1,721,003 research outputs found
Coagulation and fibrinolysis abnormalities in obesity
No full textAbnormalities in coagulation and haemostasis represent a well-known link between obesity and thrombosis (both arterial and venous). Several studies have shown that obese patients have higher plasma concentrations of all pro-thrombotic factors (fibrinogen, vonWillebrand factor (vWF), and factor VII), as compared to non-obese controls, with a positive association with central fat. Similarly, plasma concentrations of plasminogen activator inhibitor-1 (PAI-1) have been shown to be higher in obese patients as compared to non-obese controls and to be directly correlated with visceral fat. Furthermore, obesity is characterized by higher plasma concentrations of anti-thrombotic factors, such as tissue-type plasminogen activator (t-PA) and protein C, as compared to non-obese controls, the increase in these factors being likely to represent a protective response partly counteracting the increase in pro-thrombotic factors. The issue of whether adipose tissue contributes directly to plasma PAI-1, its products stimulating other cells to produce PAI-1, or whether it primarily contributes indirectly has not yet been resolved. It has been proposed that the secretion of interleukin-6 (IL-6) by adipose tissue, combined with the actions of adipose tissue-expressed TNF-alpha in obesity, could underlie the association of insulin resistance with endothelial dysfunction, coagulopathy, and coronary heart disease. The role of leptin in impairing haemostasis and promoting thrombosis has been recently reported. Finally, some hormonal abnormalities (androgen, F, catecholamines) associated with the accumulation of body fat may contribute to the impairment of coagulative pathway in obesity. As to intervention strategies, dietary (i.e., low-fat high-fiber diet) and lifestyle (i.e., physical activity) measures have been demonstrated to be effective in improving the obesity-associated pro-thrombotic risk profile
A family history of Type 2 diabetes is associated with increased plasma levels of C-reactive protein in non-smoking healthy adult women
No full textAIMS:
The aim of our study was to test whether a family history of Type 2 diabetes (FH) in women is associated with plasma C-reactive protein (CRP).
METHODS:
CRP plasma levels were measured in 162 women, aged 18-60 years; 95 had a positive family history of Type 2 diabetes in a parent or grandparent (FH+), and 67 gave no family history of this disease (FH-). Other measurements included: central fat accumulation, as evaluated by waist circumference; insulin resistance, as calculated by homeostatic model assessment (HOMAIR); systolic and diastolic blood pressure; and fasting concentrations of glucose, insulin, and lipids.
RESULTS:
CRP plasma levels were significantly higher in FH+ than in FH- subjects. Moreover, CRP was independently associated with age, body mass index, waist circumference, HOMAIR, and FH.
CONCLUSIONS:
Our study, performed in a selected population of women free from well-known risk factors for atherothrombosis, demonstrates that subjects with a family history of Type 2 diabetes have higher CRP plasma levels than age- and BMI-matched controls with no family history. Our results show that a family history of Type 2 diabetes is an independent contributor of CRP concentrations, in addition to age, total fatness, central fat accumulation, and insulin resistance
Fuel metabolism in adult individuals with a wide range of body mass index: effect of a family history of type 2 diabetes
No full textOBJECTIVE:
To evaluate whether a family history of Type 2 diabetes mellitus (T2DM) is associated with changes of fuel metabolism in normal glucose tolerant men and women with a wide range of BMI.
DESIGN:
Cross-sectional study of resting energy expenditure (REE) and substrate oxidation in adult individuals.
SUBJECTS:
Ninety-seven normal weight, overweight, and obese men and women, aged 18-45 years: 44 (38 pre-menopausal women and 6 men) with a first-degree family history of T2DM (FH+) and 53 (45 pre-menopausal women and 8 men) with no family history of T2DM (FH-).
MEASUREMENTS:
REE, fat-free mass (FFM)-adjusted REE (REE/Kg FFM), respiratory quotient (RQ), substrate oxidation (carbohydrates, lipids, and proteins), energy intake, anthropometric parameters, body composition (evaluated by BIA), blood pressure, insulin sensitivity (as calculated by Homeostatic Model Assessment) and metabolic variables (fasting levels of insulin, glucose, and lipids).
