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PubMed2001

Total and central obesity among elderly Hispanics and the association with Type 2 diabetes.

OBJECTIVE: To report the prevalence of total and central obesity in a representative sample of Puerto Rican and Dominican elders in Massachusetts, to compare them with a neighborhood-based group of non-Hispanic white elders, and to examine associations of obesity indices with the presence of type 2 diabetes. RESEARCH METHODS AND PROCEDURES: We examined the prevalence of overweight, obesity, and central obesity in 596 Hispanics of Caribbean origin, ages 60 to 92 years, and 239 non-Hispanic whites, and tested linear and logistic regression models to determine associations among body mass index (BMI), waist circumference (WC), and diabetes. RESULTS: Obesity (BMI > or = 30 kg/m(2)) was prevalent among all ethnic groups, ranging from 17% to 29% for Dominican and Puerto Rican men, respectively, and from 29% to 40% for non-Hispanic white and Dominican women, respectively. These differences were not statistically significant. Among Hispanic men and women, diabetes was prevalent across all BMI and WC categories but tended to be greatest among those with BMI of 25 to 29 kg/m(2) (41% to 43%). In contrast, diabetes was most prevalent in the obese group (36% to 45%) of non-Hispanic whites. Both BMI and WC were associated with the presence of diabetes, but the coefficients were greater for non-Hispanic whites than for Hispanics. DISCUSSION: Caribbean Hispanics and non-Hispanic whites living in the same Massachusetts localities had high prevalences of overweight and obesity. Total and central obesity exerted a differential effect on the presence of diabetes among ethnic groups; for Hispanics, diabetes was prevalent even among non-obese individuals, whereas for non-Hispanic white women, the prevalence of diabetes was strongly associated with total and central obesity. Additional research is needed to investigate the factors associated with the differential effect of obesity on the prevalence of type 2 diabetes among Hispanic and non-Hispanic white elders.

Adipose Tissue↗
PubMed2001

Is there a role for gastric accommodation and satiety in asymptomatic obese people?

OBJECTIVE: The relationships of gastric accommodation and satiety in moderately obese individuals are unclear. We hypothesized that obese people had increased gastric accommodation and reduced postprandial satiety. The objective of this study was to compare gastric accommodation and satiety between obese and non-obese asymptomatic subjects. RESEARCH METHODS AND PROCEDURES: In 13 obese (body mass index [BMI] > or = 30 kg/m(2); mean BMI, 37.0 +/- 4.9 kg/m(2)) and 19 non-obese control subjects (BMI < 30 kg/m(2); mean BMI, 26.2 +/- 2.9 kg/m(2)), we used single photon emission computed tomography to measure fasting and postprandial gastric volumes and expressed the accommodation response as the ratio of postprandial/fasting volumes. The satiety test measured maximum tolerable volume of ingestion of liquid nutrient meal (Ensure) and symptoms 30 minutes after cessation of ingestion. RESULTS: Total fasting and postprandial gastric volumes and the ratio of postprandial/fasting gastric volume were not different between asymptomatic obese and control subjects. However, the fasting volume of the distal stomach was greater in obese than in control subjects. Maximum tolerable volume of ingested Ensure and aggregate symptom score 30 minutes later were also not different between obese and control subjects. DISCUSSION: Asymptomatic obese individuals (within the BMI range of 32.6 to 48 kg/m(2)) did not show either increased postprandial gastric accommodation or reduced satiety. These data suggest that gastric accommodation is unlikely to provide an important contribution to development of moderate obesity.

Adult↗
PubMed2003

Primary care physicians' attitudes about obesity and its treatment.

