To determine the frequency of past and present obesity among patients with NIDDM and to identify the differences of body fat, blood pressure and C-peptide/glucose ratio according to obese diabetic patients (BMI$\geq$25 kg/$m^2$) and nonobese (BMI<25 kg/$m^2$). Also the final factor is to observe the anthrometric change patterns in the study. Method: The weight at 20 years-old, previous maximal body weight, and acute weight loss were queried. Current height, body weight, BMI, waist & hip circumferences, waist-hip ratio, skinfold thicknesses, blood pressure, fasting blood glucose, and fasting C-peptide were measured in one hundred sixty-seven NIDDM patients. The differences of the parameters ccording to obese and nonobese, and three anthropometric change patterns were analyzed. Result: Results were as follows: 1. 66.5 % of the NIDDM patients had a history of past obesity as assessed by their maximum weight, while only 33.2% of them were currently obese (p's < 0.001). 2. The waist & hip circumferences, skinfold thicknesses, systolic, diastolic & mean arterial blood pressure in obese patients were greater than those of nonobese patients (all p's < 0.001). 3. The waist and the hip circumferences, and skinfold thicknesses (subscapula & triceps) were highest among the obese-obese group. WHR and abdominal skinfold thickness in the obese-obese and obese-nonobese groups were higher than those in the nonobese- nonobese group. Systolic & diastolic and mean arterial blood pressures in the obese-obese group were higher than those of obese-nonobese and nonobese-nonobese groups(all p's < 0.005). 4. The abdominal and subscapular skinfold thicknesses in female diabetic patients were greater than those of male patients (all p's <0.0001). Conclusion: Although most Korean NIDDM patients were previously obese, many of them were not obese during the course of the study. Greater central and upper body adiposicity and higher blood pressure was shown in obese diabetic patients. Also, greater central and upper body adiposicity was demonstrated in female diabetic patients.
Purpose: The purpose of this study was to evaluate the effects on obesity of nurse education using the short message service (SMS) of cellular phones and wire Internet. Method: Forty patients in an experimental group, which was assessed pre- and post intervention, completed this study. The patients were divided into two groups according to degree of obesity. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied weekly for 3 months. Participants were requested to input the blood glucose level everyday at http://www.biodang.com by cellular phone or wire internet. The researcher sent optimal recommendations to each patient using SMS of cellular phones and wire Internet. The plasma glucose levels and serum lipids were measured before and after the intervention. Results: After 3 months of education, Glycosylated hemoglobin (HbAlc) decreased by 1.4% in non-obese patients and 0.7% in obese patients. Fasting plasma glucose (FPG) decreased 22.6mg/dl in non-obese patients and 22.3mg/dl in obese patients. Two-hour plasma glucose (2HPG) decreased 97.0mg/dl in non-obese patients and 67.8mg/dl in obese patients. Conclusion: These results indicate that a nurse SMS intervention would improve HbAlc, FPG, and 2HPG in both non-obese and obese patients.
The survey was done on 30 cases of obese patients who were treated by fasting therapy in the Dept. of Oriental Rehabilitation Medicine, oriental medical hospital in Won Kwang University from May 1995 to August 1995. The results are as follows: 1. The ratio of females to males was 1:14. The distribution was 20th decades (63%), 30th decade(13%), 10th decade(6.7%), and 40th decade(6.7%). 2. In the age of obese-prevalence, the middle to high school years was the highest number as 12 persons(40%). The 20th decade(23.3%) and 30th decade(13.3%) were the second and third highest frequency of subjects. 3. In the obesity index, 150% of ideal weight was the highest percentage with persons(40%). 120-129%(30%), 130-139%(23.3%) and 140-149%(6.7%) were in order of frequency. 4. In the family histories of obese patients, it was found that hypertension had a high incidence of 8 persons. Other evidences of family histories were DM (7), cancer (3) and CVD (2). In hereditary tendency of obese parents, it was known that hereditary tendency of obese mothers was high at 14 persons, that of obese fathers was 5 persons, and that of obese parents was 2 persons. 5. In identifying the cause of obesity, it was found that changes of diet patterns was high at 24 persons(80%). Pregnancy, birth and diseases were in order of cause. 6. The review of consumption showed that obese patients ate the same amount as non-obese persons in the case of 21 patients(70%), 8 patients(26.7%) ate more than non-obese persons and 1 person(3.3%) ate less than persons of the same ages. 7. Obese patients consumption of daily snacks was 10 persons(33%). 17 person(57%) of the obese patients ate midnight snacks every 3-4 days. 11 persons(37%) of the obese patients ate out every 3 - 4 days. 8. For the purpose of weight reduction, 15 patients(50%) used exercise. Fasting therapy(36.7%) and food restriction(33.3%) were the second and third methods used by obese patients. 9. In the relation of constitution medicine usage with obese patients, TAE-EUM-IN was 14 persons(46.7%), SO-EUM-IN was 11 persons(36.7%), and SO-YANG-IN was 5 persons(l6.7%).
