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

The relationships of rate of weight gain and weight fluctuation to incidence of non-insulin-dependent diabetes mellitus (NIDDM) were examined in Pima Indians. The 1,458 subjects were participants in a prospective study with examinations approximately every 2 years. Rate of weight gain was defined as the slope of the regression line of weight with time for two or more consecutive examinations > or = 2 years apart and weight fluctuation as the root-mean-square departure from this line for four examinations. Among men, incidence of NIDDM was strongly and significantly related to rate of weight gain (e.g., age-adjusted incidence = 56.7/1,000 person-years in those with weight gain > or = 3 kg/year and 16.9/1,000 person-years for those losing weight [Ptrend < 0.01]). In women, weight gain was significantly related to diabetes incidence only in those who were not initially overweight (body mass index < 27.3 kg/m2). In contrast to the relationship with weight gain, weight fluctuation was not associated with incidence of diabetes in either sex. These findings suggest that weight control in overweight individuals may be a more effective strategy for prevention of NIDDM in men than in women, whereas prevention of obesity may prevent diabetes in both sexes. Concern about a diabetogenic effect of weight fluctuation should not deter weight-control efforts.
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PMID:Rate of weight gain, weight fluctuation, and incidence of NIDDM. 788 11

The energy cost of daily physical activity was derived for 30 Pima Indians ages 19-71 using simultaneous measurements of total daily expenditure and basal metabolic rate in the free-living situation. The body fat of the subjects ranged from 10 to 45%. Weight-adjusted indexes of physical activity correlated negatively with percent body fat, reinforcing the hypothesis that obesity occurs with a lower level of physical activity.
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PMID:Reduced physical activity and its association with obesity. 788 20

Non-insulin-dependent diabetes mellitus (NIDDM) is a chronic disabling disease, that shortens length of life and implies a high burden for a community. Its prevalence goes from 0 per cent in Papua, New Guinea to 34 per cent in Pima Indians. There are very few prevalence studies in Mexico, and the strength of association of the known risk factors with the occurrence of the disease is not established. A prevalence cross sectional study was carried out with users of a first level medical care unit, with a meter measure of capillary glucose levels. Those with a previous diagnosis of diabetes or whose capillary glucose level were 200 mg or over were considered diabetics. Hyperglycemia was when the levels were recorded between 121 and 199 mg. The crude prevalence of NIDDM was 5.6 per cent (CI 95% 4.5-6.8), With almost no sex difference. Hyperglycemia prevalence was 2.9 per cent (CI 95% 2.0-3.7). Age was the main risk factor for the development of NIDDM. Those between 40 and 59 years showed a high risk (OR 10.8; CI 95% 5.4-22.0; p < 0.0001), and it was greater for the 60 years or elder (OR 20.6; CI 95% 9.8-44.1; p < 0.0001). Weight was also an important risk factor, with a 2.7 fold greater risk for obese persons (CI 95% 1.6-4.6; p < 0.0001). Other, risk factors were familiar history of diabetes (OR 1.5; CI 95% 0.9-2.3; p = 0.096), and overcrowding (OR 1.9; CI 95% 1.0-3.4; p = 0.03). In order to analyze independently each variable, a logistic regression model was applied, and a similar strength of association was observed for the crude model, but for obesity whose effect was modified by age. When only new cases were analyzed in the former model, the association with obesity was maintained. There is a need to develop prevalence studies of NIDDM in Mexico and to measure the strength of association with the known and the not jet well known risk factors of this disease in order to establish health policies according to the Mexican reality.
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PMID:[The prevalence of non-insulin-dependent diabetes mellitus and the associated risk factors in a population of Mexico, D. F]. 792 7

Measurements of total energy expenditure (TEE) by the doubly labeled water method were compiled from 22 studies to identify the range of variation and significant determinants of energy requirements in healthy adults. The 126 male and 173 female subjects (aged 18-78 y) were separated into four groups: athletes, Pima Indians, people in developing countries, and others. The groups differed significantly (P < 0.001) with respect to TEE, TEE/BMR, TEE-BMR divided by weight, and TEE-BMR. Stepwise multiple regression demonstrated that fat-free mass (FFM) and age are significant variables that can explain 65% of the variation in TEE. These data demonstrate that total daily energy expenditure varies dramatically among healthy, free-living adults. The relationship between body fatness and nonbasal energy expenditure was negative at high energy outputs but considerable variation in body fatness was present among sedentary individuals, suggesting that a low rate of nonbasal energy expenditure is a permissive factor for obesity.
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PMID:A compilation of total daily energy expenditures and body weights in healthy adults. 794 72

