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Bell, Lana Michelle. "The medical complications of childhood obesity". University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0139.
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[Truncated abstract] Introduction: Childhood obesity is currently a serious worldwide public health issue associated with many medical and psychosocial complications. The increasing disease burden with the potential for the development of medical co-morbidities has implications for future health care provision. This thesis adds to the understanding of the medical complications of overweight and obesity in childhood. Design and Aims: Two different, but related, research studies are reported. The first study is a cross-sectional study, designed to quantify the medical complications of childhood obesity in primary school-aged children in Western Australia. This study aims to identify the medical complications of primary school children with overweight/obesity. The study also aims to compare the medical complications of obesity in a community sample who have never sought treatment with a clinical sample who are actively seeking treatment for overweight/obesity. Finally, this study also aims to examine the relationship between the medical complications of childhood obesity and a continuum of children's Body Mass Index z-scores, including those in the normal range. The second study is an exercise intervention study to investigate the effect of exercise on one specific medical complication of obesity, namely insulin resistance. This study aims to determine if a structured eight-week exercise program significantly changes insulin resistance in obese children, and to determine if this decrease in insulin resistance is associated with changes in body composition and inflammatory markers. ... Conclusion: The prevalence of the medical complications of overweight and obesity in primary school children indicates that all children should have body mass index regularly checked from a young age. Children who are overweight/obese should be screened for the presence of co-morbidities despite a young age. Parents and health professionals needs to be educated that childhood obesity is associated with medical co-morbidities and is not simply a social or cosmetic concern. The continuous nature of the BMI z-score/co-morbidities relationship suggests that public health and health education strategies should include adopting a populationbased approach to weight management. This continuous relationship means that even in the normal BMI spectrum, the risk of developing co-morbidities rises with increasing BMI. Such an approach would encourage maintenance of normal weight for all children, rather than targeting overweight/obese children only. Increased activity and decreased sedentary behaviours should be recommended for all children in line with the population-based public health approach suggested above. However, exercise has a specific role in weight management strategies for overweight/obese children, and in management strategies for adiposityrelated co-morbidities. Significant metabolic benefits of exercise occur in the absence of changes in body shape and weight. After an exercise program, simple blood investigations (such as lipid profiles, fasting insulin and OGTTs) are likely to miss important metabolic improvements and anthropometry (BMI calculation, waist circumference) may be more indicative of potential metabolic improvement and decreased co-morbidity risk.
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Neves, Joana Sofia Vilela de Sousa. "Obesity prevention: from conception to adolescence". Dissertação, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/60976.
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Neves, Joana Sofia Vilela de Sousa. "Obesity prevention: from conception to adolescence". Master's thesis, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/60976.
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Mitchell, Gail A. "Long term linguistic consequences of head injury in childhood and adolescence". Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24867.
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Considerable interest has been expressed regarding the issue of recovery of language following head injury in childhood. The two questions most frequently addressed are:
1) Do children recover linguistic abilities faster and better than adults after suffering a head Injury?
2) Is the linguistic disorder, if evident, mainly syntactic or lexical in nature?
We have examined 8 children from 6;10-17; 0 who suffered traumatic head injury and who are in varying stages of recovery. Each child has been matched with a normal child of the same age. Despite reports of complete recovery from childhood aphasia, our results indicate persistent word finding problems, with otherwise normal language abilities. There was no correlation between severity of deficit and age at injury or length of coma.Medicine, Faculty of
Audiology and Speech Sciences, School of
Graduate
5
Yeung, Chun-yu. "Adipocyte- and epidermal-fatty acid-binding proteins in relation to obesity and its medical complications". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B44204565.
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Zaal, Afra Ahmed bin. "Factors related to obesity in preparatory and high schools in Dubai : a study of the prevalence, determination, consequences and the perception of obesity in adolescents in Dubai, United Arab Emirates". Thesis, University of Aberdeen, 2006. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=185769.
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The study was conducted in Dubai, one of the main Emirate states. It is a cross sectional descriptive study, conducted between January and April 2004. The sample size was 661(324 males and 337 females). These were all local national students from preparatory and secondary schools with ages ranging from 12 to 17 years. A multi-stage stratified, random sampling technique was used to obtain a representative sample of appropriate size for estimating the prevalence of obesity among adolescents. A short questionnaire was used to obtained information relating to factors which contributed to obesity. The results revealed that there was a high prevalence of obesity in males (22.2%) and females (20.2%). Boys and girls in early and middle adolescence (12-15years) were more obese than late adolescents (16-17 years). An increase in body mass index may lead to high blood pressure, high blood sugar level, high cholesterol and triglyceride level. The girls were shown to be more likely to follow a dietary programmes and watch television food advertisements. Television was shown to be the most effective way of transmitting health nutrition information inclusion in the school curriculum being the next most effective way. Boys participated in physical activity more than girls; reducing the likelihood of obesity. Boys were more likely to overestimate their current body shape than girls. It was concluded that since obesity cannot be prevented or managed at an individual level, governments, the food industry, international agencies, the media and community should all work together to modify the environment so that it is less conductive to weight gain.
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Keast, Debra Rose. "Patterns of beverage consumption associated with adolescent obesity in the U.S". Diss., Connect to online resource - MSU authorized users, 2006.
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Thesis (Ph. D.)--Michigan State University. Dept. of Food Science and Human Nutrition, 2006.Title from PDF t.p. (viewed on June 19, 2009) Includes bibliographical references (p. 260-289). Also issued in print.
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Nelson, Maika E. "Examination of adolescent physical activity and overweight levels /". Diss., CLICK HERE for online access, 2004. http://contentdm.lib.byu.edu/ETD/image/etd373.pdf.
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Liu, Tsz-chiu, i 廖子超. "Lipocalin-2 is a pro-inflammatory adipokine causally involved in obesity-associated endothelial dysfunction". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45589434.
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Stewart, Victoria Stephanie. "Weight-loss interventions performed to reduce the risk of obesity-related complications". ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/109.
