Search

Eosinophils play a key role in the asthma allergic response by releasing cytotoxic molecules such as eosinophil cationic protein (ECP) and eosinophil-derived neurotoxin (EDN) that generate epithelium damages.We sought to identify genetic variants influencing ECP and EDN levels in asthma-ascertained families.We performed univariate and bivariate genome-wide association analyses of ECP and EDN levels in 1018 subjects from the EGEA study with follow-up in 153 subjects from the Saguenay-Lac-Saint-Jean study and combined the results of these 2 studies through meta-analysis. We then conducted Bayesian statistical fine mapping together with quantitative trait locus and functional annotation analyses to identify the most likely functional genetic variants and candidate genes.We identified 5 genome-wide significant loci (P amp;lt; 5 × 10lt;supgt;-8lt;/supgt;) including 7 distinct signals associated with ECP and/or EDN levels. The genes targeted by our fine mapping and functional search include RNASE2 and RNASE3 (14q11), which encode EDN and ECP, respectively, and 4 other genes that regulate ECP and EDN levels. These 4 genes were JAK1 (1p31), a transcription factor that plays a key role in the immune response and acts as a potential therapeutic target for eosinophilic asthma; ARHGAP25 (2p13), which is involved in leukocyte recruitment to inflammatory sites; NDUFA4 (7p21), which encodes a component of the mitochondrial respiratory chain and is involved in cellular response to stress; and CTSL (9q22), which is involved in immune response, extracellular remodeling, and allergic inflammation.Analysis of specific phenotypes produced by eosinophils allows the identification of genes that play a major role in allergic response and inflammation, and offers potential therapeutic targets for asthma.

Background: Little is known about the initiation, style and content of patient and healthcare provider communication around deprescribing. We report the findings from a content analysis of audio-recorded discussions of proton pump inhibitor (PPI) and benzodiazepine deprescribing in primary care. Methods: Participants were healthcare providers ( n = 13) from primary care practices ( n = 3) and patients aged ⩾65 ( n = 24) who were chronic users of PPIs or benzodiazepines. The EMPOWER educational brochures were distributed prior to ( n = 15) or after ( n = 9) the patient’s usual healthcare provider appointment. Conversations were audio-recorded and coded using MEDICODE to analyze who initiated different themes, whether they followed a monologue or dialogue style, and to what extent the thematic content addressed issues pertaining to: ‘dosage/instructions,’ ‘medication action and efficacy,’ ‘risk/adverse effects,’ ‘attitudes/emotions,’ ‘adherence’ and ‘follow up.’ Descriptive analysis of the conversations was performed with comparison between patients who received the EMPOWER brochure before or after their appointments. Results: Patients were mostly women (67%) with a mean age of 74 ± 6 years. For PPI users, prior education resulted in a greater proportion of themes initiated by patients (44% versus 17%) and maintaining dialogue-style conversations (48% versus 28%). Among benzodiazepine users, conversation initiation (52% versus 47%) and conversation style was similar between both groups. The content of deprescribing conversations for PPIs revealed that patients and their healthcare providers focused less on ‘dosage/instructions,’ and more on the ‘medication action and efficacy’ and the necessity for ‘follow up.’ Conversations about stopping benzodiazepines were more likely to stagnate on the ‘if’ rather than the ‘how.’ Conclusion: The initiation, style and content of the conversations varied between PPI and benzodiazepine users, suggesting that healthcare providers will need to tailor deprescribing conversations accordingly.

AIM Chronic inflammation has been associated to the development of cardiometabolic dysfunctions. The use of an intravenous (IV) catheter is highly recommended for physiology testing. Yet, the presence of an IV catheter triggers local inflammation that does not reflect systemic inflammatory status. The aim of this study was to assess the effect of an IV catheter on serum concentrations of IL-6, IL-8 and hsCRP in a fasting state and after a high-fat meal known to trigger low-grade inflammation. METHODS Twenty-two healthy subjects (7 men, 15 women) were included in this study. The trial included 2 visits. After an overnight fast, a venous catheter was inserted into an antecubital vein. A first blood sample was collected through this catheter at T = 0 min. On each visit, participants were requested either to drink only water for the whole duration of the test (WO test), or to consume a high-fat meal (HFM). Blood samples were collected through the catheter at T60, T120, T180 and T300 min. Additional venous punctures were performed on the contralateral arm at T180 and T300 min. Serum inflammatory mediators were measured at each time point of both interventions. RESULTS When serum was collected by venous punctures, IL-6 concentrations remained unchanged during both WO and HFM tests (Ptime = 0.15 and Ptime = 0.23, respectively), whereas the concentrations increased progressively over time when serum was collected through the catheter (Ptime

