Overweight and Obesity in the Eastern Mediterranean Region
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CONCLUSIONS: To identify Omani subjects of Arab ethnicity at high risk of CVD, cut-off points lower than currently recommended for BMI, WC and WHR are needed for men while higher cut-off points are suggested for women.
Sultan Qaboos Univ Med J. 2006 Dec;6(2):27-31. Correlation between Serum Leptin Levels, Body Mass Index and Obesity in Omanis. Al Maskari MY, Alnaqdy AA. Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. 35 Al-Khod 123, Sultanate of Oman. Abstract OBJECTIVE: To ascertain the relationship between serum leptin levels and related variables (weight, Body Mass Index (BMI) and fat percentage) in a group of Omani obese and non-obese healthy subjects.
Omanis and 20 non-obese healthy subjects. RESULTS: There was a significant difference (p< 0.001) in serum leptin between the obese group (34.78 + 13.96 ng/ml) and the control non-obese subjects (10.6 ± 4.2 ng/ml). Lep n levels were higher in females compared to males. There was a significantly positive correlation between leptin levels in obese subjects with weight (p=0.002), body fat percentage (p=0.0001) and BMI (p=0.001). 401
CONCLUSIONS: We concluded that serum leptin levels are higher in the Omani obese group and correlate positively with body fatness and obesity.
Popul Health Metr. 2006 Apr 24;4:5. Diabetes and Urbanization in The Omani Population: An Analysis of National Survey Data. Al-Moosa S, Allin S, Jemiai N, Al-Lawati J, Mossialos E. The London School of Economics and Political Science, LSE Health and Social Care, UK. sibalse@aol.com Abstract BACKGROUND: The prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated that urban-dwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more accurate urban and rural categorization would reveal different findings.
who participated in a cross-sectional interviewer-administered survey in Oman including blood and anthropomorphic tests. Multiple logistic regression analyses were conducted to analyze the factors associated with diabetes, first in the whole population and then stratified according to region.
RESULTS: The prevalence of diabetes (fas ng blood glucose > or = 7 mmol/l) in the capital region of Muscat was 17.7% compared to 10.5% in rural areas. The prevalence of self-reported diabetes was 4.3%. Urban residence was significantly associated with diabetes (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4-2.1), as was age (OR = 1.2, 95% CI: 1.1- 1.2), obesity (abnormal waist circumference) (OR = 1.8, 95% CI: 1.5- 2.1), and systolic blood pressure (SBP) 120-139 (OR = 1.4, 95% CI:1.04-1.8), SBP 140-159 (OR = 1.9, 95% CI: 1.4-2.6), SBP > or = 160 (OR = 1.7, 95% CI: 1.2-2.5). Stra fied analyses revealed higher educa on was associated with reduced likelihood of diabetes in rural areas (OR = 0.6, 95% CI: 0.4-0.9).
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CONCLUSION: A high prevalence of diabetes, obesity, hypertension and high cholesterol exist in the Omani population, particularly among urban- dwellers and older individuals. It is vital to continue monitoring chronic disease in Oman and to direct public health policy towards preventing an epidemic.
Saudi Med J. 2005 Jan;26(1):96-100. Fetal Macrosomia. Risk Factor and Outcome. Mathew M, Machado L, Al-Ghabshi R, Al-Haddabi R. Department of Obstetrics and Gynecology, PO Box 35, PC 123, Sultan Qaboos University, Sultanate of Oman. mathewz@omantel.net.om Abstract OBJECTIVE: To determine the risk factors predisposing to fetal macrosomia and assess the maternal and perinatal outcome in these patients.
the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Sultanate of Oman, during a 3-year period from January 2001 -- December 2003. The maternal and neonatal records of infants with birth weight of > or =4000 g (n=275) were reviewed. Outcome variables included demographic profile, antenatal risk factors, mode of delivery and maternal and perinatal complications.
