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Biomedical subjects

K Widhalm

Publications and source records attributed to K Widhalm.

At least 73 records · Page 4Linked to original sources
PubMed1991

Precipitation with polyethylene glycol and density-gradient ultracentrifugation compared for determining high-density lipoprotein subclasses HDL2 and HDL3.

The purpose of this study was to compare quantification of cholesterol in high-density lipoprotein subfractions HDL2 and HDL3 by precipitation with polyethylene glycol (PEG) with that by density-gradient ultracentrifugation. Fresh serum samples from 32 fasting, obese children were analyzed with precipitation reagent "Quantolip" (Immuno AG), and then fractionated with a Beckman TL 100 ultracentrifuge with a swinging-bucket rotor. After centrifugation we carefully removed the supernate with a syringe and measured the cholesterol from each fraction enzymatically with CHOD-PAP reagent (Boehringer Mannheim). The low-density lipoprotein (LDL-), HDL2-, and HDL3-cholesterol values measured by ultracentrifugation did not differ significantly from those obtained by precipitation; the correlation coefficients (r) between the two methods were 0.96 for LDL, 0.75 for HDL2, and 0.96 for HDL3. The relatively simple PEG precipitation method used in this study measures total HDL and its major subclasses HDL2 and HDL3 with accuracy and precision comparable with those of the well-established ultracentrifugation method.

Adolescent↗
PubMed1990

[Atherosclerosis Risk Factors Intervention Study Strass (ARIS)].

Mortality due to cardiovascular disease in Austria amounted to 53.7% of the overall mortality in 1986. Elevated cholesterol, cigarette smoking and hypertension are the main risk factors. In order to estimate the prevalence of these risk factors and to evaluate the effectiveness of intervention strategies, we started the ARIS (in Strass, Lower Austria) in 1987/88. 568 participants (56.7% female, 43.3% male) were asked some questions concerning their cardiovascular status; blood pressure and 22 laboratory parameters were measured (including the serum lipid profile). Doppler sonography of the carotid arteries was performed in participants older than 60 years of age (n = 229). The mean values were: cholesterol: 220.3 +/- 45 mg/dl, systolic blood pressure: 147 +/- 45 mmHg, diastolic blood pressure: 88 +/- 29 mmHg. The percentage of smokers was 18.7%. A positive family history of coronary heart disease was reported by 32.7%. Stenosis (greater than 50%) of the carotid artery was discovered in 7 cases. After this initial examination we started an information campaign at regular two-monthly intervals with around 100 participants a time. As a first result a changed consumer behaviour was observed with respect to foods. The effectiveness of the intervention trial will be seen on evaluation of annual follow-up examinations over a 10-year period in the first place.

Adolescent↗
PubMed1990

[Cholesterol, triglycerides and lipoproteins in the serum of healthy, normal weight children between 6 and 12 years of age].

Serum cholesterol, triglycerides and lipoproteins were investigated in 276 healthy, prepubertal children and adolescents of normal weight aged 6 to 12 years. The results were evaluated on the basis of the guidelines of the Austrian Cholesterol Consensus Conference 1988 and according to the 90th and 95th percentiles of the Lipid Research Clinics (LRC) data. A relatively high percentage of the probands revealed cholesterol concentrations which could be classified as "risk" (50% of the female and 53% male probands) or "high risk" (39% of the girls and 25% of the boys). Classifying the cholesterol data according to the LRC criteria 46% of the girls and 41% of the boys exceeded these "cut off" values of the 90th percentile. Our data show that the mean serum cholesterol concentrations in healthy children and adolescents of normal weight--like in other European countries--are in a region concomitant with the category in adults which is associated with an increased risk for cardiovascular diseases. We assume that apart from genetic factors a high fat intake might play a predominant role in causing these raised levels.

Austria↗
PubMed1990

[Dietary treatment of hyperlipoproteinemia].

Hyperlipoproteinemias are most common metabolic disorders, both in clinic and in practice. Primarily, these metabolic disorders are caused by exogenous factors (nutrition etc.), secondly by genetic factors (LDL-receptor defects, apoprotein variants, etc.). Although a number of efficient lipid lowering drugs is now available, basically any lipid lowering therapy should start with the change of nutritional habits. Beside the reduction of eventually increased body weight, special attention should be paid to fat modification, fat restriction and the decrease of cholesterol intake. With regard to fat restriction, mainly the intake of saturated fatty acids has to be decreased, an increase of polyunsaturated fatty acids to not more than approximately 10% of total energy intake should be considered. Recently, the beneficial effect of monounsaturated fatty acids has been discussed, particularly due to the fact that these fats do not reduce HDL cholesterol. For excessive hypertriglyceridemia the use of omega-3 fatty acids from fish oil should be considered, general recommendations for the long-term treatment with fish oil for prevention of cardiovascular diseases cannot be made.

