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

The role and value of screening for diabetes mellitus is still unclear. If asymptomatic subjects are to be screened, then a fasting plasma glucose > 6.6 mmol l-1 or a venous plasma glucose 2 h after a 75 g oral glucose load > 8.0 mmol l-1 or the presence of any glucose in a urine sample passed 2 h after a main meal should be regarded as a positive result. A fasting plasma glucose in the range 5.5-6.6 mmol l-1 is an equivocal result which should lead to retesting in 6-12 months if there is any risk factor for diabetes (obesity, family history of diabetes, Asian/African racial origin). Other screening tests or combinations of tests are not recommended. Screening should be restricted to subjects between 40 and 75 years and should be undertaken only every 5 years (3 years if a risk factor for diabetes is present), ideally in parallel with other health screening test; subjects with a positive result should have further investigations as necessary to reach a diagnosis in line with WHO criteria.
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PMID:Population screening for diabetes mellitus. Professional Advisory Committee of the British Diabetic Association. 808 36

Steroid withdrawal after renal transplantation and cyclosporine-based immunosuppression enhances growth in children, but this practice is not widely employed because of a 50%-60% rate of rejection, graft dysfunction, or graft loss. The current study evaluates growth and renal function after withdrawal and discontinuation of steroids within 1 year of transplantation in 52 children receiving tacrolimus (FK-506)-based immunosuppression. Height Z-score, weight-for-height index (WHI), and body mass index (BMI), as well as graft loss and calculated creatinine clearance as a measure of glomerular filtration rate (GFR), were assessed. Children were divided into three groups according to age at transplantation: group I, 16 children aged 0-5 years; group II, 17 children aged 6-12 years; group III, 19 children aged 13-16 years. Significant and sustained improvement in height occurred in groups I and III, with Z-scores increasing by 1.51 and 1.57 standard deviations at 3 years after transplantation compared with the Z-score at transplantation (P<0.02). Mean WHI values remained near 100% in groups I and III, and significantly increased above 100% only in group II at 2 years after transplantation. Although actual BMI scores improved significantly in groups II and III at both 2 and 3 years post transplantation (P<0.05), when BMI scores were adjusted for height age, none of these groups had values >95% denoting obesity. Failure of steroid withdrawal, defined as reinstitution of steroids, graft dysfunction, or graft loss, occurred in 9 of 68 (13%) children who underwent steroid withdrawal at any time after transplantation, and resulted in graft dysfunction or graft loss in 5 (7%). Over a 3-year period, rates of renal dysfunction, as manifested by >50% rise in the serum creatinine level above baseline, or graft loss were lower in these 68 children compared with 8 children who never had steroid withdrawal (P<0.05). Mean GFR at 3 years after transplantation ranged from 96 to 102 ml/min per 1.73 m2 in all three steroid withdrawal groups, and remained stable during the 3 years of follow-up. These data indicate that steroid withdrawal enables normalization of growth without obesity, and without imposing an excessive risk for graft dysfunction or graft loss.
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PMID:Growth and renal function after steroid-free tacrolimus-based immunosuppression in children with renal transplants. 1091 44

The purpose of this study was to estimate the national prevalence of childhood asthma and other allergic diseases in Korea, and to determine potential risk factors for the diseases. Stratified random samples of 42,886 were selected from 34 elementary (6-12 yr olds) and 34 middle schools (12-15 yr olds) nationwide, and 38,955 were in the final analysis. The Korean-translated modified version of the International Study of Asthma and Allergies in Childhood questionnaire was used in this cross-sectional survey. Twelve-month prevalences of the symptoms of asthma, rhinoconjunctivitis, and flexural eczema were 8.7%, 10.5%, 7.3% in 6-12 yr olds, and 8.2%, 10.0%, 3.9% in 12-15 yr olds, respectively. For allergic conjunctivitis, food allergy, and drug allergy, the prevalences in 6-12 yr olds were 11.2%, 6.5%, and 1.5%, respectively. Asthma and flexural eczema decreased significantly with age. Other significant risk factors were also noted. For 6-12 yr-old asthma, adjusted odds ratio (aOR) of body mass index was 1.21 with 95% confidence interval (CI) 1.0-1.48, aOR of passive smoking was 1.37 with 95%CI 1.24-1.51, aOR of carpet use was 1.28 with 95%CI 1.10-1.49. For 6-12 yr-old eczema, aOR of affluence was 1.22 with 95%CI 1.07-1.39. The control of obesity and passive smoking would be the most important preventive measures of allergic diseases.
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PMID:Prevalences of symptoms of asthma and other allergic diseases in korean children: a nationwide questionnaire survey. 1130 40

