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Query: UMLS:C0028754 (obesity)
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A long-term follow-up which is still being carried out was started in the school-year 1985-86 in a Primary School of Rome and we suggested a written diet of 1300 calories and correct physical exercises. During this long follow-up we studied the changes in percentage of obesity of these subjects, considering their familiarity with obesity. It resulted that after a starting benefit due to the diet and the sport activity, which lasted till 1989, the youngsters with familiarity have subsequently regained the initial situation in 62.5% of cases, unlike those without familiarity who have kept themselves slim in 75% of cases. Even many other facts have been considered, as for example the psychologic approach, blood-tests for cholesterol, triglycerides etc, arterial pressure and above all a very careful feeding recall that has shown as the now obese subjects intake more calories than not obese one, with and excess of calories from fats to the detriment of carbon hydrates.
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PMID:Follow-up of obese child. 854 59

Insulin resistance is found patients with diabetes mellitus type 2 as well as in obese subject without diabetes. The objective of our investigation was to compare the action of insulin in morbidly obese subject with and without diabetes and in diabetic subject with different degrees of obesity. A total of 36 diabetic were examined, divided according to the BMI into morbidly obese (DMTO: BMI > 40 kg/m-2.n = 6) those with medium severe obesity (DMSO: BMI 31-40 kg.m-2.n = 16), with slight overweight DMLO. BMI 26-91 kg.m-2.n = 9) and non-obese diabetics (DMBO). BMI 21-26 kg.m-2.n = 5). The group of morbidly obese non-diabetic subject (NDTO, BMI > 40 kg.m-2.n = 5) and non-obese healthy subject (C, BMI < 26 kg.m-2, n = 12) served as control. All examined subject were of similar age the diabetic subject had similar values of indicator of diabetic control (HbA1c was 7.1 +/- 0.5%). The examination was made using the method of an isoglycaemic hyperinsulinaemic clamp on a Biostator at an insulin infusion rate of 1mU.kg-1.min-1 for a period of 20 minutes. The results of the index of tissue sensitivity to insulin revealed a markedly deteriorated action of insulin in morbidly obese diabetes and non-diabetics in relation to control group of healthy slim controls (M/I, DMTO: 12.4 +/- 7.3 and NDTO: 9.2 +/- 4.1, p < 0.001, mumol.kg-1.min-1 na mU.l-1 x 100), in midly and medium obese diabetics the insulin resistance was of difference grades (M/I, DMLO: 34.2 +/- 9.3, p < 0.05, and DMSO: 25.9 +/- 18.5 p < 0.001 mumol.kg-1.min-1 na mU.l-1 x 100. Non-obese diabetic and non-diabetic subject had a normal insulin action (M/I, DMBO: 58.3 +/- 29.4 and C: 48.9 +/- 5.0 mumol.kg-1.min-1 per mU.l-1 x 100. The metabolic glucose clearance differed however between diabetic and non-diabetic subject (MCRG, DMTO: 2.0 +/- 0.4, p < 0.001, DMSO: 3.8 +/- 2.4, p < 0.001, DMSO: 5.4 +/- 1.7, p < 0.05 v.s. C: 8.6 +/- 1.1 and NDTO: 3.8 +/- 1.5, p < 0.001 ml.kg-1.min-1). The statistical significance is related to the control group of slim healthy subject. From this ensues that no significant difference was found between slim diabetic and non-diabetic subjects in the majority of parameters expressing the action of insulin with the exception of the metabolic glucose clearance. At the same time the authors found in the whole group of 53 examined subject a statistically significant correlation between the BMI and the index of tissue sensitivity for insulin (M/I) (r = -0.55, p < 0.001). On examination of characteristics of insulin receptors on erythrocytes the authors found a reduced number in diabetic subject as compared with the two control groups (p < 0.05). It may thus be concluded from this investigation that the BMI has a decisive role in the action insulin.
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PMID:[The effect of body weight on insulin activity]. 1095 79

The prevalence of hypertension among the obese is twice as high as that in persons of normal weight. Not only the BMI, but, and in particular, the circumference of the waist correlates with blood pressure. A relationship also obtains between BMI and left-ventricular muscle mass, with left-ventricular hypertrophy occurring twelve times more often among the obese than among slim persons. Obesity puts a strain on both the hemodynamics and metabolism of the heart. On the one hand, long-term sequelae include disordered cardiac function extending to cardiomyopathy, on the other, obesity is responsible for sympatho-adrenergic stimulation considered to be a cause of insulin resistance, and is thus, in particular in the hypertensive, closely associated with metabolic syndrome. Specific nondrug treatment options include weight reduction, a low-salt diet and physical exercise. In some cases, Sibutramine and Orlistat may have a supporting role. For the antihypertensive treatment of the obese, drugs with a favorable hemodynamic and metabolic effect should be used.
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PMID:[Hypertension and cardiomyopathy in obesity. Treat the heart simultaneously]. 1169 85

