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1.
The United States is in the midst of an escalating epidemic of obesity. Over one-third of the adult population in the United States is currently obese and the prevalence of obesity is growing rapidly. By any criteria, obesity represents a chronic disease which is associated with a wide range of comorbidities, including coronary heart disease (CHD), Type 2 diabetes, hypertension and dyslipidemias. The comorbidities of obesity are common, occurring in over 70% of individuals with a BMI of ≥ 27. In addition to obesity itself, excessive accumulation of visceral abdominal fat and significant adult weight gain also represent health risks. Physicians have an important role to play in the treatment of obesity. Unfortunately, the medical community has not been involved actively enough to help stem the major epidemic of obesity occurring in the United States. This article puts forth a proposed model for the treatment of obesity in clinical practice, including obtaining the “vital signs” of obesity, recommending lifestyle measures, and instituting pharmacologic therapy when appropriate. By utilizing a chronic disease treatment model, physicians can join other health care professionals to effectively treat the chronic disease of obesity. Relatively modest weight loss, on the order of 510% of initial body weight can result in significant health improvements for many patients and represent an achievable goal for most obese patients.  相似文献   

2.

Background

Excess adiposity is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus and dyslipidemia. Amongst the various measures of adiposity, the best one to help predict these risk factors remains contentious. A novel index of adiposity, the Body Adiposity Index (BAI) was proposed in 2011, and has not been extensively studied in all populations. Therefore, the purpose of this study is to compare the relationship between Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Body Adiposity Index (BAI) and CVD risk factors in the local adult population.

Methods and Findings

This is a cross sectional study involving 1,891 subjects (Chinese 59.1% Malay 22.2%, Indian 18.7%), aged 21–74 years, based on an employee health screening (2012) undertaken at a hospital in Singapore. Anthropometric indices and CVD risk factor variables were measured, and Spearman correlation, Receiver Operating Characteristic (ROC) curves and multiple logistic regressions were used. BAI consistently had the lower correlation, area under ROC and odd ratio values when compared with BMI, WC and WHtR, although differences were often small with overlapping 95% confidence intervals. After adjusting for BMI, BAI did not further increase the odds of CVD risk factors, unlike WC and WHtR (for all except hypertension and low high density lipoprotein cholesterol). When subjects with the various CVD risk factors were grouped according to established cut-offs, a BMI of ≥23.0 kg/m2 and/or WHtR ≥0.5 identified the highest proportion for all the CVD risk factors in both genders, even higher than a combination of BMI and WC.

Conclusions

BAI may function as a measure of overall adiposity but it is unlikely to be better than BMI. A combination of BMI and WHtR could have the best clinical utility in identifying patients with CVD risk factors in an adult population in Singapore.  相似文献   

3.
We have tested the hypothesis that the relationship between body mass index (BMI) and other cardiovascular disease (CVD) risk factors as well as socioeconomic status is different in five Latin American populations (where BMI is high) and seven Asian populations (where BMI is low). Random samples of approximately 200 males aged between 35 and 65 years were selected from 12 general or industrial populations in Latin America and Asia. Standardized measures of height, weight, blood pressure, blood cholesterol, cigarette smoking, highest level of completed education, occupation and income were made. The mean BMI (kg/m2) was 253 (SD 3.74) in the five Latin American populations (which were all urban), 22.2 (SD 3.24) in the four Asian urban populations and 21.4 (SD 3.33) in the three Asian rural populations. Despite the differences in mean BMI levels, statistically significant positive relationships of a similar magnitude were seen between BMI and blood pressure levels in Latin America and Asia. Similarly, there was a statistically significant positive relationship found between BMI and total cholesterol in both Latin American and Asian urban samples, but of a higher magnitude in Asian rural samples. Current cigarette smokers had significantly lower BMI than ex-smokers or never smokers in Latin America and Asia. In Asia, there were statistically significant positive associations between BMI and levels of education and income as well as with occupation — these relationships were stronger for education and occupation in rural than in urban samples. There were no statistically significant associations between BMI and these measures of socioeconomic status in Latin America. The similarities of the associations between BMI and blood pressure and cholesterol levels in the two groups suggest that efforts to reduce BMI in all populations is likely to be important in reducing risk of CVD. Preventing the future rise of BMI in populations tions where BMI is still relatively low is a high priority. The difference in association between BMI and socioeconomic status in the different population groups requires study of the way sociocultural factors influence behavior that determines BMI levels.  相似文献   

