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Obesity and Diabetes, the major cause for morbidity and mortality in United States raises a general curiosity regarding health care expenses when talked about treating them. Every year approximately 300,000 US adults die of reasons associated to obesity and diabetes, becoming the sixth leading cause of death. The prevalence of those diagnosed with diabetes witnessed an exponential curve in the last decade and for the year 2011 about 8.3% of the population in the US has been diagnosed with diabetes and it is predicted that in the year 2030 the prevalence of diabetes is to reach 4.4% globally. Type 2 diabetes is a condition, which develops when the body no longer makes enough insulin or when the insulin so produced does not work effectively. In reaction to the increase in obesity, treatments for obesity became more common especially the pharmacological treatments. Since this treatment also required one to change their lifestyle and food habits, bariatric surgeries were considered as an option to treat obesity and diabetes. A range of surgical procedures have been used to stimulate weight loss for obese patients. These procedures resulted in weight loss by restricting the size of the stomach (Gastric Banding) or bypassing a portion of the intestine (Gastric Bypass). Roux-en-Y Gastric Bypass (RYGB) accomplishes weight loss during a combination of gastric restriction and malabsorption. Reduction of the stomach to a small gastric pouch results in feelings of satiety. The RYGB procedure has been performed regularly since the early 1980s; it was first performed laparoscopically in the early 1990s. Ileal interposition (IT) is a surgical procedure where a section of ileum is snipped and moved closer to the jejunum. It is said that the food takes just ten minutes to reach the ileum instead of an hour after this procedure. The ileum produces Glucagon like Peptide-1 (GLP-1) which helps in insulin secretion. Glucose is a key stimulator for mammals and is derived from the diet consumed, transferred from the circulation into the target cells. Glucose penetrates the eukaryotic cells through membrane associated carrier proteins, the Na+ coupled glucose transporter (SGLT-1) and the glucose transporter (GLUT). These transporters are structurally and functionally distinct. The main research question was "are the receptors involved in glucose transport across the membrane (GLUT2 and SGLT1) important for Ileal Interposition"? With experiments like real time PCR (qPCR) and immunohistochemistry (IHC), we have observed the differences in the expression of these receptors with respect to the location and organ. Ileal interposition showed a significant difference (p<0.01) compared to sham-operated rats in the expression of GLUT2 in the gluconeogenic organs. The increased GLUT2 levels in ileal interposition may explain glucose sensitivity and these data emphasize the need for GLUT2 to maintain a positive glucose homeostasis and further study on SGLT1/GLUT2 influence on gluconeogenesis.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-07-13T16:23:31Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DissertacaoFinal_Maira_22.01.16.pdf: 16468774 bytes, checksum: c1641a7c80fa9087218ff05f0c946365 (MD5) / Made available in DSpace on 2016-07-13T16:23:31Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DissertacaoFinal_Maira_22.01.16.pdf: 16468774 bytes, checksum: c1641a7c80fa9087218ff05f0c946365 (MD5) Previous issue date: 2015-12-14 / Introdução: Sobrepeso e obesidade estão associados à síndrome metabólica e obesidade abdominal, aumentando o risco de diabetes mellitus tipo 2 e doenças cardiovasculares. No Brasil, ainda não há dados precisos sobre a prevalência destas alterações, principalmente entre pessoas que estão realizando algum tipo de atividade física em ambientes públicos. Objetivo: Investigar a prevalência da obesidade e comorbidades em frequentadores de um parque em Recife. Métodos: Realizou-se um estudo prospectivo, transversal e descritivo, onde 619 indivíduos foram avaliados e estratificados por perfil definido em protocolo específico. Resultados: Características da população estudada: sexo feminino (50,1%) e média de idade = 50,6 ± 14,8, havendo predomínio entre 50 e 59 anos (26,8% dos casos) e de indivíduos com ensino superior (68%) e renda familiar entre 4 e 10 salários mínimos (29,2%). A prática regular de exercícios físicos foi relatada por 78% das pessoas e foi constatado ainda que 70,7% apresentavam excesso de peso: 45% com sobrepeso e 25,7% obesidade, dos quais 20,7% com obesidade grau I, 3,9% com grau II e 1,1% com grau III. A prevalência de síndrome metabólica foi de 4,3%, com predomínio nos homens (6,3%). Hipertensão arterial e diabetes