Adipokines, Coronary Heart Disease Risk and Metabolic
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- Abstract OBJECTIVE
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- Abstract OBJECTIVES
- Abstract BACKGROUND AND OBJECTIVES
- Pulmonary Ventilatory Functions and Obesity in Kuwait.
- SUBJECTS AND METHODS: A
- Beneficial Effects of Ketogenic Diet in Obese Diabetic Subjects.
- MATERIALS AND METHODS
- Metabolic Syndrome among Adults Attending Obesity Clinics in Kuwait.
- Slippage after Adjustable Gastric Banding According to the Pars Flaccida and the Perigastric Approach.
Adipokines, Coronary Heart Disease Risk and Metabolic
Abnormali es in Type 2 Diabetes Mellitus?
Mojiminiyi OA, Al Mulla F, Abdella NA.
Department of Pathology, Faculty of Medicine, Kuwait University, Safat,
OBJECTIVE: The aim of this study was to determine, which of: body mass
index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and
waist circumference (WC) correlates best with adipokines and is, therefore,
the most suitable for the assessment of insulin resistance (IR), metabolic
syndrome (MS), type 2 diabetes mellitus (T2DM) and coronary heart
disease (CHD) risk.
SUBJECTS AND METHODS: We studied 248 T2DM pa ents classiﬁed by
gender, IR, MS and CHD. Fasting adiponectin, leptin, resistin, high-
sensitivity C-reactive protein (CRP), insulin, glucose, IR (HOMA), and lipid
profile were measured. Univariate and multivariate regression analyses
were used to find the associations of these variables with each other and
with IR, MS and CHD. Receiver operating characteristic (ROC) analyses were
used to find the best markers of IR, MS and CHD.
associations of BMI, WHR, WHtR and WC with IR, MS and CHD; e.g. in
males, WHR showed significant correlation with only resis n (r = 0.30) and
lep n (r = 0.39) whereas in females, it showed signiﬁcant correla ons with
only adiponectin (r = -0.33). In males and females WHR showed the weakest
correlations with CRP and the adipokines and BMI showed the highest
correlations. ROC analysis showed that the BMI had the highest diagnostic
values for detection of IR, MS and CHD; WHR had the worst diagnostic
and associations with adipokines, CRP, IR, MS and CHD. In patients with
T2DM, BMI should be the preferred marker for risk assessment on account
of its association with adipokines and diagnostic performance
Med Princ Pract. 2009;18(2):111-7. Epub 2009 Feb 9.
Breastfeeding and Obesity among Kuwaiti Preschool
Al-Qaoud N, Prakash P.
Administra on of Food and Nutri on, Ministry of Health, Shuwaikh 70655,
OBJECTIVES: To determine if breastfeeding and its duration are associated
with a reduced risk of obesity among Kuwaiti preschool children.
SUBJECTS AND METHODS: The sample consisted of 2,291 (1,092 males and
1,199 females) preschool children (3-6 years of age) and their mothers. The
data were collected from September 2003 to June 2004. Height and weight
measurements were used for defining weight status while other data were
collected by questionnaire.
duration with either overweight or obesity among preschool children after
adjusting for effects of the confounders. The child's gender, age and birth
weight were the significant factors influencing current weight. Girls were at
32% higher risk of becoming obese than boys. Children aged 4-5 years were
at nearly 3 mes higher risk of overweight and obesity than children of less
than 4 years. Children with higher birth weight (>or=4 kg) had double the
risk of obesity than those of normal birth weight (>or=2.5 to <4.0 kg).
Maternal obesity was a strong predictor of obesity in the children. A child
with an obese mother had nearly 2 mes higher risk of being overweight
(BMI between the 85th the 95th percen les) and 3 mes of being obese
(BMI >or=95th percen le) compared to a child born to a mother with a
normal body weight.
obesity status. However, there is a positive association between child and
Asia Pac J Public Health. 2009 Apr;21(2):153-9. Epub 2009 Feb 3.
Prevalence of Obesity among Adolescents (10 To 14 Years)
El-Bayoumy I, Shady I, Lotfy H.
Public Health Department, Tanta Faculty of Medicine, Shaab, Kuwait.
The purpose of this cross-sectional study was to find out the prevalence of
obesity and overweight among intermediate school adolescents aged 10 to
14 years. The study comprised a mul stage stra ﬁed random sample that
included 5402 children (2657 males and 2745 females). They represent
12.7% of the total number of children between 10 and 14 years during the
educa onal year 2005-2006. The weights and heights of adolescents were
measured, from which the body mass index (BMI) was calculated, which is
the weight in kilograms divided by the height in meters squared (kg/m(2)).