In orther to find the characteristics of each constitution, the examine of Kyung Hee medical center was diagnosed constitution, and resulted body measures and diagnosis. That was considered and the results are as follows 1. The obese patients is that there are the best many people(91.0%) to Taeumin. The frequency of Taeumin group is more than Soyangin group and Soeumin group. The degree of obesity grade is the highest in Taeumin. 2. The systolic blood & diastolic blood pressure of obese patients did not show any significant differences. Only, the obesity patients is the higher than nomal examine, without regard to Sasang constitution. 3. The hypertensive frequency of obese patients is that Taeumin group is more than Soyangin group and Soeumin group. there is not show any significant differences. specially, the hypertension of Soyangin group is caused by an ascending of diastolic pressure. 4. Glucose value of obese patients did not show any significant differences. generally, the frequency of Taeumin group is more than Soyangin group and Soeumin group. The diabetes of obese patients is the highest in Taeumin. 5. The serum lipids of obese patients did not show any significant differences. Total cholesterol, Triglyceride value of Taeumin group is more than Soyangin group and Soeumin group. HDL-cholesterol of obese patients is that Taeumin group is more than Soyangin group and Soeumin group. 6. The frequency of hyperlipidemia is the highest in Taeumin. 7. GOT, GPT of obese patients did not show any significant differences, but GGT is higher in Taeumin than Soyangin & Soeumin group. 8. Uric acid of obesity patients did not show any significant differences between Sasang constitution, but the value of obese patients is higher than nomal examine. The abnomality of Uric acid is higher in Taeumin than the other constitutions. The frequency of abnomality is the highest in Taeumin females. 9. Arteriosclerosis frequency of obese patients did not show any significant differences, the frequency of Sasang constitution is higher in Taeumin than Soyangin & Soeumin group. 10. Hemoglobin of obese patients did not show any significant differences, but Hematocrit is higher in Soyangin than Taeumin & Soeumin group. Anemia of obese patients did not show any significant differences. The frequency of anemia is higher in the females than the males. 11. BUN, creatinine of obese patients did not show any significant differences.
Moon, Hongran;Lee, Yeonhee;Kim, Sejoong;Kim, Dong Ki;Chin, Ho Jun;Joo, Kwon Wook;Kim, Yon Su;Na, Ki Young;Han, Seung Seok
Journal of Korean Medical Science
/
제33권48호
/
pp.312.1-312.10
/
2018
Background: Obesity is related to several comorbidities and mortality, but its relationship with acute kidney injury (AKI) and long-term mortality remain undetermined in patients undergoing coronary artery bypass grafting. Methods: Data from 3,018 patients (age ${\geq}18$ years) who underwent coronary artery bypass graft surgery from two tertiary referral centers were retrospectively reviewed between 2004 and 2015. Obesity was defined using the body mass index, according to the World Health Organization's recommendation. The odds and hazard ratios in post-surgical, AKI, and all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed for $90{\pm}40.9$ months (maximum: 13 years). Results: Among the cohort, 37.4%, 2.4%, 21.1%, 35.1%, and 4.0% of patients were classified as normal weight, underweight, overweight-at-risk, obese I, and obese II, respectively. Post-surgical AKI developed in 799 patients (26.5%). Patients in the obese groups (overweight-at-risk to obese II) had a higher risk of AKI than did those in the normal-weight group. During the follow-up period, 787 patients (26.1%) died. Underweight patients had a higher risk of mortality than did normal-weight patients, whereas overweight-at-risk, obese I, and obese II patients showed better survival rates. Conclusion: After coronary artery bypass graft surgery, obese patients encountered a high risk of AKI, and underweight patients exhibited a low chance of survival. Awareness of both obese and underweight statuses should be raised in these patients.
Jung, Ji Hoon;Ryu, Seong Yeop;Jung, Mi Ran;Park, Young Kyu;Jeong, Oh
Journal of Gastric Cancer
/
제14권3호
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pp.187-195
/
2014
Purpose: Laparoscopic gastrectomy in obese patients has been investigated in several studies, but its feasibility has rarely been examined in morbidly obese patients, such as in those with a body mass index (BMI) of ${\geq}30kg/m^2$. The present study aimed to evaluate the technical feasibility and safety of laparoscopic gastrectomy in morbidly obese patients with gastric cancer. Materials and Methods: A total of 1,512 gastric cancer patients who underwent laparoscopic distal gastrectomy (LDG) were divided into three groups: normal (BMI< $25kg/m^2$, n=996), obese (BMI $25{\sim}30kg/m^2$, n=471), and morbidly obese ($BMI{\geq}30kg/m^2$, n=45). Short-term surgical outcomes, including the course of hospitalization and postoperative complications, were compared between the three groups. Results: The morbidly obese group had a significantly longer operating time (240 minutes vs. 204 minutes, P=0.010) than the normal group, but no significant differences were found between the groups with respect to intraoperative blood loss or other complications. In the morbidly obese group, the postoperative morbidity and mortality rates were 13.3% and 0%, respectively, and the mean length of hospital stay was 8.2 days, which were not significantly different from those in the normal group. Subgroup analysis showed that postoperative complication rates were not high in morbidly obese patients, independent of the type of anastomosis technique used and level of lymph node dissection. Conclusions: LDG is technically feasible and safe in morbidly obese patients with a BMI of ${\geq}30kg/m^2$ and early gastric carcinoma. Except for a longer operating time, LDG might represent a reasonable treatment option in these patients.
