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Anxiety and Social Anxiety Symptoms among Overweight
Females Seeking Treatment for Obesity.
Menan A. Rabie
, Nahla Fawzy Abo-El-Ezz
, Mervat Salah-El-Din
Lecturer of Psychiatry, Faculty of Medicine, Ain Shams University
Lecturer of Community Medicine, Faculty of Medicine, Ain Shams
Professor of Nutrition, Faculty of Agriculture, Ain Shams University
INTRODUCTION: Obesity has become an epidemic problem worldwide. In
the Egyptian community the status of overweight has reached an alarming
level. About one out of four cases of obesity is associated with a mood or
anxiety disorder, but the causal relationship and complex interplay
between both problems is still unclear.
anxiety symptoms among the female subjects seeking treatment for
obesity; and to examine the correlation of anxiety and social anxiety
symptoms with age, multiparity, duration of obesity, Body Mass Index (BMI)
and Binge Eating (BE).
used to screen 93 Arab females who are seeking treatment at the obesity
clinic. The assessment tools included: Questionnaire on Eating and Weight
Patterns-Revised (QEWP-R), Beck Anxiety Inventory (BAI), and Brief Social
Phobia Scale (BSPS).
cons tuted 68.8% of the sample with a highly signiﬁcant rela onship
between binge eating and anxiety symptoms. A comparison between social
anxiety symptoms among obese subjects and subjects having morbid
obesity showed high statistically significant difference. Correlation of the
social anxiety symptoms with the duration since last pregnancy and the
duration of obesity was significant.
CONCLUSION: The prevalence of social anxiety symptoms among
overweight females seeking treatment for obesity is relatively high.
Journal of American Science 2011;7(8):240-250
Body Mass Index as an Assessment Tool for Overweight
and Obesity in School Children in El-Qalubia Governorate
Ahmed Mahmoud Ezzat1, Mahmoud Fawzy EL Gendy2, Doaa Refaey
Soliman1, Ashraf Hassan Mohammed3 and Hazem Salem Abdel Azeem
1Department of Pediatrics, Faculty of Medicine, Benha University, Benha,
2Department of Community, faculty of medicine, Benha University, Benha,
3Department of Physical therapy for Surgery, Faculty of Physical Therapy,
Cairo University, Cairo, Egypt
AIM: Aim of the study was to design BMI (Body Mass Index) charts to the
studied group, to determine the prevalence of overweight and obesity in
the group and to provide suitable recommendations for prevention
overweight and obesity.
METHODS: This was a cross sec onal study that included 500 students
collected from primary and preparatory schools, aged 7-15 years and living
in El-Qalubia governorate through the academic year 2010/2011. A self
administered questionnaire was used; it included some socio-demographic
characteristics and measurements for weight and height of students. Data
was collected, revised and entered using the statistical package SPSS.
RESULTS: Obese students represented 20.4% of students. Obesity
increased in younger students with mean age 9.33±2.094 years and
increased in male students (55% of all obese students), while overweight
increased in female students (54.5% of all overweight students). Female
students recorded higher values over males in weight during the ﬁrst 5
years of age (7-11 years old) then, boys become heavier than girls.
Moreover, there was a gradual increase in height of female and male
students at age 7-15 years old.
In addition, the current study indicated that female students have the
higher values of BMI from age 7 to 15 years old than males.
J Nutr Biochem. 2011 Mar 16. [Epub ahead of print]
Acute and Chronic Saturated Fatty Acid
Treatment as a Key Instigator of the TLR-
Mediated Inflammatory Response in Human
Adipose Tissue, in Vitro.
Youssef-Elabd EM, McGee KC, Tripathi G, Aldaghri N, Abdalla MS, Sharada
HM, Ashour E, Amin AI, Ceriello A, O'Hare JP, Kumar S, McTernan PG, Harte
Biochemistry Department, National Research Centre, Dokki, Giza, Egypt
A post-prandial increase in saturated fatty acids (SFAs) and glucose (Glc)
activates an inflammatory response, which may be prolonged following
restoration of physiological SFAs and Glc levels - a finding referred to as
'metabolic memory'. This study examined chronic and oscillating SFAs and
Glc on the inflammatory signalling pathway in human adipose tissue (AT)
and adipocytes (Ads) and determined whether Ads are subject to
"metabolic memory." Abdominal (Abd) subcutaneous (Sc) explants and Ads
were treated with chronic low glucose (L-Glc): 5.6 mM and high glucose (H-
Glc): 17.5 mM, with low (0.2 mM) and high (2 mM) SFA for 48 h. Abd Sc
explants and Ads were also exposed to the aforementioned treatment
regimen for 12-h periods, with alternating rest periods of 12 h in L-Glc.
Chronic treatment with L-Glc and high SFAs, H-Glc and high SFAs up-
regulated key factors of the nuclear factor-κB (NFκB) pathway in Abd Sc AT
and Ads (TLR4, NFκB; P<.05), whilst down-regula ng MyD88. Oscilla ng Glc
and SFA concentrations increased TLR4, NFκB, IKKβ (P<.05) in explants and
Ads and up-regulated MyD88 expression (P<.05). Both tumor necrosis
factor α and interleukin 6 (P<.05) secre on were markedly increased in
chronically treated Abd Sc explants and Ads whilst, with oscillating
treatments, a sustained inflammatory effect was noted in absence of
treatment. Therefore, SFAs may act as key instigators of the inflammatory
response in human AT via NFκB activation, which suggests that short-term
exposure of cells to uncontrolled levels of SFAs and Glc leads to a longer-
term inflammatory insult within the Ad, which may have important
implications for patients with obesity and Type 2 diabetes.