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The management of obesity before a woman conceives is one of the most effective efforts a woman can take in decreasing her risk of obesity-related complications during pregnancy. Evidence supports the idea that maternal obesity influences maternal and fetal outcomes, leading to maternal and fetal morbidities. Physicians acknowledge the importance of screening women for obesity, but many do not refer patients for weight-loss therapy. In this study, the health belief model was used to explore the associations between participants' obesity risk of complications during pregnancy, the number of weight-loss interventions they attempted to implement prior to pregnancy, and how they viewed the success of their interventions. Participants were a random sample of 95 obese pregnant women older than 19 years participating in the supplemental WIC program in an urban community in Newark, New Jersey. A quantitative nonexperimental correlational study using descriptive and inferential statistics was used to analyze the data. The results of this study indicated that obese pregnant women did not perceive the risks associated with obesity as a problem, nor was there an association among the types of weight-loss methods attempted, the overall success of their weight-loss interventions, and ethnicity. Women who tried exercise and dietary restrictions or exercise only were more likely to experience success than those who tried other methods or combinations of methods (p = 0.012). The data provided can lead to better informed strategies by health care professionals to develop standards in healthcare, particularly obstetrics and gynecology offices and clinics, to help obese women be more compliant with treatment recommendations for reducing the risks of obesity-related health problems.
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Bailey, Swneke. "Genetic insights into obesity and its associated metabolic complications: a multiethnic perspective". Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=104623.
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Obesity has become one of the biggest threats to global health, as it frequently co-occurs with a constellation of type 2 diabetes (T2D) and cardiovascular disease (CVD) risk factors and is associated with increased mortality. Genetic factors account for a substantial portion of the phenotypic variance in obesity and each of the correlated vascular disease risk factors. In this thesis, I describe the identification of several common genetic variants that predispose carriers to the complications associated with obesity. First, I report the identification of common variation within the gene of a protein secreted by visceral adipose tissue, visfatin, and demonstrate the influence of these variants on the inter-individual variation in fasting insulin levels. Second, I describe the identification of an interaction between the use of thiazolidinediones (TZDs), a class of anti-hyperglycemic medication, and variation in the nuclear factor of activated T-cells cytoplasmic component 2 (NFATC2) gene that results in edema and potentially congestive heart failure (CHF). Next, using a South Asian population sample for gene discovery, I identify a novel association between variation in the dipeptidyl peptidase 4 (DPP4) gene, a target of incretin-based anti-hyperglycemic medication, and apolipoprotein B (apoB) levels, a CVD risk factor and marker of the dyslipidemia associated with obesity. In addition, using observed differences between the Europeans and South Asians I was able to identify heterogeneity in the association between DPP4 and apoB caused by adiposity. Finally, I report an association between variation in the sterol regulatory element binding protein 1 (SREBF1) gene and body mass index (BMI) and demonstrate its potential contribution to observed differences in BMI among different ethnicities around the world. I also present data that strongly suggest that these differences may have been due to recent positive selection at this locus in human populations. The findings in this thesis illustrate the importance of common genetic variants in the pathogenesis of obesity, as well as its associated complications and highlight the regulation of glucose by adipose tissue as an important underlying feature.L'obésité est devenue une des plus grandes menaces dans la santé publique, étant donné qu'elle est fréquemment co-reliée avec des facteurs de risque du diabète de type 2 (T2D) et de la maladie cardiovasculaire (CVD), et est donc associée à une mortalité accrue. Les facteurs génétiques représentent une partie substantielle de la variation phénotypique de l'obésité, ainsi que des facteurs de risque des maladies vasculaires qui y sont associés. Dans cette thèse, je décris l'identification de plusieurs variants génétiques communs qui prédisposent les porteurs aux complications associées à l'obésité. D'abord, je décris l'identification d'une variation commune dans le gène d'une protéine sécrétée par le tissu adipeux viscéral, visfatin, et démontre l'influence de ces variants sur la variation interindividuelle d'une insulinémie à jeun. Deuxièmement, je décris l'identification d'une interaction entre l'utilisation des thiazolidinediones une classe de médicaments anti-hyperglycémiques, et une variation génétique dans le gène nuclear factor of activated T-cells cytoplasmic component 2 (NFATC2) qui aboutit à l'œdème et potentiellement à l'insuffisance cardiaque congestive. Ensuite, en utilisant un échantillon de la population asiatique du Sud dans la découverte de gènes, j'identifie une nouvelle association entre la variation du gène dipeptidyl peptidase 4 (DPP4), une cible de la médication anti-hyperglycémique basée sur l'incretin, et les niveaux de l'apolipoprotéine B (apoB), un facteur de risque du CVD et un marqueur de la dyslipidémie associée à l'obésité. De plus, en utilisant des différences observées entre les Européens et les Asiatiques du Sud, j'ai pu identifier l'hétérogénéité dans l'association entre DPP4 et apoB causé par l'adiposité. Finalement, je décris une association entre la variation du gène sterol regulatory element binding protein 1 (SREBF1) et l'indice de masse corporelle (BMI) et démontre sa contribution potentielle aux différences de BMI observées parmi différentes ethnicités dans le monde entier. Je présente aussi des données qui suggèrent fortement que ces différences peuvent être dues à une récente sélection positive à ce locus dans des populations humaines. Les découvertes de cette thèse illustrent l'importance des variants génétiques communs dans la pathogenèse de l'obésité, ainsi que les complications qui s'y rattachent et mettent en évidence la régulation de glucose par le tissu adipeux comme étant une caractéristique sous-jacente importante.
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Sommers, Caitlin Helen. "Factors Influencing Youth Self-Perceptions of Overweight and Obesity". PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1484.
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This study sought to examine whether participation in physical activity affects the ability to correctly classify body size, based on body mass index classifications. Secondarily, this study determined whether adolescents who incorrectly classified their body size overestimated or underestimated their size. Self-report data from the Youth Risk Behavior Surveillance Survey collected by the Centers for Disease Control and Prevention were analyzed. Logistic regression was performed to examine relationships between self-perception of body size and physical activity, television viewing time, computer/video game use, physical education class time, and extracurricular sports activities. Significance was set to p<0.05. Physical activity was the only statistically significant independent variable (p=0.058, OR = 1.060). Although physical activity was shown to be statistically significant, it did not appear to meaningfully increase the ability of youth to correctly classify body size. Secondary analysis showed that adolescents who incorrectly classified their body size were more likely to underestimate their body size. Females more frequently underestimated their body size (females=673; males=384).
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Smith, Kenneth Albert. "Experiences of obese adolescents : a retrospective qualitative study /". Full text (PDF) from UMI/Dissertation Abstracts International, 2000. http://wwwlib.umi.com/cr/utexas/fullcit?p9992915.
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Kaw, Roop, Priyanka Bhateja, y. Mar Hugo Paz, Adrian V. Hernández, Anuradha Ramaswamy, Loutfi S. Aboussouan i Abhishek Deshpande. "Postoperative Complications in Patients with Unrecognized Obesity Hypoventilation Syndrome Undergoing Elective Non-cardiac Surgery". American College of Chest Physicians, 2015. http://hdl.handle.net/10757/558500.