4.
Alcoa recently constructed the Fjarðaál aluminum smelter in Reyðarfjörður, East Iceland. The smelter is designed to produce a maximum of 346,000 metric tons per year of aluminum. A risk assessment was conducted to evaluate the differential human health risk related to estimated potential air emissions from the planned Fjarðaál smelter with and without seawater scrubbers. Air-dispersion modeling results provided for particulate matter (PM10), sulfur dioxide (SO2), hydrogen fluoride (HF), and polycyclic aromatic hydrocarbons (PAHs) were compared to ambient air standards or air quality guidelines from Norway, Iceland, or European directives and from the U.S. Environmental Protection Agency. Risk estimates were calculated for PAHs. Modeled air estimates were mapped geospatially, to identify potential receptors, including onsite outdoor worker, seagoing worker, hypothetical fence-line resident, future hypothetical resident, closest current resident, residents in neighboring villages, closest farmer, and a visitor to the nearby Holmanes Nature Reserve. Both with and without seawater scrubbers, the predicted exceedances of standards per year for SO2 were well below the maximum number allowed. Use of seawater scrubbers was predicted to decrease average SO2 air concentration estimates in the short term; however, annual estimates were lower without seawater scrubbers. Risk estimates for carcinogenic and non-carcinogenic PAHs, and modeled air concentrations of HF and PM10, were well within acceptable levels.  相似文献   

5.

Background

The sagittal abdominal diameter (SAD) measured in supine position is an alternative adiposity indicator that estimates the quantity of dysfunctional adipose tissue in the visceral depot. However, supine SAD’s distribution and its association with health risk at the population level are unknown. Here we describe standardized measurements of SAD, provide the first, national estimates of the SAD distribution among US adults, and test associations of SAD and other adiposity indicators with prevalent dysglycemia.

Methods and Findings

In the 2011–2012 National Health and Nutrition Examination Survey, supine SAD was measured (“abdominal height”) between arms of a sliding-beam caliper at the level of the iliac crests. From 4817 non-pregnant adults (age ≥20; response rate 88%) we used sample weights to estimate SAD’s population distribution by sex and age groups. SAD’s population mean was 22.5 cm [95% confidence interval 22.2–22.8]; median was 21.9 cm [21.6–22.4]. The mean and median values of SAD were greater for men than women. For the subpopulation without diagnosed diabetes, we compared the abilities of SAD, waist circumference (WC), and body mass index (BMI, kg/m2) to identify prevalent dysglycemia (HbA1c ≥5.7%). For age-adjusted, logistic-regression models in which sex-specific quartiles of SAD were considered simultaneously with quartiles of either WC or BMI, only SAD quartiles 3 (p<0.05 vs quartile 1) and 4 (p<0.001 vs quartile 1) remained associated with increased dysglycemia. Based on continuous adiposity indicators, analyses of the area under the receiver operating characteristic curve (AUC) indicated that the dysglycemia model fit for SAD (age-adjusted) was 0.734 for men (greater than the AUC for WC, p<0.001) and 0.764 for women (greater than the AUC for WC or BMI, p<0.001).

