Displaying publications 1 - 20 of 54 in total

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  1. 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
  2. Salamt N, Muhajir M, Aminuddin A, Ugusman A
    Bosn J Basic Med Sci, 2020 May 01;20(2):149-156.
    PMID: 31509733 DOI: 10.17305/bjbms.2019.4345
    Numerous studies have evaluated the effects of exercise training on obese children and adolescents. However, the impact of aerobic and/or resistance exercise alone, without any other interventions, on vascular markers and C-reactive protein (CRP) in obese children and adolescents is still not clear. We performed a literature search in Ovid Medline, PubMed, and SCOPUS databases to identify articles on the effects of exercise on vascular markers and CRP among obese children and adolescents, published between January 2009 and May 2019. Only full-text articles in English that reported on the effect of aerobic and/or resistance exercise on the vascular markers pulse wave velocity (PWV), carotid intima-media thickness (CIMT), flow-mediated dilatation (FMD), augmentation index (AIx), or CRP in obese children and adolescents (5-19 years old) were included. The literature search identified 36 relevant articles; 9 articles that fulfilled all the inclusion criteria were selected by two independent reviewers. Aerobic exercise or a combination of aerobic and resistance exercise training significantly improved CIMT and PWV in obese children and adolescents in all studies in which they were measured (2 studies for PWV and 4 studies for CIMT). However, the effects of exercise on FMD and CRP levels were inconclusive, as only half of the studies demonstrated significant improvements (1/2 studies for FMD and 4/8 studies for CRP). The results of our review support the ability of exercise to improve vascular markers such as PWV and CIMT in obese children and adolescents. This finding is important as obesity is a modifiable risk factor of cardiovascular disease (CVD), and exercise may help in reducing the future occurrence of CVD in this population.
    Matched MeSH terms: Pediatric Obesity/physiopathology*
  3. Xia W, Tang N, Kord-Varkaneh H, Low TY, Tan SC, Wu X, et al.
    Pharmacol Res, 2020 11;161:105113.
    PMID: 32755613 DOI: 10.1016/j.phrs.2020.105113
    BACKGROUND AND AIM: Previous studies lack consistent conclusions as to whether astaxanthin is actually linked to various health benefits as claimed. Here, we attempt to unravel the association of astaxanthin consumption with selected health benefits by performing a systematic review and meta-analysis.

    METHODS: Online literature search databases including Scopus, Web of Science, PubMed/Medline, Embase and Google Scholar were searched to discover relevant articles available up to 17 March 2020. We used mean changes and SD of the outcomes to assess treatment response from baseline and mean difference, and 95 % CI were calculated to combined data and assessment effect sizes in astaxanthin and control groups.

    RESULTS: 14 eligible articles were included in the final quantitative analysis. Current study revealed that astaxanthin consumption was not associated with FBS, HbA1c, TC, LDL-C, TG, BMI, BW, DBP, and SBP. We did observe an overall increase in HDL-C (WMD: 1.473 mg/dl, 95 % CI: 0.319-2.627, p = 0.012). As for the levels of CRP, only when astaxanthin was administered (i) for relatively long periods (≥ 12 weeks) (WMD: -0.528 mg/l, 95 % CI: -0.990 to -0.066), and (ii) at high dose (> 12 mg/day) (WMD: -0.389 mg/dl, 95 % CI: -0.596 to -0.183), the levels of CRP would decrease.

    CONCLUSION: In summary, our systematic review and meta-analysis revealed that astaxanthin consumption was associated with increase in HDL-C and decrease in CRP. Significant associations were not observed for other outcomes.

    Matched MeSH terms: Obesity/physiopathology
  4. Ambak R, Mohamad Nor NS, Puteh N, Mohd Tamil A, Omar MA, Shahar S, et al.
    BMC Womens Health, 2018 07 19;18(Suppl 1):111.
    PMID: 30066637 DOI: 10.1186/s12905-018-0591-3
    BACKGROUND: Obesity is an emerging global public health concern as it is related to chronic diseases and its impact to health related quality of life. The aim of this study was to assess the effect of weight reduction on health related quality of life (HRQOL) among obese and overweight housewives.

