Saudi Med J. 2009 Dec;30(12):1542-6. Is there a Relationship between Body Mass Index and
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- Abstract OBJECTIVE
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- SUBJECTS AND METHODS
- Impact of Obesity on Fetomaternal Outcome in Pregnant Saudi Females.
- Abstract BACKGROUND
- Abstract Aim
Saudi Med J. 2009 Dec;30(12):1542-6.
Is there a Relationship between Body Mass Index and
Serum Vitamin D Levels?
Al-Elq AH, Sadat-Ali M, Al-Turki HA, Al-Mulhim FA, Al-Ali AK.
Department of Internal Medicine, College of Medicine, King Faisal
University, Dammam, and King Fahd Hospital of University, Al-Khobar,
Kingdom of Saudi Arabia.
mass index (BMI) among Saudi Arabian citizens.
METHODS: Four hundred healthy individuals aged > or =25 years (200
males and 200 females) were included in this cross-sectional study. Subjects
were recruited in the period between 1st February 2008 and 31st May 2008
from the medical staff and employees of King Fahd Hospital of the
University, Al-Khobar, Kingdom of Saudi Arabia, and from patients
attending the endocrinology, orthopedic, and infertility clinics at the same
hospital. Clinical evaluation was carried out, and BMI was calculated. Serum
25 hydroxy vitamin D (25OHD), in addition to serum parathyroid hormone
levels and calcium chemistry were measured for all subjects.
15.9 years for females (p=0.01). Mean BMI was similar in both genders, and
the diﬀerence in the level of serum 25OHD just reached sta s cal
signiﬁcance (p=0.04). Male subjects with vitamin D deﬁciency were found
to be older (p=0.03), and with higher BMI (p=0.01) compared to males with
normal 25OHD. Although female subjects with hypovitaminosis D were also
older than subjects with normal vitamin D level (p=0.01), BMI was
signiﬁcantly lower in females with vitamin D deﬁciency (p=0.001).
CONCLUSION: Obese males are at higher risk of having low 25OHD levels,
while obesity in females appears to be protective against vitamin D
deficiency in the population studied. We believe that obese male and thin
female patients should be appropriately investigated, and treated for
vitamin D deficiency.
Ann Saudi Med. 2009 Nov-Dec;29(6):437-45.
Performance of Body Mass Index in Predicting Diabetes
and Hypertension in the Eastern Province of Saudi Arabia.
Almajwal AM, Al-Baghli NA, Batterham MJ, Williams PG, Al-Turki KA, Al-
School of Health Sciences, University of Wollongong, Wollongong, NSW,
used measure to define obesity and predict its complications, such as
diabetes and hypertension, but its accuracy and usefulness in Saudi subjects
is unknown. This study aimed to assess the validity of standard BMI cut-
point values in the Saudi population.
study to detect diabetes and hypertension in the Saudi Eastern province in
2004/2005, with blood pressure, fas ng blood sugar, height and weight
measurements taken. Sensitivities, specificities, areas under the curves,
predictive values, likelihood ratios, false positive, false negatives and total
misclassification ratios were calculated for various BMI values determined
from receiver operating characteristic (ROC) curves. The significance of the
association between risk factors and BMI was assessed using regression
optimal BMI cut-oﬀs of 28.50 to 29.50 in men and 30.50 to 31.50 in women,
but the levels of sensitivity and specificity were too low to be of clinical
value and the overall misclassification was unacceptably high across all the
selected BMI values (>0.80). The rela onship between BMI and the
presence of diabetes and/or hypertension was not improved when a BMI of
25 was used. Using regression analyses, the odds ratios for hypertension
and/or diabetes increased signiﬁcantly from BMI values as low as 21-23
with no improvement in the diagnostic performance of BMI at these
CONCLUSION: In Saudi population, there is an increased risk of diabetes
and hypertension rela ve to BMI, star ng at a BMI as low as 21 but overall
there is no cutoff BMI level with high predictive value for the development
of these chronic diseases, including the WHO definition of obesity at BMI of
Int J Gynaecol Obstet. 2009 Oct;107(1):54-7. Epub 2009 Jul 3.
Effect of Body Mass Index on Clinical Manifestations in
Patients with Polycystic Ovary Syndrome.
Tamimi W, Siddiqui IA, Tamim H, AlEisa N, Adham M.
