established by the National Cholesterol Education Program. Results indicated that adults with mental retardation had cardiovascular risk profiles similar to those of individuals without mental retardation in the Framingham Offspring Study and that to the extent that cardiovascular health is a concern to the general population, it must also be a concern for individuals with mental retardation.
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PMID:Cardiovascular risk factor levels in adults with mental retardation. 814 27

The National Cholesterol Education Program and physician/patient awareness of the risks of hypercholesterolemia have resulted in aggressive screening and treatment of elevated cholesterol levels. The "one size fits all" concept has been used as the criterion for intervention. However, this has been promulgated without convincing evidence that levels of cholesterol are as important in older individuals as in those of middle age. Clearly, cholesterol is not the only contributor to cardiovascular risk, and other risk factors such as smoking, hypertension, diabetes, and obesity should not be ignored. To prevent unnecessary intervention, overzealous interpretation of cholesterol values should be avoided.
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PMID:Cholesterol and the older adult. 821 50

The principal goal of dietary treatment of heterozygous familial hypercholesterolemia (hFH) is the reduction of the plasma low density lipoprotein (LDL) cholesterol. This is best accomplished by enhancing the activity of LDL receptors and, at the same time, depressing liver synthesis of cholesterol. Both cholesterol and saturated fat down-regulate the LDL receptor and inhibit the removal of LDL from the plasma by the liver. Saturated fat down-regulates the LDL receptor, especially when cholesterol is concurrently present in the diet. The total amount of dietary fat is also important. The greater the flux of chylomicron remnants into the liver, the greater is the influx of cholesterol ester. In addition, factors that affect LDL synthesis could be important. These include excessive calories (obesity) that enhance very low density lipoprotein (VLDL) and, hence, LDL synthesis, and weight loss and omega-3 fatty acids, which depress synthesis of VLDL and LDL. The optimal diet for treatment of children and adults has the following characteristics: cholesterol (100 mg/day), total fat (20% of kcal, 6% saturated with the balance from omega-3 and omega-6 polyunsaturated and monounsaturated fat), carbohydrate (65% kcal, 67% from starch), and protein (15% kcal). This low-fat, high-carbohydrate diet can lower the plasma cholesterol 18-21%. A new concept, the Cholesterol-Saturated Fat Index, allows people to evaluate any foodstuff for its potential to elevate the plasma LDL cholesterol level. It is an antithrombotic diet, thrombosis being another major consideration in preventing coronary heart disease. Also, it contains significant amounts of antioxidants and fiber. Dietary therapy is the mainstay of treatment of hFH to which various drug therapies can be added.
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PMID:Importance of diet in the treatment of familial hypercholesterolemia. 821 96

Atherosclerosis is the principal cause of diabetic morbidity and mortality. Diabetic dyslipidemia, obesity, and hypertension are significant contributing factors in the acceleration of the atherosclerotic process. Regardless of the type of diabetes, increased levels of very-low-density lipoprotein triglyceride, modified levels of low-density lipoprotein cholesterol, and decreased levels of high-density lipoprotein (HDL) cholesterol are the main lipoprotein abnormalities in diabetic patients. These abnormalities can be improved in part by glycemic control, but additional intervention may be needed. Diet and exercise are important elements in the management of dyslipidemia, but lipid-lowering drugs (especially fibrates and HMG-CoA reductase inhibitors) also may be necessary for the control of diabetic dyslipidemia. Based on these findings, the American Diabetes Association Consensus Panel and the revised treatment guidelines of the National Cholesterol Education Program recommend treatment of hypertriglyceridemia/low HDL cholesterol as a risk factor of coronary heart disease in diabetic and nondiabetic individuals alike. Aggressive treatment is recommended, therefore, particularly in diabetic patients and in all patients with existing vascular disease.
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PMID:Prevention of atherosclerosis in diabetes: emphasis on treatment for the abnormal lipoprotein metabolism of diabetes. 826 43

Recently, violent attacks have been orchestrated, by various media and the press against medical action, via diet or drug therapy, on excess cholesterol, in order to improve primary or secondary cardiovascular prevention. The amplitude of this campaign implies a dangerous risk of a deleterious effects both on the public and on medical guidelines. The opportunity for open discussion of this question, and of a clear reply, appears to be highly desirable for all concerned. Although it is quite true that total blood cholesterol levels in excess of 200 mg/dl (5.2 mmol/l) are not automatically dangerous, they nonetheless require complete profiling of cholesterol distribution among the different fractions and, if possible, a complementary study of ApoB, ApoA1 and Lpa fractions. It must be recalled that even modest rises in total cholesterol (250 +/- 30 mgs/dl) can be atherogenic, and particularly, when present in the non-HDL fractions, and involving a low HDL Cholesterol level (< 36 mg/dl or 0.9 mmol/l). In all these cases, the associated determination of triglyceride levels is absolutely necessary. Moreover these modest rises in cholesterol have to take into account the possible association of other risk factors, such as hypertension, cigarette smoking, diabetes, obesity and ... hyperfibrinogemia. The claims of the natural protection of French people against atherosclerosis and of the irrelevance of precocious cholesterol screening, then finally of non-demonstrated benefits of such prevention, with respect to other risks due to diet or drug treatment of cholesterol disorders must be precisely rediscussed and clarified. The crucial importance of the maintenance of our present efforts in cardiovascular prevention for clinicians, concerned patients, and the general public, must be especially stressed.
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PMID:[Justification and imperatives of the campaign against excess cholesterol and prevention of atherosclerosis]. 836 58

