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High Body Mass Index (high + body_mass_index)
Selected AbstractsHigh body mass index and dietary pattern are associated with childhood asthmaPEDIATRIC PULMONOLOGY, Issue 12 2006Soo-Jong Hong MD Abstract The increasing prevalence of asthma has coincided with an increase of body mass index (BMI) in both children and adults. We investigated the relationship between BMI and the symptom prevalence of asthma and the possible influences of dietary pattern. This was a community-based, cross-sectional study of 24,260 school children aged 6,12 years. Prevalences of asthma and potential confounding factors were assessed using a Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire which was completed by parents. We analyzed the relationship between BMI and symptoms of asthma and the possible influences of dietary pattern. A significant positive association between high BMI and previous 12-month prevalence of wheeze remained in boys (adjusted odds ratio, 1.610; 95% confidence interval, 1.274,2.033) but not in girls. In addition, there were significant associations between high BMI and lifetime prevalence of wheeze, previous 12-month wheeze, exercise-induced wheeze, diagnosis, and treatment of asthma. There were significant associations between high BMI and previous 12-month wheeze regardless of breast-milk feeding or whole-milk feeding. Frequent intake of fresh seafood, fresh fruits, and vegetables was associated with reduced prevalence of current asthma symptoms and was also associated with decreased BMI. These results indicate that BMI may be an independent risk factor for the development of asthma symptoms in boys. Intake of fresh seafood, fresh fruit, and vegetables, which may be associated with decreased BMI, may contribute to protect against the development of asthma symptoms in Korean elementary schoolchildren. Pediatr Pulmonol. 2006; 41:1118,1124. © 2006 Wiley-Liss, Inc. [source] High body mass index overtakes tobacco as the leading independent risk factor contributing to disease burden in Western AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010Veronica Hoad No abstract is available for this article. [source] Spatial Cluster Detection for Weighted Outcomes Using Cumulative Geographic ResidualsBIOMETRICS, Issue 3 2010Andrea J. Cook Summary Spatial cluster detection is an important methodology for identifying regions with excessive numbers of adverse health events without making strong model assumptions on the underlying spatial dependence structure. Previous work has focused on point or individual-level outcome data and few advances have been made when the outcome data are reported at an aggregated level, for example, at the county- or census-tract level. This article proposes a new class of spatial cluster detection methods for point or aggregate data, comprising of continuous, binary, and count data. Compared with the existing spatial cluster detection methods it has the following advantages. First, it readily incorporates region-specific weights, for example, based on a region's population or a region's outcome variance, which is the key for aggregate data. Second, the established general framework allows for area-level and individual-level covariate adjustment. A simulation study is conducted to evaluate the performance of the method. The proposed method is then applied to assess spatial clustering of high Body Mass Index in a health maintenance organization population in the Seattle, Washington, USA area. [source] Clustering of cardiovascular risk factors in type 2 diabetes mellitus: prognostic significance and trackingDIABETES OBESITY & METABOLISM, Issue 1 2001J. Kaukua Summary Aim Little attention has been paid to the prognostic significance and tracking effect of risk factor clusters characteristic of type 2 diabetes mellitus. We studied the clustering of eight cardiovascular risk factors (smoking, high body mass index, elevated systolic blood pressure, high serum, low density lipoprotein (LDL) cholesterol, high serum LDL triglycerides, low serum, high density lipoprotein (HDL) cholesterol, high fasting blood glucose and high plasma insulin concentration) and their effect on the prognosis and the tracking effect. Methods This study is a population-based prospective follow-up of newly diagnosed type 2 diabetic subjects (n = 133, aged 45,64 years) in Eastern Finland. The following end points were used: all-cause mortality, cardiovascular mortality, and incidences of first myocardial infarction and first stroke. Furthermore, we studied the ,tracking effect' of the risk factor clusters during the 10-year follow-up period. Results When the clustering of risk factors typical of type 2 diabetes mellitus was taken into account, all-cause mortality increased from 28.6% to 50.0% (p <,0.05) and cardiovascular disease mortality increased from 14.3% to 50.0% (p <,0.01) depending on the number of risk factors