mellitus tipo 2 foram detectados em 17,8% e 5,5%, respectivamente. Devido a influência da obesidade na ocorrência de diabetes mellitus 2 e síndrome metabólica, foi constatado que esta associação não é significativa para as duas condições (p=0,014 e 0,017, respectivamente). Conclusão: Os achados demonstram elevada prevalência de sobrepeso e obesidade da população avaliada, e síndrome metabólica em 4,3%, apesar do relato de que 70% dos transeuntes realizavam atividade física regular. / Background: Overweight and obesity are associated with metabolic syndrome and abdominal obesity, thereby increasing the risk of type 2 diabetes mellitus and cardiovascular diseases. In Brazil, there are still no precise data on the prevalence of these disorders, especially among individuals who carry out some kind of physical activity in public spaces. Aim: To investigate the prevalence of metabolic syndrome and obesity among park users. Methods: A prospective, cross-sectional, descriptive study was conducted with 619 individuals assessed and stratified by profile according to a specific protocol. Results: The group was characterized as follows: female (50.1%) and mean age =50.6±14.8, with predominance of individuals aged between 50 and 59 years (26.8%) and with higher education (68%) and a household income of between 4 and 10 minimum wages (29.2%). Regular physical exercise was reported by 78% of the individuals and it was found that 70.7% were nevertheless of above normal weight: 45% overweight and 25.7% obese, of whom 20.7% had obesity grade I, 3.9% grade II and 1.1% grade III. The prevalence of metabolic syndrome was 4.3%, mostly in men (6.3%). Arterial hypertension and type 2 diabetes mellitus were detected in 17.8% and 5.5%, respectively. In view of the influence of obesity on the occurrence of type 2 diabetes mellitus and metabolic syndrome, it was found that this association was not significant for the two conditions (p=0.014 and 0.017, respectively). Conclusion: The findings demonstrate a high prevalence of overweight and obesity in the studied population, and metabolic syndrome in 4.3%, despite the fact that 70% reported engaging in regular physical activity.

No description available.

BACKGROUND: Risk factors associated with Metabolic Syndrome (MetS) have been implicated in cardiovascular disease (CVD) development and outcomes. Few studies have investigated relationships between psychological variables, MetS factors, and indices of cardiac structure and function (CSF) among healthy individuals in a single conceptual model. No studies to date have analyzed such relationships in patients with CVD. METHODS: The present study examined associations between cynical hostility (CynHo), MetS factors, and CSF in 186 multi-ethnic post-myocardial infarction (MI) patients. Structural equation modeling was used to test a theory driven model of MetS that had good statistical fit. Primary MetS variables included waist circumference (WC), the homeostatic model of insulin resistance (HOMA-IR), glucose area under the curve (G-AUC), triglycerides (TRIG), high-density lipoprotein cholesterol (HDL-C), and diastolic blood pressures (DBP). Secondary MetS variables included plasminogen activator inhibitor-1 (PAI-1) and a latent inflammation variable comprised of CRP and IL-6. Cardiac function variables were fractional shortening (FS), E/A ratio, and rate-pressure product (RPP). A latent cardiac mass (CM) variable was also created. RESULTS: The final structural model had good model fit (Chi-Square(102)=100.65, p=0.52, CFI=1.00, RMSEA=0.00, and SRMR=0.04). Direct paths were supported between WC and CM and all MetS factors except TRIG and G-AUC. WC was indirectly associated with DBP via CM. The model supported positive direct paths between HOMA-IR and G-AUC, TRIG, and PAI-1, but not inflammation or HDL-C. HOMA-IR demonstrated a direct positive association with RPP and direct inverse associations with FS and E/A ratio. No direct paths were supported between other MetS variables except one between TRIG and HDL-C. CynHo demonstrated a direct positive relationship with HOMA-IR. CONCLUSIONS: Similar to findings in healthy individuals, central adiposity and IR play primary roles in CSF impairment in post-MI patients. Findings suggest that CynHo could promote the progression of metabolic dysfunction and cardiac disease via factors that influence the efficiency of glucose metabolism. Interventions for post-MI patients should take into account both direct and indirect effects of CynHo, central adiposity, and IR on the progression of CVD in this population to reduce adverse outcomes and improve quality of life.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1989.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 5 uppsatser.

