Research Progresses on "Obesity and Diabetes"--2

11: J Clin Invest. 2008 Oct;118(10):3247-59.
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Molecular processes that handle - and mishandle - dietary lipids.Williams KJ.Division of Endocrinology, Diabetes, and Metabolic Diseases, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.Overconsumption of lipid-rich diets, in conjunction with physical inactivity, disables and kills staggering numbers of people worldwide. Recent advances in our molecular understanding of cholesterol and triglyceride transport from the small intestine to the rest of the body provide a detailed picture of the fed/fasted and active/sedentary states. Key surprises include the unexpected nature of many pivotal molecular mediators, as well as their dysregulation - but possible reversibility - in obesity, diabetes, inactivity, and related conditions. These mechanistic insights provide new opportunities to correct dyslipoproteinemia, accelerated atherosclerosis, insulin resistance, and other deadly sequelae of overnutrition and underexertion.PMID: 18830418 [PubMed - in process]
12: J Hum Hypertens. 2008 Oct 2. [Epub ahead of print]
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Ethnic variation in hypertension prevalence of women in Taiwan.Su TC, Hwang LC, You SL, Chen CJ.1Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.The prevalence and risk factors of hypertension vary in ethnic groups. This study aimed to estimate the hypertension prevalence and to compare risk factors associated with hypertension in women of four ethnic groups in Taiwan. The study subjects were participants in the Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH) enrolled in 2002. In this analysis, only 2810 women who were at age of 20-80 years old and whose father and mother had same ethnic background (Minnan, Hakka, Aborigines or Mainland Chinese) were included. Results showed that there were significant ethnic differences in the prevalence of hypertension, obesity indices, fasting glucose, dyslipidaemia, hyperuricaemia, history of alcohol drinking and tobacco smoking and socioeconomic status. Aborigines had the highest prevalence of hypertension (28.6%) and diabetes mellitus (8.9%), whereas the Minnan group had the second highest prevalence of hypertension (19.2%) and diabetes mellitus (7.9%). Both age and central obesity were associated with an increased prevalence of hypertension except central obesity in Mainland Chinese in all four ethnic groups. Compared with the Mainland Chinese as the referent, the multivariate-adjusted odds ratio (OR) (95% CI) was 1.19 (0.63-2.26), 1.92 (1.15-3.21) and 2.03 (1.00-4.12) for Hakka, Minnan and Aborigines, respectively. Elevated body mass index (>/=27.0 vs <24.0 kg m(-2)) and central obesity were significantly associated with hypertension showing multivariate-adjusted OR (95% CI) of 1.68 (1.18-2.38) and 1.95 (1.48-2.57), respectively. In addition, dyslipidaemia, hyperuricaemia and diabetes associated with higher OR for hypertension in Minnan women. In conclusion, there were ethnic variations in hypertension prevalence and determinants in Taiwanese women.Journal of Human Hypertension advance online publication, 2 October 2008; doi:10.1038/jhh.2008.120.PMID: 18830252 [PubMed - as supplied by publisher]
13: Eur J Cardiovasc Prev Rehabil. 2008 Oct;15(5):589-593.
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Adherence to a Mediterranean-type diet and reduced prevalence of clustered cardiovascular risk factors in a cohort of 3204 high-risk patients.Sánchez-Taínta A, Estruch R, Bulló M, Corella D, Gómez-Gracia E, Fiol M, Algorta J, Covas MI, Lapetra J, Zazpe I, Ruiz-Gutiérrez V, Ros E, Martínez-González MA; for the PREDIMED group.aDepartment of Preventive Medicine and Public Health, Clínica Universitaria-University of Navarra, Irunlarrea, Pamplona bDepartment of Internal Medicine, Hospital Clinic, Villarroel, Barcelona cHuman Nutrition Department, School of Medicine, University Rovira i Virgili, Sant Llorenç, Reus dDepartment of Preventive Medicine, School of Medicine, University of Valencia, Avda Blasco Ibáñez, Valencia eDepartment of Epidemiology, School of Medicine, University of Malaga, Campus de Teatinos s/n, Málaga fDepartment of Cardiology, University Hospital Son Dureta Andrea Doria, Mallorca gUnit of Clinical Trials, Hospital Txagorritxu, José Achotegui s/n, Vitoria hCardiovascular Epidemiology Unit, Municipal Institut for Medical Research, Dr. Aiguader, Barcelona iDepartment of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Damasco s/n jDepartment of Nutrition and Food Sciences, Physiology and Toxicology, Clínica Universitaria-University of Navarra, Irunlarrea, Pamplona kInstituto de la Grasa, Consejo Superior de Investigaciones Científicas, Avda Padre García Tejero, Sevilla lCIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.BACKGROUND: The Mediterranean food pattern (MeDiet) has been suggested to have beneficial effects on cardiovascular risk factors. Scarcity of assessment of this effect on large samples of patients at high risk