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Query: UMLS:C0497406 (overweight)
 26,365 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nutritional status is known to alter immune function, a suspected risk factor for non-Hodgkin lymphoma (NHL). To investigate whether long-term over, or under, nutrition is associated with NHL, self-reported anthropometric data on weight and height from over 10,000 cases of NHL and 16,000 controls were pooled across 18 case-control studies identified through the International Lymphoma Epidemiology Consortium. Study-specific odds ratios (OR) were estimated using logistic regression and combined using a random-effects model. Severe obesity, defined as BMI of 40 kg m(-2) or more, was not associated with NHL overall (pooled OR = 1.00, 95% confidence interval (CI) 0.70-1.41) or the majority of NHL subtypes. An excess was however observed for diffuse large B-cell lymphoma (pooled OR = 1.80, 95% CI 1.24-2.62), although not all study-specific ORs were raised. Among the overweight (BMI 25-29.9 kg m(-2)) and obese (BMI 30-39.9 kg m(-2)), associations were elevated in some studies and decreased in others, while no association was observed among the underweight (BMI < 18.5 kg m(-2)). There was little suggestion of increasing ORs for NHL or its subtypes with every 5 kg m(-2) rise in BMI above 18.5 kg m(-2). BMI components height and weight were also examined, and the tallest men, but not women, were at marginally increased risk (pooled OR = 1.19, 95% CI 1.06-1.34). In summary, whilst we conclude that there is no evidence to support the hypothesis that obesity is a determinant of all types of NHL combined, the association between severe obesity and diffuse large B-cell lymphoma may warrant further investigation.
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PMID:Non-Hodgkin lymphoma and obesity: a pooled analysis from the InterLymph Consortium. 1844 86

The etiology of morbid obesity is multifactorial and is related to inheritance, physiology, metabolism, sociocultural, behavioral, and psychological factors. In China, the incidence of obesity is increasing with the improvement of the standard of living each year. The USA is known as the nation that has a high prevalence of overweight and obese individuals, as indicated from the Nutrition and Health Status report. Obesity in China is a growing phenomenon that cannot be ignored. In this paper, we review the relatively new concept of bariatric surgery in China.
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PMID:The new concept of bariatric surgery in China--reevaluation of surgical indications and criteria of therapeutic effect of laparoscopy for treatment of obesity. 1844 91

Obesity is a chronic endocrine-metabolic disease with a multifactorial etiology and a polygenetic basis, whose complex patophysiologic mechanism causes numerous complications. Fat tissue is a gland which "communicates" intensively with the whole organism. It secretes adipokines which have an endocrine, paracrine and autocrine function. In obesity, adipokine synthesis, secretion into the blood and effect on the target tissues and organs is impaired, leading to development of complications in all organic systems. Pandemic levels of obesity and overweight are such that both in developed and developing countries only a small part of the population has normal body weight. In Croatia every fifth adult is obese, and overall 2/3 of men and little more than 1/2 of women have body weight greater than normal. Mortality rises with BMI >25 kg/m2 and in obese persons it is 1.5-2 times greater, while in persons with morbid obesity (BMI >40 kg/m2) the life expectancy is 5-15 years shorter. Treatment of obesity is a long-term endeavor and requires the participation of physicians of various specialties. The Croatian Obesity Society held the 3d Croatian Congress on Obesity with international participation in Opatija from 4-6 April. The main topics of discussion were obesity epidemiology and diagnostics, patophysiologic mechanisms, complications, mortality and disease treatment. The National Programe for Countering the Obesity Epidemic was presented. At the end of the Congress the 3d National Consensus on Diagnostics and Treatment of Obesity was adopted. It incorporated some changes compared to the previous 2006 Consensus. The new obesity treatment guidelines take individual needs and capabilities more into account, with the aim of increasing the success of the treatment.
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PMID:[Comment on Croatian National Consensus on Diagnosis and Treatment of Obesity]. 1914 82