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BACKGROUND: Among patients with obstructive sleep apnea (OSA) a higher number of medical morbidities are known to be associated with those that have obesity hypoventilation syndrome (OHS) compared to OSA alone. OHS can therefore pose a higher risk of postoperative complications after elective non-cardiac surgery (NCS) and is often unrecognized at the time of surgery. The objective of this study was to retrospectively identify patients with OHS and compare their postoperative outcomes with those who have OSA alone. METHODS: Patients meeting criteria for OHS were identified within a large cohort of patients with OSA who underwent elective NCS at a major tertiary care center. We identified postoperative outcomes associated with OSA and OHS as well as the clinical determinants of OHS (BMI, AHI). Multivariable logistic or linear regression models were used for dichotomous or continuous outcomes, respectively. RESULTS: Patients with hypercapnia from definite or possible OHS, and overlap syndrome are more likely to develop postoperative respiratory failure [OR: 10.9 (95% CI 3.7-32.3), p<0.0001], postoperative heart failure (p<0.0001), prolonged intubation [OR: 5.4 (95% CI 1.9-15.7), p=0.002), postoperative ICU transfer (OR: 3.8 (95% CI 1.7-8.6), p=0.002]; longer ICU (beta coefficient: 0.86; SE: 0.32, p=0.009) and hospital length of stay (beta coefficient: 2.94; SE: 0.87, p=0.0008) when compared to patients with OSA. Among the clinical determinants of OHS, neither BMI nor AHI showed associations with any postoperative outcomes in univariable or multivariable regression. CONCLUSIONS: Better emphasis is needed on preoperative recognition of hypercapnia among patients with OSA or overlap syndrome undergoing elective NCSRevisión por pares
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Scholle, Lori A. "Association Between Vitamin D Intake and Obesity During Pre- and Early Adolescence". Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/nutrition_theses/39.
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Background: Prevalence of obesity in US children has increased substantially. The influence of vitamin D intake on body mass index (BMI) is yet to be clearly defined. Results are mixed regarding the relationship of vitamin D deficiency with obesity in children. The objective of this study was to examine the association between vitamin D intake and BMI over a 6 month period in pre-to early adolescent children in Pittsburgh, PA.
Methods: Secondary analysis was done on 256 healthy 6-14 year old (54% male) Caucasian and African American (70%) children from Pittsburgh, PA. Participants completed a food frequency questionnaire (FFQ) and a Sun Exposure Questionnaire (SEQ) and provided anthropometric measures at 2 time points 6 months apart. Vitamin D intake was compared by BMI status (normal = <85th percentile, overweight = 85th to 95th percentile, obese = >95th percentile) as well as by change in BMI over 6 months. Statistical analysis included descriptive statistics, Kruskal-Wallis analysis of variance, Spearman’s correlation, Chi Square test, and regression analysis (vitamin D intake, gender, race, baseline BMI, total energy intake, sun exposure and sunscreen use).
Results: Median reported vitamin D intake was 245.85 IU at baseline and 382.51 IU at 6 month follow up. After subdividing children by BMI, at baseline the obese group reported lowest median intake (188 IU) and at 6 month follow up the normal group reported lowest median intake (374 IU) (P=0.03). Overall relation between vitamin D intake and BMI was significant (P=0.033) but weak (r=-0.015). Regression analysis revealed only baseline BMI status (P=<0.001) as a predictor of 6 month follow up BMI. No relation was observed between change in BMI and vitamin D intake.
Conclusion: The results of this study do not support a strong relationship between vitamin D intake and change in BMI status over a 6 month time period.
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Stenberg, Erik. "Preventing complications in bariatric surgery". Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-50649.
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Obesity is a major public health problem. Bariatric surgery is currently the only available treatment that offers sufficient weight-loss and metabolic benefits over time. Although bariatric surgery is considered safe now, serious complications still occur. The aim of this thesis was to identify factors associated with an increased risk for postoperative complication after laparoscopic gastric bypass surgery. Study I included patients operated with laparoscopic gastric bypass surgery in Sweden from May 2007 until September 2012. The risk for serious complication was low (3.4%). Suffering an intraoperative adverse event or conversion of the operation to open surgery were the strongest risk factors for postoperative complication. The annual operative volume and experience of the procedure at the institution were also important risk factors. Patient-specific risk factors appeared to be less important although age was associated with an increased risk. In Study II, a raised glycated haemoglobin A1c (HbA1c) was evaluated as a risk factor for serious postoperative complications in non-diabetics. A higher incidence of serious postoperative complications was seen with elevated HbA1c values, even at levels classified as ‘‘pre-diabetic’’. Study III was a multicentre, randomised clinical trial (RCT). 2507 patients planned for laparoscopic gastric bypass surgery were randomised to either mesenteric defects closure or non-closure. Closure of the mesenteric defects reduced the rate of reoperation for small bowel obstruction from 10.2% to 5.5% at 3 years after surgery. A small increase in the rate of serious postoperative complication within the first 30 days was seen with mesenteric defects closure. This relatively small increase in risk was however outweighed by the marked reduction of later reoperations for small bowel obstruction. Study IV was a comparison between study III and an observational study on the same population under the same period of time. Although the observational study reached the same conlusion as the RCT, the efficacy of mesenteric defects closure was less pronounced. Observational studies may thus be an alternative to RCTs under situations when RCTs are not feasible. The efficacy may however be underestimated.
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Duncan, Elizabeth Karndu. "Obesity and its determinants in girls from five ethnic groups a thesis submitted to the Auckland University of Technology in fulfilment of the degree of Doctor of Philosophy, July 2008 /". Click here to access this resource online, 2008. http://hdl.handle.net/10292/463.
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Yeung, Chun-yu, i 楊振宇. "Adipocyte- and epidermal-fatty acid-binding proteins in relation to obesity and its medical complications". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B44204565.
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Ong, Kwok-leung, i 王國良. "Genetic variants of obesity- and inflammation-related genes in hypertension: genetic association studiesusing candidate gene approach". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45200555.
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Fuchs, Florent. "Obésité maternelle et macrosomie foetale : complications et prise en charge obstétricale". Thesis, Université Paris-Saclay (ComUE), 2015. http://www.theses.fr/2015SACLS037/document.
