Abstract:
:The unique worldwide spread of the human species and the remarkably long post-reproductive survival show that our genome permits excellent adaptation to vastly different environments. Moreover, the main scourges of later age, namely malignant growths and atherosclerosis, appear in humans later than in shorter-living animals. In recent years, excess weight and obesity have become mass phenomena with a pronounced upward trend in all developed countries. However, despite the detrimental effects of being overweight, these populations live longer than ever, which in part may be explained by the availability of better medical treatment. The prevalence and predicted further spread of obesity can be understood in the light of evolution. In all animal species energy metabolism is asymmetric with energy accumulation ('thrifty genotype') being the necessary condition of survival during hard times. For humans, which are no different to other animals in this respect, this genetic programming was necessary for survival because during the course of history, including the recorded history in the more developed Middle East, Europe or China, there was never a long period of uninterrupted food abundance, whereas famines were regular and frequent. Therefore fat accumulation, when food was available, meant survival at times of shortage, while the possible detrimental effects of overindulgence in food and being overweight expressed in unrealistically old age were irrelevant. It is the central, mostly intra-abdominal fat (in both humans and animals) that is more medically important than the subcutaneous truncal fat, and the accumulation of both types of fat is conditioned by high food consumption; therefore it is a historic novelty for human populations. In contrast, lower-body fat in human females is unique in the animal kingdom: it is much less metabolically active, it is of much lower pathologic significance than central fat, and it is programmed to be mobilized mostly during pregnancy and lactation. In view of all this, norms of desired weight should be based on hard mortality and morbidity statistics and not on theoretical, esthetic or fashion considerations. By this criterion, the upper limit of desirable weight is likely to be body mass index (BMI) 27 or 28, but specified for different populations (sex, race, ethnic origin); moreover, with aging, the detrimental effects of obesity diminish and finally disappear. Risks of other pathologies related to obesity (e.g. diabetes, hypertension and coronary disease) are also population-specific. However, total fatness, measured by BMI, is insufficiently sensitive as a risk factor, and fat distribution (upper-body versus low-body type, as reflected by waist circumference and waist:hip ratio) plays at least as prominent a role. Therefore the detailed norms, not yet available, should take into account both general obesity and fat distribution and be specific for different populations. Since long-term weight loss in adults is rarely achievable, public health measures should be aggressively directed at the prevention of obesity from childhood.
journal_name
Diabetes Metab Res Revjournal_title
Diabetes/metabolism research and reviewsauthors
Lev-Ran Adoi
10.1002/dmrr.230keywords:
subject
Has Abstractpub_date
2001-09-01 00:00:00pages
347-62issue
5eissn
1520-7552issn
1520-7560pii
10.1002/dmrr.230journal_volume
17pub_type
杂志文章,评审abstract:BACKGROUND:To evaluate the association between fasting plasma glucose (FPG) and mortality by gender. METHODS:A total of 17 248 eligible participants from a rural Chinese prospective cohort population were included. The same questionnaire interview and anthropometric and laboratory measurements were performed at both b...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.3129
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Treatment with DiaPep277, a peptide derived from HSP60, has been shown to preserve beta-cell function in non-obese diabetic mouse (NOD) mice and in a trial with newly diagnosed human patients with type 1 diabetes treated over a 10-month period. This article extends the clinical trial observations to a total ...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,随机对照试验
doi:10.1002/dmrr.712
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The possible effect of random intrasite placement on the outcome of the Semmes-Weinstein monofilament (SWF) test is not known. We sought to determine the significance of this variable in the diagnosis of loss of protective sensation (LOPS) in patients with diabetes. METHODS:Forty-five patients with diabetes...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2388
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:To ascertain which demographic, clinical, and microbiological factors might affect clinical outcomes of patients with diabetic foot infections, excluding known osteomyelitis, by analysing Clinical Assessment Program and Teflaro® Utilization Registry study data of patients treated with ceftaroline fosamil. M...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,多中心研究
doi:10.1002/dmrr.2624
更新日期:2015-05-01 00:00:00
abstract:AIMS:Type 2 diabetes (T2D) is a global health problem that will be diagnosed in almost 300 million people by 2025 according to the World Health Organization. Before being diagnosed with T2D, individuals may have glucose levels above normal but below the diabetic range. This condition is known as prediabetes. Studies sh...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.3405
