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- Abstract BACKGROUND
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- Abstract AIM
- Dehydroepiandrosterone Sulfate Levels in Women. Relationships with Body Mass Index, Insulin and Glucose Levels.
RESULTS: Obesity was found to be significantly associated with
periodontitis in the uni-variate regression analysis (OR = 2.37, 95% CI, 1.55-
3.63). A er adjus ng for age, gender, smoking, employment, diabetes,
marital status, and number of teeth present, obese subjects were found to
be 1.86 mes more likely to have periodon
s (95% CI, 0.99-3.51) than
non-obese ones. When the sample was stratified based on age, the
multivariate association was sta s cally signiﬁcant among individuals < 40
years of age (OR = 2.67, 95% CI, 1.09-6.58) while among individuals > or =
40 years of age the associa on was sta s cally insigniﬁcant (OR = 1.06, 95%
CI, 0.57-1.95). Stra fying the sample based on gender and smoking status
revealed a stronger associa on among females than males (OR = 3.14 vs.
1.95) and among non-smokers than smokers (OR = 3.36 vs. 2.22).
periodontitis as measured by radiographic alveolar bone loss, especially
among younger individuals. Prevention and management of obesity may be
considered to promote better systemic and periodontal health.
Obes Surg. 2005 Jan;15(1):101-5.
Intragastric Balloon for Obesity: A Retrospective
Evaluation of Tolerance and Efficacy.
Al-Momen A, El-Mogy I.
The Bariatric Surgery Center, Saad Specialist Hospital, Al-Khobar, Saudi
BACKGROUND: The intragastric balloon may be used for weight reduction
for mild or moderate obesity, or for preoperative weight loss for super-
obesity. The authors retrospectively evaluated the tolerance and efficacy of
the BioEnterics Intragastric Balloon (BIB).
METHODS: From October 2002 to July 2004, intragastric balloons were
placed, under endoscopic control, in 44 pa ents (mean BMI 45 kg/m2 ,
mean age 31 years). The balloons were ﬁlled with 500-600 mL of normal
saline. Removal was recommended for 6 months a er balloon inser on.
RESULTS: 6 pa ents (13.6%) were lost to follow-up, 7 super-obese patients
underwent LAGB at our hospital, and 2 pa ents had the BIB procedure
performed twice. Balloon placement was uneventful. Removal was
performed endoscopically in 38 pa ents under conscious seda on with
anesthesiological assistance (2 pa ents had the BIB removed under general
anesthesia). No cases of tracheal aspiration or spontaneous balloon
evacua on were encountered. Sideeﬀects were vomi ng during the 1st
week (77.2%), occasional vomi ng for >3 weeks (11.3%), hypokalemia
(6.8%), func onal renal insuﬃciency (4.5%), abdominal pain (15.9%), and
gastroesophageal reﬂux (6.8%). There was 1 gastric perfora on (treated
laparoscopically a er removal of the BIB), 1 gastric ulcer, 4 cases of
intolerance (1 of these elected to have LAGB), and 1 died (from other
medical condi ons). Mean excess weight loss was 13 kg (33 kg in the super-
CONCLUSIONS: The BIB appears to be safe provided that it is removed
within the speciﬁed 6 months. Surveillance is necessary. It was eﬃcient in
reducing weight in patients with mild or moderate obesity and as
preoperative treatment for super-obese patients to reduce the surgical risk
Saudi Med J. 2004 Sep;25(9):1193-8.
Relationship between Plasma Angiotensinii, Leptin and
Arterial Blood Pressure.
Al-Hazimi AM, Syiamic AY.
Physiology Department, College of Medicine, King Abdul-Aziz University, PO
Box 80205, Jeddah 21589, Kingdom of Saudi Arabia. firstname.lastname@example.org
OBJECTIVE: Obesity and hypertension are 2 closely associated conditions
and obesity probably predisposed to hypertension. The mechanism of the
association between obesity and hypertension is not clear. The aim of the
present study was to clarify the relationship between blood pressure (BP),
body mass index (BMI), serum angiotensinII (AGII) and serum leptin levels
and to investigate the relation between serum AGII and leptin. This study
also aimed to rule out if there is a difference in serum AGII and leptin levels
between lean and obese hypertensive females.
