bluuebunny/crossref_metadata_2025 huggingface dataset:
Dopamine Transporter Genotype as a Risk Factor for Obesity in African‐American Smokers
Authors: Epstein Leonard H. , Jaroni Jodie L. , Paluch Rocco A. , Leddy John J. , Vahue Holly E. , Hawk Larry , Wileyto E. Paul , Shields Peter G. , Lerman Caryn
Published: April 2008

Objective: To assess the association between a polymorphism related to dopamine function, dopamine transport (SLC6A3), and obesity in smokers.

Research Methods and Procedures: Logistic regression was used to assess the relationship between this genetic polymorphism and obesity (body mass index ≥ 30 kg/m2) from a sample of 510 smokers who smoked at least 10 cigarettes per day and who were participating in a study designed to examine genetic and nongenetic predictors of response to a pharmacological treatment.

Results: The likelihood of obesity in African Americans (N = 90) with the 10/10 SLC6A3 genotype was 5.16 times that of African Americans with 9/9 or 9/10 SLC6A3 genotypes (odds ratio = 5.16, confidence interval = 1.60 to 16.65). There was no association of the SLC6A3 genotype with obesity for non‐Hispanic whites (N = 420).

Discussion: These results suggest that variants of the dopamine transporter gene may be related to obesity in African‐American smokers. Possible mechanisms responsible for the association between dopamine transport and obesity in African‐American smokers are discussed.
Abdominal Obesity and Ethnic Differences in Diabetes Awareness, Treatment, and Glycemic Control
Authors: Okosun Ike S. , Dever G.E. Alan
Published: April 2008

Objective: To compare racial/ethnic differences in diabetes awareness, treatment, and glycemic control between non‐Hispanic white, non‐Hispanic black, and Hispanic Americans. We also determined the impact of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control between these population groups.

Research Methods and Procedures: Third National Health and Nutrition Examination Survey (NHANES III) data were utilized for this study. Diabetes awareness was defined as acknowledging diabetic status. Diabetes treatment was defined as current use of anti‐diabetic medications, good glycemic control as HbA1c < 8%, and abdominal obesity as waist circumference larger than expected. The impacts of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control were assessed using logistic regression analyses. Adjustments were made for age, education, smoking, alcohol intake, and health insurance.

Results: Rates of diabetes awareness in whites, blacks, and Hispanics suffering from abdominal obesity were ∼74%, 30%, and 21% in men and 77%, 32%, and 19% in women, respectively. Rates of diabetes treatment were 70%, 23%, and 14% in men and 57%, 45%, and 23% in women, respectively. In men, rates of glycemic control were 64%, 40%, and 30%, and in women, they were 62%, 51%, and 27%, respectively. Abdominal obesity was associated with decreased diabetes awareness and glycemic control in women.

Discussion: Subjects with abdominal obesity were found to have poorer glycemic controls compared to those without abdominal obesity. Because diabetes prevalences were partially explained by racial/ethnic differences in diabetes awareness, treatment, and glycemic control, there is a need to craft diabetes awareness, treatment, and control programs along racial/ethnic origins.
Development and Validation of the Food‐Craving Inventory
Authors: White Marney A. , Whisenhunt Brooke L. , Williamson Donald A. , Greenway Frank L. , Netemeyer Richard G.
Published: April 2008

Objective: The primary aim of this study was to develop and validate the Food‐Craving Inventory (FCI), a self‐report measure of specific food cravings.

Research Methods and Procedures: In a preliminary study, participants (n = 474) completed the initial version of the FCI. The results from this study were used in developing the revised FCI. Participants (n = 379) completed the revised FCI in the primary study designed to develop a self‐report measure of specific food cravings.

Results: Common factor analysis yielded four conceptual factors (subscales) that were interpreted as high fats, sweets, carbohydrates/starches, and fast‐food fats. Confirmatory factor analysis found that the four factors could be modeled as dimensions (or first‐order factors) of a higher order construct—food craving. Test–retest and internal consistency analyses indicated good reliability for the total score and each of the subscales. Subscale scores were compared with scores on the Three Factor Eating Questionnaire and a conceptual measure of food craving. We found support for the content, concurrent, construct, and discriminant validity of the FCI.

Discussion: The FCI was found to be a reliable and valid measure of general and specific food cravings. The FCI can be used in research related to overeating and binge eating. Also, it may be useful in treatment studies that target obesity and/or food cravings.
Cost of In‐Patient Care over 7 Years among Surgically and Conventionally Treated Obese Patients
Authors: Ågren Göran , Narbro Kristina , Jonsson Egon , Näslund Ingmar , Sjöström Lars , Peltonen Markku
Published: April 2008

Objective: Bariatric surgery improves cardiovascular risk factors and quality of life, but few studies have directly addressed the relation between obesity treatment and hospitalization costs. This prospective controlled study compares in‐patient care between surgically and conventionally treated obese patients.

Research Methods and Procedures: A total of 962 surgically and conventionally treated obese patients from the intervention study, Swedish Obese Subjects, were followed for 6 years. Changes in days of hospitalization and hospitalization costs were analyzed. Information on hospitalizations for each subject were obtained from the Swedish Hospital Discharge Register.