OBJECTIVE: This study was designed to assess physicians' attitudes toward obese patients and the causes and treatment of obesity. RESEARCH METHODS AND PROCEDURES: A questionnaire assessed attitudes in 2 geographically representative national random samples of 5000 primary care physicians. In one sample (N = 2500), obesity was defined as a BMI of 30 to 40 kg/m(2), and in the other (N = 2500), obesity was defined as a BMI > 40. RESULTS: Six hundred twenty physicians responded. They rated physical inactivity as significantly more important than any other cause of obesity (p < 0.0009). Two other behavioral factors-overeating and a high-fat diet-received the next highest mean ratings. More than 50% of physicians viewed obese patients as awkward, unattractive, ugly, and noncompliant. The treatment of obesity was rated as significantly less effective (p < 0.001) than therapies for 9 of 10 chronic conditions. Most respondents (75%), however, agreed with the consensus recommendations that a 10% reduction in weight is sufficient to improve obesity-related health complications and viewed a 14% weight loss (i.e., 78 +/- 5 kg from an initial weight of 91 kg) as an acceptable treatment outcome. More than one-half (54%) would spend more time working on weight management issues if their time was reimbursed appropriately. DISCUSSION: Primary care physicians view obesity as largely a behavioral problem and share our broader society's negative stereotypes about the personal attributes of obese persons. Practitioners are realistic about treatment outcomes but view obesity treatment as less effective than treatment of most other chronic conditions.

Adult↗
PubMed2004

Resistin, adiponectin, ghrelin, leptin, and proinflammatory cytokines: relationships in obesity.

OBJECTIVE: To evaluate interactions among leptin, adiponectin, resistin, ghrelin, and proinflammatory cytokines [tumor necrosis factor receptors (TNFRs), interleukin-6 (IL-6)] in nonmorbid and morbid obesity. RESEARCH METHODS AND PROCEDURES: We measured these hormones by immunoenzyme or radiometric assays in 117 nonmorbid and 57 morbidly obese patients, and in a subgroup of 34 morbidly obese patients before and 6 months after gastric bypass surgery. Insulin resistance by homeostasis model assessment, lipid profile, and anthropometrical measurements were also performed in all patients. RESULTS: Average plasma lipids in morbidly obese patients were elevated. IL-6, leptin, adiponectin, and resistin were increased and ghrelin was decreased in morbidly obese compared with nonmorbidly obese subjects. After adjusting for age, gender, and BMI in nonmorbidly obese, adiponectin was positively associated with HDLc and gender and negatively with weight (beta = -0.38, p < 0.001). Leptin and resistin correlated positively with soluble tumor necrosis factor receptor (sTNFR) 1 (beta = 0.24, p = 0.01 and beta = 0.28, p = 0.007). In the morbidly obese patients, resistin and ghrelin were positively associated with sTNFR2 (beta = 0.39, p = 0.008 and beta = 0.39, p = 0.01). In the surgically treated morbidly obese group, body weight decreased significantly and was best predicted by resistin concentrations before surgery (beta = 0.45, p = 0.024). Plasma lipids, insulin resistance, leptin, sTNFR1, and IL-6 decreased and adiponectin and ghrelin increased significantly. Insulin resistance improved after weight loss and correlated with high adiponectin levels. DISCUSSION: TNFalpha receptors were involved in the regulatory endocrine system of body adiposity independently of leptin and resistin axis in nonmorbidly obese patients. Our results suggest coordinated roles of adiponectin, resistin, and ghrelin in the modulation of the obesity proinflammatory environment and that resistin levels before surgery treatment are predictive of the extent of weight loss after bypass surgery.

Adiponectin↗
PubMed2004

The FOXC2 C-512T polymorphism is associated with obesity and dyslipidemia.

