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1.
Eur J Endocrinol ; 182(1): G1-G32, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31855556

RESUMEN

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.


Asunto(s)
Índice de Masa Corporal , Hipotiroidismo/diagnóstico , Obesidad/diagnóstico , Comorbilidad , Endocrinología , Humanos , Hipotiroidismo/epidemiología , Obesidad/epidemiología , Prevalencia , Pruebas de Función de la Tiroides
2.
J Assoc Physicians India ; 67(11): 22-24, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31793264

RESUMEN

Statement of the Problem: It is important to note, liver and pancreas are majorly responsible for normal glucose metabolism, these organs are located centrally hence central obesity/abdominal distension will affect glycaemic control more than generalise obesity. Scientific literature highlights a strong and consistent relation between abdominal girth and diabetes risk. Haemoglobin A1c (HbA1c) is recognized as a diagnostic test for DM as well as for its monitoring. Aim: The purpose of this study is to assess association of anthropometric markers viz. Body mass index (BMI) and abdominal girth (AG) for prediction of glycaemic control in Indian population. Methods: This single centre observational study was carried out from Feb 2015 to Oct 2015 at Khopoli, Maharashtra. Participants of both gender, andgt;20 yrs and willing to screen for HbA1c and anthropometry were included. Findings: Out of the 2640 participants who visited the centre, 1870 (N=860 non-DM, age median (range): 57 (48/65) and N=1010 DM, age: 60 (53/65)) were enrolled in this study. HbA1c levels were statistically significantly elevated in DM vs. non-DM group (median (range): 7.5 (6.5/8.9) vs. 5.7 (5.2/6.3); p=0.000). Interestingly, abdominal girth showed significant difference between DM and non-DM groups (median (range): 95 (88/102) vs. 93 (86/100); p=0.022). Whereas BMI did not differ across the groups (median (range): 25.5 (23.2/28.6) vs. 25.7 (23.1/28.8); p=0.486). Conclusion and Significance: Among the anthropometric markers namely BMI and AG, AG is a better predictor of DM risk. Therefore AG should also be considered along with HbA1c for predicting DM risk.


Asunto(s)
Glucemia , Diabetes Mellitus , Obesidad , Biomarcadores , Índice de Masa Corporal , Diabetes Mellitus/diagnóstico , Hemoglobina A Glucada , Humanos , India , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico
4.
Dis Colon Rectum ; 62(11): 1278-1280, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31596759

RESUMEN

CASE SUMMARY: A 66-year-old obese (BMI 34) diabetic man, a former smoker who had quit 4 months ago, had a 20-year history of perianal, inguinal, and gluteal hidradenitis suppurativa. He presented to the office with persistent perianal and gluteal inflammation and drainage. He had had various surgical excisions of the affected area over the preceding 10 years. The patient was also following up with dermatology and was previously on doxycycline and infliximab with little improvement in his symptoms. On physical examination of his gluteal and perianal region, he had multiple areas of scarring and draining sinus tracts with significant induration ( and ). The patient underwent extensive unroofing of the sinus tracts and excision of active disease ().(Figure is included in full-text article.)(Figure is included in full-text article.)(Figure is included in full-text article.).


Asunto(s)
Antibacterianos/uso terapéutico , Tratamiento Conservador/métodos , Diabetes Mellitus Tipo 2/complicaciones , Hidradenitis Supurativa , Obesidad/complicaciones , Procedimientos Quirúrgicos Operativos/métodos , Anciano , Canal Anal/patología , Glándulas Apocrinas/patología , Índice de Masa Corporal , Nalgas/patología , Nalgas/cirugía , Diagnóstico Diferencial , Hidradenitis Supurativa/complicaciones , Hidradenitis Supurativa/diagnóstico , Hidradenitis Supurativa/fisiopatología , Hidradenitis Supurativa/terapia , Humanos , Masculino , Obesidad/diagnóstico , Manejo de Atención al Paciente/métodos , Selección de Paciente
5.
BMJ ; 367: l5584, 2019 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-31619383

RESUMEN

OBJECTIVE: To investigate the association between weight changes across adulthood and mortality. DESIGN: Prospective cohort study. SETTING: US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014. PARTICIPANTS: 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline). MAIN OUTCOME MEASURES: All cause and cause specific mortality from baseline until 31 December 2015. RESULTS: During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality. CONCLUSIONS: Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.