Saudi Med J. 2011 Sep; 32(9):919-24.
Subclinical Atherosclerosis in Obese Adolescents with
Normal Left Ventricular Function.
Abdel-Wahab AM, Atwa HA, El-Eraky AZ, El-Aziz MA.
Department of Pediatrics, Faculty of Medicine, Suez Canal University,
OBJECTIVE: To assess the impact of obesity on carotid intima media
thickness and left ventricular (LV) mass in obese adolescents.
METHODS: The study included 52 obese adolescents (mean age 14.16+/-
2.64 years) and 52 healthy adolescents who served as a control group
(mean age 12+/-2.3 years), who were a ended the outpa ent clinic at Suez
Canal University Hospital, Ismailia, Egypt. The study population was
submitted for medical history, clinical examination, laboratory
investigations (fasting blood sugar and lipid profile), and echocardiographic
examination of LV mass and dimensions. Assessment of carotid intima-
media thickness was carried out by using carotid duplex. All children had
normal LV function.
triglyceride, LDL-C, and low HDL-C compared to the control group. Also,
there was a significant increase in blood pressure, carotid intima media
thickness, LV mass, and LV mass index. There was a significant correlation
between BMI and dyslipidemia, blood pressure, carotid intima/media
thickness, LV mass, and posterior wall thickness. Carotid intima-media
thickness had a significant correlation with increased LDL-C and low HDL-C,
blood pressure, LV mass, and posterior wall thickness.
CONCLUSION: Obesity in childhood and adolescents is associated with
subclinical atherosclerosis. Although obese children had no LV dysfunction,
yet there are LV structure changes.
Obesity Research (2002)10, 1087–1091; doi: 10.1038/oby.2002.147
Amylin, Food Intake, and Obesity
Tarek K. Reda
, Allan Geliebter
and F. Xavier Pi-Sunyer
New York Obesity Research Center, Department of Medicine, St.-
Luke's-Roosevelt Hospital Center, Columbia University–College of
Physicians and Surgeons, New York
Correspondence: Tarek Reda, M.D., M.P.H., Dr.P.H., Nutrition Medical
Center, 18 Abdel La f El-Soufani, Sidi Gaber 21311, Alexandria, Egypt.
Amylin, also known as islet amyloid polypep de, iden ﬁed in 1987, is a
naturally occurring hormone, released by the cells of the pancreas and
consists of 37 amino acids. Amylin seems to decrease food intake through
both central and peripheral mechanisms and indirectly by slowing gastric
emptying. The mean basal amylin concentration is higher in obese than in
lean human subjects. The amylin response to oral glucose is also greater in
obese subjects, whether or not they have impaired glucose tolerance. The
elevated amylin levels in obesity may lead to down-regulation of amylin
receptors and lessen the impact of postprandial amylin secretion on satiety
and gastric emptying. Amylin administration may overcome resistance at
target tissues, delay gastric emptying, and have potential for inducing
weight loss in obese individuals.
Indian J Dermatol Venereol Leprol. 2010 Sep-Oct;76(5):538-42.
Increased Tissue Leptin Hormone Level And Mast Cell Count in
Skin Tags: A Possible Role of Adipoimmune in the Growth of
Benign Skin Growths.
El Safoury O, Fawzi M, Abdel Hay RM, Hassan AS, El Maadawi Z, Rashed L.
Department of Dermatology, Faculty of Medicine, Cairo University, Egypt.
BACKGROUND: Skin tags (ST) are common tumors. They mainly consist of
loose fibrous tissue and occur on the neck and major flexures as small, soft,
pedunculated protrusions. Decrease in endocrine, hormone level and other
factors are thought to play a role in the evolution of ST. Leptin is an
adipocyte-derived hormone that acts as a major regulatory hormone for
food intake and energy homeostasis. Leptin deficiency or resistance can
result in profound obesity and diabetes in humans. A role of mast cell in the
pathogenesis of ST is well recognized.
AIMS: To investigate the role of leptin in the pathogenesis of ST and to
clarify whether there is a correlation between mast cell count and leptin
level in ST.
From each pa ent, a biopsy of a large ST (length >4 mm), a small ST (length
<2 mm) and a normal skin biopsy (as a control) were taken. The samples
were processed for leptin level. Skin biopsies were stained with
hematoxylin and eosin and toluidine blue-uranyl nitrate metachromatic
method for mast cell count was used.
RESULTS: There was a significant increased level of leptin in the ST
compared to the normal skin. It was highly significant in small ST than in big
ST (P = 0.0001) and it was highly signiﬁcant in small and big ST compared to
controls, P = 0.0001 and P = 0.001, respec vely. There was a signiﬁcant
increase in mast cell count in the ST, which did not correlate with the
increased levels of leptin.
CONCLUSION: This is the first report to demonstrate that tissue leptin may
play a role in the pathogenesis of ST. The significant increase in the levels of
leptin and mast cell count in ST may indicate a possible role of
adipoimmune in the benign skin growths.
