The prevalence and impact of overweight and obesity in an Australian obstetric population

OBJECTIVE: To assess the prevalence and impact of overweight and obesity in an Australian obstetric population. DESIGN, SETTING AND PARTICIPANTS: The Mater Mother's Hospital (MMH), South Brisbane, is an urban tertiary referral maternity hospital. We reviewed data for the 18 401 women who were booked for antenatal care at the MMH, delivered between January 1998 and December 2002, and had a singleton pregnancy. Of those women, 14 230 had an estimated pre-pregnancy body mass index (BMI) noted in their record; 2978 women with BMI < or = 20 kg/m2 were excluded from further study; the remaining 11 252 women were divided into four categories: "normal" (BMI 20.01-25 kg/m(2)), "overweight" (BMI 25.01-30 kg/m(2)), "obese" (BMI 30.01-40 kg/m(2)) and "morbidly obese" (BMI > 40 kg/m(2)). MAIN OUTCOME MEASURES: Prevalence of overweight and obesity in an obstetric population; maternal, peripartum and neonatal outcomes associated with raised BMI. RESULTS: Of the 14 230 women, 6443 (45%) were of normal weight, and 4809 (34%) were overweight, obese or morbidly obese. Overweight, obese and morbidly obese women were at increased risk of adverse outcomes (figures represent adjusted odds ratio [AOR] [95% CI]): hypertensive disorders of pregnancy (overweight 1.74 [1.45-2.15], obese 3.00 [2.40-3.74], morbidly obese 4.87 [3.27-7.24]); gestational diabetes (overweight 1.78 [1.25-2.52], obese 2.95 [2.05-4.25], morbidly obese 7.44 [4.42-12.54]); hospital admission longer than 5 days (overweight 1.36 [1.13-1.63], obese 1.49 [1.21-1.86], morbidly obese 3.18 [2.19-4.61]); and caesarean section (overweight 1.50 [1.36-1.66], obese 2.02 [1.79-2.29], morbidly obese 2.54 [1.94-3.32]). Neonates born to obese and morbidly obese women had an increased risk of birth defects (obese 1.58 [1.02-2.46], morbidly obese 3.41 [1.67-6.94]); and hypoglycaemia (obese 2.57 [1.39-4.78], morbidly obese 7.14 [3.04-16.74]). Neonates born to morbidly obese women were at increased risk of admission to intensive care (2.77 [1.81-4.25]); premature delivery (< 34 weeks' gestation) (2.13 [1.13-4.01]); and jaundice (1.44 [1.09-1.89]). CONCLUSIONS: Overweight and obesity are common in pregnant women. Increasing BMI is associated with maternal and neonatal outcomes that may increase the costs of obstetric care. To assist in planning health service delivery, we believe that BMI should be routinely recorded on perinatal data collection sheets.     

单纯性肥胖患者血清C反应蛋白水平的变化

为研究血清高敏C反应蛋白(high sensitivity CRP,hs-CRP)水平与肥胖及胰岛素抵抗的关系,采用乳胶增强速率免疫散射比浊法测定31例单纯性肥胖患者及30例正常人血清高敏C反应蛋白水平。结果显示,单纯肥胖组和体质量正常组血清CRP水平[中位数(四分位距)]分别为2.78(1.27-4.67)和0.62(0.32-2.32)mg/L,单纯肥胖组明显高于正常组(P<0.01)。血清CRP与体质量指数(BMI)、胰岛素敏感性简易参数(HOMA-IR)、空腹胰岛素(FINS)及空腹血糖(FPG)分别呈正相关(r=0.443,0.454,0.406及0.306,P<0.01),与腰围和脂肪百分比也呈正相关(P<0.01)。提示单纯性肥胖患者血清CRP水平较正常人升高;血清CRP与胰岛素抵抗密切相关,慢性炎症参与了胰岛素抵抗的发生和发展。     

Relationship of physical activity vs body mass index with type 2 diabetes in women