Conclusions

Measured inexpensively by bedside caliper, SAD was associated with dysglycemia independently of WC or BMI. Standardized SAD measurements may enhance assessment of dysfunctional adiposity.  相似文献   

6.
Ischemic stroke represents a leading cause of morbidity and mortality in thedeveloped world. This disabling and sometimes fatal event puts an everincreasing burden on the family members and medical professionals who care forstroke victims. Preclinical ischemic stroke research has predominantly utilizedyoung adult, healthy animals, a clear discrepancy when considering the clinicalpopulation affected by stroke. A broad spectrum of risk factors such as age,obesity, diabetes, and hypertension has been associated with an increased strokerisk. The effect of these comorbidities on both stroke pathophysiology andoutcome has not been emphasized and has been recognized as a shortcoming ofpreclinical studies. By addressing these conditions in experimental models ofischemic stroke, it may be possible to more accurately represent the clinicalscenario and improve therapeutic translation from bench-to-bedside. In thiswork, we review many of the risk factors associated with increased stroke risk,particularly as each risk factor relates to inflammation. Additionally, weexplore potential animal models that could be utilized in identifying thecontribution of these risk factors to stroke outcome. By investigating the riskfactors for stroke and how these may alter stroke pathophysiology, the presentdiscrepancies between preclinical studies and the clinical reality can bereconciled in an effort to improve therapeutic development and translation frombench-to-bedside.  相似文献   

7.
Predictive ecological risk assessment was used to determine whether any risk-reduction benefit would result from the installation and operation of wet scrubbers at an aluminum smelter in East Iceland. Sulfur dioxide and hydrogen fluoride exposure will not result in any appreciable risk to mosses, lichens, lodgepole pine, and heather/heath grassland communities beyond the dilution zone without scrubbers. With scrubbers, exceedances of plant criteria may occur beyond the dilution zone. Critical concentrations of polycyclic aromatic hydrocarbons (PAHs) and hydrogen fluoride (HF) in terrestrial wildlife food items were converted to critical air concentrations, which were then compared to modeled air concentrations. Terrestrial wildlife species are not expected to be exposed to PAH concentrations that result in appreciable risk. If wildlife species are assumed to consume only grasses, predicted HF exposures will not result in exceedance of toxicity thresholds. However, if wildlife species are assumed to consume only heather, thresholds are exceeded at some locations for the rock ptarmigan and wood mouse. Results of population modeling indicate no potential for population impacts to rock ptarmigan outside the facility boundary. Impacts to wood mouse carrying capacity are expected to extend beyond the dilution zone with scrubbers, but not without.  相似文献   

8.
9.
Protection of human health and ecosystems is gaining importance in corporate decision- making regarding industrial development. During the design phase for an aluminum smelter in East Iceland, it became necessary to determine whether a wet scrubber system should be installed to reduce sulfur dioxide emissions. Predictive risk assessment was used to determine whether there would be a consequential difference in the level of risk to human and ecological receptors from constituents in air emissions from the aluminum smelter, either with or without wet scrubbers. Benchmark exposure concentrations were established for avian, mammalian, and plant receptors and were compared to air modeling predictions to develop risk estimates. Benchmark concentrations were derived using plant uptake models for fluoride and polycyclic aromatic hydrocarbons (PAHs), and food-web modeling for birds and mammals. Exposure models were developed for all receptors, and population-level effects were modeled for plant, bird, and mammal receptors. Results indicated that exposures under both scenarios are lower than risk thresholds, and overall risk was lower for a smelter without wet scrubbers. Thus, although mass loading of sulfur dioxide (and other constituents) would be reduced using wet scrubbers, the corresponding risk to ecological receptors would actually be higher because of higher exposure-point concentrations in air.  相似文献   