    METHODS: Data on 123 obese and overweight housewives in the intervention group from the MyBFF@home study were utilised. A validated Malaysian Malay version of Obesity Weight Loss Quality of Life (OWLQOL) questionnaire was administered at baseline and 6 months after intervention. Descriptive analysis, univariate analysis, paired t-test and multiple logistic regression were performed using SPSS Version 22.

    RESULTS: Mean body mass index (BMI) was 31.5 kg/m2 (SD:4.13), with 51 participants classified as overweight (41.5%) while 72 were obese (58.5%). About 72% of the housewives experienced weight reduction (62% reduced weight less than 5% and 11% reduced weight more than 5% of their baseline weight). There was a significant improvement in HRQOL with a pre-intervention total mean score of 59.82 (SD: 26.60) and post-intervention of 66.13 (SD: 22.82), p-value

    Matched MeSH terms: Obesity/physiopathology*
  5. Karimi G, Jamaluddin R, Mohtarrudin N, Ahmad Z, Khazaai H, Parvaneh M
    Nutr Metab Cardiovasc Dis, 2017 Oct;27(10):910-918.
    PMID: 28821417 DOI: 10.1016/j.numecd.2017.06.020
    BACKGROUND AND AIM: Recent studies have reported beneficial effects of specific probiotics on obesity. However, the difference in the anti-obesity effects of probiotics as single species and dual species is still uncertain. Therefore, we aimed to compare the efficacy of single and dual species of bacteria on markers of obesity in high-fat diet-induced obese rats.

    METHODS AND RESULTS: A total of 40 male Sprague-Dawley rats were assigned to one of five groups of varying diets as follows: standard diet, high fat diet (HFD), HFD supplemented with Lactobacillus casei strain Shirota, HFD supplemented with Bifidobacterium longum and HFD supplemented with a mixture of these two bacterial species. After 15 weeks of supplementation, the animals were examined for changes in body weight, body fat, total count of bacteria in fecal, blood serum lipid profile, leptin, adiponectin and inflammatory biomarkers. Histological analysis of the liver and adipose tissue was performed and the hepatic mRNA expression levels of genes related to lipid metabolism were measured. It was found that probiotic supplementation of either B. longum or a mixture of B. longum and LcS bacteria significantly reduced weight and triglycerides in the HFD groups. Supplementation of B. longum bacteria showed better results in terms of modulating leptin level, fat mass, adipocyte size and lipoprotein lipase expression, as well as increasing adiponectin and peroxisome proliferator-activated receptors-γ expression compared to dual species of bacteria. No significant differences were observed in the total count of fecal bacteria, glucose and inflammatory biomarker levels between supplemented groups.

    CONCLUSIONS: B. longum supplementation in obesity was more beneficial in metabolic profile changes than the mixture species.

    Matched MeSH terms: Obesity/physiopathology
  6. Sundström-Poromaa I, Thu WPP, Kramer MS, Logan S, Cauley JA, Yong EL
    Maturitas, 2020 Jul;137:50-56.
    PMID: 32498937 DOI: 10.1016/j.maturitas.2020.04.003
    OBJECTIVES: To understand the extent to which risk factors for insulin resistance are mediated by body mass index (BMI), visceral adipose tissue (VAT), physical activity and performance, and the inflammatory markers interleukin (IL)-6, tumor necrosis factor (TNF)- α, and high-sensitivity C-reactive protein (hs-CRP).

    STUDY DESIGN: A wide range of socio-demographic characteristics of Chinese, Malay and Indian women attending routine gynecologic care in Singapore were prospectively collected. Physical performance was objectively measured by hand grip strength and the Short Physical Performance Battery. Percent VAT was determined by dual-energy X-ray absorptiometry. Fasting serum concentrations of glucose, insulin, IL-6, TNF- α, and hs-CRP were measured.