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Contexte : L'obésité est considérée par l'OMS comme une « épidémie » mondiale en raison de l'essor de sa prévalence et de ses conséquences sur la santé. Chez les patientes enceintes, son impact semble tout aussi préoccupant et sa prévalence en France atteint actuellement 10%. Certaines complications de l'obésité chez la femme enceinte ont été peu étudiées et notamment le lien particulier avec la macrosomie fœtale.Objectifs : Mieux appréhender la prise en charge des patientes enceintes obèses et de certaines complications qui en découlent.Méthodes : Trois séries de données différentes ont servi pour répondre à différentes questions sur la thématique de l'obésité et de la macrosomie. 1) Une évaluation de la faisabilité et de la qualité d'une échographie obstétricale du 2ème trimestre chez les patientes obèses a été réalisée via une étude mono centrique avec recueil prospectif des données. 2) Une étude des facteurs de risques de complications maternelles en cas d'accouchement d'un enfant macrosome, indépendamment de l'obésité maternelle et du poids de naissance de l'enfant a été menée sous la forme d'une étude prospective de cohorte d'enfant de plus de 4000g dans deux maternités d'Ile de France. 3) Enfin, une comparaison de la relation entre les complications maternelles de la grossesse et /ou néonatales et l'obésité a été menée entre la France (4 maternités de type III) et le Québec (données issues d'une étude randomisée dans toute la province) entre 2009 et 2011 via une étude comparative de deux échantillons transversaux de femmes enceintes (26 973 accouchements en France et 83 545 accouchements au Québec). Résultats : 1) Une échographie du deuxième trimestre de la grossesse chez une population obèse est possible, avec un taux de réussite en une fois de 70,4 %, (versus 82% ; p=0,08). Les facteurs d'amélioration de ce taux étaient : passer plus de temps lors de l'échographie (p=0,03), déplacer le fœtus de sorte que son dos soit en position latérale ou postérieure (p=0,01), et échographie réalisée par des échographistes expérimentés (p=0,03). Néanmoins, la qualité des images reste significativement moins bonne dans la population obèse (p=0,001). 2) La survenue de complications maternelles lors de la tentative d'accouchement vaginal d'un enfant de plus de 4000 g est de 6%. Les facteurs de risque de complications maternelles, outre le poids de naissance de l'enfant (p=0,004, Risque attribuable (RA)=10%), sont l'origine asiatique de la mère (p=0,04 ; RA=3%), une durée longue du travail (>10h) (p=0,02 ; RA=12%), et une césarienne au cours du travail (p=0,004 ; RA=17%). Les patientes multipares ayant déjà accouché par voie vaginale d'un enfant macrosome avaient un risque diminué de complications maternelles (p=0,03). 3) La prévalence de l'obésité était de 9,1% en France et 16,8% au Québec (p<0,001). L'obésité était associée de manière statistiquement significative (p<0,0001), à la fois en France et au Québec, à un risque accru de diabète gestationnel, de troubles hypertensifs de la grossesse, de prééclampsie, de mort fœtale in utero, d'accouchement par césarienne et de macrosomie. L'association était différente en France et au Québec (p interaction <0,005), pour la survenue du diabète gestationnel, de complications hypertensives de la grossesse et pour la macrosomie, avec une augmentation plus importante des complications avec l'IMC au Québec par rapport à la France.Conclusion : La compréhension de certaines complications inhérentes à l'obésité (complications médicales de la grossesse, faisabilité et qualité du dépistage échographique, complications obstétricales) est améliorée par les résultats de cette thèseBackground: According to WHO, obesity is considered as an "epidemic" condition due to the global growth of its prevalence and its impact on patient health. For pregnant patients, its impact seems equally worrying and its prevalence is now reaching 10% in France. Some complications of obesity in pregnant women have been little studied and particularly the special link with fetal macrosomia.Objectives: To better understand care and obstetric outcome of obese pregnant patients as well as some of their complications such as fetal macrosomia.Methods: Three different sets of data were used to deal with questions regarding obesity and macrosomia. 1) Assessment of feasibility and quality of second trimester ultrasound scan in obese patients was performed through a mono centric case-control study with prospective data collection. 2) A study of risk factors for maternal complications in case of the delivery of a macrosomic child, regardless of maternal obesity and child's birth weight, was conducted as a prospective cohort study including children with birthweight above 4000g in two “Ile de France” maternity wards. 3) Finally, a comparison of the relationship between maternal and/or neonatal complications of pregnancy and obesity was conducted in France (4 type III maternity wards) and in Quebec (data from a randomized study throughout the province) between 2009 and 2011 through a comparative study of two cross-sectional samples of pregnant women (26,973 births in France and 83,545 births in Quebec).Results: 1) Second trimester ultrasound scan in obese pregnant women is feasible, with a success rate of 70.4% (versus 82%; p=0.08). Factors of improvement were: to spend more time at ultrasound (p=0.03), to move the fetus so that its back is in lateral or posterior position (p=0.01) and when ultrasound was performed by experienced sonographers (p=0.03). However, the quality of the image remains significantly lower in the obese population (p=0.001). 2) The occurrence of maternal complications, when attempting vaginal birth of a child of more than 4000g, was 6%. Beyond childbirth weight (p=0.004, attributable risk (AR) = 10%), the risk factors of maternal complications were Asian ethnicity (p=0.04; AR=3%), prolonged labor (> 10h) (p=0.02; AR=12%), and caesarean section during labor (p=0.004; AR=17%). Multiparous women with a previous vaginal delivery of a macrosomic child had a lower risk of maternal complications (p=0.03). 3) The prevalence of obesity was 9.1% in France and 16.8% in Quebec (p <0.001). Obesity was significantly (p <0.0001) associated with, both in France and in Quebec, an increased risk of gestational diabetes, hypertensive disorders of pregnancy, preeclampsia, stillbirth, cesarean delivery and macrosomia. The strength of the association was different in France and Quebec (p of interaction <0.005) for the occurrence of gestational diabetes, hypertensive complications of pregnancy and macrosomia, with a larger increase in complications with body mass index in Quebec compared to France.Conclusion: Understanding some inherent complications of obesity (medical complications of pregnancy, feasibility and quality of ultrasound screening, obstetric complications) is enhanced by the result of this work
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Fisher, Kimberly N. "The effect of parent education on the home food environment for overweight adolescents in West Virginia". Morgantown, W. Va. : [West Virginia University Libraries], 2009. http://hdl.handle.net/10450/10267.
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Thesis (M.S.)--West Virginia University, 2009.Title from document title page. Document formatted into pages; contains vi, 53 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 38-41).