METHODS: We measured fas ng serum AGII and lep n levels in 16
normotensive lean (LN) females, 25 obese normotensive (ON) females, 12
lean hypertensive (LH) females and 25 obese hypertensive (OH) females. All
subjects had no evidence of preexisting cardiovascular disease, were non
pregnant, had no previous history of ill health or smoking and were not on
antihypertensive therapy. This study was performed in King Abdul-Aziz
University Hospital, Jeddah, Kingdom of Saudi Arabia from January 2002
through to January 2003
RESULTS: In lean groups, there were a significant increase in BMI and
serum AGII in hypertensive group compared to normotensive group while
the serum leptin level was insignificantly higher in hypertensive group than
in normotensive group. On the other hand, there was a significant increase
in serum AGII, BMI and serum leptin for obese hypertensive compared to
obese normotensive group. The mean arterial blood pressure (ABP) was
significantly correlated to serum AGII, serum leptin and BMI in all groups. A
significant correlation was found between serum AGII and serum leptin if all
studied females (LN, LH, ON and OH) or obese females (ON and OH) were
analyzed (P=0.000 and 0.04). However, in lean females (LN and LH) there
was no relation between serum AGII and serum leptin.
were strong predictor of BP, which is not the case in lean females in whom
only serum AGII is a predictor of BP. Elevation of serum AGII and serum
leptin levels when associated with increased BMI may contribute to the
pathophysiology of obesity induced hypertension. Further study on leptin
resistance in obese persons and its relation to increased ABP has to be
East Mediterr Health J. 2004 Jul-Sep;10(4-5):663-70.
Prevalence of Physical Inactivity in Saudi Arabia: A Brief
Exercise Physiology Laboratory, King Saud University, Riyadh, Saudi Arabia.
Major lifestyle changes in recent years in Saudi Arabia may be leading to
physical inactivity and a low level of physical fitness. This paper reviews the
current literature about physical inactivity in the Saudi Arabian population
and discusses its implications for health. Available data from a small
number of studies suggests a high prevalence (43.3%-99.5%) of physical
inactivity among Saudi children and adults alike. Furthermore, the
proportion of Saudi children and adults who are at risk due to inactivity is
much higher than for any other coronary heart disease risk factor. It is
recommended that a national policy encouraging activity in daily life be
established and more studies are carried out to address physical activity
patterns with representative samples of the Saudi Arabian population.
Saudi Med J. 2004 Aug;25(8):1086-90.
Relationship of Leptin Concentration to Gender, Body
Mass Index and Age in Saudi Adults.
Department of Biochemistry, Faculty of Science, King Abdul-Aziz University,
OBJECTIVE: Leptin concentrations are highly correlated with body fat
storage and exhibit sexual dimorphism, with women having higher
concentrations at every level of relative or absolute adiposity. To test
whether or not this relation is consistent across the Saudi population. This
study aims to investigate the effect of gender, obesity related parameters,
and age on leptin levels from representative samples of Saudi women and
Jeddah, Kingdom of Saudi Arabia during the year 2003. Fas ng lep n
concentra ons were determined a er an overnight fast in 122 healthy
subjects (57 women, 65 men; age 20-75 years; body mass index [BMI] 16-56
kg/m2). The subjects were separated into female and male groups. To
clarify the age and BMI-related changes in leptin levels, each gender was
divided into 3 BMI groups (lean 15-24, overweight 25-30 and obese >30
kg/m2), and 3 age groups (younger 20-34, middle-aged 35-49 and older 50-
75 years); and they were treated separately. Anthropometrics
measurements (weight, height, waist, and hip circumferences), blood
pressure, and fasting glucose levels were taken at the time of the collection.
and females had higher lep n concentra on (6.04 +/- 4.71 ng/ml versus
1.72 +/- 0.95 ng/ml, p<0.0001) than males. Gender diﬀerences remained
clear when leptin concentrations were divided by BMI or age. In comparing
the pa ern of changes between the 2 genders, lep n levels were low in
lean individuals and rose with increased BMI in both genders. Age-related
change in leptin levels showed a tendency toward a non-significant
reduc on in older women and a signiﬁcant (p=0.05) rise in older men.
