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Biomedical subjects

J Parízková

Publications and source records attributed to J Parízková.

At least 19 recordsLinked to original sources
PubMed2005

The influence of n-3 polyunsaturated fatty acids and very low calorie diet during a short-term weight reducing regimen on weight loss and serum fatty acid composition in severely obese women.

Polyunsaturated fatty acids of n-3 series (n-3 PUFA) were shown to increase basal fat oxidation in humans. The aim of the study was to compare the effect of n-3 PUFA added to a very low calorie diet (VLCD), with VLCD only during three-week inpatient weight reduction. Twenty severely obese women were randomly assigned to VLCD with n-3 PUFA or with placebo. Fatty acids in serum lipid fractions were quantified by gas chromatography. Differences between the groups were determined using ANOVA. Higher weight (7.55+/-1.77 vs. 6.07+/-2.16 kg, NS), BMI (2.82+/-0.62 vs. 2.22+/-0.74, p<0.05) and hip circumference losses (4.8+/-1.81 vs. 2.5+/-2.51 cm, p<0.05) were found in the n-3 group as compared to the control group. Significantly higher increase in beta-hydroxybutyrate was found in the n-3 group showing higher ketogenesis and possible higher fatty acid oxidation. The increase in beta-hydroxybutyrate significantly correlated with the increase in serum phospholipid arachidonic acid (20:4n-6; r = 0.91, p<0.001). In the n-3 group significantly higher increase was found in n-3 PUFA (eicosapentaenoic acid, 20:5n-3, docosahexaenoic acid, 22:6n-3) in triglycerides and phospholipids. The significant decrease of palmitoleic acid (16:1n-7) and vaccenic acid (18:1n-7) in triglycerides probably reflected lower lipogenesis. A significant negative correlation between BMI change and phospholipid docosahexaenoic acid change was found (r = -0.595, p<0.008). The results suggest that long chain n-3 PUFA enhance weight loss in obese females treated by VLCD. Docosahexaenoate (22:6n-3) seems to be the active component.

3-Hydroxybutyric Acid↗
PubMed2004

Adiponectin and its role in the obesity-induced insulin resistance and related complications.

It is now generally accepted that adipose tissue acts as an endocrine organ producing a number of substances with an important role in the regulation of food intake, energy expenditure and a series of metabolic processes. Adiponectin is a recently discovered protein produced exclusively by adipocytes. A number of studies have shown that obesity, insulin resistance and atherosclerosis are accompanied by decreased adiponectin levels and that adiponectin replacement under experimental settings is able to diminish both insulin resistance and atherosclerosis. The aim of this review is to summarize the current knowledge about the physiology and pathophysiology of adiponectin and to discuss its potential in the treatment of insulin resistance and atherosclerosis.

Adiponectin↗
PubMed2004

[Serum leptin levels in patients with heroin addiction, the effect of one year of methadone substitution].

BACKGROUND AND AIM: The aim of the study was to explore the influence of heroin addiction and one year methadone maintenance treatment respectively on serum leptin levels. METHODS AND RESULTS: 14 heroin addicted subjects (9 men and 5 women) with average age 27.1 years (variation 22-38 years) and 17 control healthy subjects were included into the study. Mean duration of heroin addiction was 9 years. The subjects were treated for one year with mean daily dose of 90 mg of methadone. Serum leptin levels were measured by enzymoimmunoassay, the rest of the biochemical parameters was measured by standard laboratory methods. Body Mass Index (BMI) was calculated by conventional method (kg/m2). Statistical analysis was performed using t test and paired t test. Serum leptin levels in heroin addicts (7.08 +/- 2.80 ng/ml) did not significantly differ from those of control group (6.10 +/- 1.23 ng/ml). One year of methadone maintenance treatment significantly increased serum leptin levels to 12.10 +/- 3.17 ng/ml vs control group (< 0.05). The same was true for BMI which increased significantly from basal 21.47 +/- 2.54 to 24.61 +/- 2.82 (< 0.05). CONCLUSIONS: Long term addiction to heroin did not change serum leptin levels as compared with control group. One year of methadone maintenance treatment significantly increased serum leptin levels as well as BMI values. We suggest that the increase in serum leptin levels could be explained by the restoration of hypopituitary-hypothalamo-adrenal and/or hypopituitary-hypothalamo-gonadal axis by methadone maintenance treatment. Alternatively, the improvement of nutritional status with subsequent decrease in the infectious complications may be involved.

