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At least 19 recordsLinked to original sources
PubMed2001

Interventions for preventing obesity in children.

BACKGROUND: The prevalence of obesity and overweight is increasing world-wide. Obesity in children impacts on their health in both the short and longer term. Obesity prevention strategies are poorly understood. OBJECTIVES: To assess the effectiveness of interventions designed to prevent obesity in childhood. SEARCH STRATEGY: Electronic databases were searched from 1985 to October 1999. SELECTION CRITERIA: Data from RCTs and non-randomised trials with concurrent control group were included. studies with follow up of one year minimum were selected, A priori, this was subsequently amended to include studies with minimum follow up of three months. The possible susceptibility of post hoc questions to bias is addressed. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Seven studies were included, three long-term and four short- term. The studies included were diverse in terms of study design and quality, target population, theoretical underpinning of intervention approach, and outcome measures. As such, it was not possible to combine study findings using statistical methods. REVIEWER'S CONCLUSIONS: The findings of the review suggest that currently there is limited quality data on the effectiveness of obesity prevention programs and as such no generalisable conclusions can be drawn. The need for well-designed studies which examine a range of interventions remains a priority.

Adolescent↗
PubMed1999

The European Childhood Obesity Group (ECOG) project: the European collaborative study on the prevalence of obesity in children.

During the European Congress on Obesity held in Barcelona in 1996, the European Childhood Obesity Group (ECOG) proposed a study designed to estimate the prevalence of obesity by country. An overview of existing systems revealed that most countries have no suitable structure in place for the determination of obesity in children and that the most practical sources of samples would be the school systems. A protocol was drawn up for these countries, whereas for those countries already collecting data, guidelines were defined to clarify the criteria allowing inclusion in the common analysis. The target population is 7-9-y-old children. The study design consists of separate cross-sectional population studies by country with a cluster probability sample of 2000 children attending primary school. The minimum common data will be age, weight, height, and hip, thigh, and waist circumferences. The participating countries will be encouraged to collect harmonized data on social indicators, lifestyle, diet, physical activity, and anthropometric measures of the parents. Children will be measured either by centrally based traveling examiners or, in countries with limited resources, by local staff. Each country will computerize its own data and send a copy to a center responsible for the common analysis. The main analysis will be of body mass index distribution in children from the different populations and determination of the proportion of children with a BMI above the 90th percentile of a common reference population. Members of the ECOG in 14 European countries have confirmed their interest in the project.

Journal Article↗
PubMed1997

Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults?

OBJECTIVE: To investigate trends in frequency of obese children in Japan over two decades, the frequency of obese children who grow into obese adults and predictive factors for adult obesity. DESIGN: Annual cross-sectional studies for 22 y (1974-1995) with a follow-up study. SUBJECTS: Cross-sectional: Cumulatively 13,186 obese (% of standard body weight (SBW): > or = 120%) schoolchildren including 3158 extremely obese (> or = 140% of SBW) children out of 203,088 schoolchildren (age: 6-14 y) in Izumiohtsu City, Osaka, Japan. FOLLOW-UP: 151 initially obese children (initial age: 6-14 y and age at follow-up: 20-35 y) who lived in Izumiohtsu City. CONTROL: 3552 Japanese men and 4631 Japanese women (age: 20-35 y). MEASUREMENTS: Cross-sectional: height, weight, trunk circumference, skin-fold thickness, blood pressure and blood biochemicals. FOLLOW-UP: height, weight, trunk circumference, skin-fold thickness during childhood, and body height and weight at follow-up. Adulthood obesity: > or = 120% of the average body mass indices (BMI) of the controls. RESULTS: Frequency of obese children increased from 5% to more than 10%, and that of extremely obese children increased from 1% to more than 2% during these 22 y. These increases were most prominent in the schoolboys aged 9-11 y. Prevalence of hyperglycemia and hyperlipidemia in the extremely obese children did not change, and that of hypertension and abnormal liver function gradually decreased during these two decades. After coming of age, 32.2% of the initially obese boys (relative risk: 5.3) and 41.0% of the initially obese girls (relative risk: 6.7) remained obese. BMI, percentage of the SBW and skin-fold thickness at the biceps during childhood were significantly larger in currently-obese girls. Positive correlations were demonstrated between these variables and percentage SBW at follow-up. CONCLUSIONS: Childhood obesity is increasing in Japan, especially in boys aged 9-11 y. Approximately 32% of the obese boys and 41% of the obese girls grow into obese adults, and the degree of obesity is a predictive factor for adult obesity.

