Medical Specialties Commons^™

Increasing Adipocyte Lipoprotein Lipase Improves Glucose Metabolism In High Fat Diet-Induced Obesity, R. Grace Walton, Beibei Zhu, Resat Unal, Michael Spencer, Manjula Sunkara, Andrew J. Morris, Richard Charnigo, Wendy S. Katz, Alan Daugherty, Deborah A. Howatt, Philip A. Kern, Brian S. Finlin

Barnstable Brown Diabetes Center Faculty Publications

Lipid accumulation in liver and skeletal muscle contributes to co-morbidities associated with diabetes and obesity. We made a transgenic mouse in which the adiponectin (Adipoq) promoter drives expression of lipoprotein lipase (LPL) in adipocytes to potentially increase adipose tissue lipid storage. These mice (Adipoq-LPL) have improved glucose and insulin tolerance as well as increased energy expenditure when challenged with a high fat diet (HFD). To identify the mechanism(s) involved, we determined whether the Adipoq-LPL mice diverted dietary lipid to adipose tissue to reduce peripheral lipotoxicity, but we found no evidence for this. Instead, characterization …

Tolerability Of Induction Chemotherapy Dosing Practices In Acute Myeloid Leukemia Patients, Kaylene M. Peric, David J. Reeves

Scholarship and Professional Work – COPHS

For patients with high body surface areas (BSA), differing chemotherapy dosing strategies have been utilized in attempts to reduce toxicity. In a retrospective evaluation, we compared the effects of chemotherapy dosing in acute myeloid leukemia patients with high BSA (>2 m²) who received capped doses (n = 12) to those who received uncapped doses (n = 24), and to patients with BSA ≤ 2 m² (n = 42). There were no statistically significant differences among groups (BSA ≤ 2 m², BSA > 2 m² capped, and BSA > 2 m² uncapped) …

Menthol Cigarette Smoking And Obesity In Young Adult Daily Smokers In Hawaii, Alyssa Marie M. Antonio, Pebbles Fagan, Faith D. Hamamura, Ian Joseph N. Lagua, Jenny Liu, Devin J. Park, Pallav Pokhrel, Thaddeus A. Herzog, Ian Pagano, Kevin Cassel, Angela Sy, Dorothy Jorgensen, Tania Lynch, Crissy Kawamoto, Carol J. Boushey, Adrian Franke, Mark S. Clanton, Eric T. Moolchan, Linda A. Alexander

Health, Behavior & Society Faculty Publications

This study investigates 1) the relationship between menthol cigarette smoking and obesity and 2) the association of body mass index with the nicotine metabolite ratio among menthol and non-menthol daily smokers aged 18–35 (n = 175). A brief survey on smoking and measures of height and weight, carbon monoxide, and saliva samples were collected from participants from May to December 2013 in Honolulu, Hawaii. Multiple regression was used to estimate differences in body mass index among menthol and non-menthol smokers and the association of menthol smoking with obesity. We calculated the log of the nicotine metabolite ratio to examine differences …

Restraint Stress Alters Pro-Inflammatory Cytokine Expression And Increases Superoxide Dismutase In The Rat Hypothalamus And Hippocampus, Kristina Isabel Barron

Open Access Theses & Dissertations

The impact of restraint stress on changes in cytokine expression and oxidative stress markers in hippocampal (Hipp) and hypothalamic (Hyp) regions of the brain, were assessed in a rat model. In addition, immune and inflammatory variables were assessed in peripheral blood. Male Wistar rats were acutely (30 min) or repeatedly (30 min/d for 14 consecutive days) exposed to a restraint stress, or maintained as non-stressed controls. At the time of sacrifice, whole blood and brain tissues enriched in Hyp or Hipp regions were collected; blood was collected with EDTA as an anticoagulant and centrifuged to yield plasma. All tissue samples …