is, however, observed. Our objective was to estimate the association between adherence to MeDiet and the prevalence of risk factors in 3204 asymptomatic high-risk patients. DESIGN: Cross-sectional assessment of baseline characteristics of participants in a primary prevention trial. METHODS: Participants were assessed by their usual primary-care physicians to ascertain the prevalence of diet-related cardiovascular risk factors (diabetes, hypertension, dyslipidemia, or obesity) using standard diagnostic criteria. A dietitian interviewed each participant to obtain a 14-point score measuring the degree of adherence to MeDiet. RESULTS: Adherence to MeDiet was inversely associated with individual risk factors and, above all, with the clustering of them. The multivariate adjusted odds ratio to present simultaneously the four risk factors for those above the median value of the MeDiet score was 0.67 (95% confidence interval: 0.53-0.85). The multivariate odds ratios for successive categories of adherence to MeDiet were 1 (ref.), 1.03, 0.85, 0.70 and 0.54 (P for trend <0.001). CONCLUSION: Following a MeDiet was inversely associated with the clustering of hypertension, diabetes, obesity, and hypercholesterolemia among high-risk patients.PMID: 18830087 [PubMed - as supplied by publisher]
14: Eur J Cardiovasc Prev Rehabil. 2008 Oct;15(5):503-508.
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Screen detection and the WHO STEPwise approach to the prevalence and risk factors of arterial hypertension in Kinshasa.Longo-Mbenza B, Ngoma DV, Nahimana D, Mayuku DM, Fuele SM, Ekwanzala F, Beya C.aDivision of Cardiology, University of Kinshasa bNational Programme of Nutrition, Biostatistics, Ministry of Health cLOMO MEDICAL, Clinical Epidemiology dWorld Health Organisation Representation in Democratic Republic of Congo eMinistry of Public Health, Kinshasa, Democratic Republic of Congo.BACKGROUND: The trend of hypertension and other risk factors of cardiovascular disease is changing because of epidemiological, demographic and nutritional transitions in sub-Saharan Africa. OBJECTIVES: The aim of this study is to determine the prevalence and risk factors of arterial hypertension in the Kinshasa region, Democratic Republic of Congo (DRC). DESIGN AND METHODS: Data were collected from random sample cross-sectional surveys of adult black Africans from Kinshasa, with the help of a structured questionnaire, physical examinations and blood samples, using the World Health Organisation (WHO) stepwise approach. Sex, age, place of residence (urban versus rural), psychosocial risk factors (socioeconomic status, stress), overweight status (BMI: 25-29.9 kg/m), general obesity (BMI: >/=30 kg/m), abdominal obesity (waist circumference: >/=94 cm) and diabetes mellitus were considered to be the potential risk factors for screen-detected hypertension. RESULTS: The weighted prevalences of hypertension, diabetes mellitus, overweight status, general obesity and abdominal obesity were 15.2, 140.2, 13.5, 4.8 and 7.5%, respectively. Blood pressure and the proportion of participants with hypertension increased with age and BMI group in the population, for both men and women. Age, rural residence, low socioeconomic status, high socioeconomic status, general obesity and abdominal obesity were the risk factors for hypertension. Women aged 55 years and above had higher levels of blood pressure and hypertension than men. CONCLUSION: Absolute levels of hypertension, all types of obesity and diabetes mellitus are high risk factors in the army camps and semiurban extension cities; general obesity and abdominal obesity are the risk factors for detectable hypertension. Effective control of general obesity and abdominal obesity and psychosocial strategies that target both semirural and urban areas of the Kinshasa region have the potential to prevent much premature cardiovascular disease.PMID: 18830083 [PubMed - as supplied by publisher]
15: Diabetes. 2008 Oct 1. [Epub ahead of print]
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Phenotypic switching of adipose tissue macrophages with obesity is generated by spatiotemporal differences in macrophage subtypes.Lumeng CN, Delproposto JB, Westcott DJ, Saltiel AR.Life Sciences Institute, University of Michigan, Ann Arbor, MI.Objective: To establish the mechanism of the phenotypic switch of adipose tissue macrophages from an alternatively activated (M2a) to a classically activated (M1) phenotype with obesity. Research Design and Methods: ATMs from lean and obese (high fat diet fed) C57Bl/6 mice were analyzed by a combination of flow cytometry, immunofluorescence, and expression analysis for M2a and M1 genes. Pulse labeling of ATMs with PKH26 assessed the recruitment rate of ATMs to spatially distinct regions. Results: Resident ATMs in lean mice express the M2a marker MGL1 and localize to interstitial spaces between adipocytes independent of CCR2 and CCL2. With diet-induced obesity, MGL1(+) ATMs remain in interstitial spaces, while a population of MGL1(-)CCR2(+) ATMs with high M1 and low M2a gene expression is recruited