Cholesterol, Dietary↗
PubMed1990

Effects of cornstarch treatment in very young children with type I glycogen storage disease.

Three children aged 1-2 years with glycogenosis type I were treated with 2 g/kg bodyweight oral cornstarch per meal (4-5 times a day) for a period up to 16 months. In comparison to the previous dietary regimen (day and nocturnal feedings every 3 h) the cornstarch diet stabilised serum glucose profiles and dramatically improved secondary hyperlipoproteinaemia. Mean total triglycerides decreased up to one half, consistent with a fall of very low density lipoprotein-triglycerides up to two thirds. Metabolic acidosis and hyperuricaemia did not occur and normal growth rates (0.7-1 cm/month) were achieved. We conclude that the cornstarch regimen even in the age group up to 2 years can be considered as an efficient alternative in the treatment of glycogenosis type I patients with less frequent feedings and without nocturnal infusion.

Blood Glucose↗
PubMed1990

Xanthoma disseminatum with progressive involvement of the central nervous and hepatobiliary systems.

A rapidly progressive disease with multiple organ involvement and symptoms of polyuria and polydipsia developed in a 32-year-old woman, with an initial presentation of xanthoma disseminatum. Within 6 months increasing visual impairment of the right eye developed; a computed tomographic scan revealed multiple cerebral and cerebellar lesions. Progress of her disease resulted in blindness of the right eye, internal hydrocephalus with involvement of both ventricles, and cerebellar ataxia. Ultrasound examination of the abdomen and a subsequent endoscopic retrograde cholangiopancreatographic examination revealed a xanthomatous gallbladder and liver involvement. The gallbladder and liver showed histologic changes compatible with xanthomatosis. The patient died 4 years after the appearance of skin lesions.

Adult↗
PubMed1990

[Carbohydrates in the treatment of glycogenoses].

Glycogen storage diseases (GSD) include inborn errors in glycogen synthesis and degradation which, like most metabolic diseases, evades any therapeutical concept up to now. Nevertheless, in a subgroup of glycogenoses, characterized by functional absence of the key glycogenolytic enzyme glucose-6-phosphatase (GSD-1), dietary treatment is able to ensure almost normal development of affected patients. The principle of treatment consists of oral application of raw cornstarch, which is hydrolyzed slowly in the intestinum resulting in normoglycemia over a period of several hours. Thus, nighttime nasogastric tube-feeding, the standard dietary regimen in GSD-1, could be avoided. Based on our experiences, this therapeutic approach, which has proven successful up to now only in elder children and adults, can be recommended even in children under 2 years of age, if the individual response to an oral starchload has been examined prior to the starch diet.

Adolescent↗
PubMed1990

[Fats in the diet].

The importance of nutritional fats as a source of energy declined in the past in industrialized countries due to a decrease of physical activity. On the other hand the association between the intake of particular fats and the development of cardiovascular diseases is generally accepted. Thus, some scientific societies (American Heart Association, NIH Consensus Development Conference) recommend a maximal intake of 30% of total energy by fats. In regards to the quality of fats and their effect on blood levels of lipoproteins, it is accepted that large amounts of polyunsaturated fatty acids lower increased blood levels of low density lipoproteins; however, they lower in a small extent also the antiatherogenic high-density lipoprotein (HDL) particles. Monounsaturated fatty acids also tend to lower increased LDL, without any lowering effect on HDL, W-3-fatty acids (mainly from fish oil) lower increased triglyceride levels and therefore are used a therapeutic dietary regimen. However, their long-term effects are not quite well known.

Cardiovascular Diseases↗
PubMed1990

[Risk factors of atherosclerosis and awareness of risk in employees of a Viennese insurance company].

