bluuebunny/crossref_metadata_2025 huggingface dataset:
Race, Menopause, Health‐Related Quality of Life, and Psychological Well‐Being in Obese Women
Authors: Laferrère Blandine , Zhu ShanKuan , Clarkson Jennifer R. , Yoshioka Marianne R.M. , Krauskopf Katherine , Thornton John C. , Pi‐Sunyer F. Xavier
Published: April 2008

Objective: To investigate the health‐related quality of life (HR‐QOL) in African‐American (AA) and white (W) obese women.

Research Methods and Procedures: Participants were 145 obese women (80 AA and 65 W; 87 premenopausal and 58 postmenopausal) who completed the Medical Outcomes Study short form, the Brief Symptom Inventory, the Life Distress Inventory, the Satisfaction With Life Scale, and the Rosenberg Self‐Esteem Scale before entering a weight‐loss study. The mean age of the subjects was 46.3 ± 11.1 years and the mean body mass index was 35.2 ± 4.2 kg/m2.

Results: Although AA women were slightly heavier (95.3 ± 10.3 kg vs. 91.5 ± 11.6 kg, p < 0.05) and less educated (14.2 ± 3.7 years vs. 15.7 ± 3.7 years, p < 0.05) than the W women in the sample, there was no difference between the two ethnic groups in any of the reported HR‐QOL variables. Menopausal status had a significant effect on HR‐QOL, with premenopausal women being more distressed (p = 0.002), having more limitations in social activity (p = 0.007), and having less vitality (p < 0.001) than the postmenopausal women. This was especially true in the AA women.

Discussion: These data show no difference in HR‐QOL between AA and W obese women and suggest that menopausal status may have an impact on HR‐QOL, especially in AA women.
The Lean Woman
Authors: Baghaei Fariba , Rosmond Roland , Westberg Lars , Hellstrand Monica , Landén Mikael , Eriksson Elias , Holm Göran , Björntorp Per
Published: April 2008

Objective: In the current obesity epidemic, the ability to remain lean is beginning to be uncommon. Therefore, it was considered of interest to characterize such subjects.

Research Methods and Procedures: From a population of premenopausal women (n = 270), all 40 years of age, those with a similar body mass index (BMI) as women at the age of 21 years, born the same year (BMI = 21.1 kg/m2) were selected among nonsmokers and compared with the remaining nonsmoking women.

Results: Lean women showed, as expected, low waist‐to‐hip circumference ratio and abdominal sagittal diameter as well as absence of other disease risk factors. Compared with the remaining women, 17β‐estradiol was high and androgens were low, whereas insulin‐like growth factor I and thyroid hormones showed no differences. Dihydroepiandrosterone sulfate was lower, whereas cortisol, measured in saliva repeatedly over a day, and adrenocorticotropin hormone were not different. Results from questionnaires indicated higher education and socioeconomic status, frequent sports activities, and better psychosocial adaptation and psychological health. A tetranucleotide repeat polymorphism in the fifth intron of the aromatase P450 gene was longer among the lean (187 base pairs) than the rest of the women. Women with opposite phylogenetic characteristic have a short microsatellite (168 base pairs) in this gene locus.

Discussion: Lean, nonsmoking women enjoy an excellent health in not only anthropometric and metabolic factors, but also in neuroendocrine, endocrine, and psychological variables. The endocrine measurements suggest a well‐functioning aromatase, which in turn might have a genetic background, contributing to health. The aromatase gene might be important for regulation of body fat mass.
Does Ethnicity Influence Body‐Size Preference? A Comparison of Body Image and Body Size
Authors: Cachelin Fary M. , Rebeck Ramona M. , Chung Grace H. , Pelayo Elizabeth
Published: April 2008

Objective: Obesity is most common in the United States among women of ethnic minority groups (black and Hispanic). Researchers have hypothesized that these subcultures are more accepting of overweight figures. The purpose of this study was to examine body image and body size assessments in a large community sample of men and women.

Research Methods and Procedures: Participants were 801 women and 428 men: 23% Asian, 45% Hispanic, 17% black, and 15% white. The figure rating scale was used to rate: body dissatisfaction, attractive male and female shapes, acceptable female size, and perceptions of underweight to obese female figures.

Results: Controlling for age, education, and body weight, no ethnic differences were found for men. Asian women reported less body dissatisfaction than the other groups. Women were more dissatisfied with their size than men and chose thinner female figures as attractive and acceptable.

Discussion: Ethnicity, independent of age, education, and body weight, does not influence preference for female and male shapes or tolerance for obesity.
Chronic Application of MTII in a Rat Model of Obesity Results in Sustained Weight Loss
Authors: Hamilton Bradford S. , Doods Henri N.
Published: April 2008

Objective: To examine the effects of a cafeteria diet and a chronic treatment with melanocortin agonist (MTII) on mature weight‐stable female rats.

Research Methods and Procedures: Ex‐breeder Chbb:Thom rats (350 to 400 g) were divided into two groups: highly palatable food (HPF) and normal rat chow (RC). Both groups had ab libitum access to rat chow. The HPF group had access to chocolate bars, cookies, cheese, and nuts (∼20 g/d). After 21 days, the rats in each group were then divided into control and treated groups. Mini‐pumps delivering saline or MTII (1 mg/kg per day) for minimally 28 days were implanted. Oxygen consumption was measured for 17 days in a second group of rats implanted with mini‐pumps containing MTII (1 mg/kg per day) or saline.

