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Huang L, Guo Z, Jiang Z, Xu Y, Huang H. Resting metabolic rate in obesity. Postgrad Med J 2025; 101:396-410. [PMID: 39561990 DOI: 10.1093/postmj/qgae153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/17/2024] [Indexed: 11/21/2024]
Abstract
The prevalence of obesity has continued to rise, and obesity and its attendant metabolic disorders are major global health threat factors. Among the current interventions for obesity, none have demonstrated sustained efficacy in achieving long-term outcomes. So, the identification of therapeutic targets is of paramount importance in the advancement and sustainability of obesity. Resting metabolic rate (RMR) constitutes 60%-75% of total energy expenditure and serves a crucial function in maintaining energy balance. Nevertheless, there exists considerable heterogeneity in RMR among individuals. Low RMR is associated with weight gain, elevating the susceptibility to obesity-related ailments. Hence, RMR will be the main focus of interest in the study of obesity treatment. In this review, we will elucidate the influence factors and mechanisms of action of RMR in obesity, with particular emphasis on the effects of obesity treatment on RMR and the alterations and influence factors of RMR in special types of populations with obesity.
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Affiliation(s)
- LingHong Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - ZhiFeng Guo
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - ZhengRong Jiang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - YaJing Xu
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - HuiBin Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
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Zhang Y, Duan R, Chen X, Wei L. Blood pressure, gallstones, and age at first cholecystectomy in U.S. adults: a cross-sectional study. BMC Gastroenterol 2025; 25:65. [PMID: 39920609 PMCID: PMC11806608 DOI: 10.1186/s12876-025-03641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 01/21/2025] [Indexed: 02/09/2025] Open
Abstract
BACKGROUND Gallstones are a prevalent health issue. Recent studies have revealed that blood pressure (BP) may affect gallstone formation. This study assessed the association between hypertension (HTN) and both the prevalence of gallstones and the age at first cholecystectomy among U.S. adults. METHODS Data were extracted from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020. Weighted logistic and linear regression analyses and subgroup analyses were employed to investigate the relationships between HTN, gallstone disease (GD), and age at first cholecystectomy. Additionally, this study employed generalized additive models (GAM) and smooth-fitting curves to delineate the relationships. The two-piecewise linear regression model and logarithmic likelihood ratio test elucidated the inflection point of systolic blood pressure (SBP) on the age at first cholecystectomy. RESULTS The study included 7,532 participants aged over 20 years. Of these, 817 reported a history of cholecystectomy, and 781 reported a history of gallstones. After adjustment for age, gender, race, diabetes, and hypercholesterolemia, HTN was significantly associated with gallstones in individuals aged 48 years (OR = 1.39; 95% CI: 1.03, 1.88). SBP was positively correlated with the age at first cholecystectomy (β = 0.20, 95% CI: 0.13, 0.26). When examining the correlation between SBP and age at surgery, age was first positively and then negatively correlated with BP, with 170 as an inflection point. We carried out subgroup analyses to evaluate the robustness of the link between HTN and cholecystectomy. The results revealed a consistent positive association between HTN and cholecystectomy across these variables (p > 0.05). CONCLUSION The study found a correlation between BP and the prevalence of gallstones in individuals aged 42 years and older and a positive association between SBP and the age at first cholecystectomy. While causality cannot be confirmed, these findings may assist in identifying early risk groups for GD and early cholecystectomy, thereby enhancing risk stratification and potentially reducing screening costs.
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Affiliation(s)
- Yue Zhang
- Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University, Changchun, PR China
| | - Ruifeng Duan
- Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University, Changchun, PR China
| | - Xin Chen
- Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University, Changchun, PR China
| | - Lijuan Wei
- Department of Gastroenterology and Digestive Endoscopy Center, The Second Hospital of Jilin University, Changchun, PR China.
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Feyisa BR, Tamiru A, Debelo S, Feyisa I, Tola EK, Tolesa EJ, Negeri A, Shibiru T, Galata A, Biru B. Magnitude of hypertension and its association with obesity among employees of Wallaga University, Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e070656. [PMID: 37438078 PMCID: PMC10347519 DOI: 10.1136/bmjopen-2022-070656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/02/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE To determine the magnitude of hypertension, its association with obesity and the associated factors among employees of Wallaga University, Ethiopia. DESIGN, SETTING AND PARTICIPANTS This institution-based cross-sectional study was employed among 588 employees of the university. Respondents were selected by stratified random sampling technique and interviewed with the aid of a structured questionnaire. THE MAIN OUTCOME MEASURED Hypertension and obesity were measured using WHO Stepwise approach and recommendations. We used a stratified random sampling technique to select 588 employees of the university from 3 August 2021 to 15 October 2021. A structured questionnaire and anthropometric measurements were used for data collection. Multivariable logistic regression analysis was used to determine factors independently associated with hypertension. A p value less than or equal to 0.05 and its 95% confidence level was used to declare the statistical significance. RESULTS A total of 578 participants consented and completed the study, giving a response rate of 98.3%. The mean age of the respondents was 31.78 years with SD of 5.4. The overall prevalence of hypertension, general obesity and central obesity was 14.4% (95% CI 11.6% to 17.5%), 31.3% (95% CI 27.6% to 35.3%) and 37% (95% CI 33.1% to 41.1%), respectively. Obesity was significantly associated with hypertension (adjusted OR (AOR): 6.3; 95% CI 2.60 to 8.19). Age range from 35 to 46 (AOR 7.01; 95% CI 1.56 to 31.74), age ≥46 years (AOR 8.45; 95% CI 1.14 to 62.04), being non-academic staff (AOR 2.74; 95% CI 1.56 to 4.81), having additional income (AOR 2.48; 95% CI 1.08 to 5.70), physical inactivity (AOR 2.36; 95% CI 1.44 to 3.88) and poor practice of dietary salt consumption (AOR 1.65; 95% CI 1.01 to 2.87) were factors associated with hypertension. CONCLUSION One in seven, more than two in seven and nearly two in six of the employees of Wallaga University were hypertensive, centrally obese and generally obese, respectively. There was a positive association between obesity and hypertension. Comprehensive awareness creation and devising workplace intervention strategies are highly recommended to reduce the hypertension burden and associated obesity.
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Affiliation(s)
- Bikila Regassa Feyisa
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Afework Tamiru
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
- Department of Public Health, College of Medical and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Sidise Debelo
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Ilili Feyisa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Edosa Kifle Tola
- Department of Medical Laboratory Science, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Edosa Jabesa Tolesa
- Sport Studies, College of Computational and Natural Sciences, Wallaga University, Nekemte, Ethiopia
| | - Asefa Negeri
- Institute of Health Sciences, Wallaga University Referral Hospital, Wallaga University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- Institute of Health Sciences, Wallaga University Referral Hospital, Wallaga University, Nekemte, Ethiopia
| | - Alemtsehay Galata
- Department of Nursing, School of Nursing and Midwifery, Wallaga University, Nekemte, Ethiopia
| | - Bayise Biru
- Department of Public Health, Institutes of Health Sciences, Wallaga University, Nekemte, Ethiopia
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Balsevich G, Petrie GN, Heinz DE, Singh A, Aukema RJ, Hunker AC, Vecchiarelli HA, Yau H, Sticht M, Thompson RJ, Lee FS, Zweifel LS, Chelikani PK, Gassen NC, Hill MN. A genetic variant of fatty acid amide hydrolase (FAAH) exacerbates hormone-mediated orexigenic feeding in mice. eLife 2023; 12:e81919. [PMID: 37039453 PMCID: PMC10159625 DOI: 10.7554/elife.81919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/06/2023] [Indexed: 04/12/2023] Open
Abstract
Fatty acid amide hydrolase (FAAH) degrades the endocannabinoid anandamide. A polymorphism in FAAH (FAAH C385A) reduces FAAH expression, increases anandamide levels, and increases the risk of obesity. Nevertheless, some studies have found no association between FAAH C385A and obesity. We investigated whether the environmental context governs the impact of FAAH C385A on metabolic outcomes. Using a C385A knock-in mouse model, we found that FAAH A/A mice are more susceptible to glucocorticoid-induced hyperphagia, weight gain, and activation of hypothalamic AMP-activated protein kinase (AMPK). AMPK inhibition occluded the amplified hyperphagic response to glucocorticoids in FAAH A/A mice. FAAH knockdown exclusively in agouti-related protein (AgRP) neurons mimicked the exaggerated feeding response of FAAH A/A mice to glucocorticoids. FAAH A/A mice likewise presented exaggerated orexigenic responses to ghrelin, while FAAH knockdown in AgRP neurons blunted leptin anorectic responses. Together, the FAAH A/A genotype amplifies orexigenic responses and decreases anorexigenic responses, providing a putative mechanism explaining the diverging human findings.
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Affiliation(s)
| | - Gavin N Petrie
- Hotchkiss Brain Institute, University of CalgaryCalgaryCanada
| | - Daniel E Heinz
- Neurohomeostasis Research Group, Department of Psychiatry and Psychotherapy, University Hospital BonnBonnGermany
| | - Arashdeep Singh
- Monell Chemical Senses Center and Department of Neuroscience, University of PennsylvaniaPhiladelphiaUnited States
| | - Robert J Aukema
- Hotchkiss Brain Institute, University of CalgaryCalgaryCanada
| | - Avery C Hunker
- Department of Psychiatry and Behavioral Sciences, University of WashingtonSeattleUnited States
| | | | - Hiulan Yau
- Hotchkiss Brain Institute, University of CalgaryCalgaryCanada
| | - Martin Sticht
- Hotchkiss Brain Institute, University of CalgaryCalgaryCanada
| | | | - Francis S Lee
- Weill Cornell Medical College, Cornell UniversityNew YorkUnited States
| | - Larry S Zweifel
- Department of Psychiatry and Behavioral Sciences, University of WashingtonSeattleUnited States
| | | | - Nils C Gassen
- Neurohomeostasis Research Group, Department of Psychiatry and Psychotherapy, University Hospital BonnBonnGermany
| | - Matthew N Hill
- Hotchkiss Brain Institute, University of CalgaryCalgaryCanada
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Zakharenko LP, Petrovskii DV, Bobrovskikh MA, Gruntenko NE, Yakovleva EY, Markov AV, Putilov AA. Motus Vita Est: Fruit Flies Need to Be More Active and Sleep Less to Adapt to Either a Longer or Harder Life. Clocks Sleep 2023; 5:98-115. [PMID: 36975551 PMCID: PMC10047790 DOI: 10.3390/clockssleep5010011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Activity plays a very important role in keeping bodies strong and healthy, slowing senescence, and decreasing morbidity and mortality. Drosophila models of evolution under various selective pressures can be used to examine whether increased activity and decreased sleep duration are associated with the adaptation of this nonhuman species to longer or harder lives. Methods: For several years, descendants of wild flies were reared in a laboratory without and with selection pressure. To maintain the “salt” and “starch” strains, flies from the wild population (called “control”) were reared on two adverse food substrates. The “long-lived” strain was maintained through artificial selection for late reproduction. The 24 h patterns of locomotor activity and sleep in flies from the selected and unselected strains (902 flies in total) were studied in constant darkness for at least, 5 days. Results: Compared to the control flies, flies from the selected strains demonstrated enhanced locomotor activity and reduced sleep duration. The most profound increase in locomotor activity was observed in flies from the starch (short-lived) strain. Additionally, the selection changed the 24 h patterns of locomotor activity and sleep. For instance, the morning and evening peaks of locomotor activity were advanced and delayed, respectively, in flies from the long-lived strain. Conclusion: Flies become more active and sleep less in response to various selection pressures. These beneficial changes in trait values might be relevant to trade-offs among fitness-related traits, such as body weight, fecundity, and longevity.