BMC Cardiovasc Disord. 2011 Aug 16; 11:53.
Cut Off Values of Waist Circumference & Associated
Cardiovascular Risk in Egyptians.
Ibrahim MM, Elamragy AA, Girgis H, Nour MA.
Cardiology Department - Cairo University Faculty of Medicine, Kasr Al-Aini
St,, Cairo, 11562, Egypt. email@example.com.
BACKGROUND: Recent guidelines stressed the need to adopt different
values of waist circumference (WC) measurements to define abdominal
obesity in different ethnic groups. The aim of this study is to identify WC
cutoff points in normotensive and hypertensive subjects which are
diagnostic of abdominal obesity in a Middle Eastern population and the
prevalence of abdominal obesity in a nationwide sample.
METHODS: Data were collected during phase-2 of the Egyp ans Na onal
measurements and laboratory studies were performed according to a
standardized protocol by trained personnel. To derive the cutoff points for
WC, we applied the factor analysis on CV risk factors: diabetes mellitus,
decrease in HDL-C and increase in LDL-C, triglycerides and left ventricular
mass index by echocardiography.
RESULTS: The sample included 2313 individuals above the age of 25 years.
WC values (mean ± SD) were 88 ± 14 cm and 95 ± 14 cm for normotensive
(NT) and hypertensive (HT) men respec vely, and 89.6 ± 14.7 cm and 95.7 ±
15.9 cm for NT and HT women respec vely. Applying factor analysis, the
weighted average cutoﬀ points were 93.5 cm for both NT and HT men and
91.5 and 92.5 cm for NT and HT women respectively. Based on these
thresholds, the prevalence of abdominal obesity was 48% in men and 51.5%
CONCLUSION: This is the first report of specific abdominal obesity cutoff
points in a Middle Eastern country. The cutoff points were different from
the Europid standards. There is a high prevalence rate of abdominal obesity
among Egyptians which is associated with increased prevalence of
cardiometabolic risk factors.
Ital J Pediatr. 2011 Jul 19;37:34.
Obesity Modulate Serum Hepcidin And Treatment
Outcome of Iron Deficiency Anemia in Children: A Case
Sanad M, Osman M, Gharib A.
Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt.
BACKGROUND: Recently, hepcidin expression in adipose tissue has been
described and shown to be increased in patients with severe obesity. We
tried to assess the effect of obesity on hepcidin serum levels and treatment
outcome of iron deficiency anemia in children.
METHODS: This was a case control study included 70 children with iron
deﬁciency anemia "IDA" (35 obese and 35 non-obese) and 30 healthy non-
obese children with comparable age and sex(control group). Parameters of
iron status (Serum iron, ferritin, transferrin, total iron binding capacity and
transferrin saturation) and serum hepcidin levels were assessed initially and
a er 3 months of oral iron therapy for IDA.
RESULTS: Compared to the control group, serum hepcidin was significantly
lower in non-obese children with IDA(p < 0.01) and signiﬁcantly higher in
obese children with IDA (p < 0.01). Hepcidin increased signiﬁcantly in non-
obese children with IDA a er 3 months of iron therapy (P < 0.01). On the
other hand, obese children showed non-significant change in hepcidin level
a er iron therapy (p > 0.05). Although hepcidin showed signiﬁcant posi ve
correlations with Hb, serum iron and transferrin saturation in non-obese
children with IDA, it showed significant negative correlations with Hb,
serum iron and transferrin satura on in obese children with IDA (P < 0.05).
diminished response to oral iron therapy in childhood iron deficiency
Pediatr Nephrol. 2011 Jun 3. [Epub ahead of print]
Evaluation of Microalbuminuria in Obese Children and Its
Relation to Metabolic Syndrome.
Sanad M, Gharib A.
Pediatrics, Zagazig University, Zagazig City, El Sharkia Governorate, Egypt,
Several epidemiologic studies have clearly demonstrated that obesity
increases the risk of kidney diseases. We have attempted to evaluate the
association of obesity with albuminuria, an early marker of kidney disease,
among obese children and its relation to metabolic syndrome. This study
included 150 obese children. Blood pressure, fas ng blood glucose, plasma
insulin and the lipid profile were assessed. The homeostasis model
assessment of insulin resistance (HOMA-IR) was used to calculate in vivo
insulin resistance. Urinary albumin and creatinine were estimated.
Microalbuminuria was detected in 22 (14.7%) of the obese children. Waist
circumference, blood pressure, triglyceride, low-density lipoprotein (LDL),
insulin resistance and fasting blood glucose were significantly higher in
obese children with microalbuminuria than in those with normoalbuminuria
and showed significant positive correlations with microalbuminuria. High-
density lipoprotein (HDL) was significantly lower in obese children with
microalbuminuria than in those with normoalbuminuria, with a significant
negative correlation with microalbuminuria. We found that body mass
index, abdominal obesity, hypertension, impaired fasting glucose level and
insulin resistance significantly increased the odds of microalbuminuria in
the obese children enrolled in this study. Moreover, high triglyceride, high
LDL and low HDL were significantly associated with microalbuminuria. In
our patient group, childhood obesity was a risk factor for the development
of microalbuminuria, which in turn was significantly associated with
metabolic syndrome and its different constituents.