CONTEXT: Physical inactivity and body mass index (BMI) are established independent risk factors in the development of type 2 diabetes; however, their comparative importance and joint relationship with diabetes are unclear. OBJECTIVE: To examine the relative contributions and joint association of physical activity and BMI with diabetes. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 37 878 women free of cardiovascular disease, cancer, and diabetes with 6.9 years of mean follow-up. Weight, height, and recreational activities were reported at study entry. Normal weight was defined as a BMI of less than 25; overweight, 25 to less than 30; and obese, 30 or higher. Active was defined as expending more than 1000 kcal on recreational activities per week. MAIN OUTCOME MEASURE: Incident type 2 diabetes, defined as a new self-reported diagnosis of diabetes. RESULTS: During the follow-up, 1361 cases of incident diabetes occurred. Individually, BMI and physical activity were significant predictors of incident diabetes. Compared with normal-weight individuals, the multivariate-adjusted hazard ratio (HR) was 3.22 (95% confidence interval [CI], 2.69-3.87) for overweight individuals and 9.09 (95% CI, 7.62-10.8) for obese individuals. For overall activity (kilocalories expended per week), compared with the least active first quartile, the multivariate-adjusted HRs were 0.91 (95% CI, 0.79-1.06) for the second quartile, 0.86 (95% CI, 0.74-1.01) for the third, and 0.82 (95% CI, 0.70-0.97) for the fourth (P for trend =.01). In the combined analyses, overweight and obese participants, whether active or inactive, had significantly elevated risks, compared with normal-weight active individuals. The multivariate-adjusted HRs were 1.15 (95% CI, 0.83-1.59) for normal-weight inactive, 3.68 (95% CI, 2.63-5.15) for overweight active, 4.16 (95% CI, 3.05-5.66) for overweight inactive, 11.5 (95% CI, 8.34-15.9) for obese active, and 11.8 (95% CI, 8.75-16.0) for obese inactive participants. CONCLUSIONS: Although BMI and physical inactivity are independent predictors of incident diabetes, the magnitude of the association with BMI was greater than with physical activity in combined analyses. These findings underscore the critical importance of adiposity as a determinant of diabetes.     

Who's overweight? Comparison of the medical definition and community views

OBJECTIVE: To investigate the extent to which people who are medically defined as overweight perceive themselves to be overweight. DESIGN: Secondary data analysis of the National Health Survey and the National Nutrition Survey conducted by the Australian Bureau of Statistics in 1995. PARTICIPANTS: 10,652 people aged 18 years and over (5076 men, 5576 women) in a multistage cluster sample of households throughout Australia. MAIN OUTCOME MEASURES: Body mass index (BMI) based on measured height and weight; self-reported perception of body weight (underweight, acceptable weight, or overweight). RESULTS: Among people with a measured BMI > or = 25, 49.3% of men (95% CI, 48.1%-50.5%) and 72.0% of women (95% CI, 70.8%-73.1%) considered themselves overweight. Among those with a measured BMI < 25, 3.4% of men (95% CI, 2.8%-4.1%) and 12.4% of women (95% CI, 11.4%-13.3%) considered themselves overweight. Older women were less likely to perceive themselves as overweight than younger women. The lowest BMI at which at least half the respondents considered themselves overweight was 26 to < 27 for women aged 18-59 years, and 28 to < 29 for older women and men. CONCLUSION: For many people, particularly men and older women, the meaning of "overweight" differs from the medical definition. Clinical and public health weight reduction programs which do not take this into account are unlikely to be successful.     

