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Obesity paradox

Parham Parto, Carl J Lavie, Ross Arena, Samantha Bond, Dejana Popovic, Hector O Ventura
The prevalence of obesity among adults and children worldwide has reached epic proportions and has become a major independent risk factor for the development of heart failure (HF), in addition to a contributor of hypertension and cardiovascular disease. The implications of obesity in the development of HF involve adverse effects on cardiac structure and function. Despite all of this, in the setting of chronic HF, excess body mass is associated with improved clinical outcomes, demonstrating the presence of an obesity paradox...
October 20, 2016: Future Cardiology
Samaneh Asgari, Maryam Barzin, Farhad Hosseinpanah, Farzad Hadaegh, Fereidoun Azizi, Davood Khalili
BACKGROUND: Although current data shows a positive association between obesity and development of coronary heart disease (CHD) in general population, there is limited data on the important protective role of central or general obesity in patients with prevalent CHD or the "obesity paradox", from this region. OBJECTIVES: The objective of the present investigation was to describe the relationship between BMI categories and the recurrence of CHD in patients with a history of CHD using data from a large population-based study, the Tehran lipid and glucose study (TLGS)...
April 2016: International Journal of Endocrinology and Metabolism
Satya P Sharma, Hea J Chung, Hyeon J Kim, Seong T Hong
Obesity is exponentially increasing regardless of its preventable characteristics. The current measures for preventing obesity have failed to address the severity and prevalence of obesity, so alternative approaches based on nutritional and diet changes are attracting attention for the treatment of obesity. Fruit contains large amounts of simple sugars (glucose, fructose, sucrose, etc.), which are well known to induce obesity. Thus, considering the amount of simple sugars found in fruit, it is reasonable to expect that their consumption should contribute to obesity rather than weight reduction...
October 14, 2016: Nutrients
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Ki Chul Sung
BMI is a proxy measure for adiposity in population-based studies and it is well established that increasing body fat is strongly associated with component features of the metabolic syndrome (MetS), such as dyslipidaemia (low high density lipoprotein cholesterol (HDL-C) and high triglyceride concentrations, increased glucose concentrations, high blood pressure, hypertension, and type 2 diabetes. Whether any or all of these components of the MetS account for relationships between body fatness and all cause mortality is uncertain, but we have recently shown in a large Korean cohort that co-existing cardiovascular disease (CVD), diabetes or hypertension explained much of the increased risk of CVD mortality in obese individuals...
September 2016: Journal of Hypertension
Cheng-Wei Lin, Brend Ray-Sea Hsu, Jir-Shiong Tsai, Hui-Mei Yang, Jr-Rung Lin, Chia-Hung Lin, Chung-Huei Huang, Shih-Yuan Hung, Yu-Yao Huang
AIMS: To evaluate the effect of limb preservation status and body mass index (BMI) on the survival of patients with diabetic foot ulcers (DFUs). METHODS: A total of 1346 patients treated for limb-threatening DFUs at a major diabetic foot center in Taiwan from 2002 to 2009 were tracked until December 2012. The patients were classified into three groups: limb-preserved (n=858), minor lower-extremity amputation (LEA) (n=249), and major LEA (n=239). Clinical data during treatment were used for survival analysis...
September 30, 2016: Journal of Diabetes and its Complications
Nina Braun, Claus Hoess, Alexander Kutz, Mirjam Christ-Crain, Robert Thomann, Christoph Henzen, Werner Zimmerli, Beat Mueller, Philipp Schuetz
OBJECTIVE: Positive associations between body mass index (BMI) and clinical outcomes have been found and are called "the obesity survival paradox." However, whether obesity has protective effects or if this paradox is because of confounding remains unclear. Herein, we analyzed the effects of weight on long-term mortality in a large cohort of patients with community-acquired pneumonia (CAP) and investigated whether the differential effects of obesity on inflammation pathways accounted for mortality differences...
August 9, 2016: Nutrition
Jeffrey I Mechanick, Shan Zhao, W Timothy Garvey
Adipokines are peptides, secreted by adipocytes and other cell types with targets in other tissues, participating in a complex network of humoral factors involved in obesity, insulin resistance, and cardiovascular (CV) disease. This review describes recent information about adipokine effects on the CV system. Rather than simply providing a listing of adipokines and their respective effects, network analysis is used to enhance understanding. Various relationships and emergent processes in the adipokine-CV system network are discussed, with the most significant interactors being responses to hypoxia, regulation of cell migration, effects on blood coagulation, and platelet activation...
