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Fulltext Central obesity, insulin resistance, syndrome X, lipoprotein(a), and cardiovascular risk in Indians, Malays, and Chinese in Singapore

Hughes K, Aw TC, Kuperan P, Choo M

J Epidemiol Community Health, 1997 Aug;51(4):394-9.
PMID: 9328546

STUDY OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is at least partly explained by central obesity, insulin resistance, and syndrome X (including possible components).
DESIGN: Cross sectional study of the general population.
SETTING: Singapore.
PARTICIPANTS: Random sample of 961 men and women (Indians, Malays, and Chinese) aged 30 to 69 years.
MAIN RESULTS: Fasting serum insulin concentration was correlated directly and strongly with body mass index (BMI), waist-hip ratio (WHR), and abdominal diameter. The fasting insulin concentration was correlated inversely with HDL cholesterol and directly with the fasting triglyceride concentration, blood pressures, plasminogen activator inhibitor 1 (PAI-1), and tissue plasminogen activator (tPA), but it was not correlated with LDL cholesterol, apolipoproteins B and A1, lipoprotein(a), (Lp(a)), fibrinogen, factor VIIc, or prothrombin fragment (F)1 + 2. This indicates that the former but not the latter are part of syndrome X. While Malays had the highest BMI, Indians had a higher WHR (men 0.93 and women 0.84) than Malays (men 0.91 and women 0.82) and Chinese (men 0.91 and women 0.82). In addition, Indians had higher fasting insulin values and more glucose intolerance than Malays and Chinese. Indians had lower HDL cholesterol, and higher PAI-1, tPA, and Lp(a), but not higher LDL cholesterol, fasting triglyceride, blood pressures, fibrinogen, factor VIIc, or prothrombin F1 + 2.
CONCLUSIONS: Indians are more prone than Malays or Chinese to central obesity with insulin resistance and glucose intolerance and there are no apparent environmental reasons for this in Singapore. As a consequence, Indians develop some but not all of the features of syndrome X. They also have higher Lp(a) values. All this puts Indians at increased risk of atherosclerosis and thrombosis and must be at least part of the explanation for their higher rates of CHD.

Matched MeSH terms: Obesity/physiopathology
Growth hormone deficiency and cardiovascular risk

Hew FL, O'Neal D, Kamarudin N, Alford FP, Best JD

Baillieres Clin. Endocrinol. Metab., 1998 Jul;12(2):199-216.
PMID: 10083892

It is now recognized that growth hormone (GH) deficiency in adults represents a distinct clinical syndrome that encompasses reduced psychological well-being as well as specific metabolic abnormalities. The latter features, which include hypertension, central obesity, insulin resistance, dyslipidaemia and coagulopathy, closely resemble those of metabolic insulin resistance syndrome. The increased cardiovascular morbidity and mortality demonstrated in these GH-deficient (GHD) adults reinforce the close association between the two syndromes. Replacement of GH in GHD adults has resulted in a marked reduction of central obesity and significant reduction in total cholesterol but little change in other risk factors, in particular insulin resistance and dyslipidaemia. The persistent insulin resistance and dyslipidaemia, together with the elevation of plasma insulin levels and lipoprotein (a) with GH replacement in these subjects are of concern. Long-term follow-up data are required to assess the impact of GH replacement on the cardiovascular morbidity and mortality of GHD adults. Further exploration of the appropriateness of the GH dosage regimens currently being employed is also indicated.

