Complicaciones de la obesidad / Complications of obesity

La obesidad, valorada positivamente en épocas pasadas en nuestra cultura e incluso considerada por algunos sólo como un problema estético, supone una enfermedad con graves consecuencias sobre la salud de quien la padece y sobre la economía de aquellos a quienes corresponde costear sus gastos. Su prevalencia actual en España se sitúa alrededor del 13 por ciento y, si nos fiamos de los pronósticos que se establecen para otros países occidentales como EEUU, irá aumentando hasta convertirse en la epidemia del siglo actual. Son bien conocidas las consecuencias del exceso de peso sobre los sistemas cardiovascular, respiratorio, digestivo, osteoarticular, reproductor y endocrino-metabólico así como la relación entre obesidad y algunos tipos de cáncer. Como norma general conviene tener en cuenta que las mayores complicaciones corresponderán a los mayores sobrepesos (obesidad mórbida y superobesidad) y que también influye la edad, la duración del exceso ponderal y la distribución de la grasa adicional puesto que la obesidad androide/visceral/abdominal se acompaña del llamado síndrome de resistencia insulínica por lo que suele cursar con hipertensión arterial, dislipemia, alteraciones de la tolerancia hidrocarbonada y de la coagulación, elementos implicados en su conjunto en la morbi-mortalidad cardiovascular (AU)

[Complications of obesity]. / Complicaciones de la obesidad.

Obesity, which was evaluated positively in our culture in past periods and which was even considered by some to be merely an aesthetic question, is a disease with serious consequences for the health of the person suffering from it, and for the economy of those who have to meet its costs. Its present prevalence in Spain is situated around 13% and, if we can trust the forecasts established for other western countries such as the USA, it will increase to become the epidemic of the present century. The consequences of excess weight on the cardiovascular, respiratory, digestive, osteoarticular, reproductive and endocrine-metabolic systems are well known, as well as the relation between obesity and some types of cancer. As a general rule, it is worth bearing in mind that the greatest complications will correspond to the greater overweight (morbid obesity and severe obesity) and that age, the duration of ponderal excess and the distribution of the additional fat also have an influence, given that android/visceral/abdominal obesity is accompanied by the so-called insulin resistance syndrome. It is thus usually accompanied by hypertension, dyslipemia, alterations of hydrocarbonate tolerance and coagulation, elements involved as a whole in cardio-vascular morbi-mortality.

[Clinical study and hormonal evaluation of a 48, XXYY male. Comparison with previously published cases]. / Descripción clínica y evaluación hormonal de un varón 48, XXYY. Comparación con los casos previos publicados.

A new case of the infrequent 48, XXYY syndrome is presented. The somatomedin C and HGH values were high, perhaps playing a role in the above of the mean height of Klinefeter patients, of which this cromosomic abnormality is a variant.

[A clinical description and hormonal assessment of a 48, XXYY male. A comparison with cases previously published]. / Descripción clínica y evaluación hormonal de un varón 48, XXYY. Comparación con los casos previos publicados.

A new case of the infrequent 48, XXYY syndrome is presented. The somatomedin C and HGH values were high, perhaps playing a role in the above of the mean height of Klinefelter patients, of which this chromosomic abnormality is a variant.

Time dependency and reversibility of the effects of exclusive cyproterone acetate therapy on pituitary adrenal function in hirsute women.

The effects of cyproterone acetate (CA) administration on the pituitary-adrenal axis were studied in 30 hirsute females. The patients were treated continuously with a daily dose of 100 mg of CA for a maximal period of 12 months. Insulin-induced hypoglycaemia and ACTH infusion were performed on pre-treatment conditions and after 1, 4, 6 and 12 months of CA treatment. From a clinical point of view, a dramatic improvement of hirsutism was evident after 6 months of therapy. The most commonly reported side effects were amenorrhoea and transient uterine haemorrhage. Apart from asthenia, no symptoms of adrenal insufficiency were noticed. No changes in pituitary-adrenal secretion were observed during the first 4 months of therapy. From the 6th month, a reduction in basal as well as stimulated cortisol levels was seen. Simultaneously, an enhanced ACTH response to hypoglycaemia was observed. Both effects became more pronounced after 1 year of treatment. There were no significant changes in ACTH basal values. Six months after discontinuation of the drug, adrenocortical reserve improved but was still slightly reduced when compared to pre-treatment range at that time. These findings suggest a time-dependent negative effect of CA on adrenal steroidogenesis which shows a reversible character 6 months after antiandrogen withdrawal. Therefore, steroid cover should be considered for intercurrent illness in patients treated for longer than 6 months with this therapeutic regime.