Adolescent↗
PubMed1998

Hyperinsulinemia and sex hormones in healthy premenopausal women: relative contribution of obesity, obesity type, and duration of obesity.

Insulin secretion in response to an oral glucose tolerance test (OGTT) and sex hormone levels (free testosterone, androstenedione, dehydroepiandrosterone sulfate [DHEAS], estradiol, and sex hormone-binding globulin [SHBG]) were evaluated in 49 healthy obese premenopausal women (body mass index [BMI], 30 to 50.6 kg/m2) and 21 control subjects (BMI, 17.8 to 24.0 kg/m2) with normal glucose tolerance and without signs of hyperandrogenism. Obese women were divided into two groups according to waist to hip ratio (WHR): 27 subjects with upper-body obesity (WHR > 0.85) and 22 subjects with lower-body obesity (WHR < 0.8). Both fasting and glucose-induced insulin levels were higher in women with upper-body obesity than in controls (P < .001) and those with lower-body obesity (P < .001). Hyperandrogenism was observed in women with upper-body obesity, as evident by significantly elevated free testosterone (P < .05 v controls and subjects with lower-body obesity) and decreased SHBG (P < .001 v controls). The most important independent determinants of fasting insulin levels were BMI (P < .01) and the ratio of DHEAS to free testosterone (P < .01). The most important determinants of cumulative insulin response were WHR (P < .0005), duration of obesity (P < .01), and androstenedione levels (P < .01). In conclusion, in healthy obese premenopausal women without clinical signs of hyperandrogenism, a high BMI and more pronounced upper-body fat localization resulted in hyperinsulinemia and hyperandrogenism. The duration of obesity exaggerated the glucose-induced insulin level and cumulative insulin response independently of the degree of obesity and obesity type. The ratio of DHEAS to free testosterone was an independent determinant of fasting insulin concentration. Furthermore, the ratio of DHEAS to free testosterone rather than either of these androgens alone may be important in the regulation of insulin action in women.

Adult↗
PubMed1995

Metabolic predictors of obesity. Contribution of resting energy expenditure, thermic effect of food, and fuel utilization to four-year weight gain of post-obese and never-obese women.

This prospective study was designed to identify abnormalities of energy expenditure and fuel utilization which distinguish post-obese women from never-obese controls. 24 moderately obese, postmenopausal, nondiabetic women with a familial predisposition to obesity underwent assessments of body composition, fasting and postprandial energy expenditure, and fuel utilization in the obese state and after weight loss (mean 12.9 kg) to a post-obese, normal-weight state. The post-obese women were compared with 24 never-obese women of comparable age and body composition. Four years later, without intervention, body weight was reassessed in both groups. Results indicated that all parameters measured in the post-obese women were similar to the never-obese controls: mean resting energy expenditure, thermic effect of food, and fasting and postprandial substrate oxidation and insulin-glucose patterns. Four years later, post-obese women regained a mean of 10.9 kg while control subjects remained lean (mean gain 1.7 kg) (P < 0.001 between groups). Neither energy expenditure nor fuel oxidation correlated with 4-yr weight changes, whereas self-reported physical inactivity was associated with greater weight regain. The data suggest that weight gain in obesity-prone women may be due to maladaptive responses to the environment, such as physical inactivity or excess energy intake, rather than to reduced energy requirements.

Aged↗
PubMed2001

Obesity-related knowledge, attitudes, and behaviors in obese and non-obese urban Philadelphia female adolescents.