Prevalence of overweight/obesity in Chinese children

BACKGROUND: The purpose of this paper was to report the prevalence of overweight/obesity by area, age, and gender in the year 2000 and to explore at what age adiposity rebound as measured by BMI occurs for Chinese children. METHODS: A cross-sectional study was carried out among 262,738 children aged 3.5-6.4 years in 26 counties/cities in China. Weight and height were measured from March 2000 through July 2000 by local trained health workers. International age- and gender-specific BMI cut-off points were used to obtain comparable prevalence rates of overweight/obesity. Multiple logistic regression was used to estimate odds ratios (OR) of being overweight/obesity for different comparisons. RESULTS: There were 19,390 overweight (16,738) or obese (2,652) children, resulting in an overall prevalence rate of 7.4% (95% CI: 7.3-7.5%). Girls were more likely to be overweight or obese than boys (OR = 1.14, 95% CI: 1.11-1.17). Compared with children living in the southern urban area, multivariate ORs for those living in northern rural and southern rural areas were 2.58 and 1.15, respectively. Compared with children aged 6.0-6.4 years old, multivariate ORs for children aged 3.5, 4.0, 4.5, 5.0 and 5.5 years were 1.96, 1.88, 1.56, 1.53, and 1.11, respectively (p<0.001). CONCLUSIONS: Childhood overweight/obesity in Chinese children in 2000 is similar to the conditions of Great Britain or the U.S. in the 1980s or earlier. Age at adiposity rebound as measured by BMI for Chinese children is >6.5 years old.     

Serum leptin levels and adiposity in adult Chinese: a preliminary observation

Ｏｂｊｅｃｔｉｖｅ　ＴｏｅｓｔａｂｌｉｓｈｎｏｒｍａｌｓｅｒｕｍｌｅｐｔｉｎｌｅｖｅｌｓｉｎＣｈｉｎｅｓｅａｎｄｉｎｖｅｓｔｉｇａｔｅｔｈｅｒｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｓｅｒｕｍｌｅｐｔｉｎｌｅｖｅｌｓａｎｄｂｏｄｙｆａｔ,ｇｅｎｄｅｒ,ａｇｅａｎｄａｎｄｒｏｇｅｎＭｅｔｈｏｄｓ　Ｓｅｒｕｍｌｅｐｔｉｎｌｅｖｅｌｓｗｅｒｅｍｅａｓｕｒｅｄｉｎ７７ｌｅａｎ（ＢＭＩ＜２５）ａｎｄ２８ｏｖｅｒｗｅｉｇｈｔｏｒｏｂｅｓｅ（ＢＭＩ≥２５）ｓｕｂｊｅｃｔｓｂｙａｒａｄｉｏｉｍｍｕｎｏａｓｓａｙ（…     

C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus

CONTEXT: Inflammation is hypothesized to play a role in development of type 2 diabetes mellitus (DM); however, clinical data addressing this issue are limited. OBJECTIVE: To determine whether elevated levels of the inflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP) are associated with development of type 2 DM in healthy middle-aged women. DESIGN: Prospective, nested case-control study. SETTING: The Women's Health Study, an ongoing US primary prevention, randomized clinical trial initiated in 1992. PARTICIPANTS: From a nationwide cohort of 27 628 women free of diagnosed DM, cardiovascular disease, and cancer at baseline, 188 women who developed diagnosed DM over a 4-year follow-up period were defined as cases and matched by age and fasting status with 362 disease-free controls. MAIN OUTCOME MEASURES: Incidence of confirmed clinically diagnosed type 2 DM by baseline levels of IL-6 and CRP. RESULTS: Baseline levels of IL-6 (P<.001) and CRP (P<.001) were significantly higher among cases than among controls. The relative risks of future DM for women in the highest vs lowest quartile of these inflammatory markers were 7.5 for IL-6 (95% confidence interval [CI], 3.7-15.4) and 15.7 for CRP (95% CI, 6.5-37.9). Positive associations persisted after adjustment for body mass index, family history of diabetes, smoking, exercise, use of alcohol, and hormone replacement therapy; multivariate relative risks for the highest vs lowest quartiles were 2.3 for IL-6 (95% CI, 0.9-5.6; P for trend =.07) and 4.2 for CRP (95% CI, 1.5-12.0; P for trend =.001). Similar results were observed in analyses limited to women with a baseline hemoglobin A(1c) of 6.0% or less and after adjustment for fasting insulin level. CONCLUSIONS: Elevated levels of CRP and IL-6 predict the development of type 2 DM. These data support a possible role for inflammation in diabetogenesis.     