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Affiliation(s)
- Lyudmila P. Zakharenko
- Department of Insect Genetics, Institute of Cytology and Genetics of the Siberian Branch, The Russian Academy of Sciences, Novosibirsk 630000, Russia
| | - Dmitrii V. Petrovskii
- Department of Insect Genetics, Institute of Cytology and Genetics of the Siberian Branch, The Russian Academy of Sciences, Novosibirsk 630000, Russia
| | - Margarita A. Bobrovskikh
- Department of Insect Genetics, Institute of Cytology and Genetics of the Siberian Branch, The Russian Academy of Sciences, Novosibirsk 630000, Russia
| | - Nataly E. Gruntenko
- Department of Insect Genetics, Institute of Cytology and Genetics of the Siberian Branch, The Russian Academy of Sciences, Novosibirsk 630000, Russia
| | | | - Alexander V. Markov
- Department of Biological Evolution, The Moscow State University, Moscow 101000, Russia
- Borisyak Paleontological Institute of the Russian Academy of Sciences, Moscow 101000, Russia
| | - Arcady A. Putilov
- Research Group for Math-Modeling of Biomedical Systems, Research Institute for Molecular Biology and Biophysics of the Federal Research Centre for Fundamental and Translational Medicine, Novosibirsk 630000, Russia
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow 101000, Russia
- Correspondence: ; Tel.: +49-30-53674643 or +49-30-61290031
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Li Z, Cao L, Zhou Z, Han M, Fu C. Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: a 2-year longitudinal study. BMC Public Health 2023; 23:339. [PMID: 36793011 PMCID: PMC9930240 DOI: 10.1186/s12889-022-14410-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/20/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND This study aimed to investigate the proportion of prehypertension cases progressing to hypertension among Chinese middle-aged and elderly populations over a 2-year period and related influencing factors. METHODS Data were obtained from the China Health and Retirement Longitudinal Study, and 2,845 individuals who were ≥ 45 years old and prehypertensive at baseline were followed from 2013-2015. Structured questionnaires were administered, and blood pressure (BP) and anthropometric measurements were performed by trained personnel. Multiple logistic regression analysis was done to investigate factors associated with prehypertension progressing to hypertension. RESULTS Over the 2-year follow-up, 28.5% experienced progression of prehypertension to hypertension; this occurred more frequently in men than women (29.7% vs. 27.1%). Among men, older age (55-64 years: adjusted odds ratio [aOR] = 1.414, 95% confidence interval [CI]:1.032-1.938; 65-74 years: aOR = 1.633, 95%CI: 1.132-2.355; ≥ 75 years: aOR = 2.974, 95%CI: 1.748-5.060), obesity (aOR = 1.634, 95%CI: 1.022-2.611), and number of chronic diseases (1: aOR = 1.366, 95%CI: 1.004-1.859; ≥ 2: aOR = 1.568, 95%CI: 1.134-2.169) were risk factors for progression to hypertension whereas being married/cohabiting (aOR = 0.642, 95% CI: 0.418-0.985) was a protective factor. Among women, risk factors included older age (55-64 years: aOR = 1.755, 95%CI: 1.256-2.450; 65-74 years: aOR = 2.430, 95%CI: 1.605-3.678; ≥ 75 years: aOR = 2.037, 95% CI: 1.038-3.995), married/cohabiting (aOR = 1.662, 95%CI: 1.052-2.626), obesity (aOR = 1.874, 95%CI: 1.229-2.857), and longer naps (≥ 30 and < 60 min: aOR = 1.682, 95%CI: 1.072-2.637; ≥ 60 min: aOR = 1.387, 95%CI: 1.019-1.889). CONCLUSIONS Chinese middle-aged and elderly individuals experienced a risk of prehypertension progressing to hypertension over a 2-year period, although the influencing factors differed by sex; this should be considered in interventions.
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Affiliation(s)
- Zhen Li
- Yantai Center for Disease Control and Prevention, No.17 Fuhou Road, Yantai, 264003 Shandong China
| | - Lianmeng Cao
- grid.452240.50000 0004 8342 6962Department of Gastrointestinal Surgery Bariatric and Metabolic Surgery, Binzhou Medical University Hospital, No. 661 2nd Huanghe Road, Binzhou, 256603 Shandong China
| | - Ziyu Zhou
- Department of Anesthesiology, the 80Th Army Hospital, No. 256 Beigongxijie Rd, Weifang, Shandong, 261021 China
| | - Maozhi Han
- Department of Pharmacy, the 80Th Army Hospital, No. 256 Beigongxijie Rd. , Weifang, 261021 Shandong China
| | - Chang Fu
- Department of Health Service and Management,School of Public Health and Management, Binzhou Medical University, No.346 Guanhai Road, Yantai, 264003, Shandong, China.
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Kos M, Nađ T, Stanojević L, Lukić M, Stupin A, Drenjančević I, Pušeljić S, Davidović Cvetko E, Mihaljević Z, Dumančić D, Jukić I. Estimation of Salt Intake in Normotensive and Hypertensive Children: The Role of Body Weight. Nutrients 2023; 15:736. [PMID: 36771442 PMCID: PMC9921955 DOI: 10.3390/nu15030736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The connection between increased dietary salt intake and arterial hypertension has been recognized for a long time, even in children. This study aimed to investigate salt consumption in normotensive and hypertensive children and evaluate their dietary habits. MATERIALS AND METHODS A total of fifty participants were included in this cross-sectional study: twenty-five normotensive children and 25 children of both sexes with essential arterial hypertension from 12-17 years old. Subjects' body mass index, waist-to-hip ratio, body composition and arterial blood pressure were measured, and their daily salt intake was calculated from 24-h urine samples. Using the food frequency questionnaire (FFQ), the data on the average daily total energy and food intakes were collected and analyzed using a suitable program. RESULTS Estimated daily salt intake was significantly higher in hypertensive compared to normotensive children, and this is positively associated with blood pressure and body mass index (BMI). Hypertensive children had significantly higher BMIs, which also positively correlated with blood pressure. Consistently, resting metabolic rate (kcal) is higher in hypertensive children compared to normotensive, and this is also associated with blood pressure. Reported energy intake is also enlarged in hypertensive compared to normotensive children and for both groups, levels are significantly higher than the recommended values. CONCLUSIONS Our study results confirm the relationship between daily salt consumption, blood pressure and body weight. Sodium consumption related to blood pressure and body weight among children. Cardiovascular disease prevention should start in early childhood by reducing salt intake and preventing overweight/obesity since these are two of the most important modifiable risk factors for hypertension.
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Affiliation(s)
- Martina Kos
- Clinic of Pediatrics, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Pediatrics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Tihana Nađ
- Clinic of Pediatrics, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Pediatrics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Lorena Stanojević
- Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Matea Lukić
- Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Ana Stupin
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
| | - Ines Drenjančević
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
| | - Silvija Pušeljić
- Clinic of Pediatrics, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Pediatrics, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Erna Davidović Cvetko
- Lavoslav Ružička College of Applied Sciences of Vukovar, Županijska 50, HR-32000 Vukovar, Croatia
| | - Zrinka Mihaljević
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
| | - Dijana Dumančić
- Department of Diagnostic and Interventional Radiology, University Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Department of Radiology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
| | - Ivana Jukić
- Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
- Scientific Centre of Excellence for Personalized Health Care, University of Osijek, Trg Sv. Trojstva 3, HR-31000 Osijek, Croatia
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Zhang Y, Sun L, Wang X, Chen Z. The association between hypertension and the risk of gallstone disease: a cross-sectional study. BMC Gastroenterol 2022; 22:138. [PMID: 35346065 PMCID: PMC8961935 DOI: 10.1186/s12876-022-02149-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To explore the association between hypertension and the risk of gallstone disease. METHODS We collected the data about the subjects receiving physical examination. Gallstone disease was diagnosed by abdominal ultrasound. Multivariable logistic regression was used to study the association between blood pressure and the risk of gallstone disease. SPSS version 23.0 was used for statistical analysis, and two-tailed P < 0.05 was defined as statistically significant. RESULTS A total of 318,403 people were included in the study and 171,276 (53.8%) of them were men and 147,127 (46.2%) were women. Among them, 27,463 (8.6%) were diagnosed with gallstone disease on ultrasound examination, with 12,452 (3.9%) cases of gallstones and 15,017 (4.7%) cases of cholecystectomy. Multivariable logistic regression showed that hypertension was significantly associated with the risk of gallstone disease (OR = 1.05; 95% CI: 1.02-1.10; P = 0.03) and gallstones (OR = 1.12; 95% CI: 1.06-1.19; P < 0.01) and the association between hypertension and gallstone disease was stronger in women than in men. However, hypertension was not significantly correlated with cholecystectomy (OR = 0.99; 95% CI: 0.95-1.04; P = 0.85). Additionally, results showed that with the severity of hypertension increased, the risk of gallstone disease was also marked elevated (P for trend < 0.001). CONCLUSIONS The gallstone disease was prevalent and hypertension is significantly associated with the gallstone disease risk with a significant dose-response association. This study showed that the association between hypertension and cholecystectomy was not statistically significant, maybe hypertension correlated with gallstones but not with symptomatic gallstone disease which would require cholecystectomy.
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Affiliation(s)
- Yalan Zhang
- Health Management Center, First Affiliated Hospital, Army Medical University, 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Li Sun
- Health Management Center, First Affiliated Hospital, Army Medical University, 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
| | - Xin Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Zongtao Chen
- Health Management Center, First Affiliated Hospital, Army Medical University, 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 China
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9
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The association of dietary acid load with resting metabolic rate and metabolic components in overweight and obese women: A cross sectional study. Clin Nutr ESPEN 2022; 47:267-276. [DOI: 10.1016/j.clnesp.2021.11.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022]
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10
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Pedrianes-Martin PB, Martin-Rincon M, Morales-Alamo D, Perez-Suarez I, Perez-Valera M, Galvan-Alvarez V, Curtelin D, de Pablos-Velasco P, Calbet JAL. Treatment of hypertension with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and resting metabolic rate: A cross-sectional study. J Clin Hypertens (Greenwich) 2021; 23:2106-2114. [PMID: 34846787 PMCID: PMC8696230 DOI: 10.1111/jch.14392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/26/2022]
Abstract
Hypertension in obese and overweight patients is associated with an elevated resting metabolic rate (RMR). The aim of this study was to determine whether RMR is reduced in hypertensive patients treated with angiotensin‐converting enzyme inhibitors (ACEI) and blockers (ARB). The RMR was determined by indirect calorimetry in 174 volunteers; 93 (46.5 %) were hypertensive, of which 16 men and 13 women were treated with ACEI/ARB, while 30 men and 19 women with untreated hypertension served as a control group. Treated and untreated hypertensives had similar age, BMI, physical activity, and cardiorespiratory fitness. The RMR normalized to the lean body mass (LBM) was 15% higher in the untreated than ACEI/ARB‐treated hypertensive women (p = .003). After accounting for LBM, whole‐body fat mass, age, the double product (heart rate x systolic blood pressure), and the distance walked per day, the RMR was 2.9% lower in the patients taking ACEI/ARB (p = .26, treatment x sex interaction p = .005). LBM, age, and the double product explained 78% of the variability in RMR (R2 = 0.78, p < .001). In contrast, fat mass, the distance walked per day, and total T4 or TSH did not add predictive power to the model. Compared to men, a greater RMR per kg of LBM was observed in untreated hypertensive overweight and obese women, while this sex difference was not observed in patients treated with ACEI or ARBs. In conclusion, our results indicate that elevated RMR per kg of LBM may be normalized by antagonizing the renin‐angiotensin system.
