Evaluation of the automatic quantification of left ventricular function using ECG gated 99mTc-MIBI myocardial SPECT

OBJECTIVE: To compare temporal changes in body mass index (BMI) (kg/m2) and prevalence of obesity (BMI > 25 and > 30 kg/m2) among adult Kuwaitis between two periods 14 y apart. DESIGN: Comparison of two independent cross-sectional samples of Kuwaitis studied in 1980-1981 and 1993-1994. SUBJECTS: 2067 (896 men and 1171 women) and 3435 (1730 men and 1705 women) adult Kuwaitis (aged > or = 18 y), drawn from primary health care (PHC) clinics and studied for nutritional assessment and for prevalence of obesity in 1980-1981 and 1993-1994, respectively. MEASUREMENTS: BMI, which is the weight in kilograms divided by the height in meters squared (kg/m2), was based on measured weight and height. Obesity was defined as BMI > 25 kg/m2 (grade 1) and BMI > 30 kg/m2) (grade 2). RESULTS: Mean BMI increased significantly (P < 0.001) by 10.0% and 6.2% (2.5 and 1.7 kg/m2) among men and women, respectively. Prevalence of obesity (BMI > 25 and > 30 kg/m2) increased by 20.6% and 15.4% and by 13.7% and 8.4% among men and women, respectively. After controlling for sociodemographic differences between the two study periods, BMI was 2.0 and 1.6 kg/m2 higher in 1993-1994 than in 1980-1981 among men and women respectively. The risk of obesity (BMI > 25 and > 30 kg/m2) also increased among both genders between the two periods (OR = 2.1, 95% CI 1.7-2.7 and OR = 1.9, 95% CI 1.5-2.4, for men and OR = 2.2, 95% CI 1.6-3.0 and OR = 1.4, 95% CI 2.2 CI-1.0-1.9, for women). CONCLUSION: BMI and prevalence of obesity increased among Kuwaitis between 1980-1981 and 1993 and 1994 probably due to the effects of modernization, affluence, increased food consumption and the concomitant changes to sedentary lifestyles. The rate of temporal changes in BMI and obesity were higher, by comparison, in Kuwait than in selected other countries.     

Body mass and social class: a comparison of Finland and Sweden in the 1990s

High physical weight affects public health as well as people's social relations. This study seeks to examine the distribution of physical weight across the social structure in Finland and Sweden in the early 1990s. We compare physical weight, classified by overweight and obesity, 1) between men and women, 2) between different age groups, and 3) between social classes in these two countries. Comparable interview surveys were conducted in Finland 1994 (N = 8,650, response rate 73%) and in Sweden 1991 (N = 5,306, response rate 79%). Physical weight, overweight and obesity of populations are described in terms of body mass index (BMI = weight (kg)/height (m2)). The average BMI is higher in Finnish men (25.6) and women (24.6) than in their Swedish counterparts (24.6 and 23.2, respectively). In both countries, the average BMI is higher in men than in women below the age of about 55-64 years. In both countries and in both genders the average BMI is higher, the higher the age. The level of overweight as well as obesity is lower in Sweden than in Finland. Social class differences can be found in both countries. The odds ratio for overweight is higher in Finnish male and female farmers (OR = 1.57 and 1.94, respectively) as compared to upper white collars (OR = 1.0). In Sweden, high odds ratio for overweight can be found among male entrepreneurs (OR = 1.80) and female unskilled manuals (OR = 2.65). Obesity varies by social class in Swedish men and women as well as in Finnish women, but not in Finnish men. The results show that Finnish men and women are more often overweight and obese than their Swedish counterparts, but social class differences in overweight and obesity are larger in Sweden than in Finland.     

