BMI and Waist Circumference Have Positive Correlation With Mitochondrial DNA Copy Number in Young Adult Male

Background:Abdominal obesity is associated with metabolic and cardiovascular diseases. Mitochondrial dysfunction is often related to metabolic disorder commonly found in abdominal obesity. Mitochondrial DNA (mtDNA) copy number is a biomarker which can be used to reflect the activity of mitochondria. Abdominal obesity is more commonly found in males compared to females and the incidence is growing in young adult male, therefore we investigated the relationship of mtDNA copy number and anthropometric and metabolic biomarkers in young adult male.Methods:A total of 25 healthy young adult males of age 19 to 24 years old were recruited in the study. Metabolic biomarkers were evaluated along with body mass index, waist circumference and total body fat, visceral fat by bioelectrical impedance analysis. mtDNA copy number was measured in peripheral blood leukocytes by using real-time polymerase chain reaction method.Results:After adjusting for ages, mtDNA copy number correlated with body mass index (r= 0.45,P= 0.03) and waist circumference (r= 0.43,P= 0.04) but had no significant correlation with fasting plasma glucose, insulin, HOMA-IR, testosterone, total body fat and visceral fat.Conclusion:mtDNA copy number has a positive correlation with BMI and waist circumference. Even though it is still controversial over other studies, further studies are needed to explain the causality and significance of our findings.

Physical Function and Health Related Quality of Life Before and 18 Months after Bariatric Surgery

Introduction: The mobility disability experienced by people with obesity is well known and has been found to be associated with reduced health related quality of life (HRQoL) compared to people without obesity. Research is lacking related to the patients experiences that how their capacity to perform various daily physical activities and HRQoL are affected by weight loss following bariatric surgery. Aim: To evaluate patients’ experiences of their HRQoL and physical function before and 18 months after laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGB). Method: A series of 70 patients filled in one HRQoL questionnaire, the EQ-5D (including EQ VAS and EQ-5D descriptive system) and two self-assessment questionnaires that evaluate disability by assessing activity and participation limitations, the Disability Rating Index (DRI) and a questionnaire with five disease-specific questions. Results: All activities, in both DRI as well as the five disease-specific questions were experienced as significantly less difficult to perform postoperatively than preoperatively (p<0.05). In this study, the median (min, max) EQ VAS score was 60 (20, 100) mm preoperatively and 80 (20, 100) mm postoperatively (100 = best imaginable health; 0 = worst imaginable health). The difference between pre- and postoperative EQ VAS was significant (p<0.001). Conclusion: Both the HRQoL and the self experienced ability to perform various daily physical activities increased significantly 18 months after LRYGB compared to preoperatively.

Foot Pressure Distribution Variation in Pre-obese, Obese and Non-obese Individuals – Forensic Implications

The present commentary refers to recent research on the plantar pressure distribution variation in pre-obese, obese and non-obese adult individuals. While the studies observe significant changes in the contact area in the mid foot region i.e. instep region, no statistically significant differences were observed in the pressure distribution of the fore-foot and hind-foot region among the pre-obese and non-obese groups. Thus, the pressure distribution of the sole of the individuals depends upon the body weight of the individuals. In this commentary, we emphasize that the results of these studies; besides their clinical implications, have applications in forensic sciences especially in the field of forensic podiatry too which is concerned with the examination of pedal evidence recovered at the crime scene.

An Examination of Socioeconomic Determinants of Average Body Mass Indices in Rwanda

Obesity is increasingly becoming a common problem in Africa. Many studies have been pre-occupied with analyzing the causes of malnutrition whose effects are more pronounced. The main objective of this research was to determine the socio-economic factors that influence body mass indices in Rwanda. Inflation rate, body mass indices (bmi) for males and females (from 1960 to 2009) and food supply indices were obtained mainly from the Food and Agriculture Organization (FAOSTAT). A double log multiple regression model was used to assess the relationship between average bmi and several predictor variables. Further tests of autocorrelation, multicollinearity, heteroscedasticity and normality were carried out and subsequently corrected. Results showed that obesity is not a problem in Rwanda. However, bmi for men and women have been increasing. Food self sufficiency, fat supply and food aid had a positive and significant impact on average bmi (p<0.05) while GDP per capita and inflation rate were insignificant. These results indicate the positive impact of efforts of government of Rwanda through Vision 2020. However, food aid may be contributing to rapid bmi increases in the country.

Should we Fear Insulin Therapy in the Treatment of Type 2 Diabetes?