Hyperinsulinaemia and insulin resistance are usually associated phenomena of obesity and the polycystic ovary syndrome (PCO syndrome). On the other hand the PCO syndrome and obesity are often associated with disorders of the menstrual cycle and/or sterility. The authors examined 35 women aged 21 to 38 years (x = 27 +/- 4.4) with a history of anovulation cycles and/or sterility. 24 of them (68.6%) suffered from PCO syndrome. Their mean BMI was 28.95 kg/m2. 11 patients had a normal body weight, 6 were overweight and 18 were obese. The authors used the oral glucose tolerance test (oGTT) and during minute 0 and 120 blood samples were collected for assessment of the blood sugar and plasma insulin. Insulin levels in minute 0 (Io above 20 and in minute 120 (I120) above 65 uIU/ml were classified as hyperinsulinaemia. In the follicular stage of the anovulation cycle the authors assessed FSH, LH, testosterone, progesterone and prolactin. Hyperinsulinaemia ws recorded in 16 of 35 women. The mean insulin level at minute 0 was 11.9 +/- 1.3 and during minute 120 54.2 +/- 8.1 uIU/ml. The authors found significant differences in levels of I0 (6.4 +/- 1.2 vs. 16.1 +/- 1.9 uIU/ml, p < 0.01) and I120 (17.5 +/- 3 vs. 71.3 +/- 10.3 uIU/ml, p < 0.01) between obese and non-obese patients, Also in patients with the PCO there was a statistically significant difference in insulin levels of slim (BMI less than 25) as compared with obese women (BMI more than 30) (p < 0.01). A positive correlation was found between insulin levels and BMI (p < 0.01) and a liminal correlation between insulin and testosterone (p = 0.05). Patients with hyperinsulinaemia were treated with oral antidiabetics from the group of biguanides--metformin for a period of three months. During metformin treatment the insulin level declined and subsequently the menstrual cycle became normal in 11 of 16 patients with hyperinsulinaeia (68.7%), incl. two women who became pregnant. The results indicate a possible new indication of metformin in the treatment of ovarian hyperandrogenism in insulin resistant patients.
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PMID:[Hyperinsulinemia and disorders of the menstrual cycle]. 1196 79

The aim of the study was to determine the serum leptin level and anthropometric indices (body mass index - BMI) in a group of prepubertal children with simple obesity. These parameters were compared with the values characteristic for the group of slim children. The study showed that serum leptin levels were significantly higher in obese children compared with the group of slim children (p<0.0001). There was a positive correlation (r=0.48; p<0.05) between leptin levels and nutritional status indices expressed by BMI. Results of this study suggest that leptin level in the group of children with simple obesity does not have an effect on satiety, on reduction of appetite or on the increment of adipose tissue. The study showed also that hyperleptinemia might be an effect of leptin resistance.
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PMID:[Serum leptin level in prepubertal children with simple obesity. Part one]. 1200 38

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.
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PMID:Approaching healthy body mass index norms for children and adolescents from health-related physical fitness. 1216 76

We examined the extent of coronary heart disease (CHD) risk factor clustering in overweight persons with a body mass index (BMI) of 25 to 29 and an obesity BMI of >/=30 and the influence of this on the hazard of myocardial infarction and coronary mortality. A total of 1,309 men and 739 women aged 30 to 74 years, initially free of cardiovascular disease, comprised the overweight subject group, and 375 men and 356 women comprised the obese subject group at risk. The sample was derived from the original Framingham Study cohort at the 11th biennial examination, and their offspring at initial examination. During 16 years of follow-up of overweight subjects, 188 men and 44 women had CHD events, indicating an age-adjusted rate that was not much different from the slim subjects. In the obese subject group, 72 men and 37 women developed CHD, corresponding to age-adjusted risk ratios 1.48 times that of lean men, and 2.09 times that of lean women. Risk factors were categorized as systolic blood pressure >/=140 mm Hg, total cholesterol >/=240 mg/dl, high-density lipoprotein (HDL) cholesterol <35 mg/dl for men and <40 mg/dl for women, heart rate >80 beats/min, history of smoking, history of type 2 diabetes, and electrocardiographic left ventricular hypertrophy. Being overweight occurred in isolation of CHD risk factors in 22% of men and in 16.4% of women. Being obese occurred in isolation in only 12.8% of men and 9% of women. Clusters of >/=2 risk factors occurred in 56% of obese men and in 62.4% of obese women, a frequency substantially exceeding that in slim subjects. Compared with obese men without risk factors, those with >/=3 factors had a 2.07 age-adjusted relative risk of developing CHD, and obese women had a 10.9 relative risk (p <0.05). Being overweight and obese promotes clusters of CHD risk factors that greatly influence their impact. Global risk assessment can identify high-risk overweight candidates for CHD who most urgently need correction of associated risk factors, as well as sustained weight reduction.
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PMID:Risk stratification of obesity as a coronary risk factor. 1235 80