Results: HPF rats ate less (<50%) rat chow than RC rats. After 20 days, the HPF group had reached a plateau and weighed significantly more (p < 0.005) than the RC group (411.7 ± 9.3 g; n = 17 vs. 365.1 ± 9.4 g; n = 16). HPF rats and RC rats receiving MTII reduced their pellet intake and body weight in the initial 2 weeks of treatment (day 14, RC‐saline: −1.6 ± 1.8 g; RC‐MTII, −22.5 ± 3.7 g; HPF‐saline, −7.1 ± 1.7 g; HPF‐MTII, −30.7 ± 4.8 g). Subsequently, pellet intake returned to pre‐implantation values, although body weights remained reduced in both HPF and RC groups. Oxygen consumption was increased in rats treated with MTII.

Discussion: This suggests that MTII initially reduced body weight by limiting food intake; however, maintenance of weight is most likely due to increased energy expenditure under conditions of normal and highly palatable diets in mature animals.
Leptin's Sexual Dimorphism Results from Genotype by Sex Interactions Mediated by Testosterone
Authors: Martin Lisa J. , Mahaney Michael C. , Almasy Laura , MacCluer Jean W. , Blangero John , Jaquish Cashell E. , Comuzzie Anthony G.
Published: April 2008

Objective: Recent studies have reported the existence of marked sexual dimorphism in serum leptin levels in humans, with women having approximately three times the levels of men. As we have shown for other measures of adiposity, such sexual dimorphism can arise from a special case of genotype by environment interaction, that of genotype by sex interaction.

Research Methods and Procedures: Using maximum likelihood‐based variance decomposition techniques, we examined the genetic and environmental architecture of sexual dimorphism in serum leptin levels in 1147 Mexican Americans from the San Antonio Family Heart Study.

Results: Both the genetic and environmental variances for this trait differed significantly between the sexes (p < 0.001 and p < 0.01, respectively), with women displaying larger values for both components. We found significant evidence that different genes influence variation in serum leptin levels between the two sexes (p = 0.05). Furthermore, this pattern of sexual dimorphism in serum leptin levels persisted even after accounting for the effects of either the percentage of body fat or total body fat. However, this pattern of sexual dimorphism was eliminated after accounting for the effects of testosterone.

Discussion: These findings suggest that the sexual dimorphism seen in leptin levels is not simply explained as differences in total adiposity between the sexes. We conclude that the genes, which influence variation in serum leptin levels, are differentially expressed depending on sex, and that the sexes also show differences in response of the expression of this obesity‐related trait to unmeasured residual effects.
Modeling the Impact of Adjustable Gastric Banding on Survival in Patients with Morbid Obesity
Authors: Sendi Pedram , Palmer Andrew J. , Hauri Philipp , Craig Bruce A. , Horber Fritz F.
Published: April 2008

Objective: Morbid obesity is associated with premature death. Adjustable gastric banding may lead to substantial weight loss in patients with morbid obesity. Little is known about the impact of weight loss on survival after adjustable gastric banding. We therefore developed a mathematical model to estimate life expectancy in patients with a body mass index (BMI) ≥40 kg/m2 undergoing bariatric surgery.

Research Methods and Procedures: We developed a nonhomogeneous Markov chain consisting of five states: the absorbing state (“dead”) and the four recurrent states BMI ≥40 kg/m2, BMI 36 to 39 kg/m2, BMI 32 to 35 kg/m2, and BMI 25 to 31 kg/m2. Scenarios of weight loss and age‐ and sex‐dependent risk of death, as well as BMI‐dependent excess mortality were extracted from life tables and published literature. All patients entered the model through the state of BMI ≥40 kg/m2.

Results: In men aged either 18 or 65 years at the time of surgery, who moved from the state BMI ≥40 kg/m2 to the next lower state of BMI 36 to 39 kg/m2, life expectancy increased by 3 and 0.7 years, respectively. In women aged either 18 or 65 years at the time of surgery, who moved from the state BMI ≥40 kg/m2 to the next lower state BMI 36 to 39 kg/m2, life expectancy increased by 4.5 and 2.6 years, respectively. Weight loss to lower BMI strata resulted in further gains of life expectancy in both men and women.

Discussion: Within the limitations of the modeling study, adjustable gastric banding in patients with morbid obesity may substantially increase life expectancy.
Familial Resemblance for Plasma Leptin: Sample Homogeneity across Adiposity and Ethnic Groups
Authors: Rice Treva , Chagnon Yvon C. , Borecki Ingrid B. , Pérusse Louis , Collier Greg , Gagnon Jacques , Leon Arthur S. , Skinner James S. , Wilmore Jack H. , Bouchard Claude , Rao D. C.
Published: April 2008

Objective: Previous studies show a wide range in the percentage of variance in leptin levels attributable to genetic factors. These studies differ markedly with respect to ethnicity, study design, and statistical methodology. Therefore, the purpose of this study was to investigate heterogeneity hypotheses across ethnic groups and by adiposity level, using the same statistical methods.

Research Methods and Procedures: Samples included black vs. white (HERITAGE Family Study) and random vs. obese (Québec Family Study) individuals from 432 families (1432 individuals). Heritability for leptin, alternatively adjusted for age and sex and then for age, sex, and adiposity was estimated with the use of familial correlations. Heterogeneity in the magnitude of the familial resemblance between samples and the effect of adjusting for adiposity was explored.

Results: Heritability did not vary across samples stratified by adiposity level or ethnic group or across adjustment schemes. Maximal heritability, the percentage of additive phenotypic variability due to all familial sources, was 32%.