    MAIN OUTCOME MEASURE: was insulin resistance, expressed as the homeostatic model assessment of insulin resistance (HOMA-IR).

    RESULTS: 1159 women were analyzed, mean age 56.3 (range 45-69) years, comprising women of Chinese (84.0%), Indian (10.2%), and Malay (5.7%) ethnic origins. The adjusted mean differences for obesity (0.66, 95% CI 0.32-1.00), VAT area in the highest vs lowest tertile (1.03, 95% CI 0.73-1.34), low physical performance (0.63, 95% CI 0.05-1.24), and highest vs lowest tertile of TNF- α (0.35, 95% CI 0.13-0.57) were independently associated with HOMA-IR. Women of Malay and Indian ethnicity had higher crude HOMA-IR than Chinese women. However, after adjustment for obesity, VAT, physical performance, and TNF- α, no differences in mean HOMA-IR remained, when comparing Chinese women with those of Malay ethnicity (0.27, 95% CI -0.12 to 0.66) and with those of Indian ethnicity (0.30, 95% CI -0.01 to 0.66).

    CONCLUSIONS: Insulin resistance was independently associated with obesity, high VAT, low physical performance, and high levels of TNF- α in midlife Singaporean women. These variables entirely explained the significant differences in insulin resistance between women of Chinese, Malay and Indian ethnicity.

    Matched MeSH terms: Obesity/physiopathology*
  7. 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
  8. 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
  9. Tung SEH, Mohd Nasir MT, Chin YS, Zalilah MS, Zubaidah JO, Yim HS
    Child Obes, 2019 01;15(1):56-62.
    PMID: 30339034 DOI: 10.1089/chi.2018.0066
    BACKGROUND: Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia.

    METHODS: This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechsler's Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function.

    RESULTS: A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children.

    CONCLUSION: Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.

    Matched MeSH terms: Pediatric Obesity/physiopathology*
  10. Alagappan M, Rampal L, Zalilah MS
    Med J Malaysia, 2019 12;74(6):513-520.
    PMID: 31929478
    INTRODUCTION: This cross-sectional study aimed to determine the prevalence of overweight and obesity and factors associated among secondary school students in Batang Padang District, Perak, Malaysia.

    METHODS: Out of the 7247 students in the ten selected schools studied, a total of 6248 students (2928 males, 3320 females) took part. A validated self-administered questionnaire was used. Data was analysed using SPSS version 22. Multivariable logistic regression was used to determine the adjusted odd ratio.

    RESULTS: The prevalence of overweight and obesity was 16.0% and 11.5% respectively. Obesity/overweight was significantly (p<0.05) associated with gender, age, ethnicity, education level of father, education level of mother, physical activity, disordered eating, smoking status, body size perception and body part satisfaction. The multivariable analysis results showed that the odds of being overweight/obesity were higher in males compared to females (OR 1.56, 95%CI: 1.37, 1.77). The results also showed that the odds of being overweight/obesity were highest among those in age group 12 and 13 years and among Malay ethnicity. The odds of overweight/obesity were higher in those who was dissatisfied with their body parts, (OR 1.96, 95%CI: 1.71, 2.25), dissatisfied with their body size (OR: 4.25, 95%CI: 3.60, 5.02), low physical activity (OR 1.23, 95%CI: 1.06, 1.44), current smokers (OR 1.38, 95%CI: 1.07, 1.78) and at risk of having eating disorder (OR: 1.39, 95%CI 1.22, 1.59).

    CONCLUSION: The overall prevalence of overweight and obesity is high. The findings from this study can be used by policy makers to plan an integrated intervention program in schools.

    Matched MeSH terms: Pediatric Obesity/physiopathology
  11. 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
  12. Bui Van N, Vo Hoang L, Bui Van T, Anh HNS, Minh HT, Do Nam K, et al.
    High Blood Press Cardiovasc Prev, 2019 Jun;26(3):239-246.
    PMID: 31020550 DOI: 10.1007/s40292-019-00314-8
    INTRODUCTION: Hypertension (HT) is considered as a major determinant of cardiovascular complications. However, few studies have addressed HT prevalence among adults aged 60 years and older in the northern mountainous region of Vietnam.