High temporal, geographic, and income variation in body mass index among adults in Brazil

OBJECTIVES: Population-based data on body mass index for developing countries are scarce. Body mass index data from two Brazilian surveys were examined to determine regional and temporal variations in the prevalences of underweight, overweight, and obesity. METHODS: Nationwide surveys in 1974/75 and 1989 collected anthropometric data in Brazil from 55,000 and 14,455 households, respectively. Trained interviewers used the same methods to measure weight and stature in both surveys, and survey designs were identical. Prevalences of underweight, overweight, and obesity were determined for persons 18 years of age and older. RESULTS: In the 1989 survey, body mass index varied greatly according to region of the country, urbanization, and income. In the wealthier South, the prevalence of overweight/obesity was the highest and the prevalence of underweight was the lowest; in the poorer rural Northeast, these patterns were reversed. For both surveys, overweight/obesity was more common among women than among men and peaked at age 45 to 64 years in both sexes. Over the 15 years between surveys, the prevalence of both overweight and obesity increased strikingly. CONCLUSIONS: In contrast to findings in developed countries, obesity in Brazil was positively associated with income and was much more prevalent among women than among men. For Brazilian women, the overall prevalence of overweight was nearly as high as that among women in the United States.     

Prevalence and risk factors of obesity in adults

INTRODUCTION: A population-based cross-sectional study was conducted in Pelotas, Southern Brazil, with the objective of determining the prevalence of obesity and identify associated, variables as this condition increased markedly in the country between 1974 and 1989. MATERIAL AND METHODS: One thousand and thirty-five adults between 20 and 69 years of age were studied. Obesity was defined as a Body Mass Index--BMI--equal to or over 30 Kg/square meter). The multivariate analyses took into account the hierarchical model of the variables associated with obesity for both men and women. RESULTS: The prevalence for the overall population was of 21% (CI 18-23). It was higher among women--25% (CI 22-29) than for men--15% (CI 12-18). Socioeconomic status was positively associated with obesity among men, whereas the opposite situation was reported for women, with those belonging to the poorest social strata presenting increased BMI. Reported obesity in their parents was associated with increased BMI in the subjects, and this association remained statistically significant even after compensating for the effect of possible confounding variables. Self-reported diabetes and arterial hypertension doubled the risk of obesity, whereas non-smoking was associated with obesity only among women. Variables which were not associated with obesity after adjusting for confounders were alcohol consumption, marital status and parity. Women having more daily meals were less prone to obesity, even after controlling for confounders, and this association was not quite significant for men (p = 0.07). CONCLUSIONS: The prevalence of obesity was higher among women, and important differences in risk factors were noticed when the population was considered by sex.     

Obesity in primary care patients in Kelantan, Malaysia: prevalence, and patients' knowledge and attitudes

This study measured the body mass index (BMI), and assessed attitudes and knowledge about obesity, of 197 male and 217 female patients aged 20-59 years attending the primary care clinic of the university hospital in Kelantan, Malaysia. There was no significant difference between the mean BMI of males (23.7) and females (24.2). In the overweight group (BMI 25-29.9) were 60 men (30%) and 66 women (30%). In the obese group (BMI 30 and above) were 12 men (6%) and 22 women (10%). Both diabetes mellitus and hypertension were associated with significantly higher BMI's. Knowledge about obesity was lacking. Sixty-three (15%) failed to recognize that obesity is bad for health. When asked the causes of obesity, 88 (21%) failed to mention either diet or lack of exercise. "Being happy" was suggested as a cause by 32 (8%). When asked if certain foods would cause obesity if eaten in excess, 45 (11%) said "No" for fatty foods, and 164 (40%) said "No" for sweet foods. Concerning appearance, 30 (15%) men regarded an obese man as normal or even handsome, while 49 (23%) women regarded an obese woman as normal or beautiful. Obesity is common among our adult patients, and is associated with some of their common health problems. However, a substantial minority do not regard obesity as unhealthy, do not relate it to diet or lack of exercise, do not recognize important groups of fattening foods, and do not regard obesity as unattractive.     