Locus Of Control And Obesity, Florence Neymotin, Louis R. Nemzer

Chemistry and Physics Faculty Articles

In the developed world, the hazards associated with obesity have largely outstripped the risk of starvation. Obesity remains a difficult public health issue to address, due in large part to the many disciplines involved. A full understanding requires knowledge in the fields of genetics, endocrinology, psychology, sociology, economics, and public policy - among others. In this short review, which serves as an introduction to the Frontiers in Endocrinology research topic,we address one cross-disciplinary relationship: the interaction between the hunger/satiation neural circuitry, an individual's perceived locus of control, and the risk for obesity. Mammals have evolved a complex system for modulating …

Preliminary Efficacy Of Group Medical Nutrition Therapy And Motivational Interviewing Among Obese African American Women With Type 2 Diabetes: A Pilot Study, Stephania T. Miller, Veronica J. Oates, Malinda A. Brooks, Ayumi Shintani, Tebeb Gebretsadik, Darlene M. Jenkins

Human Sciences Faculty Research

Objective. To assess the efficacy and acceptability of a group medical nutritional therapy (MNT) intervention, using motivational interviewing (MI). Research Design & Method. African American (AA) women with type 2 diabetes (T2D) participated in five, certified diabetes educator/dietitian-facilitated intervention sessions targeting carbohydrate, fat, and fruit/vegetable intake and management. Motivation-based activities centered on exploration of dietary ambivalence and the relationships between diet and personal strengths. Repeated pre- and post-intervention, psychosocial, dietary self-care, and clinical outcomes were collected and analyzed using generalized least squares regression. An acceptability assessment was administered after intervention. Results. Participants (n = 24) were …

Abdominal Fat Suspension Device For Maintaining Normal Cardiorespiratory Function In Patients Undergoing Conscious Sedation During Surgery: A Feasibility Study, Norman F Truong, Joanna C Nathan, Daeun Yoon, Gabriel Ochoa, Marisa Prevost, Sehyun Yun, Z Maria Oden, Mehdi Razavi

The Texas Heart Institute Journal

Obese patients undergoing conscious-sedation surgery have increased perioperative morbidity because their excess abdominal tissue limits diaphragmatic excursion. We describe a simple device that might help attenuate this risk. We created a noninvasive suction device for abdominal suspension. By lifting the burden of excess weight, this device should decrease respiratory effort. To test the feasibility of excess weight removal in relieving cardiac stress, we tested 22 supine, healthy, normal-weight subjects by measuring their heart rates with and without a 13-kg tissue model on their abdomen to simulate excess weight. There was no significant difference in blood oxygen saturation before and after …

Osteopontin: A Novel Regulator At The Cross Roads Of Inflammation, Obesity And Diabetes, Florian Kahles, Hannes M. Findeisen, Dennis Bruemmer

Gill Heart & Vascular Institute Faculty Publications

Since its first description more than 20 years ago osteopontin has emerged as an active player in many physiological and pathological processes, including biomineralization, tissue remodeling and inflammation. As an extracellular matrix protein and proinflammatory cytokine osteopontin is thought to facilitate the recruitment of monocytes/macrophages and to mediate cytokine secretion in leukocytes. Modulation of immune cell response by osteopontin has been associated with various inflammatory diseases and may play a pivotal role in the development of adipose tissue inflammation and insulin resistance. Here we summarize recent findings on the role of osteopontin in metabolic disorders, particularly focusing on diabetes and …

Obesity And Diabetes Cause Cognitive Dysfunction In The Absence Of Accelerated Β-Amyloid Deposition In A Novel Murine Model Of Mixed Or Vascular Dementia, Dana M. Niedowicz, Valerie L. Reeves, Thomas L. Platt, Katharina Kohler, Tina L. Beckett, David K. Powell, Tiffany L. Lee, Travis R. Sexton, Eun Suk Song, Lawrence D. Brewer, Caitlin S. Latimer, Susan D. Kraner, Kara L. Larson, Sabire Özcan, Christopher M. Norris, Louis B. Hersh, Nada M. Porter, Donna M. Wilcock, Michael Paul Murphy

