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At least 757 records · Page 42Linked to original sources
PubMed2006

Chronic obesity lymphoedematous mucinosis: three cases of pretibial mucinosis in obese patients with pitting oedema.

Pretibial mucin deposition on the shins is known as pretibial myxoedema. We report three patients with pretibial mucinosis without thyroid disease. The patients were characterized clinically by morbid obesity and bilateral lower extremity pitting oedema with gradual and painless onset, and that did not involve the feet and ankles. Vesicles, semitranslucent papules or a woody plaque were found on the shins. Histologically, patients showed characteristic features of epidermal atrophy with effacement of the rete ridge pattern, separation of collagen bundles associated with oedema with stellate to linear fibroblasts, upward-running increased capillary and small vessels with haemosiderin deposition, and mucin deposition at the superficial papillary dermis and around the vessels. We propose that the present cases of 'chronic obesity lymphoedematous mucinosis' belong to the clinical entity of pretibial mucinosis.

Adult↗
PubMed1984

Triglyceride metabolism in human liver: studies on hepatic phosphatidic-acid phosphatase in obese and non-obese subjects.

According to current concepts, soluble phosphatidic-acid phosphatase, converting phosphatidic acid into a diglyceride, is a rate-limiting enzyme in the hepatic biosynthesis of triglycerides. The present paper is the first report on this enzyme in human liver. The enzyme activity was assayed in ammonium sulphate precipitates of cytosol obtained from human liver biopsies. The activity was stimulated by preincubation with alkaline phosphatase and inhibited by Mg-ATP, suggesting that phosphorylation-dephosphorylation may be of some importance for the expression of the activity of the enzyme. When assayed under optimal conditions, the activity obtained in liver biopsies from normal-weight gallstone patients averaged 12.8 +/- 2.0 nmol min-1 (mg protein)-1 (mean +/- SEM) (n = 17). The enzyme activity was slightly higher in liver biopsies from morbidly obese subjects 16.4 +/- 2.8 nmol min-1 (mg protein)-1 (n = 14). The difference between the two groups of subjects was probably in part sex-dependent and was not statistically significant. A similar small and insignificant difference between the two groups of subjects was found when the enzyme activity was assayed in the maximally stimulated state--i.e. after incubation with alkaline phosphate. These findings suggest that an increased capacity of the soluble phosphatidic-acid phosphatase is not of major importance for the increased triglyceride synthesis known to occur in obesity. Other factors (i.e. availability of substrate and cofactors) may be of greater importance.

Adult↗
PubMed2006

Trafficking of dietary fat in obesity-prone and obesity-resistant rats.

The trafficking of dietary fat was assessed in obesity-prone (OP) and obesity-resistant (OR) male and female rats. Test meals containing [1-(14)C]palmitate were delivered through gastric feeding tubes while rats consumed a high-carbohydrate diet (HCD) or after 5 days of a high-fat diet (HFD). Over the subsequent 24 h, the appearance of (14)C was followed in the GI tract, skeletal muscles (SM), liver, adipose tissues (AT), and expired CO(2). There was no difference in the production of (14)CO(2) between OP and OR rats consuming a HCD. However, after 5 days on HFD, OR rats produced significantly more (14)CO(2) after the test meal than OP rats (P < 0.001 females, P = 0.03 males). The differential oxidation of dietary fat between OP and OR rats on HFD was not due to differences in absorption but rather was associated with preferential disposition of tracer to AT in OP rats. Measurements of lipoprotein lipase in part explained increased tracer uptake by AT in OP rats but were not consistent with increased SM tracer uptake in OR rats. Surprisingly, female rats oxidized more tracer than male rats irrespective of phenotype or diet. These results are consistent with the notion that differences in the partitioning of dietary fat between storage in AT and oxidation in SM and liver that develop shortly after the introduction of a HFD may in part underlie the differential tendency for OR and OP rats to gain weight on this diet.

Adipose Tissue↗
PubMed1994

Time course of adaptation to a high-fat diet in obesity-resistant and obesity-prone rats.

