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PubMed1999

Lack of sex difference in cerebrospinal fluid (CSF) leptin levels and contribution of CSF/plasma ratios to variations in body mass index in children.

In adults, leptin seems to cross the blood-brain barrier by a saturable transporter. This may contribute to the development of obesity. The present study in healthy children investigates leptin levels in plasma and cerebrospinal fluid (CSF) in relation to body constitution. This prospective study analyzed leptin levels in plasma and CSF samples (stored at -80 C) of patients without CNS infection or blood-brain barrier dysfunction. Inclusion criteria included temperature less than 38.5 C, C-reactive protein levels below 10 mg/L, CSF leukocyte levels less than 10(7)/L, no need for neurosurgical or oncological treatment, and no history of trauma. Four groups were designated according to body mass index. Sixty-five children (28 girls and 37 boys) entered the study. Plasma leptin (median) was 7.4 in girls and 2.6 ng/mL in boys., CSF leptin was 0.273 and 0.204 ng/mL, respectively, leading to CSF/plasma ratios of 0.045 and 0.071, respectively. Ratios were clearly dependent on body mass index percentiles (r = -0.484; P < 0.01, significant differences between groups by ANOVA). Median plasma leptin levels in the 4 groups (body mass index, <10th, 10th-50th, 50th-90th, and >90th percentile) were 2.0, 2.3, 4.1, and 8.8 ng/mL; CSF/plasma ratios were inversely related: 8.2%, 7.6%, 5.5% and 3.6%. In healthy children, CSF leptin levels account for approximately 5% of plasma levels. CSF/plasma ratios in girls are lower than those in boys, explaining why calorie intake and energy expenditure are not grossly different despite large differences in circulating plasma leptin concentrations. CSF/plasma ratios of lean children are higher than those in obese children. The dynamic changes in the CSF/plasma ratios are more pronounced in lean children, i.e. the nonlinear transport characteristics of the leptin system amplifies the information about changes in body energy stores in this population, indicating that leptin is part of a mechanism to protect the body from critical weight loss rather than to avoid obesity.

Adolescent↗
PubMed2007

Genital foreign bodies: more than the eye can see.

Genital foreign bodies constitute a diverse but surprisingly common means of presentation to emergency departments. Although the presentation usually means the initial diagnosis is easily made, we present a case here that stresses the importance of attention to history, clinical examination and radiological investigation. A 44-year-old gentleman presented with a history of pain and discharge from a self-inflicted scrotal wound. Further questioning revealed a history of genital foreign bodies, but the full extent of his condition was not apparent until plain pelvic radiographs were obtained. The initial management of genital foreign bodies follows basic surgical principles. Constricting bands must be removed, devitalized tissues debrided and the surgical field extensively irrigated. Underlying psychiatric illness may be present and a high index of suspicion is required in the initial assessment of such patients. A plain pelvic radiograph is recommended to fully identify all foreign bodies present.

Adult↗
PubMed1996

Organ donation consanguinity or universality.

1. Neither the "Diseased Persons" nor the "Genetic Relations" provide an answer to "trading" in human body parts. 2. Live human body constitutes a vital source of supply of organs and tissues and the possibilities of optimum utilisation should be explored. 3. There is no scope for dogmatic postures and open-mindedness should be the approach while dealing with the issue of Organ Transplantation. 4. Society owes a duty to save the file of a dying man and in the event of failure to do so, it is absolutely immoral to interfere with his own arrangements by making unrealistic laws. No immorality is involved if an individual disposes of his spare body parts for a valid consideration to a needy person. 5. The scarcity needs to be urgently overcome otherwise unwarranted trade and crime are liable to thrive. 6. Families are not unconnected or antagonistic fragments of humanity. After thousands of years of continuous efforts the individuals on this earth have attained the stage of organic and functional integration. Atomisation of society on the basis of consanguineous proximities amounts to reversing this holistic trend. Organ transplantation is a functional expression of a highly evolved pursuit with inherent and intimate interaction in the form of organic exchange at the individual level, independent of consanguineous inducements or motivations. As such there is absolutely no scope for restricting organ donations by strangers. 7. Commercialisation should be curbed by making the enforcement agencies more efficient and not by depriving a needy person of his genuine requirements. Legislative craftsmanship lies in providing an answer without curtailing the freedom of the people.

Adult↗
PubMed1967

The obese person as an adolescent.