rate of macrosomic deliveries was 3.75% and the rate of deliveries > or =4500 g was 0.48%. The mean birth weight of the study group was 4230 +/- 220 g. Obesity, diabetes, prolonged gesta on and postpartum hemorrhage were significantly higher in the study group. The cesarean section rate was 25.8% for the study group compared to the general incidence of 13.1% during the study period (p<0.0001). The incidence of shoulder dystocia was 7.6% compared to the general incidence of 0.48% during the study period (p<0.0001). There were 7 cases of Erb's palsy, all except one recovered without sequelae by 3 months of age. CONCLUSION: Gestational diabetes, maternal obesity, increasing age and parity were the main risk factors for fetal macrosomia. The incidence of shoulder dystocia, birth injuries and neonatal morbidity increased in this group. 403
Saudi Med J. 2004 Mar;25(3):346-51. Prevalence and 10-Year Secular Trend of Obesity in Oman. Al-Lawati JA, Jousilahti PJ. Department of Non-Communicable Diseases Control, Ministry of Health, Sultanate of Oman . jallawat@omantel.net.om Abstract OBJECTIVE: To determine the prevalence of overweight and obesity by age, gender and region and to assess the difference between rural and urban populations and determine the trends of the past decade.
sec onal surveys conducted in 1991 and 2000, containing 5,086 and 6,400 Omani ci zens aged >or=20 years. Body mass index (BMI) (weight in kg) divided by height (in meters squared) was calculated using measured height and weight data. Overweight was defined as BMI 25-29.9 kg/m2 and obesity as BMI >or= 30 kg/m2. RESULTS: In the year 2000, the age adjusted prevalence of obesity reached 16.7% in men, compared to 10.5% in 1991 (p<0.001). In women, the prevalence was 23.8% in 2000, compared to 25.1% in 1991 (p=0.231). Similarly, the prevalence of overweight increased among men, from 28.8- 32.1% (p=0.011) and decreased among women, from 29.5-27.3% (p=0.053). When obesity and overweight were combined, there was a significant increase in men (9.5%; p for the change <0.001) and decrease in women (3.5%; p for the change <0.003). Obesity and overweight combined was markedly more common in the Southern part of Oman (70%) compared to Northern areas (32-57%). People living in urban areas were more obese (21.1%) than those living in the rural communi es (13.1%) (p<0.001).
predominantly among men. Primary prevention programs are needed to counteract this condition and its cardiovascular and metabolic complications.
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Saudi Med J. 2003 Aug;24(8):875-80. The Relation of Smoking to Body Mass Index and Central Obesity among Omani Male Adults . Al-Riyami AA, Afifi MM. Department of Research and Studies, Ministry of Health, Sultanate of Oman.
Abstract OBJECTIVE: Despite the prevalence that smoking has declined in many countries, there is a large increase in the number of young adults starting to smoke and in per capita cigarette consumption. In some studies smoking was associated with a lower body mass index (BMI) and increased waist hip ratio (WHR). Our aim is to study the association of smoking with BMI and WHR among male adults aged 20 years and above in a community based survey as a part of the Na onal Health Survey, 2000.
designed in the year 2000. A part of the survey was door to door interviews including demographic data and inquiry regarding current and former smoking for male adults aged 20 years and above. In addi on, taking the weight, hip and waist measurements, blood pressure and fasting blood glucose for them. RESULTS: The crude prevalence of current smoking was 13.3% among adult males and 4.6% of them were former smokers. The mean BMI was not significantly lower among smokers than never or former smokers. There was no significant difference also regarding WHR. Adjus ng BMI by 10 different multiple linear regression models for other co-variates; age, educational level, marital status, having hypertension and total fasting glucose intolerance revealed significant associa on in 3 of them of BMI with smoking status. Non-significant association was revealed for WHR. CONCLUSION: Current smokers were of low BMI compared to non smokers and ex smokers, and currently light smokers were also of low BMI compared to ex smokers. There was no association of central obesity to smoking status. The association between smoking status and relative weight is modified by social factors as education.