OBJECTIVES: To examine relationships between knowledge, attitudinal and behavioral factors, and obesity and to determine how these factors influence obesity status in west Philadelphia female adolescents. RESEARCH METHODS AND PROCEDURES: A matched-pairs study was conducted with 32 stature- and age-matched pairs of obese (body mass index and triceps skinfold > or =95th percentile of National Health and Nutrition Examination Survey I) and non-obese (body mass index and triceps skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination Survey I) female African American adolescents (aged 11 to 15 years), selected from a school-based study sample, based on obesity status and matching criteria. Adolescents were compared on the following measures: physical activity, inactivity, dietary intake, eating attitudes, health behavior knowledge, body image, self-esteem, and maturation status. Differences between obese and non-obese females were tested using paired t tests and Wilcoxon matched-pairs signed-rank tests. RESULTS: Physical activity, inactivity, and perception of ideal body size emerged as the most important contributory factors to obesity status. There were no statistically significant matched-pair differences in macronutrient and micronutrient intakes, self-esteem, eating attitudes, health behavior knowledge, or maturation status of these adolescents. Obese adolescents had significantly lower levels of physical activity, higher inactivity, and a larger perception of ideal body size than non-obese adolescents. DISCUSSION: Knowledge and attitudinal factors (with the exception of perception of ideal body size) had far less association with obesity than activity-related behavioral factors. These findings suggest that future intervention strategies should pay particular attention to physical activity, inactivity, and body image attitudes.

Adolescent↗
PubMed1999

The role of central fat distribution in coronary artery disease in obesity: comparison of nondiabetic obese, diabetic obese, and normal weight subjects.

OBJECTIVE: To investigate the degree of coronary artery disease (CAD) in relation to obesity and fat distribution in obese patients with normal glucose tolerance, in comparison with CAD of diabetic obese patients and of normal weight subjects with CAD. DESIGN: Patients listed for coronary angiography with different body mass index (BMI) with or without diabetes: study of the correlation between severity of coronary damage and fat distribution. SUBJECTS: 92 patients subdivided into: 30 normal glucose tolerant obese (BMI 31.7+/-0.5, aged 53+/-1.7 y), 28 type 2 diabetic obese (BMI 30.7+/-0. 3, aged 57+/-1.2 y), and 34 normal weight patients (BMI 23.1+/-0.3, aged 54+/-1.7 y). MEASUREMENTS: CAD assessed by angiography and evaluated according to the method of Gensini. Fat mass and fat distribution assessed by bioelectrical impedance and anthropometry. Clinical, biochemical and hormonal variables, as well as smoking habits and alcohol intake. RESULTS: The angiographic coronary scores were similar in nondiabetic obese and in diabetic obese patients, and were significantly higher than those of normal weight subjects. In the entire population coronary score correlated with indices of abdominal fat distribution. In the stepwise analysis of each group separately, waist hip ratio (WHR) correlated with coronary score only in normal weight nondiabetic patients. CAD was inversely associated with BMI only in nondiabetic obese patients. CONCLUSION: CAD of obese patients: 1) is similar to that of diabetic obese patients; 2) is more severe than that of normal weight individuals; and 3) is inversely correlated with BMI. CAD appears to be associated with WHR, not with BMI, only in nondiabetic patients with normal body weight. On the contrary, CAD of diabetic obese patients is unrelated to BMI and parameters of fat distribution, but is associated with smoking habits.

Adipose Tissue↗
PubMed1997

Human leptin receptor gene in obese Japanese subjects: evidence against either obesity-causing mutations or association of sequence variants with obesity.

Leptin is an adipocyte-derived blood-borne satiety factor that acts on its cognate leptin receptor (Ob-R) in the hypothalamus, thereby regulating food intake and energy expenditure. To explore whether mutations in the Ob-R gene cause obesity in humans, we have searched for mutations in the gene for Ob-Rb, a biologically active receptor isoform, in obese Japanese subjects. We have also examined associations between such mutants and obesity in the Japanese. Genomic DNAs were used as templates in polymerase chain reaction (PCR) with primers selected to amplify exons 2 to 20 of the human Ob-Rb gene. Direct sequence analysis of the PCR products revealed 7 nucleotide sequence variants (Lys109Arg, Gln223Arg, Ser343Ser, Ser492Thr, Lys656Asn, Ala976Asp, and Pro1019Pro) in the Ob-Rb coding region from 17 obese Japanese subjects with a family history of obesity (BMI 39.3 +/- 8.4 kg/m2). No missense and nonsense mutations were found such as those in Zucker fatty (fa/fa) rats and Koletsky (fa[k]/ fa[k]) rats. Nucleotide substitutions occurred at relatively high frequencies at codons 109, 223, 976, and 1019 (79, 91, 100, and 85%, respectively). Allele frequency of each variant determined by PCR-RFLP and PCR-single strand conformation polymorphism analyses showed no significant differences between 47 obese (BMI 35.1 +/- 6.5 kg/m2) and 68 non-obese (BMI 21.6 +/- 2.2 kg/m2) subjects. The present study represents the first report of sequence variants of the Ob-Rb gene in the Japanese and provides evidence against either obesity-causing mutations or association of sequence variants with obesity in obese Japanese subjects.

