bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired Lung Function Is Associated with Obesity and Metabolic Syndrome in Adults
Authors: Lin Wen‐Yuan , Yao Chien‐An , Wang Hao‐Chien , Huang Kuo‐Chin
Published: April 2008

Objective: Impaired lung function is associated with obesity and insulin resistance. In this study, we investigated the relationship between metabolic syndrome and impaired lung function in adults.

Research Methods and Procedures: A total of 46,514 subjects 20 years and over (21,669 men and 24,845 women, mean age = 37.3 ± 11.2 and 37.0 ± 11.3 years, respectively) were recruited from four nationwide MJ Health Screening Centers in Taiwan from 1998 to 2000. Metabolic syndrome was defined using the National Cholesterol Education Panel (NCEP) metabolic syndrome criteria or America Heart Association/National Heart Lung Blood Institute (AHA/NHLBI) criteria. The relationship between metabolic syndrome and lung function test was examined using multivariate logistic regression analysis.

Results: The prevalence of impaired lung function was 11.1% in men and 14.0% in women. The prevalence of metabolic syndrome was 5.8% using NCEP criteria and 12.8% using AHA/NHLBI criteria. In multivariate logistic regression analysis with adjustment for age, gender, BMI, smoking, alcohol drinking, and physical activity, restrictive lung impairment was independently associated with increased risk of having metabolic syndrome (p < 0.01, odds ratios = 1.221 using NCEP criteria and 1.150 using AHA/NHLBI criteria).

Discussion: Obesity and metabolic syndrome were associated with impaired lung function in adults in Taiwan. Our results imply that obesity and insulin resistance may be the common pathways underlying lung function impairment and metabolic syndrome. Moreover, lung function test may be applied as an additional evaluation for metabolic syndrome in a clinical setting.
Relation of BMI and Physical Activity to Sex Hormones in Postmenopausal Women
Authors: McTiernan Anne , Wu LieLing , Chen Chu , Chlebowski Rowan , Mossavar‐Rahmani Yasmin , Modugno Francesmary , Perri Michael G. , Stanczyk Frank Z. , Van Horn Linda , Wang C.Y. ,   Women's Health Initiative Investigators
Published: April 2008

Objective: Levels of estrogen, androgen, and prolactin have been related to risk of postmenopausal breast cancer. However, the determinants of these hormone concentrations are not established. The purpose of this study was to examine correlates of endogenous sex hormones.

Research Methods and Procedures: Associations among adiposity, physical activity, and diet and concentrations of estradiol, free estradiol, estrone, testosterone, free testosterone, sex hormone‐binding globulin (SHBG), androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and prolactin were evaluated in 267 postmenopausal women randomly selected from the Women's Health Initiative Dietary Modification Trial.

Results: In multiple regression analyses on log‐transformed hormones, BMI was positively associated with estrone (β = 0.031, p < 0.001), estradiol (β = 0.048, p < 0.001), free estradiol (β = 0.062, p < 0.001), free testosterone (β = 0.017, p = 0.02), and prolactin (β = 0.012, p = 0.02) and negatively associated with SHBG (β = −0.02, p = 0.001). Total physical activity (metabolic equivalent tasks per week) was negatively associated with concentrations of estrone, estradiol, and androstenedione (β = −0.006, −0.007, and −0.005, respectively, all p ≤ 0.05). Using a composite variable of BMI and physical activity dichotomized by median values, women with high BMI/low physical activity had a mean estrone concentration of 28.8 pg/mL, compared with 24.1, 19.9, and 18.4 pg/mL for women with high BMI/high physical activity, low BMI/low physical activity, and low BMI/high physical activity, respectively (p trend < 0.001). Similar trends were observed for estradiol and free estradiol and, in inverse, for SHBG.

Discussion: These associations may, in part, explain the positive associations between overweight/obesity and a sedentary lifestyle on breast cancer risk.
Different “Weight” of Cardiac and General Adiposity in Predicting Left Ventricle Morphology
Authors: Iacobellis Gianluca , Pond Caroline M. , Sharma Arya M.
Published: April 2008

Excess adiposity has been widely related to cardiac morphological changes. Nevertheless, the mechanistic link between increased adiposity and left ventricular (LV) morphology is controversial and not completely understood. In this context, several authors have recently debated the different “weight” of BMI as an index of general adiposity vs. the importance of the epicardial fat depot as a marker of local visceral adiposity in obesity‐related LV changes. Studies in uncomplicated obesity suggest that the role of BMI in predicting LV abnormalities remains rather doubtful. In contrast, several lines of evidence suggest that cardiac adiposity could play an important part in the development of cardiac modifications. Epicardial fat as an index of cardiac adiposity could have a functional and mechanical role in obesity‐related LV abnormalities. Epicardial fat is clinically correlated with LV mass, atrial dimensions, and diastolic function, but a causal effect of epicardial adipose tissue on cardiac chamber modifications remains to be demonstrated. Nevertheless, the close anatomical and functional relationship of epicardial adipose tissue to the adjacent myocardium should readily allow local, paracrine interactions between these tissues.
Cellular and Biochemical Features of Skeletal Muscle in Obese Yucatan Minipigs
Authors: Guillerm‐Regost Christelle , Louveau Isabelle , Sébert Sylvain P. , Damon Marie , Champ Martine M. , Gondret Florence
Published: April 2008

Objective: To examine cellular and biochemical features of skeletal muscle in response to dietary‐induced obesity in a novel Yucatan minipig model of childhood obesity.