Results: After 6 years, weight change was −16.7% in the surgical group and +0.9% in the control group (p < 0.0001). The cumulated hospital stay over 6 years was 23.4 days in the surgical group and 6.9 days in the control group (p < 0.0001). The average hospital cost for the surgical intervention was US$4300. Incremental costs that could be attributable to obesity surgery averaged US$1200 per year. After exclusion of hospitalizations for the surgical intervention and conditions common after bariatric surgery, there were no significant differences between the groups in number of hospital days or hospitalization costs.

Discussion: Our experience from bariatric surgery indicates that average weight reductions of 16% will not reduce hospitalization costs over 6 years. Costs of bariatric surgery are limited and seem to be motivated given the marked improvements of cardiovascular risk factors, cardiac structure, and function and health‐related quality of life.
CART Gene Promoter Transcription Is Regulated by a Cyclic Adenosine Monophosphate Response Element
Authors: Barrett Perry , Davidson Jane , Morgan Peter
Published: April 2008

Objective: To define the regulatory DNA sequence controlling the expression of the cocaine‐amphetamine‐regulated transcript (CART) gene expression.

Research Methods and Procedures: A rat genomic library was screened for genomic clones containing the CART gene and upstream DNA sequence. A clone containing exons 1 and 2 of the rat CART gene plus 1.2 kb of upstream sequence was isolated. The 1.2‐kb upstream sequence and truncated segments of this sequence were cloned into a luciferase reporter vector for analysis of transcriptional activity in the CART expressing pituitary GH3 cell line. Luciferase reporter assays, gel shift assays, and site‐directed mutagenesis were used to analyze potential regulatory regions in the 1.2‐kb 5′ DNA sequence.

Results: Sequence analysis of the 1.2‐kb upstream sequence reveals several potential regulatory elements. Luciferase reporter assays demonstrate that within the first 162 bp of the start codon is a functional cyclic adenosine monophosphate (cAMP) response element that can induce cAMP‐regulated gene expression of the CART promoter in GH3 cells. Mutation of this positive control plasmid construct response element abolishes cAMP‐stimulated transcription. Furthermore, the promoter is active in a neuronal cell line where it also demonstrates cAMP responsiveness.

Discussion: cAMP‐mediated transcription of the CART promoter may be an important aspect of the regulation of the CART gene. However, the cellular context of expression is also important because the CART promoter is not responsive to cAMP stimulation in all cell types. Other transcription factor binding sequences are likely to play a key role in CART promoter regulation.
Summary of the 2000 Surgeon General's Listening Session: Toward a National Action Plan on Overweight and Obesity
Authors: Jackson Yvonne , Dietz William H. , Sanders Charlene , Kolbe Lloyd J. , Whyte John J. , Wechsler Howell , Schneider Bruce S. , McNally Laura A. , Charles‐Azure Jean , Vogel‐Taylor Martina , Starke‐Reed Pamela , Hubbard Van S. , Johnson‐Taylor Wendy L. , Troiano Richard P. , Donato Karen , Yanovski Susan , Kuczmarski Robert J. , Haverkos Lynne , McMurry Kathryn , Wykoff Randolph F. , Woo Violet , Noonan Allan S. , Rowe Jonelle , McCarty Kathy , Spain Christine B.
Published: April 2008

Objective: To provide insight into discussions at the Surgeon General's Listening Session, “Toward a National Action Plan on Overweight and Obesity,” and to complement The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity.

Research Methods and Procedures: On December 7 and 8, 2000, representatives from federal, state, academic, and private sectors attended the Surgeon General's Listening Session and were given an opportunity to recommend what to include in a national plan to address overweight and obesity. The public was invited to comment during a corresponding public comment period. The Surgeon General's Listening Session was also broadcast on the Internet, allowing others to view the deliberations live or access the archived files. Significant discussion points from the Listening Session have been reviewed by representatives of the federal agencies and are the basis of this complementary document.

Results: Examples of issues, strategies, and barriers to change are discussed within five thematic areas: schools, health care, family and community, worksite, and media. Suggested cooperative or collaborative actions for preventing and decreasing overweight and obesity are described. An annotated list of some programmatic partnerships is included.

Discussion: The Surgeon General's Listening Session provided an opportunity for representatives from family and community groups, schools, the media, the health‐care environment, and worksites to become partners and to unite around the common goal of preventing and decreasing overweight and obesity. The combination of approaches from these perspectives offers a rich resource of opportunity to combat the public health epidemic of overweight and obesity.
Antibody‐Induced Lysis of Isolated Rat Epididymal Adipocytes and Complement Activation In Vivo
Authors: Dickinson Keith , North Tracey J. , Telford Gary , Smith Susan E. , Edwards Bryan M. , Main Sarah H. , Field Ray , Hatton Diane , Vaughan Tristan J. , Flint David J. , Jones Robert B.
Published: April 2008

Objective: To identify human monoclonal antibodies selectively binding to human adipocytes and to evaluate their ability to induce lysis of isolated rat adipocytes in vitro and to reduce rat complement levels in vivo.

Research Methods and Procedures: Using phage display technology, human monoclonal antibodies binding to human adipocyte plasma membranes were identified. Three antibodies (Fat 13, Fat 37, and Fat 41) were selected based on their additional cross‐reaction with rat adipocytes and reformatted as a rat chimeric IgG2bs. The ability of these antibodies, both singly and in combination, to induce lysis of rat epididymal adipocytes in vitro and the reduction of serum complement levels in vivo in the rat was evaluated.