Adolescent↗
PubMed1981

[Obesity in children. II. Possible relationship of obesity in childhood to obesity at an older age].

A review is presented of factors predisposing for obesity in childhood and of the probability to maintain early obesity in later years. From literature about retrospective studies it appears that total weight gain in the first year of life is the highest correlated factor with obesity at age 15. The risk of persisting therapy-resistant obesity at that age is not related to a specific critical period during infancy. The risk for metabolic disturbances at later age seems to be greatest when obesity develops earlier and lasts longer. Analysis of the findings among 8-year old Dutch children suggest that various environmental conditions of family-life are at the age determining the prevalence of obesity. Both material and emotional factors as well as aspects of parental education are involved. Some prospective studies demonstrate that for respectively female and male young adults ca 20 and 30 pct of the degree of fatness correlates with skinfold measurements in childhood. Once obesity among Dutch male adolescents at the age of 18 was established, for two-thirds this obesity was maintained at the age of 33. On the other hand for most of the 33 year old obese, obesity had developed after the age of 18.

Adipose Tissue↗
PubMed1997

Augmentation of obese (ob) gene expression and leptin secretion in obese spontaneously hypertensive rats (obese SHR or Koletsky rats).

To explore the pathophysiologic roles of the obese (ob) gene product, leptin, in the development of obesity and hypertension, we examined ob gene expression and leptin secretion in obese spontaneously hypertensive rats (obese SHR or Koletsky rats) at the stage of established obesity and hypertension. Expression of the ob gene was augmented in the epididymal, mesenteric, subcutaneous, and retroperitoneal white adipose tissue (WAT) from 20-week-old male obese SHR compared to their lean littermates (lean SHR). Using a radioimmunoassay for rat leptin, we also measured plasma leptin levels in 20-week-old lean and obese SHR. Plasma leptin levels in obese SHR (292.5 +/- 37.1 ng/ml) were more than 100-fold higher than those in lean SHR (2.8 +/- 1.0 ng/ml). The present study demonstrates that ob gene expression and leptin secretion are markedly augmented in obese SHR.

Animals↗
PubMed1997

Further support for linkage of extreme obesity to the obese gene in a study group of obese children and adolescents.

The role of the obese gene in human obesity is presently unclear. Evidence for linkage of markers flanking the gene to obesity has been found in some but not all studies. We investigated transmission disequilibrium between two highly polymorphic microsatellite markers (D7S504 and D7S1875) flanking the human obese gene (OB) and extreme obesity in a study group of German children and adolescents. Due to the early onset and severity of obesity in the ob/ob mouse we hypothesized that especially children and adolescents with extreme obesity are enriched for possible mutations in the human OB. The analysis of 88 trios (index probands and both parents) for transmission disequilibrium of a haplotype which has previously been determined to be linked to extreme obesity (Reed et al., 1996) revealed a one-sided transmission disequilibrium test (TDT) p-value of 0.039. Post hoc analyses revealed one-sided TDT p-values of 0.015 for the 214 bp allele of D7S1875 (corrected p-value = 0.03) and 0.215 for the 145 bp allele of D7S504 (corrected p-value = 0.43). These findings substantiate the evidence for linkage of extreme obesity to OB.

Adolescent↗
PubMed2001

Childhood onset of obesity: does an obese child become an obese adult?

The aim of this study was to highlight the influence of age of obesity onset on anthropometric parameters in obese adults. We examined 1,451 obese adults with childhood or adolescent onset of obesity, divided into three subgroups in regard to age of onset of obesity: group A--onset before 4 years, group B--onset between 5 and 11 years, and group C--onset between 12 and 19 years. Significantly higher values for body mass index (BMI) and waist circumference (WC) were found in groups with earlier obesity onset, but not for body fat percent (%BF) and waist to hip ratio (WHR). Age of obesity onset may have a significant influence in the persistence of obesity and adverse consequences in adult life. Treatment of obesity and other risk factors for cardiovascular diseases should be initiated as early as possible.

