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181.
Pharmacotherapy of obesity   总被引:4,自引:0,他引:4  
The growing recognition of the health risks of obesity coupled with the difficulties in treating it successfully by lifestyle modification predicates a need for effective drug treatment. The history of drug treatment in the second half of the 20th century is, however, one of disappointment and concern over drug toxicity. However, the advances in our understanding of the mechanism of weight control, together with improved ways of evaluating anti-obesity drugs, has resulted in two effective compounds, sibutramine and orlistat, becoming available for clinical use. Sibutramine has actions on both energy intake and expenditure and had been shown to enhance weight loss and weight maintenance achieved by diet, in simple obesity as well as when accompanied by complications of diabetes or hypertension. About 50-80% of patients can achieve a >5% loss, significantly more than if patients receive the same lifestyle intervention with placebo. Orlistat, which acts peripherally to block the absorption of dietary fat, has had similar results in clinical trials; a recent study (XENDOS) has just reported results which show that the enhanced, albeit modest, weight loss achieved with orlistat delays the development of diabetes over a 4-year period. A number of other compounds are expected to complete or enter clinical trials over the next decade. There is considerable optimism that we will soon have the pharmacological tools needed to make the treatment of obesity feasible.  相似文献   
182.

Introduction

The migration of African populations to Europe poses problems of adaptation that may increase the risk of cardiovascular disease. We assessed the cardiovascular risk of Cape Verdean university students studying in Portugal (CV-PT) compared to Cape Verdean university students in Cape Verde (CV-CV) and to Caucasian university students in Portugal (PT-PT).

Methods

A cross-sectional study was performed comparing three university populations, 54-62% female, aged 19-28 years: CV-PT (n=104), CV-CV (n=100) and PT-PT (n=100). Anthropometric data, blood pressure (BP), pulse wave velocity (PWV), albuminuria and estimated 24-h urinary sodium excretion (UNa+) using the Kawasaki formula were measured.

Results

The CV-PT group had higher body mass index and sodium intake (UNa+: CV-PT 235±91, CV-CV 197±85, PT-PT 194±90 mmol/24 h; p<0.001), more sedentary lifestyles and worse socioeconomic, integration and adaptation indices compared to CV-CV and PT-PT. CV-PT and CV-CV also had higher systolic BP (CV-PT 119±12 mmHg, CV-CV 121±15 mmHg, PT-PT 107±14 mmHg; p<0.001), PWV (CV-PT 8.7±1.1, CV-CV 8.8±1.8, PT-PT 8.0±1.2 m/s; p<0.04), and albuminuria (CV-PT 13.0±34.1, CV-CV 9.2±21.2, PT-PT 5.7±6.4 μg/mg creatinine; p<0.04).

Conclusion

Cape Verdean university students in Portugal (CV-PT) have higher albuminuria, BP and PWV values than PT-PT and CV-CV students, associated with less healthy lifestyles, higher cardiovascular risk and worse socioeconomic conditions. The higher cardiovascular risk in these African immigrants means that it is important to implement measures to address modifiable risk factors, to improve integration and to promote healthy lifestyles.  相似文献   
183.

Background and Aims

Physical inactivity, unhealthy diet, smoking and heavy drinking are four key unhealthy lifestyle behaviors (ULB) that may influence body weight and obesity development. More recently, sedentary time has been recognized as another potentially emerging ULB related to obesity. We therefore investigated the association of multiple ULB with overweight/obesity and abdominal obesity among Brazilian adolescents.

Methods and Results

This cross-sectional study involved 62,063 students (12–17 years). Physical inactivity, high screen time, low fiber intake, binge drinking and smoking were self-reported and combined to a ULB risk score, ranging from zero to five. Participants were classified as overweight/obese or with abdominal obesity using sex and age-specific cut-off points for BMI and waist circumference, respectively. Poisson regression models were used to examine the associations between ULB with overweight/obesity and abdominal obesity, adjusted for socio-demographic variables. Overall, 2.3%, 18.9%, 43.9%, 32.3% and 2.6% of participants reported zero, one, two, three and four/five ULB, respectively. Higher ULB risk score was associated with overweight/obesity and abdominal obesity in a dose–response gradient. Among 32 possible combinations of ULB, the three most prevalent combinations (physical inactivity + low fiber intake; high screen time + low fiber intake; physical inactivity + high screen time + low fiber intake) were positively associated with general and abdominal obesity.