Adult↗
PubMed2003

Soluble leptin receptor levels in patients with chronic renal failure.

Soluble leptin receptor (SLR) is the extracellular part of the leptin receptor. This protein is released into circulation and constitutes the main circulating leptin-binding protein. The aim of our study was to measure SLR concentrations in patients with chronic renal failure (CRF) and healthy subjects and to explore the relationship of SLR to other hormones and cytokines. The patients with CRF had significantly higher serum leptin, TNF-alpha and insulin levels than healthy subjects (25.1+/-23.5 vs. 9.4+/-7.6 ng.ml(-1) (S.D.); 14.2+/-4.2 vs. 4.55+/-2.5 ng.ml(-1); 39.8+/-36.1 vs. 20.3+/-11.1 mU.l(-1)). Serum soluble leptin receptor levels did not differ between these groups (19.1+/-11.3 vs. 19.6+/-6.1 U.ml(-1)). An inverse relationship between serum SLR and leptin levels was found in both groups. In patients with CRF the inverse relationship between SLR and insulin, body fat content and total protein levels were also found, while in healthy subjects only inverse relationship of SLR with insulin and albumin concentrations were detected. We conclude that soluble leptin receptor levels in patients with chronic renal failure do not differ from those of healthy subjects despite higher serum leptin levels in CRF patients. The physiological consequences of this finding require further investigation.

Blood Proteins↗
PubMed2003

[Leptin levels in female patients with restrictive and purgative types of anorexia nervosa].

BACKGROUND: Anorexia nervosa is an eating disorder with typically chronic course. Two subtypes of anorexia nervosa have been described based on the pattern of eating behavior. Restrictive form of anorexia nervosa is characterized by chronically decreased food intake, while the purgative subtype typically consists of alternating episodes of fasting and overnutrition with factitious vomiting. METHODS AND RESULTS: The aim of this study was to compare anthropometric parameters, serum levels of fat-derived hormone leptin, cholesterol, triacylglycerols and serum leptin/body mass index ratio in patients with restrictive and purgative subtypes of anorexia nervosa respectively. Significantly lower body weight (37.79 +/- 3.93 vs. 49.63 +/- 9.84 kg, p < 0.05), body mass index (13.51 +/- 1.43 vs. 17.75 +/- 2.64 kg/m2, p < 0.05),), body fat percentage (13.28 +/- 2.83 vs. 18.9 +/- 5.65%, p < 0.05), serum leptin (1.117 +/- 0.95 vs. 5.88 +/- 4.7 ng/ml, p < 0.05) and cholesterol levels (4.14 +/- 1.78 vs. 6.31 +/- 1.27 mmol/l, p < 0.05) were found in patient with restrictive relative to purgative subtype of anorexia nervosa. In contrast, no difference in triglyceride levels between both groups was found. Serum leptin levels positively correlated with body mass index and body fat percentage only in patients with purgative subtype of anorexia nervosa (body mass index r = 0.95, p < 0.001, body fat percentage r = 0.64, p < 0.05) but not in those with restrictive subtype. CONCLUSIONS: In conclusion, we demonstrated that serum leptin levels were significantly lower in restrictive relative to purgative subtype of anorexia nervosa. We suggest that this difference is primarily due to distinctions in body fat content.

Adult↗
PubMed2002

The responses of serum and adipose Fatty acids to a one-year weight reduction regimen in female obese monozygotic twins.

