Metabolic Profile in Severely Obese Women is Less Deteriorated than Expected when Compared to Moderately Obese Women

Background: Obesity is well known to be associated with an increased prevalence of metabolic complications. Severe obesity is thus expected to have more important alterations of the metabolic profile than moderate obesity. This study aimed to compare the metabolic profile of pre- and postmenopausal severely obese women with moderately obese women. Methods: First, the metabolic profile of pre- (n=165) and postmenopausal (n=43) severely obese women (body mass index (BMI) ≥40 kg/m²) was compared to that of pre- (n=52) and postmenopausal (n=35) moderately obese women (BMI of 30-40 kg/m²). Thereafter, pre- and postmenopausal severely obese women were divided into two subgroups according to the presence/absence of a dysmetabolic profile. We used for comparison, a group of pre- and postmenopausal moderately obese women without a dysmetabolic profile. Results: The metabolic profile of pre- and postmenopausal severely obese women was less deteriorated than expected when compared to moderately obese women. Moreover, severely obese women with or without a dysmetabolic profile displayed comparable or even lower plasma levels of cholesterol, HDL and LDL-cholesterol, and a lower cholesterol/HDL-cholesterol ratio than moderately obese women (P≤0.05). After menopause, the metabolic profile of severely obese women, dysmetabolic or not, was similar to that of moderately obese women. Blood pressure was, however, higher in severely obese women compared to moderately obese women, only before menopause (P≤0.0001). Conclusion: These results indicate that despite their large accumulation of adipose tissue, most of the severely obese women had a metabolic profile less deteriorated than expected, when compared to moderately obese women.     

Smaller Hip Circumference is Associated with Dyslipidemia and the Metabolic Syndrome in Obese Women

BACKGROUND: There is great need for simple anthropometric measures that predict risk. The authors explored the relationship between body composition measures and features of the metabolic syndrome (MtS) in women aged between 20 and 50 years with class I obesity. METHODS:This is a cross-sectional study of 49 obese (BMI 30-35) women recruited into a weight management randomized trial. An analysis was conducted of the baseline weight, anthropometric measures, skin-fold thickness, bioelectrical impedance, whole body dual-energy x-ray absorptiometry (DEXA), and their relationships with the features of the MtS. RESULTS: All women but one (n=48) had a population risk waist circumference of >88 cm. 16 of the 49 (33%) fulfilled the criteria of the metabolic syndrome. Simple anthropometric measures provided the strongest correlations with the presence of the MtS. Cut-off values were selected using receiver operator characteristics. Waist circumference of >100 cm and hip circumference <115cm was associated with odds ratios of 5.2 (95% CI, 1.4-20) and 12.3 (95% CI, 3.0-51) respectively for the MtS. Regional DEXA analysis showed that lower leg fat mass rather than fat-free mass was associated with the MtS. The dyslipidemia of the MtS was associated with a lower leg fat mass, while higher HbAlc levels and HOMA, an indirect measure of insulin resistance, were seen with increased trunk fat. Percentage fat as measured by skin-fold thickness and bioelectrical impedance were not related to any features. Women with the metabolic syndrome were found to have lower bone mineral content as measured by DEXA. CONCLUSION: Weight distribution is highly predictive of metabolic risk. Smaller hip and larger waist circumference provided independent effect. BMI adjusted anthropometric measures may be of value.     

Resistance Band Exercise Training Prevents the Progression of Metabolic Syndrome in Obese Postmenopausal Women