The purpose of the present study was to characterize the time course of adaptation (i.e., circulating metabolites and hormones, fat pad mass, lipoprotein lipase) to a high-fat diet in obesity-prone (OP) and obesity-resistant (OR) male Wistar rats. Delineation of OP and OR was based on body weight gain (upper tertile for OP; lower tertile for OR) after 1 wk on a high-fat diet (60% of kcal from corn oil). Rats were killed after 1, 2, or 5 wk of the dietary period. Increased body weight and percent body fat in OP rats at 1 wk could not be accounted for by increased retroperitoneal or epididymal fat pad weight. Plasma nonesterified fatty acids and triglycerides, as well as blood concentrations of glucose, lactate, and glycerol, were similar throughout the study. Plasma insulin was significantly greater in OP vs. OR rats and low-fat diet (LFD; 20% of kcal from corn oil) controls at 5 wk only, and blood beta-hydroxybutyrate (mM) was significantly higher in OR compared with OP and LFD rats at 1, 2, and 5 wk. Lipoprotein lipase mRNA and activity were significantly greater in epididymal fat pad and significantly lower in gastrocnemius muscle of OP vs. OR rats at 1 wk. Results suggest that early (i.e., 1 wk) differences in body weight and fat weight between OP and OR rats are not due to fat deposition in retroperitoneal or epididymal fat depots, and tissue-specific changes in LPL (increase in epididymal fat pad and decrease in gastrocnemius muscle) that occur in OP compared with OR rats after 1 wk on a high-fat diet provide a metabolic environment favoring fat storage.

Adaptation, Physiological↗
PubMed2006

Obesity, the Jews and psychoanalysis: on shaping the category of obesity.

Hilde Bruch was one of the most important researchers into the question of weight during the 20th century. Best known for her popularization of anorexia nervosa, she was equally important in articulating a psychological aetiology for obesity. This work was rooted in her historical experiences in Germany and in the USA, and specifically the claim made at that time for the predisposition of the Jews to obesity.

Germany↗
PubMed2004

Cortisol stress response is positively correlated with central obesity in obese women with binge eating disorder (BED) before and after cognitive-behavioral treatment.

Stress is the most commonly reported trigger of binge eating, and high cortisol levels are positively related to both central body fat and food intake after laboratory stress. We therefore examined waist circumference (WHR) and cortisol stress responsivity after a cold pressor stress test (CPT) in 22 obese (BMI > 27) women (11 BED, 11 non-BED). BMI and WHR did not differ between groups. The BED group had higher morning basal cortisol than the non-BED group (P = .03) and greater AUC cortisol after CPT, after controlling for AUC insulin (P = .04). In the BED group, WHR was related to AUC cortisol (P = .002) and peak cortisol stress responsivity (P = .003). Twenty (10 non-BED, 10 BED) were randomized to a 6-week treatment program (CBT + Diet) or Wait-List (WL) control group. There were no BED group or treatment-group differences in WHR, morning basal cortisol, or AUC cortisol after CPT. The relationship between WHR and both AUC cortisol (P = .002) and peak cortisol stress responsivity after CPT (P = .008) remained significant in the BED group. In BED, there is a hyperactive HPA axis related to abdominal obesity that persists even after treatment, suggesting that cortisol might be a primary factor in the disorder.

Adipose Tissue↗
PubMed2005

Impact of common polymorphisms in candidate genes for insulin resistance and obesity on weight loss of morbidly obese subjects after laparoscopic adjustable gastric banding and hypocaloric diet.