更新日期:2020-09-10 00:00:00
abstract:AIMS:This study was designed to investigate the association between pancreatic fat content (PFC) and insulin secretory capacity as well as glucose tolerance in Korean adults. MATERIALS:A total of 39 participants (mean age 49.9 years, 53% males) without a previous history of diabetes, or those previously diagnosed as h...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.3425
更新日期:2020-11-30 00:00:00
abstract::Cardiovascular disease now is the leading cause of mortality among patients with type 1 diabetes (T1D). The risk of death from cardiovascular events in subjects with T1D is 2-10 times higher than the general population, depending on blood glucose control. Although complications of cardiovascular disease occur in middl...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.3423
更新日期:2020-11-30 00:00:00
abstract:AIMS:Insulin-like growth factor 1 receptor (IGF1R) is involved in cell growth and glucose homeostasis. In the current study, the IGF1R locus was analysed as a candidate gene for type 2 diabetes (T2D) in American Indians. MATERIALS AND METHODS:Whole genome sequence data from 335 American Indians identified 3 novel miss...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2994
更新日期:2018-05-01 00:00:00
abstract::Initiating insulin therapy with a basal insulin analogue has become a standard of care in the treatment of type 2 diabetes mellitus (T2DM). Despite increasing choices in pharmacological approaches, intensified glucose monitoring and improvements in quality of care, many patients do not achieve the desired level of gly...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.3418
更新日期:2020-10-23 00:00:00
abstract:OBJECTIVE:Psammomys obesus gerbil exhibits PKCepsilon over-expression on high-energy (HE) diet. Muscle insulin receptor (IR) signalling and tyrosine kinase activity are inhibited eliciting insulin resistance. We aimed at preventing diabetes by inhibiting PKCepsilon-induced serine phosphorylation of IRS-1 with novel PKC...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.881
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Body mass index (BMI) is associated with death in a V-shaped manner in general populations but it is unknown whether BMI or other risk factors also exhibit V-shaped relationships with death in type 2 diabetic patients. METHODS:A prospective cohort of 7534 Chinese, type 2 diabetic patients enrolled since 199...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.792
更新日期:2008-03-01 00:00:00
abstract::The United Kingdom Prospective Diabetes Study (UKPDS) showed that tight glycemic control with any of several therapeutic regimens has the potential to significantly reduce the risk for long-term microvascular complications of type 2 diabetes. An important question that remains to be answered is what is the best approa...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.304
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:This study examined whether temporal trends exist in treatment of patients with type 2 diabetes (T2D) and quality of diabetes care after implementation of quality improvement initiative in primary care setting. METHODS:We conducted a population-based retrospective cohort study of 202,284 patients with T2D w...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2952
更新日期:2018-02-01 00:00:00
abstract::Activation of self-reactive T cells that specifically destroy the pancreatic beta-cells is one of the hallmarks in the development of type 1 diabetes. Thus, for prevention and treatment of this autoimmune disease, approaches to induce and maintain T cell tolerance toward the beta-cells, especially in islet transplanta...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.345
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Compare glycated hemoglobin (HbA1c ) diagnostic tests for prediabetes and diabetes with plasma glucose criteria and compare the metabolic profiles of people classified by HbA1c versus by glucose levels. METHODS:Participants were recruited for the San Juan Overweight Adults Longitudinal Study. The participan...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2874
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Dipeptidyl peptidase-IV (DPP-4) inhibitors and sulfonylureas are two important second-line anti-diabetic agents. The objective of this research was to evaluate the efficacy and safety of DPP-4 inhibitors compared with sulfonylureas by meta-analytic approach of available randomized studies. METHODS:We search...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/dmrr.2482
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Both metabolic syndrome (MetS) and N-amino terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) confer increased risk of cardiovascular diseases (CVD). We assessed if NT-proBNP levels were greater in people with uncomplicated MetS, who had neither CVD/chronic kidney disease (CKD) nor di...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2616
更新日期:2015-05-01 00:00:00