Obesity is the primary risk factor for the development of type 2 diabetes (T2DM) and, as the prevalence of obesity continues to increase, so does the incidence of type 2 diabetes. For most patients with T2DM, the disease will progress beyond the control of lifestyle measures, diet and oral glucose-lowering drugs. In these patients, insulin therapy is ultimately required to lower blood glucose concentrations to acceptable levels. ‘Psychological insulin resistance’ is a major barrier to the initiation of insulin therapy for patients with T2DM and for clinicians treating them. This may have a negative impact on patients’ health and weight, and also the healthcare system due to increased incidence of diabetesrelated complications if HbA1c remains poorly controlled. Ensuring timely and appropriate initiation of insulin therapy requires physicians to recognize patients’ fears and to reassure them. This review explores the concerns behind psychological insulin resistance and how they can potentially be addressed in light of recent developments in the treatment of diabetes.

Association of Changes in Body Composition with Changes in Systemic Oxidative Stress Following Weight Loss Program in Obese Adults Attending Obesity Clinic, Hospital Universiti Sains Malaysia

The main objective of the present study was to evaluate the association of changes in body composition with changes in systemic oxidative stress markers among obese adults participating in a weight loss program. Thirty four obese adults were recruited from the Obesity Clinic, Hospital Universiti Sains Malaysia (USM) to voluntarily participate in a weight loss program comprising of physical exercise and dietary modification. Levels/activities of oxidative stress markers were measured before and after the program. Mean body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC) and percentage of body fat mass decreased significantly while mean body lean mass and body water increased significantly after the weight loss program. Plasma glutathione peroxidase (GPx) activity and 4- hydroxynonenal (4-HNE) concentration increased significantly while other enzymatic antioxidant activities such as catalase (CAT) and superoxide dismutase (SOD) were not significantly increased. The ratio of reduced glutathione (GSH) to oxidized glutathione (GSSG) was significantly decreased. There was no significant association between changes in body composition and changes in systemic oxidative stress markers among obese adults. In conclusion, changes in body composition were not associated with changes in systemic oxidative stress markers among obese adults.

Early Identification of Acute Kidney Injury after Bariatric Surgery: Role of NGAL and Cystatin C

Background: The aim of our study was to evaluate plasmatic and urinary NGAL and serum cystatin C as early diagnostic markers of acute kidney injury in obese patients undergoing bariatric surgery. Methods: For this this prospective observational study, we recruited 23 patients undergoing gastric by-pass or sleeve gastrectomy, and admitted to the Low Dependence Unit after the surgery. Plasma NGAL (pNGAL), urinary NGAL (uNGAL), serum cystatin C, serum creatinine, and serum urea were measured before surgery as well as 10 h and 24 h after surgery. Mean values of pNGAL, uNGAL, cystatin C, creatinine, and urea concentrations of pre- and post-surgery periods were compared using Student’s t test for paired data. We also evaluated the presence of correlation between modifications of NGAL and cystatin C after surgery and fluid balance, hydration (ml/kg) and diuresis using Pearson’s coefficient of correlation. Results: No patient developed AKI according to the AKIN criteria. pNGAL was significantly higher at T10h than T0 (p=0.004). There was no significant difference between uNGAL at T0 and T10h (p=0.53) and between uNGAL at T0 and T24h (p=0.31). uNGAL at T was significantly higher in comparison to T10h (p=0.024). uNGAL concentrations were normal in all patients at every time step. Cystatin C concentration did not increase after surgery. Serum creatinine level was significantly higher at T48h, despite being still within the normal range, when compared to T0 (p=0.038). Conclusion: Our study shows that pNGAL can reflect mild tubular damage as its levels increase within a few hours from surgery and return to normal limits afterwards. Concerning uNGAL, there is a minimal increase at T24h, when NGAL concentration in plasma has already decreased. Serum cystatin C does not show any relevant kidney changes, or at least, no more than those ones shown by pNGAL.

Signalling Pathways Implicated in Obesity Associated Cancers

Intensive research over recent years has provided irrefutable evidence of links between obesity and the risk of an increasing number of human cancers. The predicted economic burden is causing significant concern. This has prompted investigation of the underlying mechanisms with a focus on deregulated metabolic pathways. A number of metabolic processes and associated signalling pathways are associated with the development of obesity. These include a number of interlinking pathways regulating endocrine, redox, inflammation, immunity and lipogenic processes. The identification of deregulated metabolic pathways in obesity with promotion of carcinogenesis has targeted research on the signalling molecules involved. Consequently this mini review is focused on aberrant signalling of deregulated pathways provoked by diets that lead to obesity and their role in carcinogenesis. Knowledge of the signalling molecules involved will assist in directing and establishing dietary manipulation strategies to restore metabolic health in obese individuals. Importantly the identified diversity of signalling pathways linked to obesity related cancers will permit design of more effective combinatorial and multi-targeted cancer therapies in the future.