October 18, 2016: Journal of the American College of Cardiology
Meret Branscheidt, Juliane Schneider, Patrik Michel, Elissavet Eskioglou, Georg Kaegi, Robert Stark, Urs Fischer, Simon Jung, Marcel Arnold, Maria Wertli, Ulrike Held, Susanne Wegener, Andreas Luft, Hakan Sarikaya
BACKGROUND AND PURPOSE: The impact of excess body weight on prognosis after stroke is controversial. Many studies report higher survival rates in obese patients ("obesity paradox"). Recently, obesity has been linked to worse outcomes after intravenous (IV) thrombolysis, but the number and sample size of these studies were small. Here, we aimed to assess the relationship between body weight and stroke outcome after IV thrombolysis in a large cohort study. METHODS: In a prospective observational multicenter study, we analyzed baseline and outcome data of 896 ischemic stroke patients who underwent IV thrombolysis...
2016: PloS One
Mohammad Hossein Panahi, Farzad Hadaegh, Parvin Yavari, Sara Kazempour-Ardebili, Yadollah Mehrabi, Fereidoun Azizi, Davood Khalili
INTRODUCTION: Controversial findings are reported on the risk of cardiovascular disease in chronic kidney disease (CKD). There are some interactions between CKD and other metabolic disorders including metabolic syndrome (MS) and obesity regarding coronary heart disease (CHD) outcomes. MATERIALS AND METHODS: A total of 2823 men and 3684 women aged 30 years and older, without cardiovascular disease, were followed for 10 years. Multivariable adjusted hazard ratio of CHD was estimated for those who developed CKD, MS or both by sex and body mass index levels below and above 27 kg/m2...
September 2016: Iranian Journal of Kidney Diseases
Lixian Cheng, Hui Shi, Yan Jin, Xiaoxi Li, Jinshun Pan, Yimei Lai, Yan Lin, Ya Jin, Gaurab Roy, Allan Zhao, Fanghong Li
Adipose tissue plays an important role in regulating female fertility owing to not only its energy stores but also the endocrine actions of secreted adipokines. As one of the adipokines, adiponectin is almost exclusively secreted from the fat and its circulating concentration is paradoxically reduced in obesity. Although recent studies implied a purported positive role of adiponectin in ovarian functions, definitive in vivo evidence has been sorely lacking. We have consistently observed subfertility in female adiponectin null mice, and therefore postulated a protective role of adiponectin in ovarian functions...
October 4, 2016: Endocrinology
Joel T Haas, Bart Staels
Oxidative stress has long been considered a key driving factor of many obesity-related health problems. However, recent work by Merry, Tran et al (Diabetologia DOI 10.1007/s00125-016-4084-3 ) challenges this idea with an interesting study using a hepatocyte-specific Gpx1-knockout (HGKO) mouse. GPX1 is an important detoxification enzyme that converts H2O2 to water. The authors found that high-fat diet-fed HGKO mice were more insulin sensitive than wildtype controls, despite elevated hepatic levels of H2O2 and evidence of increased systemic oxidative stress...
October 1, 2016: Diabetologia
Lewan Parker, Nigel K Stepto, Christopher S Shaw, Fabio R Serpiello, Mitchell Anderson, David L Hare, Itamar Levinger
Background: Obesity and aging are associated with increased oxidative stress, activation of stress and mitogen activated protein kinases (SAPK), and the development of insulin resistance and metabolic disease. In contrast, acute exercise also increases oxidative stress and SAPK signaling, yet is reported to enhance insulin sensitivity and reduce the risk of metabolic disease. This study explored this paradox by investigating the effect of a single session of high-intensity interval-exercise (HIIE) on redox status, muscle SAPK and insulin protein signaling in eleven middle-aged obese men...
2016: Frontiers in Physiology
Benjamin Struecker, Matthias Biebl, Mehran Dadras, Sascha Chopra, Christian Denecke, Johanna Spenke, Ann-Christin Heilmann, Marcus Bahra, Igor Maximilian Sauer, Johann Pratschke, Andreas Andreou
BACKGROUND: Obesity is generally considered to be associated with increased postoperative morbidity and mortality following intraabdominal cancer surgery. However, recent reports showed that overweight patients may have a lower risk for adverse postoperative outcomes and this observation has been described as the 'obesity paradox'. Therefore, we aimed to analyze the impact of obesity on outcomes after resection for gastric cancer. METHODS: Data of patients who underwent resection for gastric cancer between 2005 and 2012 were assessed...
