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Prevalence of obesity and overweight in housewives and its relation with household activities and socio-economical status
Banshi Saboo, Praful Talaviya, Hardik Chandarana, Smita Shah, Chintal Vyas, Himanshu Nayak
January-March 2014, 1(1):20-24
Background: Overweight and obesity are the most prevalent nutritional disorders in developed and developing countries due to rapid urbanization. Presently, the incidence of overweight, obesity and their related co-morbidities is increasing rapidly in India. Obesity itself is not an acutely lethal disease, but is a significant risk factor associated with a range of serious non-communicable diseases. Obesity is a major player responsible for increasing prevalence of diabetes mellitus, hypertension, cancer and lipid disorders. Aim: The present study was aimed to evaluate prevalence of obesity in housewives (HWs) and its relation with household activity in Ahmedabad city, India. Participants and Methods: The house-to-house survey or interview-based study was carried out among HWs (n=200) from different areas of Ahmedabad city to evaluate the prevalence of obesity. All study participants were categorized based on their socio-economical status and divided into three groups; Group I as upper middle class (UMC), Group II as middle class (MC) and Group III as lower middle class (LMC). Further, the participants were subcategorized to evaluate age-specific prevalence of overweight and obesity. Overweight and obesity were defined using body mass index criteria recommended by the World Health Organization. Participants were inquired for their daily household activity and physical activity. Results: Prevalence of overweight and obesity in HWs were found higher in MC group compared with UMC and LMC group. Moreover, age specific evaluation of prevalence of overweight and obesity was found to be higher in age group of 30-45 years followed by other age groups (<30 years and 46-60 years). Involvements of HWs in daily household activities were observed to be higher in LMC than in MC and UMC. Conclusion: The results of the present study revealed that the prevalence of overweight and obesity is higher in HWs belonging to MC families, which may be due low household and physical activities. The prevalence of obesity and overweight in HWs is directly proportional to reduced daily household activity and physical in activities.
  17,957 1,188 3
56-year-old female with type 2 diabetes mellitus
Kara N Fitzgerald, Mark Hyman, Kathie M Swift
July-September 2015, 2(3):167-176
A 56-year-old female presented with type 2 diabetes (DMII), obesity, hypertension, elevated cholesterol, and sleep apnea. She was taking atorvastatin (Lipitor ® ), glyburide (Micronase ® ), metformin (Glucophage ® ), metoprolol, amlodipine, benazepril (Lotrel ® ), aspirin, and one-a-day multivitamin, and mineral supplement. Lab tests to identify underlying imbalances and to direct treatment were ordered. Treatment included dietary, nutritional, and mind-body support. After nine months of therapy, laboratory data continued to reflect improvement, including a 30-pound weight loss, improvement in blood pressure and fasting blood sugar. A1C normalized as well as liver enzymes, lipids, Vitamins D and B, and mitochondrial markers. The patient's sleep apnea resolved, and she was able to reduce her metformin and eliminate the glyburide and metoprolol. She also began regular exercises. The mentioned comprehensive lifestyle management offered with detailed knowledge and professional skills attenuated DMII mellitus and its co-morbid conditions in this patient. The case report aptly illustrates and emphasis that today's medical fraternity often unduly depends on pharmacological therapy neglecting the nonpharmacological intervention for noncommunicable diseases.
  14,975 53 -
Metformin: A Journey from countryside to the bedside
Gauri R. Patade, A. Rosalind Marita
April-June 2014, 1(2):127-130
The discovery of metformin as an anti-diabetic drug spans three centuries-beginning in the herb, Galega officinalis in the 17 th century and ending in its launch as "Glucophage" in the 20 th century. Extract from the leaves of G. officinalis was used to treat many ailments such as fever, plague and symptoms of diabetes. The herbal extract contains guanidine and galegine as major chemical components. These compounds, although had an anti-diabetic effect, were too toxic for clinical use. Discovery of antimalarial drug, paludrine which also had blood glucose lowering activity, at the Imperial Chemical Industries, UK prompted evaluation of paludrine analogues, as potential anti-diabetic agents. This speculation was also based on the structure of paludrine, which partly resembled galegine, a compound present in the extract of G. officinalis. This development coupled with Garcia's positive results using flumamine, a guanidine analogue, on 'flu' fever accelerated the evaluation of guanidine and galegine analogues for anti-diabetic activity. These efforts culminated in the discovery of metformin, introduced as 'Glucophage', by Jean Sterne, in 1957. In this article, we have highlighted the journey of metformin from a common countryside herb to its present day status of a 'Wonder Drug' sitting at the bedside of diabetic patients.
