To identify target energy balance-related behaviors (ERBs), baseline data from 141 overweight or obese schoolchildren (aged 8-14 years old) was used to predict adiposity [body mass index (BMI) and fat percentage] one year later. The ERBs included a modified Dietary Approach to Stop Hypertension diet score (DASH score), leisure-time physical activity (PA, days/week), and leisure screen time (minutes/day). Several cardiometabolic variables were measured in the fasting state, including systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose (GLU), total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C). BMI and fat percentage were measured using a BIA body composition analyzer (MC-980MA, TANITA, Tanita Co., Guangzhou, China). Partial correlation coefficients (partial r) and multiple linear regression models were used to predict BMI and fat percentage one year later. Our sample consisted of 114 boys and 83 girls with a mean BMI of 24.7±3.7 kg/m2 and fat percentage of 34.2%±8.3% at baseline. BMI, fat percentage, and certain cardiometabolic variables were negatively associated with DASH score and leisure-time PA (all P<0.05), but positively associated with leisure screen time (all P<0.05) at baseline. Statistically significant predictors of BMI and fat percentage one year later were baseline BMI (partial r=0.85), fat percentage (partial r=0.69), eating out (times/week, partial r=0.18), and DASH Score (partial r=-0.18). Overall, childhood obesity prevention interventions should target reductions in ERBs.
Adiposity ; Adolescent ; Blood Glucose ; metabolism ; Blood Pressure ; Child ; Cholesterol ; blood ; Feeding Behavior ; Female ; Humans ; Male ; Obesity ; metabolism ; physiopathology ; psychology ; Overweight ; metabolism ; physiopathology ; psychology ; Triglycerides ; blood

OBJECTIVETo compare the differences of clinical effects in female patients with obesity and hyperlipidemia of yang deficiency of spleen and kidney syndrome between warm acupuncture combined with auricular acupuncture and simple warm acupuncture.

METHODSOne hundred and thirty patients were randomly divided into an observation group and a control group, 65 cases in each one. In the control group, acupuncture was used at Pishu (BL 20), Zhongwan(CV 12), Shenshu(BL 23), Zhongji(CV 3), Guanyuan(CV 4), Mingmen(GV 4), Taibai(SP 3), Fenglong(ST 40), etc.; warm acupuncture was applied at Pishu(BL 20), Zhongwan(CV 12), Shenshu(BL 23) and Zhongji(CV 3); the treatment was required once every two days and for 3 months continuously. In the observation group, based on the treatment in the control group, thumbtack intradermal needles were embedded at auricular points, including pi(CO13), shen(CO10), pangguang(CO9), sanjiao(CO17), neifenmi(CO18), neishengzhiqi(TF2), etc. Obesity indices [body mass(W), obesity degree(A), body mass index(BMI), body fat percentage(F%)] blood lipid indices [serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C)] and clinical efficacy were observed before and after treatment in the two groups. Results After treatment in the two groups, the obesity indices of W, A, BMI, F% and the blood lipid levels of TC, TG, LDL-C were obviously decreased compared with those before treatment (all P<0. 01) and the HDL-C levels were apparently increased than those before treatment (both P<0. 01). After treatment, the improvement of TC and HDL-C in the observation group was superior to that in the control group (both P<0. 01). The difference was not statistically significant in the aspect of improving every obesity index between two groups (all P>. 05). The comprehensive total effective rate of the observation group was 95.4% (62/65), which was better than 84. 6% (55/65) of the control group (P<0. 001).

CONCLUSIONWarm acupuncture combined with auricular acupuncture and simple warm acupuncture can both benignly adjust abnormal lipid metabolism of obesity patients with hyperlipidemia, and warm acupuncture combined with auricular acupuncture are superior to simple warm acupuncture treatment on antiobesity action and improving the TC and HDL-C levels.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Kidney ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Spleen ; physiopathology ; Triglycerides ; metabolism ; Yang Deficiency ; metabolism ; physiopathology ; therapy ; Young Adult

OBJECTIVETo explore the factors influencing insulin resistance in children with different nutritional status during pubertal development.

METHODSThree hundred children with simple obese aged 7 to 17 years, and 300 normal healthy children and 300 children with malnutrition, matched for age (+/- 3 months) and height (+/- 2 cm), were selected. Fasting serum levels of leptin, insulin, glucose, total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) were measured for them.

RESULTSLevels of fasting serum insulin in obese children, except for boys at Tanner stage I and girls at Tanner stage II, were higher than those in normal and malnutrition children (P < 0.01). Average serum level of leptin in obese boys and girls at varied Tanner stages was higher than that in normal children, and higher in normal children than that in children with malnutrition (P<0.01). Serum level of TG in obese children [(1.53 +/- 0.13) mmol/L] was higher than that in normal ones [(1.12 +/- 0.10) mmol/L] and in children with malnutrition [(1.03 +/- 0.09) mmol/L]. There was no significant difference in levels of fasting blood glucose and other blood lipids between the three groups of children. Insulin sensitivity decreased with pubertal development and its index reversely correlated with Tanner stage and serum level of leptin (r=-0.27 and -0.36, respectively, P<0.01).