This cross-sectional anthropometric study involved one thousand and five randomly selected children and adolescents aged 6 to 18 years resident in Calabar, Nigeria. It was aimed at determining the profile of Body Mass Index (BMI) as well as the prevalence of obesity in the group. Subjects had their heights and weights measured using standard methods and Body Mass Index calculated. Those with BMI of 95th percentile for their ages and sexes were considered obese. Body Mass Index as well as other anthropometric parameters were found to increase progressively with age with females having higher values. The prevalence of obesity in 6-12 years old children was 2.3%. Adolescents 13-15 years had a prevalence of 4.0% while those 16-18 years had 3.0%. Though females had a higher prevalence in both groups, the difference was not statistically significant (l2 = 4.90 df = 2, P > 0.5) We conclude that obesity hitherto seen predominantly in developed countries is a potential health problem in developing countries despite the prevailing poor socioeconomic situation. The significant role played by factors other than the environment in the development of obesity has since been recognised. Since treatment of adult obesity is largely difficult, the need for intervention during childhood and adolescence which includes early detection and prevention cannot be overemphasized.
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PMID:Profile of body mass index and obesity in Nigerian children and adolescents. 1170 64

(1) The reference treatment for achieving weight loss by obese patients is a combination of dietary measures, exercise and behavioural interventions. There is currently no drug treatment with demonstrated efficacy on the morbidity or mortality associated with excess body weight. (2) Sibutramine, a serotonin- and noradrenaline-reuptake inhibitor structurally related to the amphetamines has been granted marketing authorisation in France for the treatment of obesity and excess body weight in patients with associated risk factors. (3) The clinical file on sibutramine contains no trial focusing on morbidity or mortality end points. (4) According to comparative clinical trials, weight loss during a 6-12 month course of sibutramine is, on average, between 3 and 9 kg greater than that on placebo. Patients regain weight after sibutramine cessation. (5) Sibutramine has little or no benefit on blood sugar or lipid parameters. (6) The main known adverse effect of sibutramine is increased blood pressure. Sibutramine also has amphetamine-like side effects. (7) In practice, sibutramine currently has no place in the management of obesity.
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PMID:Sibutramine: new preparation. Slight weight loss; but also a slight rise in blood pressure ... 1182 28

The purpose of this study was to determine the prevalence of insulin resistance syndrome (IRS) and the risk factors for developing IRS among women with a history of gestational diabetes mellitus (GDM), compared with controls over 11 postdelivery years. Assessments of 106 women with a prior history of GDM and 101 controls were done on six occasions from 4-11 yr after delivery. Tests included glucose, insulin, lipids, blood pressure, and body measurements. The risk of IRS was analyzed by Cox regression. The results were that 27.2% of GDM and 8.2% of controls developed IRS by 11 yr after delivery. The hazard of developing IRS was 5.6 times (95% confidence interval = 2.6-12.3) among women with prepregnant obesity (body mass index >27.3 kg/m(2)), compared with women without prepregnant obesity and 4.4 times (95% confidence interval = 1.7-11.1) in women with a history of GDM, compared with controls. At 11 yr after delivery, the cumulative hazard for developing IRS in the next 2 yr was 26 times higher among GDM with prepregnant obesity, compared with controls without prepregnant obesity. We concluded that obesity and GDM in a prior pregnancy are significant risk factors for developing IRS over time. Early detection of markers of IRS is vital for possible prevention of type 2 diabetes and cardiovascular adverse events in women.
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PMID:Insulin resistance syndrome in women with prior history of gestational diabetes mellitus. 1210 30

Obesity is an excessive accumulation of fatty tissue in the organism. Incorrect eating habits and low physical activity are the major cause of overweight and obesity. The aim of the study was to investigate the efficiency of dietetic treatment and increased physical activity in patients with excessive body mass. The study was carried out on 140 patients with overweight or simple obesity (131 women and 9 men), aged 15-65 years, the members of the support group previously instructed in dietetics. The treatment consisted of the application of diet 1000-1500 kcal/day and the participation in the programme of body-mass reducing exercises (physical exercise twice a week and exercise in water once a week for 45 min). The attendance was monitored and those who missed the classes were excluded from the group. The study was terminated after 2 years. In the group I (exercising for 0-3 months) 39 patients reduced their body mass by 7.7 kg on the average. In the group II (exercising for 3-6 months) 59 patients reduced their body mass by the average of 14.5 kg. In the group III (exercising for 6-12 months) in 38 patients the average loss of body mass was 20.9 kg. In the group IV (exercising for over 12 months) 4 patients reduced their weight by 26-70 kg (mean 50 kg), which gave the 26.5-47% loss of the initial body mass. The patients with overweight and obesity included in the present study reduced their body mass through the application of an adequately selected diet and increased physical activity. More than 40% of the patients were able to preserve up to 6 months of the programme, and about 30% up to one year.
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PMID:[Estimation of the influence of psychological support on body mass reduction in the obese patients]. 1218 2