  14,547 163 8
Prevalence of overweight and obesity among young female college students in Chennai city
C Kalaivani Ashok, S Karunanidhi
January-March 2016, 3(1):23-31
Introduction: Late adolescents are tomorrow's adult population; assessment of their nutritional status is, therefore, primary to the prevention of noncommunicable diseases. Methodology: An ex post facto study using a cross-sectional survey design was employed to find out the prevalence of overweight and obesity among young female college students in Chennai. A total of 2765 female college students aged 17-21 from 10 women's colleges in Chennai city were included in the study. Anthropometric assessments included body mass index (BMI) and body fat percent. Dietary intake was assessed using a three 24 h dietary recall. Socioeconomic status (SES) of the sample was assessed using the Kalliath SES inventory. Results: Assessments of BMI indicated that only half the number of female college students (54.8%) had normal weight, while quite a few students were either overweight (13.2%) or obese (5.2%). More than a quarter of female college students were also underweight (26.9%). Mean energy intake of the students was (1828 kcal) lower than the Indian Council of Medical Research recommended values. The average intake of fruits, leafy vegetables, and other vegetables were dismally low. Conclusion: The findings reflect both a dual burden situation and an improper dietary pattern prevailing among the population of young female college students, necessitating the need for appropriate nutrition intervention.
  10,525 236 1
Child and adolescent obesity in Nigeria: A narrative review of prevalence data from three decades (1983-2013)
Chukwunonso E. C. C. Ejike
July-September 2014, 1(3):171-179
Child and adolescent overweight and obesity have become an important global public health problem. Prevalence data for pediatric overweight and obesity in Nigeria are available. However, a review of such data is unavailable, and is, therefore, reported in this paper. A total of 37 full-length papers and 5 detailed abstracts which met the inclusion criteria were reviewed. The subjects in the reviewed papers were 2-20 years of age. Sixty nine percent and 14% of the studies were conducted in urban and rural areas, respectively. As much as 74% of the papers and 65% of the participants were from the South of Nigeria. Half of the papers used the World Health Organization reference standards for diagnosis. When apparent outliers were excluded, the prevalence of obesity in the "adolescents only" and "children and adolescents" subgroups were 0.0-2.8% and 0.0-5.8%, while for overweight in the respective groups they were 1.0-8.6% and 5.0-12.0%. The data from this study suggests that prevalence rates of obesity and overweight in Nigeria are not only lower than the figures reported from other parts of the world, but have also remained stable (albeit within wide margins) during the period.
  9,456 47 7
Prevalence of metabolic syndrome in Mumbai City, India
Jagmeet G Madan, Ankita M Narsaria
January-March 2016, 3(1):16-22
Background: Metabolic syndrome (MetS) is a complex web of metabolic factors that are associated with a 2-fold risk of cardiovascular diseases and a 5-fold risk of diabetes. There are lacunae of Indian studies regarding its prevalence with special reference to metropolitan cities such as Mumbai, India. Aim: To determine the prevalence of MetS in apparently healthy adult male population from Mumbai city based on their anthropometric, biochemical, and clinical health markers. Materials and Methods: This study was a cross-sectional study comprising 313 apparently healthy adult males aged 18-65 years from upper-middle-income group from different locales of Mumbai. A standardized pretested questionnaire was used to collect data regarding demographic characteristics, anthropometric parameters, and biochemical and clinical health markers using standardized methods. The data were analyzed using SPSS statistical software. Any observed difference was considered statistically significant with P < 0.05. Results: The mean age of the subjects was 46 years. The prevalence of MetS was 40% with 82% of the population surveyed being overweight and obese and 70.3% of the population with waist circumference of ΃90 cm. It was observed that 36% of the subjects were prehypertensives and 23.4% had systolic and/or diastolic blood pressures ΃140/90 mmHg. Almost 40% of the subjects had dysglycemia with 34% of the subjects with high triglycerides, 26% with high total cholesterol, 64% with raised serum low-density lipoprotein cholesterol, and almost 66% with low serum high-density lipoprotein cholesterol levels. A significant positive correlation was observed between anthropometric and biochemical markers. Conclusion: In apparently healthy adult population of Mumbai, the prevalence of MetS was 40%. A significant positive correlation was observed between anthropometric, clinical, and biochemical markers. The study highlights the need for intervention to lower the risk markers predisposing the urban population to noncommunicable diseases.