Asunto(s)
Enfermedades Cardiovasculares , Causas de Muerte , Mortalidad Prematura/tendencias , Mortalidad/tendencias , Neoplasias , Aumento de Peso , Pérdida de Peso , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/mortalidad , Encuestas Nutricionales , Obesidad/diagnóstico , Obesidad/mortalidad , Estudios Prospectivos , Factores de Riesgo , Estados Unidos/epidemiología , Relación Cintura-Estatura
6.
Medicine (Baltimore) ; 98(39): e17303, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31574857

RESUMEN

Treatment with nitisinone (NTBC) has brought about a drastic improvement in the treatment and prognosis of hereditary tyrosinemia type I (HT1). We conducted a retrospective observational multicentric study in Spanish HT1 patients treated with NTBC to assess clinical and biochemical long-term evolution.We evaluated 52 patients, 7 adults and 45 children, treated with NTBC considering: age at diagnosis, diagnosis by clinical symptoms, or by newborn screening (NBS); phenotype (acute/subacute/chronic), mutational analysis; symptoms at diagnosis and clinical course; biochemical markers; doses of NTBC; treatment adherence; anthropometric evolution; and neurocognitive outcome.The average follow-up period was 6.1 ±â€Š4.9 and 10.6 ±â€Š5.4 years in patients with early and late diagnosis respectively. All patients received NTBC from diagnosis with an average dose of 0.82 mg/kg/d. All NBS-patients (n = 8) were asymptomatic at diagnosis except 1 case with acute liver failure, and all remain free of liver and renal disease in follow-up. Liver and renal affectation was markedly more frequent at diagnosis in patients with late diagnosis (P < .001 and .03, respectively), with ulterior positive hepatic and renal course in 86.4% and 93.2% of no-NBS patients, although 1 patient with good metabolic control developed hepatocarcinoma.Despite a satisfactory global nutritional evolution, 46.1% of patients showed overweight/obesity. Interestingly lower body mass index was observed in patients with good dietary adherence (20.40 ±â€Š4.43 vs 24.30 ±â€Š6.10; P = .08) and those with good pharmacological adherence (21.19 ±â€Š4.68 vs 28.58 ±â€Š213.79).intellectual quotient was ≥85 in all NBS- and 68.75% of late diagnosis cases evaluated, 15% of which need pedagogical support, and 6.8% (3/44) showed school failure.Among the 12 variants identified in fumarylacetoacetate hydrolase gene, 1 of them novel (H63D), the most prevalent in Spanish population is c.554-1 G>T.After NTBC treatment a reduction in tyrosine and alpha-fetoprotein levels was observed in all the study groups, significant for alpha-fetoprotein in no NBS-group (P = .03), especially in subacute/chronic forms (P = .018).This series confirms that NTBC treatment had clearly improved the prognosis and quality of life of HT1 patients, but it also shows frequent cognitive dysfunctions and learning difficulties in medium-term follow-up, and, in a novel way, a high percentage of overweight/obesity.


Asunto(s)
Ciclohexanonas/uso terapéutico , Diagnóstico Tardío , Nitrobenzoatos/uso terapéutico , Obesidad , Calidad de Vida , Tirosinemias , Adulto , Niño , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Diagnóstico Tardío/efectos adversos , Diagnóstico Tardío/prevención & control , Inhibidores Enzimáticos/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Enfermedades Renales/diagnóstico , Enfermedades Renales/etiología , Masculino , Evaluación de Necesidades , Tamizaje Neonatal/métodos , Obesidad/diagnóstico , Obesidad/etiología , Pronóstico , Estudios Retrospectivos , España , Tiempo de Tratamiento , Tirosinemias/complicaciones , Tirosinemias/diagnóstico , Tirosinemias/tratamiento farmacológico , Tirosinemias/psicología
7.
J Physiol Anthropol ; 38(1): 14, 2019 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-31655610