Conclusions

Our findings suggest a synergistic relationship between ULB and general and abdominal obesity. Preventive efforts targeting combined ULB should be sought to reduce the prevalence of general and abdominal obesity in Brazilian youth.  相似文献   
184.
185.
Excessive salt intake causes hypertension and cardiovascular diseases (CVDs). B-type natriuretic peptide (BNP) is synthesized and released from the ventricle, and is a surrogate marker reflecting various CVDs. Moreover, when a slight BNP elevation is shown, it leads to a poor prognosis in the general population. However, the relationship between salt intake and BNP levels in the general population remains unclear, especially in those without hypertension and heart diseases.In this study, we recruited 1404 participants without hypertension and electrocardiogram abnormalities, who received regular annual health check-ups in Japan. Plasma BNP levels were measured, and daily salt intake levels were evaluated using urinary samples. In addition, some clinical parameters were obtained, and the data were cross-sectionally analyzed.The median of plasma BNP levels was 10.50 pg/mL, and daily salt intake was 8.50 ± 1.85 g. When dividing participants into quartiles according to daily salt intake, those with the highest daily salt intake revealed the highest plasma BNP levels. Plasma BNP levels were significantly and positively associated with daily salt intake. Moreover, multiple linear regression analyses revealed that plasma BNP levels showed a significant positive association with daily salt intake levels after adjustments.Plasma BNP levels were significantly and positively associated with daily salt intake after adjustment in the general population. Plasma BNP levels may be a surrogate marker reflecting salt-induced heart diseases.  相似文献   
186.
The modern diet is closely linked to the consumption of processed foods, causing an increase in the intake of salt, simple sugars, phosphorus and added potassium. This excess intake is associated with an increased risk of obesity, diabetes, hypertension and chronic kidney disease (CKD). CKD, which according to data from the ENRICA study affects 15% of the population, magnifies its impact due to the higher prevalence of diabetes and hypertension and due to limitations in the management of sodium and phosphorus. The intake of these products far exceeds the established recommendations, assuming 72% of total sodium, 25-35% of phosphorus, 12-18% of potassium and exceeding 10% of the caloric intake in simple sugars. Measures are necessary to reduce their contribution through nutritional advice, labeling review, education campaigns on healthy habits, fees and institutional actions that involve food safety agencies, industry, distribution and scientific societies.  相似文献   
187.
Background and aimsHigh sodium intake is associated with a higher risk of a wide range of diseases. We aimed to estimate the pattern and trend of the global disease burden associated with high sodium intake from 1990 to 2019.Methods and resultsWe obtained numbers and rates of death and disability-adjusted life year (DALY) attributable to high sodium intake by sex, socio-demographic index, and country from the Global Burden of Disease Study 2019. We calculated the estimated annual percentage change to evaluate the age-standardized rate (ASR) of the burden attributable to high sodium intake between 1990 and 2019. We further calculated the contribution of population growth, population aging, and age-specific rates of death and DALY to the net change in the total number of deaths and DALYs attributable to high sodium intake. From 1990 to 2019, global age-standardized rates of death and DALY attributable to high sodium intake substantially decreased for both sexes. However, there were significant increases in the total numbers of deaths and DALYs attributable to high sodium intake, which were driven by population growth and population aging. The attribution of population growth and population aging varied widely across countries, with a higher contribution of population growth in most developing countries and a higher contribution of population aging in countries with slow population growth.ConclusionsAlthough the global burden attributable to high sodium intake in terms of age-standardized rate declined from 1990 to 2019, the absolute burden increased significantly, which was driven by population growth and population aging.  相似文献   
188.
Cholesteryl ester transfer protein (CETP) is one of the factors that regulate plasma levels of HDL-cholesterol. To identify the factors that may regulate CETP activity, and to determine to what extent CETP is correlated with physiologic concentrations of lipoprotein, we performed an epidemiologic study in 586 healthy volunteers (317 males and 269 females, mean age 52.2 ± 10.9 years). CETP activity in these subjects was 192.96 ± 48.73 (mean ± S.D.) nmol/ml/h and distributed to a wide range (60–450 nmol/ml/h). Using multiple regression analysis, we found significant positive correlations between CETP activity and LDL-cholesterol (P < 0.03), apolipoprotein (apo) E (P < 0.005) and LCAT activity (P < 0.001). CETP activities showed significant negative correlation with apo A-I (P < 0.03). However, CETP activity showed no significant correlation either with HDL cholesterol or with apo B. One-way layout analysis of variance showed that alcohol drinking and cigarette smoking significantly reduced CETP activity, but there was no significant association between CETP activity and body mass index. Although CETP activities were significantly higher in females than in males (P < 0.001), multiple regression analysis showed no correlation between CETP activity and age in either the males or the females. Our results suggest that CETP activity regulates the concentration of apo A-I and LDL-cholesterol, and that such activity may be influenced by gender, alcohol consumption and cigarette smoking.  相似文献   
189.
190.
In this research article, we propose a class of models for positive and zero responses by means of a zero‐augmented mixed regression model. Under this class, we are particularly interested in studying positive responses whose distribution accommodates skewness. At the same time, responses can be zero, and therefore, we justify the use of a zero‐augmented mixture model. We model the mean of the positive response in a logarithmic scale and the mixture probability in a logit scale, both as a function of fixed and random effects. Moreover, the random effects link the two random components through their joint distribution and incorporate within‐subject correlation because of the repeated measurements and between‐subject heterogeneity. A Markov chain Monte Carlo algorithm is tailored to obtain Bayesian posterior distributions of the unknown quantities of interest, and Bayesian case‐deletion influence diagnostics based on the q‐divergence measure is performed. We apply the proposed method to a dataset from a 24hour dietary recall study conducted in the city of São Paulo and present a simulation study to evaluate the performance of the proposed methods. Copyright © 2015 John Wiley & Sons, Ltd.  相似文献   
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