  8,022 368 4
Body fat percentage and its correlation with dietary pattern, physical activity and life-style factors in school going children of Mumbai, India
Jagmeet Madan, Neha Gosavi, Paarmi Vora, Princee Kalra
January-March 2014, 1(1):14-19
Introduction: Nutritional status of Indian children is a double-edged sword, reflecting dual burden of malnutrition. The standard norm of body mass index (BMI) percentiles may not reflect adiposity in children at both ends of the spectrum of malnutrition. The aim of the following study was to estimate body fat percentage of school-going children of different socio-economic strata and to compare it with BMI percentiles in an effort to identify the lean obese in malnourished children. An attempt was also made to correlate body fat percentage with dietary intake pattern and life-style factors including levels of physical activity, breakfast-eating patterns, frequency of eating out and sleep patterns. Materials and Methods: The sample comprised of 764 school-going children aged 10-17 years from private and government schools of Mumbai with a majority in the age group of 10 to 15 years. Results: The results indicate a high prevalence of underweight in government and private school children (82.7% and 55% respectively) based on BMI percentiles. A high percentage of government school and private school children (69.1% and 39.4%, respectively) were also classified in the category of very less body fat. The mean BMI was 18.97±3.79 and 16.09±2.9, respectively and the mean body fat percentage was 17.43±9.79 and 11.29±7.0 respectively in private and government school children There was an increase in the percentage of children who were overweight and obese in private schools (from 4.9% to 22.9%) and in government schools (from none to 4.3%) when they were classified based on body fat percentage. A number of children in underweight and normal categories of BMI did show high body fat percentage. Body fat was positively correlated to poor quality of eating and lifestyle factors including quantum of refined flour bakery products (P=0.001), eating out frequency (P=0.001), less duration of sleep (P=0.001), increased TV-viewing (P=0.013); it was negatively correlated to frequency and quantity of salad consumption (P=0.001), regular breakfast-consumption pattern (P=0.001) and increased level of physical activity (P=0.001). Conclusion: The study gives an insight in body fat percentage of Indian children and its relationship to dietary pattern and life-style factors.
  7,573 335 1
Relationship between body adiposity and arterial stiffness in young Indian adults
Jeyasundar Radhakrishnan, Narasimman Swaminathan, Natasha Pereira D'Souza, Samantha Carneiro, Gretel Goveas, Dionne Matthew, Keiran Henderson, David A Brodie
January-March 2016, 3(1):3-10
Background: Obesity is one of the major cardiovascular risk factors and is linked with arterial stiffness. This study was undertaken to establish the relationship between regional adiposity and arterial stiffness using simple noninvasive techniques. Methods: In total, 181 young Asian Indian adults aged 18-28 years (mean age 21.9 ± 2.2) were measured for adiposity and arterial stiffness. Total body fat percentage was derived from skinfold thickness of various body sites. Body mass index and waist-hip-ratio were also measured. Arterial stiffness was measured using a SphygmoCor with a carotid-radial pulse wave analysis technique. Results: Significant gender differences were observed on anthropometric variables including skinfold thickness (P < 0.05) and all the arterial stiffness variables (P < 0.05) except pulse wave velocity. Systolic pressure, augmentation pressure, augmentation index (AIx), AIx at 75% heart rate, and aortic systolic pressure had statistically significant correlations with all three adiposity variables (P < 0.05). Significant correlations were found in a higher number of variables in the females. Physical activity had negative correlations with arterial stiffness and adiposity variables (P < 0.05). Conclusion: Arterial stiffness measured by carotid-radial pulse wave analysis is strongly related to adiposity measured from skinfold thickness in females. Females had higher arterial stiffness and adiposity compared with men. These findings could be helpful in future research using noninvasive arterial stiffness measurements.
