BMC Obesity最新文献

Background: Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease and diabetes. Previous studies in obese children demonstrating a positive association between serum uric acid (sUA) and components of MetS are confounded by lack of uniformity in age and pubertal status of children. Therefore, we have examined the role of sUA in MetS and its components in pre-pubertal children (Tanner Stage I, age ≤ 9 years).

Methods: Pre-pubertal obese children (32 boys, 27 girls, age 6-9 years) were recruited from Nuevo Leon, Mexico. For comparison, an equal number of children with normal body mass index (BMI) in the same age range (22 Boys, 39 girls, age 6-9 years) were also recruited from the same community. Presence of MetS and its components was defined according to the criteria of International Diabetes Federation. Fasting blood was analyzed for lipids, glucose, insulin, and uric acid.

Results: Among the obese children, sUA was positively associated with insulin resistance and hypertriglyceridemia and negatively associated with high density lipoprotein-cholesterol (HDLc). Subjects were three times more likely to have a MetS diagnosis per one unit (md/dL) difference in sUA. Of the 59 obese pre-pubertal children, 20 were classified as having MetS defined by the presence of abdominal obesity and two or more of other components described under methods. Of these, 57.1% (20/61) had sUA between 5.1 and 7.1 mg/dl.

Conclusions: The findings of this study clearly indicate a positive relationship between uric acid and MetS and its components in pre-pubertal obese children with Tanner stage I and ≤9 years of age.

Background: Obesity was identified as a major risk factor for malignant diseases, but underlying mechanisms remain unclear. Natural killer (NK) cells, a pivotal aspect of innate immunity, are capable of identifying and killing virally infected and tumor cells. Previous studies have shown altered NK cell functions in obesity, and the current study aimed to investigate the relationship between altered NK cell functions and increased cancer risk in obesity.

Methods: To induce obesity male F344-rats received a high-fat diet (34% fat) or a control diet (4% fat). Thereafter, syngeneic mammary adenocarcinoma cells (MADB106) or a vehicle were intravenously (i.v.) injected. 15 min after injection, half of each group of rats were killed, lungs removed and immunohistochemically stained. Numbers of NK cells, MADB106 cells and NK cell-tumor cell interactions were quantified. Twenty-one days after tumor-cell injection the other half group of rats was killed and lung metastases were counted and relative mRNA concentrations of different NK cell receptors were determined.

Results: After short-term MADB106-challenge, DIO fed animals showed significantly decreased NK cell numbers in the blood and NK cell-tumor cell interactions in the lung as compared to their control littermates. Twenty-one days after MADB106 injection, the lungs of the DIO fed rats showed significantly more lung metastases compared to control animals, accompanied by reduced relative mRNA concentrations of the activating NK cell receptor NKG2D.

Conclusions: We conclude that induction of obesity in F344-rats leads to reduced lung NK cell function against tumor cells and results in significantly enhanced lung metastasis as compared to lean animals. It can be hypothesized that obesity-induced altered NK cell functions play an important role in cancer growth and metastasis.

Background: We recently showed that abdominal obesity measurements (waist and hip circumference, waist-to-hip ratio) were inaccurate when performed by general practitioners (GPs). We hypothesise that measurement error could be even higher in overweight and obese patients due to difficulty in locating anatomical landmarks. We aimed to estimate GPs' measurement error of general (weight, height and body mass index (BMI)) and abdominal obesity measurements across BMI subgroups.

Methods: This cross-sectional study involved 26 GPs in Geneva, Switzerland. They were asked to take measurements on 20 volunteers within their practice. Two trained research assistants repeated the measures after the GPs ("gold standard"). The proportion of measurement error was computed by comparing the GPs' values (N = 509) to the average value of two measurements taken in turn by the research assistants and stratified by BMI subgroup (normal/underweight: <25 kg/m², overweight: 25 ≤ BMI < 30 kg/m², obese: ≥30 kg/m²).

Results: General obesity measurements were less prone to measurement error than abdominal obesity measurements, regardless of the BMI subgroup. The proportions of error increased across BMI subgroups (except for height), and were particularly high for abdominal obesity measurements in obese patients.