abstract::Every year, over 1 million people with diabetes lose a leg due to diabetic foot disease. Most amputations are preceded by a foot ulcer. Causes for the development of foot ulcers are generally multifactorial and may include neuropathy, peripheral vasculopathy, abnormal foot mechanics and infection. Multidisciplinary ap...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2527
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Recently, a genome-wide association study identified a strong association between the fat mass- and obesity-associated rs9939609 single nucleotide polymorphism (SNP) and the risk of obesity in European population. However, the results in Chinese population were reported to be contradictory. Therefore, our ai...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.1066
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Advanced glycosylation end product (AGE) formation is a major mechanism for the development of complications in diabetes, and the possible roles of insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) are not clearly established. METHODS:We examined the associations of AGEs, free IGF-I a...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/(sici)1520-7560(200003/04)16:2<106::aid-dm
更新日期:2000-03-01 00:00:00
abstract::Around one of three diabetic patients is affected by distal symmetric polyneuropathy (DSP) which represents a major health problem, as it may present with partly excruciating neuropathic pain and is responsible for substantial morbidity and increased mortality. Treatment is based on four cornerstones: (1) multifactori...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.817
更新日期:2008-05-01 00:00:00
abstract::Rising rates of diabetes in pregnancy have led to an escalation in research in this area. As in any area of clinical research, definitions of outcomes vary from study to study, making it difficult to compare research findings and draw conclusions. Our aim was to compile and create a repository of definitions, which co...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.2640
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Increased activity of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in enhanced adrenocorticotropin (ACTH) and serum glucocorticoid levels, has been described in patients with diabetes mellitus and in animal models of this disease; however, altered steroid production by adrenocortical cells could ...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.978
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Intranasally applied insulin is one of the antigen-specific therapies currently tested in clinical type 1 diabetes prevention trials, for example, in the Type 1 Diabetes Prediction and Prevention Study (DIPP). The possibility that the therapy may cause hypoglycaemia or local irritation and the poorly known i...
journal_title:Diabetes/metabolism research and reviews
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1002/dmrr.397
更新日期:2003-09-01 00:00:00
abstract::Diabetic foot disease is an important complication of diabetes. The development and outcome of foot ulcers are related to the interplay between numerous diabetes-related factors such as nerve dysfunction, impaired wound healing and microvascular and/or macrovascular disease.The formation of advanced glycation end prod...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.861
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Data on the association between body iron and glucose homeostasis by the three glycaemic states are scarce. Thus, we investigated the association between body iron as assessed by a serum ferritin concentration and glucose homeostasis using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) a...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2628
更新日期:2015-07-01 00:00:00
abstract::In the last few years, there has been increasing focus on the impact of interventions on cardiovascular outcomes in patients with type 2 diabetes. Insulin resistance and hyperglycaemia often co-exist with a cluster of risk factors for coronary artery disease, but the underlying mechanisms leading to the development of...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.790
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:There is a controversy about self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes who are not using insulin. Randomized trials are limited in duration, size, and validity. METHODS:Systematic search for randomized trials and observational studies published since 1990. For inclusion studie...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.749
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Charcot neuroarthropathy (CN) of the ankle and hindfoot (Sanders/Frykberg Type IV) is challenging to treat surgically or nonsurgically. The deformities associated with ankle/hindfoot CN are often multiplanar, resulting in sagittal, frontal and rotational malalignment. In addition, shortening of the limb ofte...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章
doi:10.1002/dmrr.2748
更新日期:2016-01-01 00:00:00
abstract::The use of endovascular therapy (EVT) for lower extremity atherosclerosis is markedly increasing while open surgical bypass is in decline. The results of EVT for critical limb ischaemia (CLI) are difficult to evaluate, especially for patients with diabetes. To date, only one randomized, prospective trial has been publ...
journal_title:Diabetes/metabolism research and reviews
pub_type: 杂志文章,评审
doi:10.1002/dmrr.829
更新日期:2008-05-01 00:00:00