Tag Archives: obesity

Obesity and Calcium Oxalate Renal Stones

Introduction: Kidney stones are a major cause of morbidity. The lifetime prevalence of symptomatic renal stones is approximately 10% in men and 5% in women. The rate of backsliding for calcium oxalate stones is 10% in one year, 30% in 5 years and 50% in 10 years. Urine pH is one of the important factors for urinary stone formation.
Material and methods: We studied 283 renal stone formers (131 men, 152 female), divided according to their BMI (body mass index) in normal body weight (BMI <25 kg/m2), overweight (BMI 25–30 kg/m2) and obese (BMI >30 kg/m2).
Results: Urine pH is inversely related to BMI among patients with urolithiasis (higher BMI will have lower urine pH). The mean urine pH of the normal body weight, overweight, and obese groups was 6.1, 5.5 and respectively 5.7 (p <0.0001).
Conclusions: Obesity is associated with both hypercalciuria and with proteinuria, demonstrated factors in the etiology of urolithiasis, and urinary pH is inversely related to BMI in patients with urinary stones.

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The Results of ARFI (Acoustic Radiation Force Impulse) Elastographic Assessment of Liver Aspect and NAFLD (Non-alcoholic Fatty Liver Disease) in Pediatric Obese Patients Compared to Normal-weight Children

Background: The incidence of obesity has dramatically increased in the last few years, and associated disorders such as non-alcoholic fatty liver disease (NAFLD) constitute a serious threat. The objective of our study was to assess the liver aspect of obese children and adolescents by real-time elastography, ARFI-technique, compared to the liver aspect of normal-weight children.
Methods: Eighty-six children, aged 3–18 years, admitted to the County Emergency Clinical Hospital of Tîrgu Mureș between 15 September 2010 and 15 April 2012, were recruited for the study. They were included in two groups: 39 overweight/obese children and 47 normal-weight healthy controls. We evaluated the liver-tissue elasticity by measuring the Shear Wave Velocity (SWV), globally and separately for segments 1 and 8 in order to detect possible differences beetween them, knowing that the caudate-lobe has it’s own vasculature; we also evaluated biochemical parameters (transaminases, etc). Correlations between SWV and laboratory tests were established using non-parametric Spearman correlation test.
Results: In healty children in the 1st segment SWV was 1.012±0.31 m/s, smaller than in the 8th segment, 1.342±0.32 m/s (p = 0.0316). For obese children, SWV was higher in the 8th segment 1.982±0.85 m/s compared to the 1st segment 1.325±0.27 m/s (p <0.0001). Globally in obese children, the SWV was 1.746±0.49 m/s, significantly higher than in healthy children, 1.080±0.27 m/s (p = 0.0023). Positive statistical correlations have been established between SWV and aspartate-aminotransferase in obese (r = 0.61, Pearson correlation p = 0.025), with no statistically significant differences for other laboratory findings.
Conclusion: Elastographic evaluation of liver alterations in obesity by ARFI-method shows higher SWV, which could be translated in fibrosis and necroinflammatory activity. According to our study, these alterations in liver tissue affect mainly the right lobe of the liver.

 

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Using Abdominal CT Data for Visceral Fat Evaluation

DOI: 10.2478/amma-2013-0058

Background: Quantitative assessment of body fat is important for the diagnosis and treatment of diseases related to obesity, Computed tomography (CT) becoming the standard procedure for measuring the abdominal fat distribution.
Material and method: The retrospective study included 111 inpatients, who underwent routine abdominal CT exams in the Radiology Laboratory of SCJU Tg.Mures (2013). MPR MDCT (SOMATOM AS 64) data was processed using a custom written MATLAB R2009b software, ImageJ being used for tracing of the visceral fat area (VFA). Patient data (including blood glucose, cholesterol and triglycerides) were analyzed using MO Excel and GraphPad Inprism5.
Results: Visceral Fat percentage varied in population from 14.59–68.69 (SD = 11.83) with significant difference between sexes (male vs. female, 46.98 vs. 31.62, p <0.05). Cholesterol values >220 mg% and triglycerides >150 mg% are significantly associated with the VF percent (p <0.05). Overall there is a weak correlation between the lab variables and the measured fat, the strongest one being between triglycerides and the VFA (r = +0.23) and between age and VFA percentage (certain samples).
Conclusions: The technique used should decreases the human error in marking of the fat areas providing a better estimation of the VF/VF percentage. CT measured VF relates with certain lab tests. Further analysis, is required for a better use of CT in obesity related pathology diagnosis and treatment.

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Obesity Treatment Strategies

DOI: 10.1515/amma-2015-0076

Obesity is a disease with severe health consequences and increased risk of mortality. The most commonly used criteria to assess the presence and the severity of obesity are body mass index, waist circumference, waist-to-height ratio and the presence of the health conditions caused or worsened by obesity. Worldwide obesity has more than doubled in the last 4 decades. Obesity is the second of the leading preventable causes of death worldwide (after smoking). Obesity has a plurifactorial pathogenesis. The central perturbation consists in the imbalance between calories intake and calories consumption (by inappropriate diet and sedentary lifestyle). Identification of all the ethiological factors is important for treatment and prophylaxis. Weight loss benefits are multiple and important: improvement in glicemic control and in plasma lipid levels, blood presure control, obstructiv sleep apneea reduction, improvement in management of daily activities and profesional performances, increase quality of life, reduction in mortality. Overweight or obese patient will complete a diagnostic and a treatment program. Treatment of obesity claims a targeted multidimensional therapy: weight and lifestyle management, diet, sustained physical activity in daily life, exercise, decrease life stressors, smoking cessation, drug therapy, bariatric surgery psichological, familial and social suport. Weight loss program must be carefully planned, adapted to the patient’s abilities and comorbidities and supervised by a nutritionist and a physiotherapist.

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