Metabolic syndrome (MetS) is classified as a combination of risk factors for cardiovascular disease (CVD), and postmenopausal women are specifically at an increased risk for MetS, in part due to the hormonal and metabolic changes that occur at the menopause transition. It is crucial to combat the components of MetS with appropriate lifestyle interventions in this population, such as exercise. This study aimed to examine the effects of a resistance band exercise training program in obese postmenopausal women with MetS. A total 35 postmenopausal women were randomly assigned to either a control group (CON, n = 17) or a resistance band exercise training group (EX, n = 18). Participants in the EX group trained 3days/week. Levels of blood glucose, insulin, homeostatic model of insulin resistance (HOMA-IR), blood lipid profile, anthropometrics, and blood pressure (BP) were measured at baseline and after the exercise intervention. There were significant group by time interactions (p < 0.05) for blood glucose (Δ-4.5 mg/dl), insulin (Δ -1.3 μU/ml), HOMA-IR (Δ -0.6), triglycerides (Δ -9.4 mg/dl), low-density lipoprotein cholesterol(Δ -10.8 mg/dl), systolic BP(Δ -3.4 mmHg), body fat percentage (Δ -3.0 %), and waist circumference (Δ -3.4 cm), which significantly decreased (p < 0.05), and lean body mass (Δ 0.7 kg) and high-density lipoprotein cholesterol (Δ 5.1 mg/dl), which significantly increased (p < 0.05) after EX compared to no change in CON. The present study indicates that resistance band exercise training may be an effective therapeutic intervention to combat the components of MetS in this population, potentially reducing the risk for the development of CVD.Key points

• There are findings in the study that support the use of resistance band exercise for reducing risks for MetS in this population.
• There were significant improvements in insulin, glucose, HOMA-IR, and blood lipid profiles following the exercise training program.
• Body mass, BMI, BF%, SBP, and waist circumference were significantly decreased, while LBM significantly increased after 12 weeks of exercise training program.
• This is the first study to evaluate the impact of resistance band exercise training on risk factors for MetS in obese postmenopausal women.

Key words: Hyperinsulinemia, HOMA-IR, insulin resistance, resistance training, triglycerides     

Urate Transporter Gene SLC22A12 Polymorphisms Associated with Obesity and Metabolic Syndrome in Caucasians with Hypertension

Background/Aims: Hyperuricemia is associated with obesity and the metabolic syndrome. URAT1 is a urate transporter, and we tested the association of URAT1 transporter gene (SLC22A12) polymorphisms with obesity and the metabolic syndrome in hypertensive subjects. Methods: Patients with essential hypertension (n = 414) from a randomized controlled study were genotyped for SLC22A12 SNPs rs11602903, rs505802 and rs11231825. Results: In Caucasians, SLC22A12 SNPs were associated with the body mass index (BMI). rs11602903 was associated with BMI (p < 0.0001), waist circumference (p = 0.003), HDL cholesterol (p = 0.018) and the metabolic syndrome (p = 0.033), and accounted for 7% of the variation of BMI in Caucasians. In African Americans, SLC22A12 SNP rs11602903 was not associated with BMI, waist circumference, HDL cholesterol or triglycerides. Conclusion: The URAT1 gene SLC22A12 polymorphism may play a role in obesity and the metabolic syndrome in Caucasian hypertensive subjects.     

Waist Circumference and Related Anthropometric Indices Are Associated with Metabolic Traits in Severely Obese Subjects

Increased waist circumference (WC) and related anthropometric indices have been shown to be, independently of body weight and body mass index (BMI), associated with adverse metabolic traits in many populations. It is unknown, however, whether WC also predicts adverse metabolic traits in severely obese subjects displaying a BMI greater than 35 kg/m². To address this question, we analyzed a dataset including 838 severely obese patients (597 women, BMI 44.6?±?6.2 kg/m²; 241 men, BMI 44.3?±?5.7 kg/m²). Body weight, height, WC, hip circumference, and blood pressure were measured in all subjects along with the following metabolic blood markers: fasting glucose, insulin, glycolized hemoglobin levels, triglycerides, total cholesterol, low- and high-density cholesterol, and uric acid. Multivariate regression analyses indicated that WC as well as related anthropometric indices, in particular those accounting for subjects’ height, were associated with many metabolic variables independently of body weight and BMI. In general, height-adjusted WC indices were more closely associated with metabolic traits in women than in men. Collectively, our findings suggest that body fat distribution also plays an important role in determining metabolic traits in severely obese subjects and that WC represents a valuable marker of abdominal/visceral obesity in this population.     