  7,669 162 -
Glucagon - like peptide-1 receptor agonists in obesity management
Sanjay Kalra
April-June 2014, 1(2):85-88
Obesity is a fast growing pandemic, for which there are limited pharmacological options. This review describes the functional impairment of glucagon-like peptide (GLP-1) observed in obesity, and assesses the impact of the novel class of glucagon-like peptide-1 receptor agonists (GLP-1- RA) on weight. It discusses weight loss observed with GLP-1- RA use in subjects with and without diabetes, and assesses their safety and tolerability
  7,575 75 -
Study of atherosclerotic risk markers in patients with nonalcoholic fatty liver disease
Ritu Karoli, Jalees Fatima, Vaibhav Shukla, Ahraz Ahmad Khan, Mahima Pandey, Ritu Mishra
January-March 2016, 3(1):11-15
Introduction: Nonalcoholic fatty liver disease (NAFLD) is described as hepatic component of metabolic syndrome as close association exists between the two. It has gained lots of importance in midst of rising epidemic of obesity worldwide in recent times as one of the predisposing risk factors of cardiovascular events. Study Design: The study design was a cross-sectional hospital-based study. Materials and Methods: Forty-eight patients diagnosed to have NAFLD were assessed for insulin resistance (IR) and noninvasive markers of subclinical atherosclerosis and compared with age, gender, and body mass index-matched controls. Results: The patients with NAFLD had significantly higher waist circumference, diastolic blood pressure, fasting insulin, homeostasis model assessment-IR, and significantly lower levels of high-density lipoprotein-cholesterol. They also had significantly higher carotid intima media thickness (CIMT) than controls. Mean CIMT was 0.76 ± 0.12 mm in patients with NAFLD and 0.54 ± 0.18 mm in controls. This difference was statistically significant (P = 0.001). The mean increase in brachial artery diameter was 0.26 ± 0.13 mm in patients and 0.48 ± 0.09 mm in controls. Conclusion: Patients with NAFLD have greater propensity to develop cardiovascular disease in view of the presence of subclinical atherosclerotic markers compared to controls.
  6,721 113 -
Socioeconomics of obesity: A need for a national policy and a professional vigilance council
Ashok D.B. Vaidya
January-March 2016, 3(1):1-2
  6,536 153 -
Ectopic fat: The potential target for obesity management
Soumitra Ghosh
January-March 2014, 1(1):30-38
Accumulation of fat at ectopic sites rather than mere increase in body fat can explain almost all metabolic consequences of obesity. Certain characteristics of adipocytes like increased size and ectopic accumulation make them metabolically sick. Hence 'adiposopathy' seems to be more important than just 'adiposity'. Genetic and epigenetic factors, along with intra-uterine factors determine ectopic fat accumulation. These three factors result in low subcutaneous adipose tissue (SAT) volume leading to 'spillover' of excess fat to ectopic sites; determining 'metabolic economy', by creating a 'thrifty phenotype' with calorie excess later in life resulting in 'maladaptation' and excess weight gain. This is particularly important for South Asians who have been found to have low SAT volume and possess a 'thrifty phenotype'. Obesogenic diet and lack of physical activity contribute to ectopic fat deposition by creating a positive energy balance. Increased fructose and trans-fat consumption are important determinants of obesity and ectopic fat deposition. The good news is that ectopic fat is very responsive to treatment, disappearing at a faster rate with minimal weight loss, resulting in improvement in metabolic and organ functions. Physical activity causes negative energy balance and improves 'metabolic flexibility'. Targeting 'ectopic fat' should be the highlight of obesity management today and its primordial prevention should aim at targeting maternal nutrition.