present. The incidence of first myocardial infarction increased from 0% to 40.0% (p <,0.05) as the number of risk factors increased from 0 to 5. In survivors, the proportion of individuals with no risk factors decreased and the proportion on individuals with three to four risk factors increased during the 10-year follow-up period despite the high mortality among the group with many risk factors. Conclusions The risk factor clusters among type 2 diabetic subjects are of great predictive value and when not aggressively treated, show a relentless increase despite selective mortality. [source] The islet autoantibody titres: their clinical relevance in latent autoimmune diabetes in adults (LADA) and the classification of diabetes mellitusDIABETIC MEDICINE, Issue 2 2008A. W. Van Deutekom Abstract Latent autoimmune diabetes in the adult (LADA) is a slowly progressive form of autoimmune diabetes, characterized by diabetes-associated autoantibody positivity. A recent hypothesis proposes that LADA consists of a heterogeneous population, wherein several subgroups can be identified based on their autoimmune status. A systematic review of the literature was carried out to appraise whether the clinical characteristics of LADA patients correlate with the titre and numbers of diabetes-associated autoantibodies. We found that the simultaneous presence of multiple autoantibodies and/or a high-titre anti-glutamic acid decarboxylase (GAD),compared with single and low-titre autoantibody,is associated with an early age of onset, low fasting C-peptide values as a marker of reduced pancreatic B-cell function, a high predictive value for future insulin requirement, the presence of other autoimmune disorders, a low prevalence of markers of the metabolic syndrome including high body mass index, hypertension and dyslipidaemia, and a high prevalence of the genotype known to increase the risk of Type 1 diabetes. We propose a more continuous classification of diabetes mellitus, based on the finding that the clinical characteristics gradually change from classic Type 1 diabetes to LADA and finally to Type 2 diabetes. Future studies should focus on determining optimal cut-off points of anti-GAD for differentiating clinically relevant diabetes mellitus subgroups. [source] The importance of steatosis in chronic hepatitis C infection and its management: A reviewHEPATOLOGY RESEARCH, Issue 3 2010Timothy J. S. Cross Hepatitis C virus (HCV) infection is a major cause of chronic liver disease with approximately 180 million people infected worldwide. Hepatic steatosis is a frequent histological finding in chronic hepatitis C (CHC) infection and is 2- to 3-fold more common than would be expected by chance alone. A high body mass index with excess visceral fat distribution is associated with steatosis in patients infected with HCV genotype 1 but not genotype 3, re-enforcing the concept that in patients with CHC, some have "metabolic steatosis", predominantly HCV genotype 1, and others "viral steatosis", mainly HCV genotype 3. Accumulating evidence suggests that steatosis may contribute to progression of fibrosis in CHC. Hepatic insulin resistance appears to play a role through the pro-fibrogenic effects of compensatory hyperinsulinemia. The aim of this review was to assess the effect host and viral factors play in steatosis development in patients with CHC infection and its possible relationship with hepatocellular carcinoma. The review examines the mechanisms by which CHC infection causes hepatic steatosis, the impact hepatic steatosis has on the natural history of the disease and finally, explores if treatments leading to a reduction in the amount of steatosis might lead to improved treatment outcomes. The basic medical science of steatosis in CHC will be discussed including proposed models of steatogenesis and the influence of viral and metabolic factors at the molecular level and how these might impact on current and future therapies. [source] Unspecified abdominal pain in primary care: the role of gastrointestinal morbidityINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2007M.-A. Wallander Summary Background:, Many patients with abdominal pain have no obvious cause for their symptoms and receive a diagnosis of unspecified abdominal pain. Aim:, The objective of this study was to ascertain risk factors and consequences of a diagnosis of unspecified abdominal pain in primary care. Methods:, A population-based, case,control study was conducted using the UK General Practice Research Database. We identified 29,299 patients with a new diagnosis of abdominal pain, and 30,000 age- and sex-matched controls. Only diagnostic codes that did not specify the type or location of abdominal pain were included. Results and discussion:, The incidence of newly diagnosed unspecified abdominal pain was 22.3 per 1000 person-years. The incidence was higher in females than in males, and 29% of patients were below 20 years