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

Childhood obesity and its consequences have been the subject of intense interest in recent years. In this study we examined the influence of overweight on circadian variations of ambulatory blood pressure (ABP) in Chinese adolescents. First, 24-hr ABP monitoring was performed in 252 adolescents divided into two groups with equivalent sex, age, and body height (49 girls and 77 boys in each group): controls (normal weight) were aged 13.68 +/- 1.21 years, height 165.37 +/- 9.45 cm, body mass index (BMI) 18.82 +/- 2.3; overweights (BMI > or = 24) were aged 13.71 +/- 1.23 years, height 165.75 +/- 9.47 cm, BMI 27.70 +/- 3.1. ABP recordings were treated by ABP database system and analyzed by cosinor method and conventional statistics methods. The circadian variations of ABP in adolescent patterned as "dipper" and circadian rhythmicity of ABP variations were confirmed by cosinor analysis in most adolescents of both groups. Significant statistical differences were found for rhythm parameters: the MESOR (midline estimate statistic of rhythm), peak, trough (the maximum and minimum values derived from the composed curves, respectively), and amplitude values between control and overweight groups. Significant higher values also were seen in the overweight group for most of ABP parameters (p < .01), such as, BP means (SBP, DBP, MAP: mean arterial pressure, or PP: pulse pressure), BP variability, BP loads and rate-pressure product (HR x SBP). Our results have shown that overweight influenced significantly on ABP and parameters derived from ABP recordings in Chinese adolescents, which suggests an increasing risk of cardiovascular diseases in overweight adolescents.
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PMID:Overweight influence on circadian variations of ambulatory blood pressure in Chinese adolescents. 1583 82

Aim of this study was to compare the effect of valsartan and felodipine on blood pressure (BP), plasma leptin (L), insulin sensitivity and plasma norepinephrine (NE) in obese hypertensive patients. Ninty-six obese patients (body mass index [BMI] > or = 30 kg/m2) with mild to moderate essential hypertension (diastolic blood pressure [DBP] > 90 and < 110 mmHg, as evaluated with an appropriately sized cuff) aged 31-60 years, were randomized to a valsartan (80 mg/day for 16 weeks; n = 48) or felodipine (5 mg/day for 16 weeks; n = 48) treatment group after a 2-week wash-out period. After the first 4 weeks of treatment there was a titration with dose-doubling in non responder patients (DBP > 90 mmHg). At the end of the placebo period and of active treatment period, BP and BMI were evaluated and a venous sample was drawn at the same hour in the morning to evaluate plasma L and NE. Insulin resistance index (HOMA-IR) was calculated. No dietary advice was prescribed. Both valsartan and felodipine significantly decreased BP values (-19.3/15 mmHg and -18.9/13.6 mmHg, respectively p < 0.001 vs. placebo), with no difference between treatments. However, felodipine increased plasma NE (+124 pg/ml, +38.2%, p < 0.05 vs. placebo and < 0.01 vs. valsartan) and had no effect on L, body weight and HOMA-IR index, while valsartan did not modify NE and produced a significant reduction in L (-3.7 ng/ml, -10.1%, p < 0.05 vs. placebo), BMI (-1.7 kg/m2, -4.7%, p < 0.01 vs. placebo) and HOMA-IR index (-1.6, -20%, p < 0.05 vs. placebo). These results suggest that in hypertensive obese subjects, treatment with valsartan might offer an advantage over treatment with felodipine, since valsartan may help to improve obesity-related disorders in addition to lowering BP.
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PMID:Comparison of the effects of valsartan and felodipine on plasma leptin and insulin sensitivity in hypertensive obese patients. 1609 63

Adolescence is a critical temporal window for the development of obesity in adult age. We studied this period for short-term monitoring of blood pressure in both genders. Weight, height, body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP) were recorded in 937 adolescents, 474 boys and 463 girls aged 12 years, and again 2 years later in the same subjects. Boys with BP values > or = 95th percentile at both ages (no. = 8) showed at 12 years weight (kg 61.4) height (cm 159.5) and BMI (23.5), and also at 14 years (77.0, 172.4, 25.6) values consistently higher than boys with high BP values at either ages taken singularly (no. = 32 + 32) (mean 49.2, 154.4, 21.5, respectively, at 12 years, and 62.1, 167.0, 22.2 at 14 years). These 64 boys, had values higher than boys with BP always below the 95th percentile (no. = 402) (45.5, 151.4, 19.7 at 12 years, and 56.9, 164.6, 20.9 at 14 years). This was confirmed for weight and BMI in girls. Stepwise logistic regression revealed that weight at 12 years and high BP values at 12 years were predictive independent risk factors for hypertension at 14 years. Odds ratio indicated that increment of body weight unit (1 kg) at 12 years predicted an average increase of 4% of risk for high BP values at 14 years, while high BP values at 12 years was predictive for a 2.19 times risk for high BP values at 14 years. Body weight, BMI and BP at 12 years of age may give useful indications for the prevision (and possible prevention) of hypertension and overweight at 14 years of age.
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PMID:Adolescence as possible critical temporal window for blood pressure short term monitoring in boys and girls. 1612 61

