老年慢性肾衰患者瘦素水平与营养状况的关系

目的　探讨瘦素与老年慢性肾功能衰竭患者营养状况的关系。方法　检测 2 6例老年慢性肾功能衰竭患者和 2 8例正常老年人的生化指标、血浆瘦素及胰岛素水平 ,同时应用生物电阻抗方法测量身体脂肪容量和体重指数 (BMI)。结果　两组年龄与BMI相匹配。老年慢性肾衰组平均血浆瘦素水平显著高于对照组 (P <0 .0 1 ) ,两组女性的平均血浆瘦素水平均显著高于男性的平均血浆瘦素水平 (P <0 .0 5)。肾衰组男性的平均血浆瘦素水平稍高于对照组男性的平均血浆瘦素水平 ,而二者的平均身体脂肪容量和leptin/fat比值有统计学意义。两组的血浆瘦素水平均与身体脂肪容量、BMI、胰岛素浓度呈显著的正相关 ;而未发现与白蛋白、前白蛋白、血肌酐、尿素氮和肌酐清除率有相关关系。结论　瘦素可以作为评价老年CRF患者营养状况的灵敏指标之一     

Obesity and depressive symptoms in elderly Koreans: Evidence for the “Jolly Fat” hypothesis from the Ansan Geriatric (AGE) Study

The current study is to examine the association between obesity and depressive symptoms and to test the validity of “Jolly Fat” hypothesis in elderly Koreans. A total of 1229 elderly (60-85 years old) Koreans selected from the Ansan Geriatric Study participated in this study. Body mass index (BMI) was calculated from the measured weights and heights of subjects. Overweight and obese were defined as BMI ≥23 and ≥25, respectively. Depressive symptoms were measured using the 30-item Korean version of the Geriatric Depression Scale (K-GDS), with a cutoff point of 18. The prevalence of depressive symptoms in elderly Korean women was higher than in men (20.9% vs. 9.2%, p < 0.001). Among elderly women, higher mean values of obesity indexes, such as weight, BMI, waist circumference, waist-hip ratio, and body fat mass, were found in normal subjects than in those with depressive symptoms. No such differences were found in elderly men. Obese elderly women were less likely to suffer from depressive symptoms compared to those with apparently normal weight (odds ratio (OR) = 0.63, 95% CI: 0.41-0.96). This inverse association was evident after adjustment for confounders, such as age, education, personal expenses, smoking, alcohol consumption, regular exercise, self-perceived health, presence of chronic disease, and cognitive function. Our data are consistent with the “Jolly Fat” hypothesis being valid only in women, but not in men, among elderly Koreans. A causal relationship between obesity and depressive symptoms should be evaluated in future studies in elderly Korean women.     

上海某社区中老年人群超重与肥胖的现况调查

目的:了解上海社区中老年人超重和肥胖的患病情况以及肥胖相关疾病的患病风险。方法:在上海市嘉定区40岁及以上居民中进行问卷调查、体格检查及生化检测,对其中数据完整的10 375名居民进行统计分析。根据体质量指数(BMI),按照WHO标准界定肥胖和超重者。采用线性回归法分析BMI与一些危险因素的相关性,并采用Logistic回归法分析超重以及肥胖状态对于各种代谢相关性疾病患病风险的影响。结果:本研究人群的BMI均值为25.1±3.3,超重和肥胖的患病率分别为42.92%和7.27%;多元线性回归分析显示:校正多种混杂因素后,随着BMI水平的上升,腰围、收缩压、舒张压、空腹血糖、餐后2 h血糖、总胆固醇、低密度脂蛋白胆固醇、三酰甘油随之增加(均P<0.01),高密度脂蛋白胆固醇随之下降(P     