Results: All antibodies caused similar time‐ and dose‐dependent lysis of isolated rat adipocytes. Calculated mean EC50 values (maximum percentage of lysis in parentheses) were 0.680 μg/mL (63.2%), 0.546 μg/mL (72.4%), and 0.391 μg/mL (73.7%) for Fat 13, Fat 37, and Fat 41, respectively. Combinations were no more effective than individual antibodies in inducing lysis. Anti‐adipocyte antibodies (both singly and in combination) were also similarly effective in vivo. In rats, doses of monoclonal antibody up to 10 mg/kg intraperitoneal generally caused almost complete depletion of serum complement up to 24 hours after dosing recovering to baseline values by day 5.

Discussion: Individual and combinations of monoclonal anti‐adipocyte antibodies produced a complement‐dependent and concentration‐dependent activity to lyse adipocytes in vitro and in vivo as measured by a dramatic depletion in serum complement.
Plasma Leptin Response to an Epinephrine Infusion in Lean and Obese Women
Authors: Couillard Charles , Mauriège Pascale , Prud'homme Denis , Nadeau André , Tremblay Angelo , Bouchard Claude , Després Jean‐Pierre
Published: April 2008

Objective: Because leptin production by adipose tissue is under hormonal control, we examined the impact of epinephrine administration on plasma leptin concentrations.

Research Methods and Procedures: We measured plasma leptin, insulin, and free fatty acid (FFA) responses after a 60‐minute epinephrine infusion (0.010 μg/kg fat free mass/min) followed by a 30‐minute recovery period (no infusion) in a group of 11 lean (mean body mass index ± SD: 22.6 ± 1.1 kg/m2) and 15 obese (30.0 ± 1.3 kg/m2) premenopausal women. Leptin, insulin, and FFA levels were measured in plasma before (−15 and 0 minutes) and at every 30 minutes over the 90‐minute period.

Results: In both lean and obese individuals, plasma leptin was significantly reduced by epinephrine (p < 0.0001). Body fat mass was associated with fasting leptin levels (r = 0.64, p < 0.0005) as well as with the decrease in leptinemia (r = −0.51, p < 0.01) produced by epinephrine administration. Furthermore, we noted a large range of leptin response to epinephrine among our subjects, especially in obese women (from −12 to −570 ng/mL per 60 minutes). However, there was no association between postepinephrine leptin and FFA levels (r = −0.14, p = 0.55).

Discussion: Results of this study indicate that leptin levels decrease after epinephrine administration in both lean and obese premenopausal women. However, the heterogeneity in the response of leptin to catecholamines suggests potential alterations of the leptin axis that may contribute to generate a positive energy balance and, thus, may favor weight gain in some obese individuals.
The Obesity Epidemic: Pathophysiology and Consequences of Obesity
Authors: Pi‐Sunyer F. Xavier
Published: April 2008

Obesity has reached epidemic proportions in the United States: more than 20% of adults are clinically obese as defined by a body mass index of 30 kg/m2 or higher, and an additional 30% are overweight. Environmental, behavioral, and genetic factors have been shown to contribute to the development of obesity. Elevated body mass index, particularly caused by abdominal or upper‐body obesity, has been associated with a number of diseases and metabolic abnormalities, many of which have high morbidity and mortality. These include hyperinsulinemia, insulin resistance, type 2 diabetes, hypertension, dyslipidemia, coronary heart disease, gallbladder disease, and certain malignancies. This underscores the importance of identifying people at risk for obesity and its related disease states.
Classification of Obesity and Assessment of Obesity‐Related Health Risks
Authors: Aronne Louis J.
Published: April 2008

The barriers to the evaluation and treatment of obesity by health‐care providers include a lack of awareness of obesity as an independent risk factor for morbidity and mortality and inadequate training in the medical management of obesity. However, the increased risk of medical disorders and emotional consequences associated with obesity make the disorder a priority for physicians to assess and treat. Obesity researchers have published and promoted the use of evidence‐based, practical guidelines to educate physicians about how best to approach obesity as a medical disorder. The guidelines support classification and assessment of obesity as an important component of the patient's medical care. Assessment begins with classification by body mass index (BMI), with overweight and obesity defined as a BMI of 25 and 30 kg/m2, respectively. Patients with high‐risk combinations of BMI, waist circumference, and specific cardiovascular risk factors should begin a weight‐loss program if no contraindications are present. Proper assessment also includes evaluation of complicating factors for obesity, such as sleep apnea and type 2 diabetes, psychosocial factors, and the use of medications that may contribute to obesity. Special attention should be paid to elements of the physical examination that often are performed incorrectly in obese patients, such as pelvic exams. Gathering this information will allow the clinician to tailor a weight‐loss program to each patient individually. Although this represents the most challenging component of obesity care, resources are available to guide the clinician.
Management of Obesity as a Chronic Disease: Nonpharmacologic, Pharmacologic, and Surgical Options
Authors: Fujioka Ken
Published: April 2008

The successful management of obesity requires a long‐term approach that is tailored to an individual's lifestyle and needs. Initial treatment should focus on lifestyle modifications—dietary interventions and increased physical activity—with behavioral modification strategies used adjunctively. Several antiobesity drugs are approved by the Food and Drug Administration for use in obese patients, as well as in overweight individuals with at least one obesity‐related comorbidity. Most are approved only for short‐term weight loss, but sibutramine and orlistat are approved for long‐term weight loss and maintenance. In addition to weight reduction, in clinical trials these drugs provided beneficial actions on several cardiovascular risk factors. Several other drugs currently approved for other uses show promise in their ability to cause weight loss. Surgical options should be reserved for severely obese patients with significant medical comorbidities or physical conditions.
Outpatient Management of Obesity: A Primary Care Perspective
Authors: Hill James O. , Wyatt Holly
Published: April 2008