Sanders-Brown Center on Aging Faculty Publications

Mid-life obesity and type 2 diabetes mellitus (T2DM) confer a modest, increased risk for Alzheimer's disease (AD), though the underlying mechanisms are unknown. We have created a novel mouse model that recapitulates features of T2DM and AD by crossing morbidly obese and diabetic db/db mice with APP^ΔNL/ΔNLx PS1^P264L/P264L knock-in mice. These mice (db/AD) retain many features of the parental lines (e.g. extreme obesity, diabetes, and parenchymal deposition of β-amyloid (Aβ)). The combination of the two diseases led to additional pathologies-perhaps most striking of which was the presence of severe cerebrovascular pathology, including aneurysms and small …

Resveratrol And Cancer: Focus On In Vivo Evidence, Lindsay G. Carter, John A. D'Orazio, Kevin J. Pearson

Graduate Center for Nutritional Sciences Faculty Publications

Resveratrol is a naturally occurring polyphenol that provides a number of anti-aging health benefits including improved metabolism, cardioprotection, and cancer prevention. Much of the work on resveratrol and cancer comes from in vitro studies looking at resveratrol actions on cancer cells and pathways. There are, however, comparatively fewer studies that have investigated resveratrol treatment and cancer outcomes in vivo, perhaps limited by its poor bioavailability when taken orally. Although research in cell culture has shown promising and positive effects of resveratrol, evidence from rodents and humans is inconsistent. This review highlights the in vivo effects of resveratrol treatment on breast, …

Fact Sheet #2: How Do Mainecare Providers Perform On Childhood Screening And Prevention?, Jean A. Talbot Phd, Mary Lindsey Smith Phd, Msw, Kimberley S. Fox Mpa

Population Health & Health Policy

The annual Survey of Children Served by MaineCare, which collects a wealth of data on the experiences of MaineCare families, examines the extent to which MaineCare providers follow Bright Futures guidelines during well-child visits. This fact sheet presents findings on Bright Futures adherence from the 2013 survey.

Lean Body Mass May Explain Apparent Racial Differences In Carotid Intima-Media Thickness In Obese Children., Shahryar M. Chowdhury, Melissa H. Henshaw, Brad Friedman, J Philip Saul, Girish S. Shirali, Janet Carter, Bryana M. Levitan, Tom Hulsey

Manuscripts, Articles, Book Chapters and Other Papers

Background: Racial differences in carotid intima-media thickness (cIMT) have been suggested to be associated with the disproportionally high prevalence of cardiovascular disease in black adults. The objective of this study was to evaluate the effects of cardiovascular risk factors on the racial differences seen in cIMT in obese children.

Methods: Obese subjects aged 4 to 21 years were recruited prospectively. Height, weight, blood pressure, fasting insulin, glucose, lipid panel, high-sensitivity C-reactive protein, and body composition by dual-energy x-ray absorptiometry were obtained. B-mode carotid imaging was analyzed by a single blinded physician.

Results: A total of 120 subjects (46 white, 74 …

Ethical Dilemmas Posed In The Care Of Obese Patients In The Emergency Department, Arvind Venkat, Gregory Luke Larkin

Journal of Health Ethics

The rising prevalence of obesity represents a health care crisis. As the gateway to the health care system, the emergency department is the clinical setting where the difficulties posed by the care of obese patients are heightened. These difficulties include the increasing burden of obesity-related illnesses, the challenges posed in diagnostic evaluation and treatment and the known barriers to access to care seen in this patient population. The limitations posed by obesity on care in the emergency department, the one guaranteed access point for medical treatment, creates a series of ethical dilemmas for emergency physicians and the facilities in which …

Influence Of Diet And Obesity On Copd Development And Outcomes, Corrine K. Hanson, Erica P. Rutten, Emiel F.M. Wouters, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

The global increase in the prevalence and incidence of obesity has called serious attention to this issue as a major public health concern. Obesity is associated with many chronic diseases, including cardiovascular disease and diabetes, and recently the role of overweight and obesity in lung disease has received new interest. Independently of obesity, diet also plays a role as a risk factor for many chronic diseases, and evidence is accumulating to support a role for diet in the prevention and management of several lung diseases. Chronic obstructive lung disease is the third-leading cause of death globally, and both obesity and …