Cardiac hemangioma of the right ventricle--report of a case

OBJECTIVE: The prevalence of obesity and thinness is unknown among Iranian high-school age girls. We determined the prevalence of overweight and underweight among Iranian high-school girls from Kerman (south-east province of Iran). DESIGN: A cross-sectional study of indicative cluster sample. MEASUREMENTS: Weight, height, body mass index (BMI), chest, waist, abdomen, hip and thigh circumference of 1000 Iranian high-school girls aged 14-21 y (mean (standard deviation, s.d.) 16.2 (1.3)) were measured. The criteria for very underweight, underweight, desirable weight, grade 1, 2 and 3 overweight used in the present study were: BMI in kg/m2 < 15, 15-19.9, 20-24.9, 25-29.9, 30-39.9 and > or = 40, respectively. RESULTS: 4.6% (95% confidence interval (CI): 3.4%-6.1%) were grade 1 overweight (BMI = 25.0-29.9), 0.7% (95% CI: 0.3%-1.4%) were grade 2 overweight (BMI = 30-39.9), and none were grade 3 overweight (BMI > or = 40), while 54.6% (95% CI: 51.5%-57.7%) were underweight (BMI = 15-19.9) and 1.6% (95% CI: 0.9%-2.6%) were very underweight (BMI < 15). The mean (s.d.) BMI was 19.8 (2.9) (95% CI: 19.6-20.0). The mean (s.d.) waist-to-hip ratio (WHR), abdomen-to-hip ratio and chest-to-hip ratio values were 0.8 (0.06) (95% CI: 0.8-0.81), 0.8 (0.07) (95% CI: 0.8-0.81) and 0.9 (0.07) (95% CI: 0.9-0.91), respectively, in this sample. CONCLUSION: The results suggest a low prevalence of overweight among Iranian young women.     

Prevalence of overweight and associated factors among Oklahomans

BACKGROUND: Obesity among adults in the, United States has been increasing for the last three decades. Overweight is associated with numerous health risks such as diabetes, atherosclerosis, hypertension, sedentary lifestyle, etc. It also throws a very heavy economic burden on society, estimated at $39.3 billion in 1986. OBJECTIVE: To estimate the prevalence of obesity and its associated factors so that efforts to achieve the Healthy Oklahomans 2000 objectives may be brought into sharper focus. STUDY DESIGN: The study design is cross-sectional. METHODS: The study is based on the data from the Behavioral Risk Factor Surveillance System (a three-stage cluster sample survey) for the years 1991 through 1994. Statistical analysis was done with SUDAAN software for complex survey. RESULTS: More than 25% of Oklahomans are overweight. To reach the Year 2000 objectives, a reduction of 10% in overweight will have to be achieved in about three and one-half years. Prevalence of moderate obesity among women is higher than among men. Prevalence of severe obesity is higher among the black community than among other communities. However, prevalence of moderate obesity is the same among blacks and whites. Severe obesity is significantly higher among those with less than a high school education than among those with college education. The prevalence of moderate obesity among non-smokers is significantly higher than among smokers. Among the severely obese, hypertension is more than twice as prevalent as normal blood pressure. Among the moderately obese, high blood pressure is more than one and one-half times more prevalent than normal blood pressure. Obesity increases with age in a predictive manner; it drops after the age of 54. Moderate obesity is significantly higher among women who have had a hysterectomy than those who have not had a hysterectomy. Prevalence of severe obesity as well as moderate obesity is very much higher among diabetics than among non-diabetics. A large proportion of severely obese people are physically inactive. We did not find an association between consumption of fruits and vegetables as a part of normal diet and prevalence of obesity. CONCLUSION: Strenuous and focused efforts need to be made among the vulnerable groups, in view of the short time left until year 2000, to reduce the prevalence of obesity to the level laid down in the Year 2000 objectives.     

