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PubMed2004

[Effects of a comprehensive intervention program on simple obesity of children in kindergarten].

OBJECTIVE: The purpose of the study was to explore a comprehensive management program for the obese children in kindergarten. The program should be scientific, rational, suitable for kindergarten, and easy to apply. Child care workers, parents, and child health care doctors participated in the program to help obese children establish a scientific life style through their daily life, to control their weight and to maintain their physical and mental health. METHODS: The theories of behavior science, nutriology and kinematics were applied to make the weight control of obese children in kindergarten quantified and relatively standardized. Children were divided into three groups, intervened obese children, non-intervened obese children and normal children. Data such as weight, height, and body mass index (BMI) were observed to assess the effect of weight control and define whether it affects the linear gain of children's height. RESULTS: The recovery rate of intervened obese group, non-intervened group was 62.5% and 5.3%, respectively. The general effective rate was 91.7% and 15.8%, respectively. The weight gain of intervened group was 4.15 kg lower than that of non-intervened group. The BMI of intervened group significantly decreased by 2.9 as compared to the non-intervened group. The height gain of intervened group was similar to that of normal group. Parents and health care workers' realization of children obesity and their corresponding actions, the behaviors of obese children at home and in kindergarten were changed toward the direction beneficial to weight control. CONCLUSION: The implementation of the comprehensive intervention program for obesity in children, which involved obese children, child care worker, parents, and child care doctors alleviated the obesity level of those obese children without affecting their normal height gain. The program was safe and effective. Through the comprehensive intervention, the obese children could establish good habits during the sensitive period.

Body Height↗
PubMed2004

Undiagnosed obesity: implications for undiagnosed hypertension, diabetes, and hypercholesterolemia.

BACKGROUND AND OBJECTIVES: Since obesity is a risk factor for hypertension, diabetes, and hypercholesterolemia, health care providers should screen obese individuals for these common diseases. It is possible that obese adults are not receiving appropriate screening for these diseases. This study's objective was to describe the prevalence of undiagnosed obesity, diabetes, hypertension, and hypercholesterolemia, in a nationally representative sample of obese US adults, by patients' recollection of whether they had received such a diagnosis. METHODS: The prevalence of undiagnosed disease was obtained by identifying respondents in the 1999-2000 National Health and Nutrition Examination Survey (NHANES) who had findings consistent with a condition but who did not report being told they had that condition by a health care provider. RESULTS: The prevalence of undiagnosed obesity, diabetes, hypertension, and hypercholesterolemia in currently obese US adults is 22.9%, 11.3%, 16.1%, and 37.7%, respectively. Significant predictors of undiagnosed obesity include black race and younger age. In addition, obese adults with excellent self-reported general health condition and lower body mass index are less likely to have diagnosed obesity. CONCLUSIONS: Health care providers are missing valuable opportunities to address obesity and diagnose diabetes, hypercholesterolemia, and hypertension in obese adults. An emphasis on screening obese individuals for these diseases is needed to improve health promotion.

Adult↗
PubMed2006

Demographic, socioeconomic and educational aspects of obesity in an adult population.

Obesity as a disease is a yet-unidentified sum of genetic and environmental factors. Risky eating behavior and lifestyle may bring the disease. The aim of the study was to find out risk factors for obesity factors influencing definition of obesity. Participants (n = 1500) who filled out a questionnaire about eating habits are grouped according to their body mass indices as normal weight, overweight and obese (n = 500 in each group). According to our results, the prevalence of having obese first-degree relatives is significantly higher in obese individuals (p < 0.001). Sixty-two of normal weighing subjects were university graduates, whereas this ratio was only 31% in the obese group (p < 0.001). Incidence of obesity was higher in married participants when compared to the single or divorced/widowed persons (p < 0.001). Multinomial logistic regression analysis gave the following results: risk of obesity was 57% less in participants lacking a family history of obesity when compared to the ones with a positive family history (p = 0.005). Being married increases the risk of obesity 2.5 times; being a primary school graduate increases the risk about 1.5 times. Lower educational level, unemployment and lack of counseling seem to be risk factors associated with obesity. Diverging patterns of sociodemographic features, lifestyles and perception were evident even between overweight and obese populations.