RESUMEN

BACKGROUND: Obesity is defined as unhealthy excess body fat, which increases the risk of premature mortality from noncommunicable diseases. Early screening and prevention of obesity is critical for averting associated morbidity, disability, and mortality. Ethiopia has been using the international (WHO's) BMI cut-off for diagnosing obesity even though its validity among Ethiopian population was questioned. To address this problem, a new body mass index cut-off was developed for Ethiopian adults using population-specific data. However, its performance in diagnosing obesity has not been validated. Therefore, this study determined the performance of the newly developed Ethiopian and World Health Organization (WHO) BMI cut-offs in detecting obesity among Ethiopian adults. METHODS: A cross-sectional study was carried out among 704 employees of Jimma University from February to April 2015. The study participants were selected using simple random sampling technique based on their payroll. Data on sociodemographic variables were collected using an interviewer-administered structured questionnaire. Anthropometric parameters including body weight and height were measured according to WHO recommendation. Body fat percentage (BF%) was measured using the air displacement plethysmography (ADP) after calibration of the machine. The diagnostic accuracy of the WHO BMI cut-off (≥ 30 kg/m2) for obesity in both sexes and Ethiopian BMI cut-off (> 22.2 kg/m2 for males and >  24.5 kg/m2 for females) were compared to obesity diagnosed using ADP measured body fat percentage (> 35% for females and >  25% for males). Sensitivity, specificity, predictive values, and kappa agreements were determined to validate the performance of the BMI cut-offs. RESULTS: In males, WHO BMI cut-off has a sensitivity of 5.3% and specificity of 99.4% (Kappa = 0.047) indicating a slight agreement. However, the Ethiopian cut-off showed a sensitivity of 87.5% and specificity of 87.7% (Kappa = 0.752) indicating a substantial agreement. Similarly, in females, the WHO BMI cut-off showed a sensitivity of 46.9%, while its specificity was 100% (Kappa = 0.219) showing a fair agreement. The Ethiopian BMI cut-off demonstrated a sensitivity 80.0% and a specificity 95.6% (Kappa = 0.701) showing a substantial agreement. The WHO BMI cut-off underestimated the prevalence of obesity by a maximum of 73.7% and by a minimum of 28.3% among males, while the values for underestimation ranged from 31.4-54.1% in females. The misclassification was minimal using the newly developed Ethiopian BMI cut-off. The prevalence of obesity was underestimated by a maximum of 9.2% and overestimated by a maximum of 6.2%. The WHO BMI cut-off failed to identify nearly half (46.6%) of Ethiopian adults who met the criteria for obesity using BF% in the overall sample. CONCLUSIONS: The findings suggest that WHO BMI cut-off (≥ 30 kg/m2) is not appropriate for screening obesity among Ethiopian adults. The newly developed Ethiopian BMI cut-off showed a better performance with excellent sensitivity, specificity, predictive values, and agreement indicating the diagnostic significance of it use as a simple, cost-effective, and valid indicator in clinical and community setups.


Asunto(s)
Índice de Masa Corporal , Obesidad , Tejido Adiposo , Adulto , Estudios Transversales , Etiopía/epidemiología , Femenino , Humanos , Masculino , Obesidad/diagnóstico , Obesidad/epidemiología , Obesidad/fisiopatología , Valores de Referencia , Sensibilidad y Especificidad , Adulto Joven
8.
Prensa méd. argent ; 105(10): 693-699, oct 2019.
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1025972

RESUMEN

Aim: To evaluate the effects of increasing BMI on the Respiratory function. Introduction: There is a worldwide increasing prevalence of overweihgt and obesity. Researchers have found that obesity affects the respiratory function leading to different respiratory medical illnesses, including asthma and obstructive deep apnea. The effect of obesity on the pulmonary functiion is assisted using different anthropometric measurements, like BMI, waist circumference, skin fold, etc. So the aim of this study is to evaluate the effect of increasing BMI on different respiratory function test measures. Methods: 23 adult males with BMI of 25 and above were included in the study and compared with 18 normal weight adult males with BMI of (18-24.99) regarding different measures of PFT like: FVC, FEV1, PEFR and FEF. Results: no significant difference was found between the two groupsñ. Conclusions: there were no effects of increasing BMI on the respiratory functions


Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Anciano , Pruebas de Función Respiratoria , Índice de Masa Corporal , Estudios de Casos y Controles , Estudios Transversales , Obesidad/diagnóstico
9.
Acta Diabetol ; 56(12): 1333-1339, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31506721

RESUMEN

AIMS: This study aimed to evaluate the effect of pioglitazone on brown adipose tissue function and hypothalamic gliosis in humans. Brown adipose tissue and the hypothalamus are regarded as important potential pharmacological targets to metabolic diseases, and defining the impact of current therapies on their structure and/or function could provide therapeutic advance in this field. METHODS: Six patients with type 2 diabetes were treated for 24 weeks with pioglitazone 30 mg/day as an add-on therapy. Brown adipose tissue glucose uptake and volume were determined using 18F-FDG PET/CT scans; hypothalamic gliosis was determined using MRI scans; blood was collected for hormone and biochemistry measurements. All tests were performed at inclusion and six months after pioglitazone introduction. RESULTS: Pioglitazone treatment led to a significant 3% body mass increase. There were neither changes in cold-induced brown adipose tissue glucose uptake and volume nor changes in hypothalamic gliosis. CONCLUSIONS: This is a proof-of-concept study that provides clinical evidence for a lack of action of a thiazolidinedione, pioglitazone, to promote homogeneous and measurable changes in brown adipose tissue volume and also in hypothalamic gliosis after 6 months of treatment.