An estimated 64% of the adult population in the United States is either overweight or obese. Because obesity affects such a large percentage of the population and carries with it numerous health risks, it is essential that physicians treat obesity and encourage healthy‐weight maintenance within the primary care setting. Effective weight management will require providing the appropriate physical environment for the overweight or obese patient, properly evaluating the impact of a patient's weight on health, evaluating a patient's readiness to change, setting appropriate weight‐loss goals, and providing information and help about how to modify dietary and physical activity patterns. Achieving and maintaining weight loss is more likely to be successful when there is a physician‐patient partnership where the physician provides support and motivation for the patient's efforts to initiate and maintain a healthy body weight.
Probability of Adult Overweight and Risk Change during the BMI Rebound Period
Authors: He Qing , Karlberg Johan
Published: April 2008

Objective: To develop a probability chart of adult overweight based on childhood body mass index (BMI) values and to evaluate the BMI change during the BMI rebound period during childhood, in different populations, with the use of risk function curves.

Research Methods and Procedures: A longitudinal growth study of 3650 full‐term healthy Swedish children followed from birth to 18 years of age. Weight and height values of our subjects were obtained.

Results: A probability chart for reaching a BMI > 23 kg/m2 at 18 years of age was constructed for boys and girls. For example, a BMI of 18 kg/m2 at 4 years of age is associated with 0.70 probability of attaining a BMI > 23 kg/m2 at 18 years of age in boys; a BMI of 16 kg/m2 at 4 years of age leads to 0.40 probability of having a BMI > 23 kg/m2 at 18 years of age in girls. Children with an obvious BMI rebound before 8 years of age have a high risk of being overweight at 18 years of age. There is a clear trend of BMI increase from the 1970s to the 1990s in U.S. children from a parallel dataset, and Hispanic children are at the highest risk of adult overweight.

Discussion: The probability chart for adult overweight developed here provides a functional method of defining childhood obesity that is based on the risk of long‐term ill health rather than on a certain statistical cut‐off point. It will help pediatricians or healthcare workers identify those children who are at a high risk of becoming overweight in adulthood, which will allow clinical intervention at younger ages.
The Human Obesity Gene Map: The 2001 Update
Authors: Rankinen Tuomo , Pérusse Louis , Weisnagel S. John , Snyder Eric E. , Chagnon Yvon C. , Bouchard Claude
Published: April 2008

This report constitutes the eighth update of the human obesity gene map, incorporating published results up to the end of October 2001. Evidence from the rodent and human obesity cases caused by single‐gene mutations, Mendelian disorders exhibiting obesity as a clinical feature, quantitative trait loci (QTLs) uncovered in human genome‐wide scans and in crossbreeding experiments in various animal models, association and linkage studies with candidate genes and other markers is reviewed. The human cases of obesity related in some way to single‐gene mutations in six different genes are incorporated. Twenty‐five Mendelian disorders exhibiting obesity as one of their clinical manifestations have now been mapped. The number of different QTLs reported from animal models currently reaches 165. Attempts to relate DNA sequence variation in specific genes to obesity phenotypes continue to grow, with 174 studies reporting positive associations with 58 candidate genes. Finally, 59 loci have been linked to obesity indicators in genomic scans and other linkage study designs. The obesity gene map depicted in Figure 1 reveals that putative loci affecting obesity‐related phenotypes can be found on all chromosomes except chromosome Y. A total of 54 new loci have been added to the map in the past 12 months, and the number of genes, markers, and chromosomal regions that have been associated or linked with human obesity phenotypes is now above 250. Likewise, the number of negative studies, which are only partially reviewed here, is also on the rise.
Alcohol Consumption in the Severely Obese: Relationship with the Metabolic Syndrome
Authors: Dixon John B. , Dixon Maureen E. , O'Brien Paul E.
Published: April 2008

Objective: The aim of this study was to examine the association between the clinical and biochemical features of the metabolic syndrome and quantity and type of alcohol intake in the severely obese.

Research Methods and Procedures: A cross‐sectional study was performed in 486 consecutive severely obese subjects. Data on alcohol consumption was collected by serial clinical interviews and a questionnaire. The relationship between alcohol intake and the clinical and serum chemistry features of the metabolic syndrome was analyzed by multiple statistical techniques. Laboratory measures included lipid profile, fasting blood glucose, hemoglobin A1c, and fasting serum insulin. An indirect index of insulin resistance was calculated using the log‐transformed fasting insulin and glucose product.

Results: There were 486 subjects, 84% women, with a mean age of 40.6 ± 10 years (range, 16 to 71 years) and a body mass index of 45.3 ± 7 kg/m2 (range, 34 to 77 kg/m2). Alcohol consumers (N = 276) showed a marked reduction in the adjusted odds ratio of type 2 diabetes (odds ratio = 0.29; 95% confidence interval, 0.16 to 0.55) compared with rare or nonconsumers (N = 210). There was a U‐shaped relationship between the amount and frequency of alcohol consumption and fasting triglyceride, fasting glucose, hemoglobin A1c, and index of insulin resistance measurements. Consumers of <100 g/wk had more favorable measures. The effect was attenuated when diabetics were excluded from the analysis. Timing of alcohol consumption did not influence outcome measures.