Adolescent↗
PubMed2006

Mobile health unit for minority obesity education: local residents' attitudes and perceptions.

OBJECTIVE: To provide educational material to the Bronx community in their places of recreation as well as uncover attitudes and perceptions about the obesity epidemic. METHODS: Our medical team equipped a mobile health unit, called Vehicle Assisted Nutrition (VAN), with educational material and drove it to seven recreation sites in the Bronx. At these sites, participants completed a short survey, and our staff took body mass index (BMI) measurements. The medical team also distributed patient education materials pertaining to lifestyle modification and obesity. BMI and survey responses were compared and analyzed with statistical software. RESULTS: Obesity rates at these sites averaged 29.9% normal weight, 40.2% overweight, 18% class-1 obese and 11% class-2 obese or greater. Only 22.2% of normal weight, 23.3% of overweight and 43.6% of class-1 obese respondents stated that their weight was a problem (p<0.001). Most (80.6%) of the class-2 obese or greater respondents, however, stated that their weight was a problem (p<0.001). More than 44% of normal weight, 59.4% of overweight, 71.3 of class-1 obese and 90.3% of the class-2 obese or greater participants stated they were willing to do something about it (p=0.006). Of those surveyed, 37.5% of the normal weight, 54.7% of the overweight, 56.9% of the class-1 obese and 63.6% of the class-2 obese or greater indicated that they would like our help (p=0.035). More than 66% of normal weight, 41.8% of the overweight, 56.9% of the class-1 obese, and 68.9% of the class-2 obese or greater stated that they would be interested in a class to lose weight (p=0.008). CONCLUSION: Medical practitioners need to recognize the role of patients' attitudes about weight loss and clarify for patients the definitions of exercise.

Attitude to Health↗
PubMedDate not supplied

Update in the management of obesity.

Significant increase of obesity prevalence in almost all countries in the world recently has had obesity as a global health problem, and WHO in 1998 defined it as "the global epidemic". Simply, obesity is defined as an excessive fat accumulation in fat tissue due to imbalance of energy intake and expenditure. Body mass index is a simple method for defining the degree of overweight and obesity, however, waist circumference is the preferred measure of abdominal obesity because it has greater relationship with the risk of metabolic and cardiovascular diseases. Body fatness reflects the interactions of development, environment and genetic factors. The role of genetic factors has already existed, nevertheless, environment factors are likely more important in developing obesity. Increased mortality among the obese is evident for several life-threatening diseases including type 2 diabetes, cardiovascular disease, gallbladder disease, and hormone-sensitive and gastrointestinal cancers. Risks are also higher for some non-fatal conditions such as back pain, arthritis, infertility and, in many westernized countries, poor psychosocial functioning. Obesity is not only threatening health, also impacts on high economic and social cost. Effective prevention of obesity should be focused to high risk individuals or groups. Individuals who have some existing weight-related problems and those with a high risk of developing obesity co-morbidity such as cardiovascular disease and type 2 diabetes should be a key priority in this prevention strategy. Although weight loss in obese persons of any age can improve obesity-related medical complications, physical function, and quality of life, the primary purpose for weigh-loss therapy may differ across age group. The current therapeutic tools available for weight management are: (1) lifestyle intervention involving diet, physical activity, and behavior modification; (2) pharmacotherapy; and (3) surgery. Moderate weight loss (5-10% of initial weight) by any programs is a realistic target in management of obesity associated with improvement of risk factors of metabolic and cardiovascular diseases.

Appetite Depressants↗
PubMed2006

Association of plasma viscosity with cardiovascular risk factors in obesity: an old marker, a new insight.