Low Birth Weight Male Guinea Pig Offspring Display Increased Visceral Adiposity In Early Adulthood., Ousseynou Sarr, Jennifer A Thompson, Lin Zhao, Ting-Yim Lee, Timothy Regnault

Paediatrics Publications

Uteroplacental insufficiency (UPI)-induced intrauterine growth restriction (IUGR) predisposes individuals to adult visceral obesity. We postulated that low birth weight (LBW) offspring, from UPI-induced IUGR pregnancies, would display a visceral adipose lipogenic molecular signature involving altered gene expression, phosphorylation status of proteins of the lipid synthesis pathway and microRNA (miR) expression profile, occurring in association with increased visceral adiposity. Normal birth weight (NBW) and LBW (obtained by uterine artery ablation) male guinea pig pups were fed a control diet from weaning to 145 days and sacrificed. Despite being lighter at birth, LBW pups displayed body weights similar to NBW offspring at …

Association Of Demographic Characteristics With Gestational Diabetes Mellitus And Gestational Hypertension In Ohio During 2012, Jared D. Klein

Master of Public Health Program Student Publications

Background: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) are serious conditions that can arise during pregnancy. Both of these disorders can cause detrimental health effects to both mother and newborn. Methods: Ohio vital statistics birth data was obtained from Public Health- Dayton and Montgomery County. The data set included 137,268 women who gave birth during 2012 in Ohio and had a known GDM and/or GHTN status. IBM Statistical Package for Social Sciences for Mac Version 20 (SPSS, IBM, 2011) was used to analyze the data. Descriptive statistics, odds ratios, chi-square analyses, and multivariate logistic forward stepwise regressions were calculated …

The Association Of Primary Care Physician Supply To The Prevalence Of Diabetes, Obesity, Smoking, And Hypertension In Georgia, Dennis L. White

MUSC Theses and Dissertations

The primary focus of this study was to compare primary care physician supply throughout Georgia to the prevalence of diabetes, obesity, smoking, and hypertension county by county, identifying potential issues related to primary care physician supply. This research identified the distribution of the primary care physician workforce across Georgia; county by county, and in urban and rural areas, and across public health districts. Then, the research identifies whether the current supply of Georgia primary care physicians is sufficient to meet the growing need for population healthcare. Studying the area of primary care physician supply in correlation to the prevalence of …

Obesity Reduces Left Ventricular Strains, Torsion, And Synchrony In Mouse Models: A Cine Displacement Encoding With Stimulated Echoes (Dense) Cardiovascular Magnetic Resonance Study, Sage P. Kramer, David K. Powell, Christopher M. Haggerty, Cassi M. Binkley, Andrea C. Mattingly, Lisa A. Cassis, Frederick H. Epstein, Brandon K. Fornwalt

Pediatrics Faculty Publications

BACKGROUND: Obesity affects a third of adults in the US and results in an increased risk of cardiovascular mortality. While the mechanisms underlying this increased risk are not well understood, animal models of obesity have shown direct effects on the heart such as steatosis and fibrosis, which may affect cardiac function. However, the effect of obesity on cardiac function in animal models is not well-defined. We hypothesized that diet-induced obesity in mice reduces strain, torsion, and synchrony in the left ventricle (LV).

METHODS: Ten 12-week-old C57BL/6 J mice were randomized to a high-fat or low-fat diet. After 5 months on …

The Effect Of Malnutrition On Patients Undergoing Elective Joint Arthroplasty., Ronald Huang, Md, Max Greenky, Bs, Glenn J. Kerr, Md, Mathew S. Austin, Md, Javad Parvizi, Md, Frcs

Rothman Institute Papers

Malnutrition has been linked to serious complications in patients undergoing elective total joint arthroplasty (TJA). This study prospectively evaluated 2,161 patients undergoing elective TJA for malnutrition as defined by either an abnormal serum albumin or transferrin. The overall incidence of malnutrition was 8.5% (184 of 2,161) and the rate of overall complications in the malnourished group was 12% as compared to 2.9% in patients with normal parameters (P55years-old undergoing TJA and is associated with a significant increase in post-operative complications.