Discussion: Whereas leptin and adiposity were highly correlated within individuals, removing the effects of adiposity did not significantly alter the magnitude of the familial component for leptin. Moreover, this effect did not vary as a function of ethnicity (black vs. white) or adiposity level. Thus, no evidence for heterogeneity was detected. However, a comparison among previous studies raises questions concerning possible genetic heterogeneity in other ethnic groups in which complex interactions among leptin, adiposity, and diabetes status may be important.
Body Image Partially Mediates the Relationship between Obesity and Psychological Distress
Authors: Friedman Kelli E. , Reichmann Simona K. , Costanzo Philip R. , Musante Gerard J.
Published: April 2008

Objective: Body image is considered as a potential mediator of the relationship between obesity and psychological distress.

Research Methods and Procedures: One hundred ten men and women in a residential weight control facility completed the Multidimensional Body Self‐Relations Questionnaire, the Beck Depression Inventory, the Rosenberg Self‐Esteem Scale, and the Binge Eating Scale.

Results: For both men and women, body‐image satisfaction partially mediated the relationship between degree of overweight and depression/self‐esteem.

Discussion: Sociodemographic factors that may influence the relationships among weight, body image, and depression/self‐esteem are discussed.
A Prospective Study of Adiposity and All‐Cause Mortality: The Malmö Diet and Cancer Study
Authors: Lahmann Petra H. , Lissner Lauren , Gullberg Bo , Berglund Göran
Published: April 2008

Objective: This study aims to examine the association between various measures of adiposity and all‐cause mortality in Swedish middle‐aged and older men and women and, additionally, to describe the influences of age and sex on these associations.

Research Methods and Procedures: A prospective analysis was performed in a cohort of 10,902 men and 16,814 women ages 45 to 73 years who participated in the Malmö Diet and Cancer Study in Sweden. Baseline examinations took place between 1991 and 1996, and 982 deaths were documented during an average follow‐up of 5.7 years. All‐cause mortality was related to the following variables measured at baseline: body mass index (BMI), percentage of body fat, lean body mass (LBM), and waist‐to‐hip ratio (WHR), with adjustment for age and selected covariates. Body composition data were derived from bioelectrical impedance analysis.

Results: The association between percentage of body fat and mortality was modified by age, particularly in women. For instance, fatness was associated with excess mortality in the younger women but with reduced mortality in the older women. Weaker associations were seen for BMI than for percentage of body fat in both sexes. Placement in the top quintiles of waist‐to‐hip ratio, independent of overall body fat, was a stronger predictor of mortality in women than in men. The observed associations could not be explained by bias from early death or antecedent disease.

Discussion: The findings reveal sex and age differences for the effects of adiposity and WHR on mortality and indicate the importance of considering direct measures of adiposity, as opposed to BMI, when describing obesity‐related mortality risks.
Association of the TNF‐α−308 G/A Promoter Polymorphism with Insulin Resistance in Obesity
Authors: Dalziel Bronwen , Gosby Alison K. , Richman Rosemary M. , Bryson Janet M. , Caterson Ian D.
Published: April 2008

Objective: Obesity is a major risk factor for the development of type 2 diabetes. Tumor necrosis factor (TNF)‐α is a candidate gene for the development of both obesity and insulin resistance. We investigated whether a common polymorphism in the promoter region (−308 G/A) of the TNF‐α gene was associated with increased risk for the development of insulin resistance and cardiovascular disease in an obese Australian population.

Research Methods and Procedures: Obese, non‐diabetic subjects (146 women and 34 men) were genotyped with polymerase chain reaction‐restriction fragment length polymorphism techniques, and anthropometric and biochemical measurements were analyzed. A homeostasis model assessment (HOMA) score was used to gauge the level of insulin resistance.

Results: The frequencies of the G allele and the A allele were 0.759 and 0.241, respectively. Subjects homozygous for the A allele had higher fasting insulin levels (226 vs. 131 pM; p < 0.001), higher HOMA scores (10.2 vs. 5.3; p < 0.001), higher systolic blood pressure (143 vs. 129 mm Hg; p = 0.02), and lower high‐density lipoprotein (HDL) cholesterol (1.13 vs. 1.25 mM; p = 0.04) than did subjects homozygous for the G allele. Whereas an association between insulin resistance and body mass index or waist circumference was seen in all subjects, a highly significant negative correlation of HDL cholesterol to HOMA scores (r = −0.710; p < 0.001) occurred in subjects with the A allele only.

Discussion: The −308 G/A TNF‐α gene variant conveys an increased risk for the development of insulin resistance in obese subjects. The presence of low HDL cholesterol levels further increases the risks associated with insulin resistance in carriers of the A allele.
Liver Volume and Visceral Obesity in Women with Hepatic Steatosis Undergoing Gastric Banding
Authors: Busetto Luca , Tregnaghi Alberto , de Marchi Francesco , Segato Gianni , Foletto Mirto , Sergi Giuseppe , Favretti Franco , Lise Mario , Enzi Giuliano
Published: April 2008

Objective: To investigate the relationships between visceral obesity and hepatic steatosis in obese patients undergoing adjustable silicone gastric banding with the LAP‐BAND.

Research Methods and Procedures: Six premenopausal, morbidly obese women with an ultrasonographic diagnosis of liver steatosis were evaluated before surgery and 8 and 24 weeks after surgery. Liver volume and body fat distribution were simultaneously analyzed by total‐body multislices magnetic resonance imaging.

