Overweight and Obesity in the Eastern Mediterranean Region
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Anxiety and Social Anxiety Symptoms among Overweight Females Seeking Treatment for Obesity. Menan A. Rabie 1 , Nahla Fawzy Abo-El-Ezz 2 , Mervat Salah-El-Din 3
Lecturer of Psychiatry, Faculty of Medicine, Ain Shams University 1 Lecturer of Community Medicine, Faculty of Medicine, Ain Shams University
Professor of Nutrition, Faculty of Agriculture, Ain Shams University 3
INTRODUCTION: Obesity has become an epidemic problem worldwide. In the Egyptian community the status of overweight has reached an alarming level. About one out of four cases of obesity is associated with a mood or anxiety disorder, but the causal relationship and complex interplay between both problems is still unclear.
anxiety symptoms among the female subjects seeking treatment for obesity; and to examine the correlation of anxiety and social anxiety symptoms with age, multiparity, duration of obesity, Body Mass Index (BMI) and Binge Eating (BE).
used to screen 93 Arab females who are seeking treatment at the obesity clinic. The assessment tools included: Questionnaire on Eating and Weight Patterns-Revised (QEWP-R), Beck Anxiety Inventory (BAI), and Brief Social Phobia Scale (BSPS).
cons tuted 68.8% of the sample with a highly significant rela onship between binge eating and anxiety symptoms. A comparison between social anxiety symptoms among obese subjects and subjects having morbid obesity showed high statistically significant difference. Correlation of the social anxiety symptoms with the duration since last pregnancy and the duration of obesity was significant.
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CONCLUSION: The prevalence of social anxiety symptoms among overweight females seeking treatment for obesity is relatively high.
Journal of American Science 2011;7(8):240-250 Body Mass Index as an Assessment Tool for Overweight and Obesity in School Children in El-Qalubia Governorate Ahmed Mahmoud Ezzat1, Mahmoud Fawzy EL Gendy2, Doaa Refaey Soliman1, Ashraf Hassan Mohammed3 and Hazem Salem Abdel Azeem Abou Ghazy1 1Department of Pediatrics, Faculty of Medicine, Benha University, Benha, Egypt
2Department of Community, faculty of medicine, Benha University, Benha, Egypt
3Department of Physical therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt Abstract: AIM: Aim of the study was to design BMI (Body Mass Index) charts to the studied group, to determine the prevalence of overweight and obesity in the group and to provide suitable recommendations for prevention overweight and obesity. METHODS: This was a cross sec onal study that included 500 students collected from primary and preparatory schools, aged 7-15 years and living in El-Qalubia governorate through the academic year 2010/2011. A self administered questionnaire was used; it included some socio-demographic characteristics and measurements for weight and height of students. Data was collected, revised and entered using the statistical package SPSS. RESULTS: Obese students represented 20.4% of students. Obesity increased in younger students with mean age 9.33±2.094 years and increased in male students (55% of all obese students), while overweight increased in female students (54.5% of all overweight students). Female students recorded higher values over males in weight during the first 5 years of age (7-11 years old) then, boys become heavier than girls. Moreover, there was a gradual increase in height of female and male students at age 7-15 years old. In addition, the current study indicated that female students have the higher values of BMI from age 7 to 15 years old than males. 24
J Nutr Biochem. 2011 Mar 16. [Epub ahead of print] Acute and Chronic Saturated Fatty Acid Treatment as a Key Instigator of the TLR- Mediated Inflammatory Response in Human Adipose Tissue, in Vitro. Youssef-Elabd EM, McGee KC, Tripathi G, Aldaghri N, Abdalla MS, Sharada HM, Ashour E, Amin AI, Ceriello A, O'Hare JP, Kumar S, McTernan PG, Harte AL.
Biochemistry Department, National Research Centre, Dokki, Giza, Egypt 12622.
Abstract A post-prandial increase in saturated fatty acids (SFAs) and glucose (Glc) activates an inflammatory response, which may be prolonged following restoration of physiological SFAs and Glc levels - a finding referred to as 'metabolic memory'. This study examined chronic and oscillating SFAs and Glc on the inflammatory signalling pathway in human adipose tissue (AT) and adipocytes (Ads) and determined whether Ads are subject to "metabolic memory." Abdominal (Abd) subcutaneous (Sc) explants and Ads were treated with chronic low glucose (L-Glc): 5.6 mM and high glucose (H- Glc): 17.5 mM, with low (0.2 mM) and high (2 mM) SFA for 48 h. Abd Sc explants and Ads were also exposed to the aforementioned treatment regimen for 12-h periods, with alternating rest periods of 12 h in L-Glc. Chronic treatment with L-Glc and high SFAs, H-Glc and high SFAs up- regulated key factors of the nuclear factor-κB (NFκB) pathway in Abd Sc AT and Ads (TLR4, NFκB; P<.05), whilst down-regula ng MyD88. Oscilla ng Glc and SFA concentrations increased TLR4, NFκB, IKKβ (P<.05) in explants and Ads and up-regulated MyD88 expression (P<.05). Both tumor necrosis factor α and interleukin 6 (P<.05) secre on were markedly increased in chronically treated Abd Sc explants and Ads whilst, with oscillating treatments, a sustained inflammatory effect was noted in absence of treatment. Therefore, SFAs may act as key instigators of the inflammatory response in human AT via NFκB activation, which suggests that short-term exposure of cells to uncontrolled levels of SFAs and Glc leads to a longer- term inflammatory insult within the Ad, which may have important implications for patients with obesity and Type 2 diabetes.