The aim of the study was to determinate the serum leptin level, glucose concentration, lipids (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride) and thyroid hormones level (triiodothyronine, thyroid stimulating hormone and free thyroxine) in a group of prepubertal children with simple obesity. Fourfold higher leptin concentration in obese (23.3 +/- 11.8 ng/mL) in comparison to a group of slim children (6.8 +/- 2.7 ng/mL), (p<0.0001) was shown. There was no significant difference in serum glucose level (87.3 +/- 9.7 mg/dL) between both studied groups. In obese subjects we showed higher triglyceride, insignificantly lower HDL-C concentrations and invariable other lipid fractions. Mean values of triiodothyronine (T3) were 3.0 +/- 0.7 nmol/L in obese children and 2.8 +/- 0.8 nmol/L in slim children. On the contrary, mean values of thyroid stimulating hormone (TSH) were 2.5 +/- 1.7 mIU/L and 2.8 +/- 0.7 mIU/L in the group of obese and normal children respectively. Free thyroxine (FT4) concentrations in our obese children were lower (11.5 +/- 2.9 pmol/L) than in slim subjects (14.6 +/- 3.1 pmol/L) but were within the reference range. The results obtained indicate that in children with simple obesity there was no dyslipidemia connected with leptin and thyroid hormones levels. However, higher triglyceride and lower HDL-C concentrations suggest a necessity of monitoring the body mass index and lipid profile in these patients.
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PMID:[Serum leptin level in prepubertal children with simple obesity. Part II]. 1263 75

The analysis included 46 women after radical breast amputation because of cancer with which lymphoedema occurred in the upper limb, as well as 51 women in whom no lymphoedema occurred during the period of the observation. Both groups were subjected to a comparative analysis as for height, body mass, and weight-height indexes: BMI, Quetelet, Rohrer, and Pignet-Verwaeck. The results show that women with high body mass, obesity (BMI > 30.0), and high values of the Quetelet (>370), Rohrer (>1.59), and Pignet-Verwaeck (>93.1) indexes are threatened to a significant degree with lymphoedema of the upper limbs after cancer-related mastectomy. On the other hand, slim body build and low index values appear to be a factor protecting from the occurrence of lymphoedema of the upper limb.
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PMID:Influence of some anthropometric parameters on the risk of development of distal complications after mastectomy carried out because of breast carcinoma. 1270 19

This article represents another approach to the topic of obesity in African-American women. It will not give the usual statistical data on obesity in African American women, because as African-American women, it is known that a greater majority is at risk. Instead the article represents a historical, cultural and psychosocial journey in attempting to understand obesity in African-American women from this perspective. The following thoughts are reflective of interactions with African-American women who have struggled with their weight and who have strived to understand the dynamics of their dilemma of being overweight and/or obese in America. This article explains that obesity in African-American women is more than an alteration in ones physiological processes. For some African-American women obesity is the essence of ones being and it has had a deleterious impact on them. Obesity in the African-American woman is not as simplistic as perceived. It is more than the management of the intake of food. Obesity is also more than the type of food that African-American women prepare and consume. Obesity in this sense maybe linked to the very essence of the women's cultural, historical and psychosocial well being. Being large can be a familial characteristic bearing no connection to the consumption and preparation of food. Important to the latter concept, and essential to the understanding of obesity in African-American women, it needs to be remembered that food may have many symbolic meanings. The symbols may be of a cultural and psychological nature and could be consciously unknown to the individual. Whatever the situation, it needs to be clear that for many African-Americans, obesity is not merely a medical problem. Being obese in America, and particularly for African-American women, has a far-reaching effect. It has reek havoc on the cultural psyche of the African-American women. The popular cultural concept conveyed by all types of media, is one of being thin and/or slim.
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PMID:A perspective on obesity. 1285 45


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