Obesity is a well-known risk factor for developing cholesterol gallstones, but only indirect human studies are available. Presently available animal models of cholesterol gallstone disease do not become obese under normal conditions, while genetically obese or dietarily manipulated rats lack a gallbladder. The Richardson ground squirrel on a high-cholesterol diet develops impaired gallbladder contractility, excess cholesterol in its bile, and then cholesterol gallstones. To determine if ground squirrels would spontaneously become obese and serve as an appropriate model, animal weights were followed over several months while being maintained under a regulated laboratory environment. The five obese animals were twice the body weight of the five lean controls and also had a 20% rise in body fat. Plasma cholesterol levels were markedly increased and liver histology revealed mild microvesicular steatosis. Cholesterol saturation rose in the gallbladder bile of the obese group. This alteration was primarily due to a significant increase in phospholipid (33%) and cholesterol (86%) levels. Such a laboratory environment interrupts the natural annual rhythm of the ground squirrel and prevents hibernation. Animals continued to eat and develop severe obesity and abnormal gallbladder bile. These spontaneously obese animals provide an excellent means for examining altered hepatobiliary secretion and gallbladder motility relative to cholesterol gallstone disease.
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PMID:Spontaneous obesity and increased bile saturation in the ground squirrel. 841 16

The ECAT Angina Pectoris Study is a European multicentre study investigating the pathogenetic and possibly predictive role of the haemostatic system in the progress of coronary heart disease. In this paper we report the cross-sectional analysis of haemostatic factors in 3043 patients, who underwent coronary angiography due to angina pectoris. Fibrinogen levels were higher in patients with one or more coronary stenoses of at least 50% than in patients without, by an average of 0.16 g.l-1 (P < 0.0001). Depressed fibrinolytic activity due to higher levels of PAI was also associated with the presence of coronary stenoses. There was no association with the extent of coronary arteriosclerosis, as assessed by the number of involved arteries, except that patients who had more vessels with total occlusions had higher fibrinogen levels. Depressed fibrinolytic activity was also clearly associated with diabetes, obesity, higher triglyceride levels, smoking and impaired cardiac pump function as assessed by ejection fraction. Cholesterol levels were particularly correlated with protein C and plasminogen.
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PMID:ECAT angina pectoris study: baseline associations of haemostatic factors with extent of coronary arteriosclerosis and other coronary risk factors in 3000 patients with angina pectoris undergoing coronary angiography. 843 97

The prevalence of obesity is increasing today in western industrialized countries: therefore, many authors are focusing their attention on its multiple endocrine and metabolic effects. Because of the pathogenetic linkage between obesity and dyslipidemia, we have studied serum lipid pattern in a group of obese women: HDL-Cholesterol (HDL-C) deficiency was the most striking lipoproteinemic disorder. This fact points out, in our opinion, that obesity must be considered as a risk factor for cardiovascular disease.
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PMID:[Dyslipidemia in obesity: pathogenetic considerations and our experience]. 849 62

The risks of cardiovascular disease associated with dyslipidemia differ in women and men, being more strongly associated with triglyceride/high-density lipoprotein in middle-aged women than in men. Although the incidence of heart disease is lower in women because they live longer, over a lifetime, cardiovascular disease in women is equal to that in men, with the greatest incidence after age 65 years. Major coronary events are rare among reproductive-age women who use oral contraceptives and are related to the concomitant effects of age, smoking, diabetes, hypertension, and obesity. Low estrogen-progestin dose oral contraceptives appear not to promote cardiovascular disease and can be used in women with controlled cholesterol elevations. Alternative contraceptive measures should be considered for patients with severe uncontrolled hypercholesterolemia or a lipid disorder that carries a high risk of coronary heart disease. In these conditions, thrombotic propensity associated with supraphysiologic doses of estrogen in oral contraceptives might accelerate coronary thrombosis should an arteriosclerotic plaque rupture. Treatment of hypercholesterolemia should follow the guidelines of the National Cholesterol Education Program and emphasize hygienic measures. Contraceptive selection in hyperlipidemic patients should reflect a balance between the risks--and their management--of developing cardiovascular disease versus the risks of pregnancy.
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PMID:Contraception and dyslipidemia. 851 44


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