Cardiovascular risk factors in the elderly: the Tehran Lipid and Glucose Study

BACKGROUND: Coronary artery disease is becoming more prevalent in developing countries, particularly in urban areas. Because the proportion of elderly individuals in the population is on the rise, this study was conducted to determine the prevalence of cardiovascular risk factors among the Tehran urban elderly population. DESIGN AND METHODS: Among 15,005 urban individuals of 3 years old and over who had been chosen in a cross-sectional phase of a longitudinal study in Tehran, there were 1,799 people aged 60 years and over. The prevalence and distribution of high blood pressure, cigarette smoking, dyslipoproteinemia, diabetes mellitus and obesity were determined in this population. Dietary intake was assessed in a subsidiary of 54 people by means of two 24 h dietary recalls. RESULTS: The percentage of women with two or more cardiovascular disease risk factors was significantly greater than in men (74% compared with 53%, P < 0.001). One fourth of men and 55% of women had high serum cholesterol levels (>/=240 mg/dl). The prevalence of diabetes mellitus and impaired glucose tolerance was 24% and 21% in men and 29% and 20% in women, respectively. The prevalence of obesity (body mass index >/=30 kg/m(2)) was 15% for men and 36% for women. Fifty-five per cent of men and 94% of women had high waist-to-hip ratios (>0.95 in men and >0.8 in women). The mean percentage values of energy intake derived from carbohydrate, protein and fat were 60.5 +/- 8.0, 11.5 +/- 2.0 and 27.8 +/- 8.9, respectively. CONCLUSIONS: The prevalence of cardiovascular risk factors among the Tehran urban elderly population is high. Some efforts should be made to reverse the recent trend towards increasing age-related mortality and morbidity rates of coronary heart disease.     

Prevalence of metabolic syndrome in an elderly Swedish population

Abstract The prevalence of the metabolic syndrome in different elderly European populations has not been well studied. The aim of this study was to measure the prevalence of metabolic syndrome, as well as its individual components, in an elderly Swedish cohort. A random sample of 778 individuals (372 men and 406 women) was selected from a 70-year-old cohort in the H70 study, a gerontological and geriatric population study carried out in Gothenburg, Sweden. The study included medical and treatment history assessments, laboratory procedures and physical examinations to determine the presence of each of the five components of the metabolic syndrome as defined by the National Cholesterol Education Program Adult Treatment Panel III. Of the 508 adults (243 men and 265 women) included in the study, 22.6% had metabolic syndrome. The prevalence was higher in men (26.3%) than in women (19.2%). One third of the total sample had at least one of the five risk factors for metabolic syndrome. High blood pressure (≥130/85 mmHg or use of antihypertensive/diuretic medication) was the most prevalent risk factor in both men (68.3%) and women (50.2%), while abdominal obesity was the overall second most common risk factor (27.2% of men and 42.7% of women). The prevalence of high fasting plasma glucose (≥110 mg/dl or use of antidiabetic medication) was 29.0% in men and 19.1% in women. Metabolic syndrome was prevalent in a significant proportion of this elderly Swedish population, highlighting the underdiagnosis of a condition that is important to treat.     

The prevalence and trends of overweight,obesity and nutrition‐related non‐communicable diseases in the Arabian Gulf States

This paper reviews studies on the prevalence of overweight, obesity and related nutrition‐related non‐communicable diseases in Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and the UAE. Obesity is common among women; while men have an equal or higher overweight prevalence. Among adults, overweight plus obesity rates are especially high in Kuwait, Qatar and Saudi Arabia, and especially among 30–60 year olds (70–85% among men; 75–88% among women), with lower levels among younger and elderly adults. The rate of increase in obesity was pronounced in Saudi Arabia and Kuwait. Prevalence of obesity is high among Kuwaiti and Saudi pre‐schoolers (8–9%), while adolescent overweight and obesity are among the highest in the world, with Kuwait having the worst estimates (40–46%); however, comparison of child data is difficult because of differing standards. Among nutrition‐related non‐communicable diseases, hypertension and diabetes levels are very high and increase with age, with the UAE performing the worst because of a rapid rate of increase between 1995 and 2000. Additional monitoring of the prevalence of metabolic syndrome and cancers is necessary. Nationally representative longitudinal surveys with individual, household and community‐level information are needed to determine the importance of various factors that contribute to these troubling trends.     