This thesis reports on a qualitative exploration of the experiences of 30 women designated as ‘high risk’ due to the co-existence of ‘maternal obesity’ (BMI ≥ 30) and Gestational Diabetes Mellitus (GDM)/Type Two Diabetes Mellitus (T2DM) in pregnancy. This is examined in the context of medico-scientific/public health/ popular media discourses pertaining to ‘maternal obesity’/GDM/T2DM in pregnancy. ‘Maternal obesity’/GDM/T2DM in pregnancy are increasingly prevalent and clinically associated in manifold ways. Increasing prevalence is linked to the ‘global epidemic’ of ‘obesity’/diabetes: now commonly referred to as ‘diabesity’. Current biomedical knowledge asserts ‘maternal obesity’ and diabetes (‘maternal diabesity’) synergise in causing adverse pregnancy outcomes, have long term health implications for the offspring and contribute to an ‘intergenerational cycle’ of ‘obesity’/diabetes. This is the first qualitative study to consider pregnancy/post-birth experiences of women with co-existing ‘maternal obesity’ and GDM/T2DM in pregnancy from a sociological perspective. Participants undertook a series of auto/biographical narrative interviews. Longitudinal engagement provided nuanced psycho-social insight into women’s perceptions/experiences and the socio-cultural context of their lives. Analysis of pertinent ‘pregnancy’ Internet fora postings augmented interview data and was utilised for comparative/corroborative purposes. Participants were predominantly of low socio-economic status, congruent with epidemiological data. The concept of pregnancy ‘planning’ was not resonant and few women accessed/felt predisposed to access preconception care. Women did not identify as ‘obese’, and knowledge/perception of risks associated with the medical ‘conditions’ was low. Women perceived themselves to be stigmatised due to their weight in society and specifically within healthcare. Many participants were experiencing acute/chronic stress which appeared to have mediated risk perceptions/compromised diabetic regimen adherence. Expense of ‘healthy’ eating/diabetic diet was considered prohibitive. Women’s material circumstances/socio-cultural milieux may militate against ability to minimise risk and effect lifestyle change. Policy and practice, for the most part, fails to take this into account.

The prevalence of type 2 diabetes mellitus is increasing worldwide and is considered one of the top health concerns globally. The occurrence of type 2 diabetes is linked to the rapidly increasing trend of obesity in both adults and children, which is proposed to be a contributing factor in the development of insulin resistance and type 2 diabetes. White adipose tissue, an insulin target tissue, is an important endocrine organ involved in the control of energy homeostasis through its direct influence on metabolism, insulin sensitivity and food intake. To better understand these functions, we studied adipocyte differentiation in 3T3-Ll cells, a white adipose tissue cell line. Many mitochondrial proteins exhibit an increase in expression levels during adipogenesis as identified by mass spectrometry. Moreover, increased mitochondrial mass and altered morphology was observed by light microscopy. Qualitative changes in mitochondrial gene expression were also observed during adipogenesis as revealed by Affymetrix GeneChip analysis. Additionally, striking changes in mitochondrial protein expression and morphology were identified following treatment with the insulin sensitizing agent, rosiglitazone. These results suggest that mitochondrial biogenesis and remodeling is inherent to white adipocyte differentiation. To investigate the physiological relevance of these findings, mRNA and protein expression profiles and mitochondrial morphology were studied during the development of insulin resistance and obesity and following treatment with rosiglitazone in ob/ob mice. These studies reveal a marked decrease in transcript levels for over 50% of mitochondrial genes with the onset of obesity in ob/ob mice. Rosiglitazone treatment stimulates enhanced expression in approximately half of these genes, as well as changes in mitochondrial mass and remodeling. Furthermore, these studies reveal that depressed oxygen consumption and fatty acid oxidation occur with obesity development and these alterations can be reversed with rosiglitazone treatment. This work identifies the previously underscored plasticity of mitochondria in white fat and suggests that mitochondrial biogenesis and remodeling in white adipose tissue may lead to systemic changes in insulin sensitivity and energy homeostasis. Lastly, these studies suggest that mitochondria may be an important therapeutic target for antidiabetic drugs.