Department of Pathology and Laboratory Science, King Saud Bin Abdulaziz
University for Health Sciences, Riyadh, Saudi Arabia.
OBJECTIVE: To determine whether there is a correlation between body
mass index (BMI) and blood pressure or clinical features such as hirsutism in
women with polycystic ovary syndrome (PCOS).
allocated to one of 3 groups according to a BMI range deﬁning normal
weight, overweight, or obesity. Blood pressure, waist-to-hip ratio, Ferriman
and Gallwey hirsutism score, and presence of acne were recorded for each
participant and the means were compared among groups.
systolic and diastolic blood pressure, 113.02+/-16.10 mm Hg and 71.79+/-
10.04 mm Hg; waist-to-hip ra o, 0.82+/-0.07; and hirsu sm score, 3.63+/-
4.35. Acne was present in 24 par cipants. Of these, 8 (33.3%) were
overweight and 13 (54.2%) obese. When groups were compared, a
progressive and significant increase in systolic and diastolic blood pressure
was observed from the normal weight to the obese group.
between BMI and both blood pressure and clinical features in women with
Ann Saudi Med. 2009 Sep-Oct;29(5):357-60.
Cardiovascular Risk Factors in a Group of Obese Saudi
Children and Adolescents: A Hospital-Based Study.
Taha D, Ahmed O, bin Sadiq B.
Department of Pediatrics, King Faisal Specialist Hospital and Research
Centre, PO Box 40047, Jeddah 21499, Saudi Arabia. email@example.com
BACKGROUND AND OBJECTIVES: We assessed the distribution of risk
factors associated with the metabolic syndrome in a group of obese Saudi
children and adolescents. No previous studies had addressed this issue in
the Saudi pediatric population.
SUBJECTS AND METHODS: We retrospectively reviewed the medical
records of pa ents evaluated for obesity between 2004 and 2008 and
collected data on age, weight, height, body mass index (BMI), BP, fasting
lipid profile, fasting glucose, insulin concentrations, and insulin resistance
based on the homeostasis assessment model-insulin resistance (HOMA-IR)
score. Obesity was deﬁned as a BMI above the 95th percen le for age and
gender and metabolic syndrome was diagnosed according to standard
RESULTS: We studied 57 obese Saudi children and adolescents with a mean
(standard devia on) age of 9.8 (3.5) years. Mean weight and body mass
index (BMI) were 63.7 (28.3) kg and 31.6 (8.0) kg/m(2) , respec vely.
Systolic BP was elevated in 24 (42%) of the 57 subjects. Of the 39 children
who had a lipid proﬁle in their records, 10 had hypertriglyceridemia, 8 had
hypercholesterolemia, 6 had elevated LDL cholesterol levels, and 6 had low
HDL cholesterol levels. Impaired fasting glucose was found in 10 of 38
pa ents in which it was measured, and 9 of 25 pa ents had fas ng
hyperinsulinemia. Eleven of 37 pa ents (29.7%) met the diagnosis of the
metabolic syndrome. Diastolic BP correlated posi vely with BMI (r=0.440, P
=.001), and HDL cholesterol correlated negatively with weight and BMI (r=-
0.487, P =.002 and r=-0.317, P =.05). HOMA-IR correlated positively with
BMI and triglyceride levels and negatively with HDL cholesterol levels.
factors associated with metabolic syndrome.
Saudi Med J. 2009 Sep;30(9):1123-32.
Adipokines and Etiopathology of Metabolic Disorders.
Department of Physiology, College of Medicine, King Khalid University
Hospital, PO Box 2925, Riyadh 11461,
Kingdom of Saudi Arabia.
White adipose tissue is an endocrine organ producing numerous proteins
known as adipokines, which include leptin, adiponectin, resistin, visfatin,
and other factors, which are involved in most metabolic disorders. In
obesity, plasma leptin concentrations are high due to leptin resistance that
may result from the attenuation of leptin signaling in the hypothalamus.
Leptin acts to inhibit appetite, stimulate thermogenesis, enhance fatty acid
oxidation, decrease glucose, and reduce body weight, and fat. A reduced
adiponectin level has been associated with insulin resistance, dyslipidemia,
and atherosclerosis, and its low level is a predictor of later development of
type 2 diabetes. Resis n expression is low in adipose ssue and high in
bone marrow and lungs, its role in glucose homeostasis remains
controversial, it has been associated with insulin resistance and obesity.