Matched MeSH terms: Obesity/physiopathology
Regional study of nutritional status of urban primary schoolchildren. 3. Kuala Lumpur, Malaysia

Tee ES, Khor SC, Ooi HE, Young SI, Zakiyah O, Zulkafli H

Food Nutr Bull, 2002 Mar;23(1):41-7.
PMID: 11975368

A total of 5,995 (7.8% of all 7- to 10-year-old primary schoolchildren in Kuala Lumpur), randomly selected from 166 schools (97.6% of all schools), were measured for their weight and height. The analyses of all weight and height data, including the cutoffs used for defining stunting, underweight, and wasting and for thinness and overweight, were carried out as recommended by the World Health Organization (WHO). The prevalances of stunting (height-for-age Z score < -2 SD), underweight (weight-for-age Z score < -2 SD) and wasting (weight-for-height Z score < -2 SD) among all the children studies were 6.7%, 7.1%, and 4.5%, respectively. Undernutrition among boys was more serious than among girls according to all three indicators. Because it was not possible to analyze the weight-for-height data for most of the children above 8.5 years of age, body mass index (BMI)-for-age was used to determine the prevalences of thinness and overweight for all the children. Based on the reference data, the prevalence of overweight (at or above the 95th percentile) was 9.7% and 7.1% for boys and girls, respectively, and 8.4% overall.

Matched MeSH terms: Obesity/physiopathology
Fulltext Tophaceous gout causing atlanto-axial subluxation mimicking rheumatoid arthritis: a case report

Wazir NN, Moorthy V, Amalourde A, Lim HH

J Orthop Surg (Hong Kong), 2005 Aug;13(2):203-6.
PMID: 16131689 DOI: 10.1177/230949900501300220

This is a case report of an extremely rare condition of atlanto-axial subluxation secondary to gouty arthritis, which mimicked rheumatoid arthritis at presentation. Gouty arthritis involving the spine is a rare condition. We highlight a case of gouty arthritis involving the atlanto-axial joint resulting in joint instability, subluxation, and neurological deficit. A 66-year-old obese woman who had a polyarticular disease for the previous 3 years presented with neck pain and progressive neurology. A 2-stage procedure was performed: posterior decompression and occipitocervical fusion followed by further anterior trans-oral decompression. However, after an initial neurological improvement, she succumbed to aspirational pneumonia and septicaemia. Atlanto-axial subluxation caused by gouty arthritis can present in the same way as rheumatoid arthritis. Therefore, the possibility of this as a differential diagnosis should be kept in mind.

Matched MeSH terms: Obesity/physiopathology
Fulltext Obesity: basic science and medical aspects relevant to anaesthetists

Cheah MH, Kam PC

Anaesthesia, 2005 Oct;60(10):1009-21.
PMID: 16179047 DOI: 10.1111/j.1365-2044.2005.04229.x

Obesity is becoming a major public health problem throughout the world. It is now the second leading cause of death in the United States and is associated with significant, potentially life-threatening co-morbidities. Significant advances in the understanding of the physiology of body weight regulation and the pathogenesis of obesity have been achieved. A better understanding of the physiology of appetite control has enabled advances in the medical and surgical treatment of obesity. Visceral or abdominal obesity is associated with an increased risk of cardiovascular disease and type 2 diabetes. Various drugs are used in the treatment of mild obesity but they are associated with adverse effects. Surgery has become an essential part of the treatment of morbid obesity, notwithstanding the potential adverse events that accompany it. An appreciation of these problems is essential to the anaesthetist and intensivist involved in the management of this group of patients.

Matched MeSH terms: Obesity/physiopathology
Fulltext Categorization of low cardiorespiratory fitness using obesity indices in non-smoking Singaporean women

Pua YH, Lim CK, Ang A

Obesity (Silver Spring), 2006 Nov;14(11):1992-9.
PMID: 17135616 DOI: 10.1038/oby.2006.233

OBJECTIVE: To revisit cut-off values of BMI, waist circumference (WC), and waist-to-stature ratio (WSR) based on their association with cardiorespiratory fitness (CRF). The derived cut-off points were compared with current values (BMI, 25.0 kg/m(2); WC, 80 cm) as recommended by the World Health Organization.
RESEARCH METHODS AND PROCEDURES: Anthropometric indices were measured in a cross sectional study of 358 Singaporean female employees of a large tertiary hospital (63% Singaporean Chinese, 28% Malays, and 9% Indians). CRF was determined by the 1-mile walk test. Receiver operating characteristic curves were constructed to determine cut-off points.
RESULTS: The cut-off points for BMI, WC, and WSR were 23.6 kg/m(2), 75.3 cm, and 0.48, respectively. The areas under the curve of BMI, WC, and WSR were 0.68, 0.74, and 0.74, respectively. For a given BMI, women with low CRF had higher WSR compared with women with high CRF.
DISCUSSION: These findings provide convergent evidence that the cut-off points for Singaporean women were lower than the World Health Organization's criteria but were in good agreement with those reported for Asians.