CONTEXT: It is unknown whether genetic factors that play an important role in body weight homeostasis influence the response to laparoscopic adjustable gastric banding (LAGB). OBJECTIVE: We investigated the impact of common polymorphisms in four candidate genes for insulin resistance on weight loss after LAGB. DESIGN: The design was a 6-month follow-up study. SETTING: The study setting was hospitalized care. PATIENTS: A total of 167 unrelated morbidly obese subjects were recruited according to the following criteria: age, 18-66 yr inclusive; and body mass index greater than 40 kg/m2 or greater than 35.0 kg/m2 in the presence of comorbidities. INTERVENTION: LAGB was used as an intervention. MAIN OUTCOME MEASURE: Measure of correlation between weight loss and common polymorphisms in candidate genes for insulin resistance and obesity was the main outcome measure. RESULTS: The following single nucleotide polymorphisms were detected by digestion of PCR products with appropriate restriction enzymes: Gly972Arg of the insulin receptor substrate-1 gene, Pro12Ala of the proliferator-activated receptor-gamma gene, C-174G in the promoter of IL-6 gene, and G-866A in the promoter of uncoupling protein 2 gene. Baseline characteristics including body mass index did not differ between the genotypes. At the 6-month follow-up after LAGB, carriers of G-174G IL-6 genotype had lost more weight than G-174C or C-174C genotype (P = 0.037), and carriers of A-866A uncoupling protein 2 genotype had lost more weight as compared with G-866G (P = 0.018) and G-866A (P = 0.035) genotype, respectively. Weight loss was lower in carriers of Gly972Arg insulin receptor substrate-1 genotype than Gly972Gly carriers, but not statistically significant (P = 0.06). No difference between carriers of Pro12Ala and Pro12Pro proliferator-activated receptor-gamma genotype was observed. CONCLUSIONS: These data demonstrate that genetic factors, which play an important role in the regulation of body weight, may account for differences in the therapeutic response to LAGB.

Adult↗
PubMed2001

Quality-of-life assessment of morbidly obese patients who have undergone a Lap-Band operation: 2-year follow-up study. Is the MOS SF-36 a useful instrument to measure quality of life in morbidly obese patients?

BACKGROUND: Quality of life (QoL) was tested in a 2-year postoperative study using the Medical Outcome Study Short Form 36 (MOS SF-36) to assess preoperative and 1 and 2 year postoperative QoL among one group of female patients (group 1, n = 42) and a 2 year postoperative QoL study in a second group of female patients (group 2, n = 9) who underwent a stomach reduction operation involving open surgical placement of a Lap-Band during the year 1997. METHODS: The QoL of 42 patients (group 1) was assessed at most 20 hours before surgery and 1 and 2 years (12 and 24 months) postoperatively using a randomized pre-test/post-test design. The QoL of 9 patients (group 2) was assessed 2 years (24 months) postoperatively using a randomized post-test design only. The results were compared with the standardized Dutch norm datascale. Statistical data were analyzed with SPSS versions 10.0. RESULTS: The placement of a Lap-Band in group 1 resulted in a significant reduction in Body Mass Index (BMI) in the first and second-year follow-up. Mean BMI declined significantly from 40.7 kg/m2 preoperatively to 33.1 kg/m2 at the 1-year follow-up, to 31.3 kg/m2 at 2-year follow-up. In group 2 BMI also declined significantly from 43.0 kg/m2 preoperatively to 34.2 kg/m2 at 1-year follow-up to 32.1 kg/m2 at the 2-year follow-up. Compared to the MOS SF-36 standardized Dutch norm data, a significant improvement in the QoL was seen on the effect variable bodily pain, mental health and general health perceptions in group 1. Although the bodily pain, general health and mental health perceptions increased significantly 2 years postoperatively (group 1) compared with the Dutch standardized norm data, the preoperative general health and mental health perceptions of morbidly obese patients were, like all other preoperative effect variables, not significantly different from the scores on the Dutch standardized norm scale. CONCLUSION: Although other authors found that QoL improves after surgical-induced weight loss, showing significant improvements on patients' perception of their health status, these findings were not confirmed in the present study. The findings show only a significant difference in bodily pain, general health and mental health perception before and after surgical intervention and preoperatively in group 1 compared to the Dutch standardized norm data. Because of small sample size (n = 9), no significant results were found in group 2 compared to the Dutch Standardized norm data. Based on earlier and present findings, further study is recommended to ascertain whether the MOS SF-36 is valid in morbidly obese patients and whether the response set has an influence on QoL studies of these patients.

Adult↗
PubMed2004

[Spirometric values of obese and non-obese subjects on orthostatic, sitting and supine positions].