Lessons Learned From Training Of Promotores De Salud For Obesity And Diabetes Prevention, Erica T. Sosa, Lesli Biediger-Friedman, Zenong Yin

Journal of Health Disparities Research and Practice

Background: Promotores de Salud are impactful in reducing health disparities for Hispanic communities. The purpose of this paper is to present the training process and fidelity of study protocol implementation using a promotora model for community-based diabetes prevention.

Methods: Five Hispanic bilingual promotores were recruited from a Community Health Worker program and received intensive 30-hour promotora training on how to recruit participants, lead group sessions, and support participants making behavior changes. Evaluation of the training included a survey and focus group to assess promotores’ feedback, a post-training knowledge test to assess knowledge acquired during the training and an observational assessment …

Carrots, Sticks And False Carrots: How High Should Weight Control Wellness Incentives Be? Findings From A Population-Level Experiment, Harald Schmidt

Frontiers in Public Health Services and Systems Research

Employers are increasingly using wellness incentives, including penalties for unhealthy behavior. Survey data suggests that people are willing to accept the principle of penalizing those perceived to take health risks, but the equally relevant question of the magnitude of acceptable penalties is unclear.

While the principle of penalizing overweight and obese people has some support, findings from a population-level experiment (n=1,000) suggest that the acceptable size of penalties is comparatively small, around $50: more than 10-fold below levels favored by advocates. Reward-based incentives are favored over penalty-based ones by a factor of 4. Of two different ways of framing penalty …

Website Usage And Weight Loss In A Free Commercial Online Weight Loss Program: Retrospective Cohort Study, Kevin O Hwang, Jing Ning, Amber W Trickey, Christopher N Sciamanna

Faculty, Staff and Student Publications

BACKGROUND: Online weight loss programs are increasingly popular. However, little is known about outcomes and associations with website usage among members of free online weight loss programs.

OBJECTIVE: This retrospective cohort study examined the association between website usage and weight loss among members of a free commercial online weight loss program (SparkPeople).

METHODS: We conducted a retrospective analysis of a systematic random sample of members who joined the program during February 1 to April 30, 2008, and included follow-up data through May 10, 2010. The main outcome was net weight change based on self-reported weight. Measures of website usage included …

The Influence Of Obesity On The Outcome Of Treatment Of Lumbar Disc Herniation: Analysis Of The Spine Patient Outcomes Research Trial (Sport)., Jeffrey A Rihn, Mark Kurd, Alan S Hilibrand, Jon Lurie, Wenyan Zhao, Todd Albert, James Weinstein

Rothman Institute Papers

BACKGROUND: Questions remain as to the effect that obesity has on patients managed for symptomatic lumbar disc herniation. The purpose of this study was to determine if obesity affects outcomes following the treatment of symptomatic lumbar disc herniation.

METHODS: An as-treated analysis was performed on patients enrolled in the Spine Patient Outcomes Research Trial for the treatment of lumbar disc herniation. A comparison was made between patients with a body mass index of/m² (nonobese) (n = 854) and those with a body mass index of ≥30 kg/m² (obese) (n = 336). Baseline patient demographic and clinical characteristics were documented. Primary …

Linking Environmental Toxicant Exposure To Diabetes Susceptibility, Jannifer Beth Tyrrell

Wayne State University Dissertations

An important and unresolved question in the environmental health field is whether exposure to common environmental toxicants, such as dioxin and heavy metals like Pb, increase the risk of developing diabetes, especially in combination with other common metabolic stressors such as obesity.

Previous studies suggested that dioxin exposure increased peripheral insulin resistance but did not appear to cause fasting hyperglycemia or elevated hepatic glucose output. In concordance with those findings we observed that dioxin treatment caused a strong suppression of the expression of the key hepatic gluconeogenic genes PEPCK and G6Pase. However, this suppression was not solely mediated by the …