The transcription factor FOXC2 has been implicated in resistance to diet-induced obesity and insulin resistance. To investigate the possible role for FOXC2 in obesity and related phenotypes, we performed two association studies for obesity using unrelated case-control materials by genotyping the FOXC2 C-512T polymorphism. In the first study (127 obese and 127 normal-weight nondiabetic subjects matched for age and sex), the C-allele showed association with obesity, odds ratio 1.74 (1.12 to 2.73; p < 0.01) for the C- vs. T-allele and 1.81 (1.04 to 3.25; p < 0.05) for the C/C and C/T vs. T/T genotype. BMI was higher in carriers of the C/C and C/T genotype in normal weight [adjusted p value (p(adj)) = 0.02] but not in obese subjects (p(adj) = 0.1). In the replication study (223 obese and 231 nonobese subjects), subjects with the C/C genotype exhibited an increased risk for obesity, odds ratio 2.01 (1.15 to 3.52; p = 0.01). Obese carriers of the C-allele had lower high-density lipoprotein-cholesterol [1.1 (0.9 to 1.3) vs. 1.2 (1.0 to 1.4) mM, p(adj) = 0.006] and increased triglyceride levels (1.95 [1.30 to 2.68] vs. 1.60 [1.10 to 2.40] mM, p(adj) = 0.02) compared with obese carriers of the T/T genotype. Our data suggest that FOXC2 is a weak but consistent candidate gene for obesity and dyslipidemia.

Abdomen↗
PubMed2005

Trends in overweight and obesity in Portugal: the National Health Surveys 1995-6 and 1998-9.

OBJECTIVE: To assess overweight and obesity trends in the Portuguese population. RESEARCH METHODS AND PROCEDURES: National Health Surveys, conducted in 1995-6 (17,989 men; 20,249 women) and 1998-9 (17,923 men; 20,302 women), were used. RESULTS: In men, the prevalence of overweight and obesity increased from 39.9% (95% CI: 39.2 to 40.6) and 10.3% (95% CI: 9.9 to 10.7), respectively, in 1995-6, to 42.5% (95% CI: 41.8 to 43.2) and 11.5% (95% CI: 11.0 to 12.0), respectively, in 1998-9. In women, prevalence of obesity increased from 12.7% (95% CI: 12.2 to 13.2) in 1995-6 to 14.2% (95% CI: 13.7 to 14.6) in 1998-9, whereas the prevalence of overweight remained stable: 32.2% (95% CI: 31.6 to 32.9) in 1995-6 and 32.3% (95% CI: 31.6 to 32.9) in 1998-9. In men, prevalence of overweight and obesity were higher among former smokers and educational group of 6 to 12 years, and prevalence of obesity was higher in the Lisbon region. In women, prevalence of overweight and obesity were higher among never smokers, and prevalence of obesity was higher among educational group of -6 years. Prevalence of obesity was higher in the Alentejo region, and overweight was higher in the Center region. Finally, prevalence of obesity increased in both sexes for all strata studied (age, smoking status, educational level, and geographic region), whereas prevalence of overweight increased only in men. DISCUSSION: In Portugal, overweight and obesity levels are related to sociodemographic factors; the increase in obesity levels stresses the need for preventive measures.

Adult↗
PubMed2005

The human obesity gene map: the 2004 update.

This paper presents the eleventh update of the human obesity gene map, which incorporates published results up to the end of October 2004. Evidence from single-gene mutation obesity cases, Mendelian disorders exhibiting obesity as a clinical feature, transgenic and knockout murine models relevant to obesity, quantitative trait loci (QTLs) from animal cross-breeding experiments, association studies with candidate genes, and linkages from genome scans is reviewed. As of October 2004, 173 human obesity cases due to single-gene mutations in 10 different genes have been reported, and 49 loci related to Mendelian syndromes relevant to human obesity have been mapped to a genomic region, and causal genes or strong candidates have been identified for most of these syndromes. There are 166 genes which, when mutated or expressed as transgenes in the mouse, result in phenotypes that affect body weight and adiposity. The number of QTLs reported from animal models currently reaches 221. The number of human obesity QTLs derived from genome scans continues to grow, and we have now 204 QTLs for obesity-related phenotypes from 50 genome-wide scans. A total of 38 genomic regions harbor QTLs replicated among two to four studies. The number of studies reporting associations between DNA sequence variation in specific genes and obesity phenotypes has also increased considerably with 358 findings of positive associations with 113 candidate genes. Among them, 18 genes are supported by at least five positive studies. The obesity gene map shows putative loci on all chromosomes except Y. Overall, >600 genes, markers, and chromosomal regions have been associated or linked with human obesity phenotypes. The electronic version of the map with links to useful publications and genomic and other relevant sites can be found at http://obesitygene.pbrc.edu.