of age. Prior gastrointestinal morbidity was associated with abdominal pain, but high body mass index, smoking and alcohol intake were not. Patients newly diagnosed with abdominal pain were 16 to 27 times more likely than controls to receive a subsequent new diagnosis of gallbladder disease, diverticular disease, pancreatitis or appendicitis in the year after the diagnosis of abdominal pain. The likelihood of receiving other gastrointestinal diagnoses such as peptic ulcer disease, hiatus hernia, gastro-oesophageal reflux disease (GERD), irritable bowel syndrome (IBS) or dyspepsia was increased three- to 14-fold among patients consulting for abdominal pain. Conclusion:, When managing abdominal pain in primary care, morbidities such as GERD and IBS should be considered as diagnoses once potentially life-threatening problems have been excluded. [source] The prevention of dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2009Ruth Peters Abstract Objective Dementia is prevalent in older adults and the population is ageing. Many factors have been associated with dementia and anything that may aid the prevention of dementia is of importance. Method The literature in this area was evaluated and information relating to the various factors that may impact upon the prevention of dementia is presented below. Results Factors that have been associated with a possible increased risk of developing dementia include high blood pressure, (at least in midlife), high body mass index, smoking and possibly diabetes although the evidence is mixed. There is currently no clear evidence with regard to cholesterol and metabolic syndrome although both may be implicated. Having education and maintaining a Mediterranean diet, including vegetable, fruit and fish intake, have been linked to a lower incidence of dementia as has low to moderate alcohol intake. Although care must be taken with the latter given the different characteristics of the studies reporting on alcohol and dementia. Conclusion It may be that risk and protective factors vary with age, however, in the absence of prophylactic treatment it seems likely that the maintenance of a healthy lifestyle may represent the best option with regard to the prevention of dementia. Copyright © 2008 John Wiley & Sons, Ltd. [source] Depressive Symptoms in Middle Age and the Development of Later-Life Functional Limitations: The Long-Term Effect of Depressive SymptomsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Kenneth E. Covinsky MD OBJECTIVES: To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without. DESIGN: Prospective cohort study. SETTING: The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61. PARTICIPANTS: Seven thousand two hundred seven community living participants in the 1992 wave of the HRS. MEASUREMENTS: Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves. RESULTS: Eight hundred eighty-seven (12%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45% vs 23%, Cox hazard ratio (HR)=2.33, 95% confidence interval (CI)=2.06,2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95% CI=1.25,1.66). CONCLUSION: Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age. [source] Assessment of obesity in children and adolescents: synthesis of recent systematic reviews and clinical guidelinesJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2010J. J. Reilly Abstract This review summarises recent systematic reviews and evidence-based guidelines that deal with the issue of how best to diagnose or define obesity in children and adolescents. A recent systematic review showed that parents typically fail to recognise obesity in their children and adolescents, and a good deal of other evidence suggests that health professionals under-diagnose obesity in children and adolescents when using informal methods based on observation. There is therefore a need for practical, objective, methods that both identify the fattest children and adolescents adequately, and identify those who are at greatest risk of the ,co-morbidities' of obesity. A large body of consistent evidence shows that a high body mass index (BMI) for age and sex identifies the fattest children adequately, with low,moderate false negative rate and a low false positive rate. Furthermore, children and adolescents at high BMI for age are at much greater risk of the co-morbidities of obesity. A recent systematic review found that the use of BMI for age with national reference data and cut-off points (such as the 95th percentile to define obesity) was superior to the Cole,International Obesity Task Force international approach for defining obesity based on BMI for age. The same systematic review also found no evidence that use of waist circumference for age improved the diagnosis of obesity, or the cardio-metabolic co-morbidities of obesity, in children and adolescents. Recent systematic reviews are therefore supportive of current guidelines that recommend percentile-based