10.
The ability to prevent significant root feeding damage to corn, Zea mays L., by the western corn rootworm, Diabrotica virgifera virgifera LeConte, by crop rotation with soybean, Glycine max (L.) Merr., has been lost in portions of the Corn Belt because this pest has adapted to laying eggs in soybean fields. Cuphea spp. has been proposed as a new broadleaf crop that may provide an undesirable habitat for rootworm adults because of its sticky surface and therefore may reduce or prevent oviposition in these fields. A 4-yr study (1 yr to establish seven rotation programs followed by 3 yr of evaluation) was conducted to determine whether crop rotation with Cuphea would provide cultural control of corn rootworm. In support of Cuphea as a rotation crop, fewer beetles were captured by sticky traps in plots of Cuphea over the 4 yr of this study compared with traps in corn and soybean, suggesting that fewer eggs may be laid in plots planted to Cuphea. Also, corn grown after Cuphea was significantly taller during vegetative growth, had significantly lower root damage ratings for 2 of 3 yr, and had significantly higher yields for 2 of 3 yr compared with continuous corn plots. In contrast to these benefits, growing Cuphea did not prevent economic damage to subsequent corn crops as indicated by root damage ratings > 3.0 recorded for corn plants in plots rotated from Cuphea, and sticky trap catches that exceeded the threshold of five beetles trap(-1) day(-1). Beetle emergence from corn plots rotated from Cuphea was significantly lower, not different and significantly higher compared with beetle emergence from continuous corn plots for 2002, 2003 and 2004 growing seasons, respectively. A high number of beetles were captured by emergence cages in plots planted to Cuphea, indicating that rootworm larvae may be capable of completing larval development by feeding on roots of Cuphea, although peak emergence lagged approximately 4 wk behind peak emergence from corn. Based on these data, it is unlikely that crop rotation with Cuphea will provide consistent, economical, cultural control of corn rootworm.  相似文献   

11.

In this study, we developed an approach for prosthetic foot design incorporating motion analysis, mechanical testing and computer analysis. Using computer modeling and finite element analysis, a three-dimensional (3D), numerical foot model of the solid ankle cushioned heel (SACH) foot was constructed and analyzed based upon loading conditions obtained from the gait analysis of an amputee and validated experimentally using mechanical testing. The model was then used to address effects of viscoelastic heel performance numerically. This is just one example of the type of parametric analysis and design enabled by this approach. More importantly, by incorporating the unique gait characteristics of the amputee, these parametric analyses may lead to prosthetic feet more appropriately representing a particular user's needs, comfort and activity level.  相似文献   

12.
Candidate weed biocontrol agents must be screened to exclude those that could threaten desirable plants . Traditionally , this has been done by rejecting species that develop on economically important plants in laboratory no - choice tests . However , because congeneric plants often support development in these tests , even when they are not utilized in nature , the tests do not meet legislated requirements for rare plant species or the increasing public concern for native plants . Plant suitability for larval development is a poor predictor of host range because insects use a sequence of steps in which the early steps , such as host finding and acceptance for oviposition , tend to be stronger than the later ones , such as suitability for development . This study is a trial of a new approach to screening insects as weed biocontrol agents that uses risk analysis to quantify the suitability of a plant as a host on the basis of inset performance at various stages in its life cycle . The insects used for the study was a NW Chinese biotype of the leaf beetle , Altica carduorum, which in terms of climate adaptation and damage it inflicts on the weedy thistle Cirsium arvense, is a promising biocontrol agent for Canada . However , its ability to develop on all North American Cirsium spp . in laboratory no - choice tests currently excludes its release . We show by risk and factor analyses , with five sequential host - selection parameters , that the suitability of these thistles to A. carduorum is so low that the beetle would not jeopardize the continued existence of rare native thistles , so its release should not be a problem .  相似文献   

13.
The clay mineralogy and heavy metal/metalloid (As, Pb and Cu) contents of soils developed on the various rock units in a central highlands environment in Victoria (Creswick, Australia) have been investigated. The clay minerals identified showed an order of abundance as: kaolinite ? illite > smectite > mixed-layer (ML) ≈ vermiculite. The soil clay mineralogy did not change systematically with depth (0~ 10, 10~ 20 and 20~ 30 cm) and showed large variations spatially. The high proportion of kaolinite was probably due to the removal of 2:1 phyllosilicates by the formation of 1:1 kaolinite through weathering, which also reduced the cation exchange capacity (CEC) and electrical conductivity (EC, soil: water ratio of 1:5) of soils by aging. Soils were classified as silty loam to loam with a low clay size (≤ 2μ m) fraction. The soils were acidic to moderately acidic with pH ranging from 4.5 to 7.1, averaging 5.7. Concentrations of As, Pb, and Cu (average values 24.3, 16.7 and 11.0 mg/kg, respectively) did not show an association with the clay mineral contents except vermiculite. The occurrence of smectite and mixed-layer clay contents, although far lower than kaolinite and illite, contributed significantly to CEC of soils. The study area was affected by mining, high natural background As values dominate the area and the role of clay minerals in fixation of metalloid/metals was found to be less significant. Low organic matter content (average ~ 6.5%), low soil surface area (average ~ 1.0 m2/g) and the high proportion of kaolinite mineral content result in a limited ability to fix heavy metals. The role of Fe oxides appeared to be a key influence in the fixation of As and other potentially toxic metals, rather than the clay minerals, and therefore requires further research. This work highlighted the importance of the determination of types and amounts of clay minerals of natural soils in environmental management.  相似文献   