DXA Measured Visceral Adipose Tissue,Total Fat,Anthropometric Indices and its Association With Cardiometabolic Risk Factors in Mother-Daughter Pairs From India

Visceral fat is the pathogenic fat depot associated with diabetes, dyslipidemia, and cardiovascular diseases. Estimation of visceral adipose tissue (VAT) by dual energy-X-ray absorptiometry (DXA) is a newer technique with less radiation exposure, shorter scanning time, and lower cost. In this study, we attempted to look at relationship between cardiometabolic risk factors and VAT, total body fat percent (TBF%) and anthropometry. We also studied the changes in body composition and metabolic parameters with menopause. The familial resemblance of VAT and TBF% in mother-daughter pair was also compared. This was a cross sectional community study of 300 women (150 postmenopausal mothers and 150 premenopausal daughters). Body composition indices by DXA and metabolic parameters were assessed. The association between DXA-VAT, TBF%, anthropometric measures, and cardiometabolic risk factors were studied by correlation, receiver operating characteristics curves, and logistic regression analysis. VAT indices were significantly higher and lean indices lower in postmenopausal women as compared to premenopausal women. One fourth of postmenopausal women were categorized as metabolically obese normal weight. DXA-VAT was a better predictor of cardiometabolic risk factors as compared to waist circumference, body mass index, and TF% in postmenopausal women (AUC:0.68 vs 0.62, 0.60 & 0.5, respectively), whereas body mass index had a better prediction in premenopausal women(AUC:0.68). VAT area >100 cm² had a significant association with the presence of ≥2 cardiometabolic risk factors (p = 0.04, OR: 2.2, CI:1.0–4.7) in the postmenopausal women. Daughters of the mothers with higher TBF% were found to have a higher TBF% compared to daughters of mothers with normal TBF% (36.2 ± 4.2 vs 32.2 ± 4.4, p = 0.03), similar resemblance was not seen for VAT. The study showed that the VAT increases and lean mass decreases with age and menopause. DXA measured VAT is a better predictor of cardiometabolic risk in postmenopausal women but not in premenopausal women. Total body fat may have a familial resemblance, but not the VAT which is determined by age, menopause, and probable life style factors.     

Leptin and Insulin Action in Severely Obese Women

Background: The authors investigated the interrelationships between the components of the metabolic syndrome in severe obesity. Methods: In non-diabetic, severely obese women, the degree of obesity (BMI), the insulin sensitivity (from the Homeostatic Model of Assessment, HOMA), the serum leptin concentration and the presence of dyslipidemia and arterial hypertension were evaluated. Results: In insulin-resistant patients, an overall impaired metabolic status and a greater cardiovascular risk were observed, while serum leptin concentration was higher than in the insulin-sensitive ones. Leptin levels and HOMA data correlated independent of BMI findings, while the presence of dyslipidemia and hypertension was unrelated to the other metabolic syndrome factors. Conclusion: In severely obese women, although other factors independently intervene, serum leptin has a role in developing the metabolic syndrome.     

Fat Mass Does Not Increase the Precision Error of Trabecular Bone Score Measurements

Introduction: Trabecular bone score (TBS) is an indirect index of trabecular microarchitecture derived from lumbar spine dual-energy X-ray absorptiometry. Previous phantom study showed that an increase in soft tissue thickness does not affect TBS reproducibility. We investigated the effect of increasing body mass index (BMI) and waist circumference on TBS precision error on patients, compared to bone mineral density (BMD). Methodology: A population of postmenopausal Caucasian women was distributed in 3 different BMI (normal, overweight, and class I obesity), plus 2 further groups based on waist circumference diameter (≤88 cm and >88 cm, respectively). In vivo precision error was calculated on 30 consecutive subjects that were scanned 2 times, with patient repositioning, using the Hologic QDR-Discovery W densitometer. Coefficient of variation, percent least significant change, and reproducibility were calculated according to the International Society for Clinical Densitometry guidelines. Results: Ninety-five women aged 66 ± 10 (mean ± standard deviation) were included. No significant differences were found both for BMD and TBS precision errors, respectively, when comparing BMI groups and waist circumference groups. BMD reproducibility ranged from 95.9% (BMI > 30 kg/m²) to 97.5% (BMI < 25 kg/m²). TBS reproducibility ranged between 95.8% (BMI = 25–29.9 kg/m², waist circumference > 88 cm) and 96.6% (BMI < 25 kg/m²). With the exception of obese group, a significant difference was found between BMD and TBS reproducibility, being that of TBS slightly lower than BMD. A significant decrease of TBS values was found between normal and obese subjects, as well as between waist circumference groups. Conclusions: TBS precision error is not affected by BMI and waist circumference differences. TBS reproducibility showed to be slightly lower than that of BMD, but this difference was mitigated in obese patients. A negative association was found between the amount of fat mass and TBS mean values.     