Results: Before surgery, the only variable found to be correlated with liver volume was visceral adipose tissue volume (r = 0.91; p < 0.01). Weight loss was 9.9 ± 3.8 kg in the period from 0 to 8 weeks (p < 0.01) and 7.1 ± 4.9 kg in the the period from 8 to 24 weeks (p < 0.05). Total fat showed a statistically significant reduction of 6.2 ± 4.0 liters in the 0‐ to 8‐week period and a further significant reduction of 7.7 ± 3.9 liters in the 8‐ to 24‐week period. Visceral adipose tissue showed a statistically significant reduction of 1.0 ± 0.9 liters in the 0‐ to 8‐week period (p < 0.05) but only a further, not significant reduction of 0.6 ± 0.7 liters in the 8‐ to 24‐week period. The relative reduction of visceral fat in the 0‐to 8‐week period was higher than the relative reduction of total fat. Liver volume also showed a statistically significant reduction of 0.24 ± 0.26 liters in the first phase of weight loss (p < 0.05), corresponding to a relative reduction of 12.3 ± 10.6%. During the 8‐ to 24‐week period, liver volume was substantially stable.

Discussion: Hepatomegaly was associated with visceral obesity in morbidly obese women with liver steatosis. In the phase of rapid weight loss after gastric surgery, a preferential mobilization of visceral fat, compared with total adipose tissue, occurred. This preferential visceral fat loss was associated with a significant reduction in liver volume.
Effect of Group vs. Single Housing on Phenotypic Variance in C57BL/6J Mice
Authors: Nagy Tim R. , Krzywanski David , Li Jing , Meleth Sreelatha , Desmond Renee
Published: April 2008

Objective: To determine if group housing affects the variance of body composition parameters in a highly inbred mouse strain.

Research Methods and Procedures: Thirty 3‐week‐old male C57BL/6J mice were obtained from the Jackson Laboratory. Fifteen mice were housed individually, and 15 mice were housed in groups of 5/cage. Animals were fed ad libitum and maintained in the same room under a 12:12‐hour light/dark photoperiod at 22 °C for 9 weeks. Animals were killed, and fat mass, soft‐lean tissue mass, bone mineral density (BMD), and bone mineral content (BMC) were determined by DXA. At necropsy, weights of the paired epididymal fat pads, paired retroperitoneal fat pads, right inguinal fat pad, liver, kidneys, paired testes, and seminal vesicles were obtained.

Results: Relative to mice housed singly, group‐housed mice showed significantly greater variance in percentage of body fat, testes weight, and BMC. Group‐housed mice tended to show greater variance in liver weights and BMD. Mice housed singly were smaller, had less soft‐lean tissue mass and BMC, and lower BMD when compared with group‐housed mice.

Discussion: These results suggest that with respect to body composition parameters, mice housed singly are more similar to one another than are group‐housed mice, most likely because of a reduction in environmental (predominately behavioral/social) effects. Thus, mice housed singly may be more representative of genotypic effects on body composition than group‐housed mice. Whether other inbred strains of mice show similar responses to housing condition is unknown.
The Relation of Body Mass Index, Cardiorespiratory Fitness, and All‐Cause Mortality in Women
Authors: Farrell Stephen W. , Braun LeeAnn , Barlow Carolyn E. , Cheng Yiling J. , Blair Steven N.
Published: April 2008

Objective: To examine the relation of body mass index (BMI), cardiorespiratory fitness (CRF), and all‐cause mortality in women.

Research Methods and Procedures: A cohort of women (42.9 ± 10.4 years) was assessed for CRF, height, and weight. Participants were divided into three BMI categories (normal, overweight, and obese) and three CRF categories (low, moderate, and high). After adjustment for age, smoking, and baseline health status, the relative risk (RR) of all‐cause mortality was determined for each group. Further multivariate analyses were performed to examine the contribution of each predictor (e.g., age, BMI, CRF, smoking status, and baseline health status) on all‐cause mortality while controlling for all other predictors.

Results: During follow‐up (113,145 woman‐years), 195 deaths from all causes occurred. Compared with normal weight (RR = 1.0), overweight (RR = 0.92) and obesity (RR = 1.58) did not significantly increase all‐cause mortality risk. Compared with low CRF (RR = 1.0), moderate (RR = 0.48) and high (RR = 0.57) CRF were associated significantly with lower mortality risk (p = 0.002). In multivariate analyses, moderate (RR = 0.49) and high (RR = 0.57) CRF were strongly associated with decreased mortality relative to low CRF (p = 0.003). Compared with normal weight (RR = 1.0), overweight (RR = 0.84) and obesity (RR = 1.21) were not significantly associated with all‐cause mortality.

Discussion: Low CRF in women was an important predictor of all‐cause mortality. BMI, as a predictor of all‐cause mortality risk in women, may be misleading unless CRF is also considered.
Dietary Patterns and Their Associations with Obesity in the Brazilian City of Rio de Janeiro
Authors: Sichieri Rosely
Published: April 2008

Objective: To evaluate the dietary patterns of adults living in the city of Rio de Janeiro, Brazil and their associations with body mass index (BMI).

Research Methods and Procedures: A survey was conducted in 1996 in a probabilistic sample of 2040 households. Weight and height were measured and food intake was based on an 80‐item semi‐quantitative food frequency questionnaire. Dietary patterns were identified through factor analysis.

Results: More than one‐third of the adult population (20 to 60 years old) was overweight (BMI = 25 to 29.9 kg/m2), and 12% were obese (BMI ≥ 30 kg/m2). Three major dietary patterns were identified: mixed pattern when all food groups and items had about the same factor loading, except for rice and beans; one pattern that relies mainly on rice and beans, which was called a traditional diet; and a third pattern, termed a Western diet, where fat (butter and margarine) and added sugar (sodas) showed the highest positive loading and rice and beans were strong negative components. Among men, the Western diet also included deep‐fried snacks and milk products with high positive values. The traditional diet was associated with lower risk of overweight/obesity in logistic models adjusted for dieting, age, leisure physical activity, and occupation (13% reduction in men and 14% reduction in women comparing the traditional and Western diets).