Visfatin is a secretory protein highly enriched in visceral adipocytes, liver,
muscle, and lymphocytes. An increase of visfatin levels in obesity was
related to preservation of insulin sensitivity, it enhances glucose uptake by
adipocytes and inhibits hepatocyte glucose release, it induces tyrosine
phosphorylation, and interacts with insulin receptors. Many studies are still
being conducted to highlight the role of adipokines in metabolic disorders.
Int J Health Sci (Qassim). 2009 Jul;3(2):133-42.
Prevalence of Metabolic Syndrome among Qassim
University Personnel in Saudi Arabia.
Barrimah IE, Mohaimeed AR, Midhat F, Al-Shobili HA.
Departments of Family & Community Medicine and.
Qassim university personnel in Saudi Arabia using the definition proposed
by NCEP ATPIII.
diﬀerent ages and careers. 560 individuals par cipated in this study with a
response rate of 85%. For all par cipants, the data collected were
sociodemographic characteristics, past history or receiving medication for
diabetes or hypertension, smoking habits, physical activity, and
measurements necessary to identify metabolic syndrome.
RESULTS: Prevalence of metabolic syndrome was 31.4%. The prevalence
was found to show a steady increase with increasing age, BMI and serum
cholesterol. General obesity measured by BMI was the most common
component associated with the syndrome where 75% of par cipants
suffered from overweight and obesity. Participants with high-density
lipoprotein below protec ve level cons tuted 73.6%, while those with total
cholesterol and triglyceride above clinically normal level constituted 60.0%
& 46.4% respec vely. Elevated fas ng plasma glucose and hypertension
were the least common. After adjustment, factors found to be associated
with metabolic syndrome were being a Saudi national, smoking, not doing
regular exercise, being obese having total serum cholesterol above 180
mg/dl, and age groups above 40 years.
CONCLUSION: Almost a third of the university personnel have metabolic
syndrome and therefore they are at higher risk for both cardiovascular
diseases and diabetes mellitus. Similar studies are required among a wider
range of subjects to assess the scope of the problem in Saudi Arabia.
Obes Facts. 2009;2(4):217-20. Epub 2009 Jul 9.
Prevalence of Obesity in a Saudi Obstetric Population.
El-Gilany AH, El-Wehady A.
Community Medicine Department, College of Medicine, Mansoura
University, Egypt. firstname.lastname@example.org
OBJECTIVE: To estimate the prevalence of obesity and its determinants
during the first month of gestation in Saudi women.
METHODS: Retrospective chart review of measured BMI in Al-Hassa, the
largest province in Saudi Arabia, in 2007. Data were collected from records
of 791 (72.6% of 1,089) pregnant women registered for prenatal care.
skewed posi vely (skewness of 0.77). The prevalence of underweight,
normal weight, overweight, obesity, and extreme obesity (BMI > 40
kg/m(2)) were 8.5, 39.3, 23.6, 23.9, and 4.7%, respec vely. Logis c
regression revealed that the most important significant independent
predictors of obesity are parity of 4 and more (odds ra o (OR) = 5.8) and
urban residence (OR = 4.9).
(>52%) among pregnant women in Saudi Arabia. Health educa on to
control body weight before pregnancy is warranted.
Int J Health Sci (Qassim). 2009 Jul;3(2):187-95.
Impact of Obesity on Fetomaternal Outcome in Pregnant
Meher-Un-Nisa, Aslam M, Ahmed SR, Rajab M, Kattea L.
Department of Obstetrics & Gynecology, Qassim University, College of
Medicine, Buraida, Saudi Arabia.
BACKGROUND: Obesity is rapidly increasing in most populations of the
world including Saudi community. Maternal obesity adversely impacts
pregnancy outcome through increased rates of hypertensive disease,
diabetes, cesarean section and infections.
OBJECTIVES: The aim of this study is to determine frequency of obesity and
its adverse effects on reproductive outcome in pregnant Saudi females.
METHODS: Prospec ve Cohort study. Eight months (Nov 2008 to June
2009), Maternity and Children Hospital (MCH) Buraida, Saudi Arabia Sample
included a group of 1000 randomly recruited pregnant Saudi females.
Patients were admitted through Outpatient and Emergency Departments.