Asunto(s)
Tejido Adiposo Pardo/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Gliosis/prevención & control , Hipotálamo/efectos de los fármacos , Hipotálamo/patología , Pioglitazona/farmacología , Tejido Adiposo Pardo/diagnóstico por imagen , Tejido Adiposo Pardo/patología , Adulto , Anciano , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/patología , Quimioterapia Combinada , Femenino , Fluorodesoxiglucosa F18 , Gliosis/diagnóstico , Gliosis/patología , Humanos , Hipotálamo/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico , Obesidad/tratamiento farmacológico , Obesidad/patología , Tamaño de los Órganos/efectos de los fármacos , Sobrepeso/complicaciones , Sobrepeso/diagnóstico , Sobrepeso/tratamiento farmacológico , Sobrepeso/patología , Pioglitazona/administración & dosificación , Tomografía Computarizada por Tomografía de Emisión de Positrones , Prueba de Estudio Conceptual , Tiazolidinedionas/administración & dosificación , Tiazolidinedionas/farmacología
10.
Nord J Psychiatry ; 73(8): 527-531, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31502911

RESUMEN

Background: It has been suggested that obese patients with binge eating disorder (BED) show higher levels of dissociation and childhood trauma. Aim: This study assesses childhood trauma history and dissociative symptoms in obese patients with BED compared to obese patients without BED. Methods: The 241 patients participating in the study had to meet obesity criteria. These patients were applicants for bariatric surgery and were consulted by a psychiatry service. Patients were separated into two groups that were accompanied by BED diagnoses according to structured clinical interviews administered according to the DSM-IV (SCID-I). Patients were assessed using the Dissociation Questionnaire (DIS-Q) and the Childhood Trauma Questionnaire (CTQ). The two groups of patients were compared. Results: A total of 75 (31.1%) of the 241 obese patients were diagnosed with BED. The study showed that obese patients with BED had higher dissociative scores than those without BED (p < .05). The results showed higher total scores and two different types of childhood trauma (physical abuse and emotional abuse) in BED patients compared to non-BED patients (p < .05). Conclusions: Clinicians should be fully aware of BED, dissociative symptoms and childhood traumatic experiences. These results show that, for at least a sub-group of obese patients, BED is associated with obesity and may be connected with dissociative symptoms and childhood physical abuse and emotional abuse.


Asunto(s)
Trastorno por Atracón/psicología , Maltrato a los Niños/psicología , Maltrato a los Niños/tendencias , Trastornos Disociativos/psicología , Obesidad Mórbida/psicología , Adulto , Trastorno por Atracón/diagnóstico , Trastorno por Atracón/epidemiología , Niño , Estudios Transversales , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/epidemiología , Obesidad/psicología , Obesidad Mórbida/diagnóstico , Obesidad Mórbida/epidemiología , Encuestas y Cuestionarios
11.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(3): 134-141, jul.-sept. 2019. tab
Artículo en Español | IBECS | ID: ibc-182721

RESUMEN

La creciente prevalencia de mujeres obesas en edad fértil es una crisis de salud pública y social. La anticoncepción es un tema clave en mujeres con obesidad. Las mujeres obesas tienen una actividad sexual similar a las mujeres de peso normal y en ellas se considera que el uso de anticoncepción es menos eficaz, teniendo mayor riesgo de embarazo no deseado. Debido a una variedad de alteraciones del metabolismo, la obesidad es un factor de riesgo cardiovascular que puede aumentar, cuando se combina con la anticoncepción hormonal. Todos estos factores deben considerarse al elegir un método anticonceptivo en una mujer obesa. El objetivo de esta revisión es evaluar el riesgo-beneficio de cada tipo de anticoncepción disponible y la problemática de anticoncepción después de la cirugía bariátrica, proporcionando al médico una guía práctica sobre el uso de píldoras anticonceptivas orales en mujeres obesas


The increasing prevalence of obese women of childbearing age is a public and social health crisis. Contraception is a key issue in women with obesity. Obese women have a sexual activity no different from women of normal weight, and the use of contraception is considered less effective, as there is a higher risk of having an unwanted pregnancy. Due to a variety of metabolic disorders, obesity is a cardiovascular risk factor that can increase when combined with hormonal contraception. All these factors should be considered when choosing a contraceptive method in an obese woman. The objective of this review is to evaluate the risk-benefit of each type of available contraception, and the problem of contraception after bariatric surgery, in order to provide doctors with a practical guide on the use of oral contraceptive pills in obese women