OBJECTIVE: Although obesity is related with cardiovascular disease, the exact mechanism of the relationship is not fully understood. We aim to examine the relationship between plasma viscosity and obesity as a cardiovascular disease risk factor in obese and non-obese groups. METHODS: We recruited 75 obese subjects (mean age: 40.2+/-8.4 years, Body Mass Index: 33.61+/-2.57 kg/m(2)) who were admitted to the Clinic of Endocrinology and Metabolism of Cerrahpasa Medical Faculty. As a non-obese group (n=70, mean age: 41.78+/-9.7 years, Body Mass Index: 21.84+/-3.42 kg/m(2)) healthy subjects from medical and laboratory staff were selected. Plasma viscosity and lipid profile were measured and atherogenic index was calculated as atherogenic risk factors. RESULTS: Plasma viscosity, total cholesterol and LDL-cholesterol levels and atherogenic index were significantly increased in obese group compared to non-obese group for each p<0.001. We found no significant difference in plasma fibrinogen, insulin, albumin and HDL-cholesterol levels between obese and non-obese groups. Plasma viscosity was correlated with total cholesterol and atherogenic index only in the obese group (p<0.05 and p<0.05 respectively). In the non-obese group regarding PV, we determined a positive correlation with triglycerides (r: 0.470, p<0.05) and negative correlation with HDL-C (r: -0.518, p<0.05). CONCLUSION: Plasma viscosity, an early atherosclerotic risk factor, might be helpful in the assessment of cardiovascular risk in obese subjects along with classical cardiovascular risk factors such as plasma cholesterol and atherogenic index.

Adult↗
PubMed1991

Adaptation to low calorie intake in obese mice: contribution of a metabolic component to diminished energy expenditures during and after weight loss.

Adaptive changes in energy expenditure (EE) in response to low calorie intake were assessed quantitatively in obese mice using techniques that measure EE chronically over weeks (by the comparative carcass method), and also over 24 h (by indirect calorimetry). Grossly obese mice were slimmed (by restricting food to 50 per cent of normal intake) until their body weight reached that of the lean. They were subsequently either maintained in the post-obese state by continued food restriction at 25 per cent below the obese controls, or refed at the same calorie intake as controls. Total EE (assessed over 3 week periods) fell by 30 per cent during weight loss (obese controls 1356 kJ vs obese-slimmed 966 kJ, P less than 0.001), by 25 per cent during maintenance of the post-obese weight (obese control 1443 kJ vs post-obese 1062 kJ, P less than 0.001), and remained diminished by 17 per cent during weight regain upon refeeding (obese control 1443 kJ vs slimmed/refed 1176 kJ, P less than 0.001). Similar reductions in daily oxygen consumption were also obtained by indirect calorimetry, and as a function of lean body mass, 24 h VO2 were lower than controls by 17 per cent, 9 per cent and 10 per cent respectively (P less than 0.01 at least), and remained so under conditions of locomotory restraint. It is calculated that in these obese mice, a metabolic component (unassociated with changes in lean body mass and activity) comprised nearly two-thirds of the adaptive fall in EE during weight loss, and one-half of the change in EE during both phases of post-obese weight maintenance and during weight regain. These studies therefore support the notion that in response to low calorie intake, adaptive changes in the efficiency of cellular energy utilization are of considerable quantitative importance in the resistance to weight loss and in the ease with which the obese condition is rapidly regained after slimming.

Adaptation, Physiological↗
PubMed1991

Gender dimorphism in size, shape and body composition of child-onset obese and nonobese adolescents.

Gender dimorphism (percent GD) for stature (S), body size, body mass (BM) distribution and body composition for obese and nonobese male and female adolescents (mean age 12.7 years, range 10.5-14.5) was compared for 22 girths, 13 bony widths, five skin + fat folds (SF), fat mass (FM), fat free mass (FFM), body density (Db), and calculated variables (BMI, BSA, unit-size mass, waist:hip ratio (WHR), and FFM/S). BM distribution was computed with the ponderal mass equivalent somatogram. There was significant (P less than or equal to 0.05) percent GD for FM, FFM, Db, for the nonobese, but not obese. Only the neck, forearm and wrist girths revealed small but significant (P less than or equal to 0.05) percent GD for the obese. There was no girth percent GD for the nonobese. The elbow, wrist and ankle diameters revealed significant (P less than or equal to 0.05) percent GD for the obese; there was no significant percent GD for the nonobese for the same bony widths. Only the subscapula and iliac SF revealed significant (P less than or equal to 0.05) percent GD for the obese. For nonobese, percent GD was significant (P less than or equal to 0.05) for the triceps, subscapula and thigh SF, Comparisons between obese and nonobese indicated significant (P less than or equal to 0.05) differences between obese and nonobese males and females for FM, FFM, all girths and SF, but not S. Surprisingly, the obese and nonobese had nearly identical trunk diameters; the sum of biacromion, chest, biilac, and bitrochanter diameters were different by only 4.6 percent (n.s.) for the obese and nonobese males, and 1.3 percent (n.s.) for the obese and nonobese females. Thus, a large central frame-size cannot be used to justify the acquisition or maintenance of a larger than average BM for the obese. The ponderal equivalent analyses revealed that the obese's abdomen was the size of a person projected to have a BM in excess of 100 kg. The use of surface anthropometry in the study of adolescent obesity was supported.