Adipose Tissue↗
PubMed2006

Psychological workload and weight gain among women with and without familial obesity.

OBJECTIVE: High job demands and low job influence may be associated with subsequent weight gain. Predisposition to obesity may further modify such associations. The purpose of the study was to determine whether familial predisposition to obesity modified associations between psychological workload and 6-year weight changes among nurses. RESEARCH METHODS AND PROCEDURES: A total of 6404 Danish nurses 45 to 65 years old, who belonged to the workforce in both 1993 and 1999, answered a questionnaire on psychological workload, body weight, and familial obesity. Women were considered to be predisposed to obesity if they were overweight and had at least one obese parent. Parents' body shape was reported using pictograms. RESULTS: An increased psychological workload, reflected by high job demands and low influence in job, was associated with an increased body weight. This was particularly the case for nurses being predisposed to obesity, suggesting a synergy between familial obesity predisposition and the psychological workload environment. An interaction test among job demands, familial predisposition to obesity, and weight gain on adjusted data was made. The test showed p = 0.05. The adjusted interaction test among influence in job, familial predisposition to obesity, and weight gain showed p = 0.02. Predisposed nurses who were busy in their job gained 4.4 kg, whereas other nurses gained only 3.2 kg during the 6 years. Similarly, nurses predisposed to obesity with low influence in job had a higher body weight gain (5.4 vs. 3.2 kg) compared with other nurses. DISCUSSION: High psychological workload due to high job demands and low influence in job seems to predict weight gain in general and, in particular, among those nurses with a familial predisposition to obesity.

Causality↗
PubMed2000

Obesity in women from developing countries.

OBJECTIVES: The key objective was to estimate obesity (>/=30 kg/m2) in women 15-49 y from developing countries. A second objective was to study how obesity varies by educational level and by residence in urban and rural areas. A third objective was to investigate how national incomes shape the relationship between obesity and eduction or residence. DESIGN: The analyses use cross-sectional data from nationally representative surveys from developing countries carried out in the last decade. Most of the surveys were Demographic Health Surveys (DHS). Data from a survey from the USA are used for comparison. SETTING: The 39 surveys used come from 38 developing countries and the USA. SUBJECTS: A total of 147,938 non-pregnant women 15-49 y were included in the analyses. RESULTS: The percentage of obese women was 0.1% in South Asia, 2.5% in Sub-Saharan Africa, 9. 6% in Latin America and the Caribbean, 15.4% in Central Eastern Europe/Commonwealth of Independent States (CEE/CIS), 17.2% in the Middle East and North Africa, and 20.7% in the USA. Levels of obesity in countries increased sharply until a gross national product of US$1500 per capita (1992 values) was reached and changed little thereafter. In very poor countries, such as in Sub-Saharan Africa, obesity levels were greatly concentrated among urban and higher educated women. In more developed countries, such as those in Latin America and the CEE/CIS regions, obesity levels were more equally distributed in the general population. CONCLUSIONS: Based on the analyses presented and on a review of the literature, it is concluded that obesity among women is a serious problem in Latin America and the Caribbean, the Middle East and North Africa, and the CEE/CIS region. Obesity is less of a concern in Sub-Saharan Africa, China and South Asia. Obesity levels increased over time in most of the limited number of countries with data, but at varying rates. Rising national incomes in developing countries and increased 'Westernization' will most likely lead to increased levels of obesity in the future. SPONSORSHIP: Financial support was provided by the Food and Nutrition Program of the Pan American Health Organization and by the World Bank.

Adolescent↗
PubMed2000

Physical activity patterns in normal, overweight and obese individuals using minute-by-minute accelerometry.