Discussion: Factors contributing to the effects of the Brazilian traditional diet may include low‐energy density, high‐dietary fiber content, incorporation of low glycemic index foods such as beans, or a relatively low food variety.
Parental Feeding Style and the Inter‐generational Transmission of Obesity Risk
Authors: Wardle Jane , Sanderson Saskia , Guthrie Carol Ann , Rapoport Lorna , Plomin Robert
Published: April 2008

Objective: This study was designed to determine whether a community sample of obese mothers with young children used different feeding styles compared with a matched sample of normal‐weight mothers. Four aspects of feeding style were assessed: emotional feeding, instrumental feeding (using food as a reward), prompting/encouragement to eat, and control over eating.

Research Methods and Procedures: Participants were from 214 families with same‐sex twins; 100 families in which both parents were overweight or obese and 114 in which both parents were normal weight or lean.

Results: We found that obese mothers were no more likely than normal‐weight mothers to offer food to deal with emotional distress, use food as a form of reward, or encourage the child to eat more than was wanted. The obese and normal‐weight mothers did differ on “control”; obese mothers reported significantly less control over their children's intake, and this was seen for both first‐born and second‐born twins. Twin analyses showed that these differences were not in response to children's genetic propensities, because monozygotic correlations were no greater than dizygotic correlations for maternal feeding style.

Discussion: These results suggest that the stereotype of the obese mother, who uses food in nonnutritive ways so that her child also becomes obese, is more likely to be myth than fact. However, the results raise the possibility that lack of control of food intake might contribute to the emergence of differences in weight.
A Genealogical Study of Essential Hypertension with and without Obesity in French Canadians
Authors: Pausova Zdenka , Jomphe Michele , Houde Louis , Vezina Helene , Orlov Sergei N. , Gossard Francis , Gaudet Daniel , Tremblay Johanne , Kotchen Theodore A. , Cowley Allen W. , Bouchard Gerard , Hamet Pavel
Published: April 2008

Objectives: To investigate genetic homogeneity in a set of hypertensive families and in subsets chosen for high and low prevalence of obesity; and to compare fasting insulin and lipids, ion transport, and water homeostasis in the obese and lean families.

Research Methods and Procedures: The study was carried out in a relative population isolate of the Saguenay/Lac St. Jean region in Canada. Genetic homogeneity was evaluated with the mean coeffigcients of kinship (φ) and inbreeding (F) computed with ascending genealogies. Serum insulin and lipids were measured after overnight fasting. Total body water was estimated with bioelectrical impedance. Sodium‐lithium countertransport and sodium‐potassium co‐transport were determined in freshly isolated erythrocytes.

Results: F and φ were increased in hypertensive families compared with families selected at random. F and φ were further increased within the subsets of obese and lean families. In addition, fasting insulin, total body water, sodium‐lithium countertransport, and sodium‐potassium co‐transport were higher in the obese than in the lean families. The two subsets of families did not differ by fasting lipids.

Discussion: In the Saguenay/Lac St. Jean population, the degree of genetic homogeneity was increased in families selected for hypertension, and it was further increased in subsets of hypertensive families with high and low prevalence of obesity. This suggests that hypertension in lean and obese individuals may represent, at least in part, separate genetic entities. Some of the extra genes shared in common within the subsets may contribute to their differences in body weight, insulin sensitivity, ion transport, and water homeostasis.
Opposite Regulation of Interleukin‐8 and Tumor Necrosis Factor‐α by Weight Loss
Authors: Bruun Jens M. , Pedersen Steen B. , Kristensen Kurt , Richelsen Bjørn
Published: April 2008

Objective: To obtain more information on the possible influence of body mass index (BMI) and weight loss on interleukin‐8 (IL‐8) in plasma and in the adipose tissue. Tumor necrosis factor‐α (TNF‐α) was used for comparison and determined in parallel with IL‐8.

Research Methods and Procedures: The study was divided into three parts: 1) a cross‐sectional study that included 89 subjects; 2) a 20‐week intervention study in which 34 healthy obese subjects received a dietary intervention for 8 weeks followed by an additional 12 weeks on a weight‐stabilization diet; 3) from this latter study, a subgroup of 8 obese subjects was investigated with a subcutaneous adipose‐tissue biopsy.

Results: In the cross‐sectional study, plasma levels of TNF‐α (p < 0.01), but not IL‐8, was correlated with BMI. However, in a subgroup (BMI, 20 to 30 kg/m2), IL‐8 was correlated with BMI (p < 0.01). In the intervention study, weight loss and weight maintenance led to an increase in IL‐8 by 30% (p < 0.05) and a decrease in TNF‐α by 40% (p < 0.001), which were paralleled in the adipose tissue, demonstrating a 2‐ to 3‐fold increase (p < 0.01) and a 40% to 80% decrease (p < 0.01) in IL‐8 and TNF‐α, respectively.