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Saudi Med J. 2011 Sep; 32(9):919-24. Subclinical Atherosclerosis in Obese Adolescents with Normal Left Ventricular Function. Abdel-Wahab AM, Atwa HA, El-Eraky AZ, El-Aziz MA. Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. Abstract OBJECTIVE: To assess the impact of obesity on carotid intima media thickness and left ventricular (LV) mass in obese adolescents. METHODS: The study included 52 obese adolescents (mean age 14.16+/- 2.64 years) and 52 healthy adolescents who served as a control group (mean age 12+/-2.3 years), who were a ended the outpa ent clinic at Suez Canal University Hospital, Ismailia, Egypt. The study population was submitted for medical history, clinical examination, laboratory investigations (fasting blood sugar and lipid profile), and echocardiographic examination of LV mass and dimensions. Assessment of carotid intima- media thickness was carried out by using carotid duplex. All children had normal LV function.
triglyceride, LDL-C, and low HDL-C compared to the control group. Also, there was a significant increase in blood pressure, carotid intima media thickness, LV mass, and LV mass index. There was a significant correlation between BMI and dyslipidemia, blood pressure, carotid intima/media thickness, LV mass, and posterior wall thickness. Carotid intima-media thickness had a significant correlation with increased LDL-C and low HDL-C, blood pressure, LV mass, and posterior wall thickness. CONCLUSION: Obesity in childhood and adolescents is associated with subclinical atherosclerosis. Although obese children had no LV dysfunction, yet there are LV structure changes.
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Obesity Research (2002)10, 1087–1091; doi: 10.1038/oby.2002.147 Amylin, Food Intake, and Obesity Tarek K. Reda *,† , Allan Geliebter * and F. Xavier Pi-Sunyer *
* New York Obesity Research Center, Department of Medicine, St.- Luke's-Roosevelt Hospital Center, Columbia University–College of Physicians and Surgeons, New York 2. †
Correspondence: Tarek Reda, M.D., M.P.H., Dr.P.H., Nutrition Medical Center, 18 Abdel La f El-Soufani, Sidi Gaber 21311, Alexandria, Egypt. E-mail: tarekreda@link.net
Amylin, also known as islet amyloid polypep de, iden fied in 1987, is a naturally occurring hormone, released by the cells of the pancreas and consists of 37 amino acids. Amylin seems to decrease food intake through both central and peripheral mechanisms and indirectly by slowing gastric emptying. The mean basal amylin concentration is higher in obese than in lean human subjects. The amylin response to oral glucose is also greater in obese subjects, whether or not they have impaired glucose tolerance. The elevated amylin levels in obesity may lead to down-regulation of amylin receptors and lessen the impact of postprandial amylin secretion on satiety and gastric emptying. Amylin administration may overcome resistance at target tissues, delay gastric emptying, and have potential for inducing weight loss in obese individuals.
Indian J Dermatol Venereol Leprol. 2010 Sep-Oct;76(5):538-42. Increased Tissue Leptin Hormone Level And Mast Cell Count in Skin Tags: A Possible Role of Adipoimmune in the Growth of Benign Skin Growths. El Safoury O, Fawzi M, Abdel Hay RM, Hassan AS, El Maadawi Z, Rashed L. Department of Dermatology, Faculty of Medicine, Cairo University, Egypt.
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BACKGROUND: Skin tags (ST) are common tumors. They mainly consist of loose fibrous tissue and occur on the neck and major flexures as small, soft, pedunculated protrusions. Decrease in endocrine, hormone level and other factors are thought to play a role in the evolution of ST. Leptin is an adipocyte-derived hormone that acts as a major regulatory hormone for food intake and energy homeostasis. Leptin deficiency or resistance can result in profound obesity and diabetes in humans. A role of mast cell in the pathogenesis of ST is well recognized. AIMS: To investigate the role of leptin in the pathogenesis of ST and to clarify whether there is a correlation between mast cell count and leptin level in ST.
From each pa ent, a biopsy of a large ST (length >4 mm), a small ST (length <2 mm) and a normal skin biopsy (as a control) were taken. The samples were processed for leptin level. Skin biopsies were stained with hematoxylin and eosin and toluidine blue-uranyl nitrate metachromatic method for mast cell count was used. RESULTS: There was a significant increased level of leptin in the ST compared to the normal skin. It was highly significant in small ST than in big ST (P = 0.0001) and it was highly significant in small and big ST compared to controls, P = 0.0001 and P = 0.001, respec vely. There was a significant increase in mast cell count in the ST, which did not correlate with the increased levels of leptin. CONCLUSION: This is the first report to demonstrate that tissue leptin may play a role in the pathogenesis of ST. The significant increase in the levels of leptin and mast cell count in ST may indicate a possible role of adipoimmune in the benign skin growths.