Conclusions: Abdominal obesity measurements are particularly inaccurate when GPs use these measurements to assess overweight and obese patients. These findings add further strength to recommendations for GPs to favour use of general obesity measurements in daily practice, particularly when assessing overweight or obese patients.

Background: Irritable bowel syndrome has been reported as more common in patients with morbid obesity than in the general population. The reason for this association is unknown. The aims of this study were to study the prevalence of irritable bowel syndrome and other functional bowel disorders in patients with morbid obesity, and to search for predictors of irritable bowel syndrome.

Methods: Patients opting for bariatric surgery at two obesity centers in South-Eastern Norway were included. Functional bowel disorders were diagnosed according to the Rome III criteria. Predictors were evaluated in a multivariable logistic regression analysis with irritable bowel syndrome as the dependent variable.

Results: A total of 350 (58%) out of 603 consecutive patients were included. The prevalence rates of irritable bowel syndrome at the two centers were 17/211 (8%) and 37/139 (27%) respectively. High low-density lipoprotein (OR 2.10; 95% CI 1.34-3.29), self-reported psychiatric disorders (OR 2.39; 95% CI 1.12-5.08) and center (OR 5.22; 95% CI 2.48-10.99) were independent predictors of irritable bowel syndrome.

Conclusions: At one of the two obesity centers, the prevalence of irritable bowel syndrome was threefold higher than in the general population in the same region. The high prevalence appears to be related to dietary differences or altered absorption or metabolism of fat. Attention to irritable bowel syndrome is important in the care of patients with morbid obesity.

Background: Obesity is linked to cardiovascular diseases and increasingly common in type 1 diabetes mellitus (T1DM) since the introduction of intensified insulin therapy. Our main aim was to explore associations between obesity and depression, anxiety, alexithymia and self-image measures and to control for lifestyle variables in a sample of persons with T1DM. Secondary aims were to explore associations between abdominal and general obesity and cardiovascular complications in T1DM.

Methods: Cross sectional study of 284 persons with T1DM (age 18-59 years, men 56%), consecutively recruited from one secondary care hospital diabetes clinic in Sweden. Assessments were performed with self-report instruments (Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale-20 items and Structural Analysis of Social Behavior). Anthropometrics and blood samples were collected for this study and supplemented with data from the patients' medical records. Abdominal obesity was defined as waist circumference men/women (meters): ≥1.02/≥0.88, and general obesity as BMI ≥30 kg/m² for both genders. Abdominal obesity was chosen in the analyses due to the high association with cardiovascular complications. Different explanatory logistic regression models were elaborated for the associations and calibrated and validated for goodness of fit with the data variables.

Results: The prevalence of abdominal obesity was 49/284 (17%), men/women: 8%/29% (P < 0.001). Abdominal obesity was associated with women (AOR 4.9), physical inactivity (AOR 3.1), alexithymia (AOR 2.6) and age (per year) (AOR 1.04). One of the three alexithymia sub factors, "difficulty identifying feelings" (AOR 3.1), was associated with abdominal obesity. Gender analyses showed that abdominal obesity in men was associated with "difficulty identifying feelings" (AOR 7.7), and in women with use of antidepressants (AOR 4.3) and physical inactivity (AOR 3.6). Cardiovascular complications were associated with abdominal obesity (AOR 5.2).

Conclusions: Alexithymia, particularly the alexithymia subfactor "difficulty identifying feelings", physical inactivity, and women, as well as cardiovascular complications were associated with abdominal obesity. As abdominal obesity is detrimental in diabetes due to its association with cardiovascular complications, our results suggest two risk factor treatment targets: increased emotional awareness and increased physical activity.

Background: Obesity in children is increasing worldwide. Malnutrition has become a double burden challenge of public health concern in developing countries. Childhood obesity increases the risk of chronic disease in childhood as well as adulthood. However, information is very scarce about childhood obesity in developing countries specifically in Ethiopia. Therefore, we aimed to assess childhood overweight, obesity and associated factors among primary school children at Dire Dawa, Eastern Ethiopia.