Association between an excessive body mass index and coronary heart disease risk factors in military personnel

The purpose of this study was to document the extent of coronary heart disease (CHD) risk factors in military personnel (412 men, 50 women) classified as seriously overweight (body mass index [BMI] 27.0-29.9 kg/m2) or obese (BMI > or = 30 kg/m2) and to evaluate the utility of the BMI to discriminate among individuals with an adverse CHD risk profile. Mean body weight and BMI greatly exceeded Canadian norms, whereas mean heights were average. There were low but significant correlations between BMI and resting and submaximal exercise (stage A of the Canadian Aerobic Fitness Test) heart rates and blood pressures, while the correlation with predicted VO2max was negative. Except for blood glucose level (GLU) in men, there were no significant correlations between BMI and various biochemical indices. Compared to "overweight" men, the percentage of "obese" men with abnormal values for risk factors were higher, particularly for an adverse exercise blood pressure response and low predicted VO2max. In summary, the correlations between BMI and the various CHD risk factors, except for GLU and the exercise parameters, were minimal or moderate at best. It was concluded that in overweight and obese individuals, BMI does not appear to be a particularly sensitive indicator of body fat and risk factors.     

Combined effect of short stature and socioeconomic status on body mass index and weight gain during reproductive age in Brazilian women

Short stature, a marker for undernutrition early in life, has been associated with obesity in Brazilian women, but not in men. We tested the hypothesis that weight gain during the reproductive years could explain this gender difference. A national two-stage household survey of mothers with one or more children under five years of age was conducted in Brazil in 1996. The subjects were women aged 20 to 45 years (N = 2297), with last delivery seven months or more prior to the interview. The regions of the country were divided into rural, North/Northeast (urban underdeveloped) and South/Southeast/Midwest (urban developed). The dependent variables were current body mass index (BMI) measured, BMI prior to childbearing (reported), and BMI change. Socioeconomic variables included mother's years of education and family purchasing power score. A secondary analysis was restricted to primiparous women. The prevalence of current overweight and overweight prior to childbearing (BMI > or = 25 kg/m2) was higher among shorter women (<1.50 m) compared to normal stature women only in the urban developed region (P < 0.05). After adjustment for socioeconomic variables, age, parity, BMI prior to childbearing, and age at first birth, current BMI was 2.39 units higher (P = 0.008) for short stature women living in the urban developed area compared with short stature women living in the urban underdeveloped area. For both multiparous and primiparous women, BMI gain compared to the value prior to childbearing was significantly higher among short stature women living in the urban developed region (P <= 0.04). These results provide clear evidence that short stature was associated with a higher BMI and with an increased risk of weight gain/retention with pregnancy in the developed areas of Brazil, but not in the underdeveloped ones.     

High prevalence of diabetes in Bahrainis. Associations with ethnicity and raised plasma cholesterol

OBJECTIVE: To determine prevalence of diabetes and associated risk factors in the population of Bahrain. RESEARCH DESIGN AND METHODS: A cross-sectional study of 2,128 Bahrainis aged 40-69 years was conducted. RESULTS: Age-standardized prevalence of diabetes was 25% in Jaafari Arabs, 48% in Sunni Arabs, and 23% in Iranians. In multivariate analyses, positive family history of diabetes, low educational status, waist girth, plasma cholesterol, and, in women, postmenopausal status were independently associated with diabetes. Adjusting for these factors did not account for the difference in prevalence between Jaafari and Sunni Arabs. There was no association between diabetes and parental consanguinity. Mean plasma cholesterol was 0.5 mmol/l higher in diabetic than in normoglycemic participants, 0.5 mmol/l higher in Sunni than in Jaafari Arabs, and, excluding diabetic individuals, 0.2 mmol/l higher in those with a positive family history of diabetes than in those with a negative family history. Although 28% of participants had BMI > or = 30 kg/m2, only 42% of these obese individuals rated themselves as overweight. In men, obesity was inversely related to physical activity at work. In women, obesity was associated with high parity and inversely associated with employment outside the home. CONCLUSIONS: The high rates of diabetes in Bahrain and other Arabian Peninsula populations appear to be part of a familial syndrome that includes raised plasma cholesterol levels. Risk is related to ethnic origin but not to parental consanguinity. Despite the high rates of diabetes, obesity is still perceived as a desirable attribute in this population.     