Research Methods and Procedures: From 4 to 16 months of age, minipigs were fed either a recommended human‐type diet (NF; n = 4) or were overfed a western‐type diet with saturated fat and high‐glycemic index carbohydrates (OF, n = 4). Muscle samples (biceps femoris) were histochemically stained for the identification of intramuscular adipocytes, intramyocellular lipid aggregates (oil red O), and myofiber types (myosin ATPase, succinate dehydrogenase). Gene expressions and/or activities of factors involved in lipogenesis, lipolysis, or energetic metabolism were quantified in muscle.

Results: Cross‐sectional areas of myofibers paralleled pig body weight (r = 0.86, p < 0.01). The size of intramuscular adipocytes, the relative proportion of oil red O‐stained fibers, and total muscle lipid content tended (p ≤ 0.10) to increase in response to OF diet. Hormone‐sensitive lipase, carnitine palmityl transferase‐I, and uncoupling protein 2 mRNA levels were lower (p < 0.05) in OF pigs than in NF pigs. Activities of β‐hydroxyacyl‐coenzyme A dehydrogenase and citrate synthase assessing post‐carnitine palmityl transferase I events and the proportion of oxidative myofibers were not altered by OF diet. Activity and gene expression of fatty acid synthase were lower (p < 0.02) in OF pigs than in NF pigs.

Discussion: Overfeeding in Yucatan minipigs reduced the expression levels of three catabolic steps in skeletal muscle that are involved also in the etiology of human obesity.
Impact of Obesity in Intima Media Thickness of Carotid Arteries
Authors: Kotsis Vasilios T. , Stabouli Stella V. , Papamichael Christos M. , Zakopoulos Nikos A.
Published: April 2008

Objective: To explore differences in intima media thickness (IMT) of the carotid arteries induced by differences in BMI.

Research Methods and Procedures: Data from 3173 consecutive subjects, who were referred to our Hypertension Center from 1998 to 2004, were reviewed. Criteria for patients to be considered for further analysis included no past or concurrent antihypertensive medication, no concurrent medication with the potential to raise blood pressure (BP) (e.g., prednisone), and no clinical signs or laboratory evidence of secondary causes of hypertension. Our population was divided into four groups according to NIH criteria for obesity: underweight, normal weight, overweight, and obese. BMI, mean IMT of internal carotid arteries, and 24‐hour BP values were available for all subjects. Five hundred thirty six subjects of the four groups, matched for age, gender, and mean 24‐hour BP values, were included in the analysis.

Results: Mean IMT of internal carotid arteries was increased with increasing BMI. Mean IMT was significantly higher in obese subjects compared with normal‐weight (p < 0.01) and underweight (p < 0.001) subjects. Mean IMT was significantly higher in overweight subjects compared with normal‐weight ones (p < 0.05). Furthermore, multivariate regression analysis in obese subjects revealed that fasting serum glucose was independently associated with IMT.

Discussion: Obesity may be an important factor for carotid atherosclerosis, and at least some of the effects of obesity are independent of the BP levels. Fasting serum glucose levels in obese subjects may play an important role in carotid atherosclerosis.
Bioelectrical Impedance Underestimates Total and Truncal Fatness in Abdominally Obese Women
Authors: Neovius Martin , Hemmingsson Erik , Freyschuss Bo , Uddén Joanna
Published: April 2008

Objective: To compare estimates of total and truncal fatness from eight‐electrode bioelectrical impedance analysis equipment (BIA8) with those from DXA in centrally obese women. The secondary aim was to examine BMI and waist circumference (WC) as proxy measures for percentage total body fat (%TBF) and truncal body fat percentage (tr%BF).

Research Methods and Procedures: This was a cross‐sectional study of 136 women (age, 48.1 ± 7.7 years; BMI, 30.4 ± 2.9 kg/m2; %TBFDXA, 46.0 ± 3.7%; WC, 104 ± 8 cm). Fatness was measured by DXA and Tanita BC‐418 equipment (Tanita Corp., Tokyo, Japan). Agreement among methods was assessed by Bland‐Altman plots, and regression analysis was used to evaluate anthropometric measures as proxies for total and abdominal fatness.

Results: The percentage of overweight subjects was 41.9%, whereas 55.9% of the subjects were obese, as defined by BMI, and all subjects had a WC exceeding the World Health Organization cut‐off point for abdominal obesity. Compared with DXA, the BIA8 equipment significantly underestimated total %BF (−5.0; −3.6 to −8.5 [mean; 95% confidence interval]), fat mass (−3.6; −3.9 to −3.2), and tr%BF (−8.5; −9.1 to −7.9). The discrepancies between the methods increased with increasing adiposity for both %TBF and tr%BF (both p < 0.001). Variation in BMI explained 28% of the variation in %TBFDXA and 51% of %TBFBIA8. Using WC as a proxy for truncal adiposity, it explained only 18% of tr%BFDXA variance and 27% of tr%BFBIA8 variance. The corresponding figures for truncal fat mass were 49% and 35%, respectively. No significant age effects were observed in any of the regressions.

Discussion: BIA8 underestimated both total and truncal fatness, compared with DXA, with higher dispersion for tr%BF than %TBF. The discrepancies increased with degree of adiposity, suggesting that the accuracy of BIA is negatively affected by obesity.
Postprandial Variations of Plasma Inflammatory Markers in Abdominally Obese Men
Authors: Blackburn Patricia , Després Jean‐Pierre , Lamarche Benoît , Tremblay Angelo , Bergeron Jean , Lemieux Isabelle , Couillard Charles
Published: April 2008

Objective: Abdominal obesity is associated with a fasting proinflammatory condition. However, not much is known of the potential variations in circulating inflammatory markers after food intake. The purpose of the present study was to examine postprandial changes in plasma tumor necrosis factor (TNF)‐α, interleukin (IL)‐6, and C‐reactive protein (CRP) concentrations in men and their potential associations with fat distribution and metabolic profile variables.