In Austria still more than 50% of overall mortality are due to cardiovascular diseases. An efficient prevention via change of life-style has been proven. We started with an intervention-trial in a Viennese insurance company. 667 persons (50.7% m, 49.1% f, 0.1% no declaration) participated in the basic examination. The mean cholesterol level was 221.85 +/- 43.87 mg/dl, being clearly above the threshold value of 200 mg/dl. In spite of the fact, that 69.7% of the female and 65.5% of the male had elevated serum cholesterol only 1.8% already took lipid lowering drugs. Participants with a positive family history (myocardial infarction) had significantly elevated cholesterol (228.2 +/- 49.4 mg/dl vs 219.7 +/- 50.4 mg/dl). Another point we were drawing special attention to was the knowledge of the participants about the risk factors of atherosclerosis. Only 13% of the males and 13.8% of the females knew their cholesterol level. 11.5% of the males and 15.9% of the females were aware of the threshold value of cholesterol. Intervention strategies (information campaign, works kitchen) have been initiated. A possible beneficial effect will be examined in biannual follow-up examinations.

Adult↗
PubMed1990

Relationship between body fat distribution and blood lipids in obese adolescents.

Associations between body fat distribution, measured by waist/hip circumference ratio (WHR), and plasma lipids and lipoproteins were examined in 74 grossly obese adolescents. WHR was positively correlated in adolescent girls with total triglycerides (r = 0.44, P less than 0.01), total cholesterol (r = 0.49, P less than 0.001), and LDL-cholesterol (r = 0.59, P less than 0.001). In adolescent boys no correlation was found for total cholesterol but there were correlations for triglycerides (r = 0.41, P less than 0.05), LDL-cholesterol (r = 0.49, P less than 0.001), HDL-cholesterol (r = -0.66, P less than 0.001) and the ratio cholesterol/HDL-cholesterol (r = 0.62, P less than 0.001). Waist/hip ratio was not correlated with BMI or percentual overweight in obese girls, but a significant association was found in obese boys for both (r = -0.46, P less than 0.03 and r = 0.53, P less than 0.02). These results indicate that in obese girls a prevalence of abdominal fat distribution is correlated with increased triglycerides, serum cholesterol and LDL-C. In male adolescents total cholesterol is only slightly influenced but HDL-C concentrations are lower and LDL-C and the ratio CHOL/HDL-C higher.

Adipose Tissue↗
PubMed1989

[The cholesterol risk factor--initial results of a screening study in industries].

After the distribution of suitably informative leaflets all the employees of 2 companies were invited to participate in a screening programme with the aim of detecting elevated cholesterol levels. 238 out of 510 employees participated in the screening. Related to the age-adjusted Austrian recommendations for the upper limit of normal values, cholesterol was elevated in 73 people (30.7%). The percentage of smokers was slightly below the Austrian rate with 26% in company M and 30% in company H. All the participants were informed of their laboratory results within one week. Participants with a moderately or extremely increased risk were invited to a personal talk. Furthermore, a number of other previously undetected abnormalities were detected in 41 cases (17.2%), leading to subsequent clinical diagnosis and treatment. In addition, 3 plasma factor defects were discovered. These investigations served as a foundation for a more intensive planned programme. A continuation of this screening procedure is planned involving about 10,000 people per year.

Adult↗
PubMed1989

[Cholesterol screening in a bank for the detection of a risk population].

In October 1987 voluntary screening for cholesterol war performed in a bank. After preceding information had been issued to the participants 25 ml blood were drawn on 4 days from 667 employees (48.9% males, 51.1% females) for determination of the blood lipids and other parameters. The mean age (range 19 to 60) was 39 +/- 9 years; 29.2% were smokers. The mean cholesterol level amounted to 212 mg/dl. According to age- and sex-related normal values 42% exhibited an increased risk, whereby the percentage was particularly high (55%) in the age group under 30 years.

Adult↗
PubMed1989

No reduction of high density lipoprotein2 during weight reduction in obese children and adolescents.

The effects of a 3 week weight reduction regimen on lipids and lipoproteins, in particular high density lipoprotein (HDL)-subfractions in 61 grossly obese children and adolescents (37 females and 26 males) aged 11-15 years were studied. Dietary treatment resulted in a significant weight reduction of initial body weight of 9.6 +/- 2.1%, a highly significant decrease in cholesterol, low density lipoprotein cholesterol (LDL-C) and HDL-C (P less than 0.001), as well as a significant reduction in triglycerides, HDL3 and Apolipoprotein B concentrations (P less than 0.01). HDL2 concentrations remained almost constant. It is concluded that HDL reduction during a weight reducing regimen in adolescents does not result in a decrease of the antiatherogenic HDL2 subfraction.