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WOO, JESSICA GRAUS. "THE EPIDEMIOLOGY OF ADIPONECTIN DURING ADOLESCENCE: DEMOGRAPHIC, DEVELOPMENTAL, METABOLIC AND GENETIC ASSOCIATIONS". University of Cincinnati / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1100808827.
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Tossavainen, née Riihimaa P. (Päivi). "Markers of microvascular complications in adolescents with type 1 diabetes". Doctoral thesis, University of Oulu, 2003. http://urn.fi/urn:isbn:951426892X.
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Abstract
The markers of microvascular complications of type 1 diabetes were evaluated in adolescents in a cross sectional survey of 100 out of 138 eligible patients aged 9-19 years with a duration of diabetes over two years who visited the Paediatric Outpatient Clinic at Oulu University Hospital in 1997-1999, and one hundred healthy controls.
Two patients in early or mid-puberty had non-proliferative diabetic retinopathy, but no other signs of microvascular complications.
The five patients with persistent microalbuminuria were all girls; one prepubertal, one late pubertal and three postpubertal. Their mean glycated haemoglobin A1c (HbA1c) was higher, but they had a similar duration of diabetes and age distribution to those without microalbuminuria.
The adolescent patients were predisposed to higher fasting serum total and low-density lipoprotein cholesterol and triglyceride levels and higher diastolic blood pressure than the control subjects. The proportional total body fat was highest in the girls with diabetes by the end of puberty, while serum leptin levels did not differ between the patients and healthy controls. The patients had low fasting serum insulin levels and high insulin-like growth factor-binding protein 1 levels, related to hypoinsulinaemia.
Distal motor nerve function in the lower extremities were already affected before puberty, and distal and proximal nerve function deteriorated as puberty advanced. Ten patients had neurophysiologically confirmed distal diabetic polyneuropathy, and they were older and they had longer duration of diabetes and higher HbA1c than patients without polyneuropathy.
Although cardiovascular function was in the main well preserved in the adolescents with type 1 diabetes, the power spectrum analysis of heart rate variability showed attenuated autonomic nervous system reactivity.
Taken together these data show that a relatively small proportion of adolescents with type 1 diabetes have signs of microvascular complications. The prevalences of diabetic retinopathy, persistent microalbuminuria and distal diabetic polyneuropathy were 2%, 6% and 10%, respectively. Pubertal maturation seems to promote the progression of early signs of microvascular complications in patients affected by type 1 diabetes.
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Yu, Wing-sze Margaret, i 余詠詩. "The association between sleep curtailment and obesity in adolescents, a local perspective". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42998086.
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Yu, Wing-sze Margaret. "The association between sleep curtailment and obesity in adolescents, a local perspective". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42998086.
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Corliss, Carolyn Davis Witte James E. "An investigation of factors affecting the overweight status of Alabama high school adolescents". Auburn, Ala., 2005. http://repo.lib.auburn.edu/2005%20Summer/doctoral/CORLISS_CAROLYN_8.pdf.
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Dove, Jacqueline Beckham Kreider Richard B. "Effects of a multicomponent school-based intervention on health markers, body composition, physical fitness, and psychological measures in overweight and obese adolescent females". Waco, Tex. : Baylor University, 2008. http://hdl.handle.net/2104/5253.
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Pyle, Sara Anne Haddock C. Keith. "A meta-analysis of treatments for childhood and adolescent obesity". Diss., UMK access, 2006.
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Thesis (Ph. D.)--School of Education. University of Missouri--Kansas City, 2006."A dissertation in counseling psychology." Advisor: C. Keith Haddock. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed Nov. 13, 2007. Includes bibliographical references (leaves 101-113). Online version of the print edition.
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Boukhris, Tommy Tahar. "A public response to childhood obesity : evaluating the fresh fruit and vegetable program in Texas schools /". View online, 2007. http://ecommons.txstate.edu/arp/260/.
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Lee, Melissa Scharoun Gordon-Larsen Penny. "Race/ethnicity, socioeconomic status and obesity across the transition from adolescence to adulthood". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,2153.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.Title from electronic title page (viewed Feb. 26, 2009). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Nutrition, School of Public Health." Discipline: Nutrition; Department/School: Public Health.
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Rangel, Trini Gene. "The Role of Religiosity in the Development of Obesity From Adolescence to Adulthood". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2330.
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The development of obesity from adolescence to adulthood is not well understood, nor does the research support a multidimensional approach for this understanding. Studies have described primarily cross-sectional bivariate relationships between combinations of obesity, religiosity, depression, and social support, but it is still not known whether there is a relationship between adolescent religiosity, depression, and social support in the development of adult obesity or whether depression and social support mediate the religiosity-obesity relationship. The dynamic, multidimensional, functional model of wellness presented by Hawks was the basis for the spiritual, social, emotional, and physical interactions proposed in this study. The research questions sought to identify the relationship that exists between adolescent religiosity, depression, and social support and adult obesity and considered depression and social support as potential mediators of the religiosity-obesity relationship. This quantitative study employed multiple linear regression while using the prospective nature of the Add Health data set to gain a longitudinal understanding of the religiosity-obesity relationship. Adolescent male religiosity significantly predicted adult obesity, but female religiosity did not. Neither depression nor social support mediated the religiosity-obesity relationship. Social change implications include a rationale for developing sex-based multidimensional approaches, including spiritual approaches, for supporting adolescents in their transition to adulthood. Support for acknowledging the differences between sexes for multiple health interactions is provided and indicated for healthcare providers. Finally, health educators are presented with much-needed support for the concept of the multidimensionality of wellness.
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Yang, Bo, i 杨波. "Role of lipocalin-2 in cardiac dysfunction associated with aging and dietary obesity". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B47869641.
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Obesity is closely related to many medical complications such as type 2 diabetes,
hypertension and heart failure. Obesity and other factors, including elevated blood
glucose levels, hypertension, and dyslipidemia, constitute a constellation of symptoms
known as the metabolic syndrome, which are the risk factors for coronary artery
disease. Lipocalin-2 is a pro-inflammatory adipokine causally involved in the
development of obesity-associated metabolic and cardiovascular diseases. Recent
clinical and experimental evidences demonstrate an association between augmented
circulating lipocalin-2 and cardiac dysfunction. However, little is known about the
detailed roles of lipocalin-2 in regulating pathophysiological functions of the heart.
The present study was designed to compare the heart functions of mice with normal
(WT) or deficient lipocalin-2 (Lcn2-KO) expression and to examine the molecular
mechanisms underlying lipocalin-2-mediated deteriorated effects in hearts.