  6,437 214 4
Single dose metformin kinetics after co-administration of nisha-amalaki powder or mamejwa ghanavati, ayurvedic anti-diabetic formulations: A randomized crossover study in healthy volunteers
Amrutesh Puranik, Nutan Nabar, Jayashree Joshi, Ashok Amonkar, Sanjiv Shah, Sasikumar Menon, Rama Vaidya, Ashok D.B. Vaidya
April-June 2014, 1(2):99-104
Objective: The aim was to study herb-drug interaction of two ayurvedic formulations - DMFN01 (Nisha-Amalaki) powder and DMFN02 (Mamejava) ghanavati with metformin at a single dose in healthy volunteers. Materials and Methods: This was an open-labelled, single dose, crossover, and randomized volunteer study. Healthy volunteers were studied in two groups (6/group). Volunteers were randomized to oral metformin (500 mg single dose) alone or with concurrent DMFN01 (10 g), or DMFN02 (750 mg). Venous blood samples were collected at different time points from 0 to 24 h. Plasma metformin concentrations were measured by high performance liquid chromatography coupled with an ultraviolet detector. Results: Simultaneous administration of DMFN01 with metformin showed a reduction in the mean area under the curve (AUC [0-24 h]) of metformin by 51% (P < 0.002) when compared with metformin alone. However, co-administration of DMFN02 did not show any significant difference in the mean AUC of metformin (P = 0.645). One volunteer had a reduction of 41% in AUC of metformin with DMFN 02. Conclusions: These data raise relevant questions on therapeutic control of hyperglycemia when DMFN01 choorna is given concurrently with metformin. Based on known absorption pattern of metformin an interval of 2 h between the oral doses of metformin and ayurvedic formulations would be advisable to avoid interactions. In reverse pharmacological studies, at an early stage, such interaction studies are desirable.
  6,153 181 2
Obesity and surgical management in indians: A literature review
Anish Desai, Reshmi Pillai, Sandeep Sewlikar, Nilesh Mahajan
January-March 2015, 2(1):22-29
The prevalence of obesity and related co morbid conditions are on an exponential growth globally as well as in developing countries like India encompassing children to elderly population with disregard to socioeconomic status. This review is an attempt to evaluate the published work on obesity and bariatric/metabolic surgery in Indian obese patients to identify gaps in evidences. Based on the current literature research, it can be concluded that there is a need for updated information on the prevalence of obesity in Indian sub-continent. The latest National Family Health Survey is of 2007/2008 and WHO data is of 2010. The increasing prevalence of obesity and metabolic syndrome and perception of disease emphasizes that there is a need for effective communication and education to mothers to bring awareness and reduce the burden in India. Effective outcome with respect to weight loss was observed with Roux-en-Y Gastric Bypass (RYGB), laparoscopic sleeve gastrectomy (LSG), like adjustable gastric banding and also mini-gastric bypass. This weight loss was stable over long follow-up for majority of patients with a reduction of body mass index ranging from 10 to 14 kg/m 2 3 years after bariatric surgery (BS). With respect to treating type 2 diabetes mellitus (T2DM) RYGB and LSG are the two most published metabolic procedure in Indians for surgical treatment of T2DM. No mortality has been recorded so far in published literatures for any types of procedures. BS offers economic benefit to patients in the long run however further studies are warranted.
  5,868 264 2
A thought that turned into reality -an interview with Dr. Vinod Dhurandhar, founder president AIAARO
Pallavi Patankar
January-March 2014, 1(1):58-61
Dr. Vinod Dhurandhar, the founder President of the All India Association for Advancing Research in Obesity (AIAARO), is one of the first doctors to treat obesity in India. He has more than 50 publications to his credit. He has treated over 65,000 obese individuals and has worked wonders on many, including several celebrities. He has trained many physicians and dieticians on how to tackle obesity and has organised various camps and lectures. His contribution to the field of obesity has brought him tremendous recognition and fame. Dr. Pallavi Patankar, President AIAARO (who is also one of the founder members of the Association), took some time off one afternoon to interview Dr. Dhurandhar.
  5,667 66 -
Obesity among Indian adolescents: Some emerging trends
Anita Malhotra
January-March 2014, 1(1):46-48
An epidemic of obesity has engulfed children and adolescents across the developed and the developing world in recent years and India is not unscathed by this crisis in public health. This article underscores some emerging trends in obesity among Indian adolescents.
