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PubMed2003

[Relationship between serum levels of leptin and glucose, lipids in simple obese children].

OBJECTIVE: To investigate the relationship between fasting serum levels of leptin, glucose, insulin resistance, lipids in simple obese children. METHODS: Fasting serum levels of leptin and insulin (Fins) were measured by RIA in 42 obese and 42 normally-weighted children matched on age, sex and height, and their total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) were analyzed with enzymatic methods. HOMA-IR and LDL-C were calculated. RESULTS: Serum level of leptin was (2.74 - 45.12) micro g/L and (0.53 - 10.18) micro g/L in obese and normally-weighted children, respectively, with an average level of leptin (log) significantly higher in obese group than that in control group (P < 0.001). Serum level of leptin was positively correlated with BMI, WHR and percentage of body fat. Of obese children, 83% were leptin resistant. Serum levels of TC, TG, LDL-C and insulin were significantly higher in obese leptin-resistant group than those in normally-weighted control group, but no significant difference in them between obese leptin-sensitive group and its normally-weighted control group was observed. Significantly higher serum levels of TG and lower HDL-C were observed in obese leptin-resistant group, as compared with those in obese leptin-sensitive group. CONCLUSIONS: A big difference in serum level of leptin between obese and normally-weighted children was found, suggesting most obese children were resistant to endogenous leptin. Leptin resistance correlated significantly with the risk of metabolic syndrome and cardiovascular disease, indicating serum level of leptin could be used as an indicator in screening obese children at high risk.

Blood Glucose↗
PubMed1992

Basal intermediary metabolism in impaired glucose tolerance and morbid obesity.

The effects of impaired glucose tolerance and obesity, in isolation and in combination, on basal (postabsorptive) intermediary metabolism were examined in four groups of subjects (n = 10 for each) matched for age and gender: Group 1: Non-obese healthy controls with normal glucose tolerance (75 g); Group 2: Non-obese subjects with impaired glucose tolerance; Group 3: Morbidly obese subjects with normal glucose tolerance; Group 4: Morbidly obese subjects with impaired glucose tolerance. While there was no significant difference in fasting blood glucose concentrations between the four groups plasma immuno-reactive insulin concentrations were elevated (p < 0.01 or less) in the obese subjects relative to the non-obese subjects within each category of glucose tolerance. Basal immunoreactive insulin concentrations in non-obese subjects with impaired glucose tolerance were also elevated (p < 0.01) relative to the non-obese healthy controls. Concentrations of glycerol (p < 0.01), non-esterified fatty acids (p < 0.01), and total ketone bodies (p < 0.001) were significantly higher in the obese/normal glucose tolerance and obese/impaired glucose tolerance groups relative to their matched non-obese counterparts. Compared with the subjects with normal glucose tolerance, only lactate (p < 0.05) and pyruvate (p < 0.05) concentrations were elevated in the non-obese/impaired glucose tolerance and obese/impaired glucose tolerance groups, respectively. In conclusion, in addition to fasting hyperinsulinaemia the regulation of lipolysis and ketone body metabolism is abnormal in the basal state in morbid obesity. By contrast, despite normal fasting blood glucose concentrations, impaired glucose tolerance is associated with disturbances of other aspects of basal carbohydrate metabolism.

Adult↗
PubMed1992

The variation in blood lipid levels described by various measures of overall and abdominal obesity in Danish men and women aged 35-65 years.