2004年西安市11～17岁青少年超重和肥胖现状及其相关因素

目的 了解西安市11～17岁青少年超重和肥胖的现状及其相关因素.方法 通过多阶段整群抽样方法抽取西安市6城区30所中学1 804名学生（11～17岁）,测量其身高、体重并计算体质指数（BMI）,采用2000美国疾病预防控制中心（CDC）低体重标准及中国肥胖工作组（WGOC）推荐的超重和肥胖判定标准计算低体重率、超重和肥胖率.出生体重、家庭住址、经济状况、家长学历、职业和身高、体重等信息通过家长填写问卷采集.结果 西安市青少年总超重肥胖率为17.4%（超重率11.2%、肥胖率6.2%）,其中男性总超重肥胖率为20.2%,女性为14.4%.低体重率为2.7%.多元logistic回归显示：性别、年龄、家庭居住地、家庭经济状况及父母体重与青少年超重和肥胖显著相关（P＜0.05）.经性别、年龄调整后,城区青少年超重和肥胖的风险是郊区的2.7倍（95%可信区间1.8～4.0）;家庭富裕青少年的超重和肥胖风险是不富裕家庭的1.6倍（95%可信区间1.04～2.5）;父母超重或肥胖的青少年超重肥胖发病风险是父母体重正常的1.8倍（95%可信区间1.3～2.5）.结论 超重和肥胖已经成为影响西安市青少年健康的一个主要公共卫生问题,多发于城区、经济富裕或父母肥胖的家庭,以男性居多.     

Overweight and obesity from childhood to adulthood: a follow-up of participants in the 1985 Australian Schools Health and Fitness Survey

OBJECTIVE: To examine overweight and obesity in Australian children followed through to adulthood. DESIGN AND PARTICIPANTS: A cohort study of 8498 children aged 7-15 years who participated in the 1985 Australian Schools Health and Fitness Survey; of these, 2208 men and 2363 women completed a follow-up questionnaire at age 24-34 years in 2001-2005. MAIN OUTCOME MEASURES: Height and weight were measured in 1985, and self-reported at follow-up. The accuracy of self-reported data was checked in 1185 participants. Overweight and obesity in childhood were defined according to international standard definitions for body mass index (BMI), and, in adulthood, as a BMI of 25-29.9 and > or =30 kg/m2, respectively, after correcting for self-report error. RESULTS: In those with baseline and follow-up data, the prevalence of overweight and obesity in childhood was 8.3% and 1.5% in boys and 9.7% and 1.4% in girls, respectively. At follow-up, the prevalence was 40.1% and 13.0% in men and 19.7% and 11.7% in women. The relative risk (RR) of becoming an obese adult was significantly greater for those who had been obese as children compared with those who had been a healthy weight (RR = 4.7; 95% CI, 3.0-7.2 for boys and RR = 9.2; 95% CI, 6.9-12.3 for girls). The proportion of adult obesity attributable to childhood obesity was 6.4% in males and 12.6% in females. CONCLUSION: Obesity in childhood was strongly predictive of obesity in early adulthood, but most obese young adults were a healthy weight as children.     

Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions.

OBJECTIVE: To review the prevalence of overweight and obesity in Australian children and adolescents in two national samples, 10 years apart, using the new standard international definitions of the International Obesity Task Force Childhood Obesity Working Group. DESIGN: Body mass index (BMI) cut-off points defining overweight and obesity were applied to the individual BMI values in the two cross-sectional samples. SETTING: Australian community. PARTICIPANTS: 8,492 schoolchildren aged 7-15 years (Australian Health and Fitness Survey, 1985) and 2,962 children aged 2-18 years (National Nutrition Survey, 1995). MAIN OUTCOME MEASURE: Prevalence of overweight and obesity. RESULTS: In the 1985 sample, 9.3% of boys and 10.6% of girls were overweight and a further 1.7% [corrected] of boys and 1.6% [corrected] of girls were obese. In the 1995 sample, overall 15.0% of boys (varied with age from 10.4% to 20.0%) and 15.8% of girls (varied with age from 14.5% to 17.2%) were overweight, and a further 4.5% of boys (2.4%-6.8%) and 5.3% of girls (4.2%-6.3%) were obese. The prevalence of overweight and obesity in the 1995 sample peaked at 12-15 years in boys and 7-11 years in girls. In schoolchildren aged 7-15 years, the rates represent a relative risk of overweight in 1995 compared with 1985 of 1.79 (95% CI, 1.59-2.00) and of obesity of 3.28 (95% CI, 2.51-4.29). Compared with previous estimates from these samples, the revised prevalence data are slightly higher for the 1985 data and considerably higher for the 1995 data. CONCLUSION: The secular trend of increasing overweight and obesity in the decade from 1985 and the high prevalence rates in Australian children and adolescents are a major public health concern.     