  5,328 292 -
A cross-sectional study of childhood and adolescent obesity in affluent school children from western suburb of Mumbai 2001-2002 and 2013-2014
Shefali Pandey, Anupama Bhaskaran, Shubhada Agashe, Rama Vaidya
January-March 2014, 1(1):7-13
Introduction: Change in lifestyle patterns associated with genetic factors is causing increasing prevalence of childhood and adolescent obesity in India. Obesity during childhood and adolescence puts these children at a high risk for adult cardio-metabolic disorders and other chronic diseases. It is important that this avalanche is prevented in time by comprehensive school health education programmes and other timely interventions. An observational cross-sectional study, as a part of the School Health Education and Enlightened Living (SHEEL) project, was conducted to assess the prevalence in childhood overweight and obesity during the academic years 2000-2001 and 2013-2014 at a private school. Materials and Methods: As a part of the SHEEL project, a total of 2421 children consists of 1346 boys and 1075 girls (age ranged, 4 -15 years) were evaluated for their height (stadiometer), weight (electronic weighing scale) and body mass index (BMI) during the academic year 2000-2001 (stage 1 study). We approached the same school again in the academic year 2013-14 (stage 2 study). In this stage, a total of 2056 children (1067 boys and 989 girls; age range 5-15 years) were measured for the same parameters to evaluate in childhood and adolescent obesity when compared with that observed in 2000-2001.The measurements were plotted on gender specific BMI charts (Center for Disease Control and Prevention [CDC] charts) for obtaining percentiles. Identification of overweight and obesity was arrived at by CDC centile charts. Results: The stage 1 study done during the academic year 2000-2001 in school children from an affluent class of society showed a prevalence of overweight, in girls as 16.7% (180/1075) and in boys, 13.7% (185/1346). The prevalence of obesity for the total number of children was 15.3% (14.2% in 1075 girls and 16.1% in 1346 boys). In stage 2 study done during the academic year 2013-2014 in the same school, prevalence of overweight in girls was 16% (158/989) and in boys, 15.3% (163/1067) and the prevalence of obesity was 11.1% (9.1% in 989 girls and 12.9% in 1067 boys). If children at risk for obesity (overweight) and obese were clubbed together, nearly 1/3 of the children, 30.4% in 2001 and 26.7% in 2013, had above-normal BMI percentiles. In this study, the percentage of children showing overweight/obesity increased from the age groups 7 to 8 years and above as compared to the younger age groups. Conclusions: The current cross-sectional study shows that the prevalence of childhood and adolescent overweight and obesity amongst children from a upper-socio-economic stratum of society has remained high at 25-30% during both the periods of the school-based study. However, the trend for the prevalence of overweight and obesity in this >10 years has shown a definite decline of 5.8% in girls, while the decline of 1.6% in boys was not as remarkable.
  5,208 265 -
Comparison of efficacy and safety of metformin, oral contraceptive combination of ethinyl estradiol and drospirenone alone or in combination in polycystic ovarian syndrome
Jyoti A. Bobde, Deepak Bhosle, Rajesh Kadam, Satish Shelke
April-June 2014, 1(2):112-117
Introduction: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder, which can cause various reproductive complications and is associated with metabolic syndrome. In India, strong comparative evidence of oral contraceptive pills (OCP), metformin or their combination in treatment of polycystic ovarian disease is lacking. Objectives: The objective of this study is to compare the efficacy and safety of metformin alone, OCP containing drospirenone or a combination of OCP and metformin in patients with PCOS. Materials and Methods: This was an open-label, randomized, parallel group, and comparative three-arm prospective study, in 60 patients. Patients either received OCPs containing etinyl estradiol plus drospirenone, metformin or combination of OCPs plus metformin for 6 months. Luteinizing hormone: Follicle stimulating hormone (LH:FSH) ratio, serum insulin level, ovarian morphology, body mass index (BMI), acceptance of treatment, regularization of the menstrual cycle and improvement in acne and hirsuitism were evaluated. Results: In patients receiving metformin either as monotherapy or in combination showed significant improvement in BMI. All the study medicines were effective in significantly decreasing ovarian volume, LH/FSH ratio and serum insulin level. Improvement in acne was better in patients receiving OCPs either as monotherapy or in combination with metformin. Improvement in hirsuitism and regularization of the menstrual cycle was highest in patients receiving combination treatment. Acceptance of treatment was maximum in patients receiving monotherapy of OCPs. The total incidence of adverse events was 16.7% (15%, 15% and 20% in OCP, metformin, and combination group, respectively). Conclusion: OCPs containing ethinylestradiol plus drospirenone, metformin, and combination of both are effective and well tolerated in the management of PCOS. Metformin either as monotherapy or combination can be preferred in cases with high BMI. Combination of metformin plus OCP regularizes menstrual cycle better than monotherapy of either drug.