Resistance training (RT) has been shown to decrease fat mass (FM), and increase fat-free mass (FFM), which can be a useful for weight loss maintenance. Objective To examine the effects of a 1-year RT intervention on weight loss maintenance following a 6-month dietary weight loss intervention. Design Following a 6-month dietary weight loss intervention (−6% ± 5.8; 5.05 kg ± 4.45), 70 postmenopausal women living with overweight or obesity were randomized to a control group ( n = 34) or a RT group ( n = 36) (3×/week first 6 months, 2×/week last 6 months, 70–80% of 1-repetition maximum). Body composition (DXA), abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (CT scan), resting energy expenditure (EE) (indirect calorimetry), physical activity EE and total daily EE were measured (doubly-labelled water). Results A total of 54 participants completed the study (control group n = 29; RT group n = 25) and compliance to the RT program was on average 64%. Significant regains were noted for body weight 0.98 (3.71) kg vs. 1.33 (3.94) kg and FM regain 1.32 (2.69) kg vs. 0.81 (3.26) kg in control and RT groups after the 1-year weight maintenance phase. No group differences were noted. Resting EE and total daily EE did not change after the weight maintenance phase, and no differences were observed between groups. Both groups had significantly greater than predicted decrease in resting EE after the 6-month dietary intervention and at the end of the 1-year weight-loss maintenance phase. Conclusions Our results suggest that a 1-year RT intervention following a 6-month dietary weight loss intervention does not improve weight loss maintenance, body composition or EE in post-menopausal women living with overweight or obesity.

A subpopulation of obese individuals remains insulin sensitive (ISO). They represent a unique human model to investigate factors underlying insulin resistance (IR) without the confounding effect of major differences in weight/adiposity. Altered fatty-acid (FA) metabolism in sc adipose tissue (SAT) contributes to obesity-associated IR.To test the hypothesis that ISO and body mass index-matched insulin-resistant obese (IRO) patients demonstrate differential SAT expression profiles of genes involved in glycerolipid-FA metabolism and that weight loss-induced improvement of IR ameliorates these changes.A cross-sectional and longitudinal study.Thirty-eight nondiabetic obese women were stratified into ISO (n = 25) or IRO (n = 13) groups based on hyperinsulinemic-euglycemic clamp results. Subjects were studied before and after a 6-month hypocaloric diet intervention.mRNA (quantitative RT-PCR) and protein (mass spectrometry and immunoblots) levels were measured in SAT biopsies.Despite having age, body mass index, and fat mass similar to ISO individuals, IRO patients had lower insulin sensitivity and glucose tolerance (P.05). Baseline SAT mRNA and protein levels of genes involved in both the synthesis and lipolysis of glycerolipid-FAs were higher in IRO individuals (P.05), even when groups were matched for visceral adipose tissue content. The dietary intervention resulted in approximately 6% weight loss in both the IRO and ISO groups (P.05) but only ameliorated insulin sensitivity in IRO individuals (P.05). Likewise, the intervention reduced the expression of most glycerolipid-FA metabolism genes (P.05), with expression levels in IRO individuals being restored to ISO levels.Increased SAT expression of genes involved in both the synthesis and hydrolysis of glycerolipid-FAs is closely associated with IR in obese women. The results suggest that enhanced glycerolipid-FA cycling in SAT contributes to obesity-associated IR.

