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- MATERIAL AND METHODS
METHOD: Attempts were made to include all healthy Kuwaiti kindergarten
and elementary education children in this study The total sample was
113,013, comprising 55,053 males and 57,960 females. The children were
measured for weight and height from which the BMI was calculated.
Appropriate polynomial regression smoothing techniques were used to
obtain the best-fitting percentile curves.
RESULTS: At percen les < or =25th, the BMI of boys exceeded that of girls.
At the 50th percen le, boys' BMI was mostly higher than or equal to that of
the girls except at age nine where it was lower At the 75th percen le, the
BMI of both genders was similar, with exceptions at age six and nine years.
At the 85th and 95th percen les, girls' BMI was consistently higher than
males. At the lowest percentile, the BMI of US children was higher than
Kuwaiti, Saudi (starting at six) and Iranian children. The BMI of Kuwaiti
children at higher percentiles was higher than that of Saudi, Iranian (except
at age < four years) and US children.
pattern as their US counterparts but with noticeable variations especially at
the lower and higher percentiles. This study may reflect that western
standards may not be directly applicable to assess the level of BMI in
Kuwait and possibly in the neighbouring Gulf countries, since they may
overestimate the levels of overweight, obesity and underweight.
Saudi Med J. 2005 Dec;26(12):1918-25.
Metabolic Syndrome in Saudi Arabia.
Al-Nozha M, Al-Khadra A, Arafah MR, Al-Maatouq MA, Khalil MZ, Khan NB,
Al-Mazrou YY, Al-Marzouki K, Al-Harthi SS, Abdullah M, Al-Shahid MS, Al-
Mobeireek A, Nouh MS.
Department of Medicine, College of Medicine, King Khalid University
Hospital, Riyadh, Kingdom of Saudi Arabia. firstname.lastname@example.org
OBJECTIVES: Metabolic syndrome (MS) is a well-established risk factor for
the development of coronary artery disease (CAD). We designed this study
to obtain the prevalence of MS and each of its components in Saudi Arabia.
This study is part of Coronary Artery Disease in Saudi Study (CADISS).
METHODS: We conducted this community-based national epidemiological
health survey by examining Saudi subjects in the age group of 30-70 years
of selected households over a 5-year period between 1995 and 2000 in
Saudi Arabia. We interviewed all subjects, examined and took
measurements of their blood pressure, weight, height, waist circumference,
as well as fasting samples of plasma glucose, triglycerides, and high-density
lipoprotein (HDL) cholesterol. We obtained the prevalence of MS based on
the presence of at least 3 of the following: abdominal obesity (waist
circumference > 102 cm (40 inch) in male and > 88 cm (35 inch) in female),
triglycerides > or = 150 mg/dl (1.69 mmol/L), HDL cholesterol < 40 mg/dl
(1.03 mmol/L) in male and < 50 mg/dl (1.29 mmol/L) in female, blood
pressure > or = 130/85 mm Hg, fas ng glucose > or = 110 mg/dl (6.1
mmol/L) as deﬁned by the Adult Treatment Panel (ATP) III in 2001.
period. The overall age-adjusted prevalence of MS in Saudi Arabia obtained
from this study is 39.3%. Age adjusted prevalence in males is 37.2% and
crude prevalence is 40.9% (95% conﬁdence interval [CI] 39.8-42), while
females have a higher prevalence of 42% and crude prevalence of 41.9%
(95% CI 40.9-42.9). Saudi subjects from urban areas have significantly
higher prevalence of 44.1% (95% CI 43.2-45) compared to those living in
rural areas of 35.6% (95% CI 34.3-36.7) (p<0.0001). Low HDL aﬀects 81.8%
of females and 74.8% of males with MS leading all other factors, and it
continued to be consistent in all different age groups. Metabolic syndrome
is a risk factor for CAD, as the prevalence of CAD was higher among patients
with MS (6.7%) compared to subjects without MS (4.6%) (p<0.0001).
CONCLUSION: The prevalence of MS is high in Saudi Arabia. Low HDL
cholesterol plays a major role in the contribution to the MS in Saudi Arabia.
Therefore, we recommend routine assessment for the components of MS in
patients with CAD, furthermore, we encourage aggressive management of
the MS for primary prevention of CAD, particularly, measures to increase
Saudi Med J. 2005 Sep;26(9):1360-6.
Prevalence of Metabolic Syndrome in Saudi Adult
Al-Qahtani DA, Imtiaz ML.