RESULTS:
REE, REE/Kg FFM, and lipid oxidation were lower, whereas carbohydrate oxidation and RQ were higher in FH+ than in FH- individuals.
CONCLUSIONS:
This study suggests that a family history of T2DM decreases REE, REE/Kg FFM and lipid oxidation, thus possibly contributing to the development of obesity and to the adverse metabolic profile of subjects with a genetic background for T2DM
Effect of glucose tolerance status on PAI-1 plasma levels in overweight and obese subjects
No full textOBJECTIVE:
The aim of our study was to examine whether plasminogen activator inhibitor-1 (PAI-1) plasma levels varied as a function of differences in glucose tolerance status independently of body fatness, body-fat distribution, and insulin sensitivity.
RESEARCH METHODS AND PROCEDURES:
Plasma PAI-1 antigen levels, along with insulin resistance [measured by homeostatic model assessment (HOMA(IR))], central fat accumulation, body composition, blood pressure, and fasting concentrations of glucose, insulin, and lipids, were measured in 229 overweight and obese [body mass index (BMI) > or =25 kg/m(2)) subjects with normal glucose tolerance (NGT) and in 44 age- and BMI-matched subjects with impaired glucose tolerance (IGT).
RESULTS:
Plasma PAI-1 antigen levels were significantly higher in IGT than in NGT subjects. Log PAI-1 was positively correlated with BMI, HOMA(IR), and log insulin, and inversely associated with high-density lipoprotein-cholesterol both in IGT and in NGT individuals. On the other hand, log PAI-1 was positively correlated with waist circumference, fat mass (FM), fat-free mass, systolic and diastolic blood pressure, and log triglycerides only in the NGT group. After multivariate analyses, the strongest determinants of PAI-1 levels were BMI, FM, waist circumference, and high-density lipoprotein cholesterol in the NGT group and only HOMA(IR) in the IGT cohort.
DISCUSSION:
This study demonstrates that PAI-1 concentrations are higher in IGT than in NGT subjects. Furthermore, we suggest that the influences of total adiposity, central fat, and insulin resistance, main determinants of PAI-1 concentrations, are different according to the degree of glucose tolerance
Urinary albumin excretion is independently associated with c-reactive protein levels in overweight and obese nondiabetic premenopausal women.
No full textOBJECTIVES:
C-reactive protein (CRP) and microalbuminuria are nowadays considered markers of chronic inflammation of the arterial wall and of endothelial dysfunction, respectively. An increase of CRP levels and of urinary albumin excretion (UAE) rate have both been reported to be independently associated with a higher risk of cardiovascular morbidity and mortality in the general population. The aim of the present study was to evaluate the possible correlation between UAE and CRP concentrations in overweight and obese premenopausal women.
DESIGN AND SETTING:
A cross-sectional study in a primary care setting. SUBJECTS, MAIN OUTCOME MEASURES: CRP levels and UAE rate were measured in 103 overweight and obese premenopausal women, aged 18-45 years. Other measurements included: central fat accumulation, as evaluated by waist circumference, insulin resistance, as calculated by homeostatic model assessment (HOMAIR); fat-free mass (FFM), as measured by bioimpedance analysis; blood pressure; and fasting plasma levels of glucose, insulin, and lipids.
RESULTS:
Urinary albumin excretion was positively correlated with body mass index (BMI) (P < 0.01), waist circumference (P < 0.001), diastolic blood pressure (P < 0.01), triglycerides (P < 0.01), HOMAIR (P < 0.05), and CRP levels (P < 0.05); and negatively associated with HDL cholesterol (P < 0.001). After multivariate analysis, diastolic blood pressure, HDL cholesterol, and CRP levels maintained their significant correlation with UAE.