Years of life lost due to obesity

CONTEXT: Public health officials and organizations have disseminated health messages regarding the dangers of obesity, but these have not produced the desired effect. OBJECTIVE: To estimate the expected number of years of life lost (YLL) due to overweight and obesity across the life span of an adult. DESIGN, SETTING, AND SUBJECTS: Data from the (1) US Life Tables (1999); (2) Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994); and (3) First National Health and Nutrition Epidemiologic Follow-up Study (NHANES I and II; 1971-1992) and NHANES II Mortality Study (1976-1992) were used to derive YLL estimates for adults aged 18 to 85 years. Body mass index (BMI) integer-defined categories were used (ie, <17; 17 to <18; 18 to <19; 20 to <21; 21 to 45; or > or =45). A BMI of 24 was used as the reference category. MAIN OUTCOME MEASURE: The difference between the number of years of life expected if an individual were obese vs not obese, which was designated YLL. RESULTS: Marked race and sex differences were observed in estimated YLL. Among whites, a J- or U-shaped association was found between overweight or obesity and YLL. The optimal BMI (associated with the least YLL or greatest longevity) is approximately 23 to 25 for whites and 23 to 30 for blacks. For any given degree of overweight, younger adults generally had greater YLL than did older adults. The maximum YLL for white men aged 20 to 30 years with a severe level of obesity (BMI >45) is 13 and is 8 for white women. For men, this could represent a 22% reduction in expected remaining life span. Among black men and black women older than 60 years, overweight and moderate obesity were generally not associated with an increased YLL and only severe obesity resulted in YLL. However, blacks at younger ages with severe levels of obesity had a maximum YLL of 20 for men and 5 for women. CONCLUSION: Obesity appears to lessen life expectancy markedly, especially among younger adults.     

Correlates of body mass index in the 1990 Ontario Health Survey.

OBJECTIVES: To determine the average body mass index (BMI) and the prevalence of overweight and obesity among people aged 20 to 64 years, to identify sociodemographic, lifestyle and health variables that correlate with overweight and obesity, and, through a comparison of the results with those from an earlier survey, to determine whether prevalence has changed over time. DESIGN: Cross-sectional survey. SETTING: Ontario. PARTICIPANTS: The 1990 Ontario Health Survey surveyed 61,239 people representative of the Ontario population. The authors' analyses were restricted to those aged 20 to 64 years, excluding pregnant women. In the multivariate analyses they included only people with no missing values for any of the variables in the models (n = 26,306). OUTCOME MEASURES: BMI (weight in kilograms divided by height in metres squared) was used to measure healthy weight (BMI between 20 and 25), overweight (BMI greater than 25) and obesity (BMI greater than 27). RESULTS: The prevalence of obesity among men and women was 33.6% and 22.8% respectively (adjusted odds ratio [OR] 1.78, 95% confidence interval [CI] 1.63 to 1.95). There was a positive relation with age (adjusted OR 1.53 [95% CI 1.24 to 1.89] for age 25 to 29 years and 2.78 [95% CI 2.20 to 3.51] for age 50 to 54 years compared with age 20 to 24 years) and an inverse relation with education level (postsecondary education v. primary education: adjusted OR 0.65 [95% CI 0.54 to 0.79]). Analysis of birthplace showed that the prevalence of obesity was lowest among those born in Asia (compared with Canadian born: adjusted OR 0.36 [95% CI 0.27 to 0.47]). The prevalence was higher among former smokers than among those who had never smoked (adjusted OR 1.20 [95% CI 1.18 to 1.22]). People with more health problems and those who rated their health as fair or poor were more likely to be obese. The estimates of the prevalence of obesity were higher than those reported in the 1985 Health Promotion Survey for both sexes in all three age groups examined. CONCLUSIONS: These self-reported data indicate that overweight and obesity remain important health problems in Ontario, and the prevalence appears to be increasing.     