The purpose of the study was to describe the proportion of the variation in blood lipid levels [high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), total cholesterol, very-low-density lipoprotein cholesterol (VLDLC) and triglycerides] explained by different measures of overall obesity [body fat (kg), percentage body fat, or body mass index (kg/m2)] and abdominal obesity [waist/hip ratio, waist/thigh ratio or waist circumference (cm)]. This was done in a Danish population sample of 1523 men and 1464 women aged 35-65 years. This was done to assess, on a population level, the effects on the different lipid levels to be expected from a possible reduction in the level of obesity. The proportion of the variation in lipid levels explained by the various measures of overall obesity differed only slightly, as did the proportion of the variation in lipid levels explained by the various measures of abdominal obesity. In men more of the variation in the blood lipids could be explained by overall obesity than by abdominal obesity, whereas in women the reverse was true. More of the variation in the lipids was explained by overall obesity in men than in women, but more of the variation was explained by abdominal obesity in women than in men. In women the obesity measures predicted between 0% and 11% of the variation in lipid level, and in men the obesity measures predicted between 0% and 14% of the variation. Between 16% and 30% in women and between 5% and 21% in men of the variation in the lipid levels could be explained by obesity, age and several lifestyle variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed2002

[Effects of the alveolar recruitment manoeuver and PEEP on arterial oxygenation in anesthetized obese patients].

BACKGROUND: Diminished functional residual capacity and pulmonary collapse during general anesthesia lead to alterations in respiratory mechanics and gas exchange. Such phenomena are more pronounced in obese patients. We recently demonstrated the beneficial effects of the alveolar recruitment strategy on oxygenation in anesthetized patients of normal body mass index (BMI). The aim of the present study was to evaluate whether obese patients also benefit from the alveolar recruitment strategy and to determine the level of positive end-expiratory pressure (PEEP) that prevents recollapse in obese patients. METHODS: Three groups of 30 patients each were studied: patients with normal BMI (control group) and obese patients to whom we applied PEEP at 5 and 10 cm H2O (obese-5 and obese-10 groups, respectively) after the recruitment maneuver. We studied respiratory mechanics (respiratory distensibility, airway pressures and flow volume) and arterial oxygenation (PaO2) before and after the recruitment. RESULTS: PaO2 at baseline was higher in the control group (174 +/- 44 mm Hg) than in either the obese-5 or obese-10 group (108 +/- 24 and 114 +/- 22 mm Hg, respectively, p < 0.001). Oxygenation improved in all groups after recruitment (p < 0.001), and PaO2 in the obese-10 group was similar to that of the control group (218 +/- 25 mm Hg and 259 +/- 80 mm Hg, respectively, p > 0.05). Oxygenation in the obese-5 group, however, was worse (153 +/- 41 mm Hg) than that of either of the other groups (p < 0.001). CONCLUSIONS: We conclude that the alveolar recruitment strategy was effective for increasing PaO2 in anesthetized patients, regardless of body mass. The oxygenation of obese patients receiving the higher level of PEEP was similar to that of non-obese patients.

Aged↗
PubMed2003

The prevalence of overweight and obesity in relation to social and behavioral factors (Lithuanian health behavior monitoring).

The aim of the study is to estimate the trends in the prevalence of overweight and obesity among Lithuanian adult population and to examine the association of social and health behavior factors with overweight and obesity. Since 1994 five cross-sectional surveys have been conducted among adult population aged 20-64 within the international FINBALT HEALTH MONITOR project. An independent national random sample of 3000 inhabitants of Lithuania was drawn from National Population Register for each survey. The data were collected through mailed questionnaires (covering sociodemographic characteristics, health behaviors, and self-reported height and weight). Overweight was defined as BMI>25 kg/m ( 2 ) and obesity - as BMI>30 kg/m ( 2 ). In 2002 the overall prevalence of obesity was 16% and the prevalence of overweight - 49.1%. Since 1994 both indicators have increased in men while in women the prevalence of overweight has decreased. The prevalence of obesity and overweight increased with age. Obesity and overweight were least prevalent among the highly educated women, but most prevalent among the highly educated men. Women living in cities were less obese and overweight than those living in towns and villages. Obesity and overweight were less prevalent among daily smokers and physically active persons. Women drinking beer at least once a week were less obese and overweight than those who consumed beer more rarely. There was no consistent association between nutrition habits and the prevalence of obesity and overweight. The National obesity control program aimed at promotion of healthy nutrition and physical activity should be elaborated in order to decrease the prevalence of obesity and overweight in Lithuanian population.

