scholarly journals Pathophysiology of obesity

2000 ◽  
Vol 59 (3) ◽  
pp. 331-336 ◽  
Author(s):  
M. E. J. Lean

The rapidly rising prevalence of obesity, worldwide, has prompted re-evaluations of the definitions and diagnostic criteria, and of the extent of the burden it contributes to health care services. Although categorized arbitrarily for epidemiological purposes according to BMI > 25 kg/m2 (‘overweight’) and BMI > 30 kg/m2 (‘obese’), the disease itself (ICD code E.66) is the process of excess fat accumulation. It leads to multiple organ-specific pathological consequences, particularly if there is a tendency to intra-abdominal fat accumulation. The simplest field method to identify obesity and risk of medical problems is the waist circumference, and this method has found a special role in health promotion. Risks begin with waist > 80 cm (women) or > 94 cm (men). As a broad generalization, obesity produces few symptoms below the age of 40 years, but then several symptoms often develop; tiredness, breathlessness, back pain, arthritis, sweatiness, poor sleeping, depression and menstrual disorders all being common. The symptoms are often attributed to diseases in other body systems. Metabolic diseases like diabetes, hyperlipidaemia and, hypertension develop later, but the mean BMI at diagnosis of diabetes is 28 kg/m2. Ultimately, obesity increases the likelihood of myocardial infarction, stroke and several major cancers, but its biggest impact on health, especially in the elderly, is probably the multiplicity of effects on other body systems. The greatest challenge for public health is to develop effective preventive measures, recognizing that BMI > 25 kg/m2 before the age of 20 years is a very strong predictor of obesity and ill health in adulthood.

Author(s):  
Marco Giammanco ◽  
Laura Lantieri ◽  
Gaetano Leto ◽  
Fulvio Pescia ◽  
Danila Di Majo

Obesity is a chronic pathological condition with a multifactorial aetiology, characterised by an excessive body fat accumulation with multiple organ-specific consequences. Emerging evidence highlights that obesity appears to be associated with multiple alterations in the endocrine system. However, the mechanisms underlying the interactions between obesity and this system remain still controversial. This review discusses the impact of obesity on various endocrine systems and, in particular, would provide a general overview on the biochemical changes that may occur in each of these axes in association with obesity.


2019 ◽  
Vol 25 (22) ◽  
pp. 2467-2473 ◽  
Author(s):  
Enrique Reyes-Muñoz ◽  
Federica Di Guardo ◽  
Michal Ciebiera ◽  
Ilker Kahramanoglu ◽  
Thozhukat Sathyapalan ◽  
...  

Background: Gestational Diabetes Mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, represents one of the most common maternal-fetal complications during pregnancy and it is associated with poor perinatal outcomes. To date, GDM is a rising condition over the last decades coinciding with the ongoing epidemic of obesity and Type 2 Diabetes Mellitus (T2DM). Objective: The aim of this review is to discuss the role of diet and nutritional interventions in preventing GDM with the explanation of the special role of myo-inositol (MI) in this matter. Methods: We performed an overview of the most recent literature data on the subject with particular attention to the effectiveness of diet and nutritional interventions in the prevention of GDM with the special role of MI. Results: Nutritional intervention and physical activity before and during pregnancy are mandatory in women affected by GDM. Moreover, the availability of insulin-sensitizers such as different forms of inositol has dramatically changed the scenario, allowing the treatment of several metabolic diseases, such as those related to glucose dysbalance. Although the optimal dose, frequency, and form of MI administration need to be further investigated, diet supplementation with MI appears to be an attractive alternative for the GDM prevention as well as for the reduction of GDM-related complications. Conclusion: More studies should be conducted to prove the most effective nutritional intervention in GDM. Regarding the potential effectiveness of MI, further evidence in multicenter, randomized controlled trials is needed to draw firm conclusions.


2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.


2021 ◽  
Vol 10 (5) ◽  
pp. 933
Author(s):  
Byung Woo Cho ◽  
Du Seong Kim ◽  
Hyuck Min Kwon ◽  
Ick Hwan Yang ◽  
Woo-Suk Lee ◽  
...  

Few studies have reported the relationship between knee pain and hypercholesterolemia in the elderly population with osteoarthritis (OA), independent of other variables. The aim of this study was to reveal the association between knee pain and metabolic diseases including hypercholesterolemia using a large-scale cohort. A cross-sectional study was conducted using data from the Korea National Health and the Nutrition Examination Survey (KNHANES-V, VI-1; 2010–2013). Among the subjects aged ≥60 years, 7438 subjects (weighted number estimate = 35,524,307) who replied knee pain item and performed the simple radiographs of knee were enrolled. Using multivariable ordinal logistic regression analysis, variables affecting knee pain were identified, and the odds ratio (OR) was calculated. Of the 35,524,307 subjects, 10,630,836 (29.9%) subjects experienced knee pain. Overall, 20,290,421 subjects (56.3%) had radiographic OA, and 8,119,372 (40.0%) of them complained of knee pain. Multivariable ordinal logistic regression analysis showed that among the metabolic diseases, only hypercholesterolemia was positively correlated with knee pain in the OA group (OR 1.24; 95% Confidence Interval 1.02–1.52, p = 0.033). There were no metabolic diseases correlated with knee pain in the non-OA group. This large-scale study revealed that in the elderly, hypercholesterolemia was positively associated with knee pain independent of body mass index and other metabolic diseases in the OA group, but not in the non-OA group. These results will help in understanding the nature of arthritic pain, and may support the need for exploring the longitudinal associations.


1998 ◽  
Vol 28 (3) ◽  
pp. 555-574 ◽  
Author(s):  
Larissa I. Remennick ◽  
Naomi Ottenstein-Eisen

The post-1989 immigration wave from the former U.S.S.R. has increased the Israeli population by over 12 percent, seriously affecting the host health care system. This study draws on semi-structured interviews with the immigrants visiting outpatient clinics in the Tel-Aviv area in order to explore organizational and cultural aspects of their encounter with the Israeli medical services. While instrumental aspects of care were seen as an improvement over the Soviet standards, communication between providers and clients was seriously flawed, reflecting both a language barrier and diverse cultures of illness and cure. Many interviewees complained of the impersonal, “technical” attitude of Israeli physicians toward patients and the lack of holism in care, which they allegedly enjoyed before emigration. Some immigrant patients feel deprived of the paternalism of the Soviet medical system, complaining that Israeli providers “forego responsibility” for patients' health. A consumerist approach to medical services is also a novelty, and immigrants have to learn to be informed and assertive clients. Most problems are experienced by the elderly patients; overall, women seem to adjust to the new system better than men.


2004 ◽  
Vol 10 (3) ◽  
pp. 365-371
Author(s):  
A. A. Mahfouz ◽  
A. I. Al Sharif ◽  
M. N. El Gamal ◽  
A. H. Kisha

Use of primary health care [PHC] services and satisfaction among elderly people [60 + years] in Asir was studied in 26 PHC centers. They visited PHC centers significantly less often than younger adults but they were referred significantly more often to secondary and tertiary care and for more laboratory tests. A r and om sample of 253 elderly people attending the centers was interviewed about accessibility, continuity, humaneness, informativeness and thoroughness of care. Overall, 79.0% were satisfied with the services provided. The leading 3 items of dissatisfaction were:not enough audiovisual means for health education [65.1%], long time spent in the centre [46.4%], and not enough specialty clinics [42.5%]


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