Asunto(s)
Humanos , Femenino , Adulto , Obesidad/complicaciones , Obesidad/diagnóstico , Anticoncepción , Factores de Riesgo , Progestinas/administración & dosificación , Medición de Riesgo , Cirugía Bariátrica/métodos , Enfermedades Metabólicas/complicaciones , Periodo Fértil , Tromboembolia Venosa/complicaciones , Organización Panamericana de la Salud
12.
Acta méd. costarric ; 61(3): 111-118, jul.-sep. 2019. tab, graf
Artículo en Español | LILACS | ID: biblio-1019302

RESUMEN

Resumen Objetivo : El objetivo del estudio fue analizar el consumo de azúcares añadidos por la población urbana costarricense y los factores asociados a este. Método: Estudio transversal donde se analizan los datos de 798 participantes del Estudio ELANS-Costa Rica, que constituyen una muestra representativa de la población urbana costarricense, (con edades entre 15 y 65 años). Para conocer el consumo de azúcares añadidos, se realizan dos recordatorios de 24 horas, en días no consecutivos. Se recolectan variables sociodemográficas, cantidad, lugar y momento del consumo. Resultados: El consumo de azúcares añadidos representa el 14,7% de la energía consumida por la población urbana costarricense, siendo este porcentaje mayor en las mujeres y en las personas más jóvenes. La mayor cantidad de azúcares añadidos se consume en el hogar y durante las meriendas. Las bebidas azucaradas constituyen la principal fuente de azúcares añadidos en la dieta costarricense, y las bebidas gaseosas son la fuente más importante en el quintil de mayor consumo. Conclusión: La ingesta de energía obtenida de los azúcares añadidos supera la recomendación máxima establecida por la Organización Mundial de la Salud, por lo tanto, es necesario establecer políticas públicas dirigidas a reducir su consumo y a la modificación de conductas asociadas a la preparación e ingesta de alimentos fuente de azúcares añadidos.


Abstract Aim: High consumption of added sugars has been associated with a greater risk of chronic diseases, appearance of caries and weight gain, which implies a lower quality of life for the population and an increase in costs for the health system. The aim of this study was to evaluate the intake of added sugar and its related factors in urban Costa Rican population. Methods : This was a cross-sectional study conducted in a representative sample of the Costa Rican urban population (798 participants aged between 15 and 65 years). To determine the consumption of added sugars, two 24 hours recalls were conducted, in non-consecutive days. Sociodemographic variables, quantity of food consumed, place and time of consumption were collected. Results: The consumption of added sugars represents 14.7% of total energy intake for the Costa Rican urban population. This consumption is higher among women and younger people. The greater amount of added sugars was consumed in the home and during snacks. Sugar-sweetened beverages were the main source of this added sugar in the Costa Rican diet and soft drinks were the most important source in the highest consumption quintile. Conclusions: The intake of energy obtained from the added sugars exceeds the máximum recommendation established by the World Health Organization, therefore it is necessary to establish public policies aimed at reducing consumption and modifying behaviors associated with the preparation and intake of food source of added sugars.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Bebidas Gaseosas/efectos adversos , Diabetes Mellitus/patología , Azúcares/análisis , Azúcares de la Dieta/administración & dosificación , Obesidad/diagnóstico , Costa Rica
13.
Res Vet Sci ; 125: 374-381, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31400635

RESUMEN

Adiponectin is an adipokine that exerts insulin-sensitizing and antiinflammatory properties. The aim of this study was to develop and validate a new heterologous ultrasensitive assay based on amplified luminescent technology for adiponectin determination in serum and saliva of dogs. A complete analytical validation of the assay was made in these fluids, and also this assay was applied to quantify adiponectin in serum and saliva of obese and lean dogs and dogs with leishmaniosis. These conditions were selected because in obesity there is a controversy about how adiponectin concentrations change in dogs, and in case of canine leishmaniosis, although it is described a decrease in serum adiponectin, there are not studies about how adiponectin changes after treatment. A total of 11 dogs were used in the validation and 26 dogs with different body condition and 8 with canine leishmaniosis were used for the clinical evaluation of the new assay for adiponectin quantification in serum and saliva of dogs. The analytical evaluation showed that the developed method could measure adiponectin in serum and saliva of dogs with high repeatability and sensitivity, adding a limit of quantification lower than commercially available ELISAs. In addition, significantly higher adiponectin concentrations were found in lean dogs and a correlation between serum and saliva was observed (P < .01). Moreover, dogs with leishmania presented reduced levels of adiponectin in serum. In conclusion, a new assay has been developed for adiponectin measurements which is more sensitive and faster than the traditional ELISA assays requiring less sample volume.