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Affiliation(s)
- Pablo B Pedrianes-Martin
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Marcos Martin-Rincon
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - David Morales-Alamo
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Ismael Perez-Suarez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Mario Perez-Valera
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Victor Galvan-Alvarez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Pedro de Pablos-Velasco
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Jose A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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11
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Pedrianes-Martin PB, Perez-Valera M, Morales-Alamo D, Martin-Rincon M, Perez-Suarez I, Serrano-Sanchez JA, Gonzalez-Henriquez JJ, Galvan-Alvarez V, Acosta C, Curtelin D, de Pablos-Velasco P, Calbet JAL. Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms. Scand J Med Sci Sports 2021; 31:1461-1470. [PMID: 33749940 DOI: 10.1111/sms.13955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/15/2021] [Indexed: 12/17/2022]
Abstract
The purpose of this investigation was to determine whether differences in body composition, pharmacological treatment, and physical activity explain the increased resting metabolic rate (RMR) and impaired insulin sensitivity in hypertension. Resting blood pressure, RMR (indirect calorimetry), body composition (dual-energy X-ray absorptiometry), physical activity (accelerometry), maximal oxygen uptake (VO2 max) (ergospirometry), and insulin sensitivity (Matsuda index) were measured in 174 patients (88 men and 86 women; 20-68 years) with overweight or obesity. Hypertension (HTA) was present in 51 men (58%) and 42 women (49%) (p = .29). RMR was 6.9% higher in hypertensives than normotensives (1777 ± 386 and 1663 ± 383 kcal d-1 , p = .044). The double product (systolic blood pressure × heart rate) was 18% higher in hypertensive than normotensive patients (p < .001). The observed differences in absolute RMR were non-significant after adjusting for total lean mass and total fat mass (estimated means: 1702 kcal d-1 , CI: 1656-1750; and 1660 kcal d-1 , CI: 1611-1710 kcal d-1 , for the hypertensive and normotensive groups, respectively, p = .19, HTA × sex interaction p = .37). Lean mass, the double product, and age were the variables with the higher predictive value of RMR in hypertensive patients. Insulin sensitivity was lower in hypertensive than in normotensive patients, but these differences disappeared after accounting for physical activity and VO2max . In summary, hypertension is associated with increased RMR and reduced insulin sensitivity. The increased RMR is explained by an elevated myocardial oxygen consumption due to an increased resting double product, combined with differences in body composition between hypertensive and normotensive subjects.
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Affiliation(s)
- Pablo B Pedrianes-Martin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Perez-Valera
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Morales-Alamo
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marcos Martin-Rincon
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ismael Perez-Suarez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose A Serrano-Sanchez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Juan Jose Gonzalez-Henriquez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Victor Galvan-Alvarez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Carmen Acosta
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Pedro de Pablos-Velasco
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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12
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Ramadan MS, Russo V, Nigro G, Durante-Mangoni E, Zampino R. Interplay between Heart Disease and Metabolic Steatosis: A Contemporary Perspective. J Clin Med 2021; 10:1569. [PMID: 33917867 PMCID: PMC8068259 DOI: 10.3390/jcm10081569] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/26/2021] [Accepted: 04/03/2021] [Indexed: 12/12/2022] Open
Abstract
The liver-heart axis is a growing field of interest owing to rising evidence of complex bidirectional interplay between the two organs. Recent data suggest non-alcoholic fatty liver disease (NAFLD) has a significant, independent association with a wide spectrum of structural and functional cardiac diseases, and seems to worsen cardiovascular disease (CVD) prognosis. Conversely, the effect of cardiac disease on NAFLD is not well studied and data are mostly limited to cardiogenic liver disease. We believe it is important to further investigate the heart-liver relationship because of the tremendous global health and economic burden the two diseases pose, and the impact of such investigations on clinical decision making and management guidelines for both diseases. In this review, we summarize the current knowledge on NAFLD diagnosis, its systemic manifestations, and associations with CVD. More specifically, we review the pathophysiological mechanisms that govern the interplay between NAFLD and CVD and evaluate the relationship between different CVD treatments and NAFLD progression.
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Affiliation(s)
- Mohammad Said Ramadan
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Vincenzo Russo
- Department of Translational Medical Sciences, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, Italy; (V.R.); (G.N.)
- Cardiology Unit, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, Italy
| | - Gerardo Nigro
- Department of Translational Medical Sciences, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, Italy; (V.R.); (G.N.)
- Cardiology Unit, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, Italy
| | - Emanuele Durante-Mangoni
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Infectious and Transplant Medicine Unit, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, Italy;
| | - Rosa Zampino
- Infectious and Transplant Medicine Unit, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, Italy;
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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13
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Xing Z, Pei J, Huang J, Peng X, Chen P, Hu X, Gao S. Weight change is associated with increased all-cause mortality and non-cardiac mortality among patients with type 2 diabetes mellitus. Endocrine 2019; 64:82-89. [PMID: 30864142 DOI: 10.1007/s12020-019-01892-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/05/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND It is unclear whether changes in weight affect subsequent adverse events in patients with type 2 diabetes mellitus (T2DM) already at high risk of cardiovascular disease (CVD). METHODS AND RESULTS This is a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study data to examine the relationship between changes in weight and adverse events. Patients were divided into groups based on changes in body mass index (BMI): stable weight, gain or loss of BMI ≤1.5 kg/m2; moderate weight gain, BMI gain of 1.5-5 kg/m2; pronounced weight gain, BMI gain >5 kg/m2; moderate weight loss, BMI loss of 1.5-5 kg/m2; and pronounced weight loss, BMI loss >5 kg/m2. The primary endpoint of the present study was all-cause mortality. Secondary endpoints were cardiac death, non-fatal myocardial infarction (MI), and non-cardiac mortality. A total of 9372 T2DM patients with a mean follow-up of 8.08 ± 3.00 years were included for analysis. The average change in weight across the entire study population was 1.80 ± 9.00%, representing ~0.448 ± 2.98 kg/m2. Patients with pronounced weight loss had the highest risk of all-cause mortality (hazard ratio (HR) 2.07, 95% confidence interval (CI): 1.68-2.55), followed by patients with pronounced weight gain (HR 1.23, 95% CI: 1.02-1.56); patients with stable weight had the lowest risk. An asymmetric V-shaped relationship was observed between changes in BMI and all-cause mortality and non-cardiac mortality. Although no statistical significance was observed in terms of cardiac death and non-fatal MI, a flat V-shaped relationship may exist. CONCLUSIONS Weight was stable in most T2DM patients with high risk of CVD. Weight loss and gain is associated with increased all-cause mortality and non-cardiac mortality. Pronounced weight loss and weight gain is associated with a slight increase in cardiac death and non-fatal MI incidence, which does not reach statistical significance.
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Affiliation(s)
- Zhenhua Xing
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Junyu Pei
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jiabing Huang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xiaofan Peng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Pengfei Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xinqun Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Shan Gao
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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14
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Wang S, Peng R, Liang S, Dong K, Nie W, Yang Q, Ma N, Zhang J, Wang K, Song C. Comparison of adiposity indices in relation to prehypertension by age and gender: A community-based survey in Henan, China. Clin Cardiol 2018; 41:1583-1592. [PMID: 30284305 PMCID: PMC6489780 DOI: 10.1002/clc.23086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/25/2018] [Accepted: 10/01/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To compare the efficiency of bioelectrical indices (visceral fat index [VFI], percentage body fat [PBF]) and anthropometric indices (body mass index, waist circumference, waist-to-height ratio, a body shape index ) in the relation to prehypertension (120-139/80-89 mm Hg) among the Chinese population. METHODS Using stratified multistage random sampling method, a general population-based sample of 11 175 adults in Henan province were selected from 2013 to 2015. The individuals were divided into three categories by blood pressure levels: normotension (<120 and 80 mm Hg), stage 1 prehypertension (120-129/80-84 mm Hg) and stage 2 prehypertension (130-139/85-89 mm Hg). RESULTS VFI and PBF tended to increase with age in men and women. However, for each age-specific group, men tended to have higher VFI than women (all P < 0.01) and women tended to have greater PBF (all P < 0.0001). The odds ratios (OR) and area under the receiver operating characteristic curves for prehypertension associated with adiposity indices declined with age. VFI and PBF showed higher standardized adjusted ORs for prehypertension in young (~40 years) men (VFI: 2.02-3.05; PBF: 1.82-2.80) and young women (VFI: 1.90-2.58; PBF:1.70-2.29). Moreover, based on Youden's index, VFI and PBF exhibited the superiority for identifying prehypertension in men (0.20-0.32) and women (0.31-0.39), respectively. CONCLUSION In summary, there was stronger association of VFI and PBF with prehypertension in men than in women, respectively, especially for young adults.
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Affiliation(s)
- Shuaibing Wang
- The Third Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
| | - Rui Peng
- The Third Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
| | | | - Kaiyan Dong
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
- Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouChina
| | - Wei Nie
- Henan Academy of Medical SciencesZhengzhouChina
| | - Qian Yang
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
| | - Nan Ma
- Henan Academy of Medical SciencesZhengzhouChina
| | - Jianying Zhang
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
- Henan Academy of Medical and Pharmaceutical SciencesZhengzhou UniversityZhengzhouChina
| | - Kaijuan Wang
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
| | - Chunhua Song
- Department of Epidemiology and Health StatisticsCollege of Public Health, Zhengzhou UniversityZhengzhouChina
- Henan Key Laboratory of Tumor EpidemiologyZhengzhouChina
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15
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Creber C, Cooper RS, Plange-Rhule J, Bovet P, Lambert EV, Forrester TE, Schoeller D, Riesen W, Korte W, Cao G, Luke A, Dugas LR. Independent association of resting energy expenditure with blood pressure: confirmation in populations of the African diaspora. BMC Cardiovasc Disord 2018; 18:4. [PMID: 29320983 PMCID: PMC5763572 DOI: 10.1186/s12872-017-0737-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 12/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is a major risk factor for hypertension, however, the physiologic mechanisms linking increased adiposity to elevations in blood pressure are not well described. An increase in resting energy expenditure (REE) is an obligatory consequence of obesity. Previous survey research has demonstrated that REE is an independent predictor of blood pressure, and eliminates the co-linear association of body mass index. This observation has received little attention and there have been no attempts to provide a causal explanation. METHODS At baseline in an international comparative study on obesity, 289 participants aged 25-44 were recruited from communities in the US, the Seychelles, Ghana and South Africa and had REE measured with indirect calorimetry. All participants were thought to be free of major illness. RESULTS In multivariate regression models, both systolic and diastolic blood pressure were positively associated with REE (p < 0.01), while body mass index and fat mass were negatively correlated with systolic blood pressure (p < 0.01, and p < 0.05 respectively), but not diastolic blood pressure. CONCLUSIONS These data confirm previous reports and suggest that a common physiologic abnormality links REE and blood pressure. Elevated catecholamines, a putative metabolic characteristic of obesity, is a possible candidate to explain this association. The direct role of excess adipose tissue is open to question.