Adolescent↗
PubMed1992

Hepatic Abnormalities in Obesity: comparison between mildly obese cases and morbidly obese cases.

Hepatic morphology and clinical course of mildly obese subjects with abnormal liver tests were determined in comparison with those of surgically treated morbidly obese cases. Twenty mildly obese subjects (mean body mass index, 27.9) with elevated serum transaminase levels were followed up on a low-calorie diet. Nineteen morbidly obese patients (mean body mass index, 39.2) had a surgical biopsy at gastric restrictive surgery. In these two groups, the frequency and the severity of hepatic steatosis and fibrosis were comparable, whereas intralobular cell infiltration was somewhat greater in the mildly obese group. Follow-up studies of the two groups showed remarkable improvement of serum transaminase levels, the extent of which was greater in surgically treated cases. Thus, in mildly obese subjects with abnormal liver tests, (1) hepatic histological abnormalities are not milder than those in morbidly obese cases, and (2) Improvement of serum transaminase levels upon diet therapy is less satisfactory than that in morbidly obese cases treated surgically. It is suggested these two groups may not be in the same spectrum of obesity-related hepatic disorders.

Journal Article↗
PubMed1996

Augmented expression of obese (ob) gene during the process of obesity in genetically obese-hyperglycemic Wistar fatty (fa/fa) rats.

Expression of the obese (ob) gene is up-regulated in the adipose tissue in several obese rodent models. To study the regulation of the ob gene expression during the development of obesity, we examined the ob gene expression in genetically obese-hyperglycemic Wistar fatty (fa/fa) rats at several stages of obesity. The ob mRNA levels in the adipose tissue from Wistar fatty rats was unequivocally augmented and continued to rise in the process of obesity. Furthermore, the ob gene expression in this obese model was much more rapidly enhanced in the mesenteric fat than in the subcutaneous fat. Moreover, the ob gene expression was more greatly augmented in the mesenteric fat than the lipoprotein lipase gene expression. These results suggest the presence of obesity-linked and region-specific regulation of the ob gene expression.

Adipose Tissue↗
PubMed1998

Gestational obesity accentuates obesity in obesity-prone progeny.

Maternal obesity and genetic background can affect the development of obesity and diabetes in offspring. Here we used selected strains of rats resistant (DR) vs. susceptible to development of diet-induced obesity (DIO) on high-energy (HE) diets to assess this issue. DR and DIO dams were fed either Chow or HE diet for 4 wk. DIO HE diet-fed dams and additional DR rats fed a palatable liquid diet (Ensure) became more obese and hyperinsulinemic than the other groups. During lactation, all dams were fed their respective diets, and offspring were fed Chow from weaning to 16 wk of age. All offspring of DIO dams gained more weight and had heavier retroperitoneal fat pads and higher leptin levels than DR progeny, but offspring of the more obese DIO HE dams had heavier fat pads and higher glucose levels than DIO Chow offspring. After 4 wk on HE diet, all DIO offspring gained more weight and had heavier total adipose depots and higher insulin and leptin levels than DR offspring. Offspring of DIO HE dams also gained more weight and had heavier fat depots and higher leptin levels than DIO Chow offspring. Therefore maternal obesity and hyperinsulinemia were associated with increased obesity in those offspring already genetically predisposed to become obese.

Animal Feed↗
PubMed1981

Oxygen consumption by Zucker obese rats, obese yellow mice, and obese hyperglycemic mice with body protein used for metabolic mass.

Oxygen consumption was determined in three varieties of genetically-obese rodents and their lean littermates; the Zucker obese rat (fa/fa), the obese hyperglycemic mouse (ob/ob), and the yellow obese mouse (Ay/a). Values were expressed with both live body weight and total body protein as the unit of metabolic body size. When oxygen consumptions were expressed on the basis of live body weight, all three obese varieties exhibited lower values than their age-matched non-obese littermates. When values of oxygen consumption were expressed with total body protein as the unit of metabolic size, only the ob/ob mice had lower oxygen consumptions than their non-ob/ob littermates. The fa/fa rats and the Ay/a mice had similar values of oxygen consumption as their non-obese controls. Much better correlations between whole-animal resting oxygen consumption, reported values of maintenance energy requirements, and tissue oxygen consumption are obtained when body protein content rather than live body weight is used as the unit of metabolic mass.