Asunto(s)
Adiponectina/metabolismo , Inmunoensayo/veterinaria , Leishmaniasis/veterinaria , Obesidad/veterinaria , Adiponectina/sangre , Animales , Perros , Inmunoensayo/métodos , Leishmaniasis/diagnóstico , Leishmaniasis/metabolismo , Masculino , Obesidad/diagnóstico , Obesidad/metabolismo , Saliva/química
14.
Prog Cardiovasc Dis ; 62(4): 327-333, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31442513

RESUMEN

The epidemic of obesity contributes to the burden of type 2 diabetes mellitus (T2DM) in the United States and worldwide. Importantly, obesity is not only preventable but can be treated, particularly with lifestyle modifications to forestall T2DM in those with excess adiposity. The mechanisms linking obesity to T2DM are numerous and involve adipose tissue remodeling as a result of unhealthy behaviors, including unhealthy diet, reduced physical activity (PA) and exercise training (ET), and increased sedentary behaviors. Taken together, these factors markedly reduce cardiorespiratory fitness (CRF), one of the strongest predictors for cardiovascular outcomes and all-cause mortality in the general population, but also in those with T2DM. In this review we describe the mechanisms leading to adipose tissue remodeling resulting in obesity, as well as the mechanisms linking excess adiposity to insulin resistance and, in turn, T2DM. We then present the therapeutic strategies that can be implemented in obesity to prevent T2DM, with a brief discussion on weight loss, and greater emphasis on PA and ET. We finally present the evidence to support the beneficial effects of such strategies in patients with established T2DM and discuss the importance of achieving improvements in CRF in this population to potentially improve clinical outcomes.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/epidemiología , Ejercicio/fisiología , Estilo de Vida , Obesidad/epidemiología , Anciano , Índice de Masa Corporal , Comorbilidad , Diabetes Mellitus Tipo 2/diagnóstico , Terapia por Ejercicio/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Pronóstico , Calidad de Vida , Medición de Riesgo , Conducta Sedentaria , Índice de Severidad de la Enfermedad , Pérdida de Peso/fisiología
15.
Am J Health Syst Pharm ; 76(16): 1211-1217, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31369116

RESUMEN

PURPOSE: Results of a study to determine whether obesity is associated with acute kidney injury (AKI) among patients receiving combination therapy with piperacillin-tazobactam and vancomycin are reported. METHODS: A retrospective, single-center cohort study of patients who received combination therapy for at least 48 hours was conducted using data from the University of Kentucky Center for Clinical and Translational Science's Enterprise Data Trust. Patients with chronic kidney disease, baseline creatinine clearance of less than 30 mL/min, cystic fibrosis, or missing height or weight information were excluded. RESULTS: A total of 8,125 patients were included in the cohort. Among the variables evaluated, total body weight of 91 kg or more was the variable most predictive of AKI. Patients with a weight of 91 kg or higher were more likely than lower-weight patients to have diabetes (39% versus 21%, p < 0.00001), hypertension (64% versus 47%, p < 0.00001), and heart failure (15% versus 13%, p = 0.007). The median daily vancomcyin dose was lower in patients with a weight of less than 91 kg (2,000 mg versus 3,000 mg, p < 0.00001); however, weight-based doses were lower in patients weighing 91 kg or more (25.5 mg/kg/day versus 27.9 mg/kg/day, p < 0.00001). AKI was more common in patients weighing 91 kg or more (24% versus 18%, p < 0.00001; adjusted odds ratio, 1.46 [95% confidence interval, 1.28-1.66]). CONCLUSION: Increased total body weight increased the rate of AKI among patients concurrently treated with piperacillin-tazobactam and vancomycin independent of clinically important confounders, with an important breakpoint occurring at 91 kg.