  5,196 172 -
The role of Vitamin D in obesity and inflammation at adipose tissue
Wysllenny Nascimento de Souza, Ligia Araujo Martini
July-September 2015, 2(3):161-166
The prevalence of obesity and vitamin D deficiency has increased in the last decade, becoming pandemics. In obesity, macrophage accumulation occurs in the adipose tissue. This is associated with a low-grade chronic inflammation and leads to the release of inflammatory cytokines. Vitamin D was found to have anti-adipogenic activity and may exert immunoregulatory effects as well as reduce the adipose tissue inflammation. Recent studies suggest that vitamin D and vitamin D receptor (VDR) play an important role in adipose tissue whereas the expression of genes of the 25-hydroxyvitamin D 1α-hydroxylase (CYP27B1) and VDR were demonstrated in human adipocytes. Growing evidence suggests vitamin D also plays a role in the type of preadipocytes, and the proneness to the inflammatory process.
  5,294 57 3
Obesity and osteoarthritis comorbidity: Insights from Ayurveda
Ashwinikumar A. Raut, Manohar S. Gundeti
April-June 2014, 1(2):89-94
Obesity and osteoarthritis are globally reaching epidemic proportions. Their concomitant association is well-known. The cumulative impact of these conditions on morbidity and the quality-of-life is sizeable, particularly for the aged. Obesity leading to osteoarthritis of the weight-bearing joints is well-appreciated. Inversely, however it is less emphasised that osteoarthritis of big joints of the lower limbs contributes to obesity because of the resultant physical inactivity. The increased adiposity is known to secrete proinflammatory cytokines that adds to the biomechanical cause of osteoarthritis. Besides mechanical and inflammatory mechanisms, genetic factors also play a causative role in both obesity and osteoarthritis as separate and concomitant disorders. The genetic and epigenetic mechanisms are gradually being unravelled for the comorbidity of obesity and osteoarthritis. Thus, the molecular pathophysiology of the concomitant existence of obesity and osteoarthritis is highly intriguing. Identifying the appropriate choice and sequence of therapeutic targets for reversal of this complex pathogenesis is a challenging task. Ayurvedic understanding of this comorbidity and experiential therapeutic base can offer a strategy for the prevention and management of the disorders. "Sthaulya" and "Sandhigatavata" are the respective clinical syndromes, described in Ayurveda for obesity and osteoarthritis. The imbalance in the respective "Dhatvagni" (metabolic paths) of "Meda-Dhatu" (adipose tissue) and "Asthi-Dhatu" (bone tissue) is the putative central pathogenetic mechanism involved for the comorbidity. The present article analyses some of the insights and experience from Ayurveda so as to provoke a meaningful debate on the opportunities for integrative care for obesity related osteoarthritis through reverse pharmacology path.
  5,153 170 1
Body Mass Index, use of Statins or Current Lipidemic Control: Do they Affect Body Fat Distribution in Sedentary Type 2 Diabetes Mellitus?
Jayesh D Solanki, Amit H Makwana, Hemant B Mehta, Chetan B Desai, Pritesh H Gandhi
April-June 2015, 2(2):79-83
Introduction: Obesity and type 2 diabetes mellitus (T2DM) are a complementary threat around the globe. Deranged body fat distribution in T2DM needs serious attention, starting from its measurement up to guiding appropriate intervention. We tried to associate parameters of body fat distribution T2DM patients with body mass index (BMI), Lipidemic control and preventive pharmacotherapy using bio-electrical impedance analysis (BIA) method. Materials and Methods: We recruited 78 sedentary (42 males, 36 females) T2DM subjects with known glycemic and Lipidemic lipidemic control. Whole body scan was done using BIA principle with Omron Karada Scan (China) to derive total body fat, subcutaneous fat, visceral fat, ratio of subcutaneous fat to visceral fat and BMI. These parameters were compared among group based on BMI, lipidemic control and use of statin/angiotensin-converting enzyme (ACE) inhibitors for difference and statistical significance. Results: Type 2 diabetes mellitus subjects had high mean age, high BMI and fair lipidemic control. All measures of body fat distribution derived by BIA were statistically significantly different among t groups separated by BMI cut-off 25. However, there was small, statistically insignificant difference of body fat parameters amongst groups based on control of high- density lipoproteins, low-density lipoprotein and triglycerides except for subcutaneous fat. Those taking statins or ACE inhibitors did not have significantly better body fat distribution than those not taking it. Conclusion: Deranged body fat distribution in T2DM measured by BIA correlated with BMI. These parameters are improved neither by lipidemic control nor by preventive pharmacotherapy. This suggests the use of other interventions like weight reduction and optimum use of BIA for monitoring utilizing primary health care resources.