First national epidemiological survey on the prevalence of obesity and abdominal fat distribution in Greek adults

AIM: To provide estimates of the prevalence of obesity, overweight and body fat distribution among the adult population of Greece. DESIGN: Epidemiological, cross-sectional nationwide survey providing self-reported data. Subjects: A total of 17,341 men and women aged from 20 to 70 years and classified into five 10-year age groups participated. The selection was conducted by stratified sampling through household family members of Greek children attending school. MEASUREMENTS: The participants reported data on weight, height, waist and hip circumference. BMI and waist-to-hip ratio were calculated. Abdominal obesity was defined as waist circumference > or = 102 cm in men and > or = 88 cm in women. RESULTS: In the total population, the mean BMI was 26.5 kg/m2, (27.3 in men, 25.7 in women). The overall prevalence of obesity was 22.5%, (26% in men, 18.2% in women) while that of overweight was 35.2% (41.1% in men, 29.9% in women). The percentages of obesity and overweight in men were similar in almost all age groups, while in women they progressively increased with age. Abdominal obesity was more frequent among women than men (35.8 vs. 26.6%, respectively), especially after the age of 50. CONCLUSIONS: Excess body weight is reaching epidemic proportions in Greece and obesity rates are among the highest, if not the highest, in Western society. The problem affects particularly men, and women after menopause. Interestingly, more women than men present with abdominal obesity. Preventive and treatment strategies are urgently needed to stop the obesity epidemic in this Mediterranean European country.     

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

OBJECTIVES: To evaluate and compare physical activity patterns of urban and rural dwellers in Cameroon, and study their relationship with obesity, diabetes and hypertension. METHODS: We studied 2465 subjects aged >or=15 y, recruited on the basis of a random sampling of households, of whom 1183 were urban dwellers from Yaoundé, the capital city of Cameroon and 1282 rural subjects from Bafut, a village of western Cameroon. They all had an interviewer-administered questionnaire for the assessment of their physical activity and anthropometric measurements, blood pressure and fasting blood glucose determination. The procedure was satisfactorily completed in 2325 (94.3%) subjects. Prevalences were age-adjusted and subjects compared according to their region, sex and age group. RESULTS: Obesity was diagnosed in 17.1 and 3.0% urban and rural women, respectively (P<0.001), and in 5.4 vs 1.2% urban and rural men, respectively (P<0.001). The prevalence of hypertension was significantly higher in urban vs rural dwellers (11.4 vs 6.6% and 17.6 vs 9.1% in women and men, respectively; P<0.001). Diabetes was more prevalent in urban compared to rural women (P<0.05), but not men. Urban subjects were characterized by lower physical activity (P<0.001), light occupation, high prevalence of multiple occupations, and reduced walking and cycling time compared to rural subjects. Univariate analysis showed significant associations between both physical inactivity and obesity and high blood pressure. The relationship of physical inactivity with hypertension and obesity were independent in both urban and rural men, but not in women. Body mass index, blood pressure and glycaemia were higher in the first compared with the fourth quartiles of energy expenditure. CONCLUSION: Obesity, diabetes and hypertension prevalence is higher in urban compared to rural dwellers in the populations studied. Physical activity is significantly lower and differs in pattern in urban subjects compared to rural. Physical inactivity is associated with these diseases, although not always significant in women.     

Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen

OBJECTIVE: This is a population survey conducted in 1991-92 among residents aged > or =30 years in Kin-Hu, Kinmen, with a 77.7% response rate to study the prevalence of hyperuricemia and hyperuricemia associated gout. A stratified analysis based on sex and age was used to assess the interaction and analyze the associated risk factors for hyperuricemia and gout. METHODS: Hyperuricemia was defined as uric acid > or =7.0 mg/dl for men and > or =6.0 mg/dl for women. Gout was clinically diagnosed by a senior rheumatologist based on patient's history and examination according to the clinical criteria of Wallace. Basic demographic and lifestyle variables as well as biochemical data were collected. RESULTS: The prevalence of hyperuricemia was 25.8% (391/1515) in men and 15.0% (250/1670) in women. The prevalence of gout among hyperuricemic subjects was 11.5% for men and 3% for women. According to age spectrum, the risk factor for hyperuricemia was hyperlipidemia in young adults (30-39 yrs); lifestyle and some clinical syndromes played a significant role in middle aged persons (40-59 yrs). The different risk factors between the sexes in middle age were alcohol consumption effect in men and menopause effect in women. Impaired renal function and use of diuretics became the important factors in the elderly (> or =60 yrs). The risk factors for gout among either the general population or subjects with hyperuricemia were concentration of serum uric acid, alcohol consumption, and central obesity. CONCLUSION: Risk factors for hyperuricemia tended to be different with respect to sex and age. Alcohol consumption and central obesity were independent predictors of gout among hyperuricemic subjects irrespective of uric acid level.     