    AIM: To determine the prevalence of HT and its risk factors in the elderly in that area.

    METHODS: A cross-sectional study was conducted in a study area in the northern of Vietnam. We interviewed 354 adults aged 60 years or over who were randomly selected, and then measured their blood pressure.

    RESULTS: The overall HT prevalence was 62.15%. The isolated systolic hypertension (ISH) prevalence was 22.88%. There was a slight decrease in the proportion of HT by stage 1, stage 2 and stage 3 respectively. The univariate and multivariate logistic regression analysis indicated some risk factors for HT including age groups, body mass index (BMI) and waist-hip ratio (WHR) (p 

    Matched MeSH terms: Obesity/physiopathology
  13. Mustapha S, Mohammed M, Azemi AK, Yunusa I, Shehu A, Mustapha L, et al.
    Oxid Med Cell Longev, 2021;2021:8830880.
    PMID: 33995826 DOI: 10.1155/2021/8830880
    The role of the endoplasmic reticulum (ER) has evolved from protein synthesis, processing, and other secretory pathways to forming a foundation for lipid biosynthesis and other metabolic functions. Maintaining ER homeostasis is essential for normal cellular function and survival. An imbalance in the ER implied stressful conditions such as metabolic distress, which activates a protective process called unfolded protein response (UPR). This response is activated through some canonical branches of ER stress, i.e., the protein kinase RNA-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme 1α (IRE1α), and activating transcription factor 6 (ATF6). Therefore, chronic hyperglycemia, hyperinsulinemia, increased proinflammatory cytokines, and free fatty acids (FFAs) found in diabesity (a pathophysiological link between obesity and diabetes) could lead to ER stress. However, limited data exist regarding ER stress and its association with diabesity, particularly the implicated proteins and molecular mechanisms. Thus, this review highlights the role of ER stress in relation to some proteins involved in diabesity pathogenesis and provides insight into possible pathways that could serve as novel targets for therapeutic intervention.
    Matched MeSH terms: Obesity/physiopathology*
  14. 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*
  15. 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*
  16. 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
  17. 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*
  18. Ellulu MS
    Inflammopharmacology, 2017 Jun;25(3):313-328.
    PMID: 28168552 DOI: 10.1007/s10787-017-0314-7
    Obesity means the accumulation of excessive fat that may interfere with the maintenance of optimal state of health. Obesity causes cardiac and vascular disease through well-known mediators such as hypertension, type-2 diabetes mellitus, and dyslipidemia, but there are evidences for other mediators such as chronic inflammation, oxidative stress, and thrombosis. The decreased levels of antioxidants factors and nitric oxide predispose to further cardiovascular adverse events. To reduce the risks, antioxidants can help by neutralizing the free radicals and protecting from damage by donating electrons. Having the capacity, vitamin C protects from oxidative stress, prevention of non-enzymatic glycosylation of proteins, and enhances arterial dilation through its effect on nitric oxide release. It also decreases lipid peroxidation, and alleviates inflammation. The anti-inflammatory property of vitamin C could be attributed to ability to modulate the NF-kB DNA binding activity and down-regulation in the hepatic mRNA expression for the interleukins and tumor factors.
    Matched MeSH terms: Obesity/physiopathology*
  19. 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*
  20. Chua EY, Zalilah MS, Haemamalar K, Norhasmah S, Geeta A
    J Health Popul Nutr, 2017 05 25;36(1):24.
    PMID: 28545536 DOI: 10.1186/s41043-017-0102-4
    BACKGROUND: The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia.

    METHODS: In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension.

    RESULTS: Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults.

    CONCLUSIONS: WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.

    Matched MeSH terms: Obesity/physiopathology*
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