scholarly journals The role of oxidant-antioxidant markers and resistin in metabolic syndrome elderly individuals

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110065
Author(s):  
Sylwia Dzięgielewska-Gęsiak ◽  
Karolina Wyszomirska ◽  
Edyta Fatyga ◽  
Ewa Wysocka ◽  
Małgorzata Muc-Wierzgoń
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Diastolic Blood Pressure ◽  
Plasma Lipids ◽  
Fasting Glucose ◽  
The Elderly ◽  
Older Individuals ◽  
Elderly Individuals ◽  
Healthy Elderly ◽  
Antioxidant Markers

In elderly, hormones and oxidant-antioxidant interplay are suggested to mediate biochemical balance between adipose tissue to other tissues. Thus the study attempts to explore metabolic traits, plasma resistin, and oxidant-antioxidant markers in metabolic syndrome (MetS) in comparison to non-metabolic syndrome (non-MetS) elderly individuals. A total of 541 healthy elderly Caucasians, with no acute and/or chronic disorders were invited. After taking into account inclusion/exclusion criteria’s the MetS was defined as the presence of three out of five abnormal findings and allowed to divided groups into: non-metabolic syndrome, non-MetS ( n = 25, median age 69.0 years), and newly diagnosed MetS ( n = 29; median age 70.5 years) individuals. Glucose, plasma lipids, resistin (Res), thiobarbituric acid-reacting substances (TBARS), total antioxidant status (TAS), and Cu,Zn-superoxide dismutase (SOD-1) were measured. The MetS had higher resistin than non-MetS ( p < 0.04). The linear correlation (all at p < 0.05) showed correlation for Res&triacylglycerols ( R = 0.44), and for Res&diastolic blood pressure ( R = −0.58) and for SOD-1&fasting glucose ( R = −0.34) in MetS, while in the non-MetS group fasting glucose correlates with Res ( R = 0.58) and with TAS ( R = −0.43). The multiple regression analysis (alone and in combination) showed that independently from other factors resistin correlated positively with fasting glucose (β = 0.37; R = 0.58; R 2 = 0.23; p < 0.01) in all investigated elderly participants. In the MetS resistin correlated negatively with diastolic blood pressure (β = −0.68; R = 0.80; R 2 = 0.53; p = 0.0004) moreover in that group TAS correlated negatively with HDL-C (β = −0.71; R = 0.72; R 2 = 0.37; p = 0.01). While age correlated negatively with systolic blood pressure (β = −0.60; R = 0.62; R 2 = 0.14; p = 0.03) independently from other factors in the non-MetS group. Various metabolic factors contribute to maintain serum resistin and oxidant-antioxidant balance in the elderly people in the presence or absence of MetS. Resistin may serve as a predictor of MetS in the elderly, while strong antioxidant defense interactions in older individuals may indicate good health.

scholarly journals Influence of duration of menopause, anthropometric and hormonal parameters on metabolic syndrome

2010 ◽  
Vol 63 (1-2) ◽  
pp. 33-39 ◽  
Author(s):  
Aleksandra Simoncig-Netjasov ◽  
Svetlana Vujovic ◽  
Miomira Ivovic ◽  
Milina Tancic-Gajic ◽  
Milka Drezgic
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Diastolic Blood Pressure ◽  
Fasting Glucose ◽  
Fat Distribution ◽  
Normal Weight ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Obese Women ◽  
Waist Hip Ratio

Introduction. Hypoestrogenic status in the menopausal women shows a shift to a central android fat distribution and metabolic syndrome (MS). Related metabolic changes and hypertension increase the risk for cardiovascular (CV) diseases. The aim of this study was to investigate the influence of duration of menopause, anthropometric and hormonal parameters on metabolic syndrome. Material and methods. 50 obese women were examined with BMI=31.92?5.83 kg/m2, age 54.40?3.64, time since menopause 5.90?5.46 years. Control group consisted of 37 normal weight women with BMI=23.50?2.13 kg/m2, age 53.92?3.95, time since menopause 5.96?4.92 years. Anthropometric characteristics and blood pressure were measured. Blood was taken at 8 am for: fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A (ApoA), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, FSH, LH, prolactin, estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG). Results. In obese women significant negative correlations were found for: BMI and HDL (p<0,05), waist and HDL (p<0,05), FSH and systolic blood pressure (p<0.01), FSH and fasting glucose (p<0,05), LH and waist (p<0.05), SHBG and fasting glucose (p<0.05). A positive correlation was found for lime since meno?pause and waist/hip ratio (p<0.05). In controls positive correlations were found for: waist/hip ratio and systolic and diastolic blood pressure (p<0,05), LH and HDL (p<0.05), estradiol and diastolic blood pressure (p<0,05). Negative correlations were detected for estradiol and waist (p<0,05), time since menopause and HDL (p<0,05). Conclusion. Gaining weight together with menopausal endocrine changes cause metabolic and hemodynamic imbalances, which contribute to risk for cardiovascular diseases.