Adult↗
PubMedDate not supplied

[Comorbidity of obesity and eating behavior disorders].

UNLABELLED: In the few years various factors that influence obesity have been studied, including genetic, sociocultural, metabolic and endocrine factors. Research advances in this area will help enhance our knowledge, prevention and treatment of this syndrome. OBJECTIVE: Our first aim is to establish comorbidity between obesity and eating disorders (i.e., binge eating disorder, compulsive overeating disorder and bulimia). Our second aim is to establish the relation between psychiatric diagnoses and sociodemographic, anthropometric, endocrine and psychological variables. METHOD: We interviewed 97 outpatients that attended a specialized clinic for obesity control in Mexico City, 67 females and 30 males. These patients were interviewed by a nutrition specialist, an endocrinologist and a psychiatrist, all working in the obesity clinic. For the psychiatric diagnoses, DSM-IV criteria were applied to analyze the clinical information on the charts. RESULTS: Of all patients in the group 13.4% presented no psychiatric disorder, 53.6% met criteria for binge eating disorder, 12.4% for type six NOS-ED (Not Otherwise Specified Eating Disorder) (compulsive overeating) and 20.6% for bulimia. Endocrine disorders were found as follows: 80.4% presented no endocrine disorder, 11.3% diabetes mellitus, and 8.2% other diagnoses. Obesity degree: 8.2% normal weight, 28.9% overweight, 37.1% type 1 obesity, 18.6% type II obesity and 7.2% extreme obesity; binge eating disorder was related to all obesity types. Bulimic patients had a greater energetic expenditure. Patients with psychiatric disorders generally did not present endocrine comorbidity, only 13.4% comorbidity. The number of treatments to reduce weight was in direct relationship to patients with psychiatric disorders. Patients with a largest calorie intake presented binge eating disorder with more eating periods per hay. In sum, by measuring anthropometric variables and some nutritional variables, such as the way of eating and calorie intake, it was easier to predict eating disorders in obese patients. The medical variables themselves were not associated to the mental health of obese patients. CONCLUSIONS: We found there is an important relation between obesity and psychiatric disorders and we consider it necessary to undertake further multidisciplinary, longitudinal and prospective studies in other groups of patients or non patients.

Adolescent↗
PubMedDate not supplied

[Job as a risk factor for obesity... and the contrary].

BACKGROUND: Obesity constitutes a risk for several vascular, metabolic and neoplastic diseases. In industrialised countries, but more and more in developing countries too, the prevalence of obesity is increasing. Body Mass Index and circumference of the abdomen are the two simplest and most utilized methods of measuring the degree of obesity in an individual and of comparing selected groups with different ethnic, social, cultural and occupational features. OBJECTIVES: The main aim of this article is to initiate a discussion on the possible contribution that the Occupational Health Physician can make to solving the problem of obesity, which is becoming more and more alarming in social terms. The working conditions favouring an increase in body weight and the negative effects that obesity has on various types of work are reported. METHODS AND RESULTS: A critical review of the literature on obesity and overweight stresses that a low educational level, a low socio-economic status, lack of physical activity in leisure time and certain working conditions, together with the ready availability of food, are the main factors favouring increased prevalence of obesity. Certain jobs also contribute significantly to this problem. Automation and the use of machines/robots for very heavy work in industrialised countries have the "collateral effect" of favouring body weight increase due to low energy consumption. Jobs that are a source of stress, such as work on three rotating shifts, can cause metabolic disorders leading to an increased prevalence of obesity. Contrariwise, obesity renders the individual unfit for some jobs, in fact, an increased incidence of industrial accidents has been related to obesity. CONCLUSIONS: The occupational health physicians engaged in surveillance of workers' health conditions can make a positive contribution to alleviating this problem by focusing their activity on the primary prevention of obesity and advising workers on how to maintain the right weight; otherwise, obese workers should be referred to appropriate medical centres.