Discussion: Light‐to‐moderate alcohol consumption is associated with a lower prevalence of type 2 diabetes, reduced insulin resistance, and more favorable vascular risk profile in the severely obese. We would propose that light to moderate alcohol consumption should not be discouraged in the severely obese.
Overweight, Waist Circumference, Age, Gender, and Insulin Resistance as Risk Factors for Hyperleptinemia
Authors: Mendoza‐Núñez Víctor Manuel , García‐Sánchez Ángel , Sánchez‐Rodríguez Martha , Galván‐Duarte Rosa Elba , Fonseca‐Yerena María Eugenia
Published: April 2008

Objective: To evaluate the influence of overweight, waist circumference, age, gender, and insulin resistance as risk factors for hyperleptinemia.

Research Methods and Procedures: A cross‐sectional study was carried out in a population of 197 subjects: 59 men (21 aged <60 years and 38 aged ≥60 years) and 138 women (37 aged <60 years and 101 aged ≥60 years). The groups were stratified by overweight and normal weight. After a 12‐hour fasting period, we measured serum leptin and insulin levels with radioimmunoassay methods. We also measured serum glucose and lipid profile. The data were analyzed by means of comparative tests. A variance‐stabilizing transformation (natural logarithmic) was used to meet multiple linear regression, analysis of covariance, and logistic regression models.

Results: The leptin serum levels were higher and statistically significant in young and older women than they were in men. We observed an interaction between gender and body mass index to explain the difference in leptin levels (p < 0.0001). Our study demonstrated an inverse relationship between leptin with age and high‐density lipoprotein cholesterol. In logistic regression analysis, the overweight × gender interaction and waist circumference have a statistically significant influence as independent variables on hyperleptinemia (overweight × gender odds ratio = 6.81; 95% confidence interval, 1.10 to 46.86; p < 0.05 and waist circumference odds ratio = 4.34; 95% confidence interval, 1.47 to 12.83; p = 0.001).

Discussion: Women who were overweight or had a higher waist circumference (women ≥ 88 cm and men ≥ 102 cm) have a significantly higher risk of having hyperleptinemia. The increase in age as an isolated variable is not a risk factor for hyperleptinemia.
Regional Intra‐Subject Variability in Abdominal Adiposity Limits Usefulness of Computed Tomography
Authors: Greenfield Jerry R. , Samaras Katherine , Chisholm Donald J. , Campbell Lesley V.
Published: April 2008

Objective: Computed tomography (CT) and magnetic resonance imaging, the most accurate methods of abdominal fat measurement, have been applied using a number of protocols, ranging from single‐slice area determination to multiple‐slice volume calculation. The aim of this study was to assess the validity of single‐slice CT for abdominal fat area measurement by estimating the intra‐subject variability in abdominal fat areas and comparing the ranking of subjects across four contiguous abdominal levels.

Research Methods and Procedures: Nineteen premenopausal women (age, 35.3 ± 1.4 years; mean ± SE) were studied. CT was used to measure intra‐abdominal fat (IAF) area, percentage of total intra‐abdominal area (%IAF), subcutaneous abdominal fat (SAF) area, and IAF/SAF at four adjacent cross‐sectional lumbar levels (L2–L4). Intra‐subject variability (percentage) was defined as SD/mean × 100. Total body fat was measured by DXA, which was further analyzed for central abdominal fat.

Results: Mean body mass index was 24.9 ± 1.0 kg/m2. The average (range) intra‐subject variability was 28% (8% to 61%) for IAF, 46% (19% to 124%) for %IAF, 26% (14% to 38%) for SAF area, and 19% (7% to 71%) for IAF/SAF. The pattern of this variability was not uniform between subjects, because their ranking by IAF area was markedly different at each CT level.

Discussion: We demonstrated significant intra‐subject variability in CT‐measured adipose tissue areas across four predetermined sites. This resulted in a difference in the ordering of subjects by IAF at each of the four imaging sites, suggesting that the usefulness of single‐slice CT in the assessment of abdominal adiposity in premenopausal women may be limited, particularly when performed for the purpose of making comparisons between subjects based on abdominal fat area.
Work‐Related Physical Activity Is Not Associated with Body Mass Index and Obesity
Authors: Gutiérrez‐Fisac Juan L. , Guallar‐Castillón Pilar , Díez‐Gañán Lucía , García Esther López , Banegas Jose R. Banegas , Artalejo Fernando Rodríguez
Published: April 2008

Objective: To analyze the association of work‐related physical activity (WRPA) and leisure‐time physical activity (LTPA) with body mass index (BMI) and obesity in the Spanish adult population aged 20 to 60 years.

Research Methods and Procedures: The data were taken from the 1993 Spanish National Health Survey. We analyzed a sample of 12,044 men and women representative of the Spanish population aged 20 to 60 years. BMI and frequency of obesity (BMI ≥ 30 kg/m2) were obtained from self‐reported weight and height. Multiple linear regression and logistic regression models were constructed, adjusting for the main confounding factors. WRPA and LTPA were measured by two questions to classify subjects into four categories of physical activity.