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BMC Cardiovasc Disord. 2011 Aug 16; 11:53. Cut Off Values of Waist Circumference & Associated Cardiovascular Risk in Egyptians. Ibrahim MM, Elamragy AA, Girgis H, Nour MA. Cardiology Department - Cairo University Faculty of Medicine, Kasr Al-Aini St,, Cairo, 11562, Egypt. ehs@link.net. Abstract BACKGROUND: Recent guidelines stressed the need to adopt different values of waist circumference (WC) measurements to define abdominal obesity in different ethnic groups. The aim of this study is to identify WC cutoff points in normotensive and hypertensive subjects which are diagnostic of abdominal obesity in a Middle Eastern population and the prevalence of abdominal obesity in a nationwide sample. METHODS: Data were collected during phase-2 of the Egyp ans Na onal Hypertension Project survey.
Blood pressure, anthropometric measurements and laboratory studies were performed according to a standardized protocol by trained personnel. To derive the cutoff points for WC, we applied the factor analysis on CV risk factors: diabetes mellitus, decrease in HDL-C and increase in LDL-C, triglycerides and left ventricular mass index by echocardiography. RESULTS: The sample included 2313 individuals above the age of 25 years. WC values (mean ± SD) were 88 ± 14 cm and 95 ± 14 cm for normotensive (NT) and hypertensive (HT) men respec vely, and 89.6 ± 14.7 cm and 95.7 ± 15.9 cm for NT and HT women respec vely. Applying factor analysis, the weighted average cutoff points were 93.5 cm for both NT and HT men and 91.5 and 92.5 cm for NT and HT women respectively. Based on these thresholds, the prevalence of abdominal obesity was 48% in men and 51.5% in women. CONCLUSION: This is the first report of specific abdominal obesity cutoff points in a Middle Eastern country. The cutoff points were different from the Europid standards. There is a high prevalence rate of abdominal obesity among Egyptians which is associated with increased prevalence of cardiometabolic risk factors.
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Ital J Pediatr. 2011 Jul 19;37:34. Obesity Modulate Serum Hepcidin And Treatment Outcome of Iron Deficiency Anemia in Children: A Case Control Study. Sanad M, Osman M, Gharib A. Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt. zanad_zanad2005@yahoo.com. Abstract BACKGROUND: Recently, hepcidin expression in adipose tissue has been described and shown to be increased in patients with severe obesity. We tried to assess the effect of obesity on hepcidin serum levels and treatment outcome of iron deficiency anemia in children. METHODS: This was a case control study included 70 children with iron deficiency anemia "IDA" (35 obese and 35 non-obese) and 30 healthy non- obese children with comparable age and sex(control group). Parameters of iron status (Serum iron, ferritin, transferrin, total iron binding capacity and transferrin saturation) and serum hepcidin levels were assessed initially and a er 3 months of oral iron therapy for IDA. RESULTS: Compared to the control group, serum hepcidin was significantly lower in non-obese children with IDA(p < 0.01) and significantly higher in obese children with IDA (p < 0.01). Hepcidin increased significantly in non- obese children with IDA a er 3 months of iron therapy (P < 0.01). On the other hand, obese children showed non-significant change in hepcidin level a er iron therapy (p > 0.05). Although hepcidin showed significant posi ve correlations with Hb, serum iron and transferrin saturation in non-obese children with IDA, it showed significant negative correlations with Hb, serum iron and transferrin satura on in obese children with IDA (P < 0.05).
diminished response to oral iron therapy in childhood iron deficiency anemia.
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Pediatr Nephrol. 2011 Jun 3. [Epub ahead of print] Evaluation of Microalbuminuria in Obese Children and Its Relation to Metabolic Syndrome. Sanad M, Gharib A. Pediatrics, Zagazig University, Zagazig City, El Sharkia Governorate, Egypt, zanad_zanad2005@yahoo.com. Abstract Several epidemiologic studies have clearly demonstrated that obesity increases the risk of kidney diseases. We have attempted to evaluate the association of obesity with albuminuria, an early marker of kidney disease, among obese children and its relation to metabolic syndrome. This study included 150 obese children. Blood pressure, fas ng blood glucose, plasma insulin and the lipid profile were assessed. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate in vivo insulin resistance. Urinary albumin and creatinine were estimated. Microalbuminuria was detected in 22 (14.7%) of the obese children. Waist circumference, blood pressure, triglyceride, low-density lipoprotein (LDL), insulin resistance and fasting blood glucose were significantly higher in obese children with microalbuminuria than in those with normoalbuminuria and showed significant positive correlations with microalbuminuria. High- density lipoprotein (HDL) was significantly lower in obese children with microalbuminuria than in those with normoalbuminuria, with a significant negative correlation with microalbuminuria. We found that body mass index, abdominal obesity, hypertension, impaired fasting glucose level and insulin resistance significantly increased the odds of microalbuminuria in the obese children enrolled in this study. Moreover, high triglyceride, high LDL and low HDL were significantly associated with microalbuminuria. In our patient group, childhood obesity was a risk factor for the development of microalbuminuria, which in turn was significantly associated with metabolic syndrome and its different constituents.