绝经后活动性类风湿性关节炎患者低骨密度的相关危险因素分析

目的分析绝经后活动性类风湿性关节炎(rheumatoid arthritis,RA)患者出现低骨密度相关的危险因素。方法研究对象为106例患有活动性RA的绝经后妇女,患者按体质量指数(BMI)分组:I组消瘦(18.5～24.9 kg/m~2,n=36),II组超重(25.0～29.9 kg/m~2,n=35),III组肥胖(30.0 kg/m~2,n=35)。检测这些患者的股骨BMD和血清BTM水平:骨钙素(OC)和I型胶原交联C-端肽片段(CTX)和骨桥蛋白(OPN)、抵抗素、高敏C反应蛋白、白细胞介素-6、肿瘤坏死因子(TNF)-a。结果与较瘦的女性相比,肥胖女性的总股骨BMD和总T评分显然更高(P0.05);发现BMD和CTX水平与体重存在显著相关性(P0.05)。调整股骨颈BMD后,BMI与TNF-α水平呈负相关(P0.05)。骨钙素水平与抵抗素呈负相关(P0.05),CTX水平与OPN呈正相关(P0.05);并发现BTM和BMD与其他炎症指标之间的关联。观察到OPN水平与体重、腰围和绝经后时间之间呈负相关性(P0.05)。结论本研究结果表明,体重和OPN、抵抗素和TNF-α在绝经后活动性RA患者的骨密度降低中起重要作用。     

Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome

The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26-75 years) and BMI (18.4-46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 x 10(-5) min(-1)/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P < 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P < 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose <6.4 mmol/l.     

Association of Visceral and Subcutaneous Fat Mass With Bone Density and Vertebral Fractures in Women With Severe Obesity

Introduction: The aim of this study was to evaluate the association of visceral and subcutaneous adipose tissue with bone mineral density (BMD), geometric indices of femoral neck strength and vertebral fractures in pre- and postmenopausal women with severe obesity. Methods: A cross-sectional study was conducted with pre- (n = 37) and postmenopausal (n = 21) women with body mass index higher than 40 kg/cm². BMD at total body, lumbar spine, hip and forearm, presence of vertebral fractures, lean mass, visceral, and subcutaneous adipose tissue were assessed by DXA. Geometric indices of femoral neck strength were calculated by DXA. Serum bone turnover markers (CTX and osteocalcin) and 25(OH)D were also measured. Results: BMD at all studied sites was similar in pre- and postmenopausal women. In postmenopausal women, total subcutaneous adipose tissue was inversely associated with BMD at total femur (β = −0.009; 95% confidence interval [CI] −0.017; −0.002) and with strength index (β = −0.03; 95% CI −0.04; −0.01). In premenopausal women, visceral adipose tissue was inversely associated with cross-sectional moment of inertia (β = −0.95; 95%CI −1.89; −0.01). Vertebral fractures were highly prevalent in premenopausal (32%), and even more frequent among postmenopausal women (55%). Conclusion: Taken together, our results suggest that both visceral and subcutaneous fat may be detrimental for bone health in pre- and postmenopausal women, and that severe obesity may increase the risk of vertebral fractures, even in young women.     