to clusters surrounding necrotic adipocytes. Pulse labeling showed that the rate of recruitment of new macrophages to MGL1(-) ATM clusters is significantly faster than that of interstitial MGL1(+) ATMs. This recruitment is attenuated in Ccr2(-/-) mice. M2a and M1 polarized macrophages produced different effects on adipogenesis and adipocyte insulin sensitivity in vitro. Conclusions: The shift in the M2a/M1 ATM balance is generated by spatial and temporal differences in the recruitment of distinct ATM subtypes. The obesity-induced switch in ATM activation state is coupled to the localized recruitment of an inflammatory ATM subtype to macrophage clusters from the circulation, and not to the conversion of resident M2a macrophages to M1 ATMs in situ.PMID: 18829989 [PubMed - as supplied by publisher]
16: J Public Health (Oxf). 2008 Sep 30. [Epub ahead of print]
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Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study.Erem C, Hacihasanoglu A, Kocak M, Deger O, Topbas M.Karadeniz Technical University, Faculty of Medicine,Department of Internal Medicine, Division of Endocrinology and Metabolism, The Trabzon Endocrinological Studies Group, Trabzon, Turkey.BACKGROUND: To estimate the prevalence, awareness and control of prehypertension (preHT) and hypertension (HT) as defined by JNC-7 criteria in the Trabzon Region and its associations with demographic factors (age, sex, obesity, marital status, reproductive history in women and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, obesity and cardiovascular disease), lifestyle factors (smoking habits, physical activity and alcohol consumption) in the adult population. METHODS: In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4809 adult subjects (2601 women and 2208 men) were included in the study. Demographic and socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (BP) and diastolic BP levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00-10:00 following 12 hours of fasting. The levels of serum glucose (FBG), total cholesterol (Total-C), high density cholesterol (HDL-C), low density cholesterol (LDL-C) and triglycerides were measured with autoanalyzer. Definition and classification of HT was performed according to guidelines from the US JNC-7 report. Prevalence, awareness, treatment and control of HT were assessed. RESULTS: The prevalences of HT and preHT were 44.0% (46.1% in women and 41.6% in men) and 14.5% (12.6% in women and 16.8% in men), respectively. Overall, only 41% of the hypertensive individuals had been previously diagnosed. Furthermore, 54.5% of the hypertensive subjects were being treated with antihypertensive drugs (AHD), but only 24.3% of treated subjects had their BP adequately controlled. Among all hypertensive subjects (known and newly diagnosed), only 5.43% had their BP under control. The prevalence of HT increased with age, being highest in the 60- to 69-year-old age group (84.4%) but lower again in the 70+ age group. Interestingly, the prevalence was 16.9% in the 20-to 29-year old age group. HT was associated positively with marital status, parity, cessation of cigarette smoking, and negatively with level of education, alcohol consumption, current cigarette use, and physical activity. Multinomial logistic regression analysis revealed that HT were significantly associated with age, male gender, BMI, low education level, nonsmoking, positive family history of selected medical conditions, occupation, and parity. CONCLUSIONS: The Trabzon Hypertension Study data indicated that HT is very common and is an important health problem in the adult population of Trabzon. Patients who are unaware of their status and treated uncontrolled hypertensives are at high risk of early cardiovascular morbidity and mortality. To control preHT and HT, effective public health education and urgent precautions are needed. The precautions include serious health education, a well-balanced diet and increasing physical activity.PMID: 18829520 [PubMed - as supplied by publisher]
17: Diabetes Metab. 2008 Sep 29. [Epub ahead of print]
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The metabolic syndrome, diabetes and lung dysfunction.Tiengo A, Fadini GP, Avogaro A.Division of Metabolic Diseases, Department of Clinical Medicine, University of Padova, Padova, Italy.Sleep-disordered breathing and sleep apnoea are conditions frequently associated with comorbidity, including obesity, diabetes, hypertension, insulin resistance (metabolic syndrome) and cardiovascular disease. The diabetic state (type 1 and type 2 diabetes) may be associated to diminished lung function and, in particular, decreased vital capacity, and the association between chronic obstructive pulmonary disease (COPD) and type 2 diabetes may be due to a shared inflammatory process. Also, the alteration in circulating endothelial progenitor cells found in respiratory disease, the metabolic syndrome and cardiovascular disease reflect a common condition of endothelial dysfunction.PMID: 18829364 [PubMed - as supplied by publisher]