BMI values higher than 95 percen le were accepted as being obese and
those in between 85 and 94 percen le were accepted as overweight.
Dietary intake was assessed by the investigators using food exchange lists
designed by American Diabetic Association and physical fitness was
measured by modified Harvard step test. Data regarding monthly income of
the chosen sample were collected from parents of those children. The
overall prevalence of overweight and obesity in adolescent Kuwaiti children
aged 10 to 14 years was 30.7% and 14.6%, respec vely. The overall
prevalence of overweight and obesity among males was 29.3% and 14.9%,
respec vely (P < .001) and the prevalence of overweight and obesity among
females was 32.1% and 14.2%, respec vely (P < .001). High daily caloric
intake by the obese and overweight children and physical inactivity was
reported among the majority of them. Health education programs should
be conducted to control this syndrome in order to prevent future risk of
obesity-related disease, and physical activity programs should be
incorporated in the schools. Any management plan for overweight and
obese children should include 3 major components: diets, exercise, and
family-based behavior and they should not be placed on restrictive diets
because adequate calories are needed for proper growth.
Ann Saudi Med. 2008 Sep-Oct;28(5):367-70.
Serum Leptin and its Relationship with Metabolic
Variables in Arabs with Type 2 Diabetes Mellitus.
Al-Shoumer KA, Al-Asousi AA, Doi SA, Vasanthy BA.
Division of Endocrinology and Metabolic Medicine, Mubarak Al-Kabeer
Hospital, Kuwait University, Jabriya, Kuwait. email@example.com
BACKGROUND AND OBJECTIVES: Most studies on serum lep n in type 2
diabetes mellitus have focused on white populations. We studied serum
leptin concentrations and parameters related to glycemic control and the
association between leptin levels and anthropometric and metabolic factors
in Arab pa ents with type 2 diabetes and in Arab control subjects.
with type 2 diabetes and 69 matched normal control subjects (48 females
and 21 males) were included. Anthropometric measures (including body
mass index [BMI] and waist:hip ratio) were assessed in all subjects. After an
overnight fast, blood was collected for serum leptin assay. Other metabolic
parameters including glucose, insulin, C-peptide, intact proinsulin, insulin
resistance index (HOMA-IR), insulin-like growth factor 1 (IGF-1), lipids and
hemoglobin A1c (HbA1c) were determined.
RESULTS: Fasting serum leptin levels, IGF-1 and high-density lipoprotein
(HDL) cholesterol were similar in pa ents with type 2 diabetes and control
subjects. When obese subjects (BMI > or =30 kg/m2) were analyzed
separately, serum levels of leptin were significantly lower in patients
compared to controls. In contrast, patients had higher fasting glucose,
insulin, C-peptide, intact proinsulin, insulin resistance, total cholesterol,
triglycerides, HbA1c, and a larger waist circumference and waist-to-hip ratio
than controls. Serum leptin correlated positively with BMI, negatively with
waist-to-hip ratio, and demonstrated no relationship to other parameters.
showed evidence of an unfavorable metabolic profile despite having leptin
levels similar to controls. Obesity influences serum leptin levels more
signiﬁcantly in type 2 diabetes, in which lep n levels tends to be low.
East Mediterr Health J. 2008 Mar-Apr;14(2):333-43.
Body Mass Index of Kuwai Adolescents Aged 10-14
Years: Reference Percentiles and Curves.
Al-Isa AN, Thalib L.
Department of Community Medicine and Behavioral Sciences, Faculty of
Medicine, University of Kuwait, Kuwait. firstname.lastname@example.org
The aim of this population-based study was to develop body mass index
(BMI) reference standards for Kuwaiti adolescents for use in Kuwait and
other Gulf countries. All available intermediate school students aged 10-14
years (32 624 males and 30 209 females) were measured for weight and
height. Polynomial regression smoothing techniques were used to obtain
the best-fitting curves for BMI percentiles. The BMI of boys at lower
centiles and ages was almost always higher than girls. At higher centiles,
the BMI of girls was almost always higher than boys. The data were
compared with the United States National Center for Health Statistics
standards and data from Saudi Arabian and Iranian adolescents.
Med Princ Pract. 2008;17(1):20-6.
Pulmonary Ventilatory Functions and Obesity in Kuwait.
Al-Bader WR, Ramadan J, Nasr-Eldin A, Barac-Nieto M.