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Mol Genet Metab. 2011 Apr;102(4):461-4. Epub 2010 Dec 31. Homozygosity for a Novel Missense Mutation in the Lep n Receptor Gene (P316T) in Two Egyp an Cousins with Severe Early Onset Obesity. Mazen I, El-Gammal M, Abdel-Hamid M, Farooqi IS, Amr K. Clinical Genetics Department, National Research Centre, Cairo, Egypt. doctormazen@hotmail.com Abstract Congenital deficiency of the leptin receptor is a very rare cause of severe early-onset obesity. To date, only 9 families have been reported in the literature to have mutations in the leptin receptor gene. The clinical features include severe early onset obesity, severe hyperphagia, hypogonadotropic hypogonadism, and
T cell
and neuroendocrine/metabolic dysfunction. Here we report two cousins with severe early onset obesity and recurrent respiratory tract infections. Their serum leptin levels were elevated but they were within the range predicted by the elevated fat mass in both cousins. Direct sequencing of the entire coding sequence of the leptin receptor gene revealed a novel homozygous missense muta on in exon 6, P316T. The muta on was found in the homozygous form in both cousins and in the heterozygote state in their parents. This muta on was not found in 200 chromosomes from 100 unrelated normal weight control subjects of Egyptian origin using PCR-RFLP analysis. In conclusion, finding this new mutation in the LEPR beside our previous mutation in the LEP gene implies that monogenic obesity syndromes may be common in the Egyptian population owing to the high rates of consanguineous marriages. Further screening of more families for muta ons in LEP, LEPR, and MC4 might confirm this assump on.
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Br J Anaesth. 2011 Mar; 106(3):359-63. Epub 2010 Dec 10. Incidence of Perioperative Adverse Events in Obese Children Undergoing Elective General Surgery. El-Metainy S, Ghoneim T, Aridae E, Abdel Wahab M. Department of Anaesthesia, Faculty of Medicine, High Institute of Public Health,
University of
Alexandria, Alexandria, Egypt. shelmetainy@yahoo.com Abstract BACKGROUND: A worldwide increase in the prevalence of obesity has been observed in both developed and developing countries. Few studies have addressed the anaesthetic or perioperative implications of childhood obesity. METHODS: Children aged 2-16 yr undergoing general surgery were classified using age- and sex-adjusted BMI. Patient characteristic, co- morbidity, and perioperative data were collected to ascertain the risks associated with overweight and obese children. RESULTS: We enrolled 1465 subjects in our study, of which 154 (10.5%) were classified as obese and a further 223 (15.2%) as overweight. A er adjusting for age, we identified increased rates of arterial hemoglobin desaturation, difficult mask ventilation, airway obstruction, and bronchospasm in obese children. The relative risk (RR) of adverse respiratory events was higher among obese subjects than non-obese subjects and higher in younger age groups. Controlling for age, adjusted-RR (confidence interval) was 1.49 (1.2-1.86). There was a significant associa on between obesity and asthma with a higher odds ratio (OR) in younger age groups controlling for age: adjusted-OR=1.8 (1.15-2.82). A significant association was detected between obesity and sleep apnoea controlling for age: adjusted-OR=4.03 (2.37-6.8). CONCLUSIONS: These results suggest an increased incidence of perioperative adverse respiratory events in obese children, especially at younger ages.
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Int J Hypertens. 2011 Mar 8;2011:952537. Prevalence of Elevated Blood Pressure and Association with Obesity in Egyptian School Adolescents. Abolfotouh MA, Sallam SA, Mohammed MS, Loutfy AA, Hasab AA. King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), P.O. Box 22490, Riyadh 11426, Saudi Arabia.
and obesity in Egyptian adolescents. METHODS: A cross-sec onal study of 1500 adolescents (11-19 years) in Alexandria, Egypt, was conducted. Resting BP was measured and measurements were categorized using the 2004 fourth report on blood pressure screening recommendations. Additional measures included height, weight, and waist and hip circumferences. Obesity was determined based on BMI, waist circumference (WC) and waist-to-hip ratio (WHR), and waist- to-height ratio (WHtR) indicators. Crude and adjusted odds ratios were used as measures of association between BP and obesity. RESULTS: Prevalence rates of prehypertension and hypertension were 5.7% and 4.0%, respec vely. Obesity was seen in 34.6%, 16.1%, 4.5%, and 16.7% according to BMI, WHR, WC, and WHtR, respectively. Adjusting for confounders, HBP was significantly associated with overall obesity based on BMI (OR = 2.18, 95%, CI = 1.38-3.44) and central obesity based on WC (OR = 3.14, 95%, CI = 1.67-5.94). Conclusion. Both overall obesity and central obesity were significant predictors of HBP in Egyptian adolescents.