Accidents, Occupational↗
PubMed2004

[Obesity and mortality in advanced chronic renal failure patients].

A protective effect of obesity on the mortality of end-stage renal failure patients has been observed in several studies. Most of these studies have been based on prevalent dialysis population. The aim of the present study was to evaluate if obesity has beneficial effects on the survival of advanced chronic renal failure patients. The study group consisted of 376 patients (mean age 63 +/- 15 years) with advanced chronic renal failure not yet on dialysis. Obesity was defined as a body mass index (BMI) > or = 30 kg/m2. Grade of comorbidity was quantified by the method devised by Davies. Survival was analyzed as time from the referral to the predialysis outpatient clinic to patient death, censoring from contributing additional survival data to the analysis following transplantation. Kaplan-Meier analysis was used to test survival differences according to quartiles of BMI, and between obese and nonobese patients. Further analysis were performed, stratifying survival curves by comorbid scores, lean body mass, age, and sex. Cox proportional hazard regression models were used to investigate the best determinants of mortality, and the role of obesity adjusted for other covariates. Median survival time was 1,453 days. During the follow-up time, 158 patients (42%) died. Survival differences among quartiles of BMI were statistically significant (Breslow = 10.7, p = 0.017). Patients within the lowest and the highest quartiles of BMI had higher mortality than the rest of patients. Survival curves between obese and non-obese patients did not differ significantly. However, when patients without comorbidity were studied apart, those with obesity showed worse survival than the rest of patients (log-rank = 7.42, p = 0.0064). Since the effect of obesity on mortality did not follow a proportional hazard pattern throughout the study period, multivariable analysis for mortality was stratified by 18 months intervals. The variables which fitted the best model were: age (Hazard Ratio: 1.04), comorbid score (HR: 2.17), serum albumin (HR: 0.62), GFR at the study entry (HR: 0.91), male gender (HR: 1.48), and obesity (HR: 1.51). In conclusion, obesity had no survival benefit in patients with advanced chronic renal failure. Obesity had a noteworthy impact on early mortality of advanced chronic kidney disease patients without comorbidities.

Blood Chemical Analysis↗
PubMed2004

[A relationship between dehydroepiandrosterone sulphate and insulin resistance in obese men and women].

UNLABELLED: The aim of our study was to investigate if there is any significant relationship between adrenal steroid hormone dehydroepiandrosterone-sulphate (DHEAS) and insulin resistance, as there are some previous signs in the literature suggesting such relationship but the results are not conclusive. METHODS: In our study participated 50 obese women and 20 obese men both with BMI over 27 kg/m2. Insulin resistance was calculated using HOMA insulin resistance index (HOMA-IR) that is based on fasting glycaemia and basal insulin levels. RESULTS: The negative correlation between DHEAS and HOMA-IR was found in the whole group of obese women but close behind statistical significance (r = -0.27, p = 0.055). But the group of obese women does not seem to be homogenous in correlation between DHEAS and insulin resistance. The significant negative correlation between DHEAS and insulin resistance was found in the subgroup (n = 21) of obese type 2 diabetic women (r = -0.55, p = 0.01) but no correlation was found in the subgroup (n = 29) of obese non-diabetic women (r = -0.06, p = 0.77). The relationship between DHEAS and glycaemia homeostasis was also confirmed by significant negative correlation between DHEAS and glycated haemoglobin (HbA1c) both in the subgroup of type 2 diabetic women (r = -0.51, p = 0.03) and in the subgroup of non-diabetic women (r = -0.70, p = 0.001). There was not found any significant correlation between DHEAS and insulin resistance neither in the whole group (n = 20) of obese men (r = 0.04, p = 0.87) nor in the subgroup (n = 11) of obese type 2 diabetic men (r = 0.55, p = 0.08) or in the subgroup (n = 9) of obese non-diabetic men (r = -0.42, p = 0.26). CONCLUSIONS: Significant negative correlation between DHEAS and HOMA-IR was found in the group of obese type 2 diabetic women but not in obese non-diabetic women suggesting that low DHEAS level might be connected to the development of insulin resistance and type 2 diabetes mellitus in obese women.