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Saudi Med J. 2003 Jun;24(6):641-6. Prevalence and Correlates of Obesity and Central Obesity among Omani Adults. Al-Riyami AA, Afifi MM. Department of Research & Studies, Ministry of Health, PO Box 393, PC 113, Sultanate of Oman. afifidr@yahoo.co.uk Abstract OBJECTIVE: Overweight, particularly obesity is a major risk factor for several important diseases, especially hypertension, coronary heart diseases and diabetes mellitus. Our aim is to determine the prevalence of obesity and central obesity among Omani adults aged > or =20 years, and to identify the socio-demographic and health variables that correlate to obesity and central obesity in a community based survey (National Health Survey, 2000).
parts of Oman was designed in the year 2000. A part of the survey was a door to door interviews including demographic data, weight, height, hip and waist measurements, blood pressure and fasting blood glucose and serum cholesterol for adults aged > or =20 years.
index >25 kg/m2) was 47.9% for the whole sample, and 46.2% for males, 49.5% for females. The crude prevalence of central obesity (abnormal weight hips ra o) was 49.3% for the whole sample, 31.5% for males, and 64.6% for females. Obesity and central obesity were less prevalent among younger age groups and highly educated subjects. Both obesity and central obesity increased the odds of having diabetes, hypertension and hyperchlostremia. CONCLUSION: The prevalence of obesity and central obesity is quietly high in Oman. Launching nutritional programs and promotional life style modification programs are recommended.
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Diabetes Care. 2003 Jun;26(6):1781-5. Prevalence of The Metabolic Syndrome among Omani Adults. Al-Lawati JA, Mohammed AJ, Al-Hinai HQ, Jousilahti P. Ministry of Health, Non-communicable Diseases, Muscat, Muscat, Oman. jallawat@omantel.net.om Abstract OBJECTIVE: To estimate the prevalence of the metabolic syndrome by age and sex in the Omani population as defined by the third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]) of North America.
sec onal survey conducted in 2001 containing a probability random sample of 1,419 Omani adults aged > or =20 years living in the city of Nizwa. The metabolic syndrome, defined by the ATP III, was defined as having three or more of the following abnormali es: waist circumference >102 cm in men and >88 cm in women, serum triglycerides > or =150 mg/dl (1.69 mmol/l), HDL cholesterol <40 mg/dl (1.04 mmol/l) in men and <50 mg/dl (1.29 mmol/l) in women, systolic blood pressure > or =130 mmHg and/or diastolic > or =85 mmHg or on treatment for hypertension, and fasting serum glucose > or =110 mg/dl (6.1 mmol/l) or on treatment for diabetes. RESULTS: The age-adjusted prevalence of the metabolic syndrome was 21.0%. The crude prevalence was slightly lower (17.0%). The age-adjusted prevalence was 19.5% among men and 23.0% among women (P = 0.236). Low HDL cholesterol was the most common component (75.4%) of the metabolic syndrome among the study population followed by abdominal obesity (24.6%). Abdominal obesity was markedly higher in women (44.3%) than in men (4.7%).
similar to that in developed countries. Future prevention and control strategies should not overlook the importance of noncommunicable disease risk factors in rapidly developing countries.
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Diabet Med. 2002 Nov;19(11):954-7. Increasing Prevalence of Diabetes Mellitus in Oman. Al-Lawati JA, Al Riyami AM, Mohammed AJ, Jousilahti P. Research Department and Health Affairs, Ministryof Health, Muscat, Oman
, Finland. jallawat@omantel.net.om Abstract AIMS: To determine the prevalence of diabetes mellitus and impaired fasting glucose by age, gender, and by region and compare results with the 1991 survey; and es mate previously undiagnosed diabetes mellitus in the Omani population. METHODS: Cross-sectional survey containing a probability random sample of 5838 Omani adults aged >or= 20 years. Diabetes and impaired fas ng glucose (IFG) were assessed by fas ng venous plasma glucose using 1999 World Health Organiza on's diagnos c criteria (normoglycaemia < 6.1 mmol/l, IFG >or= 6.1 but < 7 mmol/l,and diabetes >or= 7 mmol/l). The 1991 survey was reanalysed using the same diagnostic criteria, and results were compared.
aged 30-64 years reached 16.1% (95% confidence interval (CI) 14.7-17.4) compared with 12.2% (95% CI11.0-13.4) in 1991. IFG was found among 7.1% (95% CI6.2-8.1) of males and 5.1% (95% CI 4.4-6.0) of females. Generally, diabetes was more common in urban then rural regions. Only one-third of diabetic subjects knew that they had diabetes. Nearly half of the study popula on had a body mass index > 25 kg/m2.
increased over the past decade. The high rate of abnormal fasting glucose together with high rates of overweight and obesity in the population make it likely that diabetes will continue to be a major health problem in Oman. Primary prevention programs are urgently needed to counteract major risk factors that promote the development of diabetes.