scholarly journals Menopause and Metabolic Syndrome in Tunisian Women

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Samir Ben Ali ◽  
Hanen Belfki-Benali ◽  
Hajer Aounallah-Skhiri ◽  
Pierre Traissac ◽  
Bernard Maire ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Plasma Lipids ◽  
Fasting Glucose ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Mean Values ◽  
History Of

Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS) in Tunisian women.Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition.Results. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6%) than in premenopausal women. A binary logistic regression analysis showed that menopause was independently associated with MetS (OR = 1.41, 95% CI 1.10–1.82) after adjusting for age, residence area, marital status, family history of cardiovascular disease, education level, and occupation.Conclusions. The present study provides evidence that the MetS is highly prevalent in this group of women. Menopause can be a predictor of MetS independent of age in Tunisian women.

scholarly journals Gaining weight and components of metabolic syndrome in the period of menopause

2008 ◽  
Vol 136 (9-10) ◽  
pp. 505-513 ◽  
Author(s):  
Aleksandra Simoncig-Netjasov ◽  
Svetlana Vujovic ◽  
Miomira Ivovic ◽  
Milina Tancic-Gajic ◽  
Milka Drezgic
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Diastolic Blood Pressure ◽  
Abdominal Obesity ◽  
Fasting Glucose ◽  
Normal Weight ◽  
Obese Women ◽  
Reactive Protein ◽  
Waist Hip Ratio ◽  
Anthropometric Characteristics

INTRODUCTION Menopause induces redistribution of fat mass and development of abdominal obesity, increasing risk for metabolic syndrome (MS) by 60%. Related cardiovascular diseases become a leading cause of morbidity and mortality in women after fifty years of age. OBJECTIVE The aim of this study was to investigate the influence of gaining weight on components of MS in the menopause. METHOD The study included 50 obese women, BMI=31.92? 5.83 kg/m2, age 54.40?3.64, time since menopause 5.90?5.46 years, and 37 normal weight women, BMI=23.50?2.13 kg/m2, age 53.92?3.95, time since menopause 5.96?4.92 years. Both groups were divided according to the presence of MS into two subgroups. Anthropometric characteristics and blood pressure were measured. Blood was taken at 8 am for the following: fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A (ApoA), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, FSH, LH, prolactin, oestrogen, progesterone, testosterone and sex hormonebinding globulin (SHBG). RESULTS 66% of obese women had MS compared with 22% normal weight women. Significant differences between groups were found for the following: weight, BMI, waist, hip circumference, waist/hip ratio, diastolic blood pressure, Lp(a), FSH, LH, prolactin (all p<0.01) and fasting glucose (p<0.05). Obese women with and without MS were significantly diverse for the following: waist/hip ratio, systolic blood pressure and fasting glucose (all p<0.01); age, BMI, waist circumference, triglycerides, HDL, Lp(a) and SHBG (all p<0.05). Normal weight women with and without MS had significantly different values of waist/hip ratio, systolic, diastolic blood pressure, triglycerides (all p<0.01); HDL and testosterone (p<0.05). Significant differences were found between obese and normal weight women with MS in anthropometric characteristics, ApoA, Lp(a), fibrinogen (all p<0.01) and FSH (p<0.05). CONCLUSION Abdominal obesity significantly increases incidence of MS as a cluster of cardiovascular risk factors in the menopause.

scholarly journals METABOLIC SYNDROME PREVALENCE IS NOT ASSOCIATED WITH DIET QUALITY IN THE CHILEAN ELDERLY POPULATION: A CROSS SECTIONAL ANALYSIS FROM THE NATIONAL HEALTH SURVEY 2009-2010

2016 ◽  
pp. 1-7
Author(s):  
C. Dussaillant ◽  
G. Echeverría ◽  
L. Villarroel ◽  
C.B. Yu ◽  
A. Rigotti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Food Intake ◽  
Diet Quality ◽  
Elderly Population ◽  
The Elderly ◽  
National Health Survey ◽  
Cross Sectional ◽  
Sectional Analysis