cut-offs relative to national reference data to (e.g. BMI at or above the 95th or 98th percentile in the UK) to define obesity for clinical applications in children and adolescents. [source] No evidence found that childhood onset of psoriasis influences disease severity, future body mass index or type of treatments usedJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 11 2010MEA De Jager Abstract Background, In more than one-third of the psoriatic population, the first manifestations occur in childhood. Whether the age of onset of psoriasis influences the march of psoriasis is not known. Objectives, To describe the epidemiology and clinical features as well as prescribed treatments and familial distribution in psoriasis depending on the age of onset of the disease. Methods, A structured questionnaire was sent to 5300 adult psoriatic patients. Respondents were divided into two groups: patients who experienced an onset of disease before the age of 18 [childhood onset psoriasis (COP)] and patients with an onset of disease from the age of 18 [adult onset psoriasis (AOP)]. Results, Questionnaires of 1926 (36.3%) patients were suitable for analysis. In 37.1% of patients, first signs of the disease occurred before the age of 18. COP occurs predominantly in females, has a longer delay in diagnosis and a higher frequency of familial distribution. The development of guttate and erythrodermic psoriasis in adulthood is more frequently seen in COP. In contrast to common belief, type of psoriasis in COP often remains the same from childhood to adulthood. There was no evidence found that getting psoriasis before the age of 18 years influences development of high body mass index in adulthood, disease severity in later life or type of treatments used. Conclusions, The age of onset of psoriasis essentially does not influence the subsequent course of the disease in adulthood. [source] Obesity, hyperlipidemia, and metabolic syndromeLIVER TRANSPLANTATION, Issue S2 2009Michael Charlton Key Points 1. Obesity is increasingly common among liver transplantation (LT) recipients and donors. Outcomes following LT for selected patients with class I-III obesity are similar to those for nonobese recipients. In patients who are otherwise satisfactory candidates for LT, a high body mass index, as long as it does not present a technical barrier, should not be considered to be an absolute contraindication to LT. 2. The most common causes of death beyond the first year of LT are, in descending order of frequency, graft failure (especially secondary to hepatitis C virus recurrence), malignancy, cardiovascular disease, infections, and renal failure. Metabolic syndrome is an important risk factor for each of these etiologies of posttransplant death. Posttransplant diabetes, posttransplant hypertension, and an original diagnosis of cryptogenic cirrhosis, which is commonly associated with metabolic syndrome, are all associated with an increased risk of post-LT mortality. Features of metabolic syndrome should be screened for and treated in LT recipients. 3. Because of the physiological mechanism of post-LT hypertension, which includes renal arteriolar constriction secondary to calcineurin inhibition, calcium channel blocking agents are a good pharmacological treatment modality and have been shown to be effective in renal protection in randomized controlled trials of posttransplant hypertension. 4. It is rare for dietary changes and weight reduction to result in normalization of the lipid profile. Statins should thus be initiated early in the course of management of post-LT dyslipidemia. Forty milligrams of simvastatin per day, 40 mg of atorvastatin per day, and 20 mg of pravastatin per day are reasonable starting doses for post-LT hypercholesterolemia. It is important to remember that the effects of statin therapy are additive to those of a controlled diet (eg, a Mediterranean diet rich in omega-3 fatty acids, fruits, vegetables, and dietary fiber). 5. Nonalcoholic steatohepatitis, an increasingly common etiology of cirrhosis and liver failure, recurs commonly after LT and may also arise de novo. Treatment should be directed at managing obesity and complications of metabolic syndrome. Optimal immunosuppression in patients with nonalcoholic steatohepatitis is still evolving but should include steroid minimization. Liver Transpl 15:S83,S89, 2009. © 2009 AASLD. [source] Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studiesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2010Bruno R. da Costa PT Abstract Objective This systematic review was designed and conducted in an effort to evaluate the evidence currently available for the many suggested risk factors for work-related musculoskeletal disorders. Methods To identify pertinent literature we searched four electronic databases (Cinahl, Embase, Medline, and The Cochrane Library). The search strategies combined terms for musculoskeletal