Adipose Tissue↗
PubMed1990

Hypertension in obese children: fasting serum insulin levels are closely correlated with blood pressure.

The relationship between blood pressure and anthropometric or metabolic factors was studied in 324 obese children aged 9.5 +/- 1.8 years (mean +/- standard deviation). Obese children had a significantly higher blood pressure than non-obese children (systolic blood pressure: 121 +/- 14 mmHg in obese children vs 112 +/- 11 mmHg in non-obese children, P less than 0.001; diastolic blood pressure: 72 +/- 9 mmHg in obese children vs 66 +/- 7 mmHg in non-obese children, P less than 0.001). When the obese children were divided into hypertensive and normotensive groups, there was a significant difference in fasting serum insulin levels between the two groups (19.3 +/- 9.3 microU/ml in the hypertensive group vs 13.0 +/- 6.1 microU/ml in the normotensive group), and a close correlation between fasting serum insulin levels and systolic blood pressure was demonstrated (r = 0.63, P less than 0.001). However, there was no significant correlation between blood pressure and the degree of obesity itself or the waist-to-hip ratio in the obese children. There was no significant correlation between blood pressure and fasting plasma glucose, serum total cholesterol, or triglycerides levels in the obese children. Moreover, the correlation between fasting insulin levels and blood pressure was shown to be independent of the degree of obesity or waist-to-hip ratio and age by multiple regression analysis. These results indicate that hyperinsulinemia itself may play an important role in the pathogenesis of hypertension in obese children.

Anthropometry↗
PubMed1989

Pharmacokinetic characteristics of the obese overfed rat.

The present study was undertaken to examine the appropriateness of the obese overfed rat and the obese Zucker rat as animal models for evaluating drug disposition changes in human obesity. It was found that 11 of 12 characteristics that control or influence drug clearance and volume of drug distribution in obese humans were qualitatively reproduced in the obese overfed rat. In contrast, existing literature shows that the obese Zucker rat resembles the obese human in only five of 12 characteristics, with meaningful discrepancies in fat-free mass, creatinine clearance, and thyroid function. Perhaps of greatest significance were changes in hepatic cytochrome P-450, which increased in proportion to total body mass in the obese overfed rat but remain unchanged in the Zucker rat. Although P-450 status in human obesity is unknown, the overfed rat model provides an opportunity for examining increased oxidative drug elimination that appears as an established feature of human obesity. In conclusion, the obese overfed rat appears to be superior to the obese Zucker rat as an animal model for evaluating the pharmacological consequences of human obesity, particularly those in which reproducing drug pharmacokinetics is an important consideration.

Animals↗
PubMed1988

Forearm haemodynamics in obese normotensive and hypertensive subjects.

Forearm haemodynamics using pulsed Doppler flowmetry were studied in 83 men: 15 non-obese and eight obese normotensive subjects; 30 non-obese and 30 obese hypertensive patients. Mean ages were similar in the four subgroups. The blood pressure of normotensives and hypertensives was identical in obese and non-obese subjects. Blood flow, expressed in ml/min, was significantly higher in obese subjects, whether normotensive or hypertensive. However, when blood flow was expressed per unit litre of forearm volume, it was similar in the four subgroups. Forearm vascular resistance, whether expressed as absolute or normalized values, was significantly higher (P less than 0.001) in non-obese hypertensives. When obese and non-obese hypertensives were compared, the former were characterized by higher values of blood flow velocity and blood flow, and lower values of vascular resistance, whether absolute or normalized values were used. This study shows firstly that forearm vascular resistance in hypertensives is increased exclusively in non-obese subjects, and secondly that obese hypertensives, when compared with non-obese hypertensives, are characterized by a hyperkinetic forearm circulation.