CONCLUSIONObesity (BMI), serum level of leptin and pubertal development were independent risk factors for insulin resistance in children aged 7 to 17 years.

Adolescent ; Body Mass Index ; Child ; Estradiol ; blood ; Growth Hormone ; metabolism ; Humans ; Insulin ; blood ; Insulin Resistance ; Leptin ; blood ; physiology ; Male ; Malnutrition ; blood ; Obesity ; blood ; physiopathology ; Puberty ; physiology ; Testosterone ; blood

OBJECTIVETo explore the efficacy and effect mechanism of the combined therapy of acupuncture and tapping method in the treatment of obesity and hyperlipidemia of liver qi stagnation and spleen deficiency pattern in the patients.

METHODSOne hundred and four female patients were randomized into a combined therapy of acupuncture and tapping (combined therapy group) group method and an acupuncture group, 52 cases in each group. In the acupuncture group, acupuncture was applied to Qimen (LR 14), Taichong (LR 3), Zhangmen (LR 13), Taibai (SP 3), Zusanli (ST 36), Geshu (BL 17), Ganshu (BL 18), Pishu (BL 20), etc. In the combined therapy group, on the basis of acupuncture treatment, the tapping method with plum blossom needle was used at each acupoint. The treatment was given once every two days, continuously for 3 months in the two groups. The indices were observed, including the obesity indices, such as body mass, body mass index (BMI), body fat percentage (F%) and obesity degree (A); the blood lipid levels such as total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL); the fat-islet axie relevant indices such as fasting plasma glucose (FBS), fasting leptin (FLP), fasting insulin (FINS), insulin sensitive index (ISI), insulin resistance in- dex (Homa IR), insulin secretion index (Homa-β) and autonomic nerve function index (Y value) before and after treatment in the patients of two groups. The efficacy was compared between the two groups.

RESULTSThe total effective rates were 96.2% (50/52) and 84.6% (44/52) in the combined therapy group and the acupuncture group respectively, without significant difference in comparison (P > 0.05). Obesity indices, blood lipid indices, fat-islet axie relevant indices and autonomic nerve function indices were all improved after treatment as compared with those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements in the combined therapy group were much more significant (P < 0.01, P < 0.05).

CONCLUSIONThe combined therapy of acupuncture and tapping method achieves the double effects of weight loss and lipid loss in the treatment of obesity combined with hyperlipidemia. The effect mechanism is possibly related to the positive regulations of blood glucose, lipid metabolism and fat-islet axie in the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Insulin ; metabolism ; Leptin ; metabolism ; Liver ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Qi ; Spleen ; physiopathology ; Treatment Outcome ; Triglycerides ; metabolism ; Young Adult

BACKGROUNDObstructive sleep apnea syndrome (OSAS) is strongly associated with obesity and with cardiovascular disease. Ghrelin and obestatin are two peptides from the same source but have opposite roles. Both of them can affect feeding and regulate vascular tune. The aim of this study was to investigate the relationship between plasma ghrelin, obestatin, the ratio of ghrelin and obestatin (G/O) and sleep parameters and blood pressure circadian rhythms in patients with OSAS.

METHODSThis study enrolled 95 newly diagnosed over-weight OSAS patients (OSAS group), 30 body mass index (BMI)-match non-OSAS adults (over-weight group) and 30 non-OSAS normal weight adults (control group). Polysomnography (PSG) was performed in the OSAS group and over-weight group. Blood pressure of all subjects was monitored by means of 24-hour ambulatory blood pressure monitoring. The concentration of plasma ghrelin and obestatin was detected by enzyme-linked immunosorbent assay (ELISA).

RESULTSPlasma ghrelin levels in the OSAS group and over-weight group were significantly lower than that of the control group (P < 0.05). Plasma obestatin levels were lower in the over-weight group and OSAS group, but there was no significant difference among the three groups. The blood pressure in OSAS patients was higher, and there was a significant difference in all blood pressure parameters compared to the control group, and in the daytime average diastolic blood pressure (DBP), nocturnal average systolic blood pressure (SBP) and DBP, DBP variability values as compared to over-weight subjects. Furthermore, there were significantly more non-dipper patterns of blood pressure (including hypertension and normotension) in the OSAS group than in the other two groups (P < 0.01). Correlation analysis showed that ghrelin levels had a significant correlation with BMI and nocturnal average DBP but not with PSG parameters. In contrast, the G/O ratio had a negative correlation with apnea-hypopnea index (AHI) (P < 0.05), as well as a strong positive correlation with the blood pressure variability values (P < 0.01). In multivariate analyses, AHI (P < 0.05) and G/O (P < 0.05) were independently related to SBP variability changes, while AHI (P < 0.05), G/O (P < 0.01) and BMI (P < 0.05) were independently related to DBP variability changes.