Correlation analysis between leptin and BMI were highly significant in
female (r=0.64; p=0.0001) and male (r=0.49; p=0.0001) groups independent
of age and sex. The findings were further explored using stepwise multiple
linear regression analysis with leptin concentrations as the dependent
variable and age, BMI, waist hip ratio (WHR), waist, and hip measurements
as independent variables. The analysis demonstrated that the determinants
of lep n concentra ons were BMI and age (r=0.69; p=0.015) in women and
BMI, age and WHR (r=0.61; p=0.01) in men.
CONCLUSION: The present study demonstrates that there are gender-
specific and age-dependent gender-specific differences in leptin
concentrations in healthy Saudi individuals. However, this study indicates
that there may be unknown variables that may also influence leptin levels
in Saudi women and men.
Acta Paediatr. 2003 Dec;92(12):1482-5.
Body Mass Index for Saudi Children with Down's
Al Husain M.
Department of Pediatrics, College of Medicine, Riyadh, Saudi Arabia.
AIM: Children with Down's syndrome (DS) have a higher prevalence of
obesity than children without DS. This study aimed to assess the prevalence
of overweight/obesity and to establish reference body mass index (BMI)
percentile curves for Saudi children with uncomplicated DS below the age
of 5 y.
compared with 989 Saudi children without DS. Both groups were compared
with the international cut-off point figures for age and gender.
and their mean BMI curves were linear to the international cut-off points
for BMI, indicating a clear tendency for overweight. BMI reference
percentile curves were constructed.
CONCLUSION: Reference curves for BMI worked out in this study, taken in
conjunction with those for height and weight, will be useful in monitoring
the size and shape of Saudi children with DS up to the age of 5 y.
East Mediterr Health J. 2003 Sep-Nov;9(5-6):884-92.
Cardiovascular Risk Factors in Saudi Arabian and Non-
Saudi Arabian Diabetic Patients in Saudi Arabia.
Akbar DH, Ahmed MM, Algamdi AA.
Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi
To determine frequency of cardiovascular risk factors in Saudi and non-
Saudi diabetics, we studied patients attending King Abdulaziz University
Hospital for follow-up in the period January 1997 to December 2001.
Cardiovascular risk factors, including hypertension, hyperlipidaemia, obesity
and smoking, were studied as well as degree of blood glucose control. Of
1122 pa ents in the study, 48% were Saudis and 52% non-Saudis. No
statistically significant difference was found for prevalence of
cardiovascular risk factors between the two groups. Correlation of each of
the risk factors to patient's age showed significant correlation to
hypertension and smoking.
Saudi Med J. 2003 Aug;24(8):837-41.
Dehydroepiandrosterone Sulfate Levels in Women.
Relationships with Body Mass Index, Insulin and Glucose
Womens Biochemistry Department, King Abdul-Aziz University, PO Box
40288, Jeddah 21499, Kingdom of Saudi Arabia. email@example.com
OBJECTIVE: Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S)
are the most abundant steroids in human plasma. Previous studies have
shown that administration of DHEA-S is more effective than DHEA in
reducing adipose tissue mass and cellularity in rats. Another study
suggested that maintaining high levels of DHEA-S might prevent the
development of obesity. Therefore, this study aims to determine the
relationship of plasma dehydroepiandrosterone sulfate (DHEA-S) levels with
respect to obesity, fasting insulin and glucose levels in a cohort of obese
and normal weight healthy Saudi women.
METHODS: This study was carried out at King Abdul-Aziz University
Hospital, Jeddah, Kingdom of Saudi Arabia during the year 2001. A total of
65 healthy volunteers between 19-30 years of age with body mass index
(BMI) of 15.35-38.30 kg/m2 were grouped into 26 young obese females of
BMI > 27 kg/m2 and 39 young lean females of BMI < 27 kg/m2. Weight,
height, waist and hip circumference, fasting blood glucose, insulin and
DHEA-S levels were measured.
group than in the lean women. In all subjects, DHEA-S levels were related
nega vely with BMI (p=0.02, correla on co-efficient [r]=-0.25) and hip
circumference (p=0.03, r=-0.27). In the obese group, DHEA-S levels showed
a signiﬁcant posi ve rela onship with insulin (p=0.03, r=0.43). No
significant relationship was found between DHEA-S and glucose levels in
considering either the whole group or the obese women.
better associated with DHEA-S than the waist circumference or waist-to-hip
ratio. The data indicated that BMI and hip circumference are important
factors in explaining DHEA-S variability. Insulin could have an independent
regulatory effect on DHEA-S secretion, but glucose metabolism is not
Ann Saudi Med. 2003 Jan-Mar;23(1-2):24-7.