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Med Sci Monit. 2011 Feb 25;17(3):CR174-9. Relationship Between Pro-Anti-Inflammatory Cytokines, T-Cell Ac va on and CA 125 in Obese Pa ents with Heart Failure. Hamdy NM. Department of Biochemistry, Ain Shams University, Faculty of Pharmacy, Cairo, Egypt. adia_hamdy@hotmail.com Abstract BACKGROUND: This researcher previously found that serum levels of some inflammatory cytokines are elevated in patients with cardiovascular disease (CVD). Hence, this study investigated the relationship between circulating levels of pro-anti-inflammatory cytokines, T-cell activation marker and carbohydrate an gen 125 (CA 125) for the first me in obese Egyp an patients with heart failure (HF). MATERIAL/METHODS: This study included 60 HF pa ents, and 30 normal controls, with age range 50-70 years. HF pa ents were divided into 2 groups: non-obese mild HF according to clinical status (New York Heart Associa on Class) (NYHA class I/II) (n = 20) and obese severe HF (NYHA class III/IV) (n = 40). Serum pro-anti-inflammatory cytokine levels (TNF-α, IL-6, and IL-10), T-cell activation marker (sIL-2R/CD25), and CA 125; tumor marker were measured by ELISA.
cytokines, sIL-2R/CD25 as T-cell ac va on marker, and CA 125 as tumor marker were significantly higher in HF patients than in normal controls. Moreover, serum levels of TNF-α, IL-6, sIL-2R/CD25, and IL-10, as well as CA 125 were significantly higher in the obese than in the non-obese mild HF pa ents. Correla on analysis showed that CA 125 was posi vely related to BMI, TNF-α, IL-6, and sIL-2R/CD25 in the HF pa ents group.
patients, and is correlated with serum TNF-α, IL-6, and sIL-2R/CD25 levels. Therefore, we can conclude that CA125, being a tumor marker, is closely related to the cytokine system.
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Saudi J Gastroenterol. 2011 Jan-Feb;17(1):40-6. Predictors of Non-Alcoholic Fatty Liver Disease in Obese and Overweight Egyptian Children: Single Center Study. el-Karaksy HM, el-Koofy NM, Anwar GM, el-Mougy FM, el-Hennawy A, Fahmy ME. Department of Pediatrics, Cairo University, Research Institute of Ophthalmology, Egypt. hanaakaraksy@yahoo.com
global problem which has been increasingly recognized with the dramatic rise in pediatric obesity. The aim of the present study was to identify the clinical, sonographic, and biochemical predictors for NAFLD in obese children.
included after an informed consent. All were subjected to full anthropometric assessment (including height, weight, body mass index, subscapular skin fold thickness, waist and hip circumference and calculation of waist: hip ratio), biochemical assessment of liver function tests, lipid profile and insulin resistance and sonographic assessment of hepatic echogenicity. Liver biopsy when indicated, was done in 33 pa ents.
elevated AST. Significant dyslipidemia (low HDL-c, high total cholesterol, high LDL-c and triglycerides) and higher insulin resistance were found in obese pa ents (P<0.01). The main sonographic findings were hepatomegaly in 20 pa ents (26.3%) and echogenic liver in 41 pa ents (53.9%). Liver biopsy showed simple steatosis in eight cases (24.2%) and non-alcoholic steatohepa s (NASH) in seven cases (21.2%). Anthropometric measurements, increased hepatic echogenicty by ultrasound, insulin resistance and lipid profile were good predictors of NAFLD in obese children if assessed together. However, LDL-c was the only sensitive predictor (independent variable) for NAFLD in both uni- and multivariate logistic regression analyses.
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BMC Womens Health. 2011 Jan 19;11:1. Elevated Serum Neutrophil Elastase is related to Prehypertension and Airflow Limitation in Obese Women. El-Eshmawy MM, El-Adawy EH, Mousa AA, Zeidan AE, El-Baiomy AA, Abdel- Samie ER, Saleh OM. Internal Medicine Department, Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt. eman.eladawy@yahoo.com Abstract BACKGROUND: Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.
obese normotensive subjects and 30 healthy controls. The study groups were matched for age. Measurements: The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary func on tests including forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ra o.
in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC. 37
CONCLUSION: Neutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.
J Biosoc Sci. 2011 Jan;43(1):85-99. Domestic Violence and Obesity in Egyptian Women. Yount KM, Li L. Departments of Global Health and Sociology, Emory University, Atlanta, USA.
Abstract Domestic violence and obesity are global public health problems.This study explores associa ons of domes c violence and obesity in 5015 ever- married, non-pregnant women aged 15-49 years who took part in the 2005 Egypt Demographic and Health Survey (EDHS). Women's mean body mass index (BMI) was 30.4 kg/m², and 48% were obese. Thirty-seven percent reported any prior psychological, physical or sexual domestic violence.Compared with their counterparts, the adjusted odds of being obese were marginally higher among women who reported any prior sexual (aOR=1.31),physical or sexual (aOR=1.18), or psychological, physical or sexual (aOR=1.17) domes c violence. Women who experienced severe or repeated domestic violence--as measured by reported exposure to three or more acts of physical(aOR=1.25), psychological or physical (aOR=1.18), physical or sexual(aOR=1.36), and psychological, physical or sexual (aOR=1.26) domes c violence--had higher adjusted odds of being obese. Marginally significant adjusted dose-response relationships remained between obesity and the number of specific acts of: (1) physical or sexual violence and (2) psychological, physical or sexual domes c violence. Obesity among women in poorer settings like Egypt may partly have its roots in gender subordination, as manifested in women's exposure to multiple acts of domestic violence.