Adult↗
PubMed1987

The effect of diet composition on weight gain and pyruvate dehydrogenase activity in heart muscle in the gold thioglucose obese mouse.

Pyruvate dehydrogenase complex activity is the major determinant of glucose oxidation in animal cells. Tissue glucose oxidation is reduced in obesity and states of insulin resistance and alternate fuels are utilized for energy and pyruvate dehydrogenase activity is reduced in cardiac muscle in obesity. The effect of four different diets (standard laboratory chow, high-carbohydrate, high-protein and high-fat) on weight gain, cardiac pyruvate dehydrogenase activity (PDHa) and serum insulin, glucose and free fatty acids was studied in the gold thioglucose obese mouse. All four diets produced significant weight gain in the gold thioglucose injected animal. Cardiac PDHa was influenced by both obesity and diet composition. The obese chow-fed animals had significantly reduced PDHa. On high-carbohydrate and high-protein feeding lean controls had a significant decrease in cardiac PDHa compared to chow-fed controls, but only in high-carbohydrate-fed animals was this further reduced by obesity. High-fat feeding produced a rapid and almost complete suppression of PDHa in both lean and obese animals. Serum insulin, glucose and free fatty acids were also affected by diet as well as obesity. The highest serum insulins were found in chow-fed obese animals whereas the highest serum glucoses were in high-carbohydrate-fed obese animals. Hyperinsulinaemia did not develop in the high-fat-fed obese animal, but the highest serum free fatty acids were found in high-fat feeding. It is concluded that both diet composition and obesity affect cardiac PDHa and therefore glucose utilization in this tissue. Insulin resistance in the acute stages of obesity development is also affected by diet composition.

Animals↗
PubMed1986

Nocturnal hypoxia and sleep apnoea in asymptomatic obese men.

A disorder of breathing during sleep with a fall in arterial oxygen saturation (%SaO2) and apnoea is reported in association with obesity. In obese women an increased severity of oxygen desaturation and the appearance of sleep apnoea is often seen after the menopause whereas the factors influencing sleep-breathing patterns in obese men are uncertain. We investigated this by studying respiration during sleep in 20 asymptomatic obese men (mean wt 125 kg, age range 18-59 y) and 20 control men of normal weight (mean wt 67 kg, age range 19-67 y). In the obese men the mean awake %SaO2 measured in the supine position was significantly less than controls (obese 95 +/- 0.4, controls 97 +/- 0.2, P less than 0.01) and a greater fall in %SaO2 occurred in this group during sleep (mean asleep %SaO2 obese 90.5 +/- 0.9, controls 96 +/- 0.2, P less than 0.01). In addition, the minimum asleep %SaO2 was significantly less in the obese (mean minimum %SaO2 obese 75 +/- 3, controls 93 +/- 0.9, P less than 0.001). Sleep apnoea was uncommon and infrequent in the controls but was seen in nine obese men and was frequent throughout the night in seven of them. In the obese group increasing age and increasing obesity were not significantly correlated with an increased severity of nocturnal oxygen desaturation. We conclude that disordered sleep-breathing with marked oxygen desaturation and apnoea is a common finding in extremely obese men of all ages and suggest that this results from the mechanical impedence of breathing due to abdominal adipose tissue combined with abnormal central respiratory control.

Adolescent↗
PubMed1982

[Obesity in childhood].

It is impossible to make general statements on obesity, and apply them to all adipose patients. These statements can be more or less valid for various populations of obese subjects depending on the definition of obesity chosen. Obesity in infancy should not be disregarded, although it has not been proven that obese infants become obese adults, whereas obese adolescents tend to remain obese. Obesity is genetically determined yet exogenous factors are more or less necessary for its development. The significance of risk factors changes during childhood, depends on the gender, and varies with different populations. The hypothesis that obese patients have a diminished thermogenesis should be considered although it is not clear whether this applies to all obese patients. Research on disregulation of appetite could result in further clarification of the pathogenic mechanism causing obesity. Treatment of obesity is necessary in patients with 120% or more overweight related to height, preferably before age of 7 years to take advantage of further growth as a regulating factor.