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Affiliation(s)
- Chloe Creber
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL USA
| | - Richard S. Cooper
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL USA
| | | | - Pascal Bovet
- Institute of Social & Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Ministry of Health, Victoria, Mahè Island, Seychelles
| | - Estelle V. Lambert
- Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Terrence E. Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston Jamaica
| | - Dale Schoeller
- Department of Nutritional Sciences, University of Wisconsin, Madison, WI USA
| | - Walter Riesen
- Center for Laboratory Medicine, Canton Hospital, St. Gallen, Switzerland
| | - Wolfgang Korte
- Center for Laboratory Medicine, Canton Hospital, St. Gallen, Switzerland
| | - Guichan Cao
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL USA
| | - Amy Luke
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL USA
| | - Lara R. Dugas
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL USA
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16
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Guarino D, Nannipieri M, Iervasi G, Taddei S, Bruno RM. The Role of the Autonomic Nervous System in the Pathophysiology of Obesity. Front Physiol 2017; 8:665. [PMID: 28966594 PMCID: PMC5606212 DOI: 10.3389/fphys.2017.00665] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/22/2017] [Indexed: 12/18/2022] Open
Abstract
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i.e., hypertension, insulin resistance and dyslipidemia. This article will review current evidence about the role of the ANS in short-term and long-term regulation of energy homeostasis. Furthermore, an increased sympathetic activity has been demonstrated in obese patients, particularly in the muscle vasculature and in the kidneys, possibily contributing to increased cardiovascular risk. Selective leptin resistance, obstructive sleep apnea syndrome, hyperinsulinemia and low ghrelin levels are possible mechanisms underlying sympathetic activation in obesity. Weight loss is able to reverse metabolic and autonomic alterations associated with obesity. Given the crucial role of autonomic dysfunction in the pathophysiology of obesity and its cardiovascular complications, vagal nerve modulation and sympathetic inhibition may serve as therapeutic targets in this condition.
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Affiliation(s)
- Daniela Guarino
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy.,Institute of Clinical Physiology of CNRPisa, Italy.,Scuola Superiore Sant'AnnaPisa, Italy
| | - Monica Nannipieri
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | | | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
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17
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Christensen RAG, Raiber L, Wharton S, Rotondi MA, Kuk JL. The associations of resting metabolic rate with chronic conditions and weight loss. Clin Obes 2017; 7:70-76. [PMID: 28170155 DOI: 10.1111/cob.12178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/23/2016] [Accepted: 10/24/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to examine the associations between baseline and changes in resting metabolic rate (RMR) with chronic condition(s) and weight loss (WL). Sex stratified analysis was undertaken on 393 adults from the Wharton Weight Management Clinics. The association between baseline RMR and WL was examined adjusting for age, BMI, ethnicity and treatment time. The association between changes in RMR (ΔRMR) and WL was also examined adjusting for baseline RMR and above covariates. Models were further adjusted for high glucose, triglycerides, blood pressure, low-density lipoprotein (LDL) and low high-density lipoprotein (HDL). While men (6.0 ± 8.6 kg) and women (5.6 ± 8.3 kg) had significant WL throughout the intervention, their measured decreases in RMR (-48 ± 322 kcal and -5 ± 322 kcal, respectively) were non-significant (P > 0.05). Individuals with a high blood pressure had a higher baseline RMR and women with a high LDL had a lower baseline RMR than those without the chronic condition (P < 0.05). Regardless of sex, WL was not significantly associated with baseline RMR or ΔRMR (P > 0.05) in both models. Participants with a low baseline RMR do not appear to be at a disadvantage for WL. Further, WL can occur without decreases in RMR in populations with high levels of obesity and obesity-related comorbidities.
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Affiliation(s)
- R A G Christensen
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - L Raiber
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - S Wharton
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Wharton Weight Management Clinic, Toronto, Ontario, Canada
| | - M A Rotondi
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - J L Kuk
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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18
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Sadowska J, Gębczyński AK, Konarzewski M. Metabolic risk factors in mice divergently selected for BMR fed high fat and high carb diets. PLoS One 2017; 12:e0172892. [PMID: 28235091 PMCID: PMC5325576 DOI: 10.1371/journal.pone.0172892] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 02/10/2017] [Indexed: 11/29/2022] Open
Abstract
Factors affecting contribution of spontaneous physical activity (SPA; activity associated with everyday tasks) to energy balance of humans are not well understood, as it is not clear whether low activity is related to dietary habits, precedes obesity or is a result of thereof. In particular, human studies on SPA and basal metabolic rates (BMR, accounting for >50% of human energy budget) and their associations with diet composition, metabolic thrift and obesity are equivocal. To clarify these ambiguities we used a unique animal model-mice selected for divergent BMR rates (the H-BMR and L-BMR line type) presenting a 50% between-line type difference in the primary selected trait. Males of each line type were divided into three groups and fed either a high fat, high carb or a control diet. They then spent 4 months in individual cages under conditions emulating human "sedentary lifestyle", with SPA followed every month and measurements of metabolic risk indicators (body fat mass %, blood lipid profile, fasting blood glucose levels and oxidative damage in the livers, kidneys and hearts) taken at the end of study. Mice with genetically determined high BMR assimilated more energy and had higher SPA irrespective of type of diet. H-BMR individuals were characterized by lower dry body fat mass %, better lipid profile and lower fasting blood glucose levels, but higher oxidative damage in the livers and hearts. Genetically determined high BMR may be a protective factor against diet-induced obesity and most of the metabolic syndrome indicators. Elevated spontaneous activity is correlated with high BMR, and constitutes an important factor affecting individual capability to sustain energy balance even under energy dense diets.
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Affiliation(s)
- Julita Sadowska
- Institute of Biology, University of Białystok, Białystok, Poland
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19
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Gomart S, Gaudreau-Ménard C, Jespers P, Dilek OG, Hupkens E, Hanthazi A, Naeije R, Melot C, Labranche N, Dewachter L, Mc Entee K. Leptin-Induced Endothelium-Independent Vasoconstriction in Thoracic Aorta and Pulmonary Artery of Spontaneously Hypertensive Rats: Role of Calcium Channels and Stores. PLoS One 2017; 12:e0169205. [PMID: 28085954 PMCID: PMC5234800 DOI: 10.1371/journal.pone.0169205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 12/13/2016] [Indexed: 01/28/2023] Open
Abstract
Decreased leptin-induced endothelium-dependent vasodilation has been reported in spontaneously hypertensive rats (SHR). Here, we report leptin-induced vasoconstriction in endothelium-denuded pulmonary artery and thoracic aorta from SHR and sought to characterize calcium handling underlying these mechanisms. Vasoreactivity to leptin was evaluated on pulmonary artery and thoracic aorta rings from 18 weeks old male SHR with or without calcium free medium, caffeine + thapsigargin + carbonyl cyanide-4-trifluoromethoxyphenylhydrazone emptying intracellular calcium stores, nifedipine a voltage-gated calcium channel inhibitor, SKF-96365 a transient receptor potential cation channels (TRPC) inhibitor, wortmaninn, a phosphatidylinositide 3-kinases (PI3K) inhibitor, or PD98059 a mitogen-activated protein kinase kinase (MAPKK) inhibitor. Calcium imaging was performed on cultured vascular smooth muscle cells incubated with leptin in presence or not of wortmaninn or PD98059. Leptin induced vasoconstriction in denuded pulmonary artery and thoracic aorta from SHR. Response was abolished when intra- or extracellular calcium stores were emptied, after blocking TRPC or voltage-dependent calcium channels or when using MAPKK or PI3K inhibitors. In vascular smooth muscle cells, leptin increased intracellular calcium. This rise was higher in SHR and abolished by MAPKK or PI3K inhibitors. TRPC6 gene expression was upregulated in arteries from SHR. Leptin-induced vasoconstriction in denuded arteries of SHR requires intracellular stores and is TRPC- and voltage-gated calcium channels dependent. Intracellular calcium increase is more pronounced in spontaneously hypertensive rats.
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MESH Headings
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/metabolism
- Calcium/metabolism
- Cells, Cultured
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Hypertension/physiopathology
- Leptin/administration & dosage
- Leptin/metabolism
- Male
- Mitogen-Activated Protein Kinase Kinases/metabolism
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Phosphatidylinositol 3-Kinases/metabolism
- Pulmonary Artery/drug effects
- Pulmonary Artery/metabolism
- Rats
- Rats, Inbred SHR
- Rats, Wistar
- Vasoconstriction/drug effects
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Affiliation(s)
- Samantha Gomart
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Caroline Gaudreau-Ménard
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
- Faculty of Medicine, University of Montréal, Montréal, Canada
| | - Pascale Jespers
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Omer Gurkan Dilek
- Faculty of Veterinary Medicine, Department of Anatomy, University of Mehmet Akif Ersoy, Burdur, Turkey
| | - Emeline Hupkens
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Aliénor Hanthazi
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Robert Naeije
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Christian Melot
- Emergency Department, Erasme University Hospital, and Biostatistics Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Nathalie Labranche
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus La Plaine, Brussels, Belgium
| | - Laurence Dewachter
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - Kathleen Mc Entee
- Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
- * E-mail:
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Medici V, McClave SA, Miller KR. Common Medications Which Lead to Unintended Alterations in Weight Gain or Organ Lipotoxicity. Curr Gastroenterol Rep 2016; 18:2. [PMID: 26700070 DOI: 10.1007/s11894-015-0479-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Obesity is one of the most common chronic conditions in the world. Its management is difficult, partly due to the multiple associated comorbidities including fatty liver, diabetes, hypertension, and hyperlipidemia. As a result, the choice of prescription medications in overweight and obese patients has important implications as some of them can actually worsen the fat accumulation and its associated metabolic complications. Several prescription medications are associated with weight gain with mechanisms that are often poorly understood and under-recognized. Even less data are available on the distribution of fat and lipotoxicity (the organ damage related to fat accumulation). The present review will discuss the drugs associated with weight gain, their mechanism of action, and the magnitude and timing of their effect.
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Affiliation(s)
- Valentina Medici
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California Davis, 4150 V Street, Sacramento, CA, 95816, USA.
| | - Stephen A McClave
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 40202, USA.
| | - Keith R Miller
- Department of Surgery, University of Louisville, ACB 2nd Floor, 550 South Jackson Street, Louisville, KY, 40202, USA.