Methods: A school based cross-sectional study was conducted in Dire Dawa from 1^st to 30^th March, 2016. Study participants were selected using multistage sampling method. Pre-tested self-administered questionnaire, face to face interview technique and anthropometric measurements were used to collect data by eight well trained data collectors. Data were coded, cleaned and entered into EpiData software version 3.5.1, and exported into SPSS (version 21.0) statistical software, for data analysis. Bivariate and multivariate logistic regression were carried out to identify associated factors with childhood overweight and obesity. Statistical significance was declared using Adjusted Odds Ratio (AOR) at 95% CI and p-value less than 0.05.

Results: The prevalence of overweight and obesity were 14.7% (95% CI: 11.7, 18.0) and 5.8% (95% CI: 3.6, 8.0), respectively. Children who were from private school (AOR = 3.4, 95% CI: 1.4, 8.5), from families belonged to high socioeconomic class (AOR = 16.9, 95% CI: 6.5, 23.9), preferred sweetened foods (AOR = 2.3, 95% CI: 1.1, 5.1), had not engaged in regular physical exercise (AOR = 3.8, 95% CI: 1.5, 9.8), had experienced sedentary life style like spent their free time watching TV (AOR = 3.6, 95% CI: 1.6, 7.9), play computer game (AOR = 4.6, 95% CI:1.4,15.4), and were not having close friends (AOR = 2.9, 95% CI: 1.4, 6.2) were significantly associated with overweight/obesity risk.

Conclusion: Overweight/obesity in children is on alarming stage in the study area. Therefore, more attention should be given to creating awareness about healthy diet and improving life style through school and public media in collaboration with concerned bodies.

Background: Globally, overweight and obesity are becoming a mounting concern, impacting negatively on the health of populations especially in low-income settings. However, there is paucity of epidemiological information available in Ghana to support intervention activities. We conducted a study among public servants to estimate overweight/obesity, hypertension and diabetes prevalence and associated risk factors.

Methods: A descriptive cross sectional survey involving 271 purposively sampled public servants aged 20 to 59 years was conducted. We used a structured questionnaire to collect data on eating patterns, risk factors for overweight and obesity, as well as data on socio-demographics and physical activity. Anthropometric measurements were carried out and body mass index (BMI) calculated. Information on blood pressure and diabetes was also gathered. We used descriptive statistical and logistic regression analyses to, respectively, estimate overweight/obesity prevalence, and examine associations between behavioral factors and overweight/obesity and hypertension/diabetes.

Results: The overall hypertension/diabetes, overweight and obesity prevalence were 20, 29.9 and 4.8% respectively. The study found that marital status (p < 0.001), leisure time with physical activity and level of physical activity during work (p < 0.035) as well as morbidities such as diabetes and hypertension (p < 0.012) were significantly associated with BMI. Findings showed no significant relationship between mealtime, eating habits, education, age and body mass index. Even though prevalence of overweight/obesity was higher among respondents who travelled to work by car compared to respondents who used motor bikes or walked, the association between weight status and means of transport was not statistically significant. Both smoking (p = 0.730) and alcohol consumption (p = 0.109) were not linked to weight status.

Conclusion: Population-based interventions are needed to promote nutritious food selection and consumption, physical activity and healthy life styles. We also recommend that age and gender-specific interventions should be designed and implemented by relevant authorities to promote and support healthy living and healthy-lifestyles at home and in workplaces.

Background: Broiler chickens are compulsive feeders that become obese as juveniles and are thus a unique model for metabolic disorders in humans. However, little is known about the relationship between dietary composition, fasting and refeeding and adipose tissue physiology in chicks. Our objective was to determine how dietary macronutrient composition and fasting and refeeding affect chick adipose physiology during the early post-hatch period.

Methods: Chicks were fed one of three isocaloric diets after hatch: high-carbohydrate (HC; control), high-fat (HF; 30% of ME from soybean oil) or high-protein (HP; 25% vs. 22% crude protein). At 4 days post-hatch, chicks were fed (continuous ad libitum access to food), fasted (3 h food withdrawal), or refed (fasted for 3 h and refed for 1 h). Subcutaneous, clavicular, and abdominal adipose tissue was collected for histological analysis and to measure gene expression, and plasma to measure non-esterified fatty acid (NEFA) concentrations (n = 6-10 per group).