Relationship between body mass index,waist circumference and waist to hip ratio and the steroid hormone receptor status in breast carcinoma of pre- and postmenopausal women

ObjectiveTo assess whether body mass index (BMI), waist circumference (WC) and waist to hip ratio (WRH) are associated to the steroid receptor status in breast carcinomas.MethodsFour hundred and seventy three women with breast malignancies stage I–III were included. Weight, height, the waist and hip circumferences (WC), body mass index (BMI), and the waist to hip ratio (WHR) were determined. The expression of estrogen (ER) and progesterone (PR) receptors was determined with immunohistochemistry.ResultsMost women had central obesity (WC ≥ 88 and WHR ≥ 0.85 in 64.3 and 73.4%, respectively). The majority (78.1%) of the women had tumors that expressed at least one of the HR. BMI, WC and WHP were not related to the HR status in neither the pre- or postmenopausal women. Multivariate analysis confirmed these findings.ConclusionsBMI, WC or WHR may not be good predictors of HR status in breast malignancies in either pre- or postmenopausal women.     

Obesity and postmenopausal bone loss: The influence of obesity on vertebral density and bone turnover in postmenopausal women

This study was undertaken to evaluate the effect of obesity on the postmenopausal bone mass. Bone mineral density, measured by dual photon absorptiometry of the lumbar spine, serum osteocalcin (OC), fasting urinary calcium to creatinine (Ca:Cr), serum estradiol (E2) dehydroepiandrosterone (DHA) and testosterone (T) were measured in 176 women aged 45–71 years. Women were divided into four groups according to their menopausal status and their weight: 49 perimenopausal, 28 obese perimenopausal, 49 obese postmenopausal. Within each population (perimenopausal and postmenopausal), mean age was the same, only weight was significantly different (p < 0.0001). For the two groups of postmenopausal women mean interval since menopause (YSM) was the same (5.8 ± 3 and 5.4 ± 5 yr). Comparison between groups revealed a significant effect of menopausal status and obesity on BMD and bone turnover. As compared to perimenopausal women, BMD was lower, OC and Ca: Cr higher only in nonobese-postmenopausal women. E2, T, DHA did not differ between the two groups of postmenopausal women. The results of this study suggest that even moderate obesity can play a protective role on postmenopausal bone loss.     

Impact of metabolic syndrome on stress urinary incontinence in pre- and postmenopausal women

Aim

In the present study, we prospectively collected data from pre- to postmenopausal women with or without metabolic syndrome (MetS) and evaluated the impact of MetS on stress urinary incontinence (SUI) in women.

Material and methods

The women divided into four equal groups: premenopausal with and without MetS; postmenopausal with and without MetS. There were 100 women in each group. We assessed the women for SUI at gynecologic position and we determined cough stress test. MetS was defined according to the criteria established in 2005 by the NCEP/ATP III.

Results

Mean age was 48.52 ± 8.16 in women with MetS and 48.81 ± 8.31 in women without MetS. SUI was found more often in both pre- and postmenopausal women with MetS (p = 0.001 and p < 0.001). It seems that postmenopausal women have more SUI than premenopausal women with MetS. We also evaluated the association between five components of MetS and SUI. Just, higher fasting glucose levels and waist circumference were significantly associated with SUI (p < 0.05).

Conclusion

Our study shows that SUI is more prevalent in pre- and postmenopausal women with the MetS. SUI can be prevented with lifestyle changes for MetS. Multicenter studies with larger series and molecular studies are needed to determine the impact of the MetS on SUI.     

Weight loss after Swedish Adjustable Gastric Banding: relationships to insulin resistance and metabolic syndrome

Background:The metabolic syndrome is a cluster of cardiovascular risk factors (central obesity, hypertension,dyslipidemia, disturbance in glucose metabolism) associated with insulin-resistance. The cluster of risk factors defining the metabolic syndrome increases cardiovascular risk more than each single component. The aim of the present longitudinal study was to evaluate the relationship between weight loss and changes in insulin-resistance and in the prevalence of the metabolic syndrome 1-year after SAGB implantation. Methods: 51 premenopausal severely obese women (mean age 35.2±8.8 years, BMI 43.3±6.9) were enrolled. As a control group, 51 premenopausal nonobese women (BMI<30) were enrolled. All obese subjects underwent successful implantation of the SAGB via videolaparoscopy. In all subjects insulinresistance was estimated by HOMA index and metabolic syndrome was defined according to the criteria of the European Group for the Study of Insulin Resistance. Results: HOMA (4.2±2.0 vs 1.9±0.8, P<0.001) and the prevalence of the metabolic syndrome (58.8% vs 7.8%, P<0.001) were significantly higher in obese than non-obese women. 1 year after SAGB, BMI significantly decreased from 43.3±6.9 to 34.5±7.4 (P<0.001). HOMA index showed a significant dramatic breakdown (4.2±2.0 vs 2.4±1.0, P<0.001). The prevalence of the metabolic syndrome declined significantly (58.8% vs 21.6%, P<0.001). Conclusion: Our study shows that in severely obese women, insulin-resistance and the prevalence of the metabolic syndrome significantly decrease 1 year after SAGB. Our findings indicate that SAGB could be a useful tool to reduce the global cardiovascular risk in severely obese people and to improve their long-term prognosis.     