Healthy diet and physical activity are associated with a lower cardiometabolic risk (CMR). Little is known about whether they interact to improve CMR. The purpose of the present study was to determine the synergistic associations of diet quality and physical activity energy expenditure (PAEE) on CMR factors. The present study was ana posteriorianalysis of two cross-sectional studies on 124 inactive non-diabetic postmenopausal women with a BMI ≥ 27 kg/m2. The following factors were measured: diet quality (assessed by the Canadian Healthy Eating Index (C-HEI) from a 3 d food record); PAEE (doubly labelled water); body composition (dual-energy X-ray absorptiometry, computed tomography scan); lipoprotein profile (total, HDL- and LDL-cholesterol (HDL-C and LDL-C), non-HDL-C, total cholesterol:HDL-C, TAG, apoA1, apoB, apoA1:apoB and LDL-C:apoB); insulin sensitivity (homeostasis model assessment of insulin resistance and hyperinsulinaemic–euglycaemic clamp); inflammatory markers (high-sensitivity C-reactive protein (hs-CRP), haptoglobin, orosomucoid, IL-6 and leucocyte count). The association of the interaction PAEE × C-HEI and CMR factors was evaluated by hierarchical regressions. Fat mass-adjusted ANCOVA determined the interaction between PAEE and the C-HEI. In hierarchical regressions, the interaction PAEE × C-HEI was a correlate of more favourable values of HDL-C, apoB, apoA1:apoB and LDL-C:apoB ratios, and hs-CRP, while only PAEE was a negative correlate of haptoglobin. Compared with those in the low-PAEE/low-C-HEI group, women in the high-PAEE/high-C-HEI group had 10 % higher HDL-C, 13 % lower apoB, 11 % larger LDL particles and 28 % lower hs-CRP concentrations (P

Introduction. Subcutaneous fat (ScF) and visceral fat (VF) measurements using CT scan are expensive and may imply significant radiation doses. Cross-sectional studies using CT scan showed that ScF and VF are significantly correlated with abdominal fat measured by DXA (AF-DXA). The association has not been studied after a weight loss.Objective. To determine (1) the associations between AF-DXA and ScF and VF before and after weight loss and (2) the associations between their changes.Methods. 137 overweight/obese postmenopausal women were divided in two groups (1-caloric restriction or 2-caloric restriction + resistance training). AF was assessed using DXA and CT scan.Results. Correlations between AF-DXA and ScF (before:r=0.87, after;r=0.87;P<.01) and, AF-DXA and VF (before:r=0.61, after;r=0.69;P<.01) are not different before and after the weight loss. Correlations between delta AF-DXA and delta ScF (r=0.72;P<.01) or delta VF (r=0.51;P<.01) were found.Conclusion. The use of AF-DXA as a surrogate for VF after weight loss is questionable, but may be interesting for ScF.

ObjectiveTo evaluate the validity of a new lipid-based index (Disse index) in assessing insulin sensitivity (IS) compared with the hyperinsulinemic-euglycemic (HIEG) clamp in overweight and obese, non-diabetic, postmenopausal women, before and after a weight loss intervention.Research design and methodsAssociation between Disse index and the HIEG clamp was evaluated in 86 non-diabetic postmenopausal overweight and obese women before and after weight loss. Percentage changes (%Δ) were calculated for several fasting indices and compared with %Δ of HIEG clamp.ResultsWe observed a strong correlation between Disse index and HIEG clamp (r=0.69, Pr=0.34, PConclusionsWe validated the reliability of Disse index in assessing IS in non-diabetic post-menopausal overweight and obese women, before and after weight loss intervention. Disse index may be useful not only for insulin resistant diagnostics in this type of population, but also for the IS follow-up after a weight-loss program and weight stabilization. The presence of lipid elements in this fasting index improves the estimation of IS in overweight and obese non-diabetic post-menopausal women and could add more information about peripheral IS.