High blood pressure, abnormal glucose tolerance, and obesity are frequently associated with each other, but the mechanism of these associations is poorly understood. Studying them in children may help in understanding the pathogenesis of hypertension. Blood pressure, height, weight, and plasma glucose and serum insulin concentrations during a 75-g oral glucose tolerance test were measured in 1,698 Pima Indian children aged 6-17 years who participated in an ongoing epidemiologic study. Weight relative to height was used as an index of obesity. The parents of many of the children were also examined. Fasting and 2-hour glucose and insulin concentrations, adjusted for age, sex, and relative weight, were positively related to systolic blood pressure but not to diastolic blood pressure. Relative weight, 2-hour glucose, and fasting insulin concentrations were independently and significantly associated with systolic blood pressure in a stepwise regression analysis that included age and sex. After parental hypertension was taken into account, maternal but not paternal non-insulin-dependent diabetes mellitus, controlled for the child's relative weight and glucose and insulin concentrations, was significantly associated with higher blood pressure in children. The stronger association with maternal diabetes suggests a greater sharing of environmental factors between mother and child than between father and child, but familial similarities in obesity and glucose and insulin concentrations, the diabetic intrauterine milieu, and shared environmental factors probably all contribute to this association.
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PMID:Familial and metabolic factors related to blood pressure in Pima Indian children. 802 1

To determine whether hyperinsulinemia is associated with menstrual irregularity or hyperandrogenemia among Pima Indians, a population with a high prevalence of hyperinsulinemia, we retrospectively studied 20 hyperinsulinemic (higher insulin [HI ) and 20 relatively nonhyperinsulinemic (lower insulin [LI]) nondiabetic Pima women 18 to 45 years of age. Reproductive histories were obtained by review of medical records. Stored serum samples were used for measurement of total testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS) levels. Fifty percent (nine of 18) of HI women had irregular menses, as compared with none of the LI women (0 of 19, P = .0004). HI women were significantly more obese than LI women. Serum testosterone and androstenedione levels were similar in HI and LI women (median testosterone, 1.13 v 1.13 nmol/L, P = .55; median androstenedione, 3.79 v 3.26 nmol/L, P = .90). Serum DHEAS was lower in HI than in LI women (median, 2.85 v 4.55 mumol/L, P < .01). HI women with irregular menses had significantly higher testosterone levels than HI women with regular menses (median, 1.62 v 0.76, nmol/L, P = .04). Androstenedione and DHEAS levels were not different between these women. In conclusion, the association of obesity, hyperinsulinemia, irregular menstruation, and high testosterone concentration described in the polycystic ovarian syndrome (PCO) also occurs in Pima Indian women. Moreover, low concentrations of DHEAS are associated with hyperinsulinemia in these women.
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PMID:Hyperinsulinemia is associated with menstrual irregularity and altered serum androgens in Pima Indian women. 802

The basal (BMR) to sleeping metabolic rate (SMR) ratio might represent an estimate of the activation of the nervous system (central/sympathetic) from sleeping to basal state. Since this activation might be influenced by the degree of obesity, and might be different between sexes, we retrospectively analysed energy expenditure data collected for a large number of subjects. Twenty-four hour energy expenditure (24EE), BMR and SMR were measured in a respiratory chamber in 122 Caucasians (63 males/59 females, 32 +/- 10 years, 94 +/- 33 kg, 29 +/- 11% fat) (means +/- s.d.) and in 123 Pima Indians (68 males/55 females, 29 +/- 7 years, 100 +/- 25 kg, 34 +/- 9% fat). The BMR/SMR ratio varied greatly between individuals (1.05 +/- 0.08; range 0.87-1.34). In Pima Indians, BMR/SMR was inversely correlated to both fat mass (r = -0.26; P < 0.01) and BMI (r = -0.22; P < 0.05), whereas, in Caucasians, BMR/SMR was inversely correlated to waist/thigh circumference ratio (r = -0.28; P < 0.01). On average, the BMR/SMR was higher in Pima Indians than in Caucasians (1.06 +/- 0.08 vs. 1.03 +/- 0.07, P < 0.01) and higher in Pima Indian males than in Pima Indian females (1.08 +/- 0.09 vs. 1.04 +/- 0.06, P < 0.05). Studies are needed to investigate whether these differences in the increase in energy expenditure from the sleeping to the basal state are related to differences in the activation of the nervous system and/or to other metabolic factors.
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PMID:Energy cost of arousal: effect of sex, race and obesity. 811 75