Mol Genet Metab. 2011 Apr;102(4):461-4. Epub 2010 Dec 31.
Homozygosity for a Novel Missense Mutation in the
Lep n Receptor Gene (P316T) in Two Egyp an Cousins
with Severe Early Onset Obesity.
Mazen I, El-Gammal M, Abdel-Hamid M, Farooqi IS, Amr K.
Clinical Genetics Department, National Research Centre, Cairo, Egypt.
Congenital deficiency of the leptin receptor is a very rare cause of severe
early-onset obesity. To date, only 9 families have been reported in the
literature to have mutations in the leptin receptor gene. The clinical
features include severe early onset obesity, severe hyperphagia,
neuroendocrine/metabolic dysfunction. Here we report two cousins with
severe early onset obesity and recurrent respiratory tract infections. Their
serum leptin levels were elevated but they were within the range predicted
by the elevated fat mass in both cousins. Direct sequencing of the entire
coding sequence of the leptin receptor gene revealed a novel homozygous
missense muta on in exon 6, P316T. The muta on was found in the
homozygous form in both cousins and in the heterozygote state in their
parents. This muta on was not found in 200 chromosomes from 100
unrelated normal weight control subjects of Egyptian origin using PCR-RFLP
analysis. In conclusion, finding this new mutation in the LEPR beside our
previous mutation in the LEP gene implies that monogenic obesity
syndromes may be common in the Egyptian population owing to the high
rates of consanguineous marriages. Further screening of more families for
muta ons in LEP, LEPR, and MC4 might conﬁrm this assump on.
Br J Anaesth. 2011 Mar; 106(3):359-63. Epub 2010 Dec 10.
Incidence of Perioperative Adverse Events in Obese
Children Undergoing Elective General Surgery.
El-Metainy S, Ghoneim T, Aridae E, Abdel Wahab M.
Department of Anaesthesia, Faculty of Medicine, High Institute of Public
BACKGROUND: A worldwide increase in the prevalence of obesity has
been observed in both developed and developing countries. Few studies
have addressed the anaesthetic or perioperative implications of childhood
METHODS: Children aged 2-16 yr undergoing general surgery were
classified using age- and sex-adjusted BMI. Patient characteristic, co-
morbidity, and perioperative data were collected to ascertain the risks
associated with overweight and obese children.
RESULTS: We enrolled 1465 subjects in our study, of which 154 (10.5%)
were classiﬁed as obese and a further 223 (15.2%) as overweight. A er
adjusting for age, we identified increased rates of arterial hemoglobin
desaturation, difficult mask ventilation, airway obstruction, and
bronchospasm in obese children. The relative risk (RR) of adverse
respiratory events was higher among obese subjects than non-obese
subjects and higher in younger age groups. Controlling for age, adjusted-RR
(conﬁdence interval) was 1.49 (1.2-1.86). There was a signiﬁcant associa on
between obesity and asthma with a higher odds ratio (OR) in younger age
groups controlling for age: adjusted-OR=1.8 (1.15-2.82). A signiﬁcant
association was detected between obesity and sleep apnoea controlling for
age: adjusted-OR=4.03 (2.37-6.8).
CONCLUSIONS: These results suggest an increased incidence of
perioperative adverse respiratory events in obese children, especially at
Int J Hypertens. 2011 Mar 8;2011:952537.
Prevalence of Elevated Blood Pressure and Association
with Obesity in Egyptian School Adolescents.
Abolfotouh MA, Sallam SA, Mohammed MS, Loutfy AA, Hasab AA.
King Abdullah International Medical Research Center (KAIMRC), King Saud
bin Abdulaziz University for Health Sciences (KSAU-HS), P.O. Box 22490,
Riyadh 11426, Saudi Arabia.
and obesity in Egyptian adolescents.
METHODS: A cross-sec onal study of 1500 adolescents (11-19 years) in
Alexandria, Egypt, was conducted. Resting BP was measured and
measurements were categorized using the 2004 fourth report on blood
pressure screening recommendations. Additional measures included height,
weight, and waist and hip circumferences. Obesity was determined based
on BMI, waist circumference (WC) and waist-to-hip ratio (WHR), and waist-
to-height ratio (WHtR) indicators. Crude and adjusted odds ratios were
used as measures of association between BP and obesity.
RESULTS: Prevalence rates of prehypertension and hypertension were 5.7%
and 4.0%, respec vely. Obesity was seen in 34.6%, 16.1%, 4.5%, and 16.7%
according to BMI, WHR, WC, and WHtR, respectively. Adjusting for
confounders, HBP was significantly associated with overall obesity based on
BMI (OR = 2.18, 95%, CI = 1.38-3.44) and central obesity based on WC (OR =
3.14, 95%, CI = 1.67-5.94). Conclusion. Both overall obesity and central
obesity were significant predictors of HBP in Egyptian adolescents.
Med Sci Monit. 2011 Feb 25;17(3):CR174-9.
Relationship Between Pro-Anti-Inflammatory Cytokines,
T-Cell Ac va on and CA 125 in Obese Pa ents with Heart
Department of Biochemistry, Ain Shams University, Faculty of Pharmacy,
Cairo, Egypt. firstname.lastname@example.org
BACKGROUND: This researcher previously found that serum levels of some
inflammatory cytokines are elevated in patients with cardiovascular disease
(CVD). Hence, this study investigated the relationship between circulating
levels of pro-anti-inflammatory cytokines, T-cell activation marker and
carbohydrate an gen 125 (CA 125) for the ﬁrst me in obese Egyp an
patients with heart failure (HF).