Obesity in childhood is discussed to be associated with hypertension, dyslipidemia, impaired glucose metabolism, and chronic inflammation. It has not yet been studied in obese children which of these cardiovascular risk factors are related to intima media thickness (IMT), a noninvasive marker for early atherosclerotic changes. We collected the clinical data (age, sex, pubertal stage, percentage of body fat, SD score of body mass index [SDS-BMI]) and measured systolic blood pressure [SBP] and diastolic blood pressure [DBP], triglycerides [TGs], high- and low-density lipoprotein cholesterol, glucose, insulin, and high-sensitivity C-reactive protein [hsCRP]) in 96 obese children (median age, 11 years). The control group was composed of 25 nonobese children of the same age, sex, and pubertal stage. We determined the carotid IMT of all the patients by B-mode ultrasound with a 14-MHz linear transducer. Obese children demonstrated a significantly (P < .001) thicker intima media (median, 0.6 mm) as compared with the control group (median IMT, 0.4 mm). IMT was significantly correlated to the SDS-BMI (r = 0.38, P < .001), percentage of body fat (r = 0.39, P < .001), SBP (r = 0.39, P < .001) and DBP (r = 0.29, P = .002), glucose (r = 0.30, P = .001), and hsCRP levels (r = 0.29, P = .002). In stepwise backward multiple linear regression analysis, IMT correlated significantly to BMI (r2 = 0.05, P = .044), SBP (r2 = 0.15, P = .013), glucose (r2 = 0.05, P = .028), and hsCRP (r2 = 0.07, P = .005). Because IMT is increased in obese children, vascular changes in obesity seem to occur already in childhood. These changes are related to the cardiovascular risk factors of obesity, especially hypertension, chronic inflammation, and impaired glucose metabolism.
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PMID:Intima media thickness in childhood obesity: relations to inflammatory marker, glucose metabolism, and blood pressure. 1632 29

Blacks are known to have higher blood pressure levels, a higher prevalence of hypertension, and higher body weights than whites. However, the interrelationships of these and other cardiac risk factors have not been analyzed in an obese population. We compared blood pressure (BP) and lipid levels in 174 obese blacks and 939 obese white patients who were entering a weight loss program; we also assessed the effects of weight loss on these factors. Prevalence of treated hypertension was similar in blacks and whites (28% vs. 25%, respectively). In patients not taking BP medication, black women weighed more (108 kg) than white women (102 kg) and black and white males' weights were similar (135 kg vs. 131 kg). Systolic and diastolic BP were similar in black and white women; black males had similar SBP but a significantly lower DBP than white males (83 mmHg vs. 89 mmHg, respectively). Lipid levels were similar in black and white women except black women had lower triglycerides (1.30 mmol/L) than white women (1.58 mmol/L, p < 0.05); and black males compared to white males had significantly lower total cholesterol (4.76 mmol/L vs. 5.56 mmol/L), LDL-cholesterol (3.15 mmol/L vs. 3.52 mmol/L) and triglycerides (1.31 mmol/L vs. 2.17 mmol/L, p < 0.05). Adult-onset obesity adversely affected a number of cardiovascular risk factors in whites, but not in blacks. Blacks lost significantly less weight (-13 kg) than whites (-19 kg). However, controlling for the difference in weight loss, blacks sustained comparable improvement in lipids and blood pressure, except for TC/HDL-C (whites improved significantly more, -0.36 kg/m2, than blacks, 0.03 kg/m2). Thus, the impact of obesity on cardiovascular risk factors seems ameliorated in blacks compared to whites.
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PMID:Comparison of cardiovascular risk factors in obese blacks and whites. 1635 24