In prospective studies in Pima Indians, four metabolic parameters, which are known to have a familial component, have been found to predict weight gain. These are: (i) low relative resting metabolic rate (RMR, relative to the average predicted rate for body size), (ii) low level of spontaneous physical activity (SPA), (iii) high 24 h respiratory quotient (RQ) and (iv) high insulin sensitivity (IS). Cross-sectional studies show that all four parameters correlate with body size: RMR vs. fat-free mass (FFM), r = 0.87, P < 0.0001; energy cost of SPA vs. weight, r = 0.69, P < 0.001; RQ vs. body fat, r = -0.23, P < 0.05; IS vs. weight, r = -0.38, P < 0.001. When these parameters are adjusted for differences in body size, then the initial value predicts the rate of change in body weight over the subsequent years: RMR (adjusted for FFM, fat mass, age and sex), r = -0.39, P < 0.001; SPA, r = -0.35, P < 0.005 (males); RQ (adjusted for fat mass), r = 0.24, P < 0.01; IS (adjusted for weight), r = 0.34, P < 0.0001. After gaining weight, the original deviation from the value predicted on the basis of the population (e.g. low relative RMR, high RQ and high IS) tends to diminish, suggesting a progressively decreasing physiological drive for further body weight gain. Thus, the high RMR, high energy cost of SPA, low RQ and low IS seen in obesity may act to limit additional weight gain.
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PMID:Metabolic predictors of obesity: cross-sectional versus longitudinal data. 812 97

Excessive energy intake and/or reduced total daily energy expenditure (TEE) causes obesity. To determine the relationship between obesity and TEE in an obesity-prone population, we measured TEE, 24-h sedentary energy expenditure (SEDEE), and basal metabolic rate (BMR) in 30 Pima Indian men (83.6 +/- 20.0 kg and 31 +/- 9% fat) by the doubly labeled water method and a respiratory chamber. The energy expenditure for physical activity (EEACT) was calculated as TEE - (BMR + 0.1 TEE), where 10% of TEE is an estimate of the thermic effect of food. Fat-free mass was the best single determinant (P < 0.01) of TEE, explaining 48% of its variance. TEE, SEDEE, BMR, and EEACT were 12,010 +/- 2292, 9945 +/- 1559, 7677 +/- 1901, and 3297 +/- 1732 kJ/d, respectively. Because EEACT is dependent on body weight, EEACT/kg body wt (41.7 +/- 23.2 kJ.d-1.kg-1) and TEE/(BMR + 0.1 TEE) (1.39 +/- 0.22) were used as indexes of the level of physical activity. Both indexes correlated negatively with percent body fat (r = -0.56, P < 0.01 and r = -0.42, P < 0.03, respectively). These results suggest that obesity is associated with lower levels of physical activity.
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PMID:Determinants of total daily energy expenditure: variability in physical activity. 814 22

Markers on chromosome 4q have recently been shown to be associated with insulin resistance in Pima Indians, a population in which insulin resistance precedes and predicts the development of non-insulin-dependent diabetes mellitus (NIDDM). To examine whether genes in this region could play a major role in susceptibility to NIDDM in other populations, we have examined the allele frequencies of a trinucleotide repeat near the fatty acid-binding protein 2 (FABP2) gene on 4q28-31 in three European populations: Finnish, U.K. Caucasian, and Welsh. The U.K. NIDDM population was selected for insulin resistance by studying patients whose obesity-corrected fasting plasma insulin before treatment was above the 98th percentile. Seven alleles were detected. On cross-tabulation analysis, there were no significant associations between allele frequencies and glucose intolerance in any of the populations. Log-linear analysis of the results from all three populations suggested a moderately significant interaction of glucose tolerance status (normal versus diabetic) and the FABP2 allele (partial chi 2 = 24, df 6, P = 0.027). The parameter describing the interaction of allele A3 and glucose tolerance status was the only such parameter differing significantly from zero (z-score +2.003, P = 0.046). In both the Finnish and U.K. population, the A3 allele was found approximately twice as frequently in NIDDM than in control subjects (Finnish control subjects, impaired glucose tolerance, and NIDDM: 12.2, 22.4, and 26.6%, respectively; U.K. control subjects and NIDDM: 7.8 and 14.6%, respectively). In the Finnish populations, no associations were found between FABP2 alleles and plasma insulin levels or with homeostatic model assessment (HOMA) estimates of beta-cell function and insulin sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chromosome 4q locus associated with insulin resistance in Pima Indians. Studies in three European NIDDM populations. 819 66


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