OBJECTIVE: To determine the levels and patterns of daily physical activity in groups of normal-weight, overweight and obese adults using uniaxial minute-by-minute accelerometry. DESIGN: Cross-sectional study of physical activity levels over a 7 day period using accelerometers programmed to collect minute-by-minute data. SETTING: Participants were recruited from large companies in Bristol and Cardiff. All meetings took place on company premises. PARTICIPANTS: One-hundred and eight participants volunteered for the study. Eighty-four (36 males, 48 females; 38.6+/-9.3 y) (mean+/-s.d. ) met the inclusion criteria for accelerometer measurements and were included in analyses. RESULTS: No significant differences in physical activity were identified between normal-weight (BMI<25) and overweight (BMI 25-29.9) participants. Obese participants (BMI>30) were significantly less active than non-obese participants (BMI< or =30) during weekdays (279.1+/-77.5 vs. 391.3+/-139.4 counts min(-1); P<0.001), weekends (222.3+/-93.9 vs. 386.2+/-177.5 counts min(-1); P<0.001) and evenings (221.1+/-126.3 vs. 380.8+/-220.7 counts min(-1); P=0.002), but not at work (307.5+/-87.2 vs 398.7+/-163.3 counts min(-1); P=0.06). Differences in activity levels between obese and non-obese participants were greater in males than females. Hour-by-hour physical activity patterns demonstrated that obese participants were less active than the non-obese for almost every hour of the weekdays and the weekend. CONCLUSIONS: Although no differences in activity emerged between overweight and normal-weight individuals, obese participants were substantially less active than the non-obese, particularly when there was a free choice of activity or no activity. The difference in activity levels was particularly pronounced in males, and unless obese individuals are compensating by lower energy intake, these activity patterns will contribute to the maintenance of or increase in the degree of obesity. Minute-by-minute accelerometry is a valuable tool for the assessment of activity patterns and may be useful to highlight periods of inactivity for intervention design.

Adult↗
PubMed1997

Role of plasma insulin concentration in regulating glucose and lipid metabolism in lean and obese Zucker rats.

OBJECTIVE: To determine the role of plasma insulin concentration in regulating glucose and lipid metabolism in insulin-resistant obese Zucker rats and to compare obese rats with lean controls with respect to changes in insulin sensitivity. DESIGN: Animal study of lean and obese rats with or without insulin sensitizer, YM268. ANIMALS: Nine week old male lean (Fa/-) and obese (fa/fa) Zucker rats. MEASUREMENTS: Plasma glucose, insulin, triglyceride (TG), non-esterified fatty acid (NEFA), cholesterol at baseline and after 14 d, the dose of YM268 for exhibiting a 30% decrease in each parameter (ED30). RESULTS: Insulin, TG, and NEFA concentrations were approximately 2-6 times higher in obese rats. YM268 had no effect on glucose but decreased insulin in lean and obese rats with ED30 of 3.0 and 2.9 mg/kg. YM268 also reduced TG and NEFA in lean and obese rats (ED30 (mg/kg): lean; 4.1 (TG), 5.0 (NEFA), obese; 2.1, 3.0]. A significant correlation of either TG or NEFA level to insulin was established in lean and obese rats. CONCLUSION: Plasma TG and NEFA, but not cholesterol concentration, are dependent on plasma insulin in lean and obese Zucker rats, and insulin sensitivity with respect to TG and NEFA metabolism in obese rats may not be different from that in lean rats.

Administration, Oral↗
PubMed1999

Obesity stigmatization and coping: relation to mental health symptoms, body image, and self-esteem.