BACKGROUND: It is possible that obesity could lead to pulmonary restriction with decreasing lung volumes. However, controversies about this restriction and its etiology still exist. Thus, the purpose of this report was to evaluate the effects of body weigh excess on spirometry, on three different body positions, evaluated by Body Mass Index (BMI), percentage of fatness and the ratio of abdominal girth to hip breadth (AG/HB). METHODS: Forty-six sedentary volunteers, with ages between 20 and 40 years, were studied and distributed on five groups, based on BMI. Skin fold thickness and ratio of abdominal girth to hip breadth (AG/HB) of the volunteers were measured. FVC, FEV1 and ratio of FEV1 to FVC were measured on three different body positions--sitting, supine and orthostatic positions. RESULTS: Comparing the values measured and predicted between the groups, no difference was detected. Comparing body positions, the supine position shows lower values than sitting and orthostatic positions (p<0.05). Associations between CVF, VEF1 e VEF1/CVF values and BMI, percentage of fatness and ratio of AG/HB were not found. CONCLUSIONS: Spirometric values from obese people are into normality range and decrease on the supine position.

Adult↗
PubMed2006

The Implantable Gastric Stimulator for Obesity : An Update of the European Experience in the LOSS (Laparoscopic Obesity Stimulation Survey) Study.

OBJECTIVE: To evaluate the efficacy of a gastric stimulation procedure for the treatment of morbid obesity. METHODS: All implantable gastric stimulator systems were implanted in a laparoscopic procedure. We focused on the results of the LOSS (Laparoscopic Obesity Stimulation Survey) study, which was a multicenter European survey of 16 hospitals. To date, 91 patients have undergone implantable gastric stimulator implantation in the LOSS study. RESULTS: The patient population was comprised of 62 (68%) women and 29 (32%) men. The mean age was 41 years, mean weight was 116kg, and mean body mass index was 41 kg/m(2). All surgical procedures were successfully completed. There were no deaths, and no severe peri- or postoperative complications. The mean excess weight loss (EWL) was 20% at 12 months after surgery and about 25% at 2 years after implantation. Baroscreen-selected patients achieved a 31.4% EWL, which was significantly different to the EWL of those patients who were not selected by this screening (15% EWL) [p < 0.01]. CONCLUSION: Gastric pacing is a promising, minimally invasive, safe, and effective surgical method that results in very little impairment of the patient. Patient selection for gastric stimulation therapy seems to be an important determinant of treatment outcome.

Humans↗
PubMed2003

Identification of epistatic interaction involved in obesity using the KK/Ta mouse as a Type 2 diabetes model: is Zn-alpha2 glycoprotein-1 a candidate gene for obesity?

The KK/Ta strain serves as a suitable polygenic mouse model for the common form of type 2 diabetes associated with obesity in humans. Recently, we reported the susceptibility loci contributing to type 2 diabetes and related phenotypes in KK/Ta mice. In this study, we focused on expression in the kidneys and liver of KK/Ta and BALB/c mice using differential display (DD) PCR. Zn-alpha(2) glycoprotein-1 (Azgp1) mRNA levels were increased in the kidneys and liver in KK/Ta mice, and sequence analysis revealed a missense mutation. We analyzed the relationship between this polymorphism and various phenotypes in 208 KK/Ta x (BALB/c x KK/Ta) F1 backcross mice. Statistical analysis revealed that Azgp1 and D17Mit218 exhibit a suggestive linkage to body weight (8 weeks) (logarithm of odds 2.3 and 2.9, respectively). Moderate gene-gene interactions were observed at these loci. Adiponectin mRNA levels in 3T3-L1 cells transfected with the expression pcDNA 3.1 vector containing Azgp1 coding sequence of KK/Ta mice were significantly higher than those of BALB/c mice. These results suggest that Azgp1 is a possible candidate gene for regulation of body weight, elucidation of polygenic inheritance, and age-dependent changes in the genetic control of obesity.

Adiponectin↗
PubMed1998

[Psychological characteristics of obese patients hospitalized at the obesity unit of the 4th Internal Medicine Clinic of the Medical School Hospital in Prague].

This study presents the results of a psychological survey carried out in 1995 and 1996 in the Obesity Unit of IVth Department of Internal Medicine, General Faculty Hospital in Prague. There were 86 patients examined. The patients underwent a series of tests and questionnaires--Raven's Progressive Matrices, STAI, Miniscripts, Body Image. No significant differences were found between men and women. On the basis of this screening the general characteristics of obese patients hospitalized in this Unit can be described as follows: average to above average level of mental capacity for the general population, a need to "be strong and have everything under control", a need for recognition from other people, slightly increased level of anxiety. In their perception of their bodies they see themselves as overweight, unattractive and in a poor state of health.