Height was recorded once and weight twice; at the beginning
(prepregnancy weight) and end of pregnancy. The difference between the
two weights was taken as net weight gain in pregnancy. Prepregnancy
weight was used to calculate Body mass index (BMI) using formula; Weight
in Kg/Height in (m). 2 The sample was divided into 5 groups depending
upon their BMI ;< 18.5, 18.5-24.9, 25-29.9, 30-39.9 &>40, classiﬁed as
underweight, normal weight, overweight, obese & morbidly obese
respectively. The normal weight group was used as control group. Data
were collected regarding complications of obesity in pregnancy and labor
and recorded on a Performa. Results were calculated by using computer
programme SPSS Version 13 for windows. A p-value of< 0.05 is used to
calculate statistical significance.
calculated to be 2% (lean), 31% (normal weight), 33%(overweight),
30%(obese) and 4%(morbidly obese). Compared with normal weight
women, both overweight and obese women had a significantly increased
risk (p-value-<0.05) for gesta onal diabetes, preeclampsia, cesarean
delivery, and delivery of a macrocosmic infant.
CONCLUSION: Overweight & obesity is a growing problem in pregnant
Saudi females associated with increased risks of fetomaternal complications
like preeclampsia, gestational diabetes, cesarean delivery, and delivery of a
Cardiovasc Diabetol. 2009 Jun 23;8:33.
Combined Eﬀects of Obesity and Type 2 Diabetes
Contribute to Increased Breast Cancer Risk in
Department of Biochemistry, College of Science, King Saud University,
Riyadh, Kingdom of Saudi Arabia. email@example.com
factors for breast cancer development. Combined effect of these metabolic
abnormalities on breast cancer risk however, has not been examined in
premenopausal women. We tested this associa on in type 2 diabe c
women, categorized as obese, overweight and normal body weight groups
based on BMI.
DESIGN AND METHODS: A total of 101 subjects were included in this
study. Serum levels of IL-6, TNF-alpha, C reactive protein, leptin, TGF-alpha,
adiponectin and insulin were measured by ELISA. Data were logarithmically
transformed for variables not normally distributed. Analysis of variance
with post-hoc Bonferroni was applied to compare the data between the
groups. Simple and partial correlation coefficients between the variables
were determined and a stepwise multiple linear regression analysis was
performed to determine the relationships between the variables of
significantly decreased levels of adiponectin were found in obese group,
while the levels of TNF-alpha and TGF-alpha were unaltered. A positive
correlation between waist circumference and IL-6 was found in obese
group. Similarly, C reactive protein, waist and hip circumferences were
linearly correlated with BMI in obese group. Stepwise multiple linear
regression analysis revealed several significant predictors for breast cancer
CONCLUSION: Obesity and type 2 diabetes, owing to their eﬀects on
adipocytokines and inflammatory mediators, contribute to increased breast
cancer risk in premenopausal women. This study emphasizes healthy life
style and better management of these metabolic disorders to avoid the
pathogenesis of breast cancer and of other chronic diseases.
Nutrition & Dietetics, June 2009, 66(2);94–100.
Current Dietetic Practices of Obesity Management in
Saudi Arabia and Comparison with Australian Practices
and Best Practice Criteria
Ali ALMAJWAL, Peter WILLIAMS, Marijka BATTERHAM, Almajwal, MSc
(Nutr/Diet), PhD, Candidate P. Williams, PhD, FDAA, Associate Professor M.
Batterham, PhD, AdvAPD, Senior Lecturer.
Aim: To describe the dietetic practices of the treatment of obesity in Saudi
Arabia and compare this with best practice criteria and the practice in
Arabia. The topics included barriers to obesity management, demand and
level of service and strategies and approaches used for weight
management. Best practice scores were based on those used to assess
ans par cipated in the survey. Of these, 175
(69%) were involved in the management of obesity. The best prac ce score
for Australian dietitians was slightly greater than the scores of Saudi
ans (median 43 vs 39). There was also a signiﬁcant correla on
between the best prac ce score and years of experience (r = 0.26, P <
0.001). The most common assessment approaches were assessment of
body mass index (87%) and exercise habits (81%), while the most common
strategies for obesity management were: dietary total fat reduc on (92%)
and increase incidental daily ac vity (92%). The major barrier for
establishment of a weight management clinic reported by 49% of
participants was inadequate resources.
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