Research Methods and Procedures: Thirty‐eight men were given a high‐fat meal in the morning after an overnight fast, and TNF‐α, IL‐6, and CRP levels were measured in plasma at 0, 4, and 8 hours after the meal. Physical and metabolic profiles were also assessed for each participant.

Results: We observed a substantial increase in circulating IL‐6 levels (p < 0.0001) after the meal. Although postprandial variations in circulating TNF‐α levels across time failed to reach statistical significance (p = 0.02), we noted a significant decrease in plasma TNF‐α concentrations 4 hours (−10%, p < 0.001 vs. 0 hours) after food intake. Plasma CRP levels were not affected by the fat load. We also noted that insulin‐sensitive individuals displayed a less pronounced inflammatory response after food intake than insulin‐resistant subjects.

Discussion: Results of the present study show that consumption of a high‐fat meal leads to an increase in plasma IL‐6 concentrations and transient decrease in circulating TNF‐α levels in overweight men. Our results suggest a possible role of insulin resistance in the modulation of the postprandial inflammatory response, which could, in turn, contribute to worsen the state of insulin resistance.
Confronting and Coping with Weight Stigma: An Investigation of Overweight and Obese Adults
Authors: Puhl Rebecca M. , Brownell Kelly D.
Published: April 2008

Objective: This study examined experiences of weight stigmatization, sources of stigma, coping strategies, psychological functioning, and eating behaviors in a sample of 2671 overweight and obese adults.

Research Methods and Procedures: The total sample was partitioned into two subsamples for investigation. Sample I was comprised of 2449 adult women, and Sample II was a matched sample of adult men and women (N = 222) that was disaggregated to investigate gender differences. Both samples completed an online battery of self‐report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self‐esteem, attitudes about weight and obesity, and binge eating behaviors.

Results: Experiences of weight stigmatization, in many forms and across multiple occasions, was common in both samples. A variety of coping strategies were used in response. More frequent exposure to stigma was related to more attempts to cope and higher BMI. Physicians and family members were the most frequent sources of weight bias reported. No gender differences were observed in types or frequency of stigmatization. Frequency of stigmatization was not related to current psychological functioning, although coping responses were associated with emotional well‐being.

Discussion: These findings raise questions about the relationship between stigma and psychological functioning and have important implications for obesity treatment and stigma reduction intervention efforts, both of which are discussed.
Self‐Reported Sugar‐Sweetened Beverage Intake among College Students
Authors: West Delia Smith , Bursac Zoran , Quimby Donna , Prewitt T. Elaine , Spatz Thea , Nash Creshelle , Mays Glen , Eddings Kenya
Published: April 2008

Objective: To characterize sugar‐sweetened beverage intake of college students.

Research Methods and Procedures: Undergraduates in an urban southern community campus were surveyed anonymously about sugared beverage consumption (soda, fruit drinks, energy drinks, sports drinks, sweet ice tea) in the past month.

Results: Two hundred sixty‐five undergraduates responded (66% women, 46% minority, 100% of volunteers solicited). Most students (95%) reported sugared beverage intake in the past month, and 65% reported daily intake. Men were more likely than women to report daily intake (74% vs. 61%, p = 0.035). Soda was the most common sugar‐sweetened beverage. Black undergraduates reported higher sugared beverage intake than whites (p = 0.02), with 91% of blacks reporting sugar‐sweetened fruit drink intake in the past month and 50% reporting daily consumption. Mean estimated caloric intake from combined types of sugar‐sweetened beverages was significantly higher among black students than whites, 796 ± 941 vs. 397 ± 396 kcal/d (p = 0.0003); the primary source of sugar‐sweetened beverage calories among blacks was sugared fruit drinks (556 ± 918 kcal/d). Younger undergraduates reported significantly higher intake than older students (p = 0.025).

Discussion: Self‐reported sugar‐sweetened beverage consumption among undergraduates is substantial and likely contributes considerable non‐nutritive calories, which may contribute to weight gain. Black undergraduates may be particularly vulnerable due to higher sugared beverage intake. Obesity prevention interventions targeting reductions in sugar‐sweetened beverages in this population merit consideration.
Interleukin‐6 Gene Polymorphism −174G/C Influences Plasma Lipid Levels in Women
Authors: Henningsson Susanne , Håkansson Anna , Westberg Lars , Baghaei Fariba , Rosmond Roland , Holm Göran , Ekman Agneta , Nissbrandt Hans , Eriksson Elias
Published: April 2008

Elevated levels of the pro‐inflammatory cytokine interleukin‐6 (IL‐6) have been associated with cardiovascular risk factors. The objective of this study was to investigate potential associations between the promoter polymorphism IL‐6 −174G/C and the following indices of metabolism: BMI, waist‐to‐hip ratio, and plasma levels of IL‐6, cholesterol, low‐density lipoprotein, triglycerides, high‐density lipoprotein, leptin, and C‐reactive protein in 252 42‐year‐old women and 245 51‐year‐old men. Subgroups were also studied 5 years later. The CC genotype of the IL‐6 polymorphism was associated with lower levels of cholesterol and low‐density lipoprotein (p < 0.001) in women. This finding was replicated in the follow‐up, when a significant association between the CC genotype and low triglycerides was also observed. The association between the C allele and lipid pattern found in women was not found in men, where on the contrary, C carriers tended to display elevated triglycerides. IL‐6 genotype was not associated with IL‐6 plasma levels in either sample. The results suggest different effects of the IL‐6 polymorphism on metabolic indices in women and men. None of the associations between IL‐6 genotype and lipid pattern seemed to result from an effect of the polymorphism on IL‐6 plasma levels.
Fetal and Maternal Peroxisome Proliferator‐activated Receptor γ2 Pro12Ala Does Not Influence Birth Weight
Authors: Pfab Thiemo , Poralla Christine , Richter Claus‐Michael , Godes Michael , Slowinski Torsten , Priem Friedrich , Halle Horst , Hocher Berthold
Published: April 2008