Prevalence of diabetes,impaired fasting glucose and insulin resistance syndrome in an urban Indian population

OBJECTIVE: Epidemiological study among urban subjects in western India to determine prevalence of diabetes, insulin resistance syndrome (IRS) and their risk factors. METHODS: Randomly selected adults > or =20 years were studied using stratified sampling. Target sample was 1,800 (men 960, women 840). 1123 subjects (response 62.4%) were evaluated and blood samples were available in 532 men and 559 women (n=1091, 60.6%). Measurement of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Atherosclerosis risk factors were determined using current guidelines. Diabetes was diagnosed when the subject was a known diabetic or fasting blood glucose was > or =126 mg/dl, impaired fasting glucose (IFG) diagnosed when fasting glucose was 110-125 mg/dl. IRS was diagnosed when any three of-IFG, high triglycerides >150 mg/dl, low HDL cholesterol (men<40 mg/dl, women<50 mg/dl), central obesity (men>102 cm, women>88 cm), or high normal blood pressure (>130/>85 mmHg) or hypertension-were present. RESULTS: Diabetes was present in 70 men (13.2%) and 64 women (11.5%). Age-adjusted prevalence of diabetes was 9.3% in men (95% confidence intervals (CI) 6.7-11.8), 8.1% in women (CI 5.8-10.4) and 8.6% overall (CI 6.9-10.3). IFG was in 28 men (5.3%) and 29 women (5.2%). IRS was present in 52 men (9.8%) and 114 women (20.4%) with age-adjusted prevalence of 7.9% in men (CI 6.7-9.1) and 17.5% in women (CI 14.4-20.6) with an overall prevalence of 12.8% (CI 10.8-14.8). Other metabolic abnormalities of IRS in men and women were high triglycerides in 32.1 and 28.6%, low HDL cholesterol in 54.9 and 90.2%; central obesity in 21.8 and 44.0%, and high normal blood pressure or hypertension in 35.5 and 32.4%. IFG subjects had similar atherosclerosis risk factor profile as normal subjects while those with IRS and diabetes had significantly greater prevalence of obesity, central obesity, hypertension, high triglycerides and low HDL (P<0.01). CONCLUSIONS: There is s significant prevalence of diabetes and IRS in this urban Indian population. Subjects with diabetes as well as IRS have greater prevalence of obesity, central obesity, hypertension, hypertriglyceridemia and low HDL as compared with normal subjects.     

Epidemiology of hyperglycemia in elderly persons

BACKGROUND: Our study used data collected in the Chung-Shing-Shin-Tseun community of Taiwan in May 1998 to evaluate the distribution of fasting glucose and the relation between hyperglycemia and the cardiovascular risk factors and sociodemographic factors in elderly persons. METHODS: Individuals aged 65 and over were recruited as study subjects. A total of 1,093 persons, out of 1,774 registered residents, were contacted in face-to-face interviews. The response rate was 61.6%. However, only 586 respondents took blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. The t test, chi-square analysis, and multivariate logistic regression were used to study the significant correlates of hyperglycemia. RESULTS: Of the individuals in our study, 66.0% were men and 34.0% were women. The mean age was 73.1 +/- 5.3 years. The mean values of fasting glucose were 5.5 +/- 1.6 mmol/L in elderly men and 5.7 +/- 2.1 mmol/L in elderly women. The hyperglycemic rates determined by modified World Health Organization criteria (> or =6.05 mmol/L) were 20.2% in elderly men and 20.7% in elderly women. Multivariate logistic regression analysis was used, after controlling the other covariates, to show that the significant related factors in hyperglycemia were obesity (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.02-4.5), high systolic pressure (OR 2.1, 95% CI 1.1-4.0), and hypertriglyceridemia (OR 2.1, 95% CI 1.03-4.4). No significant association was found between hyperglycemia and gender, age, high diastolic pressure, abnormal glutamic pyruvic transaminase, hypercholesterolemia, hyperuricemia, renal function impairment, education level, retirement status, or marital status. CONCLUSIONS: The prevalence of hyperglycemia is high in elderly persons. Hyperglycemia is significantly associated with obesity, high systolic pressure, and hypertriglyceridemia in elderly persons. It is important to examine other cardiovascular risk factors if one cardiovascular risk factor is observed.     