Department of Primary Care and Emergency Medicine, Northern Area
Armed Forces Hospital, King Khalid Military City, Post Box 10018, Hafr Al-
Ba n 31991, Kingdom of Saudi Arabia. email@example.com.
male soldiers aged 20 years and above using the criteria of the Na onal
Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III).
2250 Saudi male soldiers aged 20-60 years residing in a military city in
Northern Saudi Arabia in 2004. Par cipants were recruited from a primary
care setting. Anthropometric data together with a brief medical history
were obtained from the subjects at initial contact. Laboratory investigations
were performed on the following day a er fas ng for 12 hours. Data on all
variables required to define the metabolic syndrome according to NCEP ATP
III criteria were available only for 1079 subjects who a ended the
laboratory for inves ga ons (response rate: 47.9%). Data obtained from
these subjects were analyzed excluding the non-respondents from the
to be 20.8%. Abdominal obesity was the most common component in the
study popula on (33.1%) closely followed by raised serum triglycerides
(32.2%) and elevated systolic blood pressure (29.5%). Over two-thirds of
the subjects (71%) exhibited at least one criterion for metabolic syndrome.
Prevalence of individual factors and mean values of the components of the
syndrome showed a steady increase with increase in age and body fat.
Saudi Med J. 2005 Aug;26(8):1260-8.
Obesity and Cardiovascular Risk Factors in Saudi Adult
Al-Qahtani DA, Imtiaz ML, Shareef MM.
Department of Primary Care and Emergency Medicine, Northern Area
Armed Forces Hospital, PO Box 10018, KKMC, Hafr Al-Ba n 31991, Kingdom
of Saudi Arabia. firstname.lastname@example.org
cardiovascular risk factors among men aged 20 years and above.
METHODS: The study involved a cross-sec onal survey of 2,250 Saudi male
soldiers aged between 20 and 60 years residing in a military city in northern
Saudi Arabia conducted in 2004. Anthropometric measurements, blood
pressure, and a brief medical history were obtained in a pre-set
questionnaire. Serum lipid profile and fasting plasma sugar were requested
for all the subjects. A total of 1,079 subjects responded with a response
rate of 47.9%. A mul variate analysis was performed to assess the
relationship between general obesity, abdominal obesity, and
cardiovascular risk factors
Over 82% of the subjects were either overweight or obese.
Abdominal obesity was found in one third, and approximately half were
either current or ex-smokers. The means of anthropometric and laboratory
measured risk factors for cardiovascular disease showed a progressive rise
with increase in age, abdominal, and general obesity.
CONCLUSION: This study has shown a high prevalence of overweight and
obesity positively correlated with the prevalence of cardiovascular risk
factors among Saudi adult male soldiers. There is a need for concerted
efforts aimed at achieving ideal body-weight together with a reduction in
the co-existent risk factors for cardiovascular disease.
Ann Saudi Med. 2005 Jul-Aug;25(4):283-7.
Serum Resistin, Adiposity and Insulin Resistance in Saudi
Women with Type 2 Diabetes Mellitus.
Al-Harithy RN, Al-Ghamdi S.
Biochemistry Department, King AbdulAziz University, Riyadh, SaudiArabia.
BACKGROUND: The role of adipocyte hormones in modulating insulin
sensitivity and glucose tolerance are of increasing interest and importance
in studies of type 2 diabetes mellitus. Recently a unique signaling molecule,
resistin, has been proposed as playing a role in the pathogenesis of obesity-
related insulin resistance, but its relevance to human diabetes remains
uncertain. Therefore, we assessed the relationship between serum resistin
concentrations and insulin resistance in lean, overweight and obese
(OW/OB) non-diabetic and diabetic Saudi women.
SUBJECTS AND METHODS: We measured fas ng serum resis n levels in 44
diabetic women with a mean body mass index (BMI) of 31.82 +/- 4.35
kg/m2, 21 OW/OB non-diabetic women with a mean BMI 30.71 +/- 3.42
kg/m2 and in 24 lean women with a mean BMI of 23.33 +/- 1.24 kg/m2.