The association between the peroxisome proliferator‐activated receptor (PPAR)γ2 Pro12Ala polymorphism and insulin resistance is reported to depend on low birth weight. Low birth weight itself has been linked to type 2 diabetes and cardiovascular diseases in adulthood. We assessed whether the PPARγ2 Pro12Ala polymorphism determines body size at birth and whether metabolic differences between the genotypes are already detectable in the newborn. This study was conducted at the obstetrics department of the Charité, Berlin, Germany. One thousand nine hundred thirty white woman/child pairs were consecutively included and genotyped. The newborn's weight, length, and head circumference were measured. Total glycated hemoglobin in blood served as a surrogate of fetal insulin resistance and glucose use. We found that neither the fetal nor the maternal Pro12Ala genotype determined body size or total glycated hemoglobin at birth. The results suggest that the PPARγ2 Pro12Ala polymorphism is not relevant for intrauterine growth. Previously reported effects of PPARγ2 Pro12Ala on insulin resistance seem to arise later in life.
Increase in Visfatin after Weight Loss Induced by Gastroplastic Surgery
Authors: Krzyzanowska Katarzyna , Mittermayer Friedrich , Krugluger Walter , Kopp Hans Peter , Schernthaner Guntram
Published: April 2008

Objective: The recently described adipokine visfatin is produced in visceral fat and has been suggested to influence insulin resistance. To investigate whether visfatin concentrations are related to changes in body weight, this adipokine was measured in insulin‐resistant severely obese patients before and after gastroplastic surgery.

Research Methods and Procedures: Visfatin, interleukin‐6, high‐sensitivity C‐reactive protein, homeostasis model assessment of insulin resistance (HOMA‐IR), and other clinical parameters were assessed in 36 severely obese subjects (28 female; mean age, 43 years) with a median BMI of 44.3 kg/m2 (95% confidence interval, 43.3 to 48.1 kg/m2).

Results: After surgery, BMI decreased to a median of 31.9 kg/m2 (30.1 to 35.1 kg/m2) (p < 0.0001). Median visfatin concentrations increased significantly after weight loss [70.9 ng/mL (61.4 to 75.6 ng/mL) vs. 86.4 ng/mL (79.4 to 89.8 ng/mL); p < 0.0005]. This increase correlated with the decrease of insulin and HOMA‐IR and was associated with a reduction in plasma interleukin‐6 and high‐sensitivity C‐reactive protein concentrations.

Discussion: Massive weight loss after gastroplastic surgery is accompanied by an increase in circulating concentrations of the novel adipokine visfatin. This increase correlates with the decrease in plasma insulin concentrations and HOMA‐IR.
Differential Regulation of Adiponectin Receptor Gene Expression by Adiponectin and Leptin in Myotubes Derived from Obese and Diabetic Individuals
Authors: McAinch Andrew J. , Steinberg Gregory R. , Mollica Janelle , O'Brien Paul E. , Dixon John B. , Macaulay S. Lance , Kemp Bruce E. , Cameron‐Smith David
Published: April 2008

Objective: This study aimed to investigate the regulation of adiponectin receptors 1 (AdipoR1) and 2 (AdipoR2) gene expression in primary skeletal muscle myotubes, derived from human donors, after exposure to globular adiponectin (gAd) and leptin.

Research Methods and Procedures: Four distinct primary cell culture groups were established [Lean, Obese, Diabetic, Weight Loss (Wt Loss); n = 7 in each] from rectus abdominus muscle biopsies obtained from surgical patients. Differentiated myotube cultures were exposed to gAd (0.1 μg/mL) or leptin (2.5 μg/mL) for 6 hours. AdipoR1 and AdipoR2 gene expression was measured by real‐time polymerase chain reaction analysis.

Results: AdipoR1 mRNA expression in skeletal muscle myotubes derived from Lean subjects (p < 0.05) was stimulated 1.8‐fold and 2.5‐fold with gAd and leptin, respectively. No increase in AdipoR1 gene expression was measured in myotubes derived from Obese, Diabetic, or Wt Loss subjects. AdipoR2 mRNA expression was unaltered after gAd and leptin exposure in all myotube groups.

Discussion: Adiponectin and leptin are rapid and potent stimulators of AdipoR1 in myotubes derived from lean healthy individuals. This effect was abolished in myotubes derived from obese, obese diabetic subjects, and obese‐prone individuals who had lost significant weight after bariatric surgery. The incapacity of skeletal muscle of obese and diabetic individuals to respond to exogenous adiponectin and leptin may be further suppressed as a result of impaired regulation of the AdipoR1 gene.
Heat Production and Body Temperature During Cooling and Rewarming in Overweight and Lean Men
Authors: Ooijen Anne M.J. Claessens‐van , Westerterp Klaas R. , Wouters Loek , Schoffelen Paul F.M. , van Steenhoven Anton A. , van Lichtenbelt Wouter D. Marken
Published: April 2008

Objective: To compare overweight and lean subjects with respect to thermogenesis and physiological insulation in response to mild cold and rewarming.

Research Methods and Procedures: Ten overweight men (mean BMI, 29.2 ± 2.8 kg/m2) and 10 lean men (mean BMI, 21.1 ± 2.0 kg/m2) were exposed to cold air for 1 hour, followed by 1 hour of rewarming. Body composition was determined by hydrodensitometry and deuterium dilution. Heat production and body temperatures were measured continuously by indirect calorimetry and thermistors, respectively. Muscle activity was recorded using electromyography.