Asunto(s)
Lesión Renal Aguda/epidemiología , Antibacterianos/efectos adversos , Obesidad/epidemiología , Combinación Piperacilina y Tazobactam/efectos adversos , Vancomicina/efectos adversos , Lesión Renal Aguda/inducido químicamente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Peso Corporal , Quimioterapia Combinada/efectos adversos , Quimioterapia Combinada/métodos , Femenino , Humanos , Kentucky/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
16.
PLoS Genet ; 15(8): e1008277, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31369549

RESUMEN

Obesity is a worldwide health problem that is closely linked to many metabolic disorders. Regular physical exercise has been found to attenuate the genetic predisposition to obesity. However, it remains unknown what kinds of exercise can modify the genetic risk of obesity. This study included 18,424 unrelated Han Chinese adults aged 30-70 years who participated in the Taiwan Biobank (TWB). A total of 5 obesity measures were investigated here, including body mass index (BMI), body fat percentage (BFP), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). Because there have been no large genome-wide association studies on obesity for Han Chinese, we used the TWB internal weights to construct genetic risk scores (GRSs) for each obesity measure, and then test the significance of GRS-by-exercise interactions. The significance level throughout this work was set at 0.05/550 = 9.1x10-5 because a total of 550 tests were performed. Performing regular exercise was found to attenuate the genetic effects on 4 obesity measures, including BMI, BFP, WC, and HC. Among the 18 kinds of self-reported regular exercise, 6 mitigated the genetic effects on at least one obesity measure. Regular jogging blunted the genetic effects on BMI, BFP, and HC. Mountain climbing, walking, exercise walking, international standard dancing, and a longer practice of yoga also attenuated the genetic effects on BMI. Exercises such as cycling, stretching exercise, swimming, dance dance revolution, and qigong were not found to modify the genetic effects on any obesity measure. Across all 5 obesity measures, regular jogging consistently presented the most significant interactions with GRSs. Our findings show that the genetic effects on obesity measures can be decreased to various extents by performing different kinds of exercise. The benefits of regular physical exercise are more impactful in subjects who are more predisposed to obesity.


Asunto(s)
Ejercicio , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Obesidad/prevención & control , Adulto , Bancos de Muestras Biológicas/estadística & datos numéricos , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/genética , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Autoinforme/estadística & datos numéricos , Taiwán , Circunferencia de la Cintura/genética , Relación Cintura-Cadera
17.
BMC Public Health ; 19(1): 1035, 2019 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-31375086

RESUMEN

BACKGROUND: To determine the optimal cut-off values and evaluate the associations of body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR) with cardiovascular disease (CVD) risk factors. METHODS: A large-scale cross-sectional survey was conducted among 35,256 adults aged 20-74 years in Shanghai between June 2016 and December 2017. Receiver operating characteristic (ROC) analyses were conducted to assess the optimal cut-off anthropometric indices of CVD risk factors including hypertension, diabetes, dyslipidemia and hyperuricemia. Multivariate Logistic regression models were preformed to evaluate the odds ratio of CVD risk factors. RESULTS: The area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of hypertension and diabetes, and AUCs were higher in women than men. The optimal cut-off values of WHtR were approximately 0.51 in both sexes, while the cut-off values of BMI and WC were higher for men compared with women. The optimal cutoff values of BMI and WC varied greatly across different age groups, but the difference in WHtR was relatively slight. Among women, the optimal threshold of anthropometric indices appeared to increase with age for hypertension and diabetes. The odds ratio between anthropometric indices and CVD risk factors were attenuated with age. WHtR had the greatest odds ratio for CVD risk factors among adults under 60 years old except for women with hypertension, while among 60-74 years, BMI yielded the greatest odds ratio in terms of all CVD outcomes except for women with diabetes. CONCLUSIONS: WHtR had the best performance for discriminating hypertension and diabetes and potentially be served as a standard screening tool in public health. The associations between three anthropometric indices and CVD risk factors differed by sex and decreased with age. These findings indicated a need to develop age- and gender-specific difference and make effective strategies for primary prevention of CVDs.


Asunto(s)
Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Obesidad/diagnóstico , Circunferencia de la Cintura , Relación Cintura-Estatura , Adulto , Anciano , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores de Riesgo , Adulto Joven
18.
Nutrients ; 11(8)2019 07 29.
Artículo en Inglés | MEDLINE | ID: mdl-31362440