October 1, 2016: Digestive Surgery
M Bagheri, J R Speakman, F Shemirani, K Djafarian
BACKGROUND: In healthy subjects increasing BMI leads to greater mortality from a range of causes. Following onset of specific diseases, however, the reverse is often found: called the 'obesity paradox'. But we recently observed the phenomenon called the 'paradox within the paradox' for stroke patients. OBJECTIVE: The objective of our study was to examine the effect of each unit increase in BMI on renal cancer-specific survival (CSS), cancer-specific mortality (CSM), overall survival (OS) and overall mortality (OM)...
September 30, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Guo Zhi, Wang Xin, Wang Ying, Xing Guohong, Liu Shuying
BACKGROUND: It is unclear whether an "obesity paradox" exists in the respiratory system, especially in acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Previous studies have postulated a causal relation between obesity and ARDS/ALI but have lacked power to form a definitive conclusion. OBJECTIVE: To investigate the relationships between obesity, ARDS/ALIrisk, and mortality. METHODS: A systematic search current to April 2016 was performed in Pubmed, EMBASE, Medline, Cochrane databases to find relevant studies...
2016: PloS One
Sergey V Brodsky, Rolf F Barth, Xiaokui Mo, Vedat Yildiz, Patricia Allenby, Iouri Ivanov, Stephen Moore, Charles L Hitchcock, Stephen Smith, Taha Sachak, Keluo Yao, Matthew Ball, Kelly Rosborough, Zachary Olson, Micah Kiehl, Navin Muni, Renu Virmani
BACKGROUND AND AIMS: Morbid obesity generally has been associated with higher morbidity and mortality for a variety of diseases. However, a number of exceptions to this have been reported and referred to as the "obesity paradox." The purpose of the present study was to obtain objective data on aortic atherosclerosis and its relationship to body mass index (BMI, kg/m(2)), based on autopsy findings in a large cohort of overweight and obese decedents. METHODS: Decedents were ≥18 years who had autopsies between 2003 and 2014, a subset of whom were morbidly obese (BMI≥40)...
September 13, 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Mi-Sung Kim, Sarah A Krawczyk, Ludivine Doridot, Alan J Fowler, Jennifer X Wang, Sunia A Trauger, Hye-Lim Noh, Hee Joon Kang, John K Meissen, Matthew Blatnik, Jason K Kim, Michelle Lai, Mark A Herman
Obese, insulin-resistant states are characterized by a paradoxical pathogenic condition in which the liver appears to be selectively insulin resistant. Specifically, insulin fails to suppress glucose production, yet successfully stimulates de novo lipogenesis. The mechanisms underlying this dysregulation remain controversial. Here, we hypothesized that carbohydrate-responsive element-binding protein (ChREBP), a transcriptional activator of glycolytic and lipogenic genes, plays a central role in this paradox...
September 26, 2016: Journal of Clinical Investigation
Barbara E Stähli, Cathérine Gebhard, Michael Gick, Colmsee Herman, Miroslaw Ferenc, Kambis Mashayekhi, Heinz Joachim Buettner, Aurel Toma
BACKGROUND: The obesity paradox has been described in different patient populations. Data on the relation between obesity and outcomes in patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) are lacking. Therefore, long-term mortality in patients undergoing CTO PCI was assessed according to different body mass index (BMI) categories. METHODS: A total of 1993 patients undergoing CTO PCI at a tertiary care center between January 2005 and December 2013 were divided into five different BMI categories: underweight, <18...
September 16, 2016: International Journal of Cardiology
Thozhukat Sathyapalan, Zeeshan Javed, Eric S Kilpatrick, Anne-Marie Coady, Stephen L Atkin
CONTEXT: Animal studies suggest that cannabinoid receptor-1 (CB-1) blockade reduces inflammation and neovascularization by decreasing vascular endothelial growth factor (VEGF) levels associated with a reduction in inflammatory markers, thereby potentially reducing cardiovascular risk. OBJECTIVE: To determine the impact of CB1 antagonism by rimonabant on VEGF and inflammatory markers in obese PCOS women. DESIGN: Randomized, open-labelled parallel study...
September 21, 2016: Clinical Endocrinology
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