Insulin resistance was assessed using the homeostasis model assessment
for insulin resistance formula derived from fasting insulin and glucose
diﬀerences among the three groups (P<0.001). Mean serum resis n
concentrations increased from lean (11.59 +/- 2.08) to OW/OB non-diabetic
(16.29 +/- 2.29) to diabetic (19.42 +/- 3.60 ng/mL) women. Signiﬁcantly
higher levels of glucose (P<0.001) and values for the homeostasis model
assessment ratio (HOMA-R) (P<0.01) occurred in the diabetic compared to
the lean and OW/OB non-diabetic subjects. Furthermore, resistin correlated
signiﬁcantly and posi vely with hip circumferences (r=0.39, P=0.039),
weight (r=0.51, P=0.005), insulin (r=0.40, P=0.033), HOMA-R (r=0.49,
P=0.007) and glucose (r=0.39, P=0.038) in diabetic women. In OW/OB non-
diabetic subjects, resis n correlated with insulin (r=0.59, P=0.015) and
HOMA-R (r=0.616, P=0.011). No correla on was observed with glucose,
height, hip, waist, weight, and waist-hip ratio (WHR) in the lean and OW/OB
CONCLUSION: Resis n concentra ons are elevated in pa ents with type 2
diabetes and are associated with obesity and insulin resistance. These data
indicate that resistin might be involved in the development of diabetes in
Cardiovasc Diabetol. 2005 Jul 5;4(1):10.
Serum Resistin is Associated with C-Reactive Protein &
LDL Cholesterol in Type 2 Diabetes and Coronary Artery
Disease in a Saudi Population.
Al-Daghri N, Chetty R, McTernan PG, Al-Rubean K, Al-Attas O, Jones AF,
Biochemistry Department, King Saud University College of Science, Riyadh,
Saudi Arabia. email@example.com
associated type 2 diabetes (T2DM). This study examines the associa on
between human serum resis n, T2DM and coronary heart disease.
female ra o 46:68; age 51.4 (mean +/- SD)11.7 years; median and range:
45.59 (11.7) years and BMI: 27.1 (mean +/- SD) 8.1 Kgm2 median and range:
30.3 (6.3) were studied. Serum resis n and C-reactive protein (CRP), a
marker of inﬂamma on CRP levels, were measured in all subjects. (35
pa ents had type 2 diabetes mellitus (T2DM); 22 pa ents had coronary
heart disease (CHD).
1.3-fold higher in CHD than in controls (p = 0.01). In addi on, CRP was
signiﬁcantly increased in both T2DM and CHD pa ents (p = 0.007 and p =
0.002 respec vely). The use of regression analysis also determined that
serum resistin correlated with CRP levels (p = 0.04, R2 0.045).
circula ng protein associated with T2DM and CHD. In addi on this study
also demonstrates an association between resistin and CRP, a marker of
inflamma on in type 2 diabetic patients.
Respir Med. 2005 Jun;99(6):718-25. Epub 2005 Jan 26.
Sleep-Related Breathing Disorders in Obese Patients
Presenting with Acute Respiratory Failure.
BaHammam A, Syed S, Al-Mughairy A.
Sleep Disorders Center, Respiratory Unit, Department of Medicine, College
of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi
polysomnographic characteristics of patients with sleep-related breathing
disorders who presented to the intensive care unit (ICU) with acute
respiratory failure and the practicability of performing polysomnography
for such patients.
admission to the ICU, ICU course and outcome of 11 subjects with acute
respiratory failure who were diagnosed to have sleep disordered breathing
based on polysomnography between October 1999 and January 2003.
Subjects were compared to 11 pa ents with obstruc ve sleep apnea
syndrome matched to each subject using body mass index, age and apnea
hypopnea index measured at the time of diagnosis (matched comparison
group). Repeated arterial blood gases and polysomnography were done for
8 subjects compliant to treatment 6-8 months a er discharge from ICU.
respiratory failure. pH and day me PaO2 were signiﬁcantly lower in studied
subjects compared to the matched comparison group while awake daytime
PaCO2 was signiﬁcantly higher. Subjects had frequent episodes of
hypoven la on. Follow up arterial blood gases and polysomnography 6-8
months after treatment (non-invasive ventilation) in compliant subjects
showed significant improvement in all blood gases parameters.
monitoring) allows accurate diagnosis and institution of the appropriate
ventilation method Further studies should assess the evolution of
respiratory drive in patients with sleep disordered breathing and
hypercapnia under therapy (non-invasive ventilation).
Saudi Med J. 2005 May;26(5):824-9.
Obesity in Saudi Arabia.