MATERIAL/METHODS: This study included 60 HF pa ents, and 30 normal
controls, with age range 50-70 years. HF pa ents were divided into 2
groups: non-obese mild HF according to clinical status (New York Heart
Associa on Class) (NYHA class I/II) (n = 20) and obese severe HF (NYHA class
III/IV) (n = 40). Serum pro-anti-inflammatory cytokine levels (TNF-α, IL-6,
and IL-10), T-cell activation marker (sIL-2R/CD25), and CA 125; tumor
marker were measured by ELISA.
cytokines, sIL-2R/CD25 as T-cell ac va on marker, and CA 125 as tumor
marker were significantly higher in HF patients than in normal controls.
Moreover, serum levels of TNF-α, IL-6, sIL-2R/CD25, and IL-10, as well as CA
125 were signiﬁcantly higher in the obese than in the non-obese mild HF
pa ents. Correla on analysis showed that CA 125 was posi vely related to
BMI, TNF-α, IL-6, and sIL-2R/CD25 in the HF pa ents group.
patients, and is correlated with serum TNF-α, IL-6, and sIL-2R/CD25 levels.
Therefore, we can conclude that CA125, being a tumor marker, is closely
related to the cytokine system.
Saudi J Gastroenterol. 2011 Jan-Feb;17(1):40-6.
Predictors of Non-Alcoholic Fatty Liver Disease in Obese
and Overweight Egyptian Children: Single Center Study.
el-Karaksy HM, el-Koofy NM, Anwar GM, el-Mougy FM, el-Hennawy A,
Department of Pediatrics, Cairo University, Research Institute of
Ophthalmology, Egypt. email@example.com
global problem which has been increasingly recognized with the dramatic
rise in pediatric obesity. The aim of the present study was to identify the
clinical, sonographic, and biochemical predictors for NAFLD in obese
included after an informed consent. All were subjected to full
anthropometric assessment (including height, weight, body mass index,
subscapular skin fold thickness, waist and hip circumference and calculation
of waist: hip ratio), biochemical assessment of liver function tests, lipid
profile and insulin resistance and sonographic assessment of hepatic
echogenicity. Liver biopsy when indicated, was done in 33 pa ents.
elevated AST. Significant dyslipidemia (low HDL-c, high total cholesterol,
high LDL-c and triglycerides) and higher insulin resistance were found in
obese pa ents (P<0.01). The main sonographic ﬁndings were hepatomegaly
in 20 pa ents (26.3%) and echogenic liver in 41 pa ents (53.9%). Liver
biopsy showed simple steatosis in eight cases (24.2%) and non-alcoholic
s (NASH) in seven cases (21.2%). Anthropometric
measurements, increased hepatic echogenicty by ultrasound, insulin
resistance and lipid profile were good predictors of NAFLD in obese children
if assessed together. However, LDL-c was the only sensitive predictor
(independent variable) for NAFLD in both uni- and multivariate logistic
BMC Womens Health. 2011 Jan 19;11:1.
Elevated Serum Neutrophil Elastase is related to
Prehypertension and Airflow Limitation in Obese Women.
El-Eshmawy MM, El-Adawy EH, Mousa AA, Zeidan AE, El-Baiomy AA, Abdel-
Samie ER, Saleh OM.
Internal Medicine Department, Specialized Medical Hospital, Faculty of
BACKGROUND: Neutrophil elastase level/activity is elevated in a variety of
diseases such as atherosclerosis, systolic hypertension and obstructive
pulmonary disease. It is unknown whether obese individuals with
prehypertension also have elevated neutrophil elastase, and if so, whether
it has a deleterious effect on pulmonary function. Objectives: To determine
neutrophil elastase levels in obese prehypertensive women and investigate
correlations with pulmonary function tests.
obese normotensive subjects and 30 healthy controls. The study groups
were matched for age. Measurements: The following were determined:
body mass index, waist circumference, blood pressure, lipid profile, high
sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary
func on tests including forced expiratory volume in one second (FEV1),
forced vital capacity (FVC) and FEV1/FVC ra o.
in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ±
81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9
ng/ml); the level was significantly higher in the prehypertensive than the
normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both
prehypertensive and normotensive obese women were significantly lower
than in normal controls, but there was no statistically significant difference
between the prehypertensive and normotensive obese women. In
prehypertensive obese women, there were significant positive correlations
between neutrophil elastase and body mass index, waist circumference,
systolic blood pressure, diastolic blood pressure, total cholesterol,
triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive
protein and negative correlations with high density lipoprotein cholesterol,
FEV1, FVC and FEV1/FVC.
CONCLUSION: Neutrophil elastase concentration is elevated in obese
prehypertensive women along with an increase in high sensitivity C-reactive
protein which may account for dyslipidemia and airflow dysfunction in the
present study population.
J Biosoc Sci. 2011 Jan;43(1):85-99.
Domestic Violence and Obesity in Egyptian Women.
Yount KM, Li L.