CONCLUSIONSOur data show plasma ghrelin and obestatin levels were related to obesity in OSAS. Sleep apnea in OSAS patients could have led to an imbalance in G/O in the basis of obesity. Moreover, the imbalance may promote nighttime blood pressure elevation and affect blood pressure circadian disorder.

Adolescent ; Adult ; Aged ; Blood Pressure ; physiology ; Circadian Rhythm ; physiology ; Enzyme-Linked Immunosorbent Assay ; Female ; Ghrelin ; blood ; Humans ; Male ; Middle Aged ; Obesity ; blood ; physiopathology ; Pancreatic Neoplasms ; blood ; physiopathology ; Prognosis ; Repressor Proteins ; metabolism ; Sleep Apnea, Obstructive ; blood ; physiopathology ; Young Adult

PURPOSE: This study sought to determine whether abdominal obesity is a risk factor for impaired fasting glucose (IFG) and hypertriglyceridemia and to verify whether moderate effect of abdominal obesity on the relationship between IFG and hypertriglyceridemia in Korea. MATERIALS AND METHODS: Data from the Korean National Health and Nutrition Examination Survey was used for the analysis. The study population included 5,938 subjects aged 20 year old drawn from non-diabetic participants in a health examination survey. The subjects were classified according to the presence of abdominal obesity based on waist circumference, IFG based on their fasting blood glucose level, and hypertriglyceridemia on their fasting triglyceride. RESULTS: The multivariate-adjusted odds ratios for the occurrence of hypertriglyceridemia were 2.91 in the abdominal obesity group as compared with the nonobesity group and 1.31 in subjects with IFG compared with the normoglycemia controls. Abdominal obesity was found to be positively moderated in the interaction between waist circumference and fasting blood sugar. CONCLUSION: The moderate effect between abdominal obesity and IFG contributes to the development of hypertriglyceridemia in Korea.
Adult ; Aged ; Blood Glucose/*metabolism ; Fasting/blood ; Female ; Humans ; Hypertriglyceridemia/*blood/*pathology ; Logistic Models ; Male ; Middle Aged ; Obesity, Abdominal/*physiopathology ; Triglycerides/blood ; Waist Circumference/physiology ; Young Adult

OBJECTIVE: To compare the levels of the fasting blood glucose (FBG) and blood fat of the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after surgery, meanwhile to analyze the influence on blood glucose and blood fat after the changes of body mass index (BMI), apnea-hypopnea index (AHI) and lowest oxygen saturation (LSpO2). METHOD: Thirty-one patients with severe OSAHS were performed Z-palatoplasty (ZPP) or ZPP combined with genioglossus advancement with hyoid suspension (GAHM). Cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and FBG were detected before and after surgery. RESULT: Preoperative HDL was negatively related to BMI and AHI, but not LSpO2. After surgery the BMI, AHI, LSpO2, HDL and FBG were all improved. The change of HDL had correlation with the changes of BMI and AHI, and there was linear correlation with HDL and BMI (r= -0.36). CONCLUSION The surgery of ZPP and ZPP combined with GAHM can improve the AHI, LSpO2, BMI, the FBG and blood fat of the patients with OSAHS. Lose weight and rectifying sleep disordered breathing were important to improve glycolipid metabolism disorder of the patients with OSAHS.
Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Obesity ; blood ; surgery ; Sleep Apnea, Obstructive ; blood ; physiopathology ; surgery

INTRODUCTIONDeveloping effective exercise programmes for the paediatric population is a strategy for decreasing obesity and is expected to help in eventually limiting obesity-associated long-term health and societal impact. In this study, the effects of a 12-week twice weekly additional exercise training, which comprised a combination of circuit-based resistance training and aerobic exercises, in additional to typical physical education sessions, on aerobic fitness, body composition and serum C-reactive protein (CRP) and lipids were analysed in 13- to 14-year-old obese boys contrasted with a control group.

MATERIALS AND METHODSBoth the exercise group (EG, n = 12) and control group (CG, n = 12) participated in the typical 2 sessions of 40-minute physical education (PE) per week in schools, but only EG participated in additional 2 sessions per week of 45 to 60 minutes per session of exercise training, which comprised a combination of circuit-based resistance training and aerobic exercises maintained at 65% to 85% maximum heart rate (HRmax = 220 - age). Body composition was measured using dual energy X-ray absorptiometry (DEXA). Fasting serum CRP and blood lipids were analysed pre- and postexercise programme. Aerobic fitness was measured by an objective laboratory submaximal exercise test, PWC170 (Predicted Work Capacity at HR 170 bpm).