Characteristics of weight cyclers have not been fully assessed. The objective of this study was to determine the anthropometric, metabolic, psychosocial, and dietary profile of postmenopausal women according to weight-cycling history, defined as the frequency of going on a diet and losing10 kg: never (0 times), low (1 time), moderate (2 to 3 times), or frequent (or = 4 times). The sample of this cross-sectional study consisted of 121 overweight/obese postmenopausal women enrolled in a 6-month randomized weight-loss intervention between 2003 and 2006. Measures at baseline were used to evaluate body composition (fat mass by dual-energy x-ray absorptiometry and visceral fat by computed tomography); resting metabolic rate by indirect calorimetry; insulin sensitivity by hyperinsulinemic-euglycemic clamp; fasting plasma levels of glucose, lipids, leptin, ghrelin, and adiponectin; blood pressure; psychosocial profile (eg, body-esteem, self-esteem, stress, perceived risks, perceived benefits, self-efficacy, quality of life, dietary restraint, disinhibition, hunger); and dietary profile (3-day food record). Differences among groups of weight cyclers were determined using analyses of variance. Among the 121 women, 15.7%, 24.8%, 33.9%, and 25.6% were non-, low, moderate, and frequent cyclers, respectively. Frequent cyclers were characterized by higher body mass index (calculated as kg/m(2)) (current and at 25 years of age) and percent body fat mass, larger waist circumference, and lower resting metabolic rate/kg body weight than noncyclers (P0.05); and moderate cyclers had lower plasma adiponectin values than noncyclers (P0.05). For psychosocial measures, frequent cyclers were characterized by greater disinhibition and lower body esteem after controlling for body mass index (P0.05). In conclusion, weight cycling was found to be associated with some unfavorable metabolic and psychosocial parameters.

Sarcopenia is believed to be associated with disability and metabolic complications. The objective of this study was to examine the metabolic and quality-of-life profile of sarcopenic overweight and obese postmenopausal women. In this cross-sectional study of 136 healthy overweight and obese postmenopausal women, 9 class I sarcopenic women were identified. Class I sarcopenia was defined as an appendicular lean body mass index (ALBMI) ≤ 6.44 kg·m–2 (appendicular lean body mass/height). Outcome measures were body composition (dual energy X-ray absorptiometry and computed tomography), blood lipids, inflammation markers, blood pressure, insulin sensitivity (homeostasis model assessment and hyperinsulinemic-euglycemic clamp), cardiorespiratory fitness, and quality of life (Medical Outcomes Study General Health Survey questionnaire). By design, class I sarcopenic women (n = 9) had a significantly lower ALBMI and appendicular lean body mass than nonsarcopenic women (n = 127). In addition, class I sarcopenic women tended to have lower levels of insulin resistance (p = 0.070) and fasting glucose (p = 0.054). However, no difference between the groups was observed for quality of life. This study showed that, in our sample of class I sarcopenic overweight and obese postmenopausal women, subjects did not present an unfavourable metabolic or quality-of-life profile, compared with nonsarcopenic overweight and obese postmenopausal women.

The study evaluated and compared, with other surrogate indices of insulin sensitivity/resistance (IS/R), the relevance of the TyG index, a product of fasting glucose and triglyceride (TG) levels, and the EGIR index, which includes TG, high-density lipoprotein cholesterol (HDL-c) and waist circumference in its formula to estimate IS/R, in non-diabetic postmenopausal women.A secondary analysis was performed using the baseline data for 163 non-diabetic postmenopausal women from the Montreal-Ottawa New Emerging Team (MONET) population database. The subjects participated in hyperinsulinaemic-euglycaemic (HIEG) clamp and oral glucose tolerance (OGTT) tests. Correlations and comparisons between surrogate indices were performed in addition to inter-rater agreement tests. The optimal value of surrogate indices for diagnosis of IS/R was established on a receiver operating characteristic (ROC) scatter plot.A significant correlation was found between the HIEG clamp and all IS/R surrogate indices tested [r=-0.370 (TyG index) to 0.608 (SIisOGTT index); P0.001]. On ROC curve analysis, a higher AUROC was found for SIisOGTT (0.791) than for TyG and EGIR (0.706 and 0.675, respectively; P=0.07 and P0.05, respectively).The TyG and EGIR IS/R indices were only relatively modestly related to the HIEG clamp. In contrast, both fasting- and OGTT-derived IS/R surrogate indices, which include insulin values in their formulae, appeared to be more accurate in estimating IS/R in our study population. Thus, the TyG and EGIR IS/R indices need to be tested and validated more extensively in different populations before being put to large-scale clinical use.