Matched MeSH terms: Obesity/physiopathology*
An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies

Mohamed M, Diabcare-Asia 2003 Study Group

Curr Med Res Opin, 2008 Feb;24(2):507-14.
PMID: 18184454 DOI: 10.1185/030079908X261131

OBJECTIVE: To collect information on diabetes management, including psychosocial aspects, in patients managed by specialists 5 years after they were first surveyed in 1998.
METHODS: Data on demography, diabetes status, management and complications were collected via medical records, interview and laboratory assessments. HbA(1c) was analysed by a central laboratory prospectively.
RESULTS: Patient profile was similar in the 1998 (N = 21,838) and 2003 cohorts (N = 15,549): 95% were diagnosed as type 2 diabetes mellitus and were obese (BMI approximately 25 kg/m(2)). Glycaemic control was unsatisfactory in many patients (mean HbA(1c) approximately 8%; fasting glucose approximately 9 mmol/L). Lipids were well-controlled but hypertension was not. The incidence of neuropathy ( approximately 33%) and cataract ( approximately 27%) were high. The majority ( approximately 71%) of patients in both cohorts were treated with oral antidiabetic drug (OAD) monotherapy; approximately 24% were on insulin therapy. Approximately half of the 2003 cohort reported a healthy state of well-being. Quality of life did not appear to have suffered as a result of having diabetes. However, many patients were worried about hypoglycaemic risk (53.9%) or worsening of diabetes (45.8%) and insulin initiation (64.5%).
CONCLUSIONS: Although both cohorts were separate cross-sectional studies of diabetes management status in Asia, the results showed that the demography profile, glycaemic control and cardiovascular risk factors were remarkably similar in both cohorts 5 years after the first survey. More concerted efforts are needed to increase diabetes awareness and education.

Matched MeSH terms: Obesity/physiopathology*
Fulltext Glycyrrhizic acid improved lipoprotein lipase expression, insulin sensitivity, serum lipid and lipid deposition in high-fat diet-induced obese rats

Eu CH, Lim WY, Ton SH, bin Abdul Kadir K

Lipids Health Dis, 2010;9:81.
PMID: 20670429 DOI: 10.1186/1476-511X-9-81

The metabolic syndrome, known also as the insulin resistance syndrome, refers to the clustering of several risk factors for atherosclerotic cardiovascular disease. Dyslipidaemia is a hallmark of the syndrome and is associated with a whole body reduction in the activity of lipoprotein lipase (LPL), an enzyme under the regulation of the class of nuclear receptors known as peroxisome proliferator-activated receptor (PPAR). Glycyrrhizic acid (GA), a triterpenoid saponin, is the primary bioactive constituent of the roots of the shrub Glycyrrhiza glabra. Studies have indicated that triterpenoids could act as PPAR agonists and GA is therefore postulated to restore LPL expression in the insulin resistant state.

Matched MeSH terms: Obesity/physiopathology*
Obesity, metabolic syndrome, adipocytes and vascular function: A holistic viewpoint

Achike FI, To NH, Wang H, Kwan CY

Clin Exp Pharmacol Physiol, 2011 Jan;38(1):1-10.
PMID: 21083697 DOI: 10.1111/j.1440-1681.2010.05460.x