Chronic medical conditions based obesity phenotypes: A two-step cluster analysis of a representative sample of obese American adults

Background and objectiveAlthough obesity is a heterogeneous disease, little is known regarding chronic medical conditions (CMCs) that defines variability in obese populations. The characterization of obese populations using CMCs rather than categorization using BMI alone can advance understanding of obesity. The aims of this study are to phenotype obesity in a large representative sample of non-Hispanic White (NHW), non-Hispanic Black (NHB) and Mexican American (MA) obese adults using CMCs, and assess relationship between resulting phenotypes and self-rated health (SRH).MethodsSex-specific two-step cluster analysis was used to phenotype obese participants (n = 12,547) to CMC-based clusters. The prevalence of CMCs and lifestyle risk factors in each cluster was assessed. Sex and race/ethnic specific association between cluster membership and SRH was determined using odds ratio (OR) from logistic regression analysis.ResultsDistinct subgroups of obese men and women were observed: moderate dyslipidemic healthy young obese men, hypertensive-dyslipidemic middle-age obese men, hypertensive young obese men, hypertensive-dyslipidemic-asthmatic middle-age obese men, and syndemic elderly obese men, healthy young obese women, hypertensive-dyslipidemic middle-age obese women, dyslipidemic young adult obese women, syndemic middle-age obese women, and syndemic elderly obese women. Participants in the more CMCs symptomatic clusters reported high rates of behavioral risk factors and showed significantly greater odds of poor SRH than participants in the less symptomatic clusters. Compared to obese persons who are asymptomatic for CMCs, syndemic elderly obese and women men had much higher increased ORs for poor SRH with values of 3.88 [95% CI = 2.41–6.26], 3.96 [95% CI = 1.86–8.30] and 7.25 [95% CI = 2.41–9.6] for NHW, NHB and MA men, respectively. The corresponding ORs for women are 4.08 [95% CI = 2.71–6.14], 4.01 [95% CI = 2.40–6.69], and 2.62 [95% CI = 1.32–5.19], respectively.ConclusionObesity treatment and intervention should consider heterogeneity within obese persons and pay greater attention to obesity related co-morbidities and metabolic manifestations.     

Prevalence of obesity and metabolic syndrome in Korean adults

We studied the prevalence and trend of obesity and metabolic syndrome in Korean adults aged at least 20 years using Korean National Health Examination and Nutrition Survey data from 1998 and 2001. The prevalence of body mass index (BMI) ≥ 25 kg m^?2 among Korean adults in 2001 was 32.9% in men and 27.4% in women, and the number of Korean men with BMI ≥ 25 kg m^?2 has increased markedly since 1998. A significant positive association between obesity and socioeconomic status was found in Korean men, whereas a significant negative association was identified in Korean women. The prevalence rates of waist circumference (WC) ≥ 90 cm in men and WC ≥ 85 cm in women were 23.4% and 23.1% in 2001 respectively. The prevalence of metabolic syndrome among Korean adults was 15–30% according to various criteria of metabolic syndrome. Future studies are needed to determine the changes in prevalence of obesity and contributing factors for obesity in Koreans.     

Risk factors for coronary artery disease in old persons in an academic hospital-based geriatrics practice