Objective: Oxidative stress plays a role in obesity-related diseases. We hypothesize that abnormalities of the glutathione system are associated with the initial phase leading to development of cardiometabolic abnormalities such as cardiovascular diseases and type 2 diabetes in apparently healthy obese women. By measuring different glutathione parameters, we expect to find a dichotomy that can discriminate between obese women who have such sub-clinical abnormalities. Subjects: This is a cross-sectional analysis in 59 postmenopausal obese women. Total blood glutathione, glutathione peroxidase (GPx) and glutathione reductase activity, blood lipids, apolipoprotein B-100 (apoB), fasting and area under the curve (AUC) for glycemia and insulinemia during an oral glucose tolerance test, insulin sensitivity measurement and indices, serum inflammatory markers and carotid intima-media thickness (CIMT, by magnetic resonance imaging) were measured. Results: Blood GPx activity had a bimodal distribution. Subjects were then divided into two groups according to their GPx activity (cut-off: 2.0 nmol/min/mg protein, P

The presence of obesity-related metabolic disturbances varies widely among obese individuals. Accordingly, a unique subset of obese individuals has been described in the medical literature, which seems to be protected or more resistant to the development of metabolic abnormalities associated with obesity. These individuals, now known as 'metabolically healthy but obese' (MHO), despite having excessive body fatness, display a favorable metabolic profile characterized by high levels of insulin sensitivity, no hypertension as well as a favorable lipid, inflammation, hormonal, liver enzyme and immune profile. However, recent studies have indicated that this healthier metabolic profile may not translate into a lower risk for mortality. Mechanisms that could explain the favorable metabolic profile of MHO individuals are poorly understood. However, preliminary evidence suggests that differences in visceral fat accumulation, birth weight, adipose cell size and gene expression-encoding markers of adipose cell differentiation may favor the development of the MHO phenotype. Despite the uncertainty regarding the exact degree of protection related to the MHO status, identification of underlying factors and mechanisms associated with this phenotype will eventually be invaluable in helping us understand factors that predispose, delay or protect obese individuals from metabolic disturbances. Collectively, a greater understanding of the MHO individual has important implications for therapeutic decision making, the characterization of subjects in research protocols and medical education.

Chronic subclinical inflammation and regular physical activity have opposing relationships to obesity-related metabolic diseases. Yet, the association between chronic inflammation and physical activity has rarely been examined in obese subjects. We examined the association between physical activity energy expenditure (PAEE), total (TEE) and resting energy expenditure (REE) and cardiorespiratory fitness (VO(2)peak) with inflammatory markers in overweight/obese women.Cross-sectional study.The study included 152 overweight/obese postmenopausal women who were sedentary and free of chronic/inflammatory diseases (mean age: 57.5 (95% confidence interval (CI) 56.7-58.3) years, body mass index (BMI): 32.5 (95% CI 31.8-33.2) kg m(-2)). The following parameters were measured: TEE (doubly labeled water), REE (indirect calorimetry), PAEE (as (TEE x 0.90)-REE), VO(2)peak (ergocycle) and serum high-sensitive C-reactive protein (hsCRP), haptoglobin, soluble tumor necrosis factor-α receptor 1 (sTNFR1), interleukin-6, orosomucoid and white blood cells.Sedentary women with the highest tertile of PAEE (1276 (1233-1319) kcal day(-1)) had lower concentrations of hsCRP and haptoglobin than those in the lowest tertile (587 (553-621) kcal day(-1)) after adjustment for fat mass (P0.05). Soluble TNFR1 was positively correlated with VO(2)peak, TEE and REE (P0.05), and hsCRP and orosomucoid were positively associated with REE (P0.01), whereas haptoglobin was negatively associated with PAEE (P0.05). In stepwise regression analyses that examined the concomitant associations of components of energy expenditure with inflammatory markers, PAEE remained the only predictor of hsCRP and haptoglobin (P0.05), explaining 14 and 5%, respectively, of their variation,whereas REE was the only predictor of orosomucoid (r (2) = 0.05, P = 0.02) after adjustment for fat mass. Adding leptin to the regression models results in similar relationships between inflammatory markers and components of energy expenditure.PAEE is an independent predictor of hsCRP and haptoglobin in sedentary overweight/obese postmenopausal women free of chronic disease. Our data support the role of physical activity in reducing subclinical inflammation and risk of metabolic and cardiovascular diseases.