1. Obesity is a metabolic disease of pandemic proportions largely arising from positive energy balance, a consequence of sedentary lifestyle, conditioned by environmental and genetic factors. Several central and peripheral neurohumoral factors (the major ones being the anorectic adipokines leptin and adiponecin and the orexigenic gut hormone ghrelin) acting on the anorectic (pro-opiomelanocortin and cocaine- and amphetamine-regulated transcript) and orexigenic (neuropeptide Y and agouti gene-related protein) neurons regulate energy balance. These neurons, mainly in the arcuate nucleus of the hypothalamus, project to parts of the brain modulating functions such as wakefulness, autonomic function and learning. A tilt in the anorectic-orexigenic balance, perhaps determined genetically, leads to obesity. 2. Excess fat deposition requires space, created by adipocyte (hypertrophy and hyperplasia) and extracellular matrix (ECM) remodelling. This process is regulated by several factors, including several adipocyte-derived Matrix metalloproteinases and the adipokine cathepsin, which degrades fibronectin, a key ECM protein. Excess fat, also deposited in visceral organs, generates chronic low-grade inflammation that eventually triggers insulin resistance and the associated comorbidities of metabolic syndrome (hypertension, atherosclerosis, dyslipidaemia and diabetes mellitus). 3. The perivascular adipose tissue (PVAT) has conventionally been considered non-physiological structural tissue, but has recently been shown to serve a paracrine function, including the release of adipose-derived relaxant and contractile factors, akin to the role of the vascular endothelium. Thus, PVAT regulates vascular function in vivo and in vitro, contributing to the cardiovascular pathophysiology of the metabolic syndrome. Defining the mechanism of PVAT regulation of vascular reactivity requires more and better controlled investigations than currently seen in the literature.

Matched MeSH terms: Obesity/physiopathology*
Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian Childhood Obesity Treatment Trial (MASCOT)

Wafa SW, Talib RA, Hamzaid NH, McColl JH, Rajikan R, Ng LO, et al.

Int J Pediatr Obes, 2011 Jun;6(2-2):e62-9.
PMID: 21604965 DOI: 10.3109/17477166.2011.566340

CONTEXT: Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world.
AIM: To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia.
METHODS: Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days).
RESULTS: The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group.
CONCLUSIONS: Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.

Matched MeSH terms: Obesity/physiopathology
Fulltext Estimation of glomerular filtration rate using serum cystatin C in overweight and obese subjects

Marwyne MN, Loo CY, Halim AG, Norella K, Sulaiman T, Zaleha MI

Med J Malaysia, 2011 Oct;66(4):313-7.
PMID: 22299549 MyJurnal

Obesity and overweight are strong independent risk factors for chronic kidney disease (CKD). Using serum creatinine-based estimated glomerular filtration rate (eGFR) equations in these subjects may be inaccurate. On the other hand, cystatin C-based eGFR equations may overestimate CKD prevalence as recent findings suggest an association of cystatin C with obesity. The objective of this study was to assess the accuracy of a cystatin C-based eGFR equation compared to two creatinine -based eGFR equations in overweight and obese subjects.

Matched MeSH terms: Obesity/physiopathology*
Fulltext Childhood obesity, self-esteem and health-related quality of life among urban primary schools children in Kuching, Sarawak, Malaysia

Lee PY, Cheah Wl, Chang CT, Siti Raudzah G

Malays J Nutr, 2012 Aug;18(2):207-19.
PMID: 24575667 MyJurnal

There is limited data on childhood obesity and its impact on children from diverse cultural backgrounds. This study is aimed at determining the association between obesity, self-esteem and health-related quality of life (HRQOL) among Malaysian urban primary school children of different ethnicity.

Matched MeSH terms: Pediatric Obesity/physiopathology*
Physical activity, fitness and the energy cost of activities: implications for obesity in children and adolescents in the tropics

Lau XC, Chong KH, Poh BK, Ismail MN

Adv. Food Nutr. Res., 2013;70:49-101.
PMID: 23722094 DOI: 10.1016/B978-0-12-416555-7.00002-3