Dehydroepiandrosterone Sulfate↗
PubMed2005

Obesity in Saudi Arabia.

OBJECTIVE: Obesity and overweight are well known risk factors for coronary artery disease (CAD), and are expected to be increasing in the Kingdom of Saudi Arabia (KSA) particularly among females. Therefore, we designed this study with the objective to determine the prevalence of obesity and overweight among Saudis of both gender, between the ages of 30-70 years in rural as well as in urban communities. This work is part of a major national project called Coronary Artery Disease in Saudis Study (CADISS) that is designed to look at CAD and its risk factors in Saudi population. METHODS: This study is a community-based national epidemiological health survey, conducted by examining Saudi subjects in the age group of 30-70 years of selected households over a 5-year period between 1995 and 2000 in KSA. Data were obtained from body mass index (BMI) and were analyzed to classify individuals with overweight (BMI = 25-29.9 kg/m2), obesity (BMI >/=30 kg/m2) and severe (gross) obesity (BMI >/=40 kg/m2) to provide the prevalence of overweight and obesity in KSA. RESULTS: Data were obtained by examining 17,232 Saudi subjects from selected households who participated in the study. The prevalence of overweight was 36.9%. Overweight is significantly more prevalent in males (42.4%) compared to 31.8% of females (p<0.0001). The age-adjusted prevalence of obesity was 35.5% in KSA with an overall prevalence of 35.6% [95% CI: 34.9-36.3], while severe (gross) obesity was 3.2%. Females are significantly more obese with a prevalence of 44% than males 26.4% (p<0.0001). CONCLUSION: Obesity and overweight are increasing in KSA with an overall obesity prevalence of 35.5%. Reduction in overweight and obesity are of considerable importance to public health. Therefore, we recommend a national obesity prevention program at community level to be implemented sooner to promote leaner and consequently healthier community.

Adult↗
PubMed2005

Relationship between soluble leptin receptor, leptin, lipid profiles and anthropometric parameters in overweight and obese Thai subjects.

Median, range and 95% confidence interval (CI) for median of age, anthropometric variables, soluble leptin receptor, serum leptin and lipid profile levels of 48 overweight (Body mass index (BMI) = 25.00-29.99 kg/m2) and obese (BMI > or = 30. 00 kg/m2) Thai males and 166 overweight and obese Thai females, compared with 26 males and 81 females in a control group (BMI = 18.50-24.99 kg/m2), were determined The study subjects were persons who turned up regularly for physical check-ups at the Out-patient Department, General Practice Section, Ratchawithi Hospital, Bangkok, aged between 18-60 years. Serum leptin, triglyceride and low density lipoprotein cholesterol/high density lipoprotein cholesterol ratios (LDL-C/ HDL-C ratio) were significantly higher in the overweight and obese males and females. Soluble leptin receptor and HDL-C were significantly lower in the overweight and obese males and females. Cholesterol and LDL-C were significantly higher in the overweight and obese females, but there was no significant difference in the overweight and obese males when compared with the control males. Low soluble leptin receptor levels were found in 38.1% (8/21) of the overweight and obese males, while 31.5% (29/92) were found in the overweight and obese females. Elevated leptin levels were found in 66.7% (32/48) and 89.8% (149/166) of the overweight and obese males and females, respectively. Both low soluble leptin receptor levels and elevated leptin levels were found in 9.5% (2/21) and 29.4% (27/92) of the overweight and obese males and females, respectively. A significant positive correlation was found between soluble leptin receptor and cholesterol, and between weight, BMI, waist, hip and HDL-C, with leptin. Serum soluble leptin receptor levels were significantly negatively correlated with leptin and BMI. The results can elucidate the causes and consequences of obesity, and are expected to aid the provision of care for overweight and obese Thai people.