Obesity constitutes a major health problem in the United States. Hypertension, atherosclerosis, coronary artery disease, diabetes and gout are often associated with obesity and may be a direct result of persistent obesity in adult life. Obesity frequently has its beginnings in childhood and adolescence. Unfortunately, obesity which develops in early life is a progressive problem. Eighty per cent of overweight children and adolescents will continue to be overweight as adults.(12) Furthermore, adults with a history of obesity in childhood are the most resistant to treatment. Recent studies have shown there is more than one body constitutional type among obese adolescents. Obese adolescents tend to eat less than non-obese controls. While obesity may be found to have many different causative factors, efforts to control this disease may be most successful in the area of primary prevention.

Adolescent↗
PubMed2006

Identity of SMCT1 (SLC5A8) as a neuron-specific Na+-coupled transporter for active uptake of L-lactate and ketone bodies in the brain.

SMCT1 is a sodium-coupled (Na(+)-coupled) transporter for l-lactate and short-chain fatty acids. Here, we show that the ketone bodies, beta-d-hydroxybutyrate and acetoacetate, and the branched-chain ketoacid, alpha-ketoisocaproate, are also substrates for the transporter. The transport of these compounds via human SMCT1 is Na(+)-coupled and electrogenic. The Michaelis constant is 1.4 +/- 0.1 mm for beta-d-hydroxybutyrate, 0.21 +/- 0.04 mm for acetoacetate and 0.21 +/- 0.03 mm for alpha-ketoisocaproate. The Na(+) : substrate stoichiometry is 2 : 1. As l-lactate and ketone bodies constitute primary energy substrates for neurons, we investigated the expression pattern of this transporter in the brain. In situ hybridization studies demonstrate widespread expression of SMCT1 mRNA in mouse brain. Immunofluorescence analysis shows that SMCT1 protein is expressed exclusively in neurons. SMCT1 protein co-localizes with MCT2, a neuron-specific Na(+)-independent monocarboxylate transporter. In contrast, there was no overlap of signals for SMCT1 and MCT1, the latter being expressed only in non-neuronal cells. We also demonstrate the neuron-specific expression of SMCT1 in mixed cultures of rat cortical neurons and astrocytes. This represents the first report of an Na(+)-coupled transport system for a major group of energy substrates in neurons. These findings suggest that SMCT1 may play a critical role in the entry of l-lactate and ketone bodies into neurons by a process driven by an electrochemical Na(+) gradient and hence, contribute to the maintenance of the energy status and function of neurons.

Animals↗
PubMed2006

Endocrinology of the aging male.

Despite enormous medical progress during the past few decades, the last years of life are still accompanied by increasing ill health and disability. The ability to maintain active and independent living for as long as possible is a crucial factor for ageing healthily and with dignity. The most important and drastic gender differences in aging are related to the reproductive organs. In distinction to the course of reproductive ageing in women, with the rapid decline in sex hormones expressed by the cessation of menses, men experience a slow and continuous decline. This decline in endocrine function involves: a decrease of testosterone, dehydro epiandrosterone (DHEA), oestrogens, thyroid stimulating hormone (TSH), growth hormone (GH), IGF1, and melatonin. The decrease of sex hormones is concomitant with a temporary increase of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In addition sex hormone binding globulins (SHBG) increase with age resulting in further lowering the concentrations of free biologically active androgens. These hormonal changes are directly or indirectly associated with changes in body constitution, fat distribution (visceral obesity), muscle weakness, osteopenia, osteoporosis, urinary incontinence, loss of cognitive functioning, reduction in well being, depression, as well as sexual dysfunction. The laboratory and clinical findings of partial endocrine deficiencies in the aging male will be described and discussed in detail. With the prolongation of life expectancy both women and men today live 1/3 of their life with endocrine deficiencies. Interventions such as hormone replacement therapy may alleviate the debilitating conditions of secondary partial endocrine deficiencies by preventing the preventable and delaying the inevitable.

Aging↗
PubMed1985

The effect of in vivo hydrocortisone administration on the labelling index and size of the intra- and extra-adrenal chromaffin tissue of the fetal and perinatal mouse.