Adolescent↗
PubMed1989

Plasma concentrations of free amino acids during 3 weeks treatment of massively obese children with a very low calorie diet.

Eight grossly obese children (2 girls, 8 boys, age 12.6 +/- 2.1 mean +/- SD years, mean overweight 73.3 +/- 14%) were treated for 3 weeks with a very low calorie diet (VLCD), containing 1022 kJ/240 kcal, 33 g protein, 25.5 g carbohydrate and 0.7 g fat/day. Mean weight loss after 3 weeks was 9.47 +/- 2.8 kg and mean nitrogen loss was calculated to be 113.3 +/- 71.2 g. While serum electrolytes, enzymes, glucose, urea and creatinine remained almost unchanged, distinct alterations of 23 free amino acids in plasma could be observed. A transient increase of plasma valine, leucine, isoleucine and alpha-aminobutyrate during the 1st week was followed by a constant fall in the 2nd and 3rd week. Glycine, proline, serine and threonine showed a progressive increase, while cystine, histidine and, above all, alanine decreased, the diminution of alanine being most rapid during the 1st week. No significant changes were observed in plasma concentrations of arginine, asparagine, aspartic acid, citrulline, glutamic acid, glutamine, lysine, tyrosine, ornithine, phenylalanine and taurine. Total plasma amino acid content did not change during diet compared to the pre-diet period. The behavior of plasma amino acids shows a typical pattern within four groups, reflecting various interorgan substrate fluxes during hypocaloric dieting.

Adolescent↗
PubMed1989

Adipogenic activity in sera from obese children before and after weight reduction.

The adipogenic and mitogenic potentials of sera obtained from obese children before and after weight reduction and from lean control subjects were studied in clonal 3T3 L1 fibroblasts. The sera from the lean (n = 14) and obese (n = 12) children under habitual diet contained similar adipogenic activity. However, when the obese children underwent a weight-reduction program for 3 wk (600 kcal/d), the potential of their sera to stimulate glycero-phosphate dehydrogenase, an index of adipogenic activity, was significantly reduced by 32% (p less than 0.01). Similarly, the mitogenic activity of these sera decreased significantly (202 +/- 15 vs 231 +/- 27 micrograms per dish, p less than 0.01). Testing pooled sera from the different groups in cultured rat adipocyte precursor cells gave similar results. This study suggests that human childhood-onset obesity is not accompanied by increased circulatory factors involved in the formation of new fat cells. The adipogenic and mitogenic activity of sera from obese children may be influenced by long-term dietary restriction.

Adipose Tissue↗
PubMed1989

[The obese patient and surgical intervention].

In obese patients the risks of morbidity and mortality is increased with high probability in surgical procedures. The secondary metabolic disturbances of obesity do not require special regimes for parenteral and enteral nutrition in most cases, since the common marked hyperinsulinemia is normalized quickly during the catabolic phase. Due to a preoperative weight reduction of approximately 10% a normalization of the disturbed metabolic parameters and impaired lung function almost can be achieved. In the stressed obese patient a hypocaloric, parenteral nutrition enriched with proteins seems useful, whereby endogenous fat deposits serve as energy donators without using lean body mass.

Enteral Nutrition↗
PubMed1989

24 hours electrocardiographic monitoring in obese children and adolescents during a 3 weeks low calorie diet (500 kcal).

Twenty-four hour electrographic recordings were made on 36 grossly obese children and adolescents during a 3-week weight reduction regimen with a 525 kcal (2196 kj) mixed diet at weekly intervals. One hundred and ten Holter ECGs were analysed. Weight loss during the treatment was calculated to be 5.7 +/- 1.6 kg. Average and minimal heart rate decreased constantly throughout the study period from 83.9 +/- 9 to 75 +/- 9/min and 53 +/- 6 to 45 +/- 6/min, respectively (P less than 0.01, P less than 0.005). During the second week maximal heart rate increased significantly but returned to baseline values in the third week. Neither before nor during the period of therapy were any dysrhythmias monitored. Dietary regimens containing 500-700 kcal, based on a mixed composition of foods with sufficient amounts of minerals, can be regarded as a safe therapeutic tool in the treatment of obese children and adolescents.

Adolescent↗