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Tyagi A, Cohen M, Reece J, Telles S. An explorative study of metabolic responses to mental stress and yoga practices in yoga practitioners, non-yoga practitioners and individuals with metabolic syndrome. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:445. [PMID: 25398263 PMCID: PMC4247158 DOI: 10.1186/1472-6882-14-445] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 10/14/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stress places a metabolic burden on homeostasis and is linked to heightened sympathetic activity, increased energy expenditure and pathology. The yogic state is a hypometabolic state that corresponds with mind-body coherence and reduced stress. This study aimed to investigate metabolic responses to stress and different yoga practices in regular yoga practitioners (YP), non-yoga practitioners (NY) and metabolic syndrome patients (MS). METHODS YP (n = 16), NY (n = 15) and MS (n = 15) subjects underwent an experimental protocol that comprised of different 5-minute interventions including mental arithmetic stress test (MAST), alternate nostril breathing (ANB), Kapabhati breathing (KB) and meditation (Med) interspersed with 5 minutes of quiet resting (neutral condition (NC)). During the intervention periods continuous body weight adjusted oxygen consumption (VO2ml/min/kg) was measured using open circuit indirect calorimetry with a canopy hood. RESULTS This is the first study to report oxygen consumption (OC) in yoga practitioners during and after MAST and the first to report both within and between different populations. The results were analysed with SPSS 16 using 3X9 mixed factorial ANOVAs. The single between-subject factor was group (YP, NY and MS), the single within-subject factor was made up of the nine intervention phases (NC1, MAST, NC2, ANB, NC3, KB, NC4, Med, NC5). The results demonstrated that the regular YP group had significantly less OC and greater variability in their OC across all phases compared to the MS group (p = .003) and NY group (p = .01). All groups significantly raised their OC during the mental arithmetic stress, however the MS group had a significantly blunted post-stress recovery whereas the YP group rapidly recovered back to baseline levels with post stress recovery being greater than either the NY group or MS group. CONCLUSIONS Yoga practitioners have greater metabolic variability compared to non-yoga practitioners and metabolic syndrome patients with reduced oxygen requirements during resting conditions and more rapid post-stress recovery. OC in metabolic syndrome patients displays significantly blunted post-stress recovery demonstrating reduced metabolic resilience. Our results support the findings of previous randomised trials that suggest regular yoga practice may mitigate against the effects of metabolic syndrome. CLINICAL TRIAL NUMBER ACTRN12614001075673; Date of Registration: 07/10/2014.
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Affiliation(s)
- Anupama Tyagi
- />RMIT, West Campus, Building 201, Level 4, Bundoora, Vic 3083 Australia
| | - Marc Cohen
- />RMIT, West Campus, Building 201, Level 4, Bundoora, Vic 3083 Australia
- />PO Box 71, Bundoora, Vic 3083 Australia
| | - John Reece
- />PO Box 71, Bundoora, Vic 3083 Australia
| | - Shirley Telles
- />Patanjali Research Foundation, Bahdrabad, Haridwar, Uttrakhand 249402 India
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22
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Sriram N, Hunter GR, Fisher G, Brock DW. Resting energy expenditure and systolic blood pressure relationships in women across 4.5 years. J Clin Hypertens (Greenwich) 2014; 16:172-6. [PMID: 24548382 PMCID: PMC3954899 DOI: 10.1111/jch.12256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 11/01/2013] [Accepted: 11/04/2013] [Indexed: 11/30/2022]
Abstract
Recent studies have reported a strong association between blood pressure (BP) and resting energy expenditure (REE). However, it is not known whether this relationship persists over time. Therefore, the authors examined the temporal relationship between REE and systolic BP. In addition, the impact of sympathetic tone and anthropometric variables on this relationship was examined. All testing was performed on healthy, overweight African American and European American women aged 25 to 45 years over 4.5 years in the University of Alabama at Birmingham General Clinical Research Center. Repeated-measures mixed-models revealed REE as a significant determinant of systolic BP (β=0.0155, P<.0001), independent of catecholamines, leg fat, visceral fat, fat-free mass, fat mass, height, relative skeletal muscle index, and resting heart rate. Observations that REE is predictive of systolic BP across 4.5 years support previous findings that REE may potentially mediate resting BP, independent of anthropometric variables and a marker for sympathetic tone.
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Affiliation(s)
- Neeraj Sriram
- University of Alabama School of MedicineBirminghamAL
| | - Gary R. Hunter
- Department of Human StudiesUniversity of Alabama at BirminghamBirminghamAL
| | - Gordon Fisher
- Department of Human StudiesUniversity of Alabama at BirminghamBirminghamAL
| | - David W. Brock
- Department of Exercise and Movement ScienceUniversity of VermontBurlingtonVT
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Hacihasanoglu R, Inandi T, Yildirim A, Karakurt P, Saglam R. Frequency, Awareness, Treatment and Control of Hypertension in the over 40 Population of Erzincan. ACTA ACUST UNITED AC 2014; 13:357-366. [PMID: 27122997 DOI: 10.5455/pmb.1-1374044688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To determine distribution of blood pressure (BP) and prevalence, awareness, treatment and control of hypertension in 5 primary health care centers of Erzincan. A population-based cross-sectional survey was carried out in January - May 2009. A two-stage sampling method was used to select a sample of adult population 40 and over years of age. The total number of participants was 1570. Data were collected by face-to-face interview technique in the primary health care setting. Main outcome measures; mean systolic and diastolic blood pressures, distribution of blood pressure, prevalence of hypertension (mean systolic BP≥140 mmHg or mean diastolic BP ≥90 mmHg, or previously diagnosed and/or taking antihypertensive drugs) awareness, treatment and control of hypertension were assessed. The overall hypertension prevalence was 67.0% in the study sample and 77.4% of them were aware of their hypertension and received a pharmacologic treatment. Of the patients who were aware of the disease, 51.8% use drug treatment. Of the patients who had a drug treatment, 33.9 % were under control in terms of blood pressure. Our data indicate that hypertension is a highly prevalent but inadequately managed health problem in Erzincan. There is an urgent need for population-based strategies to improve prevention, early detection, and control of hypertension.
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Affiliation(s)
| | - Tacettin Inandi
- Mustafa Kemal University, Department of Public Health, Medical Faculty, 31100-Hatay, Turkey. , Tel Number: 90 326 245 51 13, Fax Number: 90 326 245 53 05
| | - Arzu Yildirim
- Erzincan University School of Health, 24100, Erzincan, Turkey, , Tel Number: +90 446 226 58 61, Fax Number: +90 446 226 58 62
| | - Papatya Karakurt
- Erzincan University School of Health, 24100, Erzincan, Turkey, , Tel Number: +90 446 226 58 61, Fax Number: +90 446 226 58 62
| | - Rabia Saglam
- Erzincan University School of Health, 24100, Erzincan, Turkey, , Tel Number: +90 446 226 58 61, Fax Number: +90 446 226 58 62
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Jackson KL, Nguyen-Huu TP, Davern PJ, Head GA. Energy metabolism in BPH/2J genetically hypertensive mice. Hypertens Res 2013; 37:413-21. [DOI: 10.1038/hr.2013.156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 10/21/2013] [Accepted: 10/29/2013] [Indexed: 11/09/2022]
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Sabounchi NS, Rahmandad H, Ammerman A. Best-fitting prediction equations for basal metabolic rate: informing obesity interventions in diverse populations. Int J Obes (Lond) 2013; 37:1364-70. [PMID: 23318720 PMCID: PMC4278349 DOI: 10.1038/ijo.2012.218] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 11/28/2012] [Accepted: 12/02/2012] [Indexed: 11/09/2022]
Abstract
Basal metabolic rate (BMR) represents the largest component of total energy expenditure and is a major contributor to energy balance. Therefore, accurately estimating BMR is critical for developing rigorous obesity prevention and control strategies. Over the past several decades, numerous BMR formulas have been developed targeted to different population groups. A comprehensive literature search revealed 248 BMR estimation equations developed using diverse ranges of age, gender, race, fat-free mass, fat mass, height, waist-to-hip ratio, body mass index and weight. A subset of 47 studies included enough detail to allow for development of meta-regression equations. Utilizing these studies, meta-equations were developed targeted to 20 specific population groups. This review provides a comprehensive summary of available BMR equations and an estimate of their accuracy. An accompanying online BMR prediction tool (available at http://www.sdl.ise.vt.edu/tutorials.html) was developed to automatically estimate BMR based on the most appropriate equation after user-entry of individual age, race, gender and weight.
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Affiliation(s)
- Nasim S. Sabounchi
- George Warren Brown School of Social Work, Washington University in St.
Louis
| | | | - Alice Ammerman
- Department of Nutrition, Gillings School of Global Public Health, and the
Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel
Hill
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Abstract
Oxygen consumption varies with physical and mental activity as well as pathological conditions. Although there is a strong relationship between yoga and metabolic parameters, the relationship between yoga and oxygen consumption has not yet been formally reviewed. This systematic review attempted to include all studies of yoga that also measured oxygen consumption or metabolic rate as an outcome. A total of 58 studies were located involving between 1 and 104 subjects (average 21). The studies were generally of poor methodological quality and demonstrated great heterogeneity with different experimental designs, yoga practices, time periods, and small sample sizes. Studies report yoga practices to have profound metabolic effects producing both increase and decrease in oxygen consumption, ranging from 383% increase with cobra pose to 40% decrease with meditation. Compared to nonpractitioners, basal oxygen consumption is reported to be up to 15% less in regular yoga practitioners, and regular yoga practice is reported to have a training effect with oxygen consumption during submaximal exercise decreasing by 36% after 3 months. Yoga breathing practices emphasize breathing patterns and retention ratios as well as unilateral nostril breathing, and these factors appear critical in influencing oxygen consumption. A number of studies report extraordinary volitional control over metabolism in advanced yoga practitioners who appear to be able to survive extended periods in airtight pits and to exceed the limits of normal human endurance. More rigorous research with standardized practices is required to determine the mechanisms of yoga’s metabolic effects and the relevance of yoga practices in different clinical populations.
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Affiliation(s)
| | - Marc Cohen
- RMIT University, Bundoora, Victoria, Australia
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Stronger associations of obesity with prehypertension and hypertension in young women than in young men. J Hypertens 2012; 30:1423-9. [PMID: 22573123 DOI: 10.1097/hjh.0b013e3283544881] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Obesity is an important risk factor for prehypertension and hypertension, and there are sex-specific differences in prevalences of obesity and hypertension. The aim of this study was to determine whether sex influences the relationships of obesity with prehypertension and hypertension. METHODS The participants were 28,325 Japanese men and women aged 20-39 years. Obesity was evaluated by BMI (≥ 25 kg/m) and waist-to-height ratio (WHtR ≥ 0.5). Associations of obesity with prehypertension and hypertension were compared in men and women by using odds ratio (OR) and area under the curve (AUC). RESULTS ORs for prehypertension and hypertension in participants with vs. participants without high BMI or WHtR were significantly higher than a reference level of 1.00 both in men and women and were significantly higher in women than in men. ORs for prehypertension and hypertension of participants with vs. participants without high BMI were 3.10 (2.84-3.38) (men) vs. 5.54 (4.80-6.40) (women) (P < 0.01) and 12.06 (10.83-13.42) (men) vs. 34.58 (26.55-45.04) (women) (P < 0.01), respectively. ORs of the interaction terms consisting of sex (male vs. female) and adiposity (high vs. not high BMI or WHtR) for prehypertension and hypertension were found to be significant. AUCs for the relationships of BMI with prehypertension and hypertension were significantly larger than a reference level of 0.500 and were significantly larger in women than in men. CONCLUSION The results suggest that the associations of obesity with prehypertension and hypertension are stronger in women than in men.