Al-Nozha MM, Al-Mazrou YY, Al-Maatouq MA, Arafah MR, Khalil MZ, Khan
NB, Al-Marzouki K, Abdullah MA, Al-Khadra AH, Al-Harthi SS, Al-Shahid MS,
Al-Mobeireek A, Nouh MS.
Department of Medicine, College of Medicine and King Khalid University
Hospital, Jeddah, Kingdom of Saudi Arabia. firstname.lastname@example.org
OBJECTIVE: Obesity and overweight are well known risk factors for
coronary artery disease (CAD), and are expected to be increasing in the
Kingdom of Saudi Arabia (KSA) particularly among females. Therefore, we
designed this study with the objective to determine the prevalence of
obesity and overweight among Saudis of both gender, between the ages of
30-70 years in rural as well as in urban communi es. This work is part of a
major national project called Coronary Artery Disease in Saudis Study
(CADISS) that is designed to look at CAD and its risk factors in Saudi
health survey, conducted by examining Saudi subjects in the age group of
30-70 years of selected households over a 5-year period between 1995 and
2000 in KSA. Data were obtained from body mass index (BMI) and were
analyzed to classify individuals with overweight (BMI = 25-29.9 kg/m2),
obesity (BMI >/=30 kg/m2) and severe (gross) obesity (BMI >/=40 kg/m2) to
provide the prevalence of overweight and obesity in KSA.
selected households who participated in the study. The prevalence of
overweight was 36.9%. Overweight is signiﬁcantly more prevalent in males
(42.4%) compared to 31.8% of females (p<0.0001). The age-adjusted
prevalence of obesity was 35.5% in KSA with an overall prevalence of 35.6%
[95% CI: 34.9-36.3], while severe (gross) obesity was 3.2%. Females are
signiﬁcantly more obese with a prevalence of 44% than males 26.4%
CONCLUSION: Obesity and overweight are increasing in KSA with an overall
obesity prevalence of 35.5%. Reduc on in overweight and obesity are of
considerable importance to public health. Therefore, we recommend a
national obesity prevention program at community level to be
implemented sooner to promote leaner and consequently healthier
Saudi Med J. 2005 Apr;26(4):607-11.
Prevalence of Obesity and Overweight among Saudi
Adolescents in Eastern Saudi Arabia.
Department of Family and Community Medicine, College of Medicine, King
Fahd University, Al-Khobar 31952, Kingdom of Saudi Arabia.
Saudi adolescents, using the 2 most widely used interna onal references.
METHODS: A cross-sectional study conducted towards the end of 2001 on
a random sample of third grade intermediate and all 3 grades of secondary
school Saudi students of both genders in Al-Khobar area, Eastern Saudi
Arabia. The body mass index (BMI) was calculated. The American National
Health and Nutrition Examination Survey (NHANES) growth charts, which
have been adopted by the World Health Organization (WHO), were used.
Student with a BMI of <85th and >95th percen le for age and genders,
were deﬁned as overweight and <95th percen le defined as obese. The
International Obesity Taskforce (IOTF) age-sex-specific BMI cut-offs
reference for defining overweight and obesity was used for comparison.
RESULTS: The sample was 1766 students, comprising 675 males and 1091
females. The mean age was 16.4 +/- 1.7 years. The prevalence of obesity
was higher in male than female students (19.3% versus 11.8%) while a
higher propor on of female students than males were overweight (17.2%
versus 10.2%). No signiﬁcant diﬀerence was found between the 2
references used to determine the prevalence of obesity and overweight.
CONCLUSION: The high prevalence of overweight and obesity recorded in
this study call for prevention programs based on dietary and physical
education in schools.
J Int Acad Periodontol. 2005 Apr;7(2):34-8.
Alveolar Bone Loss in Obese Subjects.
Alabdulkarim M, Bissada N, Al-Zahrani M, Ficara A, Siegel B.
Ministry of Health, Riyadh, Saudi Arabia.
periodontal disease prevalence as measured by probing depth and clinical
attachment loss. The aim of this study was to examine if obesity correlates
with chronic periodontitis as diagnosed by radiographic alveolar bone loss.
METHOD: Four hundred subjects > or =18 years old were included; 200
with body mass index (BMI) > or =30 kg/m2 (obese) and 200 with BMI < 25
kg/m2 (non-obese). Alveolar bone loss was determined from full mouth
radiographs for each subject. Logistic regression models were used to
estimate the association of obesity and periodontitis.
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