Results: In both groups, heat production increased significantly during cooling (lean, p = 0.004; overweight, p = 0.006). The increase was larger in the lean group compared with the overweight group (p = 0.04). During rewarming, heat production returned to baseline in the overweight group and stayed higher compared with baseline in the lean group (p = 0.003). The difference in heat production between rewarming and baseline was larger in the lean (p = 0.01) than in the overweight subjects. Weighted body temperature of both groups decreased during cold exposure (lean, p = 0.002; overweight, p < 0.001) and did not return to baseline during rewarming.

Discussion: Overweight subjects showed a blunted mild cold‐induced thermogenesis. The insulative cold response was not different among the groups. The energy‐efficient response of the overweight subjects can have consequences for energy balance in the long term. The results support the concept of a dynamic heat regulation model instead of temperature regulation around a fixed set point.
The Feet of Overweight and Obese Young Children: Are They Flat or Fat?
Authors: Mickle Karen J. , Steele Julie R. , Munro Bridget J.
Published: April 2008

Objective: The purpose of this study was to determine whether the flat feet displayed by young obese and overweight children are attributable to the presence of a thicker midfoot plantar fat pad or a lowering of the longitudinal arch relative to that in non‐overweight children.

Research Methods and Procedures: Foot anthropometry, an arch index derived from plantar footprints, and midfoot plantar fat pad thickness measured by ultrasound were obtained for 19 overweight/obese preschool children (mean age, 4.3 ± 0.9 years; mean height, 1.07 ± 0.1 m; mean BMI, 18.6 ± 1.2 kg/m2) and 19 non‐overweight children matched for age, height, and sex (mean age, 4.3 ± 0.7 years; mean height, 1.05 ± 0.1 m; mean BMI, 15.7 ± 0.7 kg/m2).

Results: Independent t tests revealed no significant between‐subject group differences (p = 0.39) in the thickness of the midfoot plantar fat pad. However, the overweight/obese children had a significantly lower plantar arch height (0.9 ± 0.3 cm) than their non‐overweight counterparts (1.1 ± 0.2 cm; p = 0.04).

Discussion: The lower plantar arch height found in the overweight/obese children suggests that the flatter feet characteristic of overweight/obese preschool children may be caused by structural changes in their foot anatomy. It is postulated that these structural changes, which may adversely affect the functional capacity of the medial longitudinal arch, might be exacerbated if excess weight bearing continues throughout childhood and into adulthood.
Inhibitory Effect of Obesity on Gonadotropin, Estradiol, and Inhibin B Levels in Fertile Women
Authors: De Pergola Giovanni , Maldera Simona , Tartagni Massimo , Pannacciulli Nicola , Loverro Giuseppe , Giorgino Riccardo
Published: April 2008

Objective: To examine whether obesity and insulin resistance have an independent effect on the gonadotropin, estradiol, and inhibin B serum levels and follicle count in the early follicular phase of fertile women with a wide range of BMI and without signs of hyperandrogenism.

Research Methods and Procedures: Twenty‐two overweight and obese (BMI ≥25.0 kg/m2) women and 10 normal‐weight (BMI <25.0 kg/m2) women, all having apparently normal fertility, were studied. Serum concentrations of follicle‐stimulating hormone (FSH), luteinizing hormone (LH), estradiol, inhibin B, and insulin, level of insulin resistance (estimated by homeostasis model assessment for insulin resistance), and follicle count were measured during the early follicular phase (Days 2 to 5 of the menstrual cycle).

Results: Overweight women showed lower FSH (p < 0.001), LH (p < 0.001), and inhibin B (p < 0.05) levels compared with normal‐weight women, whereas estradiol concentrations and follicle count were not significantly different between the two groups. When normal‐weight and overweight women were examined as a group and multiple regression analyses were performed, estradiol showed a negative association with BMI (or waist circumference) (p < 0.05) and a positive correlation with LH (p < 0.05) and FSH (p < 0.05); inhibin B maintained a positive association only with estradiol (p < 0.05); and FSH and LH showed a negative correlation with BMI (or waist circumference) (p < 0.001 and p < 0.01, respectively).

Discussion: Overweight and obese fertile women have lower FSH, LH, inhibin B, and estradiol levels in the early follicular phase, with a possible direct inhibitory effect of body mass on gonadotropin and estradiol production, independently of age, insulin (concentrations and sensitivity), and other hormones. By contrast, the number of ovary follicles does not seem to be influenced by insulin and body mass in these patients.
A Simple Venous Thromboembolism Prophylaxis Protocol for Patients Undergoing Bariatric Surgery
Authors: Frezza Eldo E. , Wachtel Mitchell S.
Published: April 2008

Objective: Pulmonary embolism is a leading cause of death for bariatric patients. Numerous regimens have been proposed, but a comprehensive, simple approach is lacking. This study provides a simple, easily implemented prophylaxis regimen.

Research Methods and Procedures: One hundred fifty bariatric surgery patients were evaluated. Patients considered at high risk for venous thromboembolism had heart failure, a BMI of ≥50 kg/m2, or a history of venous thromboembolism or pelvic surgery. Preoperatively and postoperatively, all patients received subcutaneous enoxaparin or unfractionated heparin. High‐risk patients received either preoperatively inserted inferior vena cava filters or continuous heparin infusions intraoperatively. All high‐risk patients were anticoagulated with warfarin (Coumadin; Bristol Myers‐Squibb, Princeton, NJ) for at least 3 months postoperatively. Initially, some patients experienced significant hemorrhage; to prevent this, sutures were oversewn into staple lines.