Discussion: Weight loss in obese subjects was associated with opposite changes in the secretion and transcription of IL‐8 and TNF‐α in the adipose tissue, as well as in plasma. This could indicate that plasma IL‐8 under some conditions may be related to changes in adipose tissue IL‐8 production.
Association of Lean Tissue and Fat Mass with Bone Mineral Content in Children and Adolescents
Authors: Pietrobelli Angelo , Faith Myles S. , Wang Jack , Brambilla Paolo , Chiumello Giuseppe , Heymsfield Steven B.
Published: April 2008

Objectives:There has been uncertainty in the adult body composition literature about whether fat mass (FM) or fat free mass is a better predictor of bone mineral content and bone mineral density. This issue has recently also been raised in the pediatric literature. Based on suggested skeletal muscle–bone relationships, this study tested the hypothesis that in children and adolescents lean tissue mass (LTM) is a better predictor of total bone mineral content (TBMC) than is FM.

Research Methods and Procedures:Subjects were 133 Italian children and adolescents, 5 to 17 years of age, undergoing a routine medical screen. FM (kilograms), LTM (kilograms), and TBMC (kilograms) were measured by DXA. Multiple regression analyses tested the independent association of FM and LTM with bone mineral content.

Results:Regression analyses, adjusting for pubertal status and other covariates, showed that FM and LTM were independently associated with TBMC. These associations were similar for boys and girls. TBMC was more strongly associated with LTM than FM.

Discussion:These observations support the hypothesis that in children and adolescents a close association exists between LTM, a measure of skeletal muscle, and skeletal characteristics.
Relationship of Body Composition to Body‐Fatness Estimation in Japanese University Students
Authors: Tanaka Shigeho , Itoh Yukako , Hattori Komei
Published: April 2008

Objective: To examine the relationship between self‐estimated whole body size and fatness and whole body and regional composition, and the relationship between self‐estimated whole body fatness and self‐estimated regional fatness in Japanese university students.

Research Methods and Procedures: This was a cross‐sectional study using Japanese university students (110 men and 79 women). The percentage of body fat, fat mass (FM), and fat‐free mass (FFM) were measured by underwater weighing and used as body composition variables. Subcutaneous fat thicknesses were determined at seven sites by ultrasonography to estimate regional body composition, and six circumferences and four breadths to estimate regional size. Relative body size and fatness were self‐estimated using a questionnaire.

Results: Only women tended to estimate themselves as being fatter than they actually were. Self‐estimated body fatness moderately correlated with the percentage of body fat (men, r = 0.41; women, r = 0.40) FM (men, r = 0.50; women, r = 0.51), and body mass index (r = 0.56 for men and 0.56 for women). After adjusting for the percentages of body fat and FM, self‐estimated fatness correlated with body mass index (r = 0.31 for men and r = 0.37 for women). Among self‐estimated regional fatness, self‐estimated abdominal fatness had the strongest correlation with self‐estimated whole body fatness in both genders.

Discussion: The low correlation between estimated and actual body fatness in both genders indicates that Japanese university students, especially women, inaccurately estimate their percentage of body fat. In fact, both men and women primarily estimate their whole body fatness by body weight relative to height.
Insulin Resistance, Hyperleptinemia, and Obstructive Sleep Apnea in Launois‐Bensaude Syndrome
Authors: Harsch Igor A. , Schahin Simin Pour , Fuchs Florian S. , Hahn Eckhart G. , Lohmann Tobias , Konturek Peter C. , Ficker Joachim H.
Published: April 2008

Objective: Launois‐Bensaude Syndrome (LBS) is a very rare cause of obesity, characterized by a symmetrical accumulation of a very large number of lipomata in different regions of the body, excluding the face, the forearms, and the shanks. Obesity is known to be closely associated with insulin resistance, hyperleptinemia, and obstructive sleep apnea (OSA). We were interested in studying whether these conditions are also present in patients with obesity due to LBS with a similar frequency as in patients with “simple” truncal obesity.

Research Methods and Procedures: We performed polysomnography and hyperinsulinemic euglycemic clamp studies and measured serum leptin in three patients with LBS and in six patients with “simple” truncal obesity, matched for sex and body mass index (LBS group, 36.39 kg/m2; controls, 35.82 kg/m2).

Results: Polysomnography revealed severe OSA in one LBS patient with marked “horsecollar lipomata.” In the other LBS patients, no OSA could be demonstrated. The leptin levels of the two groups were comparable (LBS group, 36.39 μg/liter; controls, 37.18 μg/liter) and the insulin responsiveness index was also comparable in the two groups (LBS group, 3.47 μmol/kg · minute; controls, 3.79 μmol/kg · minute).

Discussion: Patients with LBS demonstrated similar metabolic features in terms of insulin sensitivity and hyperleptinemia as patients with “simple” truncal obesity. LBS is not strictly associated with OSA.
Bupropion SR Enhances Weight Loss: A 48‐Week Double‐Blind, Placebo‐ Controlled Trial
Authors: Anderson James W. , Greenway Frank L. , Fujioka Ken , Gadde Kishore M. , McKenney James , O'Neil Patrick M.
Published: April 2008

Objective: To critically examine the efficacy of bupropion SR for weight loss.

Research Methods and Procedures: This 24‐week multicenter, double‐blind, placebo‐controlled study randomized obese adults to placebo, bupropion SR 300, or 400 mg/d. Subjects were counseled on energy‐restricted diets, meal replacements, and exercise. During a 24‐week extension, placebo subjects were randomized to bupropion SR 300 or 400 mg/d in a double‐blinded manner.