OBJECTIVE: To create inventories of stigmatizing situations faced by obese people and ways of coping with stigmatization, and to examine how stigma and coping are related to psychological distress in an obese patient population. DESIGN: Study 1: Items were generated by asking obese people to list stigmatizing situations they had encountered and their ways of coping. Study 2: Obese patients were surveyed about the frequency with which they encountered each form of stigmatization and employed each form of coping. Cross-sectional data on current psychological adjustment were obtained. SUBJECTS: Study 1: 63 obese patients (body mass index, BMI > 40 kg/m2); 38 obese non-patients, seven professionals who work with obese patients and 32 obese female authors from the print media. Study 2: 112 gastric bypass patients (BMI 33.9-80.9 kg/m2) and 34 less obese patients (BMI 27.1-57.2 kg/m2). MEASUREMENT: Study 1: Collection of stigmatizing situations and coping responses. Study 2: Frequency of stigmatizing experiences and coping responses, psychological symptoms, body image, and self esteem measures. RESULTS: Study 1 resulted in two objective questionnaires, consisting of 50 situations and 99 responses. Study 2 found that stigmatization is a common experience, and that obese subjects frequently engage in some effort to cope with stigma. More frequent exposure to stigmatization was associated with greater psychological distress, more attempts to cope, and more severe obesity. Certain coping strategies are associated with greater distress.

Adaptation, Psychological↗
PubMed1999

Black-white differences in social and economic consequences of obesity.

OBJECTIVE: To investigate social and economic effects of obesity for black and white females, and to explore possible explanations for race differences in obesity effects. SUBJECTS: 1354 non-Hispanic black and 3097 non-Hispanic, non-black, women aged 25-33y in 1990 from the National Longitudinal Survey of Youth 1979-1990. MEASUREMENTS: Body mass index (BMI) evaluated at age 17-24y (1982) and 25-33y (1990). METHODS: Logistic and linear regression of six labour market and marriage outcomes on early or attained BMI. Detailed controls for family socioeconomic background. RESULTS: Socioeconomic effects of obesity appear larger for whites than blacks. Obesity is associated with low self-esteem among whites, but not blacks. Differences in self-esteem do not account for race differences in the effects of obesity on socioeconomic status. Lower probability of marriage and lower earnings of husbands among those who marry account for the majority of the income differences between obese white women and those of recommended weight. Occupational differences account for more than one fifth of the effect of obesity on the hourly wages of both white and black women. CONCLUSION: Cultural differences may protect black women from the self-esteem loss associated with obesity for whites. However, differences in self-esteem do not account for the effects of obesity on socioeconomic status. Because the effect of obesity on the economic status of white women works primarily through marriage, it may therefore be less amenable to policy intervention to improve the labor market prospects of obese women.

Adolescent↗
PubMed1999

Gastric emptying in normal weight and obese children--an ultrasound study.

AIM: To investigate gastric emptying of a mixed solid and liquid meal in normal weight and obese children. METHODS: 114 volunteer children of school age (range 6-11 y) entered the study. Children were considered as being underweight, normal weight, obese, severely obese according to their body mass index (BMI), and were examined using a non-invasive ultrasound method in the morning after an overnight fast period. The examination was always performed in an upright position by the same operator. The half-emptying time and fasting antral area were assessed, and antral area measurements were performed every 30 min for 240 min after meal administration. RESULTS: Five children (4.4%) were underweight, 53 (46.5%) were normal weight, 19 (16.6%) were obese, and 37 (32.5%) were severely obese. The underweight group was not considered for the analysis. No significant difference in t 1/2 was found among the three groups. A positive statistically significant correlation was found between fasting antral area and BMI (r = 0.44; P<0.0001) in all children. The fasting antral area value was 3.5 cm2 (range 1.6-8.1) in normal weight children, 3.6 cm2 (range 1.9-7.7) in obese children, and 3.9 cm2 (range 1.5-10.8) in severely obese children. There was a significant difference between severely obese and normal weight children (P<.05). No significant difference was found in the gastric emptying between severely obese and obese children, and between severely obese and normal weight ones. CONCLUSION: The difference in fasting antral area in these groups may be considered as an early disturbance. In fact the increased gastric volume could cause a change in the sense of satiety with a consequent increase in the intake of these subjects.

Body Mass Index↗
PubMed2000

Pro12Ala mutation in the peroxisome proliferator-activated receptor gamma2 (PPARgamma2) and severe obesity: a case-control study.