Ministry of Public Health, Hawali Health Area, Rumaythia Polyclinic, Kuwait.
ventilatory functions in Kuwaiti adults.
SUBJECTS AND METHODS: A total of 200 male and 180 female Kuwai
adults aged 20-65 years were inves gated in six medical centers from April
2004 to March 2006. Parameters measured included forced expiratory
volume in 1 s (FEV(1)), forced vital capacity (FVC), FEV(1) as a percentage of
FVC (FEV%); body mass index (BMI in kg/m(2)) and waist-to-hip ratio (W/H).
were poor individual predictors of pulmonary ventilatory functions.
However, central adiposity (W/H) was associated with restrictive
respiratory impairment (10.6-13.9% decrease in FEV(1) and 10-12.3%
decrease in FVC), independent of sex, age or height. In obese females and
males (BMI >30), increasing severity of obesity was signiﬁcantly (p < 0.05,
R(2) >0.6) [corrected] associated with increasing restric ve respiratory
impairment (8.7-14.4% decrease in FEV(1) and 8-11.7% decrease in FVC),
with no evidence of obstruc ve disease (FEV(1)/FVC >0.8).
BMI >30 or W/H >1 was associated with a restric ve eﬀect on pulmonary
Mol Cell Biochem. 2007 Aug;302(1-2):249-56. Epub 2007 Apr 20.
Beneficial Effects of Ketogenic Diet in Obese Diabetic
Dashti HM, Mathew TC, Khadada M, Al-Mousawi M, Talib H, Asfar SK,
Behbahani AI, Al-Zaid NS.
Department of Surgery, Faculty of Medicine, Kuwait University, PO Box
24923, 13110 Safat, Kuwait. email@example.com
is found that effective management of body weight and changes to
nutritional habits especially with regard to the carbohydrate content and
glycemic index of the diet have beneficial effects in obese subjects with
glucose intolerance. Previously we have shown that ketogenic diet is quite
effective in reducing body weight. Furthermore, it favorably alters the
cardiac risk factors even in hyperlipidemic obese subjects. In this study the
effect of ketogenic diet in obese subjects with high blood glucose level is
compared to those with normal blood glucose level for a period of 56
MATERIALS AND METHODS: A total of 64 healthy obese subjects with body
mass index (BMI) greater than 30, having high blood glucose level and those
subjects with normal blood glucose level were selected in this study. The
body weight, body mass index, blood glucose level, total cholesterol, LDL-
cholesterol, HDL-cholesterol, triglycerides, urea and creatinine were
determined before and at 8, 16, 24, 48, and 56 weeks a er the
administration of the ketogenic diet.
total cholesterol, LDL-cholesterol, triglycerides, and urea showed a
signiﬁcant decrease from week 1 to week 56 (P < 0.0001), whereas the level
of HDL-cholesterol increased signiﬁcantly (P < 0.0001). Interes ngly these
changes were more significant in subjects with high blood glucose level as
compared to those with normal blood glucose level. The changes in the
level of creatinine were not statistically significant.
CONCLUSION: This study shows the beneficial effects of ketogenic diet in
obese diabetic subjects following its long-term administration.
Furthermore, it demonstrates that in addition to its therapeutic value, low
carbohydrate diet is safe to use for a longer period of time in obese diabetic
Acta Diabetol. 2007 Sep;44(3):106-13. Epub 2007 Aug 26.
Maternal-Foetal Status of Copper, Iron, Molybdenum,
Selenium and Zinc in Obese Gestational Diabetic
Al-Saleh E, Nandakumaran M, Al-Rashdan I, Al-Harmi J, Al-Shammari M.
Department of Obstetrics & Gynecology Faculty of Medicine, University of
Kuwait, P.O. Box 24923, Safat, 13110, Kuwait. firstname.lastname@example.org
Obesity is well known to be a contributory risk factor for several disease
states, including diabetes mellitus. Paucity of data on maternal-foetal status
of essential trace elements in obese diabetic pregnancies prompted us to
undertake this study. Maternal venous and umbilical arterial and venous
blood samples were collected from obese gestational diabetic patients
(Body Mass Index (BMI) >30) and control obese pregnant women (BMI>30)
at time of spontaneous delivery or caesarean sections and concentrations
of essential trace elements such as Cu, Fe, Mo, Se and Zn were determined
in various samples by atomic absorption spectrophotometry. Activities of
antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase
(GPX) and total antioxidant (TAO) in maternal and umbilical blood were
assessed using appropriate reagent kits. Maternal-foetal disposition and
exchange parameters of elements studied were assessed using established
criteria. Concentrations of Cu, Fe, Mo, Se and Zn in serum of control obese
pregnant women (n=10) averaged 2404, 2663, 11.0, 89.0 and 666 microg/l
respec vely, while in the obese diabe c group (n=11), the corresponding
values averaged 2441, 2580, 13.3, 85.1 and 610 microg/l respec vely.