We have reported strong intrapair resemblances (IPRs) in serum phosphatidylcholine (PC) fatty acid composition within adult monozygotic twins living apart. This study assessed the contribution of genetic factors to changes in serum and adipose tissue fatty acids resulting from weight loss and followed by a subsequent year of weight maintenance. Eleven pairs of female obese monozygotic twins (age: 38.9 +/- 1.8; BMI: 32.5 +/- 0.9) were recruited for the study. Fasting serum and adipose tissue were obtained after 1 week of inpatient stabilization, after 1 month of inpatient very-low-calorie diet (VLCD), and again after 1 year of outpatient weight maintenance. Fatty acids in serum lipid fractions and adipose tissue were quantitated by gas chromatography. Using multiple regression adjusted for age and initial value, IPRs were determined for the changes induced by VLCD and by the year of weight maintenance. There were few IPRs in nonessential fatty acids. By contrast, there were numerous IPRs for essential fatty acids (EFA), especially in the n-3 family across the VLCD. Following the maintenance year, however, frequent IPRs for nonessential fatty acids were seen, particularly in serum PC, and strong IPRs were seen for 18:3 n-3 and 20:5 n-3 across multiple fractions. These results infer the existence of strong genetic factors determining both the nonessential and EFA compositions of tissue lipids in humans independent of diet. Of particular note were the consistent IPRs for n-3 fatty acids despite dietary stress, indicating that the conservation and distribution of this EFA family are subject to considerable genetic variance in humans.

Adipose Tissue↗
PubMed2002

Serum cortisol and sex hormone binding globulin (SHBG) levels, body fat distribution and the role of genetic factors in obese females.

Fasting plasma levels of both cortisol and sex hormone binding globulin (SHBG) in obese women were significantly inversely related to anthropometric characteristics of body fat distribution. It means that a central accumulation of body fat might be partly mediated by cortisol and SHBG levels. Significant within-pair resemblance observed in plasma cortisol level in obese female monozygotic twins suggests an important role of genetic factors in determination of cortisol secretion. However, no within-pair similarities revealed in plasma SHBG concentrations favour a major role of environmental factors in the regulation of plasma SHBG level. On the other hand the twin study supported the role of genetic determinants in changes of both cortisol and SHBG levels in response to energy deficit induced by very low calorie diet (VLCD). The mechanisms controlling baseline levels of cortisol and SHBG apparently differ from those controlling their responses to energy restriction.

Adipose Tissue↗
PubMed2002

Adipose tissue distribution in obese females. Relationship to androgens, cortisol, growth hormone and leptin.

Adipose tissue distribution predicts development of obesity complications better than total adipose tissue content. The aim of the study was to evaluate the role of the hormonal factors contributing to the adipose tissue distribution in obese females. The cohort examined consisted of 94 women in the range of overweight to obesity, aged 44.2 +/- 11.2 years (21-67), weight 100.1 +/- 17.5 kg (65.8-148), BMI 37.13 +/- 5.72 kg/m2 (26.4-50.7). Adipose tissue (AT) distribution was examined by CT at level L4/5 and intraabdominal adipose tissue and the subcutaneous abdominal adipose tissue area (IAAT and SAAT, respectively) were determined. Growth hormone (GH), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), cortisol, testosterone, androstene-dione, SHBG, total thyroxine, total triiodothyronine (T3), TSH and leptin were assessed by routine methods by RIA and CLIA. GH, DHEA and DHEA-S correlated significantly negatively with IAAT (r = -0.24, p < 0.05, r = -0.30, p < 0.01, r = -0.34, p < 0.005, respectively). A borderline significant negative correlation of T3 with IAAT was shown (r = -0.20, p = 0.054). A significant positive correlation of SAAT with total testosterone and serum leptin was found (r = 0.27, p < 0.01, r = 0.64, p < 0.001, respectively). When comparing the difference of individual hormone levels between the 1st and 5th quintile of IAAT, no significant difference between the groups was found after adjustment for weight and age. In contrast, when comparing the 1st and 5th quintile according to the SAAT a significantly lower total testosterone and leptin in the 1st quintile of SAAT was found. Only in leptin the difference remained significant after adjustment for adipose tissue content. In conclusion, the results suggest that the relationship of individual hormones examined in this study to the central adipose tissue distribution are mostly mediated by age and adipose tissue content; they do not seem to be in a causal connection with the intraabdominal adipose tissue content. The only exception concerns leptin, which is significantly related to the subcutaneous abdominal adipose tissue area.