The tropics cover a large section of the world in which both developed and developing countries are situated. Rapid socioeconomic development, modernization, urbanization, and globalization have affected both the food market and physical activity (PA), which in turn have propelled the obesity epidemic in the tropics. There is growing concern that overweight and obesity are emerging as major health problems among children and adolescents in the tropics, despite the fact that undernutrition still exists in many of these countries. Physical inactivity, a low metabolic rate, and lack of physical fitness (PF) have been linked to overweight and obesity. Moreover, PF in several tropical countries is declining, and these changes may be a threat to future health, as low PA and PF levels are important risk factors for noncommunicable chronic diseases. Previous studies have reported that the relationships among PA, PF, overweight, and obesity are inconsistent and inconclusive. There is no indication that variances in the energy cost of physical activities lead to obesity. Despite a lack of definite evidence to prove a causal relationship, there is enough certainty that physical inactivity and low fitness levels are linked to overweight and obesity. Hence, people living in tropical countries need to be encouraged to lead a healthier lifestyle by increasing their PA levels and reducing sedentary behaviors to prevent overweight or obesity.

Matched MeSH terms: Obesity/physiopathology*
Prevalence of depression in breast cancer survivors: a systematic review of observational studies

Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG

Asian Pac J Cancer Prev, 2013;14(4):2649-56.
PMID: 23725190

BACKGROUND: Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors.
MATERIALS AND METHODS: An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized.
RESULTS: We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life.
CONCLUSIONS: Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.

Matched MeSH terms: Obesity/physiopathology
Objectively measured habitual physical activity and sedentary behaviour in obese and non-obese Malaysian children

Wafa SW, Hamzaid H, Talib RA, Reilly JJ

J Trop Pediatr, 2014 Apr;60(2):161-3.
PMID: 24213306 DOI: 10.1093/tropej/fmt093

The present study examined objectively measured physical activity in Malaysian children and compared the differences in physical levels between obese and healthy weight children. Eighty-six obese children were matched for age and sex with 86 healthy weight children with median age 9.5 years. Habitual physical activity and sedentary behaviour were measured over 5 days using Actigraph accelerometers. Time spent sedentary was significantly higher in the obese group (90% vs. 86% of daytime; p = 0.001). Moderate-to-vigorous-intensity physical activity was significantly higher in the healthy weight group (1.2 vs. 0.7% of daytime, p < 0.001). In both healthy weight and obese children, physical activity levels were exceptionally low, although moderate-to-vigorous-intensity physical activity was significantly lower in the obese group than the healthy weight group. Efforts to prevent and treat obesity in Malaysian children will need a substantial focus on the promotion of reductions in sedentary behaviour and increases in physical activity.

Matched MeSH terms: Obesity/physiopathology*
Maternal adiposity and blood pressure in pregnancy: varying relations by ethnicity and gestational diabetes

Lim WY, Kwek K, Chong YS, Lee YS, Yap F, Chan YH, et al.

J Hypertens, 2014 Apr;32(4):857-64.
PMID: 24390251 DOI: 10.1097/HJH.0000000000000096

OBJECTIVE: Greater maternal adiposity is a potentially modifiable risk factor for elevated blood pressure during pregnancy; however, the association has been little studied in Asian populations, and no study has evaluated potential differences in the adiposity-blood pressure relation between ethnic groups or interaction with gestational diabetes.

METHODS: We performed a cross-sectional evaluation of a Singapore mother-offspring cohort comprising 799 pregnant Chinese, Malay and Indian women. Data on body weight, height, skinfold thickness and glycaemia (oral glucose tolerance test) were collected during the 2nd trimester; peripheral SBP and DBP were measured using an oscillometric device and central pressures by noninvasive radial applanation tonometry. The associations between adiposity measures BMI and sum of skinfold thickness and blood pressure outcomes were examined by linear regression with adjustment for potential confounders.

RESULTS: Higher maternal BMI was associated with elevated peripheral and central pressures: the increases in pressure (mmHg) for each kg/m(2) increase in BMI were 1.19 (95% confidence interval, 1.03-1.36) for peripheral SBP, 0.76 (0.63-0.89) for peripheral DBP, 1.02 (0.87-1.17) for central systolic pressure and 0.26 (0.16-0.37) for central pulse pressure. The associations were generally stronger in Chinese women (P-interaction = 0.03 for central pulse pressure) and individuals with gestational diabetes (P-interaction = 0.03 for DBP and P-interaction = 0.046 for central systolic pressure). Similar patterns of results were found when using skinfold thickness as the measure of adiposity.