Results: No patient experienced venous thromboembolism; a binomial test showed that the regimen reduced the risk of this complication to less than 2% (p < 0.05). Hemorrhage sufficient to require transfusion occurred in 4 of the first 20 patients; of the remaining 130 patients, into whose staple lines sutures were oversewn, none required transfusion (p < 0.05).

Discussion: Patients should be divided into those who are at high risk and those who are at low risk for venous thromboembolism. All patients should receive pre‐ and postoperative anticoagulation. High‐risk patients should also receive either an inferior vena cava filter or intraoperative heparin infusions, as well as at least 3 months of Coumadin therapy. Oversewing of staple lines may reduce the risk of hemorrhage.
Soda Consumption and Overweight Status of 2‐Year‐Old Mexican‐American Children in California
Authors: Warner Marcella L. , Harley Kim , Bradman Asa , Vargas Gloria , Eskenazi Brenda
Published: April 2008

Objective: The prevalence of overweight in United States children, 2 to 5 years old, has increased 2‐fold since 1975, with the highest prevalence in Mexican Americans. The objective of this study was to determine the association between current soda consumption and overweight in 2‐year‐old Mexican‐American children.

Research Methods and Procedures: The Center for the Health Assessment of Mothers and Children of Salinas study is a longitudinal study of the health of low‐income Latino pregnant women and their children living in the Salinas Valley, CA. Six hundred pregnant women were enrolled (October 1999 to October 2000), and their children were followed until 2 years of age. This cross‐sectional analysis includes the 354 children who completed the 2‐year follow‐up interview. Standing height (centimeters) and weight (grams) were measured at 2 years. Overweight was defined as ≥95th percentile of the sex‐specific BMI for each child's age.

Results: Fifty‐five (15.5%) children were overweight. Over half (56%) reported consuming any soda in the last week. After covariate adjustment, compared with no soda consumption, <1 soda/d was not related to overweight (adjusted odds ratio, 0.97; 95% confidence interval, 0.47, 1.99), but ≥1 soda/d was significantly associated with overweight (adjusted odds ratio, 3.39; 95% confidence interval, 1.43, 8.07), and the test for trend was significant (p = 0.02).

Discussion: At 2 years of age, the prevalence of overweight among the Center for the Health Assessment of Mothers and Children of Salinas cohort is higher than the national prevalence estimate for Mexican‐American 2‐ to 5‐year‐old children and is significantly associated with current soda consumption. Interventions to reduce consumption of soda in young Mexican‐American children should be considered.
Health‐Related Quality of Life and Weight Loss among Overweight and Obese U.S. Adults, 2001 to 2002
Authors: Bish Connie L. , Blanck Heidi Michels , Maynard L. Michele , Serdula Mary K. , Thompson Nancy J. , Khan Laura Kettel
Published: April 2008

Objective: To examine the prevalence and association of health‐related quality of life (HRQOL) with trying to lose weight and with weight loss practices (eating fewer calories, physical activity, and both) among overweight and obese U.S. adults ≥ 20 years of age.

Research Methods and Procedures: This study used data from the 2001 to 2002 National Health and Nutrition Examination Survey, a continuous annual survey of the civilian non‐institutionalized U.S. population. This analysis included those ≥ 20 years of age with BMI ≥ 25 (n = 2578) who responded to four standard HRQOL measures that assessed general health status and recent physical health, mental health, and activity limitation.

Results: Among obese men, but not women, there were significant increasing linear trends in the adjusted prevalence of trying to lose weight as physically unhealthy and activity limitation days increased. Regardless of BMI or HRQOL, reducing calories was a common weight loss practice (66% to 86%). Except for recent activity limitation, respondents with BMI ≥ 35 did not generally differ by HRQOL level in the attainment of recommended physical activity either alone or in combination with reduced calories, whereas those in the BMI 25 to 34.9 groups often differed significantly by HRQOL level. Specifically, increased unhealthy or activity limitation days were associated with reduced prevalence of attained physical activity.

Discussion: Our findings indicate an association between trying to lose weight and a greater number of unhealthy days reported by obese men, suggesting that these men may be influenced by traditional clinical weight‐loss counseling that is prompted by weight and comorbidity, whereas women had a high prevalence of trying to lose weight irrespective of weight and HRQOL. Assessment of HRQOL, especially measures that evaluate physical domains, could provide subjective information to assist with weight counseling.
Comparison of Three Bioelectrical Impedance Methods with DXA in Overweight and Obese Men
Authors: Pateyjohns Ian R. , Brinkworth Grant D. , Buckley Jonathan D. , Noakes Manny , Clifton Peter M.
Published: April 2008

Objective: To compare bioelectrical impedance analysis (BIA) of body composition using three different methods against DXA in overweight and obese men.

Research Methods and Procedures: Forty‐three healthy overweight or obese men (ages 25 to 60 years; BMI, 28 to 43 kg/m2) underwent BIA assessment of body composition using the ImpediMed SFB7 (version 6; ImpediMed, Ltd., Eight Mile Plains, Queensland, Australia) in multifrequency mode (Imp‐MF) and DF50 single‐frequency mode (Imp‐SF) and the Tanita UltimateScale (Tanita Corp., Tokyo, Japan). Validity was assessed by comparison against DXA using linear regression and limits of agreement analysis.

Results: All three BIA methods showed good relative agreement with DXA [Imp‐MF: fat mass (FM), r2 = 0.81; fat‐free mass (FFM), r2 = 0.81; percentage body fat (BF%), r2 = 0.69; Imp‐SF: FM, r2 = 0.65; FFM, r2 = 0.76; BF%, r2 = 0.40; Tanita: BF%, r2 = 0.44; all p < 0.001]. Absolute agreement between DXA and Imp‐MF was poor, as indicated by a large bias and wide limits of agreement (bias, ±1.96 standard deviation; FM, −6.6 ± 7.7 kg; FFM, 8.0 ± 7.1 kg; BF%, −7.0 ± 6.6%). Imp‐SF and Tanita exhibited a smaller bias but wide limits of agreement (Imp‐SF: FM, −1.1 ± 8.5 kg; FFM, 2.5 ± 7.9 kg; BF%, −1.7 ± 7.3% Tanita: BF%, 1.2 ± 9.5%).