Results: Of 327 subjects enrolled, 227 completed 24 weeks; 192 completed 48 weeks. Percentage losses of initial body weight for subjects completing 24 weeks were 5.0%, 7.2%, and 10.1% for placebo, bupropion SR 300, and 400 mg/d, respectively. Compared with placebo, net weight losses were 2.2% (p = 0.0468) and 5.1% (p < 0.0001) for bupropion SR 300 and 400 mg/d, respectively. The percentages of subjects who lost ≥5% of initial body weight were 46%, 59%, and 83% (p vs. placebo < 0.0001) for placebo, bupropion SR 300, and 400 mg/d, respectively; weight losses of ≥10% were 20%, 33%, and 46% (p vs. placebo = 0.0008) for placebo, bupropion SR 300, and 400 mg/d, respectively. Withdrawals, changes in pulse and blood pressure did not differ significantly from placebo at 24 weeks. Subjects who completed 48 weeks maintained mean losses of initial body weight of 7.5% and 8.6% for bupropion SR 300 and 400 mg/d, respectively.

Discussion: Bupropion SR 300 and 400 mg/d were well‐tolerated by obese adults and were associated with a 24‐week weight loss of 7.2% and 10.1% and sustained weight losses at 48 weeks.
Three‐Month Tolerability of Orlistat in Adolescents with Obesity‐Related Comorbid Conditions
Authors: McDuffie Jennifer R. , Calis Karim A. , Uwaifo Gabriel I. , Sebring Nancy G. , Fallon Erica M. , Hubbard Van S. , Yanovski Jack A.
Published: April 2008

Objective:To study the safety, tolerability, and potential efficacy of orlistat in adolescents with obesity and its comorbid conditions.

Research Methods and Procedures:We studied 20 adolescents (age, 14.6 ± 2.0 years; body mass index, 44.1 ± 12.6 kg/m2). Subjects were evaluated before and after taking orlistat (120 mg three times daily) and a multivitamin for 3 months. Subjects were simultaneously enrolled in a 12‐week program emphasizing diet, exercise, and strategies for behavior change.

Results:Participants who completed treatment (85%) reported taking 80% of prescribed medication. Adverse effects were generally mild, limited to gastrointestinal effects observed in adults, and decreased with time. Three subjects required additional vitamin D supplementation despite the prescription of a daily multivitamin containing vitamin D. Weight decreased significantly (−4.4 ± 4.6 kg,p< 0.001; −3.8 ± 4.1% of initial weight), as did body mass index (−1.9 ± 2.5 kg/m2;p< 0.0002). Total cholesterol (−21.3 ± 24.7 mg/dL;p< 0.001), low‐density lipoprotein‐cholesterol (−17.3 ± 15.8 mg/dL;p< 0.0001), fasting insulin (−13.7 ± 19.0 μU/mL;p< 0.02), and fasting glucose (−15.4 ± 7.4 mg/dL;p< 0.003) were also significantly lower after orlistat. Insulin sensitivity, assessed by a frequently sampled intravenous glucose‐tolerance test, improved significantly (p< 0.02).

Discussion:We conclude that, in adolescents, short‐term treatment with orlistat, in the context of a behavioral program, is well‐tolerated and has a side‐effect profile similar to that observed in adults, but its true benefit versus conventional therapy remains to be determined in placebo‐controlled trials.
Development and Evaluation of Patient‐Centered Software for a Weight‐Management Clinic
Authors: Dent Robert M. , Penwarden Rhonda M. , Harris Neil , Hotz Stephen B.
Published: April 2008

Objective: To describe a weight‐management clinic software system and to report on its preliminary evaluation.

Research Methods and Procedures: The software system standardizes the collection of relevant patient information from an initial medical assessment, weekly clinic visits, and laboratory testing protocol of a medically supervised proprietary meal‐replacement program in a university‐based referral clinic. It then generates monthly patient feedback reports with graphs of clinical and laboratory parameters to support a patient‐centered approach to weight management. After patients and clinic physicians review the data to ensure accuracy, the database is used for subsequent patient feedback reports, reports to referring physicians, quality assurance, and research. Clinic physicians and referring physicians were asked to rate their acceptance of the system. In addition, in a retrospective analysis of data generated by the system, outcomes for patients who received system‐generated feedback (n = 620) were compared with those who participated in the program before the introduction of feedback (n = 130).

Results: Clinic and referring physicians reported that they had high overall satisfaction with the software and that the system saved them time, and the latter group reported that it decreased laboratory use. Regarding patients, the feedback group had lower dropout rates in the latter half of the program, better rates of attendance, completion of laboratory tests, and weight loss after 8 weeks.

Discussion: The software seems to facilitate the effectiveness of the treatment protocol for obesity and generates a high‐quality database for patient care, clinic administration, quality assurance, and research purposes.
Effect of Food Restriction on Ghrelin in Normal‐Cycling Female Rats and in Pregnancy
Authors: Gualillo Oreste , Caminos Jorge E. , Nogueiras Rubén , Seoane Luisa M. , Arvat Eva , Ghigo Ezio , Casanueva Felipe F. , Diéguez Carlos
Published: April 2008

Objective: Ghrelin is a 28‐amino‐acid acylated peptide that was recently identified as the endogenous ligand for the growth hormone secretagogue receptor. Previous studies have shown that ghrelin potently increases growth hormone release and food intake. The aim of this study was to clarify the physiological implications of ghrelin in the regulation of energy balance, by assessing the effect of undernutrition throughout 21 days in normal‐cycling and pregnant rats on ghrelin.

Research Methods and Procedures: We have determined ghrelin levels by radioimmunoassay and gastric ghrelin mRNA expression by Northern blot analysis during 21 days of chronic food restriction (30% of ad libitum available diet) in normal‐cycling female rats and in pregnancy.