Administration of hydrocortisone in vivo to pregnant mice between the eighth and sixteenth days of gestation leads to highly significant increases in both the volume and the labelling index of extra-adrenal chromaffin tissue (as represented by the para-aortic body) of 16 days fetal mice. The labelling index of intra-adrenal chromaffin cells increases slightly after hydrocortisone administration, but the volume of the adrenal chromaffin tissue was not assessed since the groups of chromaffin cells had not in all cases aggregated to form a distinct medulla. Hydrocortisone administration to mice for the last week of gestation also leads to a highly significant increase in the size and the labelling index of the perinatal para-aortic body. Although an increase in the labelling index of perinatal intra-adrenal chromaffin cells is brought about, this is much less marked than that of the extra-adrenal tissue and neither is it reflected by any increase in the volume of the now discernible adrenal medulla. These increases in size and labelling index of the para-aortic body constitute a hyperplastic response rather than a hypertrophic response. Various possible mechanisms and implications are discussed in the light of the development of chromaffin tissue and the effects of the cortex and its secretions on the medulla. Associated effects of hydrocortisone noted in this work are the resultant marked diminution of adrenocortical volume in the perinatal gland, and a slight fall in the labelling index of perinatal intra-adrenal haemopoietic cells.

Adrenal Glands↗
PubMed1996

[Tracheobronchial aspiration of foreign bodies in children].

OBJECTIVE: Our objective was to study the characteristics and follow-up of children admitted to our Pediatric Emergency Room (PER) due to tracheobronchial inhalation of foreign bodies (FB). PATIENTS AND METHODS: We have reviewed retrospectively the 55 cases admitted over the last five years to our PER in whom the diagnosis of FB inhalation was confirmed. RESULTS: Mean age was 4 years with the peak incidence (25) occurring between 1 and 2 years of age. The second risk group was 11 years (8). In 84% of the patients (46), there was a history of FB aspiration. Twenty-five percent of the children (14) presented at the hospital within 24 hours, and 18% (10) more than 1 week after inhaling the FB. Physical examination was normal in 5%. The X-ray findings were: air trapping (74%), atelectasis (13%), in cases admitted more than 1 week after aspiration, and were normal in 13%. Rigid bronchoscopy and subsequent removal of the FB was the treatment instituted in 53 cases. There were no deaths. The FB was located at the right bronchus in 67%. The ingestion of nuts accounted for the highest incidence (72%), occurring mainly in younger children. Inorganic bodies constituted the majority of the cases in children older than 9 years (p = 0.0000). CONCLUSIONS: 1. Tracheobronquial inhalation of FB continues to not alarm the general population since only 25% presented at the hospital within 24 hours. 2. There are two risk groups, the second year of life (the largest) and the eleventh year, and they are different in the type of FB inhaled. 3. It is necessary to keep insisting on the methods of prevention.

Bronchoscopy↗
PubMed1999

Adult glycogenosis II with paracrystalline mitochondrial inclusions and Hirano bodies in skeletal muscle.

Hirano bodies constitute eosinophilic intracytoplasmic inclusions, typically seen in the central nervous system, where they are related to senility and certain dementias such as Alzheimer's disease or the Parkinson-dementia complex. They have been found in different tissues of experimental animals and, on rare occasions, in extraocular muscles of elderly individuals. However, to our knowledge they have not been described in skeletal muscle in locations other than extraocular muscles or associated with muscle pathology. Glycogenosis II or Pompe's disease, is a metabolic disorder caused by acid maltase deficiency and is characterized by glycogen accumulation in lysosomes in various tissues, including skeletal muscle. There are three clinical forms depending on age at onset, the most frequent being the childhood form. We present the histopathological and ultrastructural findings of a muscle biopsy performed in a case of the adult form of glycogenosis II which showed, in addition to characteristic lysosomal glycogen storage, paracrystalline mitochondrial inclusions and, as an exceptional finding, intracytoplasmic Hirano bodies in some muscle fibres.

Female↗
PubMedDate not supplied

Dementia with lewy bodies: implications for clinical trials.

The neurobehavioral and pathologic features of Parkinson disease dementia (PDD) are virtually identical to those of dementia with Lewy bodies (DLB), suggesting that they represent different phenotypes of the same underlying disease. Both are characterized clinically by a "frontal-subcortical" dementia, fluctuating confusion, and, often, psychotic symptoms. Pathologically they are characterized by disseminated Lewy bodies and multiple transmitter deficits. These dementias with Lewy bodies constitute the second leading cause of dementia after Alzheimer disease (AD), and are thus an important treatment target. No drug has yet been approved for these indications, but treatment options are emerging. This paper addresses the conduct of clinical trials for this indication, including definition of target populations, screening metrics, outcome measures, and clinical trial designs. As the pathophysiology of these cognitive and behavioral changes becomes better understood, symptomatic as well as disease-modifying therapy may become possible, requiring an inclusive and consistent approach to clinical trials in this area.