不同人体质量指数下肺炎患儿临床特征的对比

目的：探讨不同人体质量指数（BMI）下肺炎患儿临床特征的差异,为其临床研究提供可参考依据。方法选择中国人民武装警察部队山东省总队医院诊断为肺炎的患儿160例,根据其BMI分为BMI正常组（15．00＜BMI＜18．00kg／m2）、超重组（18．00≤BMI＜20．00kg／m2）和肥胖组（BMI≥20．00kg／m2）。详细记录其临床表现及相关检查结果,对其临床特征进行比较。结果160例肺炎患儿中正常体质量组33例（20．62％）,超重组87例（54．38％）,肥胖组40例（25．00％）;BMI正常组住院时间明显低于肥胖组与超重组（P＜0．05）。肥胖组高敏C‐反应蛋白（hs‐CRP）、白细胞介素‐8（IL‐8）均高于BMI正常组与超重组（P＜0．05）;超重组hs‐CRP、IL‐8均高于BMI正常组（P＜0．05）。肥胖组IgG、IgA均低于BMI正常组与超重组（P＜0．05）,而CD4、CD4／CD8高于BMI正常组与超重组（P＜0．05）;超重组IgG、IgA均低于BMI正常组（P＜0．05）,CD4、CD4／CD8高于BMI正常组（P＜0．05）。肥胖组一秒用力呼气容积（FEV1）、肺活量（VC）、FEV1／用力肺活量（FVC）均低于BMI正常组与超重组（P＜0．05）。结论随着BMI的增加,肺炎患儿的住院时间延长、肺功能更容易受损,炎性反应及免疫异常在肥胖患儿肺炎的发生过程中起重要作用。     

肥胖与代谢综合征患者血清lipocalin-2、hsCRP变化

目的:探讨肥胖、代谢综合征患者血清中性粒细胞明胶酶相关脂质运载蛋白2( lipocalin-2,LCN2)、超敏C反应蛋白(hsCRP)的变化及其相关性.方法:选择104例正常体重者、107例超重者和52例肥胖者进行体格检查、口服葡萄糖耐量试验及血脂、胰岛素(FINS)、hsCRP、lipocalin-2检测;计算胰岛素抵抗指数(HOMAIR).结果:(1)肥胖患者血清lipocalin-2增高,校正年龄和性别后,血清lipocalin-2水平与体重指数(BMI)、腰围、体脂含量、hsCRP正相关(P＜0.05),与HDL-C水平负相关(P=0.001);(2)校正年龄、性别和BMI后,血清lipocalin-2水平仍与hsCRP正相关(P＜0.05),与HDL-C水平负相关(P=0.023);多元逐步回归分析显示,hsCRP是血清lipocalin-2的独立决定因素;(3)代谢综合征患者lipocalin-2水平增高,但lipocalin-2与代谢紊乱数目未见显著性关联.结论:肥胖与代谢综合征患者血清lipocalin-2和hsCRP均增高,且lipocalin-2水平与hsCRP正相关.lipocalin-2可以作为肥胖相关低度炎症的新的标志物.     