18: J Nutr Biochem. 2008 Sep 29. [Epub ahead of print]
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Fasting triacylglycerol status, but not polyunsaturated/saturated fatty acid ratio, influences the postprandial response to a series of oral fat tolerance tests.Dekker MJ, Wright AJ, Mazurak VC, Marangoni AG, Rush JW, Graham TE, Robinson LE.Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada N1G 2W1.Elevated postprandial lipemia is emerging as a risk factor for obesity-related chronic diseases, such as type 2 diabetes and cardiovascular disease, and is associated with alterations in several metabolic biomarkers of disease. Our goal was to examine the effects of specific polyunsaturated/saturated fatty acid (P/S) ratios on postprandial triacylglycerol (TAG) concentrations and metabolic biomarkers in men with different fasting TAG concentrations through a series of oral fat tolerance tests (OFTT) consisting solely of emulsified lipid. Otherwise healthy men with high (>1.69 mmol/L) fasting TAG (HTAG, n=8) and low fasting TAG (LTAG, n=8) underwent three OFTTs with specific P/S ratios of 0.2, 1.0 and 2.0, respectively, and a total lipid load of 1 g/kg subject body mass. All subjects received each treatment separated by at least 1 week. Postprandial plasma TAG fatty acid composition reflected fatty acids present in the OFTT. All other metabolic responses were independent of the P/S ratio ingested. An accelerated increase in postprandial TAGs was observed in HTAG compared to LTAG. Interleukin (IL)-6 and soluble intercellular adhesion molecule (sICAM)-1 were significantly elevated in HTAG at baseline (P<.05). IL-6 increased significantly following each OFTT (P<.05) in both groups. Postprandial glucose and CRP were significantly exaggerated (P<.05) in HTAG. Overall, HTAG subjects had an accelerated postprandial TAG response and increased concentrations of several inflammatory markers following an OFTT, in the absence of an insulin response. However, P/S ratio had no influence on postprandial lipid and inflammatory parameters.PMID: 18829281 [PubMed - as supplied by publisher]
19: Twin Res Hum Genet. 2008 Oct;11(5):505-516.
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Anthropometry, Carbohydrate and Lipid Metabolism in the East Flanders Prospective Twin Survey: Linkage of Candidate Genes Using Two Sib-Pair Based Variance Components Analyses.Souren NY, Zeegers MP, Janssen RG, Steyls A, Gielen M, Loos RJ, Beunen G, Fagard R, Stassen AP, Aerssens J, Derom C, Vlietinck R, Paulussen AD.1 Department of Complex Genetics, Maastricht University, the Netherlands; Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, the Netherlands; Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, United Kingdom.Abstract Insulin resistance and obesity are underlying causes of type 2 diabetes and therefore much interest is focused on the potential genes involved. A series of anthropometric and metabolic characteristic were measured in 240 MZ and 112 DZ twin pairs recruited from the East Flanders Prospective Twin Survey. Microsatellite markers located close to ABCC8, ADIPOQ, GCK, IGF1, IGFBP1, INSR, LEP, LEPR, PPARgamma and the RETN gene were genotyped. Univariate single point variance components linkage analyses were performed using two methods: (1) the standard method, only comprising the phenotypic and genotypic data of the DZ twin pairs and (2) the extended method, also incorporating the phenotypic data of the MZ twin pairs. Suggestive linkages (LOD > 1) were observed between the ABCC8 marker and waist-to-hip ratio and HDL-cholesterol levels. Both markers flanking ADIPOQ showed suggestive linkage with triglycerides levels, the upstream marker also with body mass and HDL-cholesterol levels. The IGFBP1 marker showed suggestive linkage with fat mass, fasting insulin and leptin levels and the LEP marker showed suggestive linkage with birth weight. This study suggests that DNA variants in ABCC8, ADIPOQ, IGFBP1 and LEP gene region may predispose to type 2 diabetes. In addition, the two methods used to perform linkage analyses yielded similar results. This was however not the case for birth weight where chorionicity seems to be an important confounder.PMID: 18828733 [PubMed - as supplied by publisher]
20: Mt Sinai J Med. 2008 Sep 30;75(5):454-459. [Epub ahead of print]
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Impact of obesity on hospitalized patients.Markoff B, Amsterdam A.Division of General Internal Medicine, Department of Medicine, Mount Sinai Medical Center, New York, NY.Obesity is increasing at an alarming rate worldwide and is a risk factor for cardiac disease, diabetes, and stroke. This provides a challenge for the physicians caring for this patient population in the hospital. Skin integrity, medication dosing, testing, and nutrition are all altered by obesity. We summarize some of the current data on caring for the obese inpatient. Unfortunately, few data on this unique inpatient population exist. Mt Sinai J Med 75:454-459, 2008. (c) 2008 Mount Sinai School of Medicine.PMID: 18828168 [PubMed - as supplied by publisher]