Activities of antioxidant enzymes such as SOD, GPX and TAO were not
significantly different in maternal veins of control and diabetic groups.
Varying differences were noted in the case of antioxidant enzyme activities
in umbilical blood samples of control and study groups. We conclude that
obesity is not associated with significant alterations in antioxidant enzyme
status in gestational diabetes and only with relatively minor alterations in
status of some essential trace elements.
Bulle n of Alexandria Faculty of Medicine, 2007;43(3).
Metabolic Syndrome among Adults Attending Obesity
Clinics in Kuwait.
Salah Al-Shaiji, Osama Fakher, Gamal Makboul
OBJECTIVE: Was to determine the main characteristics of adults attending
obesity clinics in Kuwait and the prevalence of the metabolic syndrome
(MS) among them
from 617 adults aged 15 years and over a ending two obesity clinics in
primary health care centers during April - May 2007 in Kuwait. The
metabolic variables analyzed were fasting blood glucose (FBS), high density
lipoprotein cholesterol (HDL), and triglycerides (TG). In addition,
measurements of obesity such as body mass index (BMI), and waist
circumference (WC) as well as blood pressure were taken. Six hundred
seventeen apparently healthy men and women were recruited for
participation in this study. Weight, height, waist girth, and blood pressure
were recorded using standard procedures. Blood samples were taken after
an overnight fasting and analyzed.
selected clinics were suﬀering from obesity (74.2%). Abnormal physical and
biochemical measurement were encountered among 86.5% of the
par cipants for WC, 34.0% for diabetes, 63.5% for HDL, 25.6 for TG and
45.9% for high blood pressure. The prevalence of the metabolic syndrome
was 46.8%.. Comparing the main characteris cs of the MS and non-MS
subjects showed significant differences in almost all the variables except for
nationality and smoking. Female gender, increased age, obesity and
sedentary life style were significantly associated with MS.
years and over. Low HDL, hypertriglyceridemia, obesity, increased waist
circumference, and high blood pressure were the most prevalent associated
factors in this study.
Med Princ Pract. 2007;16(2):110-3.
Slippage after Adjustable Gastric Banding According to the
Pars Flaccida and the Perigastric Approach.
Khoursheed M, Al-Bader I, Mohammad AI, Soliman MO, Dashti H.
Department of Surgery, Faculty of Medicine, Kuwait University, Safat,
OBJECTIVE: To evaluate laparoscopic adjustable gastric banding and the
'pars flaccida' techniques for treating morbidly obese patients.
SUBJECTS AND METHODS: Between May 1999 and July 2002, 64 pa ents
underwent laparoscopic adjustable gastric banding. The 'perigastric'
technique was performed in the ﬁrst 31 pa ents. From September 2000 the
band was positioned according to the 'pars flaccida' technique in the
remaining 33 pa ents. The pa ents were divided into three groups: group 1
- 'perigastric' technique using Lap-Band size 9.75 and 10 cm (31 pa ents);
group 2 - 'pars flaccida' technique using Lap-Band size 10 cm (12 pa ents),
and group 3 - 'pars ﬂaccida' technique using the Swedish band (21 pa ents).
There were 58 females and 6 males with a mean age of 36.6 years (range
17-56). The preopera ve mean body mass index was 46.2 kg/m(2).
RESULTS: Band slippage occurred in 10/31 pa ents (32.2%) of group 1,
3/12 pa ents (25%) of group 2 and none in group 3 pa ents (p < 0.01).
CONCLUSION: The 'pars flaccida' technique significantly reduces the
incidence of postoperative slippage after gastric banding. This complication
is further reduced in the Swedish band group. Furthermore, we do not
recommend using the 10-cm Lap-Band in the 'pars flaccida' technique.
Med Princ Pract. 2007;16(4):291-8.
Weight Loss Attempts among Kuwaiti Adults Attending
the Central Medical Nutrition Clinic.
Al-Qaoud N, Prakash P, Jacob S.
Ministry of Health, Food and Nutrition Administration, Kuwait.
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