As a consequence of the rising global prevalence and magnitude of obesity, a greater proportion of patients presenting for cardiac surgery is morbidly obese. Being overweight (body mass index; BMI 25-29.9 kg/m(2)) or obese (BMI 30-35 kg/m(2)) appears to confer some survival benefit following cardiac surgery. By contrast, morbid obesity (BMI >40 kg/m(2)) is associated with an increased likelihood of postoperative complications and prolonged intensive care unit and hospital length of stay. The physical difficulties encountered when managing this group of patients is exemplified by those undergoing complex, multiple procedures requiring prolonged cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). We present the successful management of a massively obese 19-year-old male (BMI 45 kg/m(2)) with Marfan's syndrome who required aortic root and arch replacement under DHCA. The selection of extracorporeal circuit components to accommodate a large circulating volume and permit high CPB flow rates (>9 l/min) is discussed.
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PMID:Cardiopulmonary bypass and deep hypothermic circulatory arrest in a massively obese patient. 1918 58

The prevalence of obesity is increasing globally, with nearly half of a billion of the world's population now considered to be overweight or obese. Obesity and overweight patients are one of the major health issues in Canada, resulting in approximately 57,000 deaths related to obesity over the last 15 years. The effect of obesity on outcomes following liver transplantation remains largely unclear. To determine the effect of obesity on outcome we reviewed 167 liver transplants, performed at the Vancouver General Hospital, between February 1999 and October 2003. Severe obesity was defined as body mass index (BMI) > 35 kg/m2 and moderate obesity as BMI of 30 - 34 kg/m2. One hundred forty three transplants were performed in patients with a body mass index (BMI) < 30 kg/m2, 14 in patients with a BMI of 30 - 34 kg/m2, and 10 in patients with a BMI > 35 kg/m2. Non-weight related patient demographics were similar between the groups. A very high proportion of Hepatitic C patients (7/10) were observed in the severely obese group. In the early postoperative course severely obese patients had a higher rate of wound infection (20% vs. 4%, p = 0.0001) and wound dehiscence (40% vs. 1.2%, p = 0.0001). Within the first twelve postoperative months severely obese liver transplant recipients had a higher rate of ventral wound herniation (30% vs. 2.8%, p = 0.0001) when compared to obese or non-obese recipients. The one-year graft and patient survival were similar to non-obese patients. An increased BMI in liver transplant recipients in our centre did not increase the risk of early postoperative mortality, but did increase surgical complications, such as wound infection and wound dehiscence. The 1-year patient and graft survival however was indistinguishable from those of non-obese patients.
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PMID:Surgical morbidity in severely obese liver transplant recipients - a single Canadian Centre Experience. 1922 32

This study aims to determine if morbid obesity increases morbidity in abdominoplasty. Upon examining 200 patients, 100 morbidly obese and 100 overweight and obese, it was found that there is no difference in the complication rate between the two categories. It was also found that, when compared to global rates of complication, there is no difference in the rate of complication of dermolipectomy as a whole in non-obese patients. However, co-morbid diseases are more correlated to complication. This article concludes with a remark that although morbid obesity should not preclude abdominoplasty, patients benefit from the operation even when it is performed as a functional operation and not as a cosmetic procedure.
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PMID:Abdominoplasty in obese and in morbidly obese patients. 1934 81

Cushing disease is exceedingly rare in children, especially in those under the age of 2 years. This case report describes an 18-month-old female child who presented with morbid obesity, decreased linear growth, and reversal of developmental milestones. Her diagnosis was delayed; however, she was successfully treated by surgical excision of the microadenoma. This was followed by resolution of signs and symptoms of Cushing syndrome. Although the patient's hypertension resolved, linear growth improved and development began to progress, she is still developmentally delayed and now has hypopituitarism. Review of this case, as well as a handful of other cases of infantile Cushing disease in the literature, suggests that features such as hypertension and slowed linear growth, which are rare in nutritional causes of obesity in infants, can help identify this rare, but life-threatening, illness among an increasing number of overweight infants.
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PMID:Cushing disease in a toddler: not all obese children are just fat. 1952 Dec 41