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Am Surg. 2010 Sep;76(9):995-9. Day-Case Limberg Flap for Recurrent Pilonidal Sinus: Does Obesity Complicate the Issue? Madbouly KM. Department of Surgery, University of Alexandria, Alexandria, Egypt. Khaled.Madbouly@alexmed.edu.eg Abstract The purpose of this study was to analyze the long-term outcome of rhomboid excision with Limberg flap reconstruction (LF) as one-day surgery in treatment of recurrent pilonidal sinus (RPS). The effect of obesity on outcome will be addressed. Forty-nine patients with RPS were treated by rhomboid excision and LF as one-day surgery. Data collected included demographics, body mass index, operative time, flap ischemia, wound infection, length of hospital stay, time of complete healing, and recurrence. Pa ents' mean age was 33.4 years and mean number of previous opera ons was 3.4. Opera ve me ranged from 40 to 70 minutes. Two pa ents developed sterile seroma (4.1%) and two pa ents (4.1%) had wound infections. No wound dehiscence or flap ischemia was reported. All pa ents returned to normal ac vity within 7 days. No recurrences were reported after a mean follow-up of 32.1 months. Obesity significantly increased the operative time, however, it affected neither the postoperative outcome nor the long-term recurrence. Rhomboid excision and LF as one-day surgery is a safe and reliable method for treatment of RPS. It guarantees low morbidity, short hospital stay, short time off work, and carries low risk of recurrence, even in obese patients.
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J Egypt Soc Parasitol. 2010 Aug;40(2):489-98. Adiponectin in Acute Myocardial Infarction Non Obese Egyptian Men. Mahgoub KA, Abd el MA. Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abstract Adiponectin is an adipose tissue derived mediator with significant anti atherosclerotic properties and is involved in the regulation of insulin sensitivity and lipid oxidation, a few studies were done in acute phase of myocardial infarction, especially in none obese patients. The study investigated the association between adiponectin concentration and acute phase of myocardial infarction (MI) in non obese men patients. The results showed that adiponectin levels in patients with AMI (5.2ug/ml) were significantly lower than that of control group (7.5ug/ml) (P<0.001). Lower adiponectin levels were independently associated with higher risk of AMI (odd ra o= 6.12, 95%CIs: 2.4- 18.6; P=<0.001).Adiponec n levels were negatively correlated with triglyceride (r=-0.34) in case group and (r=- 0.41) in control group (P< 0.001). In addi on, nega vely correlated with BMI(r=- 0.27) in case group and (r=-0.23) in control group (P< 0.001), but adiponectin levels is positively correlated with HDL-Cholesterol (r= 0.45) in case group and (r=0.51) in control group with (P<0.001).
Fertil Steril. 2010 Jul;94(2):581-4. Epub 2009 May 6. Semen Parameters and Hormonal Profile in Obese Fertile and Infertile Males. Hofny ER, Ali ME, Abdel-Hafez HZ, Kamal Eel-D, Mohamed EE, Abd El-Azeem HG, Mostafa T. Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Assiut University, Assuit, Egypt.
sex hormones, and serum leptin in obese fertile and infertile oligozoospermic men.
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PATIENT(S): Forty-two obese fer le and 80 obese infer le oligozoospermic men (body mass index [BMI] >30). INTERVENTION(S): The BMI calculation, semen analysis, and serum FSH, LH, T, E(2), PRL, and lep n es ma on. MAIN OUTCOME MEASURE(S): Semen and hormonal profiles. RESULT(S): Obese oligozoospermic patients had significant increase in mean BMI, serum FSH, LH, E(2), PRL, and lep n compared with obese fer le controls. The BMI had significant positive correlation with abnormal sperm morphology, LH, serum leptin and significant negative correlation with sperm concentration, sperm motility, serum T. Serum leptin demonstrated significant positive correlation with patients' age, abnormal sperm morphology, serum FSH, LH, PRL and significant negative correlation with sperm concentration, sperm motility, and serum T. CONCLUSION(S): Serum leptin mediates a link between obesity and male infertility.