Clinical Trials as Topic↗
PubMed1976

The limbic system in Alzheimer's disease. A neuropathologic investigation.

The morphologic alterations of Alzheimer's disease, presenile and senile dementia, have conventionally been associated with the cerebral cortex; however, it is clear that other areas of the brain, notably the hippocampus and amygdala, are involved as well. These structures, together with others such as the fornix, cingulate gyrus, septal nuclei, and mamillary bodies, constitute the limbic system, which has been recognized as the anatomic substrate of memory, emotion, and learning. Disturbances in these modalities are central to the clinical expression of Alzheimer's disease; therefore, the limbic system was studied in its entirety in 9 patients with Alzheimer's disease and in 3 elderly individuals with Down's syndrome, in whom identical morphologic lesions were present. The findings disclose that the limbic system is regularly involved in Alzheimer's disease, to a severe degree and in a distinctively patterned distribution.

Aged↗
PubMed2005

Optimization of expression and purification of two biologically active chimeric fusion proteins that consist of human interleukin-13 and Pseudomonas exotoxin in Escherichia coli.

We have previously reported that a variety of solid human tumor cell lines express a large number of receptors for interleukin-13 (IL-13). These receptors could be targeted with a chimeric fusion protein consisting of human IL-13 and a truncated form of Pseudomonas exotoxin (PE). We describe here optimization of critical steps involved in high yield expression of two recombinant chimeric fusion proteins for obtaining highly purified and biologically active cytotoxins in Escherichia coli. The chimeric constructs of human IL-13 and two 38 kDa truncated PEs: (i) PE38 and (ii) PE38QQR, (three lysine residues in PE38 at 590, 606, and 613 substituted with two glutamine and one arginine) were used for protein expression in pET prokaryotic expression vector system with kanamycin as a selection antibiotic. Our results suggest that fresh transformation of E. coli and induction by isopropyl-beta-D-thiogalactopyranoside (IPTG) for 6 h resulted in maximum protein expression. To further improve the yield, we used a genetically modified E. coli strain, BL21(DE3)pLysS, which carries a plasmid for lysozyme with a weak promoter that inhibits T7 RNA polymerase and minimizes protein production in the absence of IPTG. Use of this strain eliminated the need for lysozyme digestion of the induced bacteria to release inclusion bodies, which resulted in expression of purer protein as compared to the conventional BL21(DE3) strain. Additional protocol optimizations included 16 h solubilization of inclusion bodies, constitution of refolding buffer, and timing of dialysis. These proteins were finally purified by Q-Sepharose, mono-Q, and gel filtration chromatography. Between 14-22 and 21-28 mg highly purified and biologically active protein was obtained from 1L of BL21 (DE3) and BL21 (DE3) pLysS bacteria culture, respectively. As IL-13R targeting for brain tumor therapy offers an exciting treatment option, optimization of production of IL-13PE will enhance production of clinical grade material for Phase III clinical trials.

ADP Ribose Transferases↗
PubMed2000

Serum leptin correlates with serum uric acid but not serum testosterone in non-obese male adolescents.

To identify the serum factors that affect circulating leptin levels, we measured the serum concentrations of leptin, testosterone (T), estradiol (E), serum alanine aminotransferase, total cholesterol and uric acid (UA) in healthy male adolescents (age, 18.3 +/- 0.1 years, n=96). We also measured body mass index (BMI), percent body fat and thickness of skin fold to assess the effect of body constitution on serum leptin level. Since serum concentration of leptin significantly correlated with BMI (r=0.820, p<0.001), we analyzed the relation-ship between leptin/BMI ratio (L/BMI) and serum parameters. Analysis of data of subjects with normal serum T level showed a significant inverse correlation between L/BMI and serum T levels (n=96, r=-0.294, p<0.005), but no such correlation was present among non-obese subjects (n=70) with BMI of +/-20% of normal (22 kg/m2). There was no correlation between L/BMI and serum E level. Serum UA level significantly correlated with L/BMI in both the test group (n=96, r=0.520, p<0.001) and non-obese subjects (r=0.369, p<0.005). Stepwise multiple regression analysis showed that UA independently and significantly influenced serum leptin levels in both the test and control groups. Our results demonstrate that T weakly influences serum leptin concentration, and that UA concentrations strongly influences serum leptin in healthy male adolescents independent of their obesity level.