Early Onset Type 2 Diabetes And Associated Risk Factors, Grace Nyambura Kiraka

Master of Medicine in Clinical Pathology

Background: The incidence of type 2 diabetes in patients below the age of 40 (early onset diabetes) is markedly on the rise and has been linked increased prevalence of risk factors such as the metabolic syndrome and family history of diabetes. Objective: To determine the proportion of patients with type 2 diabetes at Aga Khan University Hospital Nairobi (AKUHN) who have early onset type 2 diabetes and the association of age of onset with risk factors (family history of diabetes, obesity, waist circumference, hypertension, low HDL cholesterol and hypertriglyceridaemia) in this group of patients. Methods: This was a cross sectional …

Is Laparoscopic Gastric Banding An Effective Treatment For Obesity In Adolescents And Adults As Measured By Physical Function?, Shawna Mccormick

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is laparoscopic gastric banding an effective treatment for obesity in adolescents and adults as measured by physical functioning?”

STUDY DESIGN: Review of all English language primary studies from 2009, 2010, and 2011.

DATA SOURCES: Two randomized control trials and one cohort study were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: There were multiple outcomes measured in the studies but the outcome of concern is quality of life post-operatively, specifically, physical functioning as measured by surveys including SF-36, Moorehead-Ardelt, BAROS, and CHQ CF-50. …

Emerging Modifiable Risk Factors For Cardiovascular Disease In Women: Obesity, Physical Activity, And Sedentary Behavior, Ann Smith Barnes

The Texas Heart Institute Journal

No abstract provided.

Open Versus Laparoscopic Hiatal Hernia Repair., Terrence M. Fullum, Tolulope A. Oyetunji, Gezzer Ortega, Daniel D. Tran, Ian M. Woods, Olusola Obayomi-Davies, Orighomisan Pessu, Stephanie R. Downing, Edward E. Cornwell

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The literature reports the efficacy of the laparoscopic approach to paraesophageal hiatal hernia repair. However, its adoption as the preferred surgical approach and the risks associated with paraesophageal hiatal hernia repair have not been reviewed in a large database.

METHOD: The Nationwide Inpatient Sample dataset was queried from 1998 to 2005 for patients who underwent repair of a complicated (the entire stomach moves into the chest cavity) versus uncomplicated (only the upper part of the stomach protrudes into the chest) paraesophageal hiatal hernia via the laparoscopic, open abdominal, or open thoracic approach. A multivariate analysis was performed controlling for …

25(Oh)D3 And Cardiovascular Risk Factors In Female Nonhuman Primates., Matthew J Jorgensen, Lawrence L Rudel, Matthew Nudy, Jay R Kaplan, Thomas B Clarkson, Nicholas M Pajewski, Peter F Schnatz

Division of Internal Medicine Faculty Papers & Presentations

OBJECTIVE: To determine if interindividual differences in plasma concentrations of 25-hydroxyvitamin D(3) (25(OH)D(3)) have pathophysiologic significance, we evaluated a cohort of female monkeys, seeking to identify associations with clinically relevant cardiovascular risk factors, including age, abdominal obesity (waist circumference), and high-density lipoprotein cholesterol (HDL-C).

METHODS: One hundred fifty-five female vervet monkeys (Chlorocebus aethiops sabaeus) aged 3-25 years consumed a typical western diet for 7-8 weeks that provided a woman's equivalent of approximately 1000 IU/day of vitamin D(3). Measurements of vitamin D(3) and HDL-C concentrations, as well as waist circumference, were obtained.

RESULTS: Among young monkeys (aged 3-5 years), compared to …

Sarcopenia, Obesity, And Natural Killer Cell Immune Senescence In Aging: Altered Cytokine Levels As A Common Mechanism, Charles T. Lutz, Lebris S. Quinn

Pathology and Laboratory Medicine Faculty Publications

Human aging is characterized by both physical and physiological frailty. A key feature of frailty, sarcopenia is the age-associated decline in skeletal muscle mass, strength, and endurance that characterize even the healthy elderly. Increases in adiposity, particularly in visceral adipose tissue, are almost universal in aging individuals and can contribute to sarcopenia and insulin resistance by increasing levels of inflammatory cytokines known collectively as adipokines. Aging also is associated with declines in adaptive and innate immunity, known as immune senescence, which are risk factors for cancer and all-cause mortality. The cytokine interleukin-15 (IL-15) is highly expressed in skeletal muscle tissue …