Departments of Global Health and Sociology, Emory University, Atlanta,
Domestic violence and obesity are global public health problems.This study
explores associa ons of domes c violence and obesity in 5015 ever-
married, non-pregnant women aged 15-49 years who took part in the 2005
Egypt Demographic and Health Survey (EDHS). Women's mean body mass
index (BMI) was 30.4 kg/m², and 48% were obese. Thirty-seven percent
reported any prior psychological, physical or sexual domestic
violence.Compared with their counterparts, the adjusted odds of being
obese were marginally higher among women who reported any prior sexual
(aOR=1.31),physical or sexual (aOR=1.18), or psychological, physical or
sexual (aOR=1.17) domes c violence. Women who experienced severe or
repeated domestic violence--as measured by reported exposure to three or
more acts of physical(aOR=1.25), psychological or physical (aOR=1.18),
physical or sexual(aOR=1.36), and psychological, physical or sexual
(aOR=1.26) domes c violence--had higher adjusted odds of being obese.
Marginally significant adjusted dose-response relationships remained
between obesity and the number of speciﬁc acts of: (1) physical or sexual
violence and (2) psychological, physical or sexual domes c violence. Obesity
among women in poorer settings like Egypt may partly have its roots in
gender subordination, as manifested in women's exposure to multiple acts
of domestic violence.
Am Surg. 2010 Sep;76(9):995-9.
Day-Case Limberg Flap for Recurrent Pilonidal Sinus: Does
Obesity Complicate the Issue?
Department of Surgery, University of Alexandria, Alexandria, Egypt.
The purpose of this study was to analyze the long-term outcome of
rhomboid excision with Limberg flap reconstruction (LF) as one-day surgery
in treatment of recurrent pilonidal sinus (RPS). The effect of obesity on
outcome will be addressed. Forty-nine patients with RPS were treated by
rhomboid excision and LF as one-day surgery. Data collected included
demographics, body mass index, operative time, flap ischemia, wound
infection, length of hospital stay, time of complete healing, and recurrence.
Pa ents' mean age was 33.4 years and mean number of previous
opera ons was 3.4. Opera ve me ranged from 40 to 70 minutes. Two
pa ents developed sterile seroma (4.1%) and two pa ents (4.1%) had
wound infections. No wound dehiscence or flap ischemia was reported. All
pa ents returned to normal ac vity within 7 days. No recurrences were
reported after a mean follow-up of 32.1 months. Obesity significantly
increased the operative time, however, it affected neither the
postoperative outcome nor the long-term recurrence. Rhomboid excision
and LF as one-day surgery is a safe and reliable method for treatment of
RPS. It guarantees low morbidity, short hospital stay, short time off work,
and carries low risk of recurrence, even in obese patients.
J Egypt Soc Parasitol. 2010 Aug;40(2):489-98.
Adiponectin in Acute Myocardial Infarction Non Obese
Mahgoub KA, Abd el MA.
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo,
Adiponectin is an adipose tissue derived mediator with significant anti
atherosclerotic properties and is involved in the regulation of insulin
sensitivity and lipid oxidation, a few studies were done in acute phase of
myocardial infarction, especially in none obese patients. The study
investigated the association between adiponectin concentration and acute
phase of myocardial infarction (MI) in non obese men patients. The results
showed that adiponectin levels in patients with AMI (5.2ug/ml) were
signiﬁcantly lower than that of control group (7.5ug/ml) (P<0.001). Lower
adiponectin levels were independently associated with higher risk of AMI
(odd ra o= 6.12, 95%CIs: 2.4- 18.6; P=<0.001).Adiponec n levels were
negatively correlated with triglyceride (r=-0.34) in case group and (r=- 0.41)
in control group (P< 0.001). In addi on, nega vely correlated with BMI(r=-
0.27) in case group and (r=-0.23) in control group (P< 0.001), but
adiponectin levels is positively correlated with HDL-Cholesterol (r= 0.45) in
case group and (r=0.51) in control group with (P<0.001).
Fertil Steril. 2010 Jul;94(2):581-4. Epub 2009 May 6.
Semen Parameters and Hormonal Profile in Obese Fertile
and Infertile Males.
Hofny ER, Ali ME, Abdel-Hafez HZ, Kamal Eel-D, Mohamed EE, Abd El-Azeem
HG, Mostafa T.
Department of Dermatology, Venereology & Andrology, Faculty of
Medicine, Assiut University, Assuit, Egypt.
sex hormones, and serum leptin in obese fertile and infertile
PATIENT(S): Forty-two obese fer le and 80 obese infer le oligozoospermic
men (body mass index [BMI] >30).
INTERVENTION(S): The BMI calculation, semen analysis, and serum FSH,
LH, T, E(2), PRL, and lep n es ma on.
MAIN OUTCOME MEASURE(S): Semen and hormonal profiles.
RESULT(S): Obese oligozoospermic patients had significant increase in
mean BMI, serum FSH, LH, E(2), PRL, and lep n compared with obese fer le
controls. The BMI had significant positive correlation with abnormal sperm
morphology, LH, serum leptin and significant negative correlation with
sperm concentration, sperm motility, serum T. Serum leptin demonstrated
significant positive correlation with patients' age, abnormal sperm
morphology, serum FSH, LH, PRL and significant negative correlation with
sperm concentration, sperm motility, and serum T.