Obesity: is it a problem in black Africans in Zimbabwe?

The body mass indices (BMIs) and waist: hip (W:H) ratios of 1,509 Black Africans were assessed to determine whether or not obesity is a problem in this population, as this information is scanty. Measurements of weight, height, waist and hip circumferences were done in three provinces of Zimbabwe, sampling rural and urban dwellers separately. The results showed that the ranges of BMIs and W:H ratios for all age groups (24-30 kg/sq m, W:H < 1, for males; and 20-26 kg/sq W:H < 1 for females) were below the lower limits of international values for obesity, where obesity is defined as BMI > 30 kg/sq or W:H > 1. This finding suggests that obesity is not a problem in adult Black Africans of Zimbabwe. Women, however, were overweight (BMI = 25-30 kg/sq m) and had larger mean waist circumferences. They were, therefore, at greater risk of health problems associated with abdominal adiposity. We suggest that clinicians, pharmacists, researchers and medical scientists should use local indices in the light of lower values observed in the present study.     

Height, weight and body mass index of men and women aged 40-42 years

All men and women aged 40-42 years in Norway (except in Oslo, the capital city) were invited to tuberculosis and cardiovascular screenings during the period 1963-95. Height and weight were measured. Men who attended the last screening in 1991-95 were on average 3.0 cm taller than the generation who attended the first screening (1963-75). Women who were measured in 1991-95 were 2.7 cm taller. Mean weight increased 5.6 kg for men and 1.3 kg for women, while body mass index (BMI) increased 0.9 kg/m2 for men and decreased 0.3 kg/m2 for women. BMI has increased steadily in men, but in women a U-shaped time trend was found with a somewhat lower level for the last time period. The proportion with BMI above 30 kg/m2 has doubled among men and is now 9.1%, while in women the proportion has become slightly lower in the last period, and is now 8.4%. The mean BMI was highest in ex-smokers and lowest in current smokers, with persons who had never smoked in the middle. The difference between ex-smokers and current smokers was 0.9 kg/m2 in men and 0.7 kg/m2 in women.     

Incidence of NIDDM and the effects of gender, obesity and hyperinsulinaemia in Taiwan

Our aim is to determine non-insulin-dependent diabetes mellitus (NIDDM) incidence in Taiwan and examine its relation to obesity and hyperinsulinaemia in Chinese men and women. A total of 995 men and 1195 women aged 35-74 years free from diabetes in two townships in Taiwan were followed up with a second examination. At baseline general and metabolic data were recorded, and detailed anthropometric parameters and plasma glucose and insulin were assessed. World Health Organisation (WHO) criteria of fasting glucose 7.8 mmol/l or greater was utilized for defining diabetes. The age-standardized incidence rate based on the United States population in 1970 was 9.3/1000 (CI 5.8-12.8) in men and 9.3/1000 (CI 6.2-12.4) in women and the based on the WHO population in 1976 was 8.9/1000 (CI .5-12.3) in men and 8.9/1000 (CI 5.9-11.9) in women for the Chinese who had a mean BMI slightly greater than 24 (kg/m2). The predictability of the plasma glucose level was greater than that of the insulin level and the obesity indices. NIDDM incidence increased approximately threefold with each 0.67 mmol/l increase in plasma glucose level in men and women. The present study demonstrated the essential relationship of not only BMI but also central obesity indices (such as subscapular and waist circumference) to the incidence of NIDDM among men and women and a stronger relationship between NIDDM incidence and obesity in women than in men. The predictive effects of obesity indices and fasting plasma insulin values on NIDDM risk were independent of each other in men. Obesity and hyperinsulinaemia each without the presence of the other can lead to an increased risk of NIDDM. In women the NIDDM incidence increased more than additively in those with both obesity and hyperinsulinaemia compared to those with single obesity or hyperinsulinaemia. A slightly higher incidence of NIDDM in Taiwan than in western countries was found. The importance of obesity is indicated for predicting NIDDM in the community. Hyperinsulinaemia was found to play a significant role in predicting NIDDM incidence independent of obesity in men and synergistically with obesity in women.     