Recent studies in humans and mice suggest the implication of the cysteine proteases cathepsins S, L, and K in vascular and metabolic complications of obesity.Our objective was to identify clinically relevant forms of cathepsin in human obesity.We conducted a prospective study on two independent cohorts.The first cohort includes 45 obese women eligible for gastric surgery (age, 39 +/- 1.6 yr; body mass index, 47 +/- 0.99 kg/m(2)) and 17 nonobese women (age, 38 +/- 1.8 yr; body mass index, 21 +/- 0.44 kg/m(2)). The second cohort comprises 29 obese women (age, 57 +/- 0.8 yr; body mass index, 34 +/- 0.69 kg/m(2)) undergoing 6 months of medically supervised caloric restriction.Cathepsin S, L, and K mRNA levels were determined in surgical adipose tissue biopsies. The proteins were measured in conditioned medium of adipose tissue explants and in circulation.Obese subjects had a 2-fold increase in cathepsin S mRNA in adipose tissue as compared with normal-weight subjects and an increased rate (1.5-fold) of cathepsin S release in adipose tissue explants. Cathepsin S circulating concentrations were increased with obesity (+30%) and reduced after weight reduction (P0.05 for both). By contrast, cathepsin L was unaffected in adipose tissue and serum; cathepsin K was undetectable in circulation and unchanged in adipose tissue.In humans, cathepsin S is more influenced than cathepsins L and K by changes in energy balance in adipose tissue and circulation. This opens new avenues to explore whether selective inhibition of this protease could reduce cardiovascular risk and ameliorate metabolic status in obese subjects.

Background Caloric restriction is recommended for the treatment of obesity, but it is generally characterized by large interindividual variability in responses. The factors affecting the magnitude of weight loss remain poorly understood. Epigenetic factors (ie, heritable but reversible changes to genomic function that regulate gene expression independently of DNA sequence) may explain some of the interindividual variability seen in weight-loss responses. Objective The objective was to determine whether epigenetics and gene expression changes may play a role in weight-loss responsiveness. Design Overweight/obese postmenopausal women were recruited for a standard 6-mo caloric restriction intervention. Abdominal subcutaneous adipose tissue biopsy samples were collected before (n = 14) and after (n = 14) intervention, and the epigenomic and transcriptomic profiles of the high and low responders to dieting, on the basis of changes in percentage body fat, were compared by using microarray analysis. Results Significant DNA methylation differences at 35 loci were found between the high and low responders before dieting, with 3 regions showing differential methylation after intervention. Some of these regions contained genes known to be involved in weight control and insulin secretion, whereas others were localized in known imprinted genomic regions. Differences in gene expression profiles were observed only after dieting, with 644 genes being differentially expressed between the 2 groups. These included genes likely to be involved in metabolic pathways related to angiogenesis and cerebellar long-term depression. Conclusions These data show that both DNA methylation and gene expression are responsive to caloric restriction and provide new insights about the molecular pathways involved in body weight loss as well as methylation regulation during adulthood.