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Sharma AM. Does it matter how blood pressure is lowered in patients with metabolic risk factors? ACTA ACUST UNITED AC 2012; 2:S23-9. [PMID: 20409934 DOI: 10.1016/j.jash.2008.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abdominal obesity is an important cardiovascular risk factor. It is a primary driver of the metabolic syndrome, the cluster of metabolic risk factors that includes insulin resistance and dyslipidemia, and often occurs in association with hypertension. The aim of antihypertensive therapy in patients with metabolic risk factors is to reduce cardiovascular risk, but some antihypertensive agents can exert adverse metabolic effects. For example, beta-blockers produce significant weight gain, and are associated with an increased incidence of diabetes. By contrast, agents that inhibit the renin-angiotensin system (RAS), such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have been shown to be associated with a decreased risk of new-onset diabetes. This reflects the finding that increased activation of the RAS in obese individuals can contribute to the development of the metabolic syndrome. The ARB telmisartan has been shown to act as a selective peroxisome proliferator-activated receptor (PPAR)-gamma modulator. It is known that PPAR-gamma plays a role in the regulation of multiple genes affecting carbohydrate and lipid metabolism; however, the clinical significance of this remains to be established. The potential metabolic effects of RAS blockade should be considered in the choice of antihypertensive therapy for patients with metabolic risk factors, including obesity.
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Affiliation(s)
- Arya M Sharma
- University of Alberta, Royal Alexandra Hospital, Edmonton, Canada
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Erem C, Arslan C, Hacihasanoglu A, Deger O, Topbas M, Ukinc K, Ersöz HO, Telatar M. Prevalence of Obesity and Associated Risk Factors in a Turkish Population (Trabzon City, Turkey). ACTA ACUST UNITED AC 2012; 12:1117-27. [PMID: 15292476 DOI: 10.1038/oby.2004.140] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the prevalence of overweight and obesity (general and central) in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption), and hypertension in the adult population. RESEARCH METHODS AND PROCEDURES A sample of households was systematically selected from the central province of Trabzon and its five towns, namely, Sürmene, Vakfikebir, Maçka, Hayrat, and Tonya. A total of 5016 subjects (2728 women and 2288 men) were included in the study. Individuals more than 20 years old were selected from their family health cards. Demographic factors, socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure and diastolic blood pressure levels were measured for all subjects. Study procedures were carried out in the local health centers in each town over an 8-month period. Obesity was defined as BMI > or = 30 kg/m2 and overweight as BMI = 25.0 to 29.9 kg/m2. RESULTS The prevalence of obesity was 23.5%: 29.4% in women and 16.5% in men. The combined prevalence of both overweight and obesity was 60.3%. The prevalence of abdominal obesity was 29.4%: 38.9% among women and 18.1% among men. The prevalence of obesity increased with age, being highest in the 60- to 69-year-old age group (40.8%) but lower again in the 70+ age group. Obesity was associated positively with marital status, parity, cessation of cigarette smoking, alcohol consumption, and household income and inversely with level of education, cigarette use, and physical activity. Also, obesity was associated positively with hypertension. DISCUSSION In the Trabzon Region, 60.3% of the adult population presents with some excess weight. Obesity is a major public health problem that requires generalized interventions to prevent it among the adult population.
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Affiliation(s)
- Cihangir Erem
- Department of Internal Medicine, Karadeniz Technical University, Trabzon, Turkey.
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Brock DW, Tompkins CL, Fisher G, Hunter GR. Influence of resting energy expenditure on blood pressure is independent of body mass and a marker of sympathetic tone. Metabolism 2012; 61:237-41. [PMID: 21820136 PMCID: PMC3213288 DOI: 10.1016/j.metabol.2011.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 04/13/2011] [Accepted: 06/23/2011] [Indexed: 02/07/2023]
Abstract
Two recent examinations reported a strong association between blood pressure (BP) and resting energy expenditure (REE), independent of body mass and body composition. Both reports postulate that neurohumoral processes that contribute to variation in REE may partly mediate the body mass effect on BP. Therefore, we examined the relationship of REE and BP in 108 asymptomatic women (a) to confirm previous findings in a novel population and (b) to examine the impact of a marker of sympathetic tone on this relationship, as this was indicated as a potentially salient intermediary in previous reports. All testing was performed during a 4-day admission to the General Clinical Research Center. Resting energy expenditure was measured by indirect calorimetry, body composition was determined by dual-energy x-ray absorptiometry, and 24-hour fractionated urinary norepinephrine was determined by high-performance liquid chromatography. Multiple linear regression revealed REE as a significant predictor of systolic BP (β = 0.30, P = .04), independent of race (β = 0. 28, P = .01), age (β = -0.02, P = .80), height (β = -0.38, P = .08), fat mass (β = 0.22, P = .20), fat-free mass (β = 0.08, P = .65), and 24-hour fractionated urinary norepinephrine (β = 0.06, P = .57); and the same model using diastolic BP as the dependent variable approached significance (β = 0.24, P = .09). This study affirms previous findings that REE may be a potential mediator in resting BP, independent of many well-cited factors and, additionally, a marker of sympathetic tone.
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Affiliation(s)
- David W Brock
- Department of Exercise and Movement Science, University of Vermont, Burlington, VT 05405-0068, USA.
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Abstract
As our understanding of the underlying aetiology of hypertension is far from adequate, over 90% of patients with hypertension receive a diagnosis of essential hypertension. This non-specific diagnosis leads to suboptimal therapeutics and a major problem with non-compliance. Understanding the normal control of blood pressure (BP) is, hence, important for a better understanding of the disease.This review attempts to unravel the present understanding of BP control. The local mechanisms of BP control, the neural mechanisms, renal-endocrine mechanisms, and a variety of other hormones that have a bearing in normal BP control are discussed and the possible role in the pathophysiology is alluded to.
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Affiliation(s)
- Sandeep Chopra
- Department of Cardiology, Endocrine and Diabetes Unit, Christian Medical College, Ludhiana, India
| | - Chris Baby
- Department of Cardiology, Endocrine and Diabetes Unit, Christian Medical College, Ludhiana, India
| | - Jubbin Jagan Jacob
- Department of Medicine, Endocrine and Diabetes Unit, Christian Medical College, Ludhiana, India
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Calorimetry in obese women: comparison of two different operating indirect calorimeters together with the predictive equation of Harris and Benedict. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2011. [DOI: 10.1007/s12349-010-0036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Singh M, Bedi US, Singh PP, Arora R, Khosla S. Leptin and the clinical cardiovascular risk. Int J Cardiol 2009; 140:266-71. [PMID: 19944469 DOI: 10.1016/j.ijcard.2009.07.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 07/05/2009] [Accepted: 07/19/2009] [Indexed: 02/08/2023]
Abstract
Obesity is a universal health problem of increasing prevalence and represents a major public health concern. Obesity is associated with a high risk of developing cardiovascular and metabolic diseases such as hypertension, coronary atherosclerosis, myocardial hypertrophy, diabetes, dyslipidemia, and increased cardiovascular morbidity and mortality. There has been an ongoing search for mediators between obesity and cardiovascular disease. Leptin is a novel and very promising molecule of research that may link these pathologic conditions. Since its discovery in 1994, major advances have been made in the understanding of neuroendocrine mechanisms regulating appetite, metabolism, adiposity, sympathetic tone and blood pressure. In this review, we discuss the physiological and pathophysiological roles of leptin in the causation of various cardiovascular diseases.
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Affiliation(s)
- Mukesh Singh
- Division of Cardiology, Department of Internal Medicine, Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, IL 60068, United States.
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Tank J, Heusser K, Diedrich A, Hering D, Luft FC, Busjahn A, Narkiewicz K, Jordan J. Influences of gender on the interaction between sympathetic nerve traffic and central adiposity. J Clin Endocrinol Metab 2008; 93:4974-8. [PMID: 18782878 PMCID: PMC5393368 DOI: 10.1210/jc.2007-2820] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Sympathetic activation promotes insulin resistance and arterial hypertension with increasing adiposity. A difference in the relationship between adiposity and sympathetic activity between women and men could contribute to the known gender difference in cardiovascular disease risk. OBJECTIVE We tested whether muscle sympathetic nerve activity (MSNA) is correlated differently with waist circumference, waist to hip ratio (WHR), and body mass index (BMI) in women and men. DESIGN AND SETTING We pooled data from two microneurography centers (Berlin, Germany; Gdansk, Poland) for a cross-sectional study. PARTICIPANTS We studied 111 normotensive, healthy Caucasian subjects (70 males and 41 females). Age ranged between 19 and 62 yr and BMI ranged between 18 and 40 kg/m(2). INTERVENTION No intervention was applied during the study. MEASUREMENTS Supine heart rate, blood pressure, and MSNA were recorded after at least 30 min rest. RESULTS MSNA in bursts per minute was age dependent in both sexes [r (male) = 0.56, r (female) = 0.34, P < 0.01]. Controlling for waist and hip circumferences, age dependence remained highly significant in men (r = 0.43) and women (r = 0.43). Adjusting for age, in men, waist circumference (r = 0.29), WHR (r = 0.39), and BMI (r = 0.31) were predictive for MSNA and directly correlated (P < 0.01) but not in women. Adjusting for BMI, in men, only WHR (r = 0.40) remained predictive for MSNA. CONCLUSION These data support the hypothesis of a gender difference in the regulation of the sympathetic nervous system, in which MSNA mainly relates to WHR in men but not women. The phenomenon may contribute to the sexual dimorphism in cardiovascular disease risk.
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Affiliation(s)
- Jens Tank
- Institute of Clinical Pharmacology, Hannover Medical School, Carl Neuberg Strasse 1, 30625 Hannover, Germany
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Association of lactate with blood pressure before and after rapid weight loss. Am J Hypertens 2008; 21:1337-42. [PMID: 18802433 DOI: 10.1038/ajh.2008.282] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The mechanism linking obesity with its downstream complications is poorly understood. Accumulating evidence suggests that insufficient oxidative capacity plays a central role in the development of insulin resistance and, perhaps, hypertension. METHODS To investigate this hypothesis, we measured lactate, a marker of the gap between energy expenditure and oxidative capacity, in 40 obese subjects with the metabolic syndrome (Ob-MS), 40 obese subjects without the metabolic syndrome (Ob), and 20 lean controls (LCs). The 40 Ob-MS participants were then entered into a 12-20 week very low-calorie diet (VLCD) intervention. The change in lactate and a number of other metabolic factors including blood pressure were subsequently assessed. RESULTS At baseline, median lactate levels were significantly higher in both the Ob (36.4 mg/dl) and Ob-MS (34.7 mg/dl) groups when compared to LCs (17.4 mg/dl; P < 0.001). After the VLCD intervention, Ob-MS subjects lost 14.7 kg on average, corresponding to a 5.0 kg/m(2) decrease in body mass index (BMI). Lactate levels fell from 41.3 to 28.7 mg/dl, a 31% reduction (P = 0.006). Even after adjustment for BMI change, change in lactate was strongly associated with change in diastolic blood pressure (DBP) (P = 0.007) and mean arterial pressure (P = 0.014), but not with systolic blood pressure (SBP) (P = 0.20) or other obesity-related traits. CONCLUSIONS Baseline and longitudinal associations between lactate and DBP suggest that insufficient oxidative capacity may play a role in obesity-related hypertension.