Objectives: To analyze the relationship between the prevalence of metabolic syndrome, food intake, and diet quality in elderly (≥65 years old) Chilean population. Design: Cross sectional analysis based on the last national health survey performed in the years 2009 and 2010 (ChNHS 2009-2010). Setting: Non-institutionalized individuals of 65 years or older were selected and visited at home. Participants: A subsample of 505 elderly adults from the ChNHS 2009-2010 who answered a food questionnaire and had appropriate information to diagnose metabolic syndrome following the ATPIII-NCEP guidelines. Measurements: Fasting blood samples were obtained in order to measure blood lipids and fasting blood glucose. Blood pressure, waist circumference, and body mass index (BMI) were also measured. A 5-item food frequency questionnaire was applied to all the participants of NHS 2009-2010. Results: The overall prevalence of metabolic syndrome in the Chilean adult population was 37.7%, increasing in frequency with advancing age. Among the elderly (≥65 years old), metabolic syndrome was found in 57.2% of the sample. Elevated blood pressure and increased waist circumference were the most prevalent metabolic syndrome components among this group (88% and 80%, respectively). Low intake of fruits, vegetables, whole cereals, fish, and dairy was seen among the elderly, and no association was found between food intake nor diet quality and metabolic syndrome prevalence. Conclusion: Metabolic syndrome is highly prevalent among the Chilean elderly population and its prevalence is not associated with food intake or diet quality in this age group.

Antihypertensive Efficacy and Safe Use of Once-Daily Sustained-Release Diltiazem in the Elderly: A Comparison with Captopril

1995 ◽  
Vol 23 (4) ◽  
pp. 244-253 ◽  
Author(s):  
J Nicaise ◽  
E Neveux ◽  
P Blondin ◽  
Keyword(s):  
Blood Pressure ◽  
Sustained Release ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Reduction ◽  
The Elderly ◽  
Double Blind ◽  
Once Daily ◽  
Supine Diastolic Blood Pressure ◽  
Normal Limits ◽  
Electrocardiographic Parameters

The efficacy and safety of sustained-release diltiazem, 200 – 300 mg once daily was compared with that of captopril, 12.5 – 25 mg twice-daily, in 100 elderly patients (65 – 85 years old) with mild to moderate essential hypertension (supine diastolic blood pressure 95 – 115 mmHg). All patients received placebo for 2 weeks, followed by an 8-week double-blind period, and were randomized to either diltiazem ( n = 50) or captopril ( n = 50). Their blood pressure was measured at trough level at week 4 immediately before dosing, i.e. 24 h post diltiazem dose or 12 h post captopril dose. Also at week 4, in non-responders, diltiazem was increased from 200 to 300 mg once daily and captopril from 12.5 to 25 mg twice daily to achieve a target supine diastolic blood pressure reduction of at least 10 mmHg or a diastolic blood pressure below 90 mmHg. Supine diastolic blood pressure, at week 8, was significantly ( P < 0.001) reduced from 102 ± 1 to 90 ± 1 mmHg with diltiazem and from 103 ± 1 to 89 ± 1 mmHg with captopril, bringing this parameter within normal limits for both groups. Supine systolic blood pressure was also significantly ( P < 0.001) reduced. Target blood pressure was achieved in 68% of patients taking diltiazem and in 70% taking captopril. Distribution of adverse events was comparable in both groups; no significant changes in laboratory or electrocardiographic parameters occurred. Two serious events were reported with captopril: one sudden death and one cerebrovascular stroke. Sustained-release diltiazem once a day is a convenient, well tolerated, first line treatment for hypertension in the elderly, for whom the possibility of using two dose levels allows a close regimen adjustment, 200 mg being recommended as a starting dose.

Abstract P221: Metabolic Syndrome And Its Factors Associate With Non-calcified Coronary Plaque Burden In Chronic Inflammation: Results From A Prospective Observational Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Meron Teklu ◽  
Wunan Zhou ◽  
Nidhi Patel ◽  
Grigory Manyak ◽  
Amit K Dey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Fasting Glucose ◽  
Coronary Plaque ◽  
Lipid Lowering ◽  
Plaque Burden ◽  
Cardiometabolic Health ◽  
Lipid Lowering Therapy ◽  
Early Atherosclerosis