Adolescent↗
PubMed2005

[Trends in overweight and obesity in 45-64 year old men and women in Reykjavík 1975-1994. 2001].

OBJECTIVE: The aim of this study was to assess possible changes in the prevalence of overweight and obesity in Iceland during the last decades. Furthermore, the possible effect of dietary changes on the observed trend in obesity prevalence was evaluated. MATERIAL AND METHODS: Participants came from stages III-V in the Reykjavik Health Study and the Reykjavik part of the MONICA studies from the period 1975-1994. The age groups 45-54 years and 55-64 years were examined. Only the information from the first visit of each person was included. The body mass index (BMI) for the participants was calculated and the percentage of those subjects considered overweight and obese according to WHO standards evaluated, using 25= or >BMI<30 kg/m2 as the cut-off point for overweight and BMI= or >30 kg/m2 as the cut-off point for obesity. Also, the observed trend in obesity prevalence is compared to changes in diet that have occurred in the same period. RESULTS: The results show that the mean weight and height of both men and women have been increasing during the study period. However, weight has increased more than can be accounted for by increased height, resulting in increased BMI. At the same time, the prevalence of overweight and obesity have increased, the relative increase in obesity far exceeding the relative increase in overweight. The prevalence of obesity more than doubled in both age groups of women during the study period, according to trend analyses. At the end of the period, almost 15% (95% confidence interval (CI), 9-22%) in the younger group of women and 25% (95% CI, 17-34%) in the older group were classified as obese. In the younger group of men, the prevalence of obesity almost doubled, while the observed increase in the older group was not statistically significant, according to trend analyses. The prevalence of obesity in the final period was about 19% (95% CI, 13-27%) and 17% (95% CI, 11-25%) in the younger and older groups of men, respectively. According to the food supply statistics there have been insignificant changes in the consumption of energy nutrients during the period. CONCLUSIONS: Overweight and obesity are becoming more common among middle-aged men and women in Reykjavik, during the period 1975-1994 and the rate of increase being comparable to that observed in many Western countries. It is urgent to respond to this problem by promoting a healthier lifestyle, both with respect to diet and physical activity.

Body Mass Index↗
PubMed2005

Factors associated with obesity among workers in a metropolitan waterworks authority.

To examine the relationship of socio-demographic characteristics, psychological factors, knowledge, attitude and behavior towards obesity among Metropolitan Waterworks Authority (MWWA) officers, a cross-sectional study was conducted between July and September, 2004. Two hundred and eighty-eight obese [body mass index (BMI) > or = 25 kg/m2] and 106 non-obese persons, aged 20-60 years, were recruited as study subjects. Data were collected by a self-administered questionnaire, comprised of three parts: socio-demographic; psychological factors (depression and stress); and knowledge, attitude, behavior related to obesity. Univariate analyses and Logistic regression models were used to study the association between obesity and possible risk factors. The results demonstrate significant associations between older age and obesity. Volunteers in the age groups of 40-49 and 50-59 years had a significantly higher risk of being obese than the age group of less than 40 years (adjusted OR = 3.4, 95% Cl = 1.1-11.1 and adjusted OR = 10.4, 95% CI = 3.3-32.7, respectively). Volunteers with unhealthy behaviors were at significantly higher risk than those with healthy behaviors (adjusted OR = 10.3, 95% CI = 2.0-52.4) while persons with moderately healthy behaviors also had increased risk, but to a lesser extent (adjusted OR = 4.5, 95% CI = 1.7-11.4). There were no associations between psychological factors and obesity in this group of volunteers. When we focused on whether they consumed more food when they were stressed, it was found that the obese consumed significantly more food during stress (p-value = 0.003). Watching television, videos, or playing computer continuously for more than 3 hours, were significantly associated with obesity. We conclude that although the obese have a good knowledge and attitude towards obesity, they still practise unhealthy behavior, have a sedentary lifestyle, and over eat when they are stressed. Future research regarding behavioral modification should be implemented at both community and country levels.