Echocardiographic analysis revealed that the myocardial contractile function was
significantly improved in hearts of Lcn2-KO mice, under both standard chow and
high fat diet conditions. The heart function before and after I/R injury (20-min of
global ischemia followed by 60-min of reperfusion) was assessed using the
Langendorff perfusion system. Compared with WT littermates, hearts from Lcn2-KO
mice showed improved functional recovery and reduced infarct size following I/R.
These phenomena can be observed in mice under both standard chow and high fat
feeding conditions.
Under baseline condition, the mitochondrial function of hearts from Lcn2-KO
mice was significantly enhanced, as demonstrated by biochemical analysis of
respiratory chain activity, markers of biogenesis and oxidative stress, as well as
electron microscopic investigation of the mitochondrial ultrastructure. Acute or
chronic administration of lipocalin-2 impaired cardiac functional recovery to I/R and
dampened the mitochondrial function in hearts of Lcn2-KO mice. These effects were
associated with an extensive modification of the fatty acyl chain compositions of
intracellular phospholipids. In particular, lipocalin-2 facilitated the redistribution of
linoleic acid (C18:2) among different types of phospholipid, including cardiolipin,
which is exclusively located in the mitochondria inner membrane.
The direct effects of lipocalin-2 on both H9c2 and NCM cells were also
examined. TUNEL assay and flow cytometry analysis demonstrated that lipocalin-2
treatment promoted apoptosis in cardiomyocytes. Lipocalin-2 induced an early phase
of phosphatidylserine exposure, followed by Bax-translocation and caspase-3
cleavage. The results collectively suggested that lipocalin-2 initiated the intrinsic
mitochondria-mediated apoptotic pathway. In the hearts of Lcn2-KO mice,
significantly reduced number of apoptotic cells was observed after I/R injury.
In conclusion, lacking of lipocalin-2 improved heart function recovery during I/R
injury via mitochondrial function restoration, phospholipids remodeling, and
inhibition of cardiomyocytes apoptosis.published_or_final_version
Pharmacology and Pharmacy
Doctoral
Doctor of Philosophy
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Sahu, Soumyadip. "Cross-talk of Leptin and Thrombospondin-1 in Atherosclerotic Complications". Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1492525184445034.
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Searcy, Cynthia S. "Are eating and exercise behaviors at school contributing to adolescent obesity in the United States?" Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2007. http://wwwlib.umi.com/cr/syr/main.
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Fang, Xingzhi, i 方行陟. "A systematic review of the impact of sugar-sweetened beverage consumption on children and adolescent obesity". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206908.
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Background
The consumption of sugar-sweetened beverage (SSBs) among children and adolescents, particularly carbonated soft drinks, are always blamed to be the contributor to the epidemic of overweight and obesity. With the number of obese population increased, people become increasingly more focus on the relationship between SSB and the weight gain problems. However, because there are some characteristics of these beverages that people can get energy and happiness, so that people enjoy drinking sugar-sweetened beverage especially children who like sugar and sweet. So, people are still wondering the association between SSB and obesity.
Methods
A literature search was performed using Google scholar and Pubmed to locate all relevant articles in English that study the impacts of SSB on the weight gain and obesity on children and adolescent up to December 2013.
Findings
Eleven core references were found to study the association between SSB and the weight gain among children and adolescent including 4 randomized trial studies, 6 cross-sectional studies and 1 case-control study.
Conclusions
The data collected from large cross-sectional studies, especially the long-term studies shows that there is a positive association between the intake of SSB and the weight gain and obesity in children and adolescent. A case control study based on hospital shows that the children who with less soft-drink consumptions have lower prevalence of obesity and overweight. In addition, the randomized control trials indicate that the greater consumption of SSB, the easier to gain weights among children and adolescents. Although more evidence are needed, the sufficient evidence exists now are not encouraging the public to intake too many sugar-sweetened beverage as a healthy behavior.published_or_final_version
Public Health
Master
Master of Public Health
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Fieldhouse, John Arthur. "Adolescent obesity: A study of the effects of parent attitudes on physical activity". CSUSB ScholarWorks, 2006. https://scholarworks.lib.csusb.edu/etd-project/3001.
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Examines the relationship between parent attitudes toward physical activity and physical activity in adolescents. One hundred forty-two students at Beaumont High School (Riverside County, California) completed a survey measuring their physical activity level, exercise self-efficacy, and their attitudes toward exercise. One hundred seven parents completed surveys measuring only their attitudes toward exercise. Results indicate that there is not a significant relationship between parental attitudes toward exercise and adolescent physical activity. Results also indicate that parent attitude toward physical activity is positively correlated with exercise self-efficacy in adolescents. In addition, the results indicate that gender is not a significant mediator in the effect of parental attitudes toward physical activity on exercise in adolescents.
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Khanna, Rahul. "Predicting physicians' intention to measure body mass index and assessing their identification and evaluation practices in overweight children and adolescents". Morgantown, W. Va. : [West Virginia University Libraries], 2007. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5209.
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Thesis (M.S.)-West Virginia University, 2007.Title from document title page. Document formatted into pages; contains ix, 155 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 127-144).
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Newman, Lisa K. "The Association between BMI-for-age and Intra- and Post-General Anesthesia Airway Complications". The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337213041.
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Long, Sarah. "BIOLOGICAL AND ENVIRONMENTAL PREDICTORS OF EXTERNALIZING BEHAVIOR IN LATE CHILDHOOD AND ADOLESCENCE: A TWIN STUDY". OpenSIUC, 2011. https://opensiuc.lib.siu.edu/dissertations/391.
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This study examined the role of birth complications, delinquent peers and siblings, and specific dopamine receptors on the development of externalizing behavior in children and adolescents, along with the role of heritability in aggression and delinquency. Specifically, it was hypothesized that increased birth complications, presence of specific dopamine receptor (DRD2 and DRD4) risk alleles, and delinquent peers or siblings would be related to increased externalizing behavior at follow-up. The sample consisted of 65 twin pairs, aged six to 16 (mean age = 9.06 years) who originally participated in the Southern Illinois Twins and Siblings Study (SITSS) at age five. Significant results were found for the stability of aggression from age five to follow-up and heritability of parent-rated aggression and delinquency measures was shown. Presence of delinquent peers or siblings was positively related to aggressive and delinquent behavior. Those with more delinquent peers and with the DRD2 risk allele were rated as more delinquent. In contrast, those without the DRD4 risk allele were also rated as more delinquent. Presence of birth complications was positively related to aggressive and delinquent behavior ratings by parents at follow-up. However, birth complications were negatively related to delinquency on youth-rated measures. Finally, those with fewer complications and more delinquent siblings engaged in more reported delinquent behavior. The present study provided important information concerning the effects of birth complications, delinquent peers and siblings, and specific dopamine receptors on the development of externalizing behavior in children and adolescents, along with the role of heritability in aggression and delinquency.