Body Image↗
PubMed1999

Childhood obesity: results of a multicenter study of obesity treatment in Italy.

The prevalence of pediatric obesity is increasing and many patients are followed by specialized centers or private doctors. The aim of this study was to verify short- and medium term results of a therapeutic approach based on nutritional intervention in a large pediatric population: 1383 subjects (695 females, 688 males) aged 10.1 +/- 2.7 yr, followed in 11 pediatric departments in Italy. No difference was found between centers in age, height, weight, BMI and IBW. The drop-out rate after the first visit was 30.2% (58.1% IBW > 140%) in females and 34.2% (70.7% IBW > 140%) in males. After two years of follow-up only 9.7% of females and 6.4% of males remained on treatment. Of these patients only 7.3% of females and 6.4% of males had IBW < 120%. These data show that an approach based on nutritional intervention alone is not sufficient for long-term treatment of pediatric obesity. Only an approach started early and involving the family can produce permanent results.

Adolescent↗
PubMed1999

Serum leptin concentrations in hyperinsulinemia in the sets of obese, lipodystrophic and/or non-obese patients.

OBJECTIVE: To study the relationship between serum leptin and circulating insulin under basal and in response to oral glucose administration in hyperinsulinemic patients with or without obesity. MATERIAL AND METHOD: Fifteen female patients of known hyperinsulinemia provided material for the study. Leptin and insulin in sera were estimated by radioimmunoassay methods. RESULTS: Eight of the 15 hyperinsulinemic patients with high body mass index (BMI) (31 +/- 0.94 kg/m2) had significantly (p < 0.01) elevated serum leptin concentrations (26.1 +/- 2 ng/ml) as compared to the levels in the remaining seven non-obese hyperinsulinemic patients with BMI of 20 +/- 1.0 kg/m2; their mean levels of serum leptin were low 5.7 +/- 1.1 ng/ml. Four of the latter group had face-sparing partial lipodystrophy. The mean circulating leptin concentrations in the control group of seven healthy normoinsulinemic and regularly menstruating women with normal BMI (19 +/- 0.95 kg/m2) were 13.7 +/- 1.8 ng/ml. DISCUSSION: The results of the present study in 15 hyperinsulinemic patients show that circulating levels of leptin are not related to serum insulin. However, there was a positive correlation with BMI. An interesting observation of the study is that, notwithstanding the normal BMI, the group of hyperinsulinemic patients with face-sparing partial lipodystrophy had the lowest levels of circulating leptin concentrations. They were closer to the values found in prepubertal girls.

Adolescent↗
PubMed2001

In the absence of dietary surveillance, chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects.

OBJECTIVE: To investigate the effects of Absorbitol on body weight, anthropometry, body composition, blood pressures and lipid profiles in obese, hypercholesterolaemic subjects without dietary restriction. DESIGN: A randomised, double blind. Placebo-controlled study. SUBJECTS: Normal volunteers with no history of chronic illnesses (n=88) who were obese (body fat percentage > 20% in males and > 30% in females) and hypercholesterolaemic (total cholesterol > 5.20 mmol/L). Sixty-eight (72.3%) subjects completed the study. INTERVENTION: After a 4 week run in phase, 4 placebo/Absorbitol (250 mg) capsules were prescribed 3 times a day before meals. Subjects received written information on healthy lifestyle but there was no dietary restriction or monitoring. MAIN OUTCOME MEASURES: Weight, body mass index, lean body mass, waist, hip, blood pressure, fasting lipids and insulin levels were taken at baseline, 4th and 16th week of the study. STATISTICAL ANALYSIS PERFORMED: Analyses were on an intention-to-treat basis. Comparisons between groups were made using Student's t and Mann-Whitney tests for parametric and non-parametric data respectively. RESULTS: There was no significant change in the measured parameters in Absorbitol treated subjects compared to those on placebo, with exception of HDL-cholesterol which increased in the absorbitol group and decreased in the placebo group (p=0.048). The side effects of Absorbitol were also comparable to that of placebo. CONCLUSIONS: In the absence of dietary surveillance, Absorbitol does not bring about improvement in weight, anthropometry, body composition, blood pressure or lipid profile.