Overweight, obesity and metabolic syndrome in rural southeastern Australia

OBJECTIVE: To measure the prevalence of overweight, obesity and the metabolic syndrome (MetS) in rural Australia. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional surveys were conducted in two rural areas in Victoria and South Australia in 2004-2005. A stratified random sample of men and women aged 25-74 years was selected from the electoral roll. Data were collected by a self-administered questionnaire, physical measurements and laboratory tests. MAIN OUTCOME MEASURES: Prevalence of overweight and obesity, as defined by body mass index (BMI) and waist circumference; prevalence of MetS and its components. RESULTS: Data on 806 participants (383 men and 423 women) were analysed. Based on BMI, the prevalence of overweight and obesity combined was 74.1% (95% CI, 69.7%-78.5%) in men and 64.1% (95% CI, 59.5%-68.7%) in women. Based on waist circumference, the prevalence of overweight and obesity was higher in women (72.4%; 95% CI, 68.1%-76.7%) than men (61.9%; 95% CI, 57.0%-66.8%). The overall prevalence of obesity was 30.0% (95% CI, 26.8%-33.2%) based on BMI (> or = 30.0 kg/m(2)) and 44.7% (95% CI, 41.2%-48.1%) based on waist circumference (> or = 102 cm [men] and > or= 88 cm [women]). The prevalence of MetS as defined by the US National Cholesterol Education Program Adult Treatment Panel III 2005 criteria was 27.1% (95% CI, 22.7%-31.6%) in men and 28.3% (95% CI, 24.0%-32.6%) in women; based on International Diabetes Federation criteria, prevalences for men and women were 33.7% (95% CI, 29.0%-38.5%) and 30.1% (95% CI, 25.7%-34.5%), respectively. Prevalences of MetS, central (abdominal) obesity, hyperglycaemia, hypertension and hypertriglyceridaemia increased with age. CONCLUSIONS: In rural Australia, prevalences of MetS, overweight and obesity are very high. Urgent population-wide action is required to tackle the problem.     

Relationship of insulin resistance and overweight with cortisol and dehydroepiandrosterone-sulfate levels

BACKGROUND: Our objective was to assess the relationship of hormones such as cortisol and dehydroepiandrosterone-sulfate (DHEA-S) with insulin resistance and overweight. METHODS: We designed and conducted a cross-sectional, observational survey consisting of home visits within a previously defined area of Mexico City. The study included 303 apparently healthy volunteers from a middle-class socioeconomic urban community. We measured glucose, cholesterol, triglycerides, insulin, cortisol, and DHEA-S. Insulin resistance (IR) was defined as belonging to the first quartile of fasting glucose/insulin ratio (G/IR) distribution or fourth quartile of IR (HOMA). Overweight was defined as body mass index (BMI) > or =25 kg/m(2). RESULTS: To predict IR in women < or =35 years of age, principal component analysis (PCA) disclosed three components: 1) cholesterol, BMI, and diastolic blood pressure (DBP); 2) cholesterol, triglycerides, and cortisol, and 3) dehydroepiandrosterone-sulfate [DHEA-S]. Solely the latter (DHEA-S) was significantly associated with IR (odds ratio [OR] = 1.80, confidence interval 95% [CI 95%] 1.11-2.91, p = 0.015). For men < or =35 years of age, there were two components: 1) cholesterol, triglycerides, BMI, and DBP, and 2) DHEA-S, cholesterol, and cortisol. Component 1 was significantly associated with IR (OR = 5.65; CI 95% 1.62-19.65, p = 0.006). To predict overweight in women >35 years of age, there were three components, including 1) cholesterol and triglycerides, 2) cortisol, and 3) DHEA-S and G/IR. Component 2 was significantly associated with overweight (OR = 0.38, CI 95% 0.23-0.64, p = 0.000). CONCLUSIONS: In women < or =35 years of age, high DHEA-S levels were associated with insulin resistance, which suggests that in young women DHEA-S exerts anti-estrogenic action, perhaps caused by its competitive binding with the estrogen receptor. Additionally, in women >35 years of age, low cortisol levels were associated with overweight. These associations were not identified for the male subgroup.     

The disease burden associated with overweight and obesity.