Adipose Tissue↗
PubMed2001

A twin study of weight loss and metabolic efficiency.

OBJECTIVE: To assess the genetic contribution to determinants of therapeutic weight loss in obese female identical twins. DESIGN: Subjects were studied for 40 days on an inpatient unit in three phases: 7 baseline days; 28 days of weight reduction by a very low calorie diet (1.6 MJ per day); and 5 days after weight reduction. SUBJECTS: Fourteen pairs of premenopausal obese female identical twins (age: 39.0+/-1.7 y; body weight (BW): 93.9+/-21.2 kg; body mass index (BMI): 34.2+/-7.8 kg/m2). MEASUREMENTS: : Body composition by hydrodensitometry and resting metabolic rate by indirect calorimetry were assessed before and after weight loss. RESULTS: : There was great variability among pairs in loss of weight (5.9-12.4 kg) and body fat (3.1-12.4 kg). By contrast, the intraclass correlation (ICC) within twin pairs was 0.85, P<0.001 for weight and 0.88, P<0.001 for body fat. A measure of metabolic efficiency, calculated as the difference between 'estimated' and 'measured' energy deficit showed high intrapair correlation (ICC=0.77; P<0.001). CONCLUSIONS: The high correlation in metabolic efficiency within twin pairs in response to therapeutic weight loss suggests a strong genetic contribution.

Adult↗
PubMed2001

The within-pair resemblance in serum levels of androgens, sex-hormone binding globulin and cortisol in female obese identical twins - effect of negative energy balance induced by very low-calorie diet.

The first aim of the present study was to evaluate the changes in serum levels of cortisol, testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEA-S) and sex hormone-binding globulin (SHBG) in response to weight loss induced by one month of treatment with a very low-calorie diet (VLCD) in twelve pairs of female obese monozygotic twins. The second aim of the study was to investigate any within-pair resemblance in serum levels of steroids and SHBG before and after a negative balance protocol, as well as the resemblance in changes in response to therapeutic weight loss. VLCD-induced weight loss of 8.7+2.9 kg was associated with significant increases in serum testosterone (p<0.05) and SHBG (p<0.001) levels, whereas no significant changes in serum levels of cortisol, DHEA and DHEA-S were observed. Significant within-pair resemblances for both pre-treatment and post-treatment concentrations were revealed for DHEA-S (pre-treatment ICC = 0.795, p < 0.01, post-treatment ICC = 0.712, p < 0.01) and for testosterone (pre-treatment ICC = 0.594, p <0.05, post-treatment ICC = 0.735, p < 0.01). The baseline within-twin-pair resemblance in serum cortisol level at 7 a.m. (ICC=0.747, p < 0.05) was lost with VLCD treatment, while its concentration at 9 p.m. developed a within-pair similarity with weight loss (ICC = 0.824, p < 0.001). Similarly, VLCD treatment led to a significant within-pair resemblance in post-treatment level of DHEA (ICC = 0.755, p < 0.01), while no within-twin-pair resemblance was shown for either pre-treatment or post-treatment SHBG levels. None of the hormones measured exhibited any within-pair resemblance in response to VLCD-induced energy deficit, except for serum cortisol levels. A significant within-twin-pair resemblance in the changes in serum cortisol levels at 7 a. m. (ICC = 0.789, F = 8.5, p < 0.001), at 1 p.m. (ICC = 0.660, F = 4.9, p <0.01) and at 9 p.m. (ICC = 0.795, F = 8.8, p <0.001) were demonstrated even after adjustment for fat mass loss. An absence of any within-pair similarity was observed in both pretreatment and post-treatment levels of SHBG, while a significant within-pair resemblance in SHBG response to VLCD treatment (ICC = 0.658, p < 0.05) was recorded. We conclude that the significant within-twin-pair resemblance demonstrated for androgens and cortisol might suggest an important role for genetic factors in the regulation of their serum levels. Our results also suggest that the mechanisms controlling baseline levels of cortisol and SHBG differ from those influencing their responses to energy deficit induced by VLCD.