14.
Chestnut is one of most important forest products in Korea. However, Ricania shantungensis, an invasive species, has been increasingly causing economic damage to chestnut. To increase management efficiency of R. shantungensis in chestnut fields, its spatio-temporal distributions were analyzed using spatial analysis by distance indices (SADIE) and semivariogram. Experiments were conducted by observing selected, marked, and geo-referenced trees in two commercial chestnut fields for each developmental stage (i.e., spring egg, nymph, adult, and fall egg) of R. shantungensis from 2017 to 2019. Spatial distributions of R. shantungensis were statistically (P < 0.05) aggregated except for its nymphal stage. Spatial associations of its distributions also showed the statistically (P < 0.05) positive associations regardless of years or developmental stages except for the spatial relationship between egg and nymphal stages. These results indicated that site-specific management for R. shantungensis would be applicable. In application of site-specific management for R. shantungensis, the distance of spatial dependence for nymphs, 60 m, should be considered to minimize reoccurrence possibility and additional samplings. Incorporating site-specific management into pest control program of R. shantungensis could increase its control efficiency in chestnut fields.  相似文献   

15.
The evaluation of Eurithia consobrina (Meigen) as a candidate for introduction against bertha armyworm, Mamestra configurata (Walker) (Lepidoptera: Noctuidae), in western Canada included studies of its host range, distribution, synchronization with host, constancy, abundance and life history in Europe. In addition, its diapause induction and its coldhardiness were compared with those of the target host M. configurata and its native tachinid parasitoid, Athrycia cinerea (Coq.). E. consobrina was found to fit criteria for a successful biocontrol agent reasonably well. It also had the potential to fill a largely unoccupied niche in the parasitoid complex of M. configurata. E. consobrina has a facultative diapause of the long-day type, similar to A. cinerea, but is less sensitive to diapause-inducing conditions. E. consobrina is at least as coldhardy as A. cinerea and more coldhardy than M. configurata. Laboratory exposures to temperatures of 0 C for 140 days apparently selected for greater coldhardiness, and later generations survived exposures of 140 days at -15 C without significant mortality. Adult E. consobrina were released at three locations in Manitoba in 1986 and 1987, but establishment has not been confirmed.  相似文献   

16.
Male broiler chicks (n = 120) were fed diets containing 0, 5, 10 or 15% dried distillers' grains with solubles (DDGS) from the 12th day up to the end of fattening (day 35). During this period feed intake, weight gain and excreta quality (pH, DM) were tested. A digestibility trial was carried out on four birds from each group on the last five days of the experiment to determine the digestibility of organic matter and CP of the different diets. The protein digestibility was evaluated using three different methods; uric acid correction, α-amino-N and amino acid-N. There were no significant effects of increased DDGS levels on feed intake, weight gain, excreta quality or digestibility of CP and organic matter. However, feed conversion showed a tendency to decline at the highest DDGS level (15%). Digestibility of DDGS protein was estimated to be 77%. There was no significant difference between uric acid and α-amino-N method, but both methods had a significantly lower CP digestibility than amino acid-N. The present results indicate that DDGS can be used as a protein source in diets for fattening broilers up to 10–15%.  相似文献   