Adolescent↗
PubMed2006

Foetal size and body proportion at 17-19 weeks of gestation and neonatal size, proportion, and outcome.

OBJECTIVE: To determine whether proportionate or disproportionate foetal smallness at 17 to 19 weeks of gestation in low-risk pregnancies was associated with size, body constitution, and adverse outcome at birth. METHODS: We included ultrasound measurements at 17-19 weeks of gestation in 7285 uncomplicated pregnancies with reliable information on last menstrual period. We considered a foetus with both mean abdominal diameter (MAD) and biparietal diameter (BPD) below the 10th percentile for gestational age, gender, and parity as symmetrically small. Those who had MAD below the 10th percentile and BPD at or above the 10th percentile were asymmetrically small (thin and small). RESULTS: The occurrence of small for gestational age (SGA) (birth weight below the 10th percentile) decreased with increasing second trimester MAD percentile (P<0.0001). The risk in foetuses which were both thin and extremely small (MAD below the 2.5th percentile) of having weight, ponderal index, crown-heel length, or head circumference below the 10th percentile at birth was 19-28%. The risk of perinatal composite outcome (prenatal death, Apgar score after 5 min < or =7, birth weight below the 10th percentile, or <1500 g, or preterm birth) was 37%. Apgar score of < or =7 at 5 min and explained foetal death both occurred in 7%, which was significantly higher than those with larger MAD. CONCLUSION: Asymmetric as well as symmetric foetal smallness may start early in pregnancy. Symmetric and particularly asymmetric small foetuses at 17-19 weeks of gestation were generally lighter, shorter, and thinner at birth and had more often adverse perinatal outcome.

Abdomen↗
PubMed2000

Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study.

BACKGROUND: Recent clinical guidelines on the health risks of obesity use body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and waist circumference, but the waist-hip ratio may provide independent information. METHODS: To assess the joint and relative associations of BMI, waist circumference, and waist-hip ratio with multiple disease end points, we conducted a prospective cohort study of 31,702 Iowa women, aged 55 to 69 years and free of cancer, heart disease, and diabetes, assembled by random sampling and mail survey in 1986. Study end points were total and cause-specific mortality and incidence of site-specific cancers and self-reported diabetes, hypertension, and hip fracture over 11 to 12 years. RESULTS: The waist-hip ratio was the best anthropometric predictor of total mortality, with the multivariable-adjusted relative risk for quintile 5 vs 1 of 1.2 (95% confidence interval, 1.1-1.4), compared with 0.91 (95% confidence interval, 0.8-1.0) for BMI and 1.1 (95% confidence interval, 1.0-1. 3) for waist circumference. The waist-hip ratio was also associated positively with mortality from coronary heart disease, other cardiovascular diseases, cancer, and other causes. The waist-hip ratio was associated less consistently than BMI or waist circumference with cancer incidence. All anthropometric indexes were associated with incidence of diabetes and hypertension. For example, women simultaneously in the highest quintiles of BMI and waist-hip ratio had a relative risk of diabetes of 29 (95% confidence interval, 18-46) vs. women in the lowest combined quintiles. CONCLUSION: The waist-hip ratio offers additional prognostic information beyond BMI and waist circumference.

Abdomen↗
PubMed2000

Identifying patients for weight-loss treatment: an empirical evaluation of the NHLBI obesity education initiative expert panel treatment recommendations.

BACKGROUND: The NHLBI (National Heart, Lung, and Blood Institute) Obesity Education Initiative Expert Panel recently proposed that clinicians and other health care professionals use a new treatment algorithm to identify patients for weight-loss treatment. In addition to the usual assessment of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), the new algorithm includes the assessment of abdominal obesity (as measured by waist circumference) and other cardiovascular disease (CVD) risk factors. METHODS: We examined the percentage of adults meeting the criteria of the panel's treatment algorithm: BMI > or =30 or ¿[BMI, 25.0-29.9 or waist circumference >88 cm (women) >102 cm (men)] and > or = 2 CVD risk factors¿ in a sample of 2844 black, 2754 Mexican American, and 3504 white adults, aged 25 to 64 years, from the Third National Health and Nutrition Examination Survey, 1988-1994. RESULTS: Across ethnic groups, more than 98% of adults (normal weight, overweight, and obese) received the same treatment recommendations using the panel's algorithm and an algorithm based only on BMI and CVD risk factors, without waist circumference. For normal-weight adults, almost none (0.0%-1.8%) had a large waist circumference as defined above and 2 or more CVD risk factors. Using the usual criterion of a BMI of 30 or higher, a substantial percentage of at-risk overweight women and men (BMI, 25.0-29.9) with 2 or more CVD risk factors were missed (8.4% and 19.3%, respectively). CONCLUSIONS: Despite the potential importance of abdominal obesity as a CVD risk factor, these results challenge the clinical utility of including waist circumference in this new algorithm and suggest that using BMI and CVD risk factors may be sufficient.

