Protective effect of leg fat against cardiovascular risk factors in obese premenopausal women.

BACKGROUND AND AIMS: While the relationship between abdominal fat and cardiovascular risk (CVR) factors is well established, the possible protective role of peripheral fat against these factors has received less attention, particularly in severely obese individuals. The principal aim of this study was to analyse the relationship, if any, among amount of leg fat, CVR factors and body mass index (BMI) in obese premenopausal women. METHODS AND RESULTS: Subjects were 80 obese premenopausal women. Body composition was measured by dual energy X-ray absorptiometry (DEXA); CVR factors (blood pressure, plasma lipids, glucose) were determined and anthropometric measurements (waist and hip circumferences) taken. In severely obese women (BMI>40 kg/m(2)) leg fat correlated negatively with CVR factors, whereas metabolic parameters were not significantly different from those of subjects with BMI<40 kg/m(2). CONCLUSIONS: Leg fat seems to play a protective role against CVR factors in severely obese premenopausal women.

Metabolic syndrome does not increase angiographic restenosis rates after drug-eluting stent implantation.

Metabolic syndrome (MS) is associated with an increased risk of coronary heart disease, stroke, and cardiovascular mortality; but its effect on patients undergoing cardiac revascularization is still unclear. Robust evidence demonstrates that diabetes mellitus and insulin resistance are among the main risk factors for restenosis in patients requiring percutaneous myocardial revascularization. The recent advent of drug-eluting stents (DESs) has significantly reduced the incidence of restenosis compared with bare-metal stents, both in nondiabetic and in diabetic patients. The aim of the study was to evaluate the effect of MS on the risk of binary restenosis in DES implant recipients. One hundred eighty-nine recipients of successful DES implants performed between January and March 2005 for stable coronary artery disease underwent 1-year clinical and angiographic follow-up. Body mass index (BMI), blood pressure, fasting blood glucose, and lipid profile were determined. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria, with the waist criterion being substituted by a BMI>or=28.8 kg/m2. Metabolic and anthropometric information for MS diagnosis was available for 148 of 189 patients; 87 of 148 patients (58%) had MS. Patients with MS had higher BMI (28.4+/-3.8 vs 26+/-2.7 kg/m2, P<.0001), systolic blood pressure (133+/-14 vs 124+/-14 mm Hg, P=.0004), and fasting glucose (113+/-37 vs 92+/-17 mg/dL, P<.0001). They also had higher serum triglycerides (154+/-94 vs 113+/-43, P=.0018) and lower high-density lipoprotein cholesterol levels (39+/-9 vs 46+/-10, P<.0001). Rates of restenosis (10.5% vs 8.1%, P=not significant [NS]), target vessel revascularization (10.5% vs 11.3%, P=NS), and major adverse cardiac events (11.6% vs 14.5%, P=NS) were not significantly different in patients with MS compared with those without MS, nor was any association found between increased end point risk and presence of MS. When patients were subdivided into 6 subgroups by the presence of 0, 1, 2, 3, 4, or 5 of the MS components, restenosis rates were not significantly different among subgroups. In conclusion, MS is not associated with higher rates of restenosis, target vessel revascularization, or major adverse cardiac events; and no additional MS feature was associated with an increased risk.

Lipoproteins obtained from anorexia nervosa patients induce higher oxidative stress in U373MG astrocytes through nitric oxide production.

Eating disorders (ED) are a group of important psychiatric disorders that affect young men and women, and can have serious consequences. Among all ED, anorexia nervosa (AN) is the most typical but also the most severe. The pathogenesis of AN is multifactorial and a great variety of cognitive deficits may contribute to its pathogenesis. The present study is aimed to measure NO and peroxynitrite production, iNOS and nNOS expression by Western immunoblot after incubation of AN lipoproteins at different times with human astrocytoma cells. The AN-HDL treated cells showed an increased production of NO at 3 h versus control-HDL treated cells and a decreased production at 24 h. Regarding LDL, a significant increase of NO production was obtained both at 3 and 24 h. The AN-HDL and AN-LDL treated cells showed an increased production of peroxynitrite both at 3 and 24 h compared to control lipoproteins. Densitometric analysis of bands indicated that both iNOS and nNOS protein levels were significantly higher in the cells incubated with AN lipoproteins compared to cells incubated with control lipoproteins both at 3 and 24 h. Although the pathogenesis of AN remains uncertain, evidence exists that modifications to the lipoprotein profile and cholesterol, structural alterations of phospholipids and integral constituents of myelin and synaptosomes may be related to psychotic disorders and body image distortion common to AN. Thus, a relevant pathophysiological association between NO and depression is certainly a possibility, as well as a central role played by NO in the pathogenesis.

Changes in body composition and insulin sensitivity in severely obese subjects after laparoscopic adjustable silicone gastric banding (LASGB).

BACKGROUND: Laparoscopic adjustable silicone gastric banding (LASGB) is a viable therapeutic approach to achieve stable body weight reduction in severe obesity. The aim of this study was to evaluate body composition and metabolic features in morbidly obese patients before and after LASGB. MATERIAL/METHODS: There were 15 severely obese patients (Ob) (M/F: 4/11; mean age: 32.5 +/- 3.8 years) and 16 age-and sex-matched healthy lean controls (C) (M/F: 4/12; mean age: 39.5 +/- 2 years). Body mass index (BMI), waist circumference, waist-to-hip ratio, blood pressure, lipid profile, serum glucose and insulin during OGTT, and HOMA-IR were evaluated in all subjects. Body composition and fat distribution were measured using dual energy X-ray absorptiometry (DEXA). Patients were assessed before and six months after LASGB. RESULTS: The obese subjects showed several metabolic alterations. There were also positive correlations between waist, fat mass (FM), and HOMA-IR at baseline. After LASGB, mean BMI fell from 42.2 kg/m2 to 33.2 kg/m2; waist circumference and abdominal FM% decreased significantly. FM% declined, whereas FFM% increased. The ratio of FM loss to FFM loss was 3.7:1. Serum glucose and insulin levels during OGTT diminished slightly after weight loss and triglyceride levels fell dramatically. After LASGB, fasting insulin and HOMA-IR declined. RESULTS: LASGB induced a significant improvement in insulin sensitivity and a redistribution of body composition with a relative increase of FFM.