Adult↗
PubMed2006

Factors associated with overweight and obesity among Mexican Americans and Central Americans: results from the 2001 California Health Interview Survey.

INTRODUCTION: Hispanics are the fastest growing demographic group in the United States; however, "Hispanic" is a broad term that describes people who are from or whose ancestors are from multiple countries of origin. This study examines, separately, the social, cultural, and behavioral factors associated with overweight and obesity among Mexican American adults and among Central American adults. METHODS: To estimate the prevalence of overweight and obesity among Mexican and Central Americans living in California, we conducted a cross-sectional analysis of data from the 2001 California Health Interview Survey using SUDAAN software to account for the survey's multistage sampling design. RESULTS: Of the 8304 Mexican Americans participating in the survey, 36.8% were overweight and 26.2% were obese. Of the 1019 Central Americans, 39.2% were overweight and 22.2% were obese. Among Mexican American men, age and marital status were associated with overweight and obesity; and education, acculturation, health insurance status, health status, and use of vitamins were associated with obesity only. Among Mexican American women, age, education, number of children, health status, and health behavior were associated with overweight and obesity. Among Central American men, age, education, and access to health care were associated with overweight, whereas marital status, acculturation, health care, and binge drinking were associated with obesity. Among Central American women, number of children was associated with overweight and obesity; and age and education were associated with obesity only. CONCLUSION: Our findings of high rates of overweight and obesity among Mexican and Central Americans in California indicate the need for a wide variety of effective weight-loss interventions targeting these populations, and the differences we found in the factors associated with overweight and obesity may suggest the need for unique intervention strategies for different Hispanic subgroups.

Adolescent↗
PubMed1989

[Circadian rhythms of cortisol and insulin in nutritional obesity in children].

It have been studied 90 children (obese 73, non obese or control 17), trying to analyze the following parameters: mean and standard deviation values, its circadian rhythms and relation between cortisol and insulin, correlation between both hormones and anthropometric parameters of obesity and sexual influence with all the studied parameters. The plasmatic cortisol values were higher in male, obese (180.4 +/- 11.2 ng/ml) and control (377.5 +/- 49.2 ng/ml) children. The plasmatic insulin values higher in obese children (55.3 +/- 9.5 microU/ml) verifying the hyperinsulinemia observed in obesity. There was not correlation between cortisol and insulin values with body fat. All the children showed cortisol and insulin circadian rythm. In the groups of obese children the cortisol circadian rythm was similar to the control one. However, the insulin circadian rythm was disturb. So, the acrophase was delayed two hours when male and female were analyzed all together and only one hour in the obese female group. The acrophase of cortisol and insulin rhythms in obese group is delayed in relation with the degree of obesity. The circadian rhythms of cortisol and insulin, in both obese and control groups, are not dependent. The duration of obesity do not have any relation with the mentioned alterations.

Adolescent↗
PubMedDate not supplied

Glucose disposal in obese non-diabetic and diabetic type II patients. A study by indirect calorimetry and euglycemic insulin clamp.

Insulin resistance is a characteristic finding in obesity and in non insulin dependent (Type II) diabetes mellitus. However, the interaction between diabetes and obesity has been poorly characterized and the metabolic disturbances contributing to the defect in insulin-mediated glucose uptake have not been defined. To examine these questions euglycemic and hyperinsulinemic clamp studies (40 mU/m2/min) were performed in 10 control non-obese subjects, 10 non diabetic obese subjects, 8 normal weight Type II diabetics, and 12 obese Type II diabetics. During the insulin clamp study total body glucose uptake in the obese non diabetics (157 +/- 18 mg/m2.min, p less than 0.01), the normal weight diabetics (159 +/- 21, p less than 0.01) and the obese diabetics (125 +/- 11, p less than 0.001) was significantly reduced compared to the non-obese non diabetic control group (249 +/- 22 mg/m2.min). The impairment in total body glucose uptake was the result mainly of a defect in non-oxidative glucose disposal. Indeed non-oxidative glucose disposal was blunted by 50% in the obese groups (p less than 0.01), somewhat less significantly in the non-obese diabetic group (p less than 0.05) but more when obesity and diabetes mellitus were combined (p less than 0.001). Total glucose oxidation was significantly diminished (p less than 0.01) in both diabetic groups but not in the obese non diabetic group when compared to lean control. A significant inverse correlation between the fasting free fatty acids levels and total glucose uptake (r = -0.453, p less than 0.001) and total glucose oxidation (r = -0.446, p less than 0.001) during the clamp was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Muscle tissue in obesity with different distribution of adipose tissue. Effects of physical training.