CONCLUSION(S): Serum leptin mediates a link between obesity and male
J Obstet Gynaecol Can. 2010 Jul;32(7):687-90.
Effect of Obesity on Parameters of Ovarian Reserve in
Halawaty S, ElKattan E, Azab H, ElGhamry N, Al-Inany H.
Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
ultrasound markers of ovarian reserve in premenopausal women.
METHODS: We performed a cross-sectional comparative study of two age-
matched groups of premenopausal participants (early transi on phase): 50
participants ("non-obese") had a BMI < 30 kg/m2, and the other 50
par cipants ("obese") had a BMI of 30 to 35 kg/m2. The obese women had
a mean age of 46.2 years and the non-obese women had a mean age of
46.1 years. Blood samples were collected from all participants,
anthropometric measurements were calculated, and transvaginal
ultrasonography was performed to measure the antral follicle count (AFC)
and ovarian volume during the early follicular phase. The blood samples
were assayed for antimüllerian hormone (AMH), follicle-stimulating
hormone (FSH), fasting blood glucose (FBG) and two-hour postprandial
blood glucose (2h PP).
RESULTS: There was no significant difference between the two groups in
mean age, levels of serum AMH, serum FSH, FBG, 2 hr PP, or AFC. Ovarian
volume was signiﬁcantly lower in obese women (3.7 +/- 0.8 mL) than in
non-obese women (6.6 +/- 0.4 mL) (P = 0.03). There was no signiﬁcant
correla on between BMI and serum AMH, serum FSH, FBS, or 2 hr PP.
blood glucose, or AFC indicating that obesity is unlikely to affect ovarian
reserve in the perimenopausal age group.
Prostate Cancer Prostatic Dis. 2010 Jun;13(2):186-90. Epub 2009 Dec 22.
Obesity-PSA Relationship: A New Formula.
Hekal IA, Ibrahiem EI.
To clinically apply the inverse PSA-body mass index (BMI) correlation and
enhance PSA sensitivity in obese cases, a new formula is warranted. An
innovated BMI-PSA equation is designed. PSA-BMI adjusted formula
(named Hekal's equation): measured total PSA (ng ml(-1)) mul plied by age
(years) and divided by BMI of the patient. The formula is applied over a
randomly chosen 1000 cases of diﬀerent PSA, BMI, age and trans-rectal
ultrasound biopsy results, the yield of new PSA is correlated with pathology
and age-speciﬁc PSA adjustment values. Among the 988 cases with
complete data, obesity (BMI: 30-35 kg m(-2)) in 236 cases (23.8%) and 79
cases (7.9%) have BMI>35 kg m(-2). Mean PSA was 5.8 ng ml(-1) (s.d.+/-8.4
ng ml(-1)). Cases stra ﬁed based on their age (every 10 years). The new
equation was applied. Obesity is detected in 33.5 and 43.6% of ﬁ h and
sixth decade of life respec vely (P=0.02), with low measured PSA values
(2.1, 3.8 ng ml(-1), respec vely). By such PSA measurement biopsy may be
omi ed, missing 53.3% of malignant cases. In contrast, PSA adjusted were 4
and 9.3 ng ml(-1) within the same group of patients. With such values, the
decision of a biopsy could not be missed for the targeted groups. Specificity
and sensi vity of adjusted PSA values at cutoﬀ point 4 ng ml(-1) was 41.7
and 70%, respec vely. Based on our results, the new PSA-BMI adjusted
formula is reproducible, easy applied formula. With such a formula the
higher sensitivity of PSA in obese patients could be achieved. The
misleading low PSA in obese cases in the fifth and sixth decade will be
J Clin Lipidol. 2010 May-Jun;4(3):185-95. Epub 2010 Mar 21.
Prevalence Of Metabolic Syndrome And Insulin Resistance
Among Egyp an Adolescents 10 To 18 Years Of Age.
Aboul Ella NA, Shehab DI, Ismail MA, Maksoud AA.
Clinical Nutri on Department, Na onal Nutri on Ins tute (NNI), 16 kaser el
Aini Street, Cairo, Egypt. firstname.lastname@example.org
BACKGROUND: The prevalence and magnitude of childhood obesity are
OBJECTIVES: To examine the effect of varying social, demographic, dietary,
and activity factors on the prevalence of metabolic syndrome and its
relation to insulin resistance, C-reactive protein, and homocysteine levels in
a large, representative sample of Egyptian adolescents.
METHODS: Our survey included 4250 adolescents (from 10 to 18 years of
age; male subjects comprised 42.5% of par cipants) from 7 governorates
representing Egypt. Baseline measurements included blood pressure,
fasting blood glucose, plasma lipids, C-reactive protein, and homocysteine
levels. Because the body mass index varies according to age, we
standardized the value for age and sex with the use of conversion to
no sex or area of residence predilection. Results showed that adolescents
with the full criteria of metabolic syndrome (ie, three criterion or more)
constituted nearly one fourth of those exhibiting high values of different
components, except for systolic blood pressure, where they were 42%, and
TG, where they were 31%. Family history of obesity and diabetes mellitus
increase the odds for metabolic syndrome signiﬁcantly (1.68 and 1.3,
respectively) as well as inactivity. A high level of C-reactive protein was
reported among affected adolescents. Homocysteine level did not have an
CONCLUSIONS: The prevalence of the metabolic syndrome is considerable
among obese adolescents. Proinflammatory markers associated with an
increased risk of adverse cardiovascular outcomes are already present in
East Mediterr Health J. 2010 Apr;16(4):429-33.