Objective Large inter-individual variations exist in changes in inflammation and insulin resistance (IR) in response to hypocaloric-interventions in obese subjects that are not explained by weight-loss per se . We identified the number of serum apoB-lipoproteins (serum apoB) as the primary predictor of inflammatory markers in post-menopausal overweight/obese women. As apoB-lipoproteins are related to inflammation and inflammation promotes IR, we hypothesized that the reduction in inflammation and IR following hypocaloric-interventions is associated with the reduction in serum apoB. Methods/results After a 6-month hypocaloric-dietary-intervention in 56 overweight/obese post-menopausal women, there was a significant reduction in weight, total, subcutaneous abdominal and visceral abdominal fat mass, apoB, Lp(a), hsCRP, orosomucoid, haptoglobin and IR (increased M clamp ) and an increase in LDL-C/apoB ratio. In regression analysis, % change in apoB was the primary predictor of % changes in hsCRP ( R 2 =0.22), orosomucoid ( R 2 =0.35), haptoglobin ( R 2 =0.43) and M clamp ( R 2 =0.17). When the study population was split around baseline median apoB (0.97g/L), women who were above median apoB ( N =27) had significant reduction in apoB (−17%), hsCRP (−24%), orosomucoid (−8%), haptoglobin (−18%) and IR ( M clamp +14%). On the other hand, women below median apoB ( N =29) had no significant changes in these parameters despite equivalent reduction in weight and fat depots in the two groups. Conclusion Reduction in apoB associated strongly and independently with the reduction in inflammatory markers and IR following a hypocaloric-diet in overweight/obese women. We hypothesize that the elevated apoB phenotype may be key therapeutic target to reduce obesity-associated inflammation and IR maximally by hypocaloric-dietary-interventions.

To analyze the anthropometric, metabolic, psychosocial and dietary profiles of underreporters, identified by the doubly labeled water technique, in a well-characterized population of overweight and obese postmenopausal women.The study population consisted of 87 overweight and obese sedentary postmenopausal women (age: 57.7+/-4.8 years, body mass index: 32.4+/-4.6 kg/m(2)). Subjects were identified as underreporters based on the energy intake to energy expenditure ratio of0.80. We measured (1) body composition (by dual-energy X-ray absorptiometry), (2) visceral fat (by computed tomography), (3) blood profile, (4) resting blood pressure, (5) peak oxygen consumption (VO(2 peak)), (6) total energy expenditure, (7) muscle strength and (8) psychosocial and dietary profiles.Out of 87 subjects, 50 (57.5%) were identified as underreporting subjects in our cohort. Underreporters showed higher levels of body mass index, fat mass, visceral fat, hsC-reactive protein, perceived stress and percentage of energy from protein, as well as lower levels of VO(2 peak), dietary intake of calcium, fiber, iron, vitamin B-1 and 6, as well as servings of fruit and vegetables. Logistic regression analysis showed that fat mass, odd ratio 1.068 (95% confidence interval 1.009-1.130) and perceived stress, odd ratio 1.084 (95% confidence interval 1.011-1.162) were independent characteristics of underreporters.Results from this study show significant differences in anthropometric, metabolic, psychosocial and dietary profiles between underreporters and non-underreporters in our cohort of overweight and obese postmenopausal women.

Some insulin-resistant obese postmenopausal (PM) women are characterized by an android body fat distribution type and higher levels of lean body mass (LBM) compared to insulin-sensitive obese PM women. This study investigates the independent contribution of LBM to the detrimental effect of visceral fat (VF) levels on the metabolic profile. One hundred and three PM women (age: 58.0+/-4.9 years) were studied and categorized in four groups on the basis of their VF (higher vs. lower) and lean BMI (LBMI=LBM (kg)/height (m2); higher vs. lower). Measures included: fasting lipids, glucose homeostasis (by euglycemic/hyperinsulinemic clamp technique and 2-h oral glucose tolerance test (OGTT)), C-reactive protein (CRP) levels, fat distribution (by computed tomography (CT) scan), and body composition (by dual-energy X-ray absorptiometry). Women in the higher VF/higher LBMI group had lower glucose disposal and higher plasma insulin levels compared to the other groups. They also had higher plasma CRP levels than the women in the lower VF/lower LBMI group. VF was independently associated with insulin levels, measures of glucose disposal, and CRP levels (P