Animals↗
PubMed1998

Swedish obese subjects (SOS)--an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity.

OBJECTIVE: To examine the effects of weight loss on health-related quality of life (HRQL) in subjects with severe obesity. DESIGN: Controlled clinical trial of the outcomes of surgical vs conventional weight reduction treatment. SUBJECTS: The first 487 surgical cases and their conventionally treated, matched controls were followed for two years in the Swedish Obese Subjects (SOS) intervention study. MEASUREMENTS: A battery of generic and study-specific self-assessment instruments or subscales was used to characterize HRQL in the severely obese (BMI) > or = 34 kg/m2 for males and BMI > or = 38 kg/m2 for females). Measures of general health perceptions (general health rating index; current health), mental well-being (mood adjective check list; pleasantness, activation and calmness), mood disorders (hospital anxiety and depression scale; anxiety and depression) and social interaction (sickness impact profile), were supplemented by obesity-specific modules on obesity-related psychosocial problems and eating behavior (three-factor eating questionnaire; restrained eating, disinhibition and perceived hunger). Assessments were conducted prior to treatment and repeated after 6, 12 and 24 months. RESULTS: Poor HRQL before intervention was dramatically improved after gastric restriction surgery, while only minor fluctuations in HRQL scores were observed in the conventionally treated controls. Peak values were observed in the surgical group at 6 or 12 months after intervention with a slight to moderate decrease at the two-year follow-up. The positive changes in HRQL after two years were related to the magnitude of weight loss, that is, the greater the weight reduction, the greater the HRQL improvements. Eating behavior improved accordingly. CONCLUSION: Quality of life in the severely obese is improved by substantial weight loss. Most patients benefit from weight reduction surgery, while HRQL in surgical patients with minor reduction in overweight is less positive. Further research is needed to determine outcome predictors of the surgical management of severe obesity and to ensure that HRQL improvements are maintained.

Cohort Studies↗
PubMed1998

Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity.

We investigated the relationship between uric acid (UA) metabolism and fat distribution in 36 obese men with a mean +/- SD age of 38 +/- 16 years and mean body-mass index (BMI) of 34 +/- 4 kg/m2. Subjects were divided into two groups: subcutaneous fat obesity (SFO) and visceral fat obesity (VFO), according to their abdominal fat distribution based on the results of computed tomography (CT). SFO was defined as having a ratio of visceral fat area (VFA) to subcutaneous fat area (V/S) of less than 0.4, and VFO was defined as having a V/S ratio > or = 0.4. The levels of serum total cholesterol (T-Chol), triglyceride (TG), and fasting plasma glucose (FPG), and the diastolic blood pressure (dBP) were significantly higher in the VFO group than in the SFO group. Serum UA levels were much higher in both the SFO and VFO groups than in the non-obese control group (492 +/- 107 and 474 +/- 90 v 309 +/- 48 micromol/L, respectively). The 24-hour urinary urate excretion (u-UA24h) and the UA clearance (Cua) to creatinine clearance (Ccr) ratio were significantly higher in the VFO group than in the SFO group (3.75 +/- 1.43 v 2.69 +/- 1.12 mmol/d, P < .05; and 5.9% +/- 2.0% v 3.6% +/- 1.7%, P < .001, respectively). The frequency of hyperuricemia was markedly higher in both the SFO and VFO groups compared with the control group (71% and 73% v 0%, respectively). Although the high serum UA level seemed to be related to low u-UA24h in 80% of SFO subjects with hyperuricemia, this was the case in only 10% of VFO subjects. While 44% of VFO subjects with hyperuricemia were designated as an overproduction type. These results suggest that the mechanism of hyperuricemia in obesity may be affected by the difference in body fat distribution and that the assessment of body fat distribution and types of hyperuricemia is crucial for the treatment of obese patients with hyperuricemia.

Adipose Tissue↗