J Obstet Gynaecol Can. 2010 Jul;32(7):687-90. Effect of Obesity on Parameters of Ovarian Reserve in Premenopausal Women. Halawaty S, ElKattan E, Azab H, ElGhamry N, Al-Inany H. Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
ultrasound markers of ovarian reserve in premenopausal women. METHODS: We performed a cross-sectional comparative study of two age- matched groups of premenopausal participants (early transi on phase): 50 participants ("non-obese") had a BMI < 30 kg/m2, and the other 50 par cipants ("obese") had a BMI of 30 to 35 kg/m2. The obese women had a mean age of 46.2 years and the non-obese women had a mean age of 46.1 years. Blood samples were collected from all participants, anthropometric measurements were calculated, and transvaginal ultrasonography was performed to measure the antral follicle count (AFC) and ovarian volume during the early follicular phase. The blood samples were assayed for antimüllerian hormone (AMH), follicle-stimulating hormone (FSH), fasting blood glucose (FBG) and two-hour postprandial blood glucose (2h PP). RESULTS: There was no significant difference between the two groups in mean age, levels of serum AMH, serum FSH, FBG, 2 hr PP, or AFC. Ovarian 41
volume was significantly lower in obese women (3.7 +/- 0.8 mL) than in non-obese women (6.6 +/- 0.4 mL) (P = 0.03). There was no significant correla on between BMI and serum AMH, serum FSH, FBS, or 2 hr PP.
blood glucose, or AFC indicating that obesity is unlikely to affect ovarian reserve in the perimenopausal age group.
Prostate Cancer Prostatic Dis. 2010 Jun;13(2):186-90. Epub 2009 Dec 22. Obesity-PSA Relationship: A New Formula. Hekal IA, Ibrahiem EI. Urology Department, Mansoura University, Mansoura, Egypt.
eahekal@yahoo.com Abstract To clinically apply the inverse PSA-body mass index (BMI) correlation and enhance PSA sensitivity in obese cases, a new formula is warranted. An innovated BMI-PSA equation is designed. PSA-BMI adjusted formula (named Hekal's equation): measured total PSA (ng ml(-1)) mul plied by age (years) and divided by BMI of the patient. The formula is applied over a randomly chosen 1000 cases of different PSA, BMI, age and trans-rectal ultrasound biopsy results, the yield of new PSA is correlated with pathology and age-specific PSA adjustment values. Among the 988 cases with complete data, obesity (BMI: 30-35 kg m(-2)) in 236 cases (23.8%) and 79 cases (7.9%) have BMI>35 kg m(-2). Mean PSA was 5.8 ng ml(-1) (s.d.+/-8.4 ng ml(-1)). Cases stra fied based on their age (every 10 years). The new equation was applied. Obesity is detected in 33.5 and 43.6% of fi h and sixth decade of life respec vely (P=0.02), with low measured PSA values (2.1, 3.8 ng ml(-1), respec vely). By such PSA measurement biopsy may be omi ed, missing 53.3% of malignant cases. In contrast, PSA adjusted were 4 and 9.3 ng ml(-1) within the same group of patients. With such values, the decision of a biopsy could not be missed for the targeted groups. Specificity and sensi vity of adjusted PSA values at cutoff point 4 ng ml(-1) was 41.7 and 70%, respec vely. Based on our results, the new PSA-BMI adjusted formula is reproducible, easy applied formula. With such a formula the higher sensitivity of PSA in obese patients could be achieved. The misleading low PSA in obese cases in the fifth and sixth decade will be corrected.
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J Clin Lipidol. 2010 May-Jun;4(3):185-95. Epub 2010 Mar 21. Prevalence Of Metabolic Syndrome And Insulin Resistance Among Egyp an Adolescents 10 To 18 Years Of Age. Aboul Ella NA, Shehab DI, Ismail MA, Maksoud AA. Clinical Nutri on Department, Na onal Nutri on Ins tute (NNI), 16 kaser el Aini Street, Cairo, Egypt. neballl@yahoo.com Abstract BACKGROUND: The prevalence and magnitude of childhood obesity are increasing dramatically. OBJECTIVES: To examine the effect of varying social, demographic, dietary, and activity factors on the prevalence of metabolic syndrome and its relation to insulin resistance, C-reactive protein, and homocysteine levels in a large, representative sample of Egyptian adolescents. METHODS: Our survey included 4250 adolescents (from 10 to 18 years of age; male subjects comprised 42.5% of par cipants) from 7 governorates representing Egypt. Baseline measurements included blood pressure, fasting blood glucose, plasma lipids, C-reactive protein, and homocysteine levels. Because the body mass index varies according to age, we standardized the value for age and sex with the use of conversion to percentiles.
no sex or area of residence predilection. Results showed that adolescents with the full criteria of metabolic syndrome (ie, three criterion or more) constituted nearly one fourth of those exhibiting high values of different components, except for systolic blood pressure, where they were 42%, and TG, where they were 31%. Family history of obesity and diabetes mellitus increase the odds for metabolic syndrome significantly (1.68 and 1.3, respectively) as well as inactivity. A high level of C-reactive protein was reported among affected adolescents. Homocysteine level did not have an influence. CONCLUSIONS: The prevalence of the metabolic syndrome is considerable among obese adolescents. Proinflammatory markers associated with an increased risk of adverse cardiovascular outcomes are already present in these youth.