  4,958 68 1
Mauriac syndrome: A preventable complication of type 1 diabetes mellitus
Yadav Vijay, Sharma Minoo, Bhardwaj Parveen
October-December 2014, 1(4):247-249
Type 1 diabetes mellitus (T1DM) is a common pediatric endocrine condition and Mauriac syndrome (MS) is described as one of the manifestation of poorly controlled diabetes. It manifests as hepatomegaly, growth delay, elevated liver enzymes, and serum lipids and glycogen accumulation in hepatocytes. We report a 7-year-old child of MS with poorly controlled T1DM. With appropriate management, the patient showed improvement symptomatically and in liver size. The fasting blood sugar and triglycerides showed a reduction.
  4,866 61 1
Association of dyslipidemia with psoriasis: A case-control study
Tushyata Arora, Arvind Krishna, Bhagirath Singh Rathore, Divya Srivastava
January-March 2016, 3(1):37-40
Background: Psoriasis has recently been recognized as a systemic disease associated with several comorbidities such as obesity and dyslipidemia. These markers have a profound effect on cardiovascular morbidity. Objectives: We aim to evaluate the lipid profiles in patients of psoriasis and compare them with healthy controls to determine any association between psoriasis and lipid abnormalities. Materials and Methods: A case-control study was performed on a study group including 33 patients of clinically proven psoriasis and an equal number of age- and sex-matched healthy volunteers, taken as controls. The fasting serum lipid profile was estimated using  J & J Vitros 250 Chemical Analyser (Ortho-Clinical Diagnostics), fully automated analyzer, after a period of 8-12 h of fasting. The data were analyzed by applying t-test for independent samples and Pearson's correlation by using GraphPad. Results: High-density lipoprotein cholesterol levels were found to be significantly lower in cases than in the control group (P = 0.028). There was a significant positive correlation between triglyceride (TG) levels and Psoriasis Area Severity Index or severity of the disease (r = 0.36, P = 0.036). No significant statistical difference was observed between total cholesterol, TGs, and low-density lipoprotein levels of the cases and control groups. Conclusion: The findings demonstrated a possible association between psoriasis and dyslipidemia which underlines the need for early screening of psoriasis patients for this cardiovascular risk factor.
  4,771 115 -
Irisin: A clue for metabolic disorders
Gutch Manish, Kumar Sukriti, Abhinav Gupta, Gupta Kumar Keshav, Razi Mohd Syed
January-March 2016, 3(1):41-45
Skeletal muscles express and elaborate a number of cytokines and other substances for modulating various metabolic processes which function locally and also target distant organs are known as myokines. Irisin is one of the most recently discovered myokines and is found to modulate effect of exercise on adipocytes through browning of white adipose tissue. Besides this, irisin is considered to be one of the future targets for therapies for metabolic disorders.
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A Case of Hypothalamic Obesity
Om J Lakhani, Mitali Desai
April-June 2015, 2(2):117-119
Hypothalamus plays a key role in satiety and food intake. Damage to the ventromedial nucleus of the hypothalamus bilaterally can lead to a syndrome of "hypothalamic obesity." This condition is characterized by hyperphagia and obesity along with other endocrinal and neurological manifestations. Suprasellar tumors like craniopharyngioma can often damage the hypothalamus leading to such a syndrome. Here, we report a case of a middle age male who presented to our endocrinology outpatient department with complaints of hyperphagia and massive weight gain over a period of 4-5 years. On hormonal evaluation, he was found to have panhypopituitarism along with central diabetes insipidus. Magnetic resonance imaging was suggestive of a suprasellar craniopharyngioma. Patient underwent craniotomy with subtotal resection of the tumor followed by radiotherapy for the residual lesion. Hypothalamus as a cause of obesity, though rare should be considered in patients who present with characteristic signs and symptoms of hypothalamic obesity.
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