Results: Neither mean BMI nor percentage of obesity varied significantly (p > 0.05) by WRPA. Mean BMI was significantly higher (p < 0.01) in those who were inactive in their leisure time (25.90 kg/m2 in men and 24.43 kg/m2 in women) than in those who reported vigorous activity (24.42 kg/m2 and 22.97 kg/m2 in men and women, respectively). The odds ration (OR) for obesity decreased with increasing level of LTPA in both men (OR of 0.64 for vigorous activity) and women (OR = 0.68), showing a statistically significant dose‐response relation in both men (for linear trend, p = 0.0021) and women (p = 0.0245).

Discussion: These results raise questions about the association between WRPA and obesity and suggest the need to reexamine models of the obesity epidemic that point to automation of the workplace as one of the major explanatory factors.
Age Dimorphism in the Association between Growth‐Hormone Status and the Respiratory Quotient
Authors: Christiansen Jens J. , Vahl Nina , Fisker Sanne , Møller Niels , Christiansen Jens S. , Jørgensen Jens O.L.
Published: April 2008

Objective: To investigate the impact of age on the association between the respiratory quotient (RQ) and growth‐hormone (GH) secretion and to investigate the acute lipolytic response to an exogenous GH bolus.

Research Methods and Procedures: A cross‐sectional study of 36 non‐obese healthy subjects (18 women and 18 men) from two age groups was used: “younger” (mean age, 29.5 years; range, 27 to 34 years) and “older” (mean age, 50.8 years; range, 47 to 59 years). Endogenous GH secretion by means of deconvolution analysis of 24‐hour serum GH concentrations was measured every 20 minutes. Resting RQ was measured after a 12‐hour overnight fast. The lipolytic response to an intravenous exogenous GH bolus (200 μg) was assessed by measuring serum levels of free fatty acids as well as changes in RQ. Additional measurements included body composition (regional computed tomography scan and DXA) and physical fitness (Vo2max).

Results: Resting RQ did not differ between the two age groups: 0.81 ± 0.01 (young) vs. 0.82 ± 0.01 (older; not significant). Several estimates of GH release correlated positively with RQ in the younger group, whereas a negative correlation was detected in the older subjects [GH production rate (μg/liter × kg) vs. RQ: r = 0.62, p < 0.01 (younger); r = −0.53; p = 0.02 (older)]. By regression analysis, 52% to 58% of the variation in RQ could be explained by GH status. After an exogenous GH bolus, the incremental response in nonesterified fatty acid was slightly higher in younger individuals (p = 0.09).

Discussion: Resting RQ is significantly correlated with GH status. This association is positive in younger individuals and negative in older individuals. The lipolytic response to exogenous GH is moderately higher in younger compared with older individuals. GH status should be taken into account when investigating the residual variation in RQ.
Weight Loss Expectations in Patients with Binge‐Eating Disorder
Authors: Masheb Robin M. , Grilo Carlos M.
Published: April 2008

Objective: To study weight loss expectations in patients with binge‐eating disorder and to examine whether expectations differed by sex and motivation for treatment.

Research Methods and Procedures: One hundred and thirty patients (104 women and 26 men), aged 23 to 61 (mean age, 43.0 years), with BED completed a measure of desired weights that included their dream weight, happy weight, acceptable weight, and disappointed weight. In a structured interview, participants were asked their primary motivation for seeking treatment (appearance or health) and their lowest adult weight (LAW).

Results: The BED participants reported weight loss expectations that far exceeded expert and governmental guidelines. In this sample, desired dream body mass index (BMI), happy BMI, and acceptable BMI averaged reductions in current weight of 36%, 29%, and 23%, respectively. Even the “disappointed” BMI was an average 14% reduction in current weight, and was 1.5 to 3 times greater than the expert recommendation (5% to 10%). Comparisons of desired weights were significantly different for women and men, whereas percent reductions from current weight were not. Although weight goal expectations were significantly lower for those motivated by appearance, compared with those motivated by health, percent reductions for current weight were not. Desired dream weight correlated with reported LAW, and the mean difference between these weights was not significant.

Discussion: These findings suggest that patients with BED have weight loss expectations that far exceed expert and governmental guidelines and that these expectations do not differ by sex or motivation for seeking treatment. One possible explanation for these unrealistic desired weights may be the patients’ recollections of their LAWs.
Leptin Levels, Leptin Receptor Gene Polymorphisms, and Energy Metabolism in Women
Authors: Wauters Machteld , Considine Robert V. , Chagnon Monique , Mertens Ilse , Rankinen Tuomo , Bouchard Claude , van Gaal Luc F.
Published: April 2008

Objective: Resting metabolic rate (RMR) is mainly determined by fat‐free mass and additionally by age, sex, hormones, and possibly genetic differences. We evaluated whether leptin levels and polymorphisms in the leptin receptor (LEPR) gene were associated with energy expenditure phenotypes.

Methods: RMR, body composition, and leptin levels were measured in 125 overweight and obese women. Three LEPR polymorphisms, Lys109Arg, Gln223Arg, and Lys656Asn, were typed on genomic DNA of another group of 192 women in whom RMR was measured. Fat, protein, and carbohydrate oxidation were calculated for 103 of these subjects. In 38 subjects, glucose‐induced thermogenesis was measured over 3 hours.