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East Mediterr Health J. 2010 Apr;16(4):429-33. Relationship Between Overall and Abdominal Obesity and Periodontal Disease Among Young Adults. Amin Hel-S. Department of Pedodontic and Dental Public Health, Faculty of Dentistry, Tanta University, Tanta, Egypt Hatem_ameen2@yahoo.com Abstract To assess overall and abdominal obesity and their relation to periodontal disease among young adults, body mass index (BMI) and waist circumference (WC) were measured and clinical attachment loss (CAL), gingival index (GI) and Community Periodontal Index (CPI) were estimated. The sample comprised 380 adults (170 males and 210 females) aged 20-26 years. There was a significant correlation between both BMI and WC and CAL, GI and CPI in females. In males, a significant correlation was only recorded between WC and GI and CPI. Overall and abdominal obesity in young adult females and abdominal obesity in males were significantly associated with periodontal disease.
J Clin Med Res. 2010 Mar 20;2(2):62-7. Epub 2010 Mar 9. Aortic Stiffness in Prediabetic Adults: Relationship to Insulin Resistance. Sliem H, Nasr G. Departments of Internal Medicine, Suez Canal University, Ismailia, Egypt.
arterial stiffness, results in increased cardiac workload. Several studies have shown that arterial s ffness is increased in individuals with type 2 diabetes. Also, insulin resistance is generally considered to be of major importance in the pathophysiology of type 2 diabetes mellitus given that glucose intolerance and insulin resistance precede the development of overt diabetes, these factors would be associated with arterial stiffness. This study was to evaluate the state of aortic elasticity in prediabetic adults in relation to insulin resistance.
adults with prediabetes were enrolled for the study, 32 adults had insulin resistance (group A) and 81 had insulin sensi ve (group B). Forty-five
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healthy (with normal fasting glucose) adults matched for age and gender were considered as control. All were subjected to full medical history and clinical examination including blood pressure and body mass index. Biochemical studies including lipids profile, fasting glucose and homeostasis model assessment of insulin resistance (HOMA IR) test. Echocardiographic studies were done for assessment of the aortic stiffness index. RESULTS: Significant increase in mean aortic stiffness index was seen in group A than group B. Stiffness was correlated with insulin resistance and the correlation appeared to be independent of glucose tolerance status and obesity. Similar correlations were observed with age, triglycerides and waist circumference.
represent pattern of cardiovascular risk factors. These changes are predominantly observed in prediabetic subjects with increased HOMA IR and visceral obesity independent of glucose levels. KEYWORDS: Prediabetes; Insulin resistance; Aortic stiffness index.
Obes Rev. 2010 Jan;11(1):11-8. Epub 2009 Jul 28. Subcutaneous and Visceral Adipose Tissue: Structural and Functional Differences. Ibrahim MM. Cardiology Department, Cairo University, 1 El-Sherifein Street, Abdeen, Cairo 11111, Egypt. ehs@link.net Abstract Obesity is a heterogeneous disorder. Obese individuals vary in their body fat distribution, their metabolic profile and degree of associated cardiovascular and metabolic risk. Abdominal obesity carries greater risk of developing diabetes and future cardiovascular events than peripheral or gluteofemoral obesity. There are differences between adipose tissue present in subcutaneous areas (SCAT) and visceral adipose tissue (VAT) present in the abdominal cavity. These include anatomical, cellular, molecular, physiological, clinical and prognostic differences. Anatomically, VAT is present mainly in the mesentery and omentum, and drains directly through the portal circulaion to the liver. VAT compared with SCAT is more cellular, vascular, innervated and contains a larger number of inflammatory and immune cells, lesser preadipocyte differentiating capacity and a greater percentage of large adipocytes. There are more glucocorticoid and androgen receptors in VAT than in SCAT. VAT adipocytes are more
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metabolically active, more sensitive to lipolysis and more insulin-resistant than SCAT adipocytes. VAT has a greater capacity to generate free fatty acids and to uptake glucose than SCAT and is more sensitive to adrenergic stimulation, while SCAT is more avid in absorption of circulating free fatty acids and triglycerides. VAT carries a greater prediction of mortality than SCAT.
J Epidemiol Community Health 2010;64:19-20 The Reversal of the Social Gradient of Obesity Among Women In Egypt: An Analysis of Trends Using Multiple Cross Sec onal Surveys 1995–2008 A Aitsi-Selmi 1
2
2
Author Affiliations: 1 Wellcome Trust Doctoral Fellow, London, UK. 2 Department of Epidemiology and Public Health, University College London, London, UK
social distribution that varies according to the level of economic development: as countries develop, the burden of obesity appears to shift from the rich to the poor. Studying these changes as they occur can help shed further light on the social processes that fuel the obesity epidemic and determine its social distribution. Egypt provides a case in point for this research. Findings would be relevant to other low-and-middle income countries but may also be generalisable to an extent to poor communities in high income countries.
women by socio-economic status and how it has changed over time. DESIGN AND METHODS Retrospective analysis using four nationally representative cross-sectional surveys (Demographic and Health Surveys) conducted in Egypt between 1995 and 2008. Socio-economic status was defined as the highest reported educational level attained.
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