OBJECTIVE: To explore the association of the Pro12Ala mutation in the peroxisome proliferator-activated receptor gamma2 with severe obesity and the features of the metabolic syndrome in a population-based sample of Caucasians. PARTICIPANTS AND METHODS: The study is based on a case-control design: 95 non-diabetic severely obese (body mass index, BMI > 35 kg/m2) cases and 280 normal weight (BMI < 25 kg/m2), age- and sex-matched controls selected from the same population were studied. Height, weight, waist circumference, as well as blood pressure were measured according to a standard protocol. BMI at age 25 y was calculated on the basis of current height and reported weight at age 25 y Biochemical measurements included fasting glucose, triglycerides, high-density lipoprotein cholesterol and insulin. DNA analysis was conducted by PCR and gel electrophoresis. RESULTS: Age and gender distribution were similar in obese and normal weight participants. The percentage of people with the Pro12Ala mutation was not significantly different in obese or normal weight participants (20% and 15%, respectively; P = 0.32). Conversely, in obese participants with obesity starting in early adulthood (ie with BMI at age 25 above 26.9kg/m2 which represents the median of the whole obese group), the Pro12Ala mutation was observed significantly more frequently than in the normal weight controls (29% vs 15%; chi square = 4.5, P < 0.05; odds ratio 2.4; 95% CI 1.03-5.36). No association of the Pro12Ala variant with any of the component of the metabolic syndrome measured in the study was observed in either obese, juvenile obese or normal weight participants. CONCLUSIONS: Results of this study indicate that the Pro12Ala mutation does not play a major role as a determinant of severe obesity and/or features of the metabolic syndrome in the general population. However, this mutation may be of greater importance as a contributor to early onset obesity.

Adult↗
PubMed2000

Frequency of and interaction between polymorphisms in the beta3-adrenergic receptor and in uncoupling proteins 1 and 2 and obesity in Germans.

OBJECTIVE: To determine the role of polymorphisms in the genes for beta3-adrenergic receptor (beta3-AR) and in uncoupling proteins 1 and 2 (UCP-1, UCP-2) in obesity. DESIGN: Association study with three polymorphisms and obesity. SUBJECTS: Two hundred and thirty-six morbidly obese patients who underwent gastric banding surgery, 381 patients from the medical clinic and 198 healthy blood donors. MEASUREMENTS: The frequencies of the W64R in beta3-AR, the 3826A-->G in UCP-1 and the 45bp insertion in the 3 untranslated region of exon 8 in UCP-2 polymorphisms were determined. RESULTS: There were no significant differences in the frequencies of the beta3-AR and UCP-1 polymorphisms between obese (body mass index, BMI > 30 kg/m2) and lean subjects. Lean, but not obese, carriers of the R allele of beta3-AR had a significantly higher BMI. The mean age of obese subjects (excluding diabetics) who were carriers of the G allele of the UCP-1 polymorphism, 36y, was significantly younger than wild-type, 40y (P= 0.007). This effect was not seen in lean subjects. The effect of the G allele on the mean age of obese subjects was more apparent in subjects who were also carriers of the R allele of the beta3-AR polymorphism. The frequency of the ins allele of UCP-2 was significantly higher in obese subjects, 0.31, than in lean, 0.24 (P= 0.002) and carriers of the ins allele had a significantly higher BMI, 38 vs 35 (P= 0.005). There was no association between any of the polymorphisms and type II diabetes. CONCLUSION: In a German population, there was no association between the W64R in beta3-AR or the 3826A-->G in UCP-1 polymorphisms and obesity. However, they act synergistically to accelerate the development of obesity. The 45bp insertion in the 3 untranslated region of exon 8 in UCP-2 polymorphism is associated with obesity.

Adult↗
PubMed2000

Decreased androgen levels in massively obese men may be associated with impaired function of the gonadostat.