Prevalance of obesity and overweight in northeastern peninsular Malaysia and their relationship with cardiovascular risk factors

Height and body weight were measured in 2,284 subjects over 20 years old. The subjects were chosen by cluster sampling in 9 districts of Kelantan. Blood was drawn after an overnight fast for measurement of cholesterol (chol), triglyceride (TG), VLDL and HDL-Chol. Oral glucose tolerance test was performed with 75 g glucose. The overall prevalence of overweight [BMI (kg/m2) > or = 25-< or = 30] and obesity (BMI > 30) was 21.3% and 4.5% respectively. The overweight and obese were significantly younger than the lean subjects. The prevalence of hypercholesterolemia (chol > 5.2 mmol/l) in lean, overweight and obese subjects was 65.3%, 70.2% and 74.7%, respectively. Impaired glucose tolerance was found in 16.6% of the lean, 21.6% of the overweight and 32.0% of the obese subjects. Diabetes mellitus was found in 7.9% of the lean, 10.5% of the overweight and 6.7 of the obese subjects. 10.1% of lean, 13.2% of overweight and 23.3% of obese individuals were hypertensive. In conclusion, the high prevalence of overweight and obesity in Malaysia was associated with adverse lipid and glucose metabolism as well as poor blood pressure control.     

Leukocyte adhesion molecules

An adult is considered as overweight if his body mass index is 25.0 kg/m2 or more and as obese if it is 30.0 kg/m2 or more. Since excess weight is a predisposing factor for many chronic diseases, e.g. diabetes, an increase in its incidence in the population is cause for concern. Until now, excess weight has been problem of epidemic proportions only in developed countries, but it has recently spread to the developing world. More than 30% of the population in Latin America, the Caribbean, the Middle East, and Northern Africa is overweight. Populations living on Pacific and Indian Ocean islands have the highest prevalence of obesity in the world. In Asia and Black Africa, the overall prevalence of overweight is still low but incidence is high in urban areas. In most of these countries, both underweight and overweight people can now be seen. In many countries, the increase in the number of overweight people has occurred within the last few years. Excess weight appears first among the affluent and then among low-income classes including young children and teenagers. The main causes are a nutrition transition to lipid-rich diets and, above all, reduced physical activity in city dwellers. Obesity and associated diseases could become major problems in the future since malnutrition during fetal development and early childhood are predisposing factors. Already overweight is creating an extra burden for countries where malnutrition and nutritional deficiencies are still observed in young children. Given the economic costs of management of obesity-related diseases, surveillance and prevention programs are needed to stem the growth of this problem.     