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Erem C, Hacihasanoglu A, Kocak M, Deger O, Topbas M. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study. J Public Health (Oxf) 2008; 31:47-58. [PMID: 18829520 DOI: 10.1093/pubmed/fdn078] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To estimate the prevalence, awareness and control of prehypertension (preHT) and hypertension (HT) as defined by JNC-7 criteria in the Trabzon Region and its associations with demographic factors (age, sex, obesity, marital status, reproductive history in women and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, obesity and cardiovascular disease), lifestyle factors (smoking habits, physical activity and alcohol consumption) in the adult population. METHODS In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4809 adult subjects (2601 women and 2208 men) were included in the study. Demographic and socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (BP) and diastolic BP levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00-10:00 following 12 hours of fasting. The levels of serum glucose (FBG), total cholesterol (Total-C), high density cholesterol (HDL-C), low density cholesterol (LDL-C) and triglycerides were measured with autoanalyzer. Definition and classification of HT was performed according to guidelines from the US JNC-7 report. Prevalence, awareness, treatment and control of HT were assessed. RESULTS The prevalences of HT and preHT were 44.0% (46.1% in women and 41.6% in men) and 14.5% (12.6% in women and 16.8% in men), respectively. Overall, only 41% of the hypertensive individuals had been previously diagnosed. Furthermore, 54.5% of the hypertensive subjects were being treated with antihypertensive drugs (AHD), but only 24.3% of treated subjects had their BP adequately controlled. Among all hypertensive subjects (known and newly diagnosed), only 5.43% had their BP under control. The prevalence of HT increased with age, being highest in the 60- to 69-year-old age group (84.4%) but lower again in the 70+ age group. Interestingly, the prevalence was 16.9% in the 20-to 29-year old age group. HT was associated positively with marital status, parity, cessation of cigarette smoking, and negatively with level of education, alcohol consumption, current cigarette use, and physical activity. Multinomial logistic regression analysis revealed that HT were significantly associated with age, male gender, BMI, low education level, nonsmoking, positive family history of selected medical conditions, occupation, and parity. CONCLUSIONS The Trabzon Hypertension Study data indicated that HT is very common and is an important health problem in the adult population of Trabzon. Patients who are unaware of their status and treated uncontrolled hypertensives are at high risk of early cardiovascular morbidity and mortality. To control preHT and HT, effective public health education and urgent precautions are needed. The precautions include serious health education, a well-balanced diet and increasing physical activity.
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Affiliation(s)
- Cihangir Erem
- Karadeniz Technical University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, The Trabzon Endocrinological Studies Group, Trabzon, Turkey.
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Fadl YY, Krumholz HM, Kosiborod M, Masoudi FA, Peterson PN, Reid KJ, Weintraub WS, Buchanan DM, Spertus JA. Predictors of weight change in overweight patients with myocardial infarction. Am Heart J 2007; 154:711-7. [PMID: 17892997 DOI: 10.1016/j.ahj.2007.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 06/14/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Weight loss is recommended among overweight survivors of myocardial infarction (MI). This study describes patterns of weight change among overweight patients with MI and identifies factors associated with weight change. METHODS A prospective cohort of 1253 overweight or heavier (body mass index [BMI] > or = 25 kg/m2) post-MI patients were enrolled in the 19-center PREMIER study and followed up for 1 year to determine changes in weight. Patients were categorized at 1 month as overweight (BMI = 25-29.9 kg/m2), obese (BMI = 30-39.9 kg/m2), or morbidly obese (BMI > or = 40 kg/m2). Unadjusted percent weight change was assessed at 1 year, and multivariable linear regression was used to identify independent correlates of change. RESULTS Mean weight change was -0.2% and varied by the severity of baseline obesity (+0.4% for overweight patients, -0.5% for obese patients, and -3.7% for morbidly obese patients [P < .001]). Multivariable analyses revealed the following to be significantly associated with weight change: depression 1 month post-MI (+2.7%, P = .001), lack of health insurance (+2%, P = .01), smoking cessation 1 month post-MI (+2.7% vs current smokers, P < .001), morbid obesity (+4.7% vs overweight patients, P < .0001), and increasing age (-0.8% per decade, P = .001). An interaction between smoking cessation and weight class was detected in that overweight patients who quit had a mean increase of 5.3% (95% CI 3.1%-7.4%), whereas no significant change was observed among obese and morbidly obese patients who quit. CONCLUSIONS Although post-MI patients had negligible weight loss over 1 year, several sociodemographic, clinical, and lifestyle characteristics were associated with weight change. New, targeted interventions will likely be needed to improve weight management after an MI.
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Affiliation(s)
- Yazid Y Fadl
- Washington University in St. Louis, St. Louis, MO, USA
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Mancia G, Bousquet P, Elghozi JL, Esler M, Grassi G, Julius S, Reid J, Van Zwieten PA. The sympathetic nervous system and the metabolic syndrome. J Hypertens 2007; 25:909-20. [PMID: 17414649 DOI: 10.1097/hjh.0b013e328048d004] [Citation(s) in RCA: 268] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Studies performed in the past two decades have unequivocally shown that several of the components of the metabolic syndrome are associated with indirect and direct markers of adrenergic overdrive. This is the case for hypertension and obesity, in which resting tachycardia, elevated plasma norepinephrine values, increased sympathetic nerve traffic, as well as augmented levels of total and regional norepinephrine spillover have been reported. This is also the case for insulin resistance, i.e. a metabolic condition frequently complicating the various components of the pathological condition identified as the 'metabolic syndrome'. After briefly describing the epidemiological and the cardiovascular risk profile of the disease, this paper will examine the behaviour of the sympathetic nervous system in the metabolic syndrome as well as the mechanisms potentially responsible for this neurogenic abnormality. This will be followed by an analysis of the role played by neuroadrenergic factors in disease progression as well as in the pathogenesis of its complications. Finally, the therapeutic implications of these findings will be highlighted.
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Affiliation(s)
- Giuseppe Mancia
- Ospedale San Gerardo dei Tintori, Università Milano-Bicocca, Monza, Milan, Italy.
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Abstract
Leptin, a peptide discovered more than 10 years ago, decreases food intake and increases sympathetic nerve activity to both thermogenic and non-thermogenic tissue. Leptin was initially believed to be an anti-obesity hormone, owing to its metabolic effects. However, obese individuals, for unknown reasons, become resistant to the satiety and weight-reducing effect of the hormone, but preserve leptin-mediated sympathetic activation to non-thermogenic tissue such as kidney, heart, and adrenal glands. Leptin has been shown to influence nitric oxide production and natriuresis, and along with chronic sympathetic activation, especially to the kidney, it may lead to sodium retention, systemic vasoconstriction, and blood pressure elevation. Consequently, leptin is currently considered to play an important role in the development of hypertension in obesity.
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Affiliation(s)
- Paco E Bravo
- Sections of Nephrology, Department of Internal Medicine, Louisiana State University Health Sciences CenterNew Orleans, LA, USA
| | - Stephen Morse
- Sections of Nephrology, Department of Internal Medicine, Louisiana State University Health Sciences CenterNew Orleans, LA, USA
| | - David M Borne
- Comprehensive Medicine, Department of Internal Medicine, Louisiana State University Health Sciences CenterNew Orleans, LA, USA
| | - Erwin A Aguilar
- Sections of Nephrology, Department of Internal Medicine, Louisiana State University Health Sciences CenterNew Orleans, LA, USA
| | - Efrain Reisin
- Sections of Nephrology, Department of Internal Medicine, Louisiana State University Health Sciences CenterNew Orleans, LA, USA
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Bélanger M, Boulay P. Effect of an aerobic exercise training program on resting metabolic rate in chronically beta-adrenergic blocked hypertensive patients. ACTA ACUST UNITED AC 2006; 25:354-60. [PMID: 16327530 DOI: 10.1097/00008483-200511000-00008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE There is substantial evidence that the use of beta-adrenergic receptor blockers (beta-blockers) is associated with a reduction in resting metabolic rate (RMR) and that a weight gain usually occurs in the first few months of treatment. The purpose of this study was to determine if RMR of overweight and sedentary subjects consuming beta-blockers can be increased following an aerobic exercise training program. METHODS Twenty-four subjects participated in the study; 11 (6 women, 5 men) were treated with beta-blockers for hypertension and 13 (9 women, 4 men) were nonmedicated (control group). Body composition, RMR, and peak oxygen uptake (VO2peak) were assessed for all subjects before and after a 12-week aerobic exercise training program. Weekly exercise energy expenditure equaled 83.68 kJ (20 kcal) per kg of body weight while exercise intensity was maintained between 60% and 70% of the VO2 reserve. RESULTS Body composition, RMR, and VO2peak did not differ among groups at the beginning of the study. Body weight (-1.4 kg for beta-blockers, P < .05; -2.5 kg for control, P < .05) and VO2peak (+2.2 mL x kg(-1) x min(-1) for beta-blockers, P < .05; +4.1 mL x kg(-1) x min(-1) for control, P < .001) were significantly improved in both groups, whereas RMR (-272 kJ x day(-1) for beta-blockers, NS; +573 kJ x day(-1) for control, P < .05) was increased only in the control group after the aerobic exercise training program. CONCLUSIONS These results suggest that beta-blockers limit the increase in RMR normally observed following an aerobic exercise training program. Consequently, obtaining a negative energy balance in an attempt to lose weight may be more difficult.
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Affiliation(s)
- Mathieu Bélanger
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec
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Almeida-Pititto B, Gimeno SGA, Freire RD, Ribeiro-Filho FF, Ferreira SRG. Leptin is not associated independently with hypertension in Japanese-Brazilian women. Braz J Med Biol Res 2006; 39:99-105. [PMID: 16400470 DOI: 10.1590/s0100-879x2006000100012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We evaluated the relationship of leptin with hypertension adjusted for body mass index (BMI) and/or waist circumference in a population of Japanese-Brazilian women aged > or = 30 years with centrally distributed adiposity. After excluding diabetic subjects, the study subjects--who participated in a population-based study on the prevalence of metabolic syndrome--showed prevalence rates of obesity (BMI > or = 25 kg/m2) and central adiposity (waist > or = 80 cm) of 32.0 and 37.8%, respectively. The hypertensive group (N = 162) was older, had higher BMI (24.9 +/- 4.2 vs 23.3 +/- 3.4 kg/m2, P < 0.001), waist circumference (81.1 +/- 10.1 vs 76.3 +/- 8.2 cm, P < 0.001) and insulin levels (8.0 +/- 6.2 vs 7.1 +/- 4.9 microU/mL, P < 0.05) than the normotensive group (N = 322) and showed an unfavorable metabolic profile (higher 2-h plasma glucose, C-reactive protein and non-HDL cholesterol levels). Leptin did not differ between groups (8.2 +/- 6.8 vs 7.2 +/- 6.6 ng/mL, P = 0.09, for hypertensive vs normotensive, respectively) and its levels correlated significantly with anthropometric variables but not with blood pressure. Logistic regression analysis indicated that age and waist were independently associated with hypertension but not with homeostasis model assessment of insulin resistance or leptin levels. The lack of an independent association of hypertension with metabolic parameters (2-h glucose, C-reactive protein and non-HDL cholesterol) after adjustment for central adiposity suggested that visceral fat deposition may be the common mediator of the disturbances of the metabolic syndrome. Our data indicate that age and waist are major determinants of hypertension in this population of centrally obese (waist > or = 80 cm) Japanese-Brazilian women, but do not support a role for leptin in the elevation of blood pressure.
