Relationship between cardiovascular risk indicators and types of obesity in overweight and obese women

We aimed to evaluate the relationship between different types of obesity and cardiovascular risk indicators. A total of 623 overweight (body mass index [BMI] > 25 kg/m(2)), and 2559 obese (BMI > 30 kg/m(2)) women were divided into four groups according to their BMI and waist-to-hip ratio (WHR): simple overweight (BMI 25 - 30 kg/m(2) and WHR 0.8, n = 252), peripheral (pure) obesity (BMI > 30 kg/m(2) and WHR 30 kg/m(2) and WHR > 0.8, n = 1641). The levels of the risk indicators measured (clinical, anthropometric and laboratory) were significantly higher in the central obesity group. Total body fat and abdominal fat accumulation seems to result in more serious hyperinsulinaemia and insulin resistance in central obesity. Measuring BMI and WHR in obese patients may reveal their risk for coronary heart disease

Evaluation of endothelial function in subclinical hypothyroidism and subclinical hyperthyroidism

Subclinical hypothyroidism and subclinical hyperthyroidism are two frequently occurring conditions for which exact therapeutic approaches have not yet been established. The aim of this study was to compare the endothelial function and carotid artery intimae-media thickness (IMT) of these two groups of patients to euthyroid subjects and to assess the effects of these conditions on endothelial function. Study groups comprised of 25 subclinical hypothyroid patients (mean age, 32.28 +/- 9.67 years), 13 subclinical hyperthyroid patients (mean age, 35.69 +/- 9.67 years), and 23 euthyroid subjects (mean age, 35.87 +/- 7.93 years). They were evaluated for flow-mediated dilatation (FMD), and carotid artery IMT. The groups were matched strictly for atherosclerotic risk factors. The subclinical hypothyroid group was found to have significantly lower FMD values. No significant differences were observed between the groups with respect to other vascular parameters. The only discriminative factor between the groups was the state of their thyroid function. Therefore, subclinical hypothyroidism may have adverse effects on endothelial function independent from other well-known atherosclerotic risk factors

Associations among sex hormone binding globulin concentrations and characteristics of the metabolic syndrome in obese women

The aim of this study was to determine sex hormone binding globulin (SHBG) concentrations in premenopausal obese women who were otherwise healthy, and to evaluate the relationships between SHBG concentrations and features of the metabolic syndrome; 307 premenopausal women (mean age 30.9+/-10.2 years) were studied. Subjects were divided into two groups according to the BMI: Group I, women with BMI <30 kg/m(2) (n=69) and Group II, women with BMI greater than or equal to30 kg/m(2) (n=238). Insulin resistance was determined according to the Homeostasis Model Assessment (HOMA) formula. Median SHBG concentration of Group I was 75.9 nmol/l. Group II was divided into two subgroups according to the median SHBG concentration of Group I; women with high SHBG (SHBG concentration greater than or equal to median level of the control group, i.e. greater than or equal to76 nmol/l) and women with low SHBG (i.e. <76 nmol/l). The low SHBG group was significantly younger, with higher waist-to-hip ratio (WHR). Triglycerides, uric acid, insulin and HOMA values were significantly higher and HDL-cholesterol was significantly lower in the low SHBG group. Multiple regression analysis revealed that age and uric acid concentrations were significant independent predictors of SHBG concentrations in the whole group (regression summary, adjusted r(2)=0.1414, F=10.5627, p<0.001). It is concluded that low SHBG concentrations may indicate a severe degree of insulin resistance in premenopausal obese women. (C) 2004, Editrice Kurtis

Subepicardial adipose tissue thickness and its relation with anthropometric and clinical parameters in pubertal obese children

Aim: To determine the relation of echocardiographic subepicardial adipose tissue (SAT) thickness with anthropometric and clinical parameters in pubertal obese children. Subjects and methods: A total of 52 obese pubertal subjects (13.1 +/- 1.56 yr, 27 male patients) and 39 age- and gender-matched lean pubertal subjects (13.0 +/- 1.28 yr, 16 male patients) were included in the study. Serum glucose, lipid profile, and insulin levels were measured during the fasting state. Each subject underwent a transthoracic echocardiography and the SAT thickness was measured during end-diastole from the parasternal long-axis views. Results: The obese pubertal subjects had significantly higher SAT, triceps skin fold (TSF) thickness (mm), waist (WC) and mid-arm circumference (MAC) values (cm) compared with lean pubertal subjects group (p0.05). As an optimal cut-off point, a SAT thickness of 5.25 mm determined IR with 92% sensitivity and 62.1% specificity. Conclusions: Our study showed that SAT thickness in obese pubertal children shows a good correlation with age, SDS-BMI, BMI, WC, MAC, TSF, and HOMA-IR. In addition, our results suggest that SAT thickness might be used as a supportive data for risk stratification of metabolic syndrome in obese children. (J. Endocrinol. Invest. 33: 715-719, 2010) (C) 2010, Editrice Kurti

Normal flow-mediated vasodilatation of the brachial artery and carotid artery intima-media thickness in subclinical hypothyroidism

Subclinical hypothyroidism (SHT) is a disease for which exact therapeutic approaches have not yet been established. Previous studies have suggested an association between SHT and coronary heart disease. Whether this association is related to SHT-induced changes in serum lipid levels or to endothelial dysfunction is unclear. The aim of this study was to determine endothelial function measured by the flow-mediated vasodilatation of the brachial artery and the carotid artery intima-media thickness (IMT) in a group of women with SHT compared with euthyroid subjects. Triglycerides, total cholesterol, HDL-C, LDL-C, apoprotein A (apo A), apo B, and lipoprotein(a) were also determined. Twenty-one patients with SHT (mean age: 42.4 ± 10.8 years and mean thyroid-stimulating hormone (TSH) levels: 8.2 ± 2.7 µIU/mL) and 21 euthyroid controls matched for body mass index, age and atherosclerotic risk factors (mean age: 44.2 ± 8.5 years and mean TSH levels: 1.4 ± 0.6 µIU/mL) participated in the study. Lipid parameters (except HDL-C and apo A, which were lower) and IMT values were higher in the common carotid and carotid bifurcation of SHT patients with positive serum thyroid peroxidase antibodies (TPO-Ab) (0.62 ± 0.2 and 0.62 ± 0.16 mm for the common carotid and carotid bifurcation, respectively) when compared with the negative TPO-Ab group (0.55 ± 0.24 and 0.58 ± 0.13 mm, for common carotid and carotid bifurcation, respectively). The difference was not statistically significant. We conclude that minimal thyroid dysfunction had no adverse effects on endothelial function in the population studied. Further investigation is warranted to assess whether subclinical hypothyroidism, with and without TPO-Ab-positive serology, has any effect on endothelial function