RESULTSExercise training significantly improved lean muscle mass, body mass index, fitness, resting HR, systolic blood pressure and triglycerides in EG. Serum CRP concentrations were elevated at baseline in both groups, but training did not result in a change in CRP levels. In the CG, body weight increased significantly at the end of the 12-week period.

CONCLUSIONThis study supports the value of an additional exercise training programme, beyond the typical twice weekly physical education classes, to produce physiological benefits in the management of obesity in adolescents, including prevention of weight gain.

Adolescent ; C-Reactive Protein ; analysis ; metabolism ; Exercise Therapy ; Humans ; Lipids ; analysis ; blood ; Male ; Obesity ; physiopathology ; therapy ; Physical Fitness ; physiology

BACKGROUND/AIMS: Overt thyroid dysfunction is well known to affect weight. However, the influence of normal-range changes in thyroid status on body mass index (BMI) is unclear. We sought to evaluate thyroid function (free T4, TSH) and its possible relationship with BMI and lipid profiles in euthyroid subjects. METHODS: A total of 1572 euthyroid women (mean age 46.2 years) who visited Daegu Catholic University Medical Centre for primary health screening participated in this cross-sectional study. Women who were not euthyroid and women who took thyroid medication were excluded. TSH, free T4, and lipid profile [total-cholesterol, triglyceride (TG), HDL-C, LDL-C] were evaluated. RESULTS: Obese euthyroid women had lower free T4 levels than did lean euthyroid women. After adjustment for age and smoking, free T4, but not TSH, was significantly negatively correlated with BMI. After adjustment for age, smoking, and BMI, free T4 was negatively correlated with TG to a significant degree. CONCLUSIONS: We demonstrated a negative correlation between free T4 within the normal range and BMI in euthyroid subjects. These findings suggest that low free T4 is associated with obesity in euthyroid subjects.
Adult ; *Body Mass Index ; Cholesterol/blood ; Cross-Sectional Studies ; Female ; Humans ; Korea/epidemiology ; Middle Aged ; Obesity/blood/epidemiology/*physiopathology ; Pilot Projects ; Thyroid Function Tests ; Thyroid Gland/*metabolism/physiopathology ; Thyrotropin/*blood ; Thyroxine/*blood ; Triglycerides/analysis/blood ; Triiodothyronine/blood

OBJECTIVETo explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment.

METHODSOne hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group, 55 cases in each one. Additionally, a healthy group (52 cases) was set up as the control. In the control group, the warm needling therapy was applied to Taibai (SP 3), Chongyang (ST 42), Yinlingquan (SP 9), Zusanli (ST 36), etc., once every two days. In the observation group, on the basic treatment as the control group, the auricular acupuncture was applied to Pi (CO₁₃), Wei (CO₄), Fei (CO₁₄), Shen (CO₁₀), etc., once every 2 to 3 days. The efficacy was evaluated after 3-month, treatment in the two groups. The observation was conducted on the obesity outcomes [body mass, obesity degree (A), body mass index (BMI), body fat percentage (F%)], blood-lipoids indicators [such as serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], fat-islet endocrine axis outcomes [such as fasting plasma glucose (FPG) , fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR) and insulin β cell function index (Homa-β)], as well as autonomic nerve function index (Y) before and after treatment in the patients of the two groups. The efficacy was assessed in the two groups.

RESULTSThe total effective rate was 96.4% (53/55) in the observation group, better than 87.3% (48/55, P < 0.01) in the control group. For the improvements of the obesity indices, the differences were not significant between the two groups (all P > 0.05). Before treatment, the levels of TC, TG, LDL-C, FLP, FPG, FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group (all P < 0.01), and the levels of HDL, ISI, Homa-β and Y were significantly lower than those in the healthy group (all P < 0.01). After treatment, except Homa-β, the other indices were all improved significantly (all P < 0.01). The results in the observation group were better than those in the control group (all P < 0.01).

CONCLUSIONThe patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia have the disturbances of lipid metabolism, "fat-islet endocrinal axis" function and automatic nerve function. The combined treatment of warm needling therapy and auricular acupuncture or simple warm needling therapy present the effects of weight reducing and lipid reducing. The effect of the combined treatment is better than simple warm needling therapy. The efficacy mechanism is probably relevant to the positive regulation of blood glucose, lipid metabolism, fat-islet endocrinal axis and automatic nerve function.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Blood Glucose ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Lipids ; blood ; Male ; Middle Aged ; Obesity ; metabolism ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Triglycerides ; blood ; Young Adult