Sagittal abdominal diameter as a practical predictor of visceral fat

OBJECTIVE: To evaluate the relationships between the supine sagittal abdominal diameter (SAD) and visceral fat, as well as to evaluate intra- and inter-observer reliability of sagittal diameter measurement. PATIENTS: Twenty-eight women ranging in age from 27-78 y with a body mass index (BMI) ranging from 16.9-48.1 kg/m2 and 23 men ranging in age from 32-75 y with BMI ranging from 20-41.6 kg/m2. MEASUREMENT: Body fat distribution was measured by waist circumference, waist to hip ratio (WHR), SAD, anthropometrically assessed and a single slice of computed tomography (CT) at the L4-L5 level. RESULTS: In both genders, a significant association was found between visceral adipose tissue (AT) and SAD, as evaluated by CT (women r = 0.80; men r = 0.83, P < 0.001), and SAD by anthropometry (women r = 0.76; men r = 0.82, P < 0.001), as well as between visceral AT and waist circumference (women r = 0.76, men r = 0.86, P < 0.001) and WHR (women r = 0.57, P < 0.01, men r = 0.80, P < 0.001). A significant association was also found between subcutaneous AT and SAD by anthropometry (women r = 0.79, men r = 0.74, P < 0.001). After adjusting for BMI, the association between subcutaneous AT and SAD was no longer significant in men and only moderately significant in women (r = 0.42, P < 0.05), while the association between visceral AT and SAD by anthropometry remained significant in both genders (women r = 0.63, P < 0.001; men r = 0.66, P < 0.001). When the subjects were divided into two groups according to BMI (lean to moderately overweight women with BMI < 28 and men with BMI < 30 and obese women with BMI > 28 and men with BMI > 30) we found that the relationships between SAD by anthropometry, as well as SAD by CT and visceral AT, were higher in lean to moderately overweight subjects than in those who were obese. High inter-observer correlation was found concerning SAD measurement (r = 0.99, P < 0.001). Intra- and inter-observer precision as evaluated by coefficient of variation and intraclass correlation coefficient for SAD measurement was very high. CONCLUSION: Our study shows the usefulness of SAD by anthropometry to predict visceral fat and its very high inter- and intra-observer precision.     

Obesity and body fat distribution in New Zealanders: a pattern of coronary heart disease risk

AIMS: To describe the prevalence of obesity and the body fat distribution of New Zealanders. To discuss this in the context of the coronary heart disease risk. METHODS: Body weight and height, body mass index (BMI), waist:hip ratio (WHR) and six skinfold measurements were determined for 3204 randomly selected New Zealanders who responded to an invitation to a health check (response rate 56%). RESULTS: In the study sample BMI generally increased with age. Fifty five percent of men and 38 per cent of women aged 18-64 had a BMI exceeding 25, and of these 13 per cent and 10 per cent were obese (BMI > 30). WHR was greater in men than in women of all ages, and a third of the men and a quarter of the women had values exceeding 0.9 and 0.8 respectively. Central skinfold measurements (subscapular, suprailiac and abdominal) were lowest in young men, but rose markedly with age and were similar to women above age 35. Limb skinfolds were lower in men. CONCLUSIONS: This survey indicates that a large percentage of New Zealanders are overweight or obese and their excess body fat tends to be centrally distributed, especially in men. Obesity is thus a significant health problem in New Zealand.     

Prevalence of coronary heart disease and major cardiovascular risk factors in Thailand

BACKGROUND: Coronary heart disease (CHD) is expected to become one of the major health problems in developing countries such as Thailand where prevalence data are scarce. This study reports the prevalence of CHD, as indicated by electrocardiogram (ECG) Minnesota coding, and its risk factors in Thailand. METHODS: In 1991 we conducted a cross-sectional ECG survey in a multistage random sample of the Thai population, aged > or =30. All major cardiovascular risk factors were measured. Standard supine 12-lead ECG data were collected; amplitudes and intervals were measured manually and entered into a computer. Abnormal tracings were verified by five cardiologists, and agreement among at least three of them was accepted as final. RESULTS: The total sample included 3822 men and 4967 women aged > or =30 years. The age-standardized prevalence rate of CHD was 9.9/1000 (men 9.2/1000, women 10.7/ 1000). The age-standardized level of major cardiovascular risk factors among men and women respectively were: total cholesterol 4.8 mmol/l (187.3 mg/dl), 5.1 mmol/l (197.7 mg/dl); hypercholesterolaemia (> or =6.2 mmol/l) 12.2%, 16.9%; systolic blood pressure (mmHg) 117.8, 117.7; diastolic blood pressure (mmHg) 76.9, 75.8; body mass index (kg/m2) 21.7, 22.8; fasting blood sugar 4.8 mmol/l (87.9 mg/dl), 5.0 mmol/l (90.3 mg/dl); hypertension (> or =160/95 +/- on antihypertensive drugs) 6.3%, 8.1%; smoking 65.1%, 8.5%; diabetes mellitus (> or =7.8 mmol/l) 2.4%, 3.7%; obesity (>25 kg/m2) 15.2%, 27.2%. CONCLUSIONS: Most of the age-adjusted mean values and proportion of major cardiovascular disease risk factors as well as the prevalence of total CHD in the Thai population were much lower than the median of those values found in developing countries.     