BACKGROUND: Risk factors for coronary artery disease (CAD) in old men and women include age, cigarette smoking, hypertension, diabetes mellitus, dyslipidemia, and obesity. OBJECTIVE: To investigate the association of risk factors with prevalence of CAD. METHODS: We performed a retrospective analysis of charts for all old persons seen during the period from 1 January 1998 through 15 June 1999 at an academic hospital-based geriatric practice to investigate associations of risk factors with prevalence of CAD among old persons. We studied 467 men, mean age 80 +/- 8 years, and 1444 women, mean age 81 +/- 8 years. RESULTS: CAD was present in 201 of 467 men (43%) and in 473 of 1444 women (33%; P < 0.0001). Risk factors for CAD according to univariate analysis were age (P < 0.0001 for women), cigarette smoking (P < 0.0001 for men and women), hypertension (P < 0.0001 for men and women), diabetes mellitus (P < 0.0001 for men and women), obesity (P < 0.0001 for men and women), and serum levels of total cholesterol (P < 0.0001 for men and P = 0.0001 for women), low-density lipoprotein (LDL) cholesterol (P < 0.0001 for men and P = 0.001 for women), and high-density lipoprotein (HDL) cholesterol (inverse association; P = 0.0001 for men and women). Stepwise logistic regression analysis showed that significant independent risk factors for CAD were cigarette smoking (odds ratio 6.7 for men), hypertension (odds ratios 3.3 for men and 2.7 for women), and serum levels of HDL cholesterol (odds ratio 0.83 for men and women) and LDL cholesterol (odds ratios 1.10 for men and 1.09 for women). CONCLUSIONS: Significant independent risk associations with prevalence of CAD among old persons were found for cigarette smoking by men, hypertension in men and women, and serum levels of HDL cholesterol (inverse association) in men and women, and of LDL cholesterol in men and women.     

Prevalence of obesity in Kuwait and its relation to sociocultural variables

This study ascertains the prevalence of obesity and its relationship with some sociocultural characteristics in Kuwaiti society. The sample involved 212 men and 212 women, most of whom are overweight and obese. Grades 1 (body mass index [BMI] > 25-30 kg m(-2)), 2 (BMI > 30-40) and 3 (BMI > 40) of obesity characterize 71.2% of the sample. Most individuals are in grade 2 obesity, 37.2%. Grade 1 obesity is seen in 31.4% of the sample. Obesity increases with age, especially in women. The heaviest women are aged 60 years or older (mean BMI of 33.8), about the same mean as in the 50-59-year-old age group. The highest frequency of grades 1 and 2 obesity occur in women 30-39 years old. Fifty per cent of the underweight women are 20-29 years old or are over 60 years old. Most women of normal weight are 20-29 years old. For the men, 60% of the underweight sample are 50-60 years old. Male respondents between 30 and 39 years old are the heaviest; 42.7% of the sample are within grade 1 obesity and 40.7% of the sample within grade 2 obesity. The smallest percentage of men in grades 1 and 2 obesity are those 50-59 years old. An association was found between some sociocultural variables and obesity. Data show an increasing prevalence of obesity in Kuwait compared with some previous studies.     

Diabetes in the Caribbean: results of a population survey from Spanish Town, Jamaica.

AIMS: To characterize the prevalence of diabetes and associated risk attributes in the Jamaican population. METHODS: A random population sample was recruited by door-to-door canvassing (n = 1303). A final participation of 60% was achieved. Oral glucose tolerance testing was conducted after an overnight fast and standard anthropometric and demographic data were collected. RESULTS: The prevalence of Type 2 diabetes mellitus was 9.8% (95% confidence interval (CI) 7.2-12.4) among men and 15.7% (95% CI 13.1-18.3) among women with an overall prevalence of 13.4% (95% CI 11.5-15.2). Impaired glucose tolerance was found among 12.3% of men and 14.7% of women. The sex patterns were consistent with a fourfold excess of obesity in women compared to men. The odds ratios for diabetes, fourth vs. first quartiles were 5.42 (95% CI 2.02-16.88) in men and 3.32 (95% CI 1.73-6.63) in women for body mass index (BMI) and 17.39 (95% CI 3.86-78.27) in men and 5.48 (95% CI 2.84-11.00) in women for WHR in a logistic model controlling for age. The population attributes risk percentage, for diabetes, of being overweight and having waist-to-hip ratio (WHR) greater than the median (0.80) were 66% and 80%, respectively. The contribution of central obesity, as characterized by WHR, was also significant in sex-specific multivariate models that included age and BMI. Prevalent hypertension and family history of diabetes were likewise associated with increased odds of having the disease. CONCLUSIONS: The prevalence of diabetes in Jamaica now exceeds that observed among European-origin populations and reflects the emerging epidemic of obesity. The excess risk for this population could not be attributed entirely to relative weight. The pronounced sexual dimorphism in diabetes prevalence most likely reflects the substantial excess of obesity among women compared to men. Like many other island nations, Caribbean societies now appear to be at substantial risk of diabetes.     

Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women

BACKGROUND: Surprisingly, the prevalence of polycystic ovary syndrome (PCOS) in otherwise unselected overweight or obese women is unknown, despite obesity being frequent in patients with PCOS. We conducted the present study to obtain an unbiased estimate of the prevalence of PCOS in unselected overweight and obese premenopausal women from Spain. METHODS: All premenopausal women reporting to the Department of Endocrinology, Hospital Universitario Ramón y Cajal, for dietary treatment of overweight or obesity from May 2002 to December 2005 were prospectively recruited. Women referred for any other reason were automatically excluded to avoid selection bias. Diagnosis of PCOS relied on the presence of clinical and/or biochemical hyperandrogenism, oligo-ovulation, and exclusion of secondary causes. Anthropometric measurements, hirsutism scores, and androgen, gonadotropin, metabolic, and lipid profiles were obtained. RESULTS: Of a total of 113 consecutive women recruited, 32 (28.3%) were diagnosed as having PCOS (95% confidence interval, 20.0%-36.6%). The prevalence of PCOS was not different when considering the degree of obesity. Another 3 women presented with hyperandrogenemia without oligo-ovulation, 2 had idiopathic hirsutism, 2 had chronic oligomenorrhea without clinical or biochemical hyperandrogenism, and 2 had oligomenorrhea with hyperprolactinemia, precluding the diagnosis of PCOS. The remaining 72 women (63.7%) had no evidence of hyperandrogenism or reproductive abnormalities. CONCLUSIONS: Our results demonstrate a 28.3% prevalence of PCOS in overweight and obese women from Spain, which is markedly increased compared with the 5.5% prevalence of PCOS in lean women of our country. Therefore, PCOS must be routinely ruled out in overweight and obese premenopausal women seeking advice for weight loss.     

Correlation between fatty liver and coronary risk factors: a population study of elderly men and women in Nagasaki, Japan.

The relation between fatty liver, detected by ultrasonography as a marker of visceral fat accumulation, and coronary risk factors was studied in 810 elderly men and 1,273 elderly women in Nagasaki, Japan from 1990 to 1992. The prevalence of fatty liver was 3.3% in the male and 3.8% in the female non-obese participants (BMI, body mass index < 26.0 kg/m2) and 21.6% in the male and 18.8% in the female obese participants (26.0 kg/m2 < or = BMI). Fatty liver was significantly (p < 0.01) related to hypercholesterolemia and hypertriglyceridemia in the men and to hypertension, hypercholesterolemia, low-HDL cholesterol, hypertriglyceridemia and diabetes mellitus or impaired glucose tolerance (DM+IGT) in the women independent of age, obesity, smoking and drinking. Non-obesity with fatty liver, rather than obesity with or without fatty liver, had the highest odds ratio for hypertension and low-HDL cholesterol in the men and for hypercholesterolemia, low-HDL cholesterol, hypertriglyceridemia and DM+IGT in the women. The prevalence of fatty liver is the same in elderly men and women, and fatty liver is an independent correlate of coronary risk factors in the elderly.     

Trace element status and fatty acids metabolism during healthy ageing: an example of a population from the Tunisian eastern coast

Micronutrients as well as essential fatty acids are indispensable for the correct functioning of the organism. The risk of disturbance in the associated nutrition and metabolism is expected to increase during ageing. In addition, it seems that trace elements are involved in the fatty acids metabolism. The aim of the present study was then to assess age-related changes in trace elements status and in plasma essential fatty acids composition with an emphasis on the desaturase activity estimation. Two hundred healthy Tunisian subjects (30-85 years old) were recruited and separated into two subgroups: elderly (65-85 years old) and middle-aged (30-60 years old). The findings revealed that plasma zinc and calcium concentrations significantly decreased according to age. The prevalence of zinc deficiency was therefore shown to increase in old age (over 60% of elderly subjects were deficient or at risk of deficiency). No age-related changes were obtained for copper or magnesium status. The Δ6 desaturase, involved in the EFAs conversion, was shown to decrease according to age and to be associated with the plasma zinc level. Since elderly subjects were at risk of nutritional imbalance, it would be interesting to set optimal dietary proportion. This will help to prevent age-associated alterations and diseases for a better and healthy ageing.