Objective To examine the association between obesity and high blood pressure (BP) in Chinese children and adolescents. Methods Body mass index (BMI) and blood pressure measurements of 197 191 children aged 7-17 years were obtained from a Chinese national survey in 2010. Obesity and high BP were defined according to the reference values for Chinese children. Adjusted odds ratios (ORs) and 95%confidence intervals (CIs) of different BMI categories for high BP, as well as the population attributable risk percent (PAR%), were also calculated. Results The prevalence of high BP was 16.1% for boys and 12.9%for girls in 2010. Overweight and obese children had a significantly higher prevalence of high BP than non-overweight children in both boys and girls in each age group. ORs (95%CI) for high BP were 4.1 (3.9, 4.4) in obese boys and 4.0 (3.7, 4.3) in obese girls. The overall PAR%for high BP due to overweight and obesity was 14.4%. Conclusion Overweight and obese children have a significantly higher risk of high BP than non-overweight children. Eliminating overweight and obesity could reduce 14.4%of high BP cases.

Objective Obesity is a major risk factor for type 2 diabetes, many indexes can be used to describes obesity and predict diabetes. This research attempts to identify the best indicator of obesity to screening diabetes in Chinese population. Methods A cross-sectional data of 8121 subjects aged 35-60 years were included in this research belongs to the Diabetes Appropriate Technology Intervention Study. Anthropometric indicators including body weight, height, waist circumferences (WC), body fat index (BFI) and visceral fat index (VFI) and blood biochemical indicators after an overnight fast [fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triacylglycerol] were measured. BMI (body mass index) and Weight to Height Ratio was calculated. Results Subjects with obesity had a higher risk of physician diagnosed diabetes (OR=2.50, 95% CI 1.83-3.43), new diagnosed diabetes (OR=4.23, 95% CI 2.91-6.15) and pre-diabetes (OR=1.75, 95% CI 1.31-2.34) compared to those with normal Body mass index (BMI). There was a significant trend of increased risk of all diabetes status with increased waist circumference (WC). The waist-to-height ratio (WHtR) yielded the most significant association with new diagnosed diabetes and physician diagnosed diabetes than other indices. Conclusion Central obesity is significantly correlated with diabetes. VFI was most correlated with pre-diabetes while WHtR is an efficient screening index than BMI and WC in Chinese community diabetes screening.

Objective To compare the relative risk of waist circumference (WC) and/or BMI on cardiovascular risk factors. Methods A cross-sectional data of 41 087 adults (19 567 male and 21 520 female) from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of WGOC (BMI, 24 kg/m2 and 28 kg/m2; WC, male 85 cm and 95 cm for male, 80 cm and 90 cm for female), the study population were divided into 9 groups. The prevalence and odds ratio (Ors) of cardiovascular disease (CVD) risk factors (hypertension, high fasting plasma glucose and dyslipidemia) were compared among these 9 groups. Stepwise linear regression analyses were used to compare the likelihood of BMI and/or WC on CVD risk factors. Results Both the indexes levels and the odds ratios of CVD risk factors were significantly increased (decreased for HDL-C levels) along with the increase of WC and/or BMI, even when the effect of age, sex, income, education, sedentary activity and dietary factors were adjusted. The variances (R2) in CVD risk factors explained by WC only and BMI only were quite similar, but a little bit larger when WC and BMI were combined. The standard β was higher of BMI when predicting systolic BP and was higher of WC when predicting TG, TC and HDL. Conclusions BMI and WC had independent effects on CVD risk factors and combination of BMI and WC would be more predictive. Findings from the present study provided substantive evidence for the WGOC recommendation of a combined use of BMI and WC classifications.

Is Non-exercise Activity Thermogenesis-a Target for Reversing Obesity?

Non-exercise activity thermogenesis (NEAT) is the energy expenditure of all physical activities other than volitional sporting-like exercise. NEAT includes all the activities that render us vibrant, unique and independent beings such as working, playing, and dancing. Because people of the same weight have markedly variable activity levels, it is not surprising that NEAT varies substantially between people by 2000 kcal/day. Evidence suggests that low NEAT may occur in obesity but in a very specific fashion. Obese individuals appear to exhibit an innate tendency to be seated for 2.5 hours per day more than sedentary lean counterparts. If obese individuals were to adopt the lean 'NEAT-o-type', they could potentially expend an additional 350 kcal/day. Obesity was rare a century ago and the human genotype has not changed over that time. Thus, the obesity epidemic may reflect the emergence of a chair-enticing environment to which those with an innate tendency to sit, did so and became obese. To reverse obesity therefore, we need to develop individual strategies to promote standing & ambulating time by 2.5 hours per day but also re-engineer our work, school and home environments to render active living the option of choice.