17.
The spatial distribution of exotics across riparian landscapes is not uniform, and research elaborating the environmental constraints and dispersal behavior that underlie these patterns of distribution is warranted. This study examined the spatial distribution, growth patterns, and habitat constraints of populations of the invasive Dioscorea oppositifolia in a forested stream corridor of a tributary of Drury Creek in Giant City State Park, IL. The distribution of D. oppositifolia was determined at the watershed scale mainly by floodplain structure and connectivity. Populations of D. oppositifolia were confined to the floodplain, with overbank flooding from the stream. Dioscorea oppositifolia probably originates in disturbed areas upstream of natural corridors, and subsequently, the species disperses downstream into pristine canyons or ravines via bulbils dispersing in the water. In Giant City State Park, populations of D. oppositifolia were distributed on the floodplain across broad gradients of soil texture, light, slope, and potential radiation. The study also examined the longevity of bulbils in various micro-environments to illuminate strategies for the management of the species in invaded watersheds. After 1 year, the highest percentages of bulbils were viable under leaves, and much lower percentages were viable over leaves, in soil, and in the creek (76.0±6.8, 21.2±9.6, 21.6±3.6, and 5.2±5.2%), respectively. This study suggests that management procedures that reduce leaf litter on the forest floor (e.g., prescribed burning) could reduce the number of bulbils of D. oppositifolia stored in the watershed.  相似文献   

18.
Don Moore 《Zoo biology》1987,6(2):169-182
A format is suggested for a “Species Management Plan”; the model for this presentation is the pronghorn (Antilocapra americana). By using the Species Management Plan format, the captive maintenance of pronghorn is analyzed in relation to habitat and microhabitat needs, behavioral requirements, and nutritional needs. A strategy for captive maintenance of pronghorn in relatively wet climates is presented. It is suggested that development of a Species Management Plan is necessary before any new species is acquired for captive maintenance and reproduction.  相似文献   

19.
This paper presents a survey of spider species that have not been previously recorded for Israel. Twenty species, twelve genera and two families (Mysmenidae and Phyxelididae) are recorded for the first time in Israel. Nine species, Agroeca parva Bosmans, 2011, Aulonia kratochvili Dunin et al., 1986, Ero flammeola Simon, 1881, Hogna ferox (Lucas, 1838), Maculoncus parvipalpus Wunderlich, 1995, Neon rayi (Simon, 1875), Pardosa aenigmatica Tongiorgi, 1966 and Phyxelida anatolica Griswold, 1990, are illustrated. Tarentula jaffa Strand, 1913, syn. n. is synonymised with Hogna ferox (Lucas, 1838), and Hahnia carmelita Levy, 2007, syn. n. is synonymised with Hahnia nava (Westring, 1851). A possible synonymy of the widespread Prodidomus rufus Hentz, 1847 with P. hispanicus Dalmas, 1919 known from the Iberian Peninsula is discussed. An original combination is restored for Trochosa urbana O.P.-Cambridge, 1876.  相似文献   

20.
Two micronized waste products were evaluated in a closed recirculation system for their suitability to replace a costly die of live algae in the culture of the Sudanese fairy shrimp,Streptocephalus proboscideus. The test population was kept at a density of 50 individuals 1–1 (sex ratio:1/1). An agricultural waste product (YM20; mixture of pea and corn), and an industrial waste product (POME; Palm Oil Mill Effluent) were fed at two regimes: 0.1 and 0.2mg DW animal–1 h–1. The microalgaSelenastrum capricornutum, used as a reference diet at a density of 2.0±0.82 × 105 cells ml–1, proved adequate in preliminary screening experiments. The effect of the diets and feeding regimes on selected biological variables and water quality were followed by weekly observations and measurements. Results in terms of growth (=increase in length), cyst production, and mortality were more successful when animals were supplied high densities of YM20 than in all other treatments: mean brood size was 155±6 cysts with a maximum of 266. Length after 6 weeks about 2 cm while this ranged between1.4–1.7 cm for the other treatments. Weekly mortality rate was comparable under high food conditions. Mortality rate gradually increased from 5% in the first week to 15% in the last week. Water quality, especially nitriate concentration (measured as NO2-N), was slightly better in the dry food fed than in the algae fed cultures. Present results are promising for large-scale culturing ofS. proboscideus in a cost-effective way by making use of agro-industrial waste products.  相似文献   

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