Adipose Tissue↗
PubMed2000

[Serum leptin levels and soluble leptin receptors in female patients with anorexia nervosa].

BACKGROUND: Leptin action in peripheral tissues is enabled by an interaction with specific transmembrane receptors. Several of leptin receptor isoforms were identified, including soluble leptin receptor isoform structurally identical to extracellular domain of the the long leptin receptor isoform. The soluble receptor isoform is released to the circulation and acts probably as leptin-binding factor. The aim of our study was to measure serum concentrations of the soluble leptin receptor in patients with anorexia nervosa and in the control group of healthy women. Relationships of soluble leptin receptor levels to body mass index (BMI), body fat content, serum leptin, TNF-alpha and insulin levels were also studied. METHOD AND RESULTS: 16 patients with anorexia nervosa and 16 age-matched lean healthy women were included into the study. All of the subjects were measured and weighed, the body fat content was estimated from the skinfold thickness measurement. The blood for the determination of leptin, soluble leptin receptor and other hormonal parameters was obtained from all subjects after the overnight fasting. BMI, body fat content, serum leptin and insulin levels in patients with anorexia nervosa were significantly lower than in the control group (BMI: 14.98 +/- 2.32 vs. 22.21 +/- 2.48, p < 0.01, % fat content: 16.43 +/- 4.56 vs. 27.19 +/- 4.59, p < 0.01, leptin: 1.37 +/- 1.85 ng.ml-1 vs. 7.19 +/- 3.49 ng.ml-1, p < 0.01, insulin: 12.97 +/- 2.89 mU.l-1 vs. 17.09 +/- 5.57 mU.l-1, p < 0.05). Serum soluble leptin receptor levels in patients with anorexia nervosa were significantly higher compared the to control group (24.67 +/- 8.3 U.ml-1 vs. 15.71 +/- 2.79 U.ml-1, p < 0.01). No significant differences in serum TNF-alpha levels between the groups studied were found. Serum leptin levels in both groups correlated positively with BMI and body fat content. Serum soluble leptin receptor levels in both groups correlated negatively with BMI only. No statistically significant relationships between serum soluble leptin receptor levels and the rest of parameters studied were found in any of the groups studied. CONCLUSIONS: Serum soluble leptin receptors levels in patients with anorexia nervosa were significantly higher in comparison with the healthy subjects. Except of the negative correlation between serum soluble leptin receptor levels and BMI no statistically significant relationships between serum soluble leptin receptor and the rest of parameters studied were found.

Anorexia Nervosa↗
PubMed2000

Intrapair resemblance in very low calorie diet-induced weight loss in female obese identical twins.

OBJECTIVE: To assess intrapair resemblance in changes of body weight, total body fat, fat distribution, resting metabolic rate, fasting respiratory quotient and cardiovascular disease risk factors in response to therapeutic weight loss in female obese identical twins. DESIGN: Patients stayed for 40 days on an inpatient metabolic unit under careful supervision. The stay was divided into three parts: an initial period of 7 days for adjustment to the hospital environment and for baseline measurements, 28 days of the weight reduction regimen when negative energy balance was achieved mainly by a very low calorie diet (1.6 MJ per day) and 5 days of testing after weight reduction. SUBJECTS: Fourteen pairs of premenopausal female obese identical twins (age: 39.0+/-1.7 y; body weight (BW): 93.9+/-21.2 kg; body mass index (BMI): 34.2+/-7.8 kg/m2) participated in the study. MEASUREMENTS: Before and after weight loss, the following measurements were made: body composition by anthropometry and hydrodensitometry, intra-abdominal fat by ultrasonography, resting metabolic rate by indirect calorimetry. Total cholesterol, high-density lipoprotein-cholesterol, triglycerides and uric acid were determined by standard laboratory procedures. Blood pressure was measured in the morning in the recumbent position. RESULTS: Subjects lost 8.8+/-1.9 kg of weight, from 93.9+/-21.2 to 85.1+/-10.9 kg (P<0.0001) and 6.5+/-2.3 kg of body fat (P<0.001). Weight losses varied widely among subjects, with a high correlation between losses of members of twin pairs for body weight (r=0.85; P<0.001) and for body fat (r=0.88; P<0.0001). Changes in uric acid resulting from weight loss were also correlated among members of twin pairs whereas changes in blood pressure, cholesterol and triglycerides were not. CONCLUSION: The great intrapair resemblance observed in very low calorie diet-induced weight and fat losses in female obese identical twins suggests an important role of genetic factors in response to the weight reduction regimen.