Daily prednisone improves strength in boys with Duchenne muscular dystrophy, but side effects are almost universal. We used a different dosing regimen of prednisone to determine if benefit to boys with Duchenne muscular dystrophy might be maintained with fewer side effects. Twice weekly oral prednisone was given each Friday and Saturday (5mg/kg/dose). This total dose is twice as high as the daily low dosage prednisone regimen (0.75 mg/kg/day). Twenty boys (8.0+/-1.2 years) were treated. Historical control groups included 18 untreated boys (6.1+/-1.6 years) and four boys (7.3+/-0.6 years) treated with daily prednisone. Strength (using a hand-held manometer and grip meter) and timed functional testing were measured. There was an improvement in upper extremity strength for 95% of boys (n=20) at 6 months using quantitative strength testing. Improvement in lower extremity strength occurred in all boys with antigravity quadriceps strength (17/17). The improvement (P=0.001 for proximal upper extremities; P=0.002 for grip; and P<0.0001 for proximal lower extremities) was significant compared to untreated boys. Sixteen boys were treated continuously for more than 12 months (22+/-1.5 months). Of these, 15 remained significantly stronger than prior to treatment and 8/16 showed additional gains in strength after six months of treatment. Six boys were on the weekly prednisolone 2 years or longer without interruption. All six had upper and lower extremity strength at follow-up that was as good or better than at baseline. Functional testing improved in boys less than 8 years without contractures. Three boys without antigravity quadriceps strength at the start of treatment lost the ability to walk unassisted within 6 months. Eight other boys lost the ability to ambulate unassisted between 12 and 24 months of treatment. In each, progressive contractures developed. Linear growth was maintained in all boys on weekly treatment. Obesity rates did not differ from untreated boys. Twice weekly prednisone improved strength over 6-12 months in the majority of boys, but did not slow contracture development. Sustained benefit beyond 12 months is possible with fewer side effects compared to daily prednisone.
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PMID:High dose weekly oral prednisone improves strength in boys with Duchenne muscular dystrophy. 1246 46

Obesity related to over-nutrition is investigated in a sample of 219 Mexican children from affluent families, ages 6-12 years. Defined as weight-for-age at or above the 95(th) percentile, obesity rates in middle childhood are very high in this population, being 24.2% of children (29.4% of boys and 19.1% of girls). Binary logistic regression shows that children are more likely to be obese if they are boys, from small households with few or no other children, and have more permissive, less authoritarian parents. Diet at school and activity patterns, including television viewing, are not different for boys and girls and so do not explain this gender variation. The value placed on children, especially sons, in smaller middle-class families, can result in indulgent feeding because food treats are a cultural index of parental caring. Parents also value child fatness as a sign of health. These obese Mexican children have no greater social problems (peer rejection or stigma) or psychological problems (anxiety, depression, or low self esteem) than their non-obese peers. More study specifically focused on feeding practices in the home environment is required to explain very high rates of child obesity. The differences in obesity risk related to specific aspects of children's developmental microniche emphasize the importance of including a focus on gender as a socio-ecological construct in human biological studies of child growth, development, and nutrition.
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PMID:Biocultural aspects of obesity in young Mexican schoolchildren. 1270 21

Nonalcoholic steatohepatitis is now recognized as a common chronic liver disorder. Up to 16% of affected patients may progress to cirrhosis. The incidence and prevalence of this disease are noted to be increasing, in parallel with the nationwide increase in obesity and diabetes. Treatment options for these patients remain quite limited, however. Weight reduction has been advocated, but there are little data to support this practice, as most patients are unable to comply with the proper dietary modifications. We report three obese patients with biopsy-proven nonalcoholic steatohepatitis treated for 6-12 months with a weight reduction medication, orlistat, who lost between 22-42 lb, and had significant clinical and histopathological improvement on follow-up.
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PMID:Orlistat in the treatment of NASH: a case series. 1273 78


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