Discussion: Compared with DXA, Imp‐MF produced large bias and wide limits of agreement, and its accuracy estimating body composition in overweight or obese men was poor. Imp‐SF and Tanita demonstrated little bias and may be useful for group comparisons, but their utility for assessment of body composition in individuals is limited.
Converging Prevalences of Obesity across Educational Groups in Switzerland
Authors: Wolff Hans , Delhumeau Cecile , Beer‐Borst Sigrid , Golay Alain , Costanza Michael C. , Morabia Alfredo
Published: April 2008

Objective: To assess whether the rapid increase in obesity prevalence among persons with higher education levels observed in one U.S. study is also observed in a European adult population.

Research Methods and Procedures: This study involved continuous surveillance of the adult population of Geneva, Switzerland (1993 to 2004), with annual random, independent, cross‐sectional, representative samples (6635 men and 6558 women, ages 35 to 74 years) and analysis of 12‐year trends in obesity prevalence across educational level subgroups.

Results: Obesity prevalence in men had an upward trend in the medium education subgroup (p < 0.02), a borderline upward trend in the high education subgroup (p < 0.08), but no trend in the low education subgroup. There was a borderline trend interaction between the male low and medium education subgroups (p < 0.09). Obesity prevalence in women had a borderline increase in the low education subgroup (p < 0.08), an almost borderline increase in the high education subgroup (p = 0.11), but no significant trend in the medium education subgroup. There was no evidence of trend interaction between the female education groups.

Discussion: In Geneva, as in the United States, the inverse association between education level and obesity rates has weakened over time among men, but, inconsistent with the U.S. findings, has persisted for women. Explanations may include more physically demanding occupations for men with low education levels and different attitudes toward body image between the sexes.
Relationship of Body Size and Shape to the Development of Diabetes in the Diabetes Prevention Program
Authors:   The Diabetes Prevention Program Research Group
Published: April 2008

Objective: We report the effects of several different measures of body size at baseline on the subsequent development of diabetes. High levels of body fat predict the onset of diabetes, but this association has not been previously reported in a large multiethnic population of overweight or obese people with impaired glucose tolerance.

Research Methods and Procedures: Height, weight, waist circumference, hip circumference, and skinfolds were measured at baseline in 3234 participants enrolled in a randomized clinical trial to treat individuals with impaired glucose tolerance with placebo, metformin, or a lifestyle modification program. Cox proportional hazards models were used to assess the effect of baseline body size variables on the development of diabetes.

Results: Over an average of 3.2 years in both the placebo and lifestyle groups, baseline waist circumference had the highest or second highest R2 value for predicting diabetes in both sexes. Cox hazard ratios per 1 standard deviation were 1.43 and 1.49 for men in the placebo or lifestyle groups, respectively, and 1.29 and 1.53 for women in the placebo and lifestyle groups, respectively, adjusted for age and self‐reported race/ethnicity. The c‐statistic from the receiver operating characteristic curves also favored the waist circumference in men and women in the lifestyle group and men in the placebo group. No components of body size were predictive in the metformin‐treated group, and metformin compared with the placebo group was effective in preventing diabetes only in individuals with a BMI ≥35 kg/m2 or a waist circumference ≥98.0 cm.

Discussion: Large waist circumference was a better predictor of risk for developing diabetes than most other measures in the placebo and lifestyle groups. No baseline measure of body size or shape predicted risk of diabetes in the metformin‐treated group.
A Visfatin Promoter Polymorphism Is Associated with Low‐Grade Inflammation and Type 2 Diabetes
Authors: Zhang Yuan‐Yuan , Gottardo Lucia , Thompson Ryan , Powers Christine , Nolan David , Duffy Jill , Marescotti Maria Cristina , Avogaro Angelo , Doria Alessandro
Published: April 2008

Visfatin (also known as pre‐B cell colony‐enhancing factor, or PBEF) is a pro‐inflammatory adipokine expressed predominantly in visceral fat. We investigated whether polymorphisms at the visfatin/PBEF locus influence the risk of type 2 diabetes (T2D). Linkage disequilibrium analysis of 52 single nucleotide polymorphisms spanning the entire gene (34.7 kb) plus 20.5 kb of the upstream region and 25.5 kb of the downstream region revealed a single haplotype block that could be tagged by seven single nucleotide polymorphisms. These seven tags were typed in a group of T2D patients (n = 814) and a group of non‐diabetic controls (n = 320) of white origin. A significant association was observed at −948C>A, with minor allele frequencies of 0.157 in T2D cases and 0.119 in non‐diabetic controls (p = 0.021). In a non‐diabetic population (n = 630), the same −948 allele that conferred increased risk of T2D was significantly associated with higher plasma levels of fibrinogen and C‐reactive protein (p = 0.0022 and 0.0038, respectively). However, no significant associations were observed with BMI, waist circumference, serum glucose levels, or fasting insulin levels. Our findings suggest that the visfatin/PBEF gene may play a role in determining T2D susceptibility, possibly by modulating chronic, low‐grade inflammatory responses.
A High‐Fat Diet Has a Tissue‐Specific Effect on Adiponectin and Related Enzyme Expression
Authors: Barnea Maayan , Shamay Avi , Stark Aliza H. , Madar Zecharia
Published: April 2008

Objective: This study was designed to test whether adiponectin plays a role in diet‐induced obesity and insulin resistance and acts as a mediator to induce or inhibit specific metabolic pathways involved in lipid metabolism

Research Methods and Procedures: Forty C57BL/6J male mice were fed either a high‐fat (HF) or control diet for 4 months, and adiponectin, its receptors, and enzyme expression in liver and muscle tissue were measured.