CONTEXT: Overweight and obesity are increasing dramatically in the United States and most likely contribute substantially to the burden of chronic health conditions. OBJECTIVE: To describe the relationship between weight status and prevalence of health conditions by severity of overweight and obesity in the US population. DESIGN AND SETTING: Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III), which was conducted in 2 phases from 1988 to 1994. PARTICIPANTS: A total of 16884 adults, 25 years and older, classified as overweight and obese (body mass index [BMI] > or =25 kg/m2) based on National Institutes of Health recommended guidelines. MAIN OUTCOME MEASURES: Prevalence of type 2 diabetes mellitus, gallbladder disease, coronary heart disease, high blood cholesterol level, high blood pressure, or osteoarthritis. RESULTS: Sixty-three percent of men and 55% of women had a body mass index of 25 kg/m2 or greater. A graded increase in the prevalence ratio (PR) was observed with increasing severity of overweight and obesity for all of the health outcomes except for coronary heart disease in men and high blood cholesterol level in both men and women. With normal-weight individuals as the reference, for individuals with BMIs of at least 40 kg/m2 and who were younger than 55 years, PRs were highest for type 2 diabetes for men (PR, 18.1; 95% confidence interval [CI], 6.7-46.8) and women (PR, 12.9; 95% CI, 5.7-28.1) and gallbladder disease for men (PR, 21.1; 95% CI, 4.1-84.2) and women (PR, 5.2; 95% CI, 2.9-8.9). Prevalence ratios generally were greater in younger than in older adults. The prevalence of having 2 or more health conditions increased with weight status category across all racial and ethnic subgroups. CONCLUSIONS: Based on these results, more than half of all US adults are considered overweight or obese. The prevalence of obesity-related comorbidities emphasizes the need for concerted efforts to prevent and treat obesity rather than just its associated comorbidities.     

不同体型孕妇脂肪因子Chemerin与妊娠糖尿病糖脂代谢的研究

目的:探讨孕前不同体型孕妇的脂肪因子Chemerin及脂质代谢情况与妊娠糖尿病相关关系。方法:选取2018年10月—2019年10月在内蒙古科技大学包头医学院第一附属医院产科门诊定期产检及住院待产的孕妇,参照2013年WHO诊断标准于孕24～28周诊断为妊娠糖尿病(GDM)患者60例,根据孕前体质量指数(BMI)水平分为标准组(BMI 18.5～23.9 kg/m²)、超重组(BMI 24～28 kg/m²)、肥胖组(BMI≥28 kg/m²),每组20例;另外选取血糖正常、BMI为18.5～23.9 kg/m²的孕妇20例作为对照组,所有入选对象均于37～40周分娩。入院后详细记录孕妇年龄、身高、孕前体重;同时分别测定各组分娩前空腹血糖、空腹胰岛素、糖化血红蛋白、血脂(总胆固醇、甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇)、超敏CRP(hs-CRP),并计算胰岛素抵抗指数(HOMA-IR),用酶联免疫吸附法测定外周血Chemerin值。结果:GDM三组Chemerin、空腹血糖、空腹胰岛素、...     

Smoking-induced leukocytosis can persist after cessation of smoking

BACKGROUND: Associations between smoking and leukocytosis or elevated hemoglobin concentrations in the blood need to be validated using multivariate analysis. METHODS: A total of 2,511 male subjects aged 25-62 years participated in an annual health examination held at their workplace. The relationship between white blood cells (WBC) and hemoglobin (Hb) levels in blood and smoking status was then evaluated using a cross-sectional survey and multiple logistic regression analysis. Age, body mass index (BMI), smoking and drinking status, diastolic blood pressure, and physical activity were used as covariate factors. RESULTS: Odds ratios (ORs) and 95% confidence intervals (95% CIs) of WBC of >9,000 counts/mm3 of total blood for current smokers and ex-smokers with a period of 5-9.9 years since smoking cessation vs. that of nonsmokers were 12.1 (7.0-21.0) and 3.8 (1.2-12.0), respectively. OR (95% CI) of Hb level >16 g/dL of total blood for current smokers vs. nonsmokers was 1.6 (1.1-2.3). Significant ORs for elevated Hb level in total blood were also observed for age (OR, 1.0; 95% CI, 0.9-1.0), BMI >25 (OR, 2.2; 95% CI, 1.6-3.1), and diastolic blood pressure of >90 mmHg (OR, 2.2; 95% CI, 1.5-3.2). CONCLUSIONS: Current smoking is associated with increase in WBC count and Hb levels in total blood, the former relationship recognized in subjects who have stopped smoking for 5-9.9 years. Obesity and aging are inversely related with Hb level in blood.