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Affiliation(s)
- B Almeida-Pititto
- Departamento de Medicina Interna, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Dickerson RN, Roth-Yousey L. Medication Effects on Metabolic Rate: A Systematic Review (Part 1). ACTA ACUST UNITED AC 2005; 105:835-43. [PMID: 15883565 DOI: 10.1016/j.jada.2005.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Roland N Dickerson
- University of Tennessee Health Sciences Center, 26 S. Dunlap Street, Memphis, TN 38163, USA.
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Wu X, Luke A, Cooper RS, Zhu X, Kan D, Tayo BO, Adeyemo A. A genome scan among Nigerians linking resting energy expenditure to chromosome 16. ACTA ACUST UNITED AC 2004; 12:577-81. [PMID: 15090624 DOI: 10.1038/oby.2004.66] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Energy requirements at rest account for 50% to 75% of total energy expenditure. Interindividual variation in resting energy expenditure (REE) has been studied for potential links to obesity and hypertension. REE is a modestly heritable trait, and yet virtually nothing is known about the genetic factors that might influence the familial patterns. The objectives of this study were to identify the genomic regions showing genetic linkage to REE variation in a Nigerian population. For linkage analysis across the genome, three hundred seventy-seven microsatellite markers were typed on DNA from 995 individuals in 153 families. A genome scan was performed using a multipoint variance component method. Heritability of REE was 0.30 after adjustment for body size. The strongest linkage signal was detected on chromosome 16 (16q22.3) with a likelihood of odds of 2.96 (p = 0.08). Linkage evidence (likelihood of odds > 1) was detected on another three chromosomal regions, namely 2q12.1, 8q21.2, and 15p11.2.
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Affiliation(s)
- Xiaodong Wu
- Department of Preventive Medicine and Epidemiology, Loyola Medical School, Maywood, Illinois 60153, USA.
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Gondoni LA, Tagliaferri MA, Titon AM, Nibbio F, Liuzzi A, Leonetti G. Effect of chronic treatment with beta-blockers on resting energy expenditure in obese hypertensive patients during a low-calorie and physical training program. Nutr Metab Cardiovasc Dis 2003; 13:232-237. [PMID: 14650356 DOI: 10.1016/s0939-4753(03)80016-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM To evaluate whether chronic treatment with beta-blockers influences resting energy expenditure (REE) and weight loss after a period of diet and physical activity in obese hypertensive patients. METHODS AND RESULTS Seventy-eight obese hypertensive patients (24 males and 54 females) aged 53.7 +/- 11.1 years with mean BMI of 42.4 +/- 5.8 kg/m2 were enrolled. Thirty-eight patients were using beta-blockers while 40 patients who had not received beta-blockers in the past 6 months were the control group. REE was measured with indirect calorimetric method. Total body fat mass, total body fat-free mass (FFM) and total body water (W) were determined by bioelectrical impedance analysis. Patients and controls underwent a structured physical training program and a hypocaloric diet for a period of 31.6 +/- 10.6 days. Measured REE in patients taking beta-blockers was 1818 +/- 309 kcal/24 h and 1853 +/- 348 kcal/24 h in patients not taking beta-blockers; p = non significant. Weight and BMI loss were similar between the two groups and were respectively -6.43 +/- 2.62 kg and -2.42 +/- 0.91 kg/m2 in the beta-blocker group and -7.49 +/- 3.10 kg, -2.78 +/- 1.03 kg/m2 in the non beta-blocker group. Body composition was similar in the two groups. In the comparison between patients treated with selective beta 1-adrenoceptors blockers and non selective beta-blockers we found a significant difference in REE (1704 +/- 283 vs 1974 +/- 278; p = 0.012) and in weight loss (-5.6 +/- 2.4 vs -7.5 +/- 2.7; p = 0.048) at the end of study. CONCLUSIONS Beta-blockers are not associated with a lower REE in obese subjects compared to other antihypertensive treatment. Use of non selective beta-adrenergic blockers is associated with a higher REE and weight loss compared to use of selective beta 1-adrenergic blockers. Non selective beta-blockers could be indicated among first choice drugs in hypertensive severely obese subjects without contraindications to beta-blockade.
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Affiliation(s)
- L A Gondoni
- Ospedale San Giuseppe, Istituto Auxologico Italiano, via Cadorna 90, 28824 Piancavallo, VB, Italy.
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Podbregar M, Voga G. Effect of selective and nonselective beta-blockers on resting energy production rate and total body substrate utilization in chronic heart failure. J Card Fail 2002; 8:369-78. [PMID: 12528088 DOI: 10.1054/jcaf.2002.130238] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND In chronic heart failure (CHF) beta-blockers reduce myocardial oxygen consumption and improve myocardial efficiency by shifting myocardial substrate utilization from increased free fatty acid oxidation to increased glucose oxidation. The effect of selective and nonselective beta-blockers on total body resting energy production rate (EPR) and substrate utilization is not known. METHODS Twenty-six noncachectic patients with moderately severe heart failure (New York Heart Association class II or III, left ventricular ejection fraction < 0.40) were treated with carvedilol (37.5 +/- 13.5 mg/12 h) or bisoprolol (5.4 +/- 3.0 mg/d) for 6 months. Indirect calorimetry was performed before and after 6 months of treatment. RESULTS Resting EPR was decreased in carvedilol (5.021 +/- 0.803 to 4.552 +/- 0.615 kJ/min, P <.001) and bisoprolol group (5.230 +/- 0.828 to 4.978 +/- 0.640 kJ/min, P <.05; nonsignificant difference between groups). Lipid oxidation rate decreased in carvedilol and remained unchanged in bisoprolol group (2.4 +/- 1.4 to 1.5 +/- 0.9 mg m(2)/kg min versus 2.7 +/- 1.1 to 2.5 +/- 1.1 mg m(2)/kg min, P <.05). Glucose oxidation rate was increased only in carvedilol (2.6 +/- 1.4 to 4.4 +/- 1.6 mg m(2)/kg min, P <.05), but did not change in bisoprolol group. CONCLUSIONS Both selective and nonselective beta-blockers reduce total body resting EPR in noncachectic CHF patients. Carvedilol compared to bisoprolol shifts total body substrate utilization from lipid to glucose oxidation.
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Affiliation(s)
- Matej Podbregar
- Department for Intensive Internal Medicine, General Hospital Celje, Slovenia
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Von Haehling S, Anker SD. beta-blockers in heart failure--much more than heart rate reduction. J Card Fail 2002; 8:379-80. [PMID: 12528089 DOI: 10.1054/jcaf.2002.130310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Alsaif MA, Hakim IA, Harris RB, Alduwaihy M, Al-Rubeaan K, Al-Nuaim AR, Al-Attas OS. Prevalence and risk factors of obesity and overweight in adult Saudi population. Nutr Res 2002. [DOI: 10.1016/s0271-5317(02)00439-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kunz I, Schorr U, Römmling K, Klaus S, Sharma AM. Habitual fat intake and basal fat oxidation in obese and non-obese Caucasians. Int J Obes (Lond) 2002; 26:150-6. [PMID: 11850745 DOI: 10.1038/sj.ijo.0801869] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2000] [Revised: 05/10/2001] [Accepted: 07/23/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the relationship between habitual fat intake and basal fat oxidation in obese and non-obese Caucasian men and women. METHODS Habitual fat intake was assessed by 7-day weighed dietary records and resting fat oxidation was determined after an overnight fast in 132 weight stable non-diabetic subjects (38 males, 94 females). All subjects were characterized for weight, height, waist-to-hip ratio, physical activity, plasma glucose and insulin response to an oral glucose load, plasma catecholamine and leptin levels. Under-reporters, defined according to plausibility of the relationship between energy expenditure and energy intake, were excluded from the analyses. RESULTS The mean age was 53.1+/-10.6 y (19-72 y) and mean body mass index (BMI) was 30.7+/-5.8 kg/m(2) (19.4-45.8 kg/m(2)). Sixty-eight subjects were obese (BMI>30 kg/m(2)). Univariate regression analysis revealed a significant, albeit modest, relationship between absolute fat intake and BMI (r(2)=0.06; P<or=0.05) but not between fat intake and fat mass (r(2)=0.026; P=0.08). However, multiple regression analysis revealed significant effects of body fat mass (FM) and sex on basal fat oxidation (bFO) explaining 33% of the variation of bFO (P<or=0.0001; radical s.e.=18.0 g/24 h). In univariate regression analysis, habitual fat intake was significantly related to adjusted fat oxidation, explaining 12% of the variation (P<or=0.0001; radical s.e.=11.7 g/24 h). CONCLUSION Habitual fat intake has a significant, albeit modest, effect on basal fat oxidation, even when adjusted for sex and body FM. The rather modest effect of habitual fat intake on fat oxidation may in part explain the increased propensity to gain FM on a high-fat diet.
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Affiliation(s)
- I Kunz
- German Institute of Human Nutrition, Division of Biochemistry and Physiology of Nutrition, Potsdam-Rehbrücke, Germany
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Abstract
Beta-blockers are the most frequently used drugs for the treatment of hypertension. Apart from concerns regarding potential adverse metabolic effects on lipids or insulin sensitivity, beta-blockers can also cause weight gain in some patients. This fact appears little known to clinical practitioners and trialists. Thus, only a minority of clinical trials with beta-blockers report weight changes during treatment. In trials that do report weight changes, beta-blockers are associated with a weight gain of 1.2 (range -0.4-3.5) kg. This may be attributable to the fact that beta blockade can decrease metabolic rate by 10%. Beta-blockers may also have other negative effects on energy metabolism. Obesity management in overweight hypertensive patients may therefore be more difficult in the presence of beta-blocker treatment. We therefore question the use of beta-blockers as first-line therapy for overweight or obese patients with uncomplicated hypertension.
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Affiliation(s)
- T Pischon
- Franz Volhard Clinic-Charité and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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Sharma AM, Engeli S, Pischon T. New developments in mechanisms of obesity-induced hypertension: role of adipose tissue. Curr Hypertens Rep 2001; 3:152-6. [PMID: 11276398 DOI: 10.1007/s11906-001-0030-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hypertension develops in almost 60% of obese individuals. Apart from the recent observation of obesity-associated structural changes in kidney structure that may lead to enhanced tubular sodium reabsorbtion, reports of paracrine and hormonal factors derived from adipose tissue have prompted speculations about the role of adipose tissue in the pathophysiology of obesity-induced hypertension. We summarize recent data on leptin's sympathoexcitatory actions, the possible influence of adipose tissue on atrial natriuretic peptide levels, and the formation of vasoactive substances, such as angiotensin II and nonesterified fatty acids, by adipocytes. The mechanisms discussed herein may contribute to the typical findings in obesity-induced hypertension, including volume expansion, sodium retention, enhanced sympathetic nervous system activity, increased activity of the systemic renin-angiotensin system, low atrial natriuretic peptide levels, and disturbed glucose and insulin metabolism. Together, these data strengthen the hypothesis that adipose tissue is potentially a major regulator of cardiovascular-renal function.
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Affiliation(s)
- A M Sharma
- Department of Nephrology and Hypertension, Franz-Volhard-Klinik, Universitätsklinikum Charité, Humboldt-University zu Berlin, Wiltbergstr. 50, 13125 Berlin, Federal Republic of Germany.
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