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Wedwick, Linda Crumpler Thomas P. "The socialization of a reader the literary treatment of fatness in adolescent fiction /". Normal, Ill. : Illinois State University, 2005. http://proquest.umi.com/pqdweb?index=0&did=1225101201&SrchMode=1&sid=1&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1176734714&clientId=43838.
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Thesis (Ed. D.)--Illinois State University, 2005.Title from title page screen, viewed on April 16, 2007. Dissertation Committee: Thomas P. Crumpler (chair), R. Kay Moss, Gary Weilbacher, Amelia Adkins, Sally Parry. Includes bibliographical references (leaves 151-168) and abstract. Also available in print.
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Kalogiros, Ioanna D. "How do family functioning and age of onset of weight problems relate to overweight adolescents' internalizing symptoms?" Diss., Connect to online resource - MSU authorized users, 2006.
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Nicholson, Lisa Marie. "Racial and ethnic disparities an examination of social control and contagion mechanisms linking neighborhood disadvantage and young adult obesity /". Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1189631745.
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Schneck, Anne-Sophie. "Effets de la chirurgie bariatrique sur les complications hépatiques de l’obésité". Thesis, Nice, 2014. http://www.theses.fr/2014NICE4144/document.
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La sleeve gastrectomie (SG) est une opération qui consiste à réduire le volume de l’estomac. L’hypothèse que d’autres mécanismes indépendants de la perte de poids sont impliqués dans l’amélioration des complications métaboliques de l’obésité après SG a été émise. L’effet de la SG chez des souris soumis à un régime High Fat Diet a été étudié chez trois groupes d’animaux : SG, sham pair fed (SPF) et sham. Le test de tolérance au glucose montrait une amélioration de l’insulinorésistance des animaux SG à J23. Au niveau hépatique les animaux SG montraient une diminution significative de la stéatose. Il existe donc des mécanismes améliorant les complications hépatiques et métaboliques de l’obésité qui sont en partie indépendants de la réduction de l’apport calorique. Dans le second volet nous avons étudié l’évolution à long terme des lésions hépatiques liées à la NASH chez des patients obèses morbides avec une NASH lors de la chirurgie bariatrique. Dix patients d’une cohorte prospective ont été inclus. La deuxième biopsie a été réalisée à une médiane de 57 mois après le RYGB. La perte de poids moyenne était de –13,3 points de l’IMC lors du suivi. La rémission du syndrome métabolique et du diabète a été observée chez 71,6 % et 100 % des patients respectivement. Le NAS score a été amélioré chez tous les patients. Le taux sérique moyen du fragment clivé de la cytokératine 18 (M30), marqueur de l’apoptose hépatocytaire, était significativement abaissé. Le RYGB a permis une amélioration à long terme des lésions hépatocytaires liées à la NASH chez les patients obèses morbides. L’amélioration post-opératoire de la souffrance hépatocytaire corrèle avec la baisse du taux sérique du M30The mechanisms responsible for weight loss and improvement of metabolic disturbances have not been completely elucidated. We investigated the effect of sleeve gastrectomy (SG) on body weight, adipose tissue depots, glucose tolerance, and liver steatosis independent of reduced caloric intake in high-fat-diet-induced obese mice. Mice fed a high fat diet were divided into 3 groups: SG, sham-operated ad libitum fed and sham-operated pair fed. SG mice showed improved glucose tolerance and lower levels of liver steatosis. This was associated with a decrease in the ratios of the weight of pancreas, epididymal and inguinal adipose tissues to body weight. Reduced white adipose tissue inflammation, modification of adipose tissue development, and ectopic fat are potential mechanisms that may account for the reduced caloric intake independent effects of SG. We also investigated long-term impact of RYGB surgery on liver complications in morbidly obese patients with NASH. Ten morbidly obese patients with biopsy-proven NASH were followed after RYGB and underwent a second liver biopsy. The median interval between the RYGB and second liver biopsy was 57 months. Clinical and biological data were obtained at baseline and ≥40 months after RYGB. RYGB was associated with significant weight loss, improved hepatic steatosis, resolution of hepatic inflammation and hepatocyte ballooning. Hepatocyte apoptosis, as evaluated by serum K18 fragment improved within the first year and at 57 months. Hepatic fibrosis resolved in 90% of cases. RYGB in morbidly obese patients with NASH is associated with a long-term beneficial impact on hepatic steatosis, inflammation, injury and, possibly, fibrosis
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Turner, Nicholas. "Modifiable risk factors for depression in adolescence : understanding the causal role of obesity and physical activity". Thesis, University of Bristol, 2018. http://hdl.handle.net/1983/c57cda62-9848-43e8-a71c-8e3308b002ae.
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Background: Adolescent depression is a significant burden to individuals, families and healthcare systems. Understanding modifiable risk factors, such as obesity and physical activity (PA), is key to informing preventative strategies. The aim of this project was to examine the causal relationships between obesity, PA and depression in adolescents. Methods: Longitudinal data on obesity, PA and depression in adolescents came from 3 large international cohorts (ALSPAC N=7457, TRAILS N=2230 and NDIT=1294). Linear regression and generalised estimating equations (longitudinal) were used to model effects of obesity on future depression. Cross-lagged structural equation modelling was used to investigate a bi-directional relationship between obesity and depression. Mendelian Randomization analysis was used to address residual confounding. The same analytical approaches were used to examine the association between PA and depression. Partial least squares regression was used to identify aspect(s) of PA important in adolescent depression. SEM was used to investigate the role of biological and psychosocial factors as mediators of the obesity-depression relationship. Results: There was (inconsistent) evidence of a positive relationship between obesity and depression in females; a 1 SD increase in obesity was associated with a 0.035 SD (95% CI 0.003, 0.067) increase in depression at the next time point. There was evidence (in one cohort) that this relationship may be mediated by body image. There was no consistent evidence of any association between PA and subsequent depression (e.g. a 1 SD increase in PA was associated with a -0.006 SD (SE 0.016) decrease in depression at the next time point). Conclusion: Reducing obesity may improve the mental health of adolescent females, alongside having physical health benefits. There is little evidence that increased levels of PA are beneficial for depression. Embedding data collection within existing cohorts approaching adolescence will further research in this area and potentially improve outcomes for future generations.