Relationships of serum leptin to clinical and anthropometric findings in obese patients

Background: The authors evaluated the relationship between leptin and the clinical, anthropometric and metabolic variables connected to the metabolic syndrome in obese individuals. Methods: A large group of patients with different degrees of obesity was investigated: body mass index (BMI) values, serum leptin, fasting glucose and insulin, triglycerides and HDL-cholesterol concentrations, insulin resistance index and blood pressure were measured. Results: On multiple regression analysis, serum leptin levels appeared to be positively correlated to the BMI and to the serum HDL-cholesterol concentration. Principal component factor analysis revealed three factors, explaining 61.3% of the total variance of the sample. General features of these factors were: factor 1 - BMI values and serum leptin and fasting glucose concentration; factor 2 - systolic and diastolic blood pressure and serum triglycerides and HDL-cholesterol concentration; factor 3 - fasting serum insulin concentration and insulin resistance index. Conclusions: In obese subjects multiple factors underlie the metabolic syndrome and therefore more than one mechanism may account for the clustering characteristics. In obese patients leptin loads only one factor, and therefore leptin does not appear to be a key feature in the metabolic syndrome. On the contrary, multiple correlation and factor analysis data give rise to the hypothesis that in obese patients, leptin may play a protective role against cardiovascular risk.     

Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia

The purpose of the present study was to perform a BPH risk factor analysis in men, relating the prostate gland volume to components of the metabolic syndrome and to identify clues to the etiology of BPH. Our material comprised a consecutive series of 158 patients with lower urinary tract symptoms with or without manifestations of the metabolic syndrome. In this group, the measured volume of the prostate was related consecutively to potential risk factors. The diagnoses atherosclerosis, non-insulin-dependent diabetes mellitus (NIDDM) and treated hypertension were obtained from the patient's medical history. Data on blood pressure, waist and hip measure, body height and weight were collected and body mass index (BMI) and waist/hip ratio (WHR) were calculated. Blood samples were drawn from fasting patients to determine insulin, cholesterol, triglycerides, HDL and LDL-cholesterol, uric acid and ALAT. The prostate gland volume was determined using ultrasound. Our results show that there was a larger prostate gland in men with NIDDM (P=0.0058), treated hypertension (P=0.0317), obesity (P<0.0001), low HDL-cholesterol levels (P=0.0132) and high insulin levels (P<0.0001) than in men without these conditions. The prostate gland volume correlated positively with the systolic blood pressure (r(s)=0.17; P=0.03), obesity (r(s)=0.34; P<0.0001) and fasting insulin (r(s)=0.38; P<0.0001) and negatively with HDL-cholesterol (r(s)=-0.22; P=0.009). On the basis of our findings, we concluded that NIDDM, treated hypertension, obesity, low HDL-cholesterol levels and high insulin levels constitute risk factors for the development of BPH. The results suggest that BPH is a facet of the metabolic syndrome and that BPH patients may share the same metabolic abnormality of a defective insulin-mediated glucose uptake and secondary hyperinsulinemia as patients with the metabolic syndrome. The findings generate a hypothesis of a causal relationship between high insulin levels and the development of BPH. In a clinical setting, the findings of the present report suggest that, in any patient presenting with BPH, the possible presence of NIDDM, hypertension, obesity, high insulin and low HDL-cholesterol levels should be considered. Conversely, in patients suffering from these conditions, the possibility of a clinically important BPH should be kept in mind.     