Introduction: Psoriasis is a common, inflammatory skin disease associated with systemic inflammation and heightened risk of cardiovascular diseases (CVD). Population studies have shown that psoriasis is associated with metabolic syndrome (MetSyn) and its individual components. However, the impact of MetSyn on early atherosclerosis in chronic inflammatory diseases assessed as non-calcified coronary plaque burden (NCB) by coronary computed CT angiography (CCTA) is not known. Hypothesis: We hypothesized that those with MetSyn in psoriasis would have increased NCB compared to non-MetSyn and that MetSyn and its components would associate with NCB in fully adjusted models. Methods: The cohort consisted of 336 psoriasis patients free of cardiovascular disease, of which 326 had adequate data to classify MetSyn based on the International Diabetes Federation criteria (waist circumference, triglycerides, HDL cholesterol, blood pressure and fasting glucose). Of these, 260 had quantitative CCTA data available for analyses (Stata 16). Results: Of the 260 patients, 80 had MetSyn (31%). The MetSyn group had increased cardiometabolic disease and more adverse coronary characteristics including higher non-calcified ( p <.001) and high-risk plaque ( p =.02) (Table) . In fully adjusted models for Framingham risk score, lipid lowering therapy and biologic use, MetSyn (β=0.31; p< .001) and its individual components of waist circumference (β=0.33; p <.001), triglycerides (β=0.17; p =.005), blood pressure (β=0.18; p =.005) and fasting glucose (β=0.17; p =.009) associated with NCB. Conclusions: MetSyn and its components were associated with NCB in psoriasis suggesting that early atherosclerosis is importantly impacted by poor cardiometabolic health. Components of MetSyn should be assessed in psoriasis patients and patients educated about this heightened risk of CVD associated with MetSyn.

scholarly journals High TSH Level within Normal Range Is Associated with Obesity, Dyslipidemia, Hypertension, Inflammation, Hypercoagulability, and the Metabolic Syndrome: A Novel Cardiometabolic Marker

2019 ◽  
Vol 8 (6) ◽  
pp. 817 ◽  
Author(s):  
Yi-Cheng Chang ◽  
Shih-Che Hua ◽  
Chia-Hsuin Chang ◽  
Wei-Yi Kao ◽  
Hsiao-Lin Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Central Obesity ◽  
Cardiometabolic Risk ◽  
Fasting Glucose ◽  
Reference Group ◽  
Elevated Blood ◽  
Normal Range ◽  
The Metabolic Syndrome

(1) Background: Overt and subclinical hypothyroidism has been associated with increased cardiometabolic risks. Here we further explore whether thyroid function within normal range is associated with cardiometabolic risk factors in a large population-based study. (2) Methods: We screened 24,765 adults participating in health examinations in Taiwan. Participants were grouped according to high-sensitive thyroid-stimulating hormone (hsTSH) level as: <50th percentile (0.47–1.48 mIU/L, the reference group), 50–60th percentile (1.49–1.68 mIU/L), 60–70th percentile (1.69–1.94 mIU/L), 70–80th percentile (1.95–2.3 mIU/L), 80–90th percentile (2.31–2.93 mIU/L), and >90th percentile (>2.93 mIU/L). Cardiometabolic traits of each percentile were compared with the reference group. (3) Results: Elevated hsTSH levels within normal range were dose-dependently associated with increased body mass index, body fat percentage, waist circumferences, blood pressure, hemoglobin A1c (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), high homeostasis model of assessment of beta-cell (HOMA-β), triglycerides, total cholesterols, fibrinogen, and uric acids (p-for-trend <0.001), but not with fasting glucose levels. The association remained significant after adjustment of age, sex, and lifestyle. As compared to the reference group, subjects with the highest hsTSH percentile had significantly increased risk of being overweight (adjusted odds ratio (adjOR): 1.35), increased body fat (adjOR: 1.29), central obesity (adjOR: 1.36), elevated blood pressure (adjOR: 1.26), high HbA1c (adjOR: 1.20), hyperinsulinemia (adjOR: 1.75), increased HOMA-IR (adjOR: 1.45), increased HOMA-β (adjOR: 1.40), hypertriglyceridemia (adjOR: 1.60), hypercholesterolemia (adjOR: 1.25), elevated hsCRP (adjOR: 1.34), increased fibrinogen (adjOR: 1.45), hyperuricemia (adjOR: 1.47), and metabolic syndrome (adjOR: 1.42), but significant risk of low fasting glucose (adjOR: 0.89). Mediation analysis indicates that insulin resistance mediates the majority of the association between thyroid hormone status and the metabolic syndrome. (4) Conclusion: Elevated hsTSH within the normal range is a cardiometabolic risk marker associated with central obesity, insulin resistance, elevated blood pressure, dyslipidemia, hyperuricemia, inflammation, and hypercoagulability.