Results: Mice fed the HF diet exhibited significantly greater weight gain, abnormal oral glucose tolerance test curves, and elevated homeostasis model assessment of insulin resistance (5.3 ± 0.89 vs. 2.8 ± 0.39). A significant reduction of adiponectin RNA expression (51%) and protein levels (15%) was observed in the adipose tissue of HF animals; however, serum adiponectin levels did not differ between groups (7.12 ± 0.34 μg/mL vs. 6.44 ± 0.38 μg/mL). Expression of hepatic mRNA of AdipoR1 and AdipoR2 was reduced by 15% and 25%, respectively, in animals fed the HF diet. In contrast, receptor mRNA expression of AdipoR1 and AdipoR2 increased by 25% and 30%, respectively, in muscle tissue. No effect was found on hepatic adenosine monophosphate‐activated protein kinase expression; however, a significant reduction of phosphoadenosine monophosphate kinase levels in muscles was observed. Hepatic acetyl‐coenzyme A carboxylase was similar between groups, but in muscles, the inactive form phosphoacetyl‐coenzyme A carboxylase was significantly reduced (p < 0.05).

Discussion: The HF diet led to decreased insulin sensitivity accompanied by impaired activity of adiponectin‐related enzymes in skeletal muscles but not in the liver. These results suggest that the HF diet has a tissue‐specific effect on adiponectin and associated enzyme expression.
Leptin, Superoxide Dismutase, and Weight Loss: Initial Leptin Predicts Weight Loss
Authors: Shih Ling‐Ying , Liou Tsan‐Hon , Chao Jane C.‐J. , Kau Hsin‐Nung , Wu Yi‐Jiun , Shieh Ming‐Jer , Yeh Ching‐Ying , Han Bor‐Cheng
Published: April 2008

Objective: Our goal was to study how plasma leptin concentration, superoxide dismutase (SOD) activity, and weight loss are related in obese adults.

Research Methods and Procedures: Serum leptin concentration, SOD activities, general biochemical data, and body composition measurements were obtained for 62 overweight and obese subjects before and after an 8‐week body weight reduction (BWR) regimen. The subjects were on dietary control, performed moderate aerobic and strength training exercises, and attended educational lectures.

Results: The measurement results indicated that the following criteria were significantly reduced: body weight [84.4 ± 17.0 vs. 79.3 ± 16.1 (standard error) kg, p < 0.001]; BMI (31.5 ± 4.3 vs. 29.4 ± 4.2 kg/m2, p < 0.001), and fat mass (33.3 ± 10.0 vs. 29.8 ± 10.4 kg, p < 0.001). Plasma leptin levels also significantly decreased from 31.5 ± 17.6 to 26.5 ± 17.2 ng/mL (p < 0.001). Additionally, SOD activity was significantly increased from 261.4 ± 66.0 to 302.7 ± 30.9 U/mL (p < 0.001). Based on linear regression analysis results, a 3.78‐ to 8.13‐kg reduction in weight can be expected after the 8‐week BWR regimen when initial leptin concentration was 5 to 30 ng/mL.

Discussion: We found that an 8‐week exercise and diet program was effective in reducing weight and fat mass and, notably, had further beneficial effects on leptin resistance and SOD activity. Additionally, this study demonstrated that initial plasma leptin concentration may be used as a predictor for weight loss outcome.
Resistin Concentrations in Murine Adipose Tissue and Serum Measured by a New Enzyme Immunoassay
Authors: Fujinami Aya , Ohta Kiyoe , Matsui Hidehito , Kitada Naoko , Kitaura Yuko , Kawahara Yuji , Obayashi Hiroshi , Kuno Sadako , Nakamura Naoto , Ohta Mitsuhiro
Published: April 2008

Objective: In an attempt to clarify the conflicting data on resistin mRNA expression and protein analysis by western blotting in adipose tissue and serum, we developed a sensitive enzyme‐linked immunosorbent assay (ELISA) for direct measurement of mouse resistin.

Research Methods and Procedures: We developed polyclonal antibodies directed to the N (21 to 40) and C (79 to 91) termini of mouse resistin. Then, affinity‐purified anti‐C‐terminal resistin immunoglobin G (IgG) was biotinylated. ELISA was based on the sandwiching of antigen between antibody IgG coated on polystyrene plates and biotinylated antibody IgG. The bound biotinylated antibody was quantified with streptavidin‐linked horseradish peroxidase.

Results: New ELISA can measure a concentration as low as 0.5 ng/mL of recombinant mouse resistin and is sensitive and specific enough to measure resistin protein in various adipose tissues and in sera. In normal mice, decreases in resistin concentrations in both white adipose tissue and serum were age dependent during 6 to 24 weeks of development. Resistin concentrations were significantly higher in omental adipose tissue in comparison with perirenal and abdominal adipose tissues and were 2‐ to 5‐fold higher in females than males during the growth period. ob/ob mice had significantly lower resistin concentrations than the control mice in both sera and the white adipose tissues, particularly in the omental fat. The treatment by testosterone, but not progesterone or β‐estradiol, in cultured adipocytes reduces resistin protein levels in a dose‐dependent manner.

Discussion: New sensitive ELISA for mouse resistin clarified that the resistin concentrations in normal mice were markedly elevated in the omental adipose depots as compared with the perirenal and abdominal adipocyte depots and significantly elevated compared with adipose tissues in genetically obese mice.