CONCLUSION: Maternal adiposity is associated with higher peripheral and central blood pressures during pregnancy. Stronger associations in Chinese women and individuals with gestational diabetes warrant further investigation.

Matched MeSH terms: Obesity/physiopathology
Obesity is a determinant of arterial stiffness independent of traditional risk factors in Asians with young-onset type 2 diabetes

Liu JJ, Sum CF, Tavintharan S, Yeoh LY, Ng XW, Moh AM, et al.

Atherosclerosis, 2014 Oct;236(2):286-91.
PMID: 25112799 DOI: 10.1016/j.atherosclerosis.2014.07.017

OBJECTIVE: Type 2 diabetes (T2DM) among the young population has become a serious concern globally, presumably due to the rising trend of obesity. Compared to other forms of diabetes, young-onset T2DM experiences more cardiovascular events and other vascular complications although the underlying mechanisms remain largely unknown. Increased arterial stiffness is a hallmark of vasculopathy. We aim to study the clinical and metabolic determinants of arterial stiffness in a cohort of multi-ethnic Asians with young-onset T2DM.
METHODS: 179 subjects with T2DM onset age below 30 years old were selected in this cross sectional study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWV).
RESULTS: PWV was correlated with age, duration of diabetes, systolic blood pressure, alanine aminotransferase, urinary albumin-to-creatinine ratio (ACR) and eGFR in bivariate correlation analysis. However, PWV was only significantly correlated with body mass index (BMI), waist circumference, urinary ACR and eGFR after adjustment for age. Overweight individuals with young-onset T2DM had significantly higher PWV levels compared to their lean counterparts (7.3 ± 2.4 m/s vs 6.4 ± 2.3 m/s, p = 0.072 and p < 0.0001 without and with adjustment for age, respectively). Multivariable regression models revealed that age, BMI, eGFR and usage of insulin were independently associated with PWV. These 4 variables explained 35.5% variance in PWV levels.
CONCLUSION: Age, BMI, renal function and insulin usage are the main determinants of PWV levels in Asians with young-onset T2DM. Notably, obesity is a modifiable determinant of arterial stiffness independent of high blood pressure, dyslipidemia and hyperglycemia in this population.

Matched MeSH terms: Obesity/physiopathology*
Obesity depresses baroreflex control of renal sympathetic nerve activity and heart rate in Sprague Dawley rats: role of the renal innervation

Khan SA, Sattar MZ, Abdullah NA, Rathore HA, Abdulla MH, Ahmad A, et al.

Acta Physiol (Oxf), 2015 Jul;214(3):390-401.
PMID: 25846561 DOI: 10.1111/apha.12499

AIM:
This study investigated the role of the renal innervation in arterial and cardiopulmonary baroreflex regulation of renal sympathetic nerve activity (RSNA) and heart rate (HR) in rats fed a high-fat diet to induce obesity.

METHODS:
Rats received either a normal (12% kcal) or high (45% kcal) fat diet for 60 days. On day 61, rats were anesthetized and prepared for recording left RSNA. In one group, the renal nerves remained intact, while in the other, both kidneys were denervated. Baroreflex gain curves for RSNA and HR were generated by increasing and decreasing blood pressure. Low-pressure baroreceptors were challenged by infusing a saline load.

RESULTS:
Mean blood pressure was 135 mmHg in the fat-fed and 105 mmHg (P < 0.05) in normal rats. Weight gain, adiposity index and creatinine clearance were 37, 82 and 55% higher (P < 0.05-0.001), but urine flow rate and fractional sodium excretions were 53 and 65% (both P < 0.001) lower, respectively, in the fat-fed compared to normal rats. In fat-fed rats with innervated kidneys, RSNA and HR arterial baroreflex sensitivities were reduced by 73 and 72% (both P < 0.05) but were normal in renally denervated rats. Volume expansion decreased RSNA by 66% (P < 0.001) in normal rats, but not in the intact fat-fed rats and by 51% (P < 0.01) in renally denervated fat-fed rats.