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PAKISTAN
Int J Pediatr Obes. 2011 Aug 19. [Epub ahead of print] Leptin Deficiency and Leptin Gene Mutations in Obese Children from Pakistan. Fatima W, Shahid A, Imran M, Manzoor J, Hasnain S, Rana S, Mahmood S. Department of Human Genetics and Molecular Biology, University of Health Sciences , Lahore. Abstract Abstract Background: Congenital leptin deficiency is a rare human genetic condition clinically characterized by hyperphagia and acute weight gain usually during the first postnatal year. The worldwide data on this disorder includes only 14 cases and four pathogenic mutations have been reported in the leptin gene. Study objective: The objectives of this study were to measure serum leptin levels in obese children and to detect leptin gene mutations in those found to be leptin deficient. Patients and results: A total of 25 obese children were recruited for the study. Leptin deficiency was detected in nine of them. Leptin gene sequencing identified mutations in homozygous state in all the leptin deficient children. Two cases carried novel mutations (c.481_482delCT and c.104_106delTCA) and each of the remaining seven the previously reported frameshi muta on (c.398delG). Conclusion: The results suggest that leptin deficiency caused by mutations in the leptin gene may frequently be seen in obese Pakistani children from Central Punjab.
Diabetic Medicine, July 2004;21(7):716–723, Ethnic Differences and Determinants of Diabetes and Central Obesity among South Asians of Pakistan T. H. Jafar 1,2,3,* , A. S. Levey 3 , F. M. White 1 , A. Gul
1 , S. Jessani 1 , A. Q. Khan 4 , F.
H. Jafary 2 , C. H. Schmid 5 , N. Chaturvedi 6
AIMS: To study the within ethnic subgroup variations in diabetes and central obesity among South Asians. METHODS: Data from 9442 individual age ≥ 15 years from the National Health Survey of Pakistan (NHSP) (1990–1994) were analysed. Diabetes was defined as non-fasting blood glucose ≥ 7.8 mmol/l, or known history of
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diabetes. Central obesity was measured at the waist circumference. Distinct ethnic subgroups Muhajir, Punjabi, Sindhi, Pashtun, and Baluchi were defined by mother tongue.
subgroups (P = 0.002), being highest among the Muhajirs (men 5.7%, women 7.9%), then Punjabis (men 4.6%, women 7.2%), Sindhis (men 5.1%, women 4.8%), Pashtuns (men 3.0%, women 3.8%), and lowest among the Baluchis (men 2.9%, women 2.6%). While diabetes was more prevalent in urban vs. rural dwellers [odds ra o (OR) 1.50, 95% confidence interval (CI) 1.24, 1.82], this difference was no longer significant a er adjus ng for central obesity (OR 1.15, 95% CI 0.95, 1.42). However, the ethnic differences persisted after adjusting for major sociodemographic risk factors (unadjusted OR for Pashtun vs. Punjabi 0.59, 95% CI 0.42, 0.84, adjusted OR 0.54, 95% CI 0.37, 0.78). Ethnic varia on was also observed in central obesity, which varied with gender, and did not necessarily track with ethnic differences in diabetes.
ethnic variations in diabetes and central obesity, and deserve further study. Metab Syndr Relat Disord. 2011 Jun;9(3):177-82. Epub 2011 Jan 19. Is there any Association of Serum High-Sensitivity C- Reactive Protein with Various Risk Factors for Metabolic Syndrome in A Healthy Adult Population of Karachi, Pakistan? Riaz M, Fawwad A, Hydrie MZ, Basit A, Shera AS. Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan. research@bideonline.com Abstract BACKGROUND: The aim of this study was to discover the association of serum high-sensitivity C-reactive protein (hsCRP) with various risk factors for metabolic syndrome in an urban population of Karachi, Pakistan.
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