CONCLUSION:
Our study shows a strong relationship between UAE and CRP concentrations, irrespective of age and other anthropometric and metabolic variables. On this basis, it can be argued that inflammation of the arterial wall, as indicated by higher CRP plasma levels, and endothelial dysfunction, as shown by higher UAE rate, might represent simultaneous phenomena in the development of atherosclerosis in overweight and obese premenopausal women
C-reactive protein is independently associated with total body fat, central fat, and insulin resistance in adult women.
Full text linkUrinary albumin excretion is independently associated with C-reactive protein levels in overweight and obese nondiabetic premenopausal women.
Full text linkInhibitory effect of obesity on gonadotropin, estradiol, and inhibin B levels in fertile women
No full textObjective: To examine whether obesity and insulin resistance have an independent effect on the gonadotropin, estradiol, and inhibin B serum levels and follicle count in the early follicular phase of fertile women with a wide range of BMI and without signs of hyperandrogenism. Research Methods and Procedures: Twenty-two overweight and obese (BMI >= 25.0 kg/m(2)) women and 10 normal-weight (BMI < 25.0 kg/m(2)) women, all having apparently normal fertility, were studied. Serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, inhibin B, and insulin, level of insulin resistance (estimated by homeostasis model assessment for insulin resistance), and follicle count were measured during the early follicular phase (Days 2 to 5 of the menstrual cycle). Results: Overweight women showed lower FSH (p < 0.001), LH (p < 0.001), and inhibin B (p < 0.05) levels compared with normal-weight women, whereas estradiol concentrations and follicle count were not significantly different between the two groups. When normal-weight and overweight women were examined as a group and multiple regression analyses were performed, estradiol showed a negative association with BMI (or waist circumference) (p < 0.05) and a positive correlation with LH (p < 0.05) and FSH (p < 0.05); inhibin B maintained a positive association only with estradiol (p < 0.05); and FSH and LH showed a negative correlation with BMI (or waist circumference) (p < 0.001 and p < 0.01, respectively). Discussion: Overweight and obese fertile women have lower FSH, LH, inhibin B, and estradiol levels in the early follicular phase, with a possible direct inhibitory effect of body mass on gonadotropin and estradiol production, independently of age, insulin (concentrations and sensitivity), and other hormones. By contrast, the number of ovary follicles does not seem to be influenced by insulin and body mass in these patients
Gender, age and menopause effects on the prevalence and the characteristics of obstructive sleep apnea in obesity.
No full textBACKGROUND:
In the 1970s and 80s it was believed that obstructive sleep apnea (OSA) was primarily a disease of men. The present study was addressed to evaluate the effect of gender and menopause on the prevalence and the characteristics of OSA and on anthropometric, clinical, respiratory and polysomnographic data in a population of obese individuals.
PATIENTS AND METHODS:
A total of 230 obese subjects (BMI >/= 30 kg m-2), 148 women and 82 men, aged 16-75 years, were recruited and evaluated for general and anthropometric parameters, respiratory function, sleep-related symptoms and sleep disorders of breathing.
RESULTS:
Respiratory disturbance index (RDI) and the prevalence of OSA were lower in women than in men (P < 0.001 and P < 0.001, respectively). Among subjects < 55 years, neck circumference, percentage of predicted normal neck circumference (PPNC), waist-to-hip ratio (WHR), PaCO2, RDI and the prevalence of OSA were lower in female subjects (P = 0.05, P < 0.05, P < 0.001, P < 0.01 and P < 0.01, respectively). BMI, neck circumference, PPNC, WHR, RDI and the prevalence of OSA were higher in postmenopausal compared with premenopausal women (P < 0.01, P < 0.01, P < 0.01, P < 0.01 and P < 0.01, respectively).
CONCLUSIONS:
Our study demonstrates that (i) the male dominance regarding the prevalence and the severity of OSA disappears in men older than 55 years, and (ii) menopause seems to play a pivotal role in modulating both the presence and the degree of sleep disorder
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