In the present study, we investigated the effects of hypothyroidism on the morphology of astrocytes and microglia in the hippocampus of Zucker diabetic fatty rats and Zucker lean control rats. To in-duce hypothyroidism, Zucker lean control and Zucker diabetic fatty rats at 7 weeks of age oral y received the vehicle or methimazole, an anti-thyroid drug, treatment for 5 weeks and were sacrificed at 12 weeks of age in al groups for blood chemistry and immunohistochemical staining. In the methimazole-treated Zucker lean control and Zucker diabetic fatty rats, the serum circulating tri odothyronine (T3) and thyroxine (T4) levels were significantly decreased compared to levels ob-served in the vehicle-treated Zucker lean control or Zucker diabetic fatty rats. This reduction was more prominent in the methimazole-treated Zucker diabetic fatty group. Glial fibril ary acidic protein immunoreactive astrocytes and ionized calcium-binding adapter molecule 1 (Iba-1)-immunoreactive microglia in the Zucker lean control and Zucker diabetic fatty group were diffusely detected in the hippocampal CA1 region and dentate gyrus. There were no significant differences in the glial fibril ary acidic protein and Iba-1 immunoreactivity in the CA1 region and dentate gyrus between Zucker lean control and Zucker diabetic fatty groups. However, in the methimazole-treated Zucker lean control and Zucker diabetic fatty groups, the processes of glial fibril ary acidic protein immunoreactive astrocytes and Iba-1 immunoreactive microglia, were significantly decreased in both the CA1 region and dentate gyrus compared to that in the vehicle-treated Zucker lean control and Zucker diabetic fatty groups. These results suggest that diabetes has no effect on the mor-phology of astrocytes and microglia and that hypothyroidism during the onset of diabetes promi-nently reduces the processes of astrocytes and microglia.

Activity of tamarindus indica pulp water extract in high carbohydrate diet rats as a treatment for obesity and insulin resistance

Targeting obesity-related inflammation in skin cancer:molecular and epigenetic insights for cancer chemoprevention by dietary phytochemicals

Abstract:Objective To establish an effective exercise prescription, the exercise capacity of obese subjects was investigated.Methods In 71 male obese (body mass index: BMI≥26.4) Japanese, aged 26-77 years, the body composition and physical fitness such as aerobic exercise level, muscle strength and flexibility were determined and compared with those of age- and sex-matched 71 borderline (24.2≤BMI<26.4) and 71 normal Japanese men (19.8≤BMI<24.2). The relationship between body composition and other parameters was evaluated in obese subjects.Results In obese subjects, body weight, BMI, body fat percentage, waist hip ratio, and skinfold thickness were higher than those of borderline and normal subjects. Lower aerobic exercise level and weight bearing index (WBI) were noted in obese subjects. There was a negative correlation between waist hip ratio and aerobic exercise level (oxygen uptake at ventilatory threshold) (r=-0.509, P<0.01) and also between waist hip ratio and WBI (r=-0.315, P<0.01). Conclusions Lower physical fitness is considered to be a general characteristic of male obese Japanese, and the accumulation of visceral adipose tissue might affect exercise capacity.

阻塞性睡眠呼吸暂停综合征与肥胖、颈围、颈长的相关性研究

Objective Study on relationship between obstructive sleep apnea syndrome(OSAS)and obesity,neck circumsfence(NC),neck length(NL).Methods 89 patients with OSAS were divided into mild group and moderate severe group by apnea hyponea index(AHI).32 non apneic healthy volunteer served as controls.Analysis of correlation and regression were used among AHI and height,weight,body mass index(BMI),NC,NL,NC/NL.Results The weight,BMI,NC,NC/NL in apneic patients were significantly higher than that in the controls.The AHI significant positive correlated with weight,BMI,NC and NC/NL in all patients,and had significant negative correlated with nadir oxygen saturation in sleep .Conclusions The patients with OSAS are more obese and have thicker and shorter necks,it suggests that weight,neck circumference and neck length play an important role in the pathogenic factor of patients with OSAS.