That essential hypertension is associated with metabolic syndrome is known. However, information is scant regarding the course of development of adverse levels of blood pressure and other risk variables of metabolic syndrome in youth at risk for developing hypertension. This aspect was studied, retrospectively, in a community-based cohort of normotensive (n=2206), prehypertensive (n=721), and hypertensive (n=328) subjects examined serially during childhood (4 to 11 years), adolescence (12 to 18 years), and adulthood (19 to 42 years). Prehypertensive subjects versus normotensive subjects had significantly higher body mass index and subscapular skinfold, systolic (SBP) and diastolic (DBP) blood pressures, and triglycerides beginning in childhood; higher glucose in adolescence; and higher low-density lipoprotein cholesterol, fasting insulin, and insulin resistance index in adulthood. Hypertensive subjects versus normotensive subjects had higher adiposity measures, SBP and DBP, glucose, and triglycerides beginning in childhood; higher insulin and insulin resistant index in childhood and adulthood; and lower high-density lipoprotein, cholesterol in adulthood. Most of these variables progressed adversely at an increased rate in prehypertensive and hypertensive subjects. In a multivariate analysis, adverse changes in adiposity, SBP, and DBP were independently associated with prehypertensive status; and adverse changes in adiposity, SBP and DBP, insulin resistant index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides with hypertension status. As young adults, prehypertensive and hypertensive subjects showed significantly higher prevalence of obesity, hyperinsulinemia, hyperglycemia, and dyslipidemias. Thus, excess adiposity and blood pressure beginning in childhood and accelerated adverse longitudinal changes in risk variables of metabolic syndrome through young adulthood characterize the early natural history of hypertension.
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PMID:Changes in metabolic syndrome variables since childhood in prehypertensive and hypertensive subjects: the Bogalusa Heart Study. 1676 95

Despite a growing burden of obesity and hypertension in developing countries, there is limited information on the contribution of body mass index (BMI) to blood pressure (BP) in these populations. This study examines the association between BMI and BP in three populations across Africa and Asia. Data on BMI, BP and other background characteristics of study participants were generated using the World Health Organization STEPwise approach to surveillance (STEPS), at three demographic surveillance sites in Ethiopia, Vietnam and Indonesia. BMI and BP increased along the socioeconomic gradient across the three countries. Mean (s.d.) BMI in men varied between 19.41 (2.28) in Ethiopia to 21.17 (2.86) in Indonesia. A high prevalence of overweight/obesity was noted among Indonesian women (25%) and men (10%), whereas low BMI was widely prevalent in Ethiopia and Vietnam, ranging from 33 to 43%. Mean (s.d.) systolic BP (SBP) among men varied between 117.15 (15.35) in Ethiopia to 127.33 (17.80) in Indonesia. The prevalence of hypertension was highest among women (25%) and men (24%) in Indonesia. Mean BP levels increased with increasing BMI. The risk of hypertension was higher among population groups with overweight and obesity (BMI>/=25 kg/m(2)); odds ratio (95% confidence interval); 2.47 (1.42, 4.29) in Ethiopia, 2.67 (1.75, 4.08) in Vietnam and 7.64 (3.88, 15.0) in Indonesia. BMI was significantly and positively correlated with both SBP and DBP in all the three populations, correlation coefficient (r) ranging between 0.23 and 0.27, P<0.01. High BP exists in a background of undernutrition in populations at early stages of the epidemiologic transition.
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PMID:Association between body mass index and blood pressure across three populations in Africa and Asia. 1706 86

Obesity is associated with a number of serious diseases and with a degree of motor disability, but the extent of the risk and functional derangement within the obese population is not yet completely defined. The study aims to evaluate the combined effect of degree of adiposity, body fat distribution and age on selected cardiovascular risk factors and functional motor disability in a cohort of obese women. A multivariate analysis of variance (MANOVA) is employed to show the combined impact of body mass index (BMI), waist-to-hip ratio (WHR) and age on systolic and diastolic blood pressure (SBP and DBP), total and HDL cholesterol (T-CH and HDL-CH), coronary heart disease (CHD) risk, leg power output (W, assessed with a Margaria test for stair climbing) and subjective general fatigue in a cohort of 463 obese women (BMI range 30.2-66.7 kg/m2; age range 18-83 yr). High WHR and older age, but not BMI, are to a variable degree related to unfavorable values of parameters which contribute to the cardiovascular risk. WHR in the high range is associated with significantly higher values of SBP (p<0.001), CHD risk scores (p<0.001) as well as lower levels of HDL-CH (p=0.01), while older age is significantly associated with higher SBP (p<0.001), T-CH (p<0.001) and CHD risk scores (p<0.001). A significant interaction between age and WHR was detected in the effect on DBP (p=0.01), the negative role of high WHR values being apparent in older women (age > or = 51 yr) but not in younger ones (age < 51 yr). Although not significantly related to CHD risk scores, BMI interacted significantly with WHR in determining high risk score values (p=0.01), the negative effect of a high WHR being apparent in women with a high degree of obesity (BMI > or = 40 kg/m2) but not in those with a low one (BMI < 40 kg/m2). In contrast, WHR did not significantly affect W, which appeared to be mainly dependent on age (p<0.001) and BMI (p<0.001), when considered in terms of unit body mass (BM). Subjective global fatigue, however, was unaffected by any of the factors considered. In the present cohort of obese women, older age and excessive abdominal fat distribution (as assessed by WHR) appear to be significant factors in relation to increased cardiovascular disease risk, irrespective of BMI, while older age and higher levels of overall adiposity are associated with functional motor derangement irrespective of body fat distribution. This suggests that obesity increases metabolic risk and induces motor dysfunction by means of different biological mechanisms and with a different impact within the obese female population.
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PMID:The combined effect of adiposity, fat distribution and age on cardiovascular risk factors and motor disability in a cohort of obese women (aged 18-83). 1718