Results: Our results show that chronic food restriction led to an increase in plasmatic ghrelin levels in normal‐cycling female rats. In pregnancy, ghrelin plasmatic levels were enhanced particularly during the latter part of gestation (19 and 21 days) compared with pregnant rats with free access to food. Gastric ghrelin mRNA expression showed a similar expression pattern, being higher in the food‐restricted group than in the group fed ad libitum, in normal‐cycling as well as in pregnant rats.

Discussion: These observations indicate that ghrelin plasmatic levels and ghrelin gastric mRNA are up‐modulated during undernutrition in normal‐cycling rats and in pregnancy. These findings suggest that increased ghrelin levels may have a role in mediating the physiological responses to undernutrition and could represent an adaptative response to prevent long‐lasting alterations in energy balance and body weight homeostasis.
Age‐Related Changes in Fatty Acids in Obese Offspring of Streptozotocin‐Induced Diabetic Rats
Authors: Merzouk Hafida , Madani Sihem , Hichami Aziz , Prost Josiane , Belleville Jacques , Khan Naim A.
Published: April 2008

Objective: The long‐term effects of fetal hyperinsulinemia, time course of changes in liver and very‐low‐density lipoprotein (VLDL) lipid levels and fatty acid compositions were investigated in obese offspring of streptozotocin‐induced mildly diabetic rats.

Research Methods and Procedures: Mild hyperglycemia in pregnant rats was induced by intraperitoneal injection of streptozotocin on day 5 of gestation. Control pregnant rats were injected with citrate buffer. Liver and VLDL lipids and fatty acids were analyzed in offspring at different ages.

Results: At birth, obese pups had higher VLDL triglyceride levels, saturated fatty acids, and C20:4n‐6. They also had lower C18:2n‐6 proportions in VLDL triglycerides, phospholipids, and cholesteryl esters than controls pups. In 1‐month‐old male and female obese rats, VLDL and liver lipid amounts were similar to those in their respective controls; however, high levels of C18:2n‐6 and C20:4n‐6 were noted in liver and VLDL lipids. At the age of 2 months, liver and VLDL triglyceride levels were higher in obese females than in control females. Fatty acid abnormalities seen in obese rats included low C18:3n‐3 and high C22:6n‐3 proportions in liver triglycerides and phospholipids. At the age of 3 months, obese rats, both males and females, compared with control animals, had higher VLDL and hepatic lipids with reduced C20:4n‐6 levels and polyunsaturated/saturated fatty acids ratios in hepatic and VLDL triglycerides and phospholipids.

Discussion: Fetal obesity, associated with alterations in VLDL lipid fatty acid composition, represents an important risk factor for adult obesity and diabetes.
Plasma Adiponectin Increases Postprandially in Obese, but not in Lean, Subjects
Authors: English Patrick J. , Coughlin Steven R. , Hayden Katharine , Malik Iqbal A. , Wilding John P.H.
Published: April 2008

Objective: We investigated the acute responses of plasma adiponectin levels to a test meal in lean and obese subjects.

Research Methods and Procedures: We studied 13 lean and 11 obese subjects after a 10‐hour overnight fast. Glucose, insulin, and adiponectin concentrations were measured at baseline and 15, 30, 60, 120, and 180 minutes after a fixed breakfast.

Results: At baseline, fasting adiponectin concentrations were lower in the obese group vs. the lean group [mean (95% confidence interval): 2.9 (2.1 to 4.1) μg/mL vs. 8.6 (6.5 to 11.3) μg/mL], but rose 4‐fold postprandially in the obese group, reaching a peak at 60 minutes [baseline: 2.9 (2.1 to 4.1) μg/mL vs. 60 minutes: 12.1 (8.5 to 17.4) μg/mL; p< 0.0001] and remaining elevated for the remainder of the study. There were no postprandial changes in plasma adiponectin concentrations in lean subjects.

Discussion: This increase of adiponectin concentrations in obese individuals might have important beneficial effects on postprandial glucose and lipid metabolism and might be viewed as a mechanism for maintaining normal glucose tolerance in those who are obese and insulin resistant.
Metabolic Partitioning of Endogenous Fatty Acid in Adipocytes
Authors: Wang Tong , Zang Yan , Ling Wenhua , Corkey Barbara E. , Guo Wen
Published: April 2008

Objective: To develop an accurate new method to measure the partitioning of adipocyte endogenous fatty acids among different metabolic pathways, a critical step toward understanding the regulatory mechanism by which fat disposition is modulated.

Research Methods and Procedures: Isolated primary rat adipocytes were pre‐incubated with isotope‐labeled fatty acids. This allows determination of the specific activity of labeled fatty acids in the endogenous lipid pool. After the removal of exogenous fatty acids, the disposition of endogenous fatty acids into the three major metabolic pathways, namely, oxidation, re‐esterification, and release into the medium, was measured independently. This was compared with the total lipolytic release of endogenous fatty acids, as measured by glycerol release. Adipocytes from normal fed and fasted animals were used to determine the effects of physiological variations on the metabolic fate of endogenous fatty acids.

Results: In normal fed animals, 0.2% of endogenous fatty acids were oxidized, 50.1% were released, and 49.7% were re‐esterified. Fasting doubled the partitioning of fatty acids toward oxidation (p < 0.05) in association with increased lipolysis (1.4‐fold increase) (p < 0.05). This effect was completely abolished by the addition of insulin to the cells (61% reduction) (p < 0.05).

Discussion: The endogenous fatty acids in adipocytes are actively oxidized. This process can be regulated by altered physiological conditions or by insulin. Over time, it is possible that a small shift of fatty acids toward oxidation could have a significant impact on body fuel economy. This hypothesis needs to be tested.