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SAKAMOTO, JUNICHI, HIDEKI KASUYA, YOSHITOKU YOSHIDA, MD HARUN-OR-RASHID, KARLYGASH ZHUBANYSHEVA, ZAITUNA HAMIDULLINA, TALSHYN UKYBASOVA i GULZHAN AIMUKHAMETOVA. "THE IMPACT OF MATERNAL OBESITY ON MOTHER AND NEONATAL HEALTH: STUDY IN A TERTIARY HOSPITAL OF ASTANA, KAZAKHSTAN". Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16025.
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Linné, Yvonne. "Factors affecting weight development after pregnancy - the SPAWN (Stockholm Pregnancy And Women's Nutrition) study /". Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-405-4/.
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Yeh, Yating. "Applicability of the transtheoretical model in weight management in an adolescent population in Taiwan /". View online ; access limited to URI, 2005. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3206260.
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Stucke, Sheri Ann. "Adolescent overweight location of residence, demographics, dietary behaviors and physical activity /". Diss., Online access via UMI:, 2005.
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Rizzolli, Jacqueline. "Obesidade grau III : considerações sobre complicações clínicas e tratamento cirúrgico". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2005. http://hdl.handle.net/10183/8411.
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A obesidade grau III ou também chamada obesidade mórbida é uma condição clínica freqüente e que vem apresentado crescimento progressivo, estando associada a elevadas taxas de morbi-mortalidade. Trata-se de uma doença de origem multifatorial, freqüentemente associada a comorbidezes, necessitando uma abordagem terapêutica que propicie redução de peso, melhora das doenças associadas e conseqüente melhora da qualidade de vida. O tratamento convencional deve ser sempre a primeira escolha, principalmente nos casos de inicio recente e sem antecedentes de tratamentos adequados prévios. A taxa de insucesso, contudo, é extremamente elevada, ocorrendo falha em mais de 90% dos casos. O tratamento cirúrgico atualmente é a alternativa com melhores resultados, porém com riscos de complicações a curto, médio e longo prazo, caso não seja realizado um rigoroso acompanhamento clinico, nutricional e psicológico em equipe multidisciplinar experiente. Esta revisão tem por objetivo discorrer sobre as morbidades associadas à obesidade grave, as opções de tratamento convencional e cirúrgico bem como riscos relacionados à persistência de um grande excesso de peso versus risco cirúrgico.Morbid obesity is a frequent disease with a progressive increase in incidence and associated with high morbid and mortality rates. It is a multifactorial disease, and is usually associated with comorbidities. It is necessary specific treatment to reduce weight, to improve the comorbidities and obtain a better quality of life. The classic treatment, diet and exercise, should be the first choice, especially in cases of recent onset of severe obesity and poor quality previous treatments. Unfortunately, in more than 90% of the patients this kind of treatment will fail. Bariatric surgery is, nowadays, the best option of treatment, but has several risks of complications in the short, medium or long time followup, mostly in patients not followed by a specialized multidisciplinary team. This is a review about morbid obesity, comorbidities, options of treatment and the risks of stay severely obese versus surgical procedures.
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Patouraux, Stéphanie. "Rôle de l'ostéopontine dans les complications hépatiques induites par l'alcool, l'obésité et l'ischémie-reperfusion". Thesis, Nice, 2014. http://www.theses.fr/2014NICE4134/document.
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L’ostéopontine (OPN) est une protéine synthétisée et sécrétée par de nombreux types cellulaires. Elle joue un rôle important dans la régulation de la réponse inflammatoire et immune. Elle est également pro-fibrogénique, et présente des propriétés anti-apoptiques. Les NAFLD et ALD sont les premières causes d’ hépatopathies en France. Le spectre de ces complications va de la stéatose à la stéatohépatite, la fibrose, la cirrhose voire le carcinome hépatocellulaire. Le tissu adipeux joue un rôle important dans la survenue et l’évolution des NAFLD. Nous montrons que l'OPN favorise l'inflammation du foie et du tissu adipeux dans les NAFLD, en favorisant le recrutement de macrophages, de cellules dendritiques et de lymphocytes T et en modulant la polarisation de ces cellules immunes. Chez les patients alcooliques, nous rapportons que l’OPN constitue un marqueur prédictif de la fibrose hépatique. Les lésions induites par l'IR hépatique sont la principale cause de dommages survenant au cours des chirurgies du foie. Le rôle de l'OPN lors de l’IR n’a pas été étudié dans le foie. Mes études ont mis en évidence que l'OPN pourrait jouer un rôle protecteur. Son invalidation (OPN-/-) aggrave les lésions hépatiques (inflammation, souffrance et nécrose hépatocytaire) induites par l’IR chez la souris. Ce rôle protecteur de l’OPN pourrait être dû à sa capacité à prévenir la mort hépatocytaire et à limiter la production toxique de NO dans les macrophages. L’ensemble de ces travaux a permis de mettre en évidence de nouveaux rôles de l'OPN dans les lésions induites par l'IR hépatique et pourrait constituer une cible thérapeutique pour les maladies chroniques du foieOsteopontin (OPN) is a protein synthesized and secreted by many different types of cells. It plays an important part in the regulation of the inflammatory and immune response. OPN is also pro-fibrogenic, and has anti-apoptotic properties. The nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are the leading causes of liver disease in France. The range of these complications goes from steatosis to steatohepatitis, fibrosis, cirrhosis and even hepatocellular carcinoma. Adipose tissue plays a significant part on the occurrence and evolution of the NAFLD. We show that OPN facilitates liver’s and adipose tissue’s inflammation in the NAFLD, by facilitating the intake of macrophages, dendritic cells and T cells, and by modulating the polarization of these immune cells. For alcoholic patients, we show that OPN is one of the predictive markers of liver fibrosis. The lesions induced by ischemia-reperfusion (IR) are the main cause of damages occurring during liver’s surgery. The role of OPN in hepatic injury induced by IR has not yet been investigated. My studies demonstrate that OPN could have a protecting role. OPN deficiency in mice (OPN-/-) increases hepatic lesions caused by IR (inflammation, and cell death). OPN could thus partially prevent hepatic injury and inflammation induced by IR. This could be due to its ability to prevent hepatocyte death and production of toxic NO by macrophages. OPN could thus be an important actor in the pathogenesis of chronic liver disease