Adipose Tissue↗
PubMed2000

Dietary habits and nutritional status in adolescents in Central and Eastern Europe.

The overall situation as regards dietary intake and nutritional status in the countries of Central and Eastern Europe has varied considerably during previous decades; however, after the political, social and economic changes during the nineties these differences have increased further, especially in the areas with low GDP and war, and in the regions affected by radionuclides etc. No systematic surveillance systems in representative samples of adolescents were in effect at the beginning of the nineties in Central and Eastern Europe. There exists relatively more data on nutritional status characterized by body mass index (BMI) and skinfold thickness measurements. Food intake has mainly been followed in smaller samples of adolescents, and or in special groups (athletes, obese, vegetarians, allergies, Romanies, pupils of special schools etc.). In the countries and/or areas with sufficient GDP and income the food intake has most often been too abundant when considering the real needs of the growing organism, especially from the point of view of energy output. The composition of the diet is not adequate, i.e. too much protein, fats, sugar etc. This situation is similar to that in Western countries, USA etc. On the other hand, adolescents in Central and Eastern Europe consume too few vegetables, fruit and milk products in their diet (i.e. low intakes of Ca, fibre and vitamin C), which is less apparent in Western countries. This is mainly due to bad eating habits and nutritional traditions in the families, but also due to the changes of the prices of the mentioned foodstuffs after political and economic changes in this part of the world. Certain nutritional deficiencies were also shown as factors increasing the health risks from the Chernobyl disaster, mainly in the Ukraine, Belorussia and certain parts of Poland.

Adolescent↗
PubMed2000

Respiratory quotient in obesity: its association with an ability to retain weight loss and with parental obesity.

A high fasting respiratory quotient (RQ) was observed during the treatment by very low calorie diet (VLCD) in obese patients who regained weight at two-year follow-up (weight regainers) or in those who exhibited repeated cycles of weight loss with a subsequent weight regain (weight cyclers). In contrast obese patients who succeeded to retain the weight loss achieved initially by the VLCD at 2-yr follow-up (weight losers) or those who did not exhibit weight fluctuations (weight noncyclers) were characterized by a significantly lower RQ. Therefore a high fasting RQ during the VLCD treatment should be considered predictive of body weight gain. Resting metabolic rate (RMR) expressed per kg fat free mass (FFM) did not influence body weight changes. A high RQ revealed in obese subjects reporting parental obesity and a low fasting RQ observed in those obese without family history of obesity suggest a role of hereditary factors in the ability to oxidize fat in severely obese subjects. In contrast, parental history of obesity did not affect RMR in severely obese individuals.

Adult↗
PubMed1998

Clinical guidelines for diagnosis and management of obesity in the Czech Republic.

Guidelines for the management of obesity include recommendation about diet, exercise, behavioral modification, drug therapy and bariatric surgery in the comprehensive management of an obese patient. It is emphasized that the treatment of obesity should be individually tailored according to the age of the patient, degree and phase of obesity, body fat distribution and an expression of risk factors and comorbidities. The new realistic goals in obesity management do not focus on the weight loss per se but mainly on the risk factors reduction which accompanies even modest weight loss. The system of obesity management introduced in the Czech Republic includes obesity management centres attached to major teaching hospitals, obesity out-patient clinics (led by an obesity specialist), primary care physicians and weight reduction clubs. Postgraduate training in obesity management should be recognized by health authorities as a function specialty. A time demanding therapeutic strategy in obesity management should be taken into account by both health policy makers and health insurance companies.