scholarly journals Association between Parent’s Metabolic Syndrome and 12- to18-Year-Old Offspring’s Overweight: Results from the Korea National Health and Nutrition Examination Survey (K-NHANES) 2009–2016

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Na Yeong Lee ◽  
Kyungdo Han ◽  
Yoonji Lee ◽  
Seulki Kim ◽  
Seonhwa Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Diastolic Blood Pressure ◽  
Central Obesity ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
Age And Sex

Background. Little information is available on the association between parents’ metabolic syndrome (MetS) and adolescent offspring’s obesity in Korea. The aim of our study is to determine the association between parent’s metabolic syndrome and offspring’s obesity. Methods. The study data were obtained from the Korean National Health and Nutrition Examination Survey conducted during 2009–2016. In the present study, 3140 adolescents aged 12 to 18 years, their paternal pairs (PP, fathers = 2244), and maternal pairs (MP, mothers = 3022) were analyzed. Of these 3140 adolescents, 2637 had normal weight {age- and sex-specific body mass index (BMI) under the 85th percentile}, whereas 467 were overweight (age- and sex-specific BMI over the 85th percentile). Results. Offspring’s overweight and central obesity were associated with all components of the PP’s metabolic risk factors, including central obesity ( p < 0.001 ), systolic ( p < 0.001 ) and diastolic blood pressure ( p < 0.001 ), glucose intolerance ( p < 0.001 ), and triglyceride ( p < 0.002 ) and high-density lipoprotein levels ( p = 0.049 ). In addition, offspring’s overweight and central obesity were also associated with the metabolic risk factors of MP, including central obesity ( p < 0.001 ), systolic ( p < 0.001 ) and diastolic blood pressure ( p < 0.001 ), glucose intolerance ( p < 0.001 ), and triglyceride levels ( p < 0.001 ). In multivariate logistic regression analysis, offspring’s overweight was significantly and positively associated with parental central obesity (PP, adjusted odds ratio (OR) = 1.593; 95% confidence interval (CI): 1.192–2.128; MP, adjusted OR = 2.221, 95% CI: 1.755–2.812) and parental metabolic syndrome (PP, adjusted OR = 2.032; 95% CI: 1.451–2.846; MP, adjusted OR = 2.972, 95% CI: 2.239–3.964). As the number of parental metabolic risk factors increased, offspring’s risk for overweight and central obesity increased ( p for trends < 0.001). Conclusion. Parental metabolic syndrome was associated with obesity in 12- to 18-year-old offspring in Korea.

scholarly journals Obesity in African women in the North West Province, South Africa is associated with an increased risk of non-communicable diseases: the THUSA study

2001 ◽  
Vol 86 (6) ◽  
pp. 733-740 ◽  
Author(s):  
H. S. Kruger ◽  
C. S. Venter ◽  
H. H. Vorster
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Regression Analysis ◽  
Diastolic Blood Pressure ◽  
South African ◽  
Fasting Glucose ◽  
Hdl Cholesterol ◽  
African Women ◽  
North West ◽  
The North

The objective of the present study was to assess the relationship between anthropometric measurements and risk factors for non-communicable diseases (NCD) in South African black women. A cross-sectional sample of 1040 apparently healthy black female volunteers, 15–70 years old, was recruited from thirty-seven randomly selected sites in the North West Province, stratified according to level of urbanisation. We analysed the association between BMI, waist:hip (WHR), waist circumference (WC) and skinfold measurements and the following risk factors for NCD: blood pressure, serum lipids, fasting serum glucose and insulin and plasma fibrinogen, by using age-adjusted correlation analyses and stepwise regression analysis. Of the subjects, 28·6 % were obese (BMI>30). After adjustment for age and smoking status, BMI correlated significantly with diastolic blood pressure (r0·21,P=0·037), serum triacylglycerols (TG) (r0·30,P=0·003), fasting glucose (r0·29,P=0·005) and log fasting insulin (r0·24,P=0·02). There was a significant negative correlation between BMI and HDL-cholesterol (r-0·38,P<0·001). Similar but stronger correlations were found between both WC and WHR and these risk factors. Together with age, WC was a significant predictor of TG, HDL-cholesterol and fasting glucose in regression analysis, while subscapular skinfold was a significant predictor of diastolic blood pressure and fasting glucose concentration. Triceps skinfold was a significant predictor of total serum cholesterol, LDL-cholesterol, plasma fibrinogen and the insulin sensitivity index. Measures of obesity, particularly WC, are associated with the risk for NCD in black South African women, in which a high rate of obesity has been found.

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