Increased Frequency of Angiotensin-Converting Enzyme
DD Genotype in Saudi Overweight and Obese Patients.
El-Hazmi MA, Warsy AS.
Department of Medical Biochemistry and the WHO Collaborating Centre,
College of Medicine, King Khalid University Hospital and Department of
Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia,
BACKGROUND: Several studies have been carried out to investigate the
insertion/deletion (I/D) polymorphism of angiotensin-converting enzyme
(ACE) in obese and normal weight individuals, often with contradictory
results in different populatios. In some studies, the DD genotype occurs at a
high frequency in obesity, while in others no association has been
demonstrated. Since obesity and overweight are of frequent occurrence in
the Saudi population, we initiated this study to investigate the I/D
polymorphism of ACE in obese, overweight and normal weight Saudis.
PATIENTS AND METHODS: The study group included 457 Saudi males and
females. The height and weight were measured and body mass index (BMI)
was calculated. Based on the BMI value, the total study population was
classiﬁed as normal, overweight and obese. A total of 117 obese (BMI >30
(kg/m(2))), 185 overweight (BMI=25-29.9 (kg/m(2))) and 155 normal weight
individuals (BMI< (kg/m (2)) were enrolled. Polymerase chain reac on (PCR)
and agarose gel electrophoresis were used to study the ACE polymorphism.
For the dele on (D) form, a 190 bp and for the inser on (I) form, 490 bp
DNA fragment were obtained on 2% agarose gel electrophoresis.
73.5% in the overweight individuals, compared to 19.66% and 24.86% of
the ID genotype in the obese and overweight, respectively. Among the
normal weight individuals, the frequency was significantly lower for DD and
higher for the ID genotype, i.e., 58.7% for DD and 40% for ID. The allele
frequencies in the obese were 0.867 and 0.133 for the D and I alleles,
respec vely. While in the overweight, the frequencies were 0.859 and
0.141 for these alleles, respec vely, compared to 0.787 and 0.213 in the
normal weight individuals.
CONCLUSIONS: The DD genotype and D allele occur at a high frequency in
Saudi overweight and obese individuals, and may have some role in fat
accumulation by affecting metabolic pathways of fat, thus leading to the
development of overweight and obesity.
Saudi Med J. 2003 Jan;24(1):27-33.
Obesity among Saudi Male Adolescents in Riyadh, Saudi
Department of Family and Community Medicine, College of Medicine, King
Saud University, Riyadh, Kingdom of Saudi Arabia. firstname.lastname@example.org
OBJECTIVE: The purpose of the study was to determine the prevalence of
overweight and obesity and its correlates among Saudi male adolescents in
Riyadh. As well as evaluating their knowledge, attitude and practice
METHODS: A cross-sectional study conducted in intermediate and
secondary schools in Riyadh, Saudi Arabia was carried out during a 5-month
period, September 2001-January 2002. A sample of 894 Saudi male
adolescents (age 12-20 years) was selected through the mul -stage
sampling technique. Socio-demographic characteristics; dietary and activity
history; obesity-related knowledge and behavior; and family and past
medical history data were obtained by a self-administered questionnaire.
Anthropometric measurements of weight and height were performed. Body
mass index (BMI) was calculated, and adolescents with a BMI age-specific
percen le of > or = 85th-< 95th were considered overweight and > or =
95th were considered obese.
Family history (odds ra o, 2.49; 95% conﬁdence interval, 1.72-3.61) and
lack of physical ac vity (odds ra o, 1.63; 95% conﬁdence interval, 1.01-
2.62) were associated with adolescent obesity. Twenty percent of
overweight participants did not think they were overweight.
among male adolescents in Riyadh. A national prevention program with
involvement of schools is recommended to avoid obesity-related morbidity
Int J Obes Relat Metab Disord. 2003 Jan;27(1):134-9.
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