Czech Republic↗
PubMed1998

Long-term treatment of obesity in the obesity unit.

A group of 318 obese patients followed-up at the Obesity Unit in Prague in 1995-1997 was included into a study. Their treatment was based on the standard combination of a weight reduction diet, physical activity and behavioural intervention. In patients with more severe degrees of óbesity VLCD in one daily portion, pharmacotherapy, in-patient regimen lasting 24 days, including VLCD (1,500 kJ/day), exercise and group psychotherapy; or bariatric surgery (mostly laparoscopic gastric banding) were used, if necessary. Patients were divided into two groups according to their compliance to the weight reducing regimen. Group A dropped out before 2 years of follow-up, group B was followed-up 2 years or more. The groups did not differ significantly in their mean age, initial body weight, initial BMI and fat content and in percentage of males and females. Weight, BMI, fat content, essential anthropometric indices (waist circumference, WHR, subscapular and triceps skinfolds) and blood pressure are presented in this study. The maximum weight loss was significantly higher in group B. We did not find any other significant differences between group A and group B. The most significant predictor of compliance expressed as duration of follow-up (evaluated by multiple regression with stepwise variable selection) was the maximum BMI decrease (p < 0.005). The most significant predictors of the weight loss at the end of the follow-up were maximum weight loss and maximum decrease of BMI (p < 0.001). Family history of obesity (obese one or both parents) was significantly more often in group B (p < 0.05). This trend was expressed predominantly in females (p < 0.01), where also family history of obesity in mother was significantly more often in group B (p < 0.05). The frequency of methods used in individual patients was estimated. Standard combination of diet, enhanced physical activity and behavioural intervention was used in all patients. All other methods were used significantly more frequently in group B. In group A in-patient treatment was significantly more often used in men. The in-patient treatment promotes the compliance with the therapeutic regimen in women significantly more effectively than in men.

Adult↗
PubMed1997

[Health risks and economic costs associated with obesity requiring a comprehensive weight reduction program].

An increasing prevalence of obesity all over the world reflects a lack of effective measures in both prevention and treatment of obesity. Obesity as a disease has been underestimated by the lay-public as well as health care providers. However, obesity represents a substantial health problem associated with a decreased quality of life. Obesity is linked to numerous chronic diseases (cardiovascular diseases, diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel, breast and genitourinary cancers) that lead to premature disability and mortality. Health risks increase with a body mass index (BMI) over 25 in individuals 19-35 years of age and with a BMI over 27 in those 35 years of age and older. Health risks also increase with an excess accumulation of visceral fat manifested as an increase in waist circumference (> 100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00 for males). According to studies carried out in different countries current economic costs of obesity represent 5-8% of all direct health costs. In contrast, effective treatment of obesity results in a substantial decrease in expenditures associated with pharmacotherapy of hypertension, diabetes, hyperlipidemia and osteoarthritis. Both scientists and clinicians involved in obesity research and treatment recommend to introduce the long-term weight management programs focussing more on the overall health of the participants than the weight loss per se. Therefore, it will be necessary to establish new realistic goals in the obesity management that reflect reasonable weights and recently experienced beneficial health effects of modest (5-10%) weight loss. Comprehensive obesity treatment consisting of low fat diet, exercise, behavioral modification, drug therapy and surgical procedures requires differentiated weight management programs modified according to the degree and type of obesity as well as to current health complications present. The Czech Society for the Study of Obesity defined a comprehensive weight reduction program carried out in weight reduction clubs, out-patient obesity clinics and in specialized departments attached to the university hospitals. In order to provide an integrated knowledge from many different disciplines connected with obesity three week postgraduate course has been organized for physicians involved in obesity management. Even the most spread weight reduction clubs in our country (STOB) are supervised by the trained counselors. The main goal of different weight management programs is to find out optimal approaches leading to long-term beneficial outcome and ameliorating the variety of disorders associated with obesity.

Health Care Costs↗