Adult↗
PubMed2000

Effects of walking training on weight maintenance after a very-low-energy diet in premenopausal obese women: a randomized controlled trial.

BACKGROUND: Maintenance of weight loss is a core problem in the treatment of obesity. Physical activity may improve maintenance and metabolic risk factors associated with obesity. HYPOTHESES: (1) A walking training program of moderate intensity, started after weight reduction by a very-low-energy diet, improves maintenance of weight loss and obesity-related metabolic disorders; and (2) the effect of the training program is related to the prescribed amount of physical activity, ie, a higher amount (energy expenditure) leads to more favorable results. METHODS: The participants were premenopausal women with a mean body mass index of 34.0 kg/m(2). Eighty-two participants were randomized to this study; 74 participated in the follow-up assessment. A 12-week weight reduction by mostly a very-low-energy diet was followed by a 40-week maintenance program randomized in 3 groups: a control group with no increase in habitual exercise and with counseling on diet and relapse prevention; a walk-1 group, with a walking program targeted to expend 4.2 MJ/wk and diet counseling; and a walk-2 group, with a walking program of 8. 4 MJ/wk and diet counseling. Random permuted blocks within strata were used, with weight loss (in 3 classes) as the stratifying factor. After the intervention, the subjects were followed up for 2 years. MAIN OUTCOME MEASURES: Primary outcomes were body weight, fat mass, and waist circumference at the 2-year follow-up. Secondary outcomes were the levels of serum lipoproteins and lipids, plasma glucose, insulin, and blood pressure. RESULTS: The mean weight loss after weight reduction was 13.1 kg. The main outcome variables remained stable during the maintenance program, but increased during the follow-up period. Compared with the end of weight reduction, weight regain at the 2-year follow-up was 3.5 kg less (95% confidence interval, 0.2-6.8) and waist circumference regain 3.8 cm less (95% confidence interval, 0.3-7.3) in the walk-1 group vs controls. The secondary outcomes showed a partial relapse during the maintenance program, and a further regain during the follow-up period. CONCLUSIONS: Inclusion of a walking program of moderate training regimen into a weight maintenance program improved maintenance of losses in weight and waist circumference.

Adult↗
PubMed2000

Lean body mass and body fat distribution in participants with chronic low back pain.

BACKGROUND: Loss of muscle mass and central obesity progress with aging, but the effect of muscle loss on chronic low back pain has not been precisely evaluated. METHODS: Three hundred thirty Japanese persons aged 45 to 69 years, with a complaint of low back pain for longer than 3 months (n = 203) and age- and sex-matched healthy control subjects (n = 127), were enrolled in this study. Participants with chronic low back pain were classified into the following groups: (1) women with a positive straight leg raise test result, (2) women with a negative straight leg raise test result, (3) men with a positive straight leg raise test result, and (4) men with a negative straight leg raise test result. Controls were classified by sex into a female and a male group. Anthropometric data, consisting of body mass index, percentage body fat, waist-hip ratio, and lean body mass of the upper extremities, trunk, and lower extremities divided by body weight, were measured in participants with low back pain, and the results were compared with those of controls. RESULTS: The waist-hip ratio in women with a negative straight leg raise test result was significantly higher than those in the female control group (P<.001) and in the women with a positive straight leg raise test result (P =.04). The lean body mass of the trunk and lower extremities divided by body weight of women with a negative straight leg raise test result was significantly lower than that of female controls (P =.03 for the trunk and P<.001 for the lower extremities). However, no significant differences were detected between the female negative straight leg raise test result group and the female control group for lean body mass of the upper extremities divided by body weight or body mass index. There were no significant differences in anthropometric data between the male test and control groups or between the female positive straight leg raise test result group and the female control group. CONCLUSION: Trunk and lower extremity loss of muscle mass and central obesity may be risk factors for chronic low back pain without a positive straight leg raise test result in women aged 45 to 69 years. Arch Intern Med. 2000;160:3265-3269.

Adipose Tissue↗