Results: In the first study group, a negative correlation between RMR and leptin levels was found after controlling for fat and fat‐free mass. In multiple regression analysis, leptin contributed significantly to RMR, independent of body composition. In the second study group, RMR was not associated with LEPR polymorphisms. Differences in substrate oxidation rates were found among genotypes at the Lys656Asn site. In fasting conditions, Lys656Lys showed a trend to oxidize more carbohydrates and less fat than Asn656 carriers, a trend which became significant after the glucose load when carbohydrate oxidation rate in Lys656Lys was 15% higher than in Asn656 carriers (p = 0.04), and fat oxidation rate was 44% lower (p = 0.02).

Discussion: These results suggest that DNA sequence variations in the LEPR gene could affect substrate oxidation. We hypothesize that this might be caused by differences in glucose levels, leading to differences in glucose oxidation rates.
Evidence That Intermittent, Excessive Sugar Intake Causes Endogenous Opioid Dependence
Authors: Colantuoni Carlo , Rada Pedro , McCarthy Joseph , Patten Caroline , Avena Nicole M. , Chadeayne Andrew , Hoebel Bartley G.
Published: April 2008

Objective: The goal was to determine whether withdrawal from sugar can cause signs of opioid dependence. Because palatable food stimulates neural systems that are implicated in drug addiction, it was hypothesized that intermittent, excessive sugar intake might create dependency, as indicated by withdrawal signs.

Research Methods and Procedures: Male rats were food‐deprived for 12 hours daily, including 4 hours in the early dark, and then offered highly palatable 25% glucose in addition to chow for the next 12 hours. Withdrawal was induced by naloxone or food deprivation. Withdrawal signs were measured by observation, ultrasonic recordings, elevated plus maze tests, and in vivo microdialysis.

Results: Naloxone (20 mg/kg intraperitoneally) caused somatic signs, such as teeth chattering, forepaw tremor, and head shakes. Food deprivation for 24 hours caused spontaneous withdrawal signs, such as teeth chattering. Naloxone (3 mg/kg subcutaneously) caused reduced time on the exposed arm of an elevated plus maze, where again significant teeth chattering was recorded. The plus maze anxiety effect was replicated with four control groups for comparison. Accumbens microdialysis revealed that naloxone (10 and 20 mg/kg intraperitoneally) decreased extracellular dopamine (DA), while dose‐dependently increasing acetylcholine (ACh). The naloxone‐induced DA/ACh imbalance was replicated with 10% sucrose and 3 mg/kg naloxone subcutaneously.

Discussion: Repeated, excessive intake of sugar created a state in which an opioid antagonist caused behavioral and neurochemical signs of opioid withdrawal. The indices of anxiety and DA/ACh imbalance were qualitatively similar to withdrawal from morphine or nicotine, suggesting that the rats had become sugar‐dependent.
Eicosapentaenoic Acid Induces mRNA Expression of Peroxisome Proliferator‐Activated Receptor γ
Authors: Chambrier Cécile , Bastard Jean‐Philippe , Rieusset Jennifer , Chevillotte Emmanuel , Bonnefont‐Rousselot Dominique , Therond Patrice , Hainque Bernard , Riou Jean‐Paul , Laville Martine , Vidal Hubert
Published: April 2008

Objective: To verify whether polyunsaturated fatty acids (PUFAs) can regulate the expression of the nuclear receptor peroxisome proliferator‐activated receptor γ (PPARγ) in human adipose tissue.

Research Methods and Procedures: The effect of various PUFAS on PPARγ1 and ‐γ2 mRNA expression was investigated in freshly isolated adipocytes prepared from fat samples obtained during surgery. PPARγ mRNA levels were also determined in subcutaneous adipose tissue biopsies of 11 obese women, in the fasting state, to search for in vivo associations between PPARγ expression and plasma PUFA concentrations. PPARγ mRNA levels were determined by reverse‐transcription competitive polymerase chain reaction.

Results: Eicosapentaenoic acid (EPA) significantly increased PPARγ1 mRNA levels in isolated adipocytes, without affecting the expression of PPARγ2. The other tested fatty acids (linolenic acid, docosahexaenoic acid and ω‐6 PUFAs) had no effect. The effect of EPA was dependent on the concentration (maximal effect after 6 hours with 50 μM) and was not reproduced by activators of the different members of the PPAR family. In addition, a strong positive correlation was found between plasma EPA concentrations and PPARγ mRNA levels in adipose tissue of obese subjects.

Discussion: Our results demonstrate that adipose tissue PPARγ1 mRNA concentration is positively regulated by EPA, suggesting that the composition of dietary lipids may affect PPARγ gene expression in vivo in humans. These data also suggest that an induction of the expression of this nuclear receptor isoform might be involved in the mechanism of action of EPA and in some of its beneficial effects.
Relationship between Body Mass Index and the Use of Healthcare Services in Australia
Authors: Reidpath Daniel D. , Crawford David , Tilgner Linda , Gibbons Carl
Published: April 2008

Objective: To examine the relationship between body mass index (BMI) and the use of medical and preventive health services.

Research Methods and Procedures: This study involved secondary analysis of weighted data from the Australian 1995 National Health Survey. The study was a population survey designed to obtain national benchmark information about a range of health‐related issues. Data were available from 17,033 men and 17,174 women, ≥20 years or age. BMI, based on self‐reported weight and height, was analyzed in relation to the use of medical services and preventive health services.

