Weight Loss Reduce hsCRP Levels in Korean Premenopausal Obese Women

BACKGROUND: Obesity has been proposed as a risk factor for cardiovascular diseases. CRP has been proposed as an independent risk factor for cardiovascular diseases, and has been associated with body weight and body fatness. It has been known that weight reduction reduces CRP. We examined the hypothesis that weight loss can reduce plasma CRP levels in Korean, obese premenopausal women. METHODS: In a sample of 36 Korean obese (BMI 25.00~47.02 kg/m2), premenopausal (22~48 years) women, we measured hsCRP, plasma lipid profiles, blood glucose, body weight, body mass indexes, body fatness and intra abdominal body fat area. A 12-week weight reduction program was conducted in 36 obese women. When the program was finished, fat distribution, hsCRP and lipid profile test was repeated. The effects of weight loss on CRP levels were tested by means of paired t-test and nonparametric Wilcoxon signed rank test. RESULTS: We found that plasma CRP level was positively associated with body weight, body mass index, body fatness, CT-measured abdominal visceral and subcutaneous fat area. After a 12-week weight loss protocol, the average weight loss was 7.97+/-3.46 kg (P<0.0001) with loss of fat mass 5.29+/-0.59 kg, and 1.98+/-1.20 kg lean body mass. Plasma CRP levels were both positively associated with plasma CRP level reductions (P=0.0437). CONCLUSION: Obesity and adiposity influenced significantly on plasma CRP in Korean premenopausal women on cross sectional basis. Moreover, 12-week caloric restriction induced weight loss decreased plasma CRP levels. Weight loss represents an intervention to reduce plasma CRP and can mediate to reduce cardiovascular disease risk in Korean obese premenopausal women.

The Predicting Factor of Vascular Endothelial Dysfunction in Healthy Premenopausal Obese Women

BACKGROUND: Vascular endothelial dysfunction (VED) plays a pivotal role in the pathogenesis of atherosclerosis and is associated with insulin resistance and with visceral obesity. Therefore, in this study the predicting factor of vascular endothelial dysfunction was investigated in healthy premenopausal obese women by pulse-wave analysis (PWA) combined with provocative pharmacological testing. METHODS: Thirty three obese women (BMI> or =25), aged 20~45 y and 25 age-matched control subjects (BMI; 18.5~22.9) were examined. All women were sedentary (<1 hr/wk of physical activity), non-smoker and were excluded if they had type 2 diabetes melitus, hypertension, hyperlipidemia, cardiovascular disease, or acute inflammatory disease and were studied in folicullar phase of the cycle, within the first week after cessation of menstrual bleeding. They underwent determination of anthropometric measurements, metabolic variables, adipose tissue regional distribution, and endothelial function by performing pulse-wave analysis (PWA) combined with provocative pharmacological testing. RESULTS: Augmentation Index (AIx) fell significantly after the administration of salbutamol, which causes endothelium-dependent vasodilatation, but response was significantly reduced in obese women compared with controls (10.28 6.72% vs 17.2 6.84%, P=0.0003). The change in after Nitroglycerin, which causes endothelium-independent vasodilatation, did not differ significantly (30.86 9.67% vs 30.6 10.11%, P=0.9172). In our obese subjects, visceral adipose tissue area was independently a significant predictor of vascular endothelial dysfunction (beta= 0.1381, P=0.0038, Adj-R2=0.348). CONCLUSION: Increased abdominal adiposity is a powerful independent predictor of VED in obese healthy women. Future studies of vascular endothelial function should account for the independent effects of abdominal fat.

Prediction of Esophageal Varices in Patients with Liver Cirrhosis

BACKGROUND: Patients with liver cirrhosis are regularly examined for the evaluation of esophageal varices. Those with large varices should be treated with beta-blockers. The aim of this study was to determine whether clinical variables were predictive of the presence of esophageal varices or high-grade varices. METHODS: The medical records of 257 patients, diagnosed as having liver cirrhosis and underwent esophagogastro-duodenoscopy (EGD), were reviewed. None had a history of malignancy and variceal hemorrhage before EGD. Clinical findings were analyzed in relation to the presence of esophageal varices and high grade esophageal varices. RESULTS: The multiple logistic regression analysis showed an independent association between the presence of esophageal varices and ascites and low platelet count. Only low platelet count showed association with high grade esophageal varices. The cut-off value of predictive model for high grade esophageal varices was 73,766/microliter and its sensitivity was 75%, specificity 65.7%, negative predictive value 96.2%, and positive predictive value 18.6%. CONCLUSION: Our analysis showed that low platelet count and ascites were independent predictive factors for esophageal varices. For high grade varices, the platelet count was the only predictive factor. Endoscopic screening for detection of high grade varix is highly recommended when the platelet count is lower than 74,000/microliter is observed in patients with liver cirrhosis.