Morbid obesity and diabetes cause diastolic dysfunction that can be detected by Doppler echocardiography. Patients with the metabolic syndrome could demonstrate early diastolic dysfunction that may influence effort tolerance. A total of 32 patients (17 men) who fulfilled >/=2 of the 5 metabolic syndrome criteria were studied. The average age of patients was 37+/-2 years. All patients were overweight/obese (mean body mass index of 34.4+/-0.7 kg/m(2)), 15 had blood pressure >130/85 mm Hg, 19 had elevated triglyceride levels (>150 mg/dL), and 17 had low high-density lipoprotein cholesterol levels (men <40 mg/dL, women <50 mg/dL). Maximal exercise was performed using Bruce treadmill protocol with standard stress echocardiography and tissue Doppler. Maximal oxygen consumption (VO(2max)) was measured using indirect calorimetry. Left ventricular filling pressure was indirectly derived from dividing pulse Doppler early mitral inflow velocity (E) by tissue Doppler early diastolic mitral annular motion (E') or E/E'. The group's average treadmill time was 8.06+/-0.28 minutes, VO(2max) was 28.6+/-1.1 mL/kg/min, and 8.2+/-0.3 metabolic equivalents. None had evidence of myocardial ischemia or systolic or diastolic dysfunction with exercise. Mean "resting" E/E' and "post-exercise" E/E' were 7.01+/-0.04 and 7.41+/-0.41, respectively. There was no significant correlation between resting E/E' and VO(2max) (r=-0.266; P=.14). The post-exercise E/E' significantly correlated with VO(2max) (r=-0.483; P=.005) and metabolic equivalents (r=-0.487; P=.005). Diastolic function is preserved in early metabolic syndrome. Even in the normal diastolic function range, exercise E/E' is inversely related to VO(2max). Further longitudinal studies are needed to determine whether they develop diastolic dysfunction and related heart failure.
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PMID:Correlation of Normal Diastolic Cardiac Function With VO in the Metabolic Syndrome. 1952 60

Pseudohypoparathyroidism (PHP) covers a heterogeneous group of disorders, which have in common resistance to parathyroid hormone (PTH). However, they differ in many aspects such as site of the defect in signal transduction, clinical picture (with or without Albright's hereditary osteodystrophy (AHO)), extension of hormone resistance, and the tissue activity of protein Gs. PHP type Ic, a rare subtype, is characterized by resistance to several hormones, the presence of AHO, and normal activity of protein Gs. We present the case of a patient with PHP type Ic. Although resistance to TSH was suggested at the age of 12 months, diagnosis was made when she presented with hypocalcemia and resistance to PTH. Resistance to GH was also detected, and partial resistance to gonadotropins became clear after puberty. We demonstrated a defective lipolytic response to epinephrine, suggesting a role of this resistance in the pathogenesis of her morbid obesity. In view of the difficulties in the management of overweight in this disorder, treatment with a cannabinoid receptor type 1 (CB1) antagonist was started, and it proved to be highly effective, lowering the patient's body mass index from 40.5 to 33.5, which was quite impressive. We propose that an underactive melanocortin-4 receptor, which is found in certain patients with PHP, leads to upregulation of the CB1 receptor and consequently to a good response to treatment with CB1 antagonists. Another interesting finding was the GNAS mutation that was identified in this patient. A nonsense mutation resulted in a truncated Gsa that was able to stimulate adenylyl cyclase efficiently, but could not bind to receptors in a normal way.
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PMID:Resistance to epinephrine and hypersensitivity (hyperresponsiveness) to CB1 antagonists in a patient with pseudohypoparathyroidism type Ic. 2007 45

The epidemic of childhood obesity is associated with an increased incidence of cardiovascular risk factors, adult obesity, and obesity-related comorbidity. In this review article we highlight existing data on approaches to the management of childhood obesity. There are currently three main treatment modalities for childhood obesity: a) lifestyle modifications, which include exercise, diet, counseling, and combination of these, b) pharmacotherapy, which may have a role in a select group of overweight adolescents, and c) bariatric surgery. The three main drugs currently considered for treatment of pediatric obesity are orlistat, sibutramine and metformin. Only the first two are currently approved by the Food and Drug Administration (FDA) for the long-term treatment of obesity. Safety and efficacy have not been determined beyond 4 years for orlistat and 2 years for sibutramine. Bariatric surgery in pediatric patients with morbid obesity results in sustained and clinically significant weight loss but also has the potential for serious complications. Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric binding (LAGB) are the two main surgical procedures which have been used in pediatric obesity. RYGB is considered a safe and effective option for extremely obese adolescents as long as appropriate long-term follow-up is provided. LAGB has not been approved by FDA for use in adolescents, and therefore should be considered investigational. Finally, sleeve gastrectomy, another type of weight loss surgery, which has gained significant appreciation in adults, should be also considered investigational; existing data are not sufficient to recommend widespread and general use in adolescents.
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PMID:Recent concepts of pharmacotherapy and bariatric surgery for childhood obesity: an overview. 2011 89


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