OBJECTIVE:To investigate the anti-inlfammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang (LWDH), a traditional Chinese herbal formula, in obese rats.
METHODS:After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived (OP-CD) rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water (n=12 rats per group). Twelve obese-resistant-CD (OR-CD) rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacriifce and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters.
RESULTS:After 9 weeks of treatment, LWDH lowered serum C-reactive protein (CRP) and tumour necrosis factor-α (TNF-α) levels. Serum interleukin-6 (IL-6) levels showed a tendency towards reduction, but were not signiifcantly different from the OP-CD control. Liver superoxide dismutase (SOD) activity was increased in response to all three doses of LWDH, while the levels of reduced (GSH) and oxidized glutathione (GSSG) and thiobarbituric acid reactive substances (TBARS) were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inlfammatory and oxidative stress biomarkers and circulating adiponectin levels.
CONCLUSION: The results show, for the ifrst time, the anti-inlfammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OR/OP-CD rat model as a research tool to study inlfammation, oxidative stress, and adipokine production requires further investigation.

OBJECTIVE:To compare the use of complementary and alternative medicine (CAM), including dietary supplements, by individuals with and without features of metabolic syndrome (FeMS).
METHODS:Using a cross sectional study design, information was obtained by self-administered questionnaires from 300 university individuals. FeMS was deifned as any individuals self-reporting at least one of the clinical diagnoses of diabetes, hypertension, hyperlipidemia, or obesity. Finally, two categories were created for cross tabulation, and individuals with and without FeMS were compared.
RESULTS:Of the 192 individuals completing the study, 39%(n=76) were currently using or had used CAM therapies in the past 12 months. Individuals with FeMS (n=54, 28%) were more likely (P<0.05) to use different types of CAM therapies, in particular dietary and herbal supplements, aromatherapy and massage therapy compared to individuals without FeMS (n=138, 72%).
CONCLUSION: Individuals with FeMS were more likely to use CAM, particularly supplements. Doctors need to properly inquire about and understand their patients’ supplement use, especially if CAM therapies are used in conjunction with conventional medications.

肥胖儿童青少年腹部脂肪不同评价方法比较

Objectives To assess the clinical value of ultrasonography (US) and bioelectrical impedance analysis (BIA) in analyzing abdominal fat contents of obese children and adolescents through comparison with MRI. A correlation with other obese related metabolic parameters was conducted. Methods Ninety 7-17-y-old obese children and adolescents (60 boys and 30 girls with mean age of 9.6 ± 2.9 y and mean BMI of 24.5 ± 4.5 kg/m2) were recruited. Metabolic parameters were measured, and insulin resistance was estimated according to homeostasis model assess-ment (HOMA-IR). On the same day abdomen subcutaneous fat thickness (SFTUS) was measured by US. Body fat mass (FMBIA) and abdominal visceral fat area (VFABIA) were analyzed by bioelectrical impedance analysis (BIA). After obtaining informed consent, abdominal MRI was performed in 20 subjects. Each section of umbilicus level was analyzed by image threshold value segmentation using SigmaScan Pro 5 and abdominal subcutaneous fat area (SFAMRI) and visceral fat area (VFAMRI) were calculated. Results (1) A strong positive association was found between SFTUS and SFAMRI (P< 0.05), VFABIA and VFAMRI (P < 0.01) respectively. (2) FMBIA and SFAMRI, VFAMRI, SFTUS also showed significant correlations (P < 0.05). (3) VFAMRI showed extremely significant positive correlations with TG, Insulin,C-peptide and HOMA-IR (P < 0.01 ) ; SFAMRI was also correlated positively with them (P < 0.05). (4) SFTUS was correlated positively with UA (uric acid), Insulin, 2HIns (insulin measured at 2 hours after meal), C-peptide,2HC-peptide (C-peptide measured at 2 hours after meal) and HOMA-IR (P < 0.01). (5) VFABIA was correlated significant positively with UA, insulin, TG, 2HIns and HOMA-IR. FMBIA showed positive correlation with UA, Insulin,2HIns, C-peptide, 2HC-peptide and HOMA-IR. Conclusions abdominal subcutaneous and visceral fat of obese children and adolescents evaluated by US and BIA are correlated well with those assessed by MRI, and also correlated well with TG, insulin, C-peptide and other metabolic biochemical parameters. Our data support the value of using cost effective, simple and convenient methods such as BIA and US to evaluate the obese and related metabolic risk of children and adolescents in clinical practice.