RESUMEN

Obesity is associated to chronic low-grade metabolic inflammation and hypovitaminosis D. Among extra-skeletal effects, an important role in inflammation has been described for vitamin D (25(OH)D). Phase angle (PhA) is a bioelectrical impedance analysis (BIA) parameter that represents an indicator of cellular health in chronic inflammatory states. However, it is still unknown whether a low 25(OH)D levels might correlate with PhA in obesity. Considering the lack of evidence correlating the 25(OH)D levels with PhA in obesity, the aim of this study was to investigate their possible relationship in a group of patients with obesity stratified according to body mass index (BMI) categories. Four hundred and fifty-five adult subjects (219 males and 236 females; 36 ± 11 years) were enrolled. Body composition, including PhA, was assessed using a BIA phase-sensitive system. Serum levels of 25(OH)D was determined by a direct competitive chemiluminescence immunoassay. Most of the participants were affected by grade III obesity (24%) and had 25(OH)D deficiency (67%). Subjects with 25(OH)D deficiency had highest BMI (p < 0.001). Stratifying the sample population according to the BMI classes, 25(OH)D levels decreased significantly along with the increase in BMI (p < 0.001), with the lowest 25(OH)D levels in the class III obesity. In addition, stratifying the sample population according to 25(OH)D categories, BMI and fat mass (FM) decreased, while PhA increased significantly along with the 25(OH)D categories (p < 0.001). The 25(OH)D levels showed significant positive associations with PhA (r = -0.59, p < 0.001), and this association remained significant also after adjusting for BMI and FM (r = 0.60, p < 0.001). The lowest values of PhA were significantly associated with the severity of obesity (OR 0.3, p < 0.001) and of 25(OH)D deficiency (OR 0.2, p < 0.001). To compare the relative predictive power of body composition parameters associated with the 25(OH)D levels, we performed a multiple linear regression analysis. The most sensitive and specific cut-off for 25(OH)D levels to predict the PhA above the median was >14 ng/mL (p < 0.001). In conclusion, we provided preliminary insights into a novel link between 25(OH)D levels and PhA in the setting of obesity. This association uncovered a new potential usefulness of PhA as expression of cell membrane integrity and predictor of inflammation in low 25(OH)D status that might help in identifying high-risk patients with obesity who could benefit from careful 25(OH)D supplementation.


Asunto(s)
Composición Corporal , Inflamación/diagnóstico , Obesidad/diagnóstico , Deficiencia de Vitamina D/diagnóstico , Vitamina D/análogos & derivados , Adiposidad , Adolescente , Adulto , Biomarcadores/sangre , Índice de Masa Corporal , Estudios Transversales , Impedancia Eléctrica , Femenino , Humanos , Inflamación/sangre , Inflamación/fisiopatología , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/fisiopatología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/fisiopatología , Adulto Joven
20.
BMJ ; 366: l4293, 2019 07 24.
Artículo en Inglés | MEDLINE | ID: mdl-31340931

RESUMEN

OBJECTIVES: To develop and validate a prediction model for fat mass in children aged 4-15 years using routinely available risk factors of height, weight, and demographic information without the need for more complex forms of assessment. DESIGN: Individual participant data meta-analysis. SETTING: Four population based cross sectional studies and a fifth study for external validation, United Kingdom. PARTICIPANTS: A pooled derivation dataset (four studies) of 2375 children and an external validation dataset of 176 children with complete data on anthropometric measurements and deuterium dilution assessments of fat mass. MAIN OUTCOME MEASURE: Multivariable linear regression analysis, using backwards selection for inclusion of predictor variables and allowing non-linear relations, was used to develop a prediction model for fat-free mass (and subsequently fat mass by subtracting resulting estimates from weight) based on the four studies. Internal validation and then internal-external cross validation were used to examine overfitting and generalisability of the model's predictive performance within the four development studies; external validation followed using the fifth dataset. RESULTS: Model derivation was based on a multi-ethnic population of 2375 children (47.8% boys, n=1136) aged 4-15 years. The final model containing predictor variables of height, weight, age, sex, and ethnicity had extremely high predictive ability (optimism adjusted R2: 94.8%, 95% confidence interval 94.4% to 95.2%) with excellent calibration of observed and predicted values. The internal validation showed minimal overfitting and good model generalisability, with excellent calibration and predictive performance. External validation in 176 children aged 11-12 years showed promising generalisability of the model (R2: 90.0%, 95% confidence interval 87.2% to 92.8%) with good calibration of observed and predicted fat mass (slope: 1.02, 95% confidence interval 0.97 to 1.07). The mean difference between observed and predicted fat mass was -1.29 kg (95% confidence interval -1.62 to -0.96 kg). CONCLUSION: The developed model accurately predicted levels of fat mass in children aged 4-15 years. The prediction model is based on simple anthropometric measures without the need for more complex forms of assessment and could improve the accuracy of assessments for body fatness in children (compared with those provided by body mass index) for effective surveillance, prevention, and management of clinical and public health obesity.


Asunto(s)
Tejido Adiposo/patología , Antropometría/métodos , Obesidad , Adolescente , Niño , Preescolar , Humanos , Modelos Teóricos , Obesidad/diagnóstico , Obesidad/prevención & control , Valor Predictivo de las Pruebas
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