Adolescent↗
PubMed1994

Obesity: internal medicine, obstetric and gynecological problems related to overweight.

Obesity is the major nutritional problem affecting industrialised society. According to a recent ISTAT survey, 41% of men and 19% of women in the Italian population suffer from obesity. Obesity is a complex pathological entity with a multiform and often indeterminable etiology. Studies of natural and adopted children and twins suggest that a clear hereditary, constitutional predisposing factor is present in obesity which interacts with environmental conditions. The genetic factor is also suggested by the statistical finding that if neither parent is obese, then only 7-10% of their children will be obese, whereas if one parent is obese, 40-50% of children will probably become obese, and if both parents are obese as many as 70-80% of children will be obese. The risks related to obesity can be broadly categorised as mechanical and metabolic. The former include arthrosis, osteoporosis, degenerative diseases affecting the joints and bone matrix, muscular hypotrophy and respiratory deficits. The major metabolic risks include hypercholesterolemia, altered glycoregulation and hyperuricemia. From an obstetric point of view, apart from the fact that obesity is often associated with sterility, excess weight can often lead to sometimes dramatic complications during pregnancy, involving major risks for both mother and fetus. From a gynecological point of view the links between obesity, tumours and menopause are well known.

Female↗
PubMed1994

Obesity decreases hepatic glutathione concentrations and markedly potentiates allyl alcohol-induced periportal necrosis in the overfed rat.

Liver biopsies from 9 out of every 10 obese individuals exhibit pathological changes of unknown aetiology and 3 out of every 10 reflect severe injury in the form of periportal fibrosis. To examine the hypothesis that excessive fibrosis in obesity arises in part from a predisposition to injury of the liver by drugs and xenobiotics, we administered 5, 10 and 25 mg/kg doses of the model periportal hepatotoxin, allyl alcohol, to obese Sprague-Dawley rats and age-matched non-obese controls. Alanine aminotransferase activity (ALT) in plasma was ten-fold more elevated in obese animals than in non-obese animals given the 25 mg/kg dose (P < 0.05). On fitting the ALT results to a non-linear, parametric model by iterative non-linear least squares regression, we found that the slope of the log dose ALT curve was similar for obese and non-obese rats. However, the minimum dose required to produce elevated ALT (DMIN) was 50% lower for obese animals (DMIN 6.47 +/- 2.75 vs. 13.3 +/- 0.96 mg allyl alcohol; P < 0.05). In a subsequent experiment, allyl alcohol was administered to obese rats based on ideal body weight, which is defined as the mean total body weight of an age-matched non-obese animal. With this dosing normalization, the 25 mg/kg ideal body weight doses translated to administration of a fixed dose of 13.5 mg allyl alcohol to obese rats. Obese rats treated in this fashion exhibited more severe necrosis in the periportal zone (median necrosis score 2 versus 0-1, P < 0.05) and increased mortality over controls (44% versus 0%; P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

1-Propanol↗
PubMed1995

Growth charts, growth velocity and bone development in childhood obesity.