Obesity and kidney disease:hidden consequences of the epidemic

Risk factors for atypical endometrial hyperplasia in infertile women:possible association with polycystic ovarv syndrome

Objective:Endometrial hyperplasia is considered as a precursor of endometrial carcinoma,in which oncogenic potential is low in hyperplasia without atypia,but high in a-typical hyperplasia.The objective of this study was to identify the risk factors for atypical endo-metrial hyperplasia in infertile women.Methods:Fifty four infertile women with endometrial hy-perplasia,which were selected from a large cohort of 2 098 women who desired for the future childbearing in our center,were diagnosed by hysteroscopy with directed biopsies or dilation and curettage(D&C),including 44 with hyperplasia without atypia,10 with atypical hyperplasia.Clinical characteristics were recorded in terms of age,body mass index(BMI),parity,insulin resistance,polycystic ovary syndrome(PCOS).Statistical comparison was made between women with hyperplasia without atypia and atypical hyperplasia.Logistic regression analysis Was em-ployed to assess the contribution of PCOS,obesity and insulin resistance to atypical hyperplasia.Results:The incidence of endometrial hyperplasia in infertile women Was 2.57%(54/2098),which included 1 0 women(0.48%)were diagnosed as atypical hyperplasia.PCOS in women with atypical hyperplasia(70%,7/10)was significantly higher than those of hyperplasia with-out atypia(27.27%,12/44).Stepwise regression analysis showed that PCOS contributed maximally to atypical endometrial hyperplasia in infertile women.Conclusion:PCOS is an independent risk factor for atypical endometrial hyperplasia in women with infertility.The infertile women with PCOS are at an increased risk for atypical endometrial hyperplasia and endometrial cancer.

Recently, obesity is a wel-recognized risk factor of type 2 diabetes and cardiovascular disease. There is more and more suf icient evidence that excess body weight is an avoidable cause of excess cancers including gastrointestinal, endometrial, esophageal adenocarcinoma, colorectal, postmenopausal breast, prostate, and renal cancers. The mechanism that obesity association with cancer is remains not wel understood. There be some most studied hypothesized mechanisms such as, high levels of insulin and free levels of insulin-like growth factors (IGFs), sex hormones, adipocytokines, inflammatory cytokines, c-Myc (or Myc) oncogenic transcription factor, obesity-induced hypoxia and Warburg ef ect, and so on. In the future, the potential mechanisms and conclusions in obesity associated with increased risk for developing cancer, and the underlying cel ular and molecular mechanisms wil be studied.

The Leptin Paradox-A Treacherous Art in cardiac sequelae of obesity

Leptin is the first identified obese gene product which participates in the regulation of food intake, energy expenditure, glucose and lipid metabolism. Leptin initiates both hypertrophic and antihypertrophic effects on hearts in addition to its cardiac depressant effect. Circulating leptin levels correlate with the body mass index (BMI) and total amount of body fat, which may be associated with changes of cardiac morphology and function. It has been shown that cardiac function is present in both hyperleptinemic (db/db) and hypoleptinemic (ob/ob) mouse models. Leptin replenishment reconciles the compromised myocardial function in ob/ob mice, indicating the premises of leptin on heart function. Interestingly, elevated plasma leptin levels may trigger leptin resistance and serve as an independent risk factor for cardiovascular diseases. Therefore, physiological range of leptin is essential tor normal cardiac geometry and function whereas disrupted leptin signaling (hyper-and hypoleptinemia) results in functional and morphological aberrations leading to heart problem. Given that human obesity is a syndrome of leptin resistance, which is unlikely amenable to leptin treatment, the identification of novel parallel signal transduction pathways is of particular therapeutic value for obesity-associated cardiac dysfunction.