OBJECTIVE: In obese men, sex hormone-binding globulin (SHBG) as well as total testosterone (TT) levels are decreased. Data concerning serum free testosterone (FT) levels in obese men are discordant. FT levels are decreased in only some morbidly obese men, consistent with an impairment of the feedback regulatory mechanism. In this study we aimed to verify serum levels of TT and FT in two groups of obese men (BMI < 35.0 kg/m2 and BMI > 35.1 kg/m2) before and after weight loss. DESIGN: Two groups of obese men (group 1: BMI < or = 35 kg/m2; and group 2: BMI > or =35.1 kg/m2) were studied before and after 6 months of a low energy diet (1200 kcal/day). Every patient received a therapeutic prescription of dexfenfluramine (15 mg b.i.d.) that was maintained for 6 months. SUBJECTS: Thirty-seven obese men and 20 normal weight men. MEASUREMENTS: Serum sex hormones (TT and FT), serum luteinizing hormone (LH) and insulin were analyzed by RIA assays. Plasma insulin levels, serum TT, FT and LH concentrations were obtained before and after weight loss. RESULTS: Moderately obese men (BMI = 32.3+/- 1.9 kg/m2) presented significantly decreased TT levels (390+/-120ng/dl) as well as FT (mean+/-s.d.:16.0+/-4.8pg/ml) as compared with normal controls. FT serum levels had a significant and negative correlation with body mass index (BMI), whereas for TT concentrations this correlation was not significant. Serum LH concentrations (4.5+/-2.9mlU/ml) were normal. Insulin levels were elevated in all patients (46.3+/-30.1 microU/ml). After weight loss there was a significant (P< 0.01) increase in TT, FT and LH levels, whereas insulin concentrations significantly decreased. In massively obese men (BMI = 43.0 6.7 kg/m2), TT (320+/-110ng/dl), FT (11.0+/-2.1 pg/ml) and LH (3.1+/-1.3mlU/ml) were decreased and significantly lower as compared with the previous group and normal controls. As expected, after weight loss TT, FT and LH levels increased significantly while insulin concentrations decreased. CONCLUSIONS: We concluded that FT levels are dependent on the degree of obesity, massively obese men (BMI > or =35.1 kg/m2) being considered as candidates for consistently low FT levels. A functional decrease of LH pulse amplitude and serum LH levels as well as a possible negative action of excess of circulating leptin on the steroidogenesis may be related to the decreased androgens levels in massively obese men.

Adult↗
PubMed2001

The effect of exercise training on beta-adrenergic stimulation of fat metabolism in obese men.

OBJECTIVE: To investigate the in vivo effect of exercise training at high and low intensity on beta-adrenergic stimulated fat metabolism in obese men at rest. METHOD: Twenty-three obese, healthy subjects were randomly divided in a low-intensity exercise training program (40% VO(2max), n=7), a high-intensity exercise training program (70% VO(2max); n=8), or a non-exercising control group (n=8). The exercise training program lasted for 12 weeks with a training frequency of 3 times per week. Before and after the intervention body composition and maximal aerobic capacity were measured as well as fat metabolism at rest and during beta-adrenergic stimulation by isoprenaline. For comparison, six lean subjects served as a control group. They participated in a low-intensity exercise training program and underwent the same measurements as the obese subjects. RESULTS: Relative fat oxidation decreased significantly during infusion of an increasing dose of isoprenaline in the obese low-intensity and high-intensity exercise training groups as well as in the lean group (P<0.01). Exercise training failed to influence the effect of beta-adrenergic stimulation on relative fat oxidation in obese men at both intensities and in lean men. In addition, beta-adrenergic-mediated lipolysis did not seem to be different after low intensity exercise training in lean and obese men. Lipolysis might be increased after high-intensity exercise training in obese men. CONCLUSION: Low- and high-intensity exercise training in obese men failed to affect beta-adrenergic mediated relative fat oxidation in vivo. beta-Adrenergic-mediated lipolysis might be increased in obese men after HI exercise training only. The effect of low-intensity exercise training on beta-adrenergic-mediated fat metabolism was similar in lean and obese men. International Journal of Obesity (2001) 25, 16-23

Adrenergic beta-Agonists↗

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