disorders, work, and risk factors. Only case,control or cohort studies were included. Results A total of 1,761 non-duplicated articles were identified and screened, and 63 studies were reviewed and integrated in this article. The risk factors identified for the development of work-related musculoskeletal disorders were divided and organized according to the affected body part, type of risk factor (biomechanical, psychosocial, or individual) and level of evidence (strong, reasonable, or insufficient evidence). Conclusions Risk factors with at least reasonable evidence of a causal relationship for the development of work-related musculoskeletal disorders include: heavy physical work, smoking, high body mass index, high psychosocial work demands, and the presence of co-morbidities. The most commonly reported biomechanical risk factors with at least reasonable evidence for causing WMSD include excessive repetition, awkward postures, and heavy lifting. Additional high methodological quality studies are needed to further understand and provide stronger evidence of the causal relationship between risk factors and work-related musculoskeletal disorders. The information provided in this article may be useful to healthcare providers, researchers, and ergonomists interested on risk identification and design of interventions to reduce the rates of work-related musculoskeletal disorders. Am. J. Ind. Med. 53:285,323, 2010. © 2009 Wiley-Liss, Inc. [source] The effect of age, gender, and body mass index on the pharmacokinetics and pharmacodynamics of vildagliptin in healthy volunteersBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 3 2008Yan-Ling He What is already known about this subject ,,Vildagliptin is a new, potent, and selective inhibitor of DPP-4. ,,The efficacy and safety of vildagliptin in type 2 diabetes has been intensively studied in diverse subject populations. ,,There has been little information published about the pharmacokinetics and pharmacodynamics of vildagliptin. What this study adds ,,No clinically relevant changes in pharmacokinetics or pharmacodynamics were observed between young and elderly, male and female, or high body mass index (BMI) and low BMI subjects. ,,The results suggest that no dose modification is necessary for vildagliptin based on the age, gender, or BMI of a subject. Aims To evaluate the effect of age, gender, and body mass index (BMI) on the pharmacokinetics and pharmacodynamics of vildagliptin. Methods Forty healthy subjects received a single oral dose of 100 mg vildagliptin to assess the effects of age, gender, and BMI on the pharmacokinetics and pharmacodynamics, reflected by the time course of inhibition of DPP-4 activity, of vildagliptin. Results Peak concentration and exposure (AUC(0,,)) of vildagliptin were 17% (90% CI 2, 35%) and 31% (90% CI 18, 45%) higher in elderly vs. young subjects. Renal clearance was reduced by 32% (90% CI 17, 45%) in elderly subjects. The pharmacokinetics of vildagliptin were not significantly influenced by gender or BMI. Inhibition of DPP-4 activity was similar regardless of age, gender, or BMI. Conclusions The pharmacokinetics of a single oral 100 mg dose of vildagliptin were not affected by gender and BMI. Exposure to vildagliptin was higher in elderly patients, but this was not associated with any difference in the effect of DPP-4 inhibition. Based on these results, no vildagliptin dose adjustment is necessary for age, gender, or BMI. [source] Life Style and Urinary 8-Hydroxydeoxyguanosine, a Marker of Oxidative DNA Damage: Effects of Exercise, Working Conditions, Meat Intake, Body Mass Index, and SmokingCANCER SCIENCE, Issue 1 2001Hiroshi Kasai The urinary levels of 8-hydroxydeoxyguanosine (8-OH-dG), a marker of oxidative DNA damage, of 318 healthy men aged 18-58 were measured with high resolution by a newly developed automated high-pressure liquid chromatography (HPLC) system coupled to an electrochemical detector (ECD). The mean 8-OH-dG level (,Mg/g creatinine) was 4.12±1.73 (SD). An eleven-fold inter-individual variation was observed. The accuracy of the measurement estimated from the recovery of an added 8-OH-dG standard was 90-98%. By univariate analysis, it was found that moderate physical exercise (P=0.0023) and high body mass index (BMI) (P=0.0032) reduced the 8-OH-dG level, while physical labor (P=0.0097), smoking (P=0.032), and low meat intake (less than once/ week) (P=0.041) increased its level. Based on a multi-regression analysis of the log-transformed values, moderate physical exercise (P=0.0039), high BMI (P=0.0099), and age (P=0.021) showed significant reducing effects on the 8-OH-dG level, while low meat intake (P=0.010), smoking (P=0.013), and day-night shift work (P=0.044) increased its level. These results suggest that many types of life-style factors that either generate or scavenge oxygen radicals may affect the level of oxidative DNA damage of each individual. [source] | ||||||||||