The purpose of this study to compare of clinical profile between obese and nonobese type 2 diabetic patients. The subjects were consist of 111 obese (50 male, 61 female) and 159 non obese (79 male, 80 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, fasting C-peptide and 2-hour postprandial C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association (ADA) criteria. Obesity was defined as body mass index (BMI, kilograms per meters squared) ${\geq}23$. Data analyses were t-test, chisquare test in SAS program. The results were as follows : 1) Triglycerides and 2-hour postprandial C-peptide were significant higher in obese than non-obese patients. 2) Systolic blood pressure, Diastolic blood pressure, fasting blood sugar, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high-density lipoprotein, microalbuminuria and fasting C-peptide were no difference between obese and non-obese groups. These data indicate that obesity is a risk factor for the development of coronary heart disease (CHD) in diabetic patients. Therefore, weight reductions have beneficial effects on insulin action and glycemic control in obese type 2 diabetic patients.
Aim To evaluate blood pressure, blood glucose and serum lipid level in obese and nonobese type 2 diabetic patients. Methods 206 obese(76 male, 130 female) and 442 nonobese(208 male, 234 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$ total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, blood urea nitrogen, creatinine and C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association(ADA)criteria. Obesity was defined as body mass index(BMI, kilograms per meters squared)${\geq}25$. Results In male, systolic blood pressure, triglycerides, microalbuminuria and C-peptide were significant higher in obese than nonobese patients. Fasting blood glucose were significantly lower in obese than nonobese patients. Diastolic blood pressure, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high density lipoprotein, blood urea nitrogen, and creatinine were no difference between 2 groups. In female, triglycerides and C-peptide were significant higher in obese than nonobese patients, Blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high density lipoprotein, microalbuminuria, blood urea nitrogen, and creatinine were no difference between 2 groups. Conclusion Our present study supports that increased triglycerides play a major role in increasing the risk of coronary heart disease(CHD) in obese women type 2 diabetic patients.
Purpose: The number of obese patients seeking total hip arthroplasty (THA) continues to expand despite body mass index (BMI) cutoffs. We sought to determine the outcomes of THA in the morbidly obese patient, and hypothesized they would have comparable outcomes to two cohorts of obese, and normal weight patients. Materials and Methods: THA performed on morbidly obese patients (BMI >40 kg/m2) at a single academic center from 2010 until 2020 were retrospectively reviewed. Eighty morbidly obese patients were identified, and matched in a 1:3:3 ratio to control cohorts with BMI 30-40 kg/m2 and BMI <30 kg/m2. Acute postoperative outcomes and BMI change after surgery were evaluated for clinical significance with univariate and regression analyses. Cox proportional hazard ratio was calculated to evaluate prosthetic joint infection (PJI) and revision surgery through follow-up. Mean follow-up was 3.9 years. Results: In the acute postoperative period, morbidly obese patients trended towards increased hospital length of stay, facility discharge and 90-day hospital returns. At final follow-up, a higher percentage of morbidly obese patients had clinically significant (>5%) BMI loss; however, this was not significant. Cox hazard ratio with BMI <30 kg/m2 as a reference demonstrated no significant difference in survival to PJI and all-cause revision in the morbidly obese cohort. Conclusion: Morbidly obese patients (BMI >40 kg/m2) require increased resource expenditure in the acute postoperative period. However, they are not inferior to the control cohorts (BMI <30 kg/m2, BMI 30-40 kg/m2) in terms of PJI or all-cause revisions at mid-term follow-up.
Hypertension and obesity are important modifiable risk factors for cardiovascular disease, the leading cause of death in Korea. Therefore, we assessed the association between dietary pattern and obesity in hypertensive patients to formulate health promotion strategies for the older population. Dietary information was collected from hypertensive patients visiting community health education and information center by using 24 hour recall method. The 2005 DRIs for Koreans was used to evaluate the dietary adequacy. When subjects were categorized by body mass index (BMI) as normal, overweight and obese, no significant difference in energy intake was found among groups. Dietary intakes of folate, and vitamin C in obese hypertensive patients were significantly lower than in normal weight patients (p < 0.05). When we compare the nutritional status by waist circumferences, dietary intakes of zinc, vitamin A, thiamin, vitamin C and folate were significantly lower in the obese group. Vegetable intake was significantly lower in the obese group according to BMI as well as waist circumference. Energy intake from carbohydrate was significantly higher in obese hypertensive patients (p < 0.05). Obese hypertensive patients had a higher risk of nutritional inadequacy compared to normal weight patients. Our results indicated the need for developing interventions that encourage greater consumption of vegetables while cutting down salt intake with wise selection of staple foods, for obese hypertensive patients.
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