Obesity and cardiometabolic disease risk factors among US adolescents with disabilities

AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities.METHODS: Analysis of the 1999-2010 National Health and Nutrition Examination Survey data was conducted among 12-18 years old with(n = 256) and without disabilities(n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome(Met S, ≥ 3 risk factors present) were examined by the following standardized body mass index(BMI) categories for those with and without disabilities; overweight(BMI ≥ 85th- 95 th percentile for age and sex), obesity(BMI ≥ 95 th percentile) and severe obesity(BMI ≥35 kg/m2). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status. RESULTS: Adolescents with disabilities were significantlymore likely to be overweight(49.3%), obese(27.6%) and severely obese(12%) vs their peers without disabilities(33.1%, 17.5% and 3.6%, respectively, P ≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as Met S(18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities(9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have Met S(OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no disabilities.CONCLUSION: Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.     

Effects of 12 Weeks of Combined Exercise Training on Visfatin and Metabolic Syndrome Factors in Obese Middle-Aged Women

Visfatin is a highly expressed protein with insulin-like functions located predominantly in visceral adipose tissue and has been linked to obesity and increased health risks. The purpose of this study was to examine the effects of 12 weeks of combined exercise training on visfatin and metabolic syndrome factors in obese middle-aged women. Subjects were randomly assigned to either a training (n = 10) or control (n = 10) group. The training group exercised for 1 hour, 3 days per week during the 12 week supervised training program. The training program included 3 sets of 10 repetition maximum (10RM) resistance exercise as well as aerobic exercise at an intensity of 60-70% of their heart rate reserve (HRR). The control group was asked to maintain their normal daily activities. Two-way (group X time) repeated measured analysis of variance revealed no significant main effects, but there was a significant group X time interaction for the following variables: body weight (p < 0.01), percent body fat (% fat) (p < 0.01), waist hip ratio (WHR) (p < 0.01), diastolic blood pressure (DBP) (p < 0.05), fasting glucose level (p < 0.01), triglyceride levels (TG) (p < 0.01), high density lipoprotein cholesterol levels (HDL-C) (p < 0.05), and visfatin (p < 0.01). In conclusion, the 12 week combined resistance and aerobic training program used in this study was very effective for producing significant benefits to body composition and metabolic syndrome factors, as well as lowering visfatin levels in these obese middle-aged women.

Key points

• Recent studies have linked visfatin to obesity and increased health risks.
• The study was done to investigate the effects of 12 weeks of combined exercise training on visfatin and metabolic syndrome factors in obese middle-aged women.
• The exercise program used in this study was found to be very effective for lowering visfatin levels in obese middle-aged women.

Key words: Metabolic syndrome, combined resistance, aerobic exercise, visfatin     

维生素D、维生素B12和同型半胱氨酸水平与绝经后女性骨密度的相关性研究

目的探索绝经后非骨质疏松症和骨质疏松症女性患者高半胱氨酸、维生素D、维生素B_(12)和骨密度(bone mineral density,BMD)之间的关系。方法选取2017年8～12月在我院就诊的138名女性作为研究对象,根据骨密度将绝经后女性分为骨质疏松组(n=58)和非骨质疏松组(n=80)。记录两组患者的体质量指数(body mass index,BMI)、年龄、腰围等一般资料,检测腰椎L_(1～4)前后位、左侧股骨近端的BMD,测定血清同型半胱氨酸、维生素B_(12)、维生素D、碱性磷酸酶、钙、磷水平。分析两组患者不同指标的差异以及高半胱氨酸、维生素D、维生素B_(12)和BMD之间的相关性。结果两组患者的年龄、BMI、腰围、同型半胱氨酸、维生素D、维生素B_(12)、腰椎L_(1～4)和左股骨颈骨密度比较差异有统计学意义(P均0.05);Rho相关性和回归分析表明,同型半胱氨酸与维生素D和B_(12)在绝经后非骨质疏松症和同型半胱氨酸与维生素B_(12)在绝经后骨质疏松症女性中呈显著负相关。结论高水平同型半胱氨酸可以通过绝经后非骨质疏松症患者维生素D水平和绝经后骨质疏松症女性维生素B_(12)水平预测。