CONCLUSION:
Feeding a high-fat diet caused hypertension associated with dysregulation of the arterial and cardiopulmonary baroreflexes which was dependent on an intact renal innervation. This suggests that in obese states neural signals arising from the kidney contribute to a deranged autonomic control.

KEYWORDS:
baroreflex gain curves; cardiopulmonary reflex; high-fat diet

Matched MeSH terms: Obesity/physiopathology*
Fulltext Effects of maternal diet and exercise during pregnancy on glucose metabolism in skeletal muscle and fat of weanling rats

Raipuria M, Bahari H, Morris MJ

PLoS One, 2015;10(4):e0120980.
PMID: 25853572 DOI: 10.1371/journal.pone.0120980

Obesity during pregnancy contributes to the development of metabolic disorders in offspring. Maternal exercise may limit gestational weight gain and ameliorate these programming effects. We previously showed benefits of post-weaning voluntary exercise in offspring from obese dams. Here we examined whether voluntary exercise during pregnancy influences lipid and glucose homeostasis in muscle and fat in offspring of both lean and obese dams. Female Sprague-Dawley rats were fed chow (C) or high fat (F) diet for 6 weeks before mating. Half underwent voluntary exercise (CE/FE) with a running wheel introduced 10 days prior to mating and available until the dams delivered; others remained sedentary (CS/FS). Male and female pups were killed at postnatal day (PND)19 and retroperitoneal fat and gastrocnemius muscle were collected for gene expression. Lean and obese dams achieved similar modest levels of exercise. At PND1, both male and female pups from exercised lean dams were significantly lighter (CE versus CS), with no effect in those from obese dams. At PND19, maternal obesity significantly increased offspring body weight and adiposity, with no effect of maternal exercise. Exercise significantly reduced insulin concentrations in males (CE/FE versus CS/FS), with reduced glucose in male FE pups. In males, maternal obesity significantly decreased muscle myogenic differentiation 1 (MYOD1) and glucose transporter type 4 (GLUT4) mRNA expressions (FS vs CS); these were normalized by exercise. Maternal exercise upregulated adipose GLUT4, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and peroxisome proliferator activated receptor gamma coactivator 1 alpha (PGC1α) mRNA expression in offspring of dams consuming chow. Modest voluntary exercise during pregnancy was associated with lower birth weight in pups from lean dams. Maternal exercise appeared to decrease the metabolic risk induced by maternal obesity, improving insulin/glucose metabolism, with greater effects in male than female offspring.

Matched MeSH terms: Obesity/physiopathology
Effects of endurance and high intensity training on ICAM-1 and VCAM-1 levels and arterial pressure in obese and normal weight adolescents

Kargarfard M, Lam ET, Shariat A, Asle Mohammadi M, Afrasiabi S, Shaw I, et al.

Phys Sportsmed, 2016 09;44(3):208-16.
PMID: 27291761 DOI: 10.1080/00913847.2016.1200442

OBJECTIVES: Obesity prevalence has increased in Iranian adolescents in recent years. However, few studies have examined the impact of intervention programs on this health issue. The main objective of this study was to evaluate the effects of 8-week endurance training (ET) and high intensity interval training (HIIT) on intercellular adhesion molecule-1(ICAM-1) and vascular adhesion molecule-1(VCAM-1) levels among obese and normal-weight male adolescents.
METHODS: Thirty obese and 30 normal-weight subjects were assigned to the ET, HIIT, or control group for eight weeks. Before and after the intervention, ICAM-1, VCAM-1, body weight, BMI, VO2max, and blood pressures were measured. SPSS (Version 21) was used for data analysis, and the significance level was set at p

Matched MeSH terms: Obesity/physiopathology*

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