Relationship Between Overall and Abdominal Obesity and
Periodontal Disease Among Young Adults.
Department of Pedodontic and Dental Public Health, Faculty of Dentistry,
Tanta University, Tanta, Egypt Hatem_ameen2@yahoo.com
To assess overall and abdominal obesity and their relation to periodontal
disease among young adults, body mass index (BMI) and waist
circumference (WC) were measured and clinical attachment loss (CAL),
gingival index (GI) and Community Periodontal Index (CPI) were estimated.
The sample comprised 380 adults (170 males and 210 females) aged 20-26
years. There was a significant correlation between both BMI and WC and
CAL, GI and CPI in females. In males, a significant correlation was only
recorded between WC and GI and CPI. Overall and abdominal obesity in
young adult females and abdominal obesity in males were significantly
associated with periodontal disease.
J Clin Med Res. 2010 Mar 20;2(2):62-7. Epub 2010 Mar 9.
Aortic Stiffness in Prediabetic Adults: Relationship to
Sliem H, Nasr G.
Departments of Internal Medicine, Suez Canal University, Ismailia, Egypt.
arterial stiffness, results in increased cardiac workload. Several studies have
shown that arterial s ﬀness is increased in individuals with type 2 diabetes.
Also, insulin resistance is generally considered to be of major importance in
the pathophysiology of type 2 diabetes mellitus given that glucose
intolerance and insulin resistance precede the development of overt
diabetes, these factors would be associated with arterial stiffness. This
study was to evaluate the state of aortic elasticity in prediabetic adults in
relation to insulin resistance.
adults with prediabetes were enrolled for the study, 32 adults had insulin
resistance (group A) and 81 had insulin sensi ve (group B). Forty-five
healthy (with normal fasting glucose) adults matched for age and gender
were considered as control. All were subjected to full medical history and
clinical examination including blood pressure and body mass index.
Biochemical studies including lipids profile, fasting glucose and homeostasis
model assessment of insulin resistance (HOMA IR) test. Echocardiographic
studies were done for assessment of the aortic stiffness index.
RESULTS: Significant increase in mean aortic stiffness index was seen in
group A than group B. Stiffness was correlated with insulin resistance and
the correlation appeared to be independent of glucose tolerance status and
obesity. Similar correlations were observed with age, triglycerides and waist
represent pattern of cardiovascular risk factors. These changes are
predominantly observed in prediabetic subjects with increased HOMA IR
and visceral obesity independent of glucose levels. KEYWORDS:
Prediabetes; Insulin resistance; Aortic stiffness index.
Obes Rev. 2010 Jan;11(1):11-8. Epub 2009 Jul 28.
Subcutaneous and Visceral Adipose Tissue: Structural and
Cardiology Department, Cairo University, 1 El-Sherifein Street, Abdeen,
Cairo 11111, Egypt. email@example.com
Obesity is a heterogeneous disorder. Obese individuals vary in their body
fat distribution, their metabolic profile and degree of associated
cardiovascular and metabolic risk. Abdominal obesity carries greater risk of
developing diabetes and future cardiovascular events than peripheral or
gluteofemoral obesity. There are differences between adipose tissue
present in subcutaneous areas (SCAT) and visceral adipose tissue (VAT)
present in the abdominal cavity. These include anatomical, cellular,
molecular, physiological, clinical and prognostic differences. Anatomically,
VAT is present mainly in the mesentery and omentum, and drains directly
through the portal circulaion to the liver. VAT compared with SCAT is more
cellular, vascular, innervated and contains a larger number of inflammatory
and immune cells, lesser preadipocyte differentiating capacity and a greater
percentage of large adipocytes. There are more glucocorticoid and
androgen receptors in VAT than in SCAT. VAT adipocytes are more
metabolically active, more sensitive to lipolysis and more insulin-resistant
than SCAT adipocytes. VAT has a greater capacity to generate free fatty
acids and to uptake glucose than SCAT and is more sensitive to adrenergic
stimulation, while SCAT is more avid in absorption of circulating free fatty
acids and triglycerides. VAT carries a greater prediction of mortality than
J Epidemiol Community Health 2010;64:19-20
The Reversal of the Social Gradient of Obesity Among
Women In Egypt: An Analysis of Trends Using Multiple
Cross Sec onal Surveys 1995–2008
Wellcome Trust Doctoral Fellow, London, UK.
Department of Epidemiology and Public Health, University College London,
social distribution that varies according to the level of economic
development: as countries develop, the burden of obesity appears to shift
from the rich to the poor. Studying these changes as they occur can help
shed further light on the social processes that fuel the obesity epidemic and
determine its social distribution. Egypt provides a case in point for this
research. Findings would be relevant to other low-and-middle income
countries but may also be generalisable to an extent to poor communities
in high income countries.
women by socio-economic status and how it has changed over time.
DESIGN AND METHODS
Retrospective analysis using four nationally representative cross-sectional
surveys (Demographic and Health Surveys) conducted in Egypt between
1995 and 2008. Socio-economic status was defined as the highest reported
educational level attained.
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