Obese men and women with the same body fat mass, as well as obese women in another study, were divided into groups with male or female type of body fat distribution, but again with similar body fat mass. The participants were examined with measurements of body composition, including muscle fiber distribution, as well as circulatory and metabolic variables before and after physical training under controlled conditions. Obese men had higher lean body mass, blood pressure, blood glucose and plasma insulin, C-peptide, cholesterol and triglyceride concentrations than age- and body fat-matched obese women. Obese women with male type of adipose tissue distribution showed the same differences (except cholesterol) in comparisons with women with female type of adipose tissue distribution. The women with male type obesity were also more insulin resistant in glucose clamp measurements, and had male type of muscle fiber distribution. Physical training in the group of obese men resulted in a decrease of body fat, a further increase of lean body mass, an increase of fast twitch, aerobic type, muscle fibres as well as lower plasma insulin, cholesterol and triglyceride concentrations and lower blood pressure. Obese women with male type distribution of adipose tissue responded to physical training essentially like men. The insulin sensitivity was improved to the same level as in obese women with female type of adipose tissue distribution. In contrast, the latter women showed an increase of body fat and no metabolic improvements after training. These results show that obese women with male type of body fat distribution also have male characteristics of muscle mass, morphology and function. It is suggested that the obesity complications associated with this condition are improved by physical training because of an adaptation to a negative energy balance, in combination with an improvement of insulin sensitivity of the muscle mass. In contrast, the failure of obese women with female type of adipose tissue distribution to adapt to a negative energy balance during physical training is probably explaining their failure to decrease body fat and to improve metabolism during physical training.

Adipose Tissue↗
PubMed1982

Relationship of obesity to blood estrogens.

It has become conventional wisdom that estrogenic stimulation of breast tissue has something to do with the causation of breast cancer and that the reason obesity is a risk factor for breast cancer is that obese women are hyperestrogenized. However, it has been very difficult to demonstrate that excessive exogenous estrogen increases the incidence of breast cancer, that endogenous estrogen excess is present in breast cancer, or that obese women are hyperestrogenized. We have examined the last question by measuring 24-hr mean plasma estrone and estradiol levels in the midfollicular phase in 18 healthy, regularly cycling, very obese (53 to 218% above ideal weight) women and 16 regularly cycling, age matched, nonobese control women. Unlike obese men, the obese women showed no significant elevation of either estrone or estradiol. Their average estrone level was 72 compared with 64 pg/ml in controls; their average estradiol level was 65 compared with 57 pg/ml in controls. In the combined group (obese plus nonobese), there was a significant correlation of percentage of deviation from ideal weight with plasma estrone (y = 63 + 0.12x; p less than 0.05) but not with estradiol. This correlation supports the current hypothesis that there is increased androstenedione leads to estrone conversion (i.e., increased aromatase activity) in obesity. The reason plasma estrone levels are not significantly elevated in obese women is that the small amount derived from androstenedione is swamped by the much larger amount derived from ovarian secretion, which is apparently unaffected by obesity. Unless there is increased local formation of estrogens in the breast tissue of obese women, the absence of elevated plasma estrogens in them means that their breasts are not "seeing" increased estrogen levels. Thus, endogenous hyperestrogenization is unlikely to be a causative factor of breast cancer in obese women.U

Aromatase↗