Adult↗
PubMed2001

[WHO warns of obesity epidemic. Are we becoming a society of obese persons?].

Overweight and obesity, together with their concomitant diseases and sequelae, have reached epidemic proportions. The problem is therefore not merely personal, but also societal. We have become an overweight society on its way to obesity. What we need is effective treatment over the long-term and a public health strategy to combat the condition. These two strategies are complementary, not in competition with each other. Without the latter, the successes of the former remain limited. We require national campaigns involving various aspects of our society aimed at promoting health and preventing disease. This makes necessary the involvement of politicians and representatives of various interested groups with appropriate responsibility. Members of health-related occupations should take the lead in initiating and maintaining such action.

Adolescent↗
PubMed2002

Correlation of the -3826A >G polymorphism in the promoter of the uncoupling protein 1 gene with obesity and metabolic disorders in obese families from southern Poland.

The aim of the study was to examine the allelic frequency of the -3826A > G mutation of UPC1 in patients with familiar obesity and to investigate putative association of this polymorphism with metabolic disorders. One hundred and eighteen overweight /obese patients participated in the study. The UCP1 polymorphism was determined by RFLP. Glucose, lipid, insulin and leptin levels were measured both during OGTT and OLTT. The majority of patients had a homozygous A/A genotype (51,38%), while 14,68% had a G/G genotype. We found no significant association of the G allele with either BMI or glucose tolerance. Patients with the homozygous G/G genotype had significantly higher fasting levels of TG (p < 0.04) and decreased levels of HDL-cholesterol (p = 0,004). They also had an increased concentration of FFA and the rise of TG levels during the OLTT compared to controls was significant (p = 0,058). In addition, the carriers of the G/G genotype had the lowest insulin levels both during OGTT and OLTT. In our study we have demonstrated that the -3826A > G polymorphism of UCP1 does not play a major role in the development of obesity and/or disturbances of glucose metabolism. However, the increased levels of TG and FFA and decreased levels of HDL observed in carriers of the G allele suggest FFA-induced impairment of the HDL turnover and disturbance of the beta-cell function, both of which are risk factors for endothelial injury.

Adult↗
PubMed1992

Fluoxetine increases insulin action in obese nondiabetic and in obese non-insulin-dependent diabetic individuals.

Insulin resistance contributes to the metabolic defects in non-insulin-dependent diabetes mellitus (NIDDM). Anorectic agents have been shown to improve insulin action in NIDDM, irrespective of weight reduction. The serotonin-reuptake inhibiting agent fluoxetine has recently been recognized as an anorectic agent. The effect of fluoxetine on insulin action has not yet been determined. In a double blind placebo controlled crossover study, we examined hepatic and peripheral insulin action by the sequential hyperinsulinemic euglycemic clamp technique with infusion of 3-3H-glucose in eight obese NIDDM and in eight obese nondiabetics, matched for age, sex and body mass index. Body weight was kept constant. After 14 days of fluoxetine, 60 mg daily, in NIDDM half-maximal peripheral glucose uptake was achieved at a lower insulin level than after placebo (ED50pgu 180.5 +/- 25.8 vs 225.3 +/- 39.9 mU/l, P less than 0.05), but not in nondiabetics (140 +/- 15.3 vs 135.3 +/- 22.2 mU/l, n.s.). Maximal peripheral glucose uptake (Vmaxpgu) did not change significantly. Basal hepatic glucose production (HGP) was reduced after fluoxetine in both NIDDM (9.45 vs 10.37 mumol/kg/min) and in nondiabetics (8.57 vs 9.16 mumol/kg/min), although the difference was only significant in nondiabetics (P less than 0.05). Multivariate analysis disclosed no differences in the effect of fluoxetine between NIDDM and nondiabetics. When nondiabetics and NIDDM were considered together, only the most insulin-resistant individuals demonstrated a decrease in ED50pgu (P less than 0.001). Likewise, only the individuals with the most outspoken hepatic insulin resistance demonstrated a decrease in insulin level, at which hepatic glucose production is completely suppressed (HGP0) (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

C-Peptide↗