OBJECTIVE: To compare the growth charts of obese subjects (4-18 years) with the Tanner's growth curves and to analyze the growth velocities and bone age of obese children in prepuberty and adolescence. Moreover to compare the relationship between the serum insulinemic and glycemic levels and height standard deviation score (HSDS). DESIGN: Growth charts: this study included 1250 obese subjects (669 males, 581 females) observed between 1981 and 1993 and divided into seven age categories (4-6, 7-8, 9-10, 11-12, 13-14, 15-16, 17-18 years). Growth velocities: yearly growth velocities of 579 obese subjects (325 males, 254 females) were compared to growth velocities of 473 controlled children of the same sex, chronological age and pubertal stage. Bone age (BA) of 846 obese subjects (470 males, 376 females) was estimated. Blood analysis: insulin secretion of 70 obese children was considered and compared to 70 lean controls of equal chronological age and sex. MEASUREMENTS: Growth rate, standardized height and other physical characteristics of the children were measured by trained examiners. All subjects were evaluated singularly for at least 4 years with a follow-up every 6 months. BA was estimated by radiograph of the left hand and wrist using the Tanner-Whitehouse II system by a single observer. For the insulin secretion study and glycemic levels oral glucose tolerance test (OGTT) was performed using a glucose load of 1.75 g/kg per body weight. Plasma insulin was assessed by a double antibody radioimmunoassay. RESULTS: In adipose children the growth charts, referred to 97th centile, 50th centile and 3rd centile, were superior to those of the normal population up to the age of 13 and 12.5 years for male and for female respectively; growth decreases at the above age in both sexes. The obese subjects were equal in height to the non obese subjects as they reached their 18th birthday. The growth velocity (cm/yr) of the obese child, in the age range considered here, does not show differences when compared with the lean child in the prepubertal status (P not significant) but decreases during Tanner's stage II, III IV in boys and girls (P < 0.0001). BA is more advanced over chronological age (delta BA-CA) in both sexes. The increase of BA over CA does not show a remarkable difference during pubertal maturation in boys (P not significant); whereas in girls the delta BA-CA decreases with advancing sexual maturation (P < 0.0001). Our obese subjects have significantly higher plasma insulinemic levels compared with the lean controls (P < 0.0001). Moreover there is a positive correlation between plasma insulinemic levels and HSDS (r = 0.881, P < 0.0001). We did not observe a correlation between serum glycemic levels and HSDS. CONCLUSION: Our data demonstrate that the growth increase in an obese child starts in the first years of life. The statural advantage acquired in the first years of life would be exploited and maintained up to the beginning of puberty and with a growth velocity equal to that of the lean subject. Skeletal maturation is strongly increased in both sexes. Bone age remained advanced during the entire period of pubertal development. During puberty obese subjects demonstrate a less notable growth spurt when compared with lean subjects. The growth advantage gradually decreases and final adult height of obese and normal subjects is equal.

Adolescent↗
PubMedDate not supplied

Prevalence of obesity and ischaemic heart disease in hypertensive subjects.

In the present study the prevalence of obesity and its association with ischemic heart disease, recognized according to clinical criteria (chest pain or previous infarction) and/or instrumental data, were described in 8,847 normotensive subjects and in 867 hypertensive subjects, hospitalized during a ten years period (1983-1992), through a cross-sectional study. In view of this all the subjects were considered as lean or obese according to their body mass index (BMI) and to sex specific cut-off values reported in the Italian Consensus Conference on Obesity. In particular, according to BMI values, the subjects were grouped as lean, overweight, moderate and severe obese subjects. Our results indicated that 3,982 normotensive subjects (45%) could be considered lean, whereas 2,654 of them (30%) were overweight, 1,769 of them (20%) were moderate obese and 442 of them (5%) were severe obese. On the contrary only 206 hypertensives (23.7%) might be considered lean, whereas 313 (36.1%) were overweight, 302 (34.8%) were moderate obese and 46 (5.3%) were severe obese. According to age subgrouping (lower than or equal to 65 years or higher than 65 years) the distribution of hypertensives within the lean, overweight, moderate and severe obese groups did not change significantly, but, according to sex subgrouping, the distribution of hypertensives within the BMI groups was significantly different (chi 2, p < 0.001). When we considered the degree of hypertension, distribution of hypertensives was significantly different according to c2 test (p < 0.004), suggesting that the percentage of the subjects with severe hypertension increased only in subjects with severe obesity. Concomitant ischaemic heart disease (IHD) was also documented in 350 normotensives (4%) and in 119 hypertensives (13.8%). The prevalence of IHD was not significantly different in lean, overweight, moderate and severe obese hypertensives, also when sex and smoking habits were considered. Our data indicated a strong association between obesity and hypertension. In addition they may be consistent with the suggestion that obese hypertensives were not characterized by a lower risk of ischaemic heart disease (IHD), than lean hypertensives.

Adult↗