In a population-based sample, after excluding alcohol consumption, hepatotoxic drugs and hepatitis B and C infected, we investigated if alanine-aminotransferase (ALT) was associated with metabolic syndrome and insulin resistance, and if this association was caused by non-alcoholic fatty liver disease (NAFLD). The sample (432 female and 119 male) was divided into two ALT thresholds corresponding to the 50th and 75th percentiles (P) (female > or = 15 and > or = 19 U/L; male > or = 17 and > or = 23 U/I, respectively). Blood pressure, body mass index, waist circumference, cholesterol, HDL cholesterol (HDLc), triglyceride (TG), TG/HDLc ratio, glycemia and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between those above and below each ALT threshold. Female placed above the 50th P of ALT had higher levels of TG/HDLc ratio (p=0.029), glycemia (p=0.028), and homeostasis model assessment of insulin resistance, (p=0.045), and above the 75th P had higher SBP (p=0.036), DBP (p=0.018), TG (p=0.024), TG/HDLc ratio (p=0.028), glycemia (p=0.004) and HOMA-IR (p=0.0014). Male placed above the 50th P of ALT had higher BMI (p=0.017) and TG/HDLc ratio (p=0.048), and above the 75th P had lower values of HDLc (p=0.042). Only 16.5% of women and 14.5% of men, above the 75th P of ALT, showed an increase in liver brightness in the echography. This work shows in woman an early association of ALT with TG/HDLc ratio and HOMA-IR. Since the last two are independent predictors of cardiovascular risk, attention should be drawn to ALT values near the upper limit of the normal range even in the absence of NAFLD and obesity.
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PMID:Alanine-aminotransferase: an early marker for insulin resistance? 1759 95

In a previous study in 15 inbred mouse strains, we found highest and lowest systolic blood pressures in NZO/HILtJ mice (metabolic syndrome) and C3H/HeJ mice (common lean strain), respectively. To identify the loci involved in hypertension in metabolic syndrome, we performed quantitative trait locus (QTL) analysis for blood pressure with direction of cross as a covariate in segregating F2 males derived from NZO/HILtJ and C3H/HeJ mice. We detected three suggestive main-effect QTLs affecting systolic and diastolic blood pressures (SBP and DBP). We analyzed the first principle component (PC1) generated from SBP and DBP to investigate blood pressure. In addition to all the suggestive QTLs (Chrs 1, 3, and 8) in SBP and DBP, one suggestive QTL on Chr 4 was found in PC1 in the main scan. Simultaneous search identified two significant epistatic locus pairs (Chrs 1 and 4, Chrs 4 and 8) for PC1. Multiple regression analysis revealed three blood pressure QTLs (Bpq10, 100 cM on Chr 1; Bpq11, 6 cM on Chr 4; Bpq12, 29 cM on Chr 8) accounting for 29.4% of blood pressure variance. These were epistatic interaction QTLs constructing a small network centered on Chr 4, suggesting the importance of genetic interaction for development of hypertension. The blood pressure QTLs on Chrs 1, 4, and 8 were detected repeatedly in multiple studies using common inbred nonobese mouse strains, implying substantial QTL independent of development of obesity and insulin resistance. These results enhance our understanding of complicated genetic factors of hypertension in metabolic diseases.
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PMID:Quantitative trait loci associated with blood pressure of metabolic syndrome in the progeny of NZO/HILtJxC3H/HeJ intercrosses. 1764 13


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