Results: A positive relationship was found between BMI and medical service use, such as medication use, visits to hospital accident and emergency departments (for women only); doctor visits, visits to a hospital outpatient clinics; and visits to other health professionals (for women only). A negative relationship was found in women between BMI and preventive health services. Underweight women were found to be significantly less likely to have Papanicolaou smear tests, breast examinations, and mammograms.

Discussion: This research shows that people who fall outside the healthy weight range are more likely to use a range of medical services. Given that the BMI of industrialized populations appears to be increasing, this has important ramifications for health service planning and reinforces the need for obesity prevention strategies at a population level.
Obesity Increases the Risk of Spontaneous Abortion during Infertility Treatment
Authors: Wang Jim X. , Davies Michael J. , Norman Robert J.
Published: April 2008

Objective: This study examines the relationship between body mass and the risk of spontaneous abortion in a large cohort of patients who received infertility treatment.

Research Methods and Procedures: This is a retrospective study using data on pregnancies (n = 2349) achieved after treatment in a tertiary medical center from 1987 to 1999. One pregnancy per subject was included, and the subjects were stratified into five body mass groups based on body mass index (BMI): underweight, <18.5 kg/m2; normal, 18.5 to 24.9 kg/m2; overweight, 25 to 29.9 kg/m2; obese, 30 to 34.9 kg/m2; and very obese, ≥35 kg/m2. Logistical regression analysis was used.

Results: The overall incidence of spontaneous abortion was 20% (476 of 2349). The effect of BMI on the risk of spontaneous abortion was significant after adjusting for several independent risk factors. Compared with the reference group (BMI 18.5 to 24.9 kg/m2), underweight women had a similar risk of spontaneous abortion, whereas there was progressive increase of risk in overweight, obese, and very obese groups (p < 0.05, p < 0.01, and p < 0.001, respectively).

Discussion: Of all known risk factors for spontaneous abortion, the control of obesity has great significance because it is noninvasive, potentially modifiable, possibly amenable to low cost, and self‐manageable by patients. This study established a positive relationship between BMI and the risk of spontaneous abortion in women who became pregnant after assisted reproductive technology treatment.
In Vivo Response to α1‐Adrenoreceptor Stimulation in Human White Adipose Tissue
Authors: Boschmann Michael , Krupp Götz , Luft Friedrich C. , Klaus Susanne , Jordan Jens
Published: April 2008

Objective:Recent studies in rats suggest an important effect of α1‐adrenoreceptor stimulation on glucose uptake in white adipocytes. It is not known if α1‐adrenoreceptor stimulation elicits similar metabolic effects in humans.

Research Methods and Procedures:Three microdialysis catheters in abdominal subcutaneous adipose tissue were perfused with 0.00, 0.01, 0.10, 1.00, and 10.00 μM isoproterenol, phenylephrine, or phenylephrine plus 100 μM propranolol. Dialysate concentrations of ethanol, glycerol, glucose, and lactate were measured for estimating blood flow (ethanol‐dilution technique), lipolysis, and glycolysis, respectively.

Results:Phenylephrine, with or without propranolol, did not elicit a change in ethanol ratio. In contrast, the ethanol ratio decreased markedly with isoproterenol. Dialysate glucose concentration decreased with phenylephrine with and without propranolol and increased with isoproterenol. Phenylephrine caused a dose‐dependent increase in dialysate glycerol concentration, with a maximal effect similar to that of isoproterenol. The effect was attenuated with propranolol.

Discussion:Our findings suggest that α1‐adrenoreceptor stimulation by phenylephrine increases glucose uptake and metabolism in human abdominal adipose tissue. Furthermore, phenylephrine elicits a marked increase in lipolytic activity in white adipose tissue through β‐adrenoreceptor activation.
5‐HT2A Receptor Gene Promoter Polymorphism in Relation to Abdominal Obesity and Cortisol
Authors: Rosmond Roland , Bouchard Claude , Björntorp Per
Published: April 2008

Objective: There is considerable evidence that cortisol secretion is associated with obesity. The regulation of the 5‐hydroxytryptamine receptor 2A (5‐HT2A) gene might play an essential role because it is involved in the control of cortisol secretion. Therefore, we examined the potential impact of the 5‐HT2A −1438G/A promoter polymorphism on obesity and estimates of insulin, glucose, and lipid metabolism as well as circulating hormones, including salivary cortisol, in 284 unrelated Swedish men born in 1944.

Research Methods and Procedures: The subjects were genotyped by using polymerase chain reaction amplification of the promoter region of the gene for 5‐HT2A followed by digestion of the reaction product with the restriction enzyme MspI.

Results: The frequencies were 0.39 for allele −1438A and 0.61 for allele −1438G. Homozygotes for the −1438G allele had, in comparison with −1438A/A subjects, higher body mass index, waist‐to‐hip ratio, and abdominal sagittal diameter. Moreover, cortisol escape from 0.25‐mg dexamethasone suppression was found in subjects with the −1438A/G genotype. Serum leptin, fasting insulin, and glucose, as well as serum lipids, were not different across the −1438G/A genotype groups.

Discussion: From these results, we suggest the possibility that an abnormal production rate of the 5‐HT2A gene product might lead to the development of abdominal obesity. The pathophysiology could involve stress factors that destabilize the serotonin‐hypothalamic‐pituitary‐adrenal system in those with genetic vulnerability in the serotonin receptor gene.