Fasting hyperinsulinemia and cardiovascular disease risk factors in nondiabetic adults: stronger associations in lean versus obese subjects. Atherosclerosis Risk in Communities Study Investigators

The association between hyperinsulinemia and atherogenic risk factors has not been well studied in blacks and may be different for obese versus lean individuals. To investigate this possibility and to confirm the associations of hyperinsulinemia with cardiovascular disease risk factors in blacks and whites, we analyzed the joint associations of fasting serum insulin and obesity with risk factors in the Atherosclerosis Risk in Communities (ARIC) Study (1,293 black men, 4,797 white men, 2,033 black women, and 5,445 white women). Insulin values > or = 90th percentile (> or = 21 microU/mL) constituted hyperinsulinemia; body mass index (BMI) values > or = 27.3 kg/m2 for women and > or = 27.8 for men constituted obesity. Participants with hyperinsulinemia in all four race-sex groups had more atherogenic levels of most risk factors studied than those with normoinsulinemia. Among black men and women, mean levels of triglycerides, low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo) B, glucose, and fibrinogen (men only) were higher in hyperinsulinemic lean participants as compared with the normoinsulinemic obese group. Furthermore, most associations between insulin level and risk factors were stronger among lean versus obese subjects. For example, among lean black men, the difference in mean triglyceride concentration between those with hyperinsulinemia and those with normoinsulinemia was 147 - 99 = 48 mg/dL; among obese black men, the difference was 155 - 121 = 34 mg/dL (P < .05 for the interaction). Generally, similar negative interactions between BMI and insulin concentration were also observed among whites.(ABSTRACT TRUNCATED AT 250 WORDS)     

Characterization of two monoclonal antibodies against the RON tyrosine kinase receptor

An anthropometric assessment was conducted at 238 !Kung San hunter-gatherers aged between 18 and 65 years (mean = 30.8 years), 156 Kavango horticultural pastoralists aged between 18 and 61 years (mean = 29.2 years) and for 87 urbanized Kavango people aged between 18 and 61 years (mean = 29.3 years) living as wage earning employees in northern Namibia. Weight status was estimated by using body mass index categories according to the recommendations of the WHO. As is typical for human populations, men were taller and heavier than women within the same ethnic groups. An interethnic comparison showed that both !Kung San women and men were lighter than Kavango women and men. The mean BMI of !Kung San women was 19.1 and of !Kung San men 19.4 kg/m2. Kavango people exhibited higher average BMI values, 19.4 for women, 20.3 kg/m2 for men. With the exception of the male urban Kavango people a high percentage (more than 30%) of the subjects were thin and underweight, as shown by a BMI of < 18.5 kg/m2. This was especially true of the !Kung San of both sexes and the rural Kavango men. Nearly 25% of !Kung San women met the criterion of weight depletion (BMI < 17.0). The cultural transition from nomadic hunter gatherer subsistence to a more sedentary life style over the last 20 years can be interpreted as an environmental stress which affected male as well as female nutritional status. The hard economic situation of the rural Kavango people may also be a stress factor which negatively influenced their nutritional status, especially of the men. The significantly better nutritional status of the urban Kavango men may be the result of the opportunities for work as wage earners or as soldiers.