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1. L’obésité chez l’adulte : ligne directrice de pratique clinique

Author

Leah Walker, Megha Poddar, Sanjeev Sockalingam, Christian F. Rueda-Clausen, Sean Wharton, Michael E. Green, Kristi B. Adamo, Sue Pedersen, Denis Prud’homme, Michel Gagner, Ian Patton, Angela S. Alberga, Dennis Hong, Laurie Twells, Raed Hawa, Marie-France Langlois, Ellen L. Toth, Mary Forhan, Ian Janssen, Marie-Philippe Morin, Cindy Grand, Dennis Divalentino, Carol Clarke, Margaret Hahn, Denise Campbell-Scherer, Carlene Johnson-Stoklossa, Priya Manjoo, Jennifer L. Kuk, John L. Sievenpiper, Leen Naji, Elaine Boyling, Pam Hung, Judy Shiau, Kara Nerenberg, David C.W. Lau, Scott Lear, Shelly Russell-Mayhew, Diana Sherifali, Jennifer Brown, Laurent Biertho, Leticia Pereira, Sonja Wicklum, Michael Vallis, Ashley McInnes, Richard Tytus, Rita Henderson, David Macklin, Yoni Freedhoff, Helena Piccinini-Vallis, Amy Kemp, Kristen Jacklin, Normand G. Boulé, Stephen Glazer, Ximena Ramos Salas, Shahebina Walji, Betty Calam, Arya M. Sharma, Rhonda Bell, Lindsay Crowshoe, Valerie H. Taylor, Paul Poirier, and Sara F. L. Kirk

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Ligne Directrice, business.industry, medicine, 030209 endocrinology & metabolism, 030212 general & internal medicine, General Medicine, business
Abstract

POINTS CLES L’obesite est une maladie chronique complexe dans laquelle la graisse corporelle anormale ou excessive (adiposite) nuit a la sante, augmente le risque de complications medicales a long terme et reduit la duree de vie[1][1]. Les etudes epidemiologiques definissent l’obe

Published
2020
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2. Obesity in adults: a clinical practice guideline

Author

Kristen Jacklin, Leah Walker, Michael E. Green, Stephen Glazer, Betty Calam, Kristi B. Adamo, Valerie H. Taylor, Denis Prud'homme, Lindsay Crowshoe, Richard Tytus, Michel Gagner, Paul Poirier, Angela S. Alberga, Jennifer L. Kuk, Elaine Boyling, Dennis Divalentino, Cindy Grand, Scott Lear, Laurie Twells, Raed Hawa, Carol Clarke, Judy Shiau, David Macklin, Yoni Freedhoff, Megha Poddar, Helena Piccinini-Vallis, Normand G. Boulé, Leticia Pereira, Priya Manjoo, Pam Hung, Sara F. L. Kirk, Ian Patton, Shelly Russell-Mayhew, Arya M. Sharma, Rhonda Bell, Diana Sherifali, Shahebina Walji, David C.W. Lau, Mary Forhan, Sonja Wicklum, Sanjeev Sockalingam, Sue Pedersen, Dennis Hong, Laurent Biertho, Marie-France Langlois, Ellen L. Toth, Kara Nerenberg, Michael Vallis, Ian Janssen, Ashley McInnes, Rita Henderson, Amy Kemp, Jennifer Brown, Ximena Ramos Salas, Margaret Hahn, Denise Campbell-Scherer, Leen Naji, Sean Wharton, John L. Sievenpiper, Marie-Philippe Morin, Christian F. Rueda-Clausen, and Carlene Johnson-Stoklossa

Subjects
Adult, Male, Canada, Pregnancy, medicine.medical_specialty, Primary Health Care, business.industry, MEDLINE, General Medicine, Guideline, medicine.disease, Obesity, Body Mass Index, Clinical Practice, Chronic disease, Humans, Medicine, Female, Letters, business, Intensive care medicine, Body mass index
Abstract

KEY POINTS Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications and reduces lifespan.[1][1] Epidemiologic studies define obesity using the body mass index (BMI; weight/height2), which can stratify

Published
2020
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4. Nocturnal Hypoxemia Severity and Renin–Angiotensin System Activity in Obstructive Sleep Apnea

Author

Sofia B. Ahmed, Shahebina Walji, George B. Handley, Tanvir Chowdhury Turin, Darlene Y. Sola, David D. M. Nicholl, Marc J. Poulin, Ann A Zalucky, Patrick J. Hanly, and Jill K. Raneri

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Renal function, Comorbidity, Kidney, Critical Care and Intensive Care Medicine, Hypoxemia, Renin-Angiotensin System, Young Adult, Internal medicine, Respiratory disturbance index, medicine, Humans, Obesity, Hypoxia, Aged, Sleep Apnea, Obstructive, business.industry, Hemodynamics, Effective renal plasma flow, Middle Aged, medicine.disease, Angiotensin II, respiratory tract diseases, Obstructive sleep apnea, medicine.anatomical_structure, Regional Blood Flow, Anesthesia, Cardiology, Female, medicine.symptom, business, circulatory and respiratory physiology, Kidney disease
Abstract

Obstructive sleep apnea (OSA) and nocturnal hypoxemia are associated with chronic kidney disease and up-regulation of the renin-angiotensin system (RAS), which is deleterious to renal function. The extent to which the magnitude of RAS activation is influenced by the severity of nocturnal hypoxemia and comorbid obesity has not been determined.To determine the association between the severity of nocturnal hypoxemia and RAS activity and whether this is independent of obesity in patients with OSA.Effective renal plasma flow (ERPF) response to angiotensin II (AngII) challenge, a marker of renal RAS activity, was measured by paraaminohippurate clearance technique in 31 OSA subjects (respiratory disturbance index, 51 ± 25 h(-1)), stratified according to nocturnal hypoxemia status (mean nocturnal SaO2, ≥90% [moderate hypoxemia] or90% [severe hypoxemia]) and 13 obese control subjects.Compared with control subjects, OSA subjects demonstrated decreased renovascular sensitivity (ERPF, -153 ± 79 vs. -283 ± 31 ml/min; P = 0.004) (filtration fraction, 5.4 ± 3.8 vs. 7.1 ± 2.6%; P = 0.0025) in response to 60 minutes of AngII challenge (mean ± SD; all P values OSA vs. control). The fall in ERPF in response to AngII was less in patients with severe hypoxemia compared with those with moderate hypoxemia (P = 0.001) and obese control subjects after 30 minutes (P 0.001) and 60 minutes (P 0.001) of AngII challenge, reflecting more augmented renal RAS activity. Severity of hypoxemia was not associated with the blood pressure or the systemic circulating RAS component response to AngII.The severity of nocturnal hypoxemia influences the magnitude of renal, but not the systemic, RAS activation independently of obesity in patients with OSA.

Published
2015
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