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Obesity

Fettsucht Lajos Szollár Semmelweis Universität Fakultät für Medizin Institut für Pathophysiologie 200 6. Obesity. Definition of obesity: Increase of adipose tissue Criteria of obesity, grade of severity Broca-index, relatíve weight, ideal weight, body mass index

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Obesity

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  1. FettsuchtLajos SzollárSemmelweis Universität Fakultät für MedizinInstitut für Pathophysiologie2006

  2. Obesity • Definition of obesity: Increase of adipose tissue • Criteria of obesity, grade of severity • Broca-index, relatíve weight, ideal weight, body mass index • Frequency, geographical distribution, time-trends • Effects on mortality and morbidity • Consequences and complications • Classification of obesity • Hypertrophic-hyperplastic • Central-peripheral • Pathogenesis of obesity

  3. Body fat in obesity

  4. ENERGY RESERVES IN LEAN AND OBESE SUBJECTS(After Bray, 1976 ) Lean Obese kg kJ kg kJ Body weight 70 100 Fat (triglyceride) 15 564.840 40 1.506.240 Proteine (muscle) 6 100.416 7 117.152 Glycogen 0.07 1.170 0.07 1.170

  5. Obesity • Definition of obesity: Increase of adipose tissue • Criteria of obesity, grade of severity • Broca-index, relatíve weight, ideal weight, body mass index • Frequency, geographical distribution, time-trends • Effects on mortality and morbidity • Consequences and complications • Classification of obesity • Hypertrophic-hyperplastic • Central-peripheral • Pathogenesis of obesity

  6. Clinically useful anthropometric methods • Broca-index: ideal weight=body height (cm)-100 • Modified Broca-index: ideal weight=((body height (cm)-100))-10 % • Relatíve weight: actual weight / ideal weight x 100 obese > 120 • BMI (Body Mass Index), Quetelet-index: body weight (kg) / body height2 (m2) desirable < 25, overweight 27-30, obese >30

  7. BMI (body mass index)

  8. Obesity • Definition of obesity: Increase of adipose tissue • Criteria of obesity, grade of severity • Broca-index, relatíve weight, ideal weight, body mass index • Frequency, geographical distribution, time-trends • Effects on mortality and morbidity • Consequences and complications • Classification of obesity • Hypertrophic-hyperplastic • Central-peripheral • Pathogenesis of obesity

  9. Prevalence of Overweight in Girls and Boys by Race and Age Ogden CL, et al. JAMA 2002;288:1730

  10. Total Prevalence of Obesity in the U.S.: Men and Women (Ages 20-74 years) Prevalence % Flegal KM, et al. JAMA 2002;288:1724

  11. Historic, current and projected obesity prevalence rates (BMI > 30) Kopelman, Nature 404:635, 2000

  12. Obesity • Definition of obesity: Increase of adipose tissue • Criteria of obesity, grade of severity • Broca-index, relatíve weight, ideal weight, body mass index • Frequency, geographical distribution, time-trends • Effects on mortality and morbidity • Consequences and complications • Classification of obesity • Hypertrophic-hyperplastic • Central-peripheral • Pathogenesis of obesity

  13. BMI and mortality

  14. Obesity • Definition of obesity: Increase of adipose tissue • Criteria of obesity, grade of severity • Broca-index, relatíve weight, ideal weight, body mass index • Frequency, geographical distribution, time-trends • Effects on mortality and morbidity • Consequences and complications • Classification of obesity • Hypertrophic-hyperplastic • Central-peripheral • Pathogenesis of obesity

  15. Mortality in obesity Non- obese mortality=100 Cause MenWomen Diabetes mellitus 383 372 Gallstones 206 284 Post surgery200 300 Cardiovascular and kidney149 177 Accidents 111 135 Malignant diseases 97 100 Suicide 79 73 Tuberculosis 21 35

  16. Health Consequences of Obesity • Cardiovascular disease • Dyslipidemia • Type II diabetes mellitus • Hypertension • Cancer, some common types • Degenerative joint disease • Gallstones • Gynecologic irregularities • Sleep apnea syndrome

  17. 26 -Year Incidence/10,000 of Coronary Heart Disease in Women and Men by BMI BMI Levels Hubert HB et al. Circulation 1983;67:968-977.

  18. BMI and relative risk (a=woman b=men) Kopelman, Nature 404:635, 2000

  19. Type 2 diabetes and obesity

  20. Osteoarthrosis and obesity

  21. Infertility and obesity

  22. Gout and obesity

  23. Obesity and ovarian cancer

  24. Consequences of obesity • Cardiovascular system • Arteriosclerosis • Congestív heart failure, cor pulmonale • Venous disorders, thrombophlebitis • Hypertension • Diabetes mellitus • Alveolar hypoventilation(Pickwick-syndrome) • Gastrointestinal disorders (fatty liver,gallstones) • Kidney • Arthrosis • Endocrine system (reproductive and menstrual disorders, toxaemia) • Other (intertrigosusdermatosis, hiatus hernia, endometrial carcinoma)

  25. Obesity • Definition of obesity: Increase of adipose tissue • Criteria of obesity, grade of severity • Broca-index, relatíve weight, ideal weight, body mass index • Frequency, geographical distribution, time-trends • Effects on mortality and morbidity • Consequences and complications • Classification of obesity • Hypertrophic-hyperplastic • Central-peripheral • Pathogenesis of obesity

  26. Assessment of accumulation of abdominal fat by measurement of waist at mid-distance between bottom of rib cage and iliac crest. Amount of visceral adipose tissue that can be assessed by CT can be estimated by waist measurement Despres et al. BMJ 322:716,2001

  27. Hypertension Abdominal obesity Atherosclerosis Hyperinsulinaemia Diabetes Hypercoagulability EndothelialDysfunction Dyslipidaemia • high TGs • small dense LDL • low HDL-C The Metabolic Syndrome andAssociated CVD Risk Factors InsulinResistance Deedwania PC. Am J Med 1998;105(1A);1S-3S.

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