Objective: Recent reports have suggested that the existence of associations between hormonal dysregulation and chronic upregulation of inflammatory markers, which may cause obesity-related disturbances. Thus, we examined whether acylated ghrelin (AcylG) and total ghrelin (TotG) levels could be associated with the following inflammatory markers: C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and soluble TNF receptor 1 (sTNF-R1). Design: Cross-sectional study consisting of 50 overweight and obese postmenopausal women. Methods: AcylG and TotG levels were assessed at 0, 60, 160, 170, and 180 min of the euglycemic/hyperinsulinemic clamp (EHC). We evaluated insulin sensitivity, body composition, and blood lipid profiles as well as fasting concentrations of CRP, TNF-α, and sTNF-R1. Results: In fasting conditions, sTNF-R1 was negatively correlated with AcylG (r = −0.48, P < 0.001) levels. In addition, AcylG/TotG was associated negatively with sTNF-R1 (r = −0.44, P = 0.002) and positively with TNF-α (r = 0.38, P = 0.009) values. During the EHC, TotG (at all time points) and AcylG (at 60 and 160 min) values were significantly decreased from fasting concentrations. AcylG maximal reduction and area under the curve (AUC) values were correlated to sTNF-R1 (r = −0.35, P = 0.02 and r = −0.34, P = 0.02, respectively). Meanwhile, the AcylG/TotG AUC ratio was associated negatively with sTNF-R1 (r = −0.29, P < 0.05) and positively with TNF-α (r = 0.36, P = 0.02). Following adjustments for total adiposity, sTNF-R1 remained correlated with fasting and maximal reduction AcylG values. Similarly, AcylG/TotG ratios remained significantly correlated with sTNF-R1 and TNF-α. Importantly, 23% of the variation in sTNF-R1 was independently predicted by fasting AcylG. Conclusion: These results are the first to suggest that both fasting and EHC-induced AcylG profiles are correlated with fasting values of sTNF-R1, a component of the TNF-α system. Thus, AcylG may act, at least in part, as one mediator of chronic inflammatory activity in human obesity.

Introduction Une sous-population de patients obeses ne semble pas developper d'insulino-resistance et represente ainsi un modele humain unique afin de determiner des facteurs cles pouvant prevenir ou contribuer au developpement de l'insulino-resistance, independamment de l'obesite. Un stockage inefficace des lipides du tissu adipeux sous-cutane (TASC) pourrait contribuer au developpement de l'insulino-resistance. Objectifs : Examiner l'expression de genes du metabolisme des lipides dans le TASC d'obeses insulino-sensibles (ISO) et insulino-resistants (IRO) non diabetiques avant et apres perte de poids. Patients et methodes Cinquante-neuf femmes post-menopausees obeses stratifiees en ISO (n=25) ou IRO (n=13) lors d'un clamp euglycemique-hyperinsulinemique et etudiees avant et apres diete hypocalorique de 6 mois. Expression genique mesuree par RT-qPCR dans du TASC peri-ombilical. Resultats Malgre un âge, un IMC, un pourcentage de masse grasse et un volume de TASC equivalents aux ISO, les IRO avaient une sensibilite a l'insuline reduite de 50 %, une excursion du glucose (HGPO) augmentee et un volume de TA visceral superieur (p Conclusion Ces resultats demontrent une relation etroite entre l'alteration de l'expression des genes du cycle glycerolipides/acides gras dans le TASC et l'insulino-resistance associee a l'obesite. Ceci suggere qu'une augmentation du cycle futile glycerolipides/acides gras et un stockage inefficace de lipides dans le TASC pourrait contribuer au developpement de cette complication.

Introduction: A network is a group of people or organizations that are closely connected and work with one another. Reasons to build networks and multiple-disciplinary teamwork include: finding solutions to real-world complex problems, such as obesity and chronic diseases and their risk factors, and pooling resources and expertise. Methods: A literature review was undertaken to identify promotors and barriers for multiple-disciplinary teamwork success. results: To build good teamwork, there are eight themes to consider, as summarized by the acronym “TEAMWORK”: Team, Enthusiasm, Accessibility, Motivation, Workplace, Objective, Role, and Kinship. A number of examples are used from national and international riskfactor surveillance networks, including Rapid Risk Factor Surveillance System (RRFSS, Ontario), Canadian Alliance for Regional Risk Factor Surveillance (CARRFS, Canada), Americas’ Network for Chronic Disease Surveillance (AMNET, Latin America), and World Alliance for Risk Factor Surveillance (WARFS, global). Discussion: The proposed eight themes should help build efficient networks, which, in turn, should enhance capacity in risk factor surveillance and other public health files, by providing multipledisciplinary perspectives, and pooling resources and expertise.