Biochemical and Anthropometric Characterization of Morbid Obesity in a Large Utah Pedigree

Abstract

HUNT,STEVEN C,ROGERRWILLIAMS AND TED D ADAMS. Biochemical and anthropometric characterizationofmorbidobesityinalarge Utahpedigree. ObesRes.AUtahfamilywithmorbidobesitywas extendedtoinclude 122personsinfourgenerationsforthepurposeof characterizing anthropometric and biochemicalvariables in family members with and without morbid obesity. Seventyseven subjects had blood drawnforbiochemicalanalyses. Ofthe77 subjects, 12weremorbidlyobeseQ44.5kgor 100 pounds overweight), 20 were between22.5-45.4 kg (50 and 99 pounds) overweight and 45 were less than 22.5 kg (50 pounds) overweight. Sixty-two randomly-ascertained controls were used for comparisons of age-and gender-adjusted studyvariables.Morbidly obesesubjects hadmean body mass indices (BMI)of41.0 kg/m2 (62kgoveridealweight)comparedto 25.3 kg/m2 (10 kg overweight) in the ~2 2 . 5 kg family members @<0.001). The <22.5 kg family members had lower BMIthan the random controls (27.6 kg/mz,p<0.05), indicating clear bimodality of obesity within the pedigree. Percent body fat from bioelectricalimpedance was 35% versus 24% in the morbidly obese and the <22.5 kg subjects,respectively. Idealbodyweightwas similar among thethree pedigreeweight groups. Hip andwaist circumferences weremuchlargerinthemorbidly obese and thewaistto-hip ratio remained significantly greaterin themorbidly obese subjects compared to the ~2 2 . 5 kg group.Morbidly obese subjects hadelevatedtriglycerides and VLDL-C levels,low HDL-levels,andnormalLDGC levels. Fasting insulin was the best predictor of morbid obesity of allbiochemical andlipidmeasurements (odds ratio of 4.5). Fasting insulin levels and theinsulin-to-glucose ratio were 1995;3(~~ppl2): 165s-172s. Copynght 01995 NAASO more than twice as high as control levels. Even after adjusting for differences in BMI, fasting insulin and the insulin to glucoseratio were elevated inthemorbidly obese subjects indicating that insulin levels were inappropriately high for theirweight compared to this relationship foundin the other groups. Adjustedinsulinlevelsforthe 22.5-45.4 kg group were similar to controls, indicating insulin levelwas at the predicted level for their weight.In conclusion, individuals with morbid obesity appeared to have greater insulin resistance than could be explained by theirweight. CHD riskfrom elevatedLDG C wasnotpresent,but CHD riskwasincreasedbythesocalled multiple metabolic syndrome (insulin resistance, high triglycerides andlow HDGC).

Acute caloric restriction counteracts hepatic bile acid and cholesterol deficiency in morbid obesity

“…Total and LDL cholesterol levels were similar in both groups, whereas HDL cholesterol was 35% lower in obese ( P < 0.0001) than in nonobese women, in line with previous findings . Serum total triglyceride levels in obese women were elevated by 122% ( P < 0.0001) . Next, we evaluated BA synthesis and cholesterol synthesis using the serum markers C4c and lathosterol/c , respectively.…”

Epidemic obesity: are genetic factors involved via increased rates of assortative mating?

“…27,28 In a large four generation Utah pedigree ascertained for a high loadEpidemic obesity J Hebebrand et al ing with morbid obesity a clear trend for increasing rates of assortative mating from the early to late generations was described. 29 In conclusion, the dif®-culties encountered upon our attempt to compare our results with past studies were insurmountable; only a precise delineation of the relevant data (Tables 1, 2, 3) will enable such valuable comparisons. Ideally, comparisons required to assess temporal changes in rates of assortative mating for obesity should be made within the same country.…”

Obesity related phenotypes in families selected for extreme obesity and leanness

“…36,37 One study sampled a single large pedigree having multiple, extremely obese individuals. 38 That large family design has some of the characteristics of the current study, including an extreme range and bimodality of obese phenotypes. To our knowledge, only one group of investigators has selected sibling pairs based on extreme obesity measures.…”