Results: Adipose tissue weights were reduced in chicks that were fed the HP diet and adipocyte diameter was greater in the adipose tissue of chicks that ate the HF diet. Consumption of diets differing in protein and fat content also affected gene expression; mRNAs encoding fatty acid binding protein 4 and a lipolytic enzyme, monoglyceride lipase, were greater in chicks fed the HC and HF than HP diet in all three adipose tissue depots. Fasting influenced gene expression in a depot-dependent manner, where most fasting and refeeding-induced changes were observed in the clavicular fat of chicks that consumed the HC diet. Fasting increased plasma NEFA concentrations in chicks fed the HC and HP diets.

Conclusions: The decreased adipose tissue deposition in chicks fed the HP diet is likely explained by decreased rates of adipogenesis. Consumption of the HF diet was associated with greater adipose tissue deposition and larger adipocytes, likely as a result of greater rates of adipocyte hypertrophy. The depot-dependent effects of diet and fasting on gene expression may help explain mechanisms underlying metabolic distinctions among subcutaneous and visceral fat depots in humans.

Background: Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses.

Methods: Semi-structured qualitative interviews based on the TDF were conducted with nurses (n = 16) to explore factors that behavioural theories suggest may influence nurses' eating and physical activity behaviour. Important determinants of the target behaviours were identified using both inductive coding (of categories emerging from the data) and deductive coding (of categories derived from the TDF) of the qualitative data.

Results: Thirteen of the fourteen domains in the TDF were found to influence nurses' eating and physical activity behaviour. Within these domains, important barriers to engaging in healthy eating and physical activity behaviour were shift work, fatigue, stress, beliefs about negative consequences, the behaviours of family and friends and lack of planning. Important factors reported to enable engagement with healthy eating and physical activity behaviours were beliefs about benefits, the use of self-monitoring strategies, support from work colleagues, confidence, shift work, awareness of useful guidelines and strategies, good mood, future holidays and receiving compliments.

Conclusions: This study used a theory-informed approach by applying the TDF to identify the key perceived determinants of nurses' eating and physical activity behaviour. The findings suggest that future efforts to change nurses' eating and physical activity behaviours should consider targeting a broad range of environmental, interpersonal and intrapersonal level factors, consistent with a socio-ecological perspective.

Background: In Mongolia, mean waist circumference (WC) has increased dramatically over the last decade, however, it is unknown whether these increases have been greater than corresponding increases in weight. In this study we aimed to assess whether recent increases in WC were greater than expected from changes in weight in Mongolian adults.

Methods: We used data on 13260 Mongolian adults, aged between 18 and 64 years, who participated in one of three (2005, 2009, 2013) nationally representative cross-sectional surveys. Linear regression was used to estimate changes in mean WC over time, adjusted for age, sex, height and weight. We also estimated the age-standardised prevalence for four obesity classification categories (not obese; obese by WC only; obese by body mass index (BMI) only; obese by both BMI and WC) at each survey year.

Results: The estimated mean WC in 2009 and 2013, respectively, was 1.26 cm (95% CI: 0.35 to 2.17) and 1.88 cm (95% CI: 1.09 to 2.67) greater compared to 2005, after adjusting for age, sex, height and weight. Between 2005 and 2013, the age-standardised prevalence of those obese according to both BMI and WC increased from 8.0 to 13.6% for men and from 16.5 to 25.5% for women. During the same period, the percentage who were obese by WC only increased from 1.8 to 4.8% for men and from 16.5 to 26.8% for women. In contrast, the percentage who were obese by BMI only remained relatively stable (women: 2.4% in 2005 to 1.0% in 2013; men: 2.7% in 2005 to 4.0% in 2013).

Conclusion: Over the last decade, among Mongolian adults, there has been substantially greater increase in WC and the prevalence of abdominal obesity than would be expected from increases in weight. Women are at greater risk than men of being misclassified as not obese if obesity is defined using BMI only. Obesity should be monitored using WC in addition to BMI to ensure the prevalence of obesity is not underestimated.