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   Table of Contents - Current issue
Coverpage
January-June 2018
Volume 6 | Issue 1
Page Nos. 1-40

Online since Friday, March 13, 2020

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EDITORIAL  

Saudi Journal of Obesity: Its new term and vision p. 1
Mohammed Alnaami
DOI:10.4103/sjo.sjo_11_18  
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SPECIAL ARTICLE Top

Obesity care: Urgent call for national standards in Saudi Arabia p. 2
Yahia M Al-Khaldi
DOI:10.4103/sjo.sjo_21_18  
Obesity/overweight is very common health problems globally. In KSA, about three-quarter of population have either overweight or obesity. Obesity is known to be associated and complicated with other common health problems.. There is adequate evidence that obesity can be prevented and managed. Despite these facts, there were no standards for obesity care in Kingdom of Saudi Arabia (KSA)A. The objective of this paper is to present some standards for obesity care at different levels of health care in KSA.
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REVIEW ARTICLE Top

Role of renin–angiotensin system in obesity associated disorders p. 5
Rukhsana Gul, Hafedh Dekhil, Assim A Alfadda
DOI:10.4103/sjo.sjo_15_18  
Activation of renin–angiotensin system (RAS) plays a key role in the maintenance of blood pressure, fluid, and electrolyte homeostasis through the action of the vasoactive peptide angiotensin II (Ang II). RAS has now been recognized to play an important role in metabolic diseases. Evidence from both animal and clinical studies suggest that blockade of RAS by reducing the synthesis of Ang II or its binding to angiotensin type 1 receptor (AT1R) via angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) prevents the activation of inflammatory signaling mechanism involved in obesity-associated metabolic disorders. Conversely, angiotensin converting enzyme 2 (ACE2)/Ang-(1–7)/Mas receptor (MasR) axis has been proposed as counter regulatory arm with effects opposite to those produced by ACE/Ang II/AT1R. This review summarizes the relevant studies enlightening the role of RAS in obesity-associated disorders with emphasis on the inhibitory effect of ACEi and ARBs on ACE/Ang II/AT1R and stimulation of ACE2/Ang-(1–7)/MasR axis in obesity.
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ORIGINAL ARTICLES Top

Study of metabolic syndrome among health professionals in a rural eastern Indian population and its relation with quality of life p. 12
Arpan K Ghosh, Arunima Chaudhuri, Asha Kahar, Debasis Adhya
DOI:10.4103/sjo.sjo_2_18  
Background The increasing prevalence of metabolic syndrome (MetS) is a challenging threat for the 21st century. Aims To assess the prevalence of MetS and find out the relation with the quality of life among health professionals in a population of eastern India. Materials and Methods This study was conducted in a time span of 1 year among the various categories of 300 health professionals working at Burdwan Medical College and Hospital after taking institutional ethical clearance and informed consent from the participants. The presence of at least three out of five components of MetS was used for diagnosis. Data collection methodology was based on WHO STEP-wise approach using questionnaire, physical, and biochemical measurements. Results MetS was found among 131 participants (43.7%). Among the participants with MetS, there were 71 (54.2%) doctors, 32 (24.4%) nurses, 16 (12.2%) paramedics, and 12 (9.2%) other health professionals. But there was no significant difference in prevalence among the categories of profession. MetS was diagnosed more among females compared to males (53.8% vs. 34.2%, χ2 = 11.699, P < 0.001). Females were twice as likely to develop MetS compared to males (odds ratio 2.24, confidence interval 1.40–3.57, P < 0.001). Among the various components of MetS within the study population, increased waist circumference (58.7%) had the highest prevalence, followed by low high-density lipoprotein cholesterol (48.3%), high blood pressure (46.3%), increased blood glucose (39.7%), and hypertriglyceridemia (35.3%). Conclusions The present study highlighted the high prevalence of MetS among health professionals with a female preponderance. MetS was associated with the poor quality of life, especially the domains of physical health, psychological health, and social relationships.
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Metabolic syndrome among patients who had acute stroke in Hadramout, Republic of Yemen p. 20
Rasheed M Bamekhlah, Hussain S Alghazali, Adnan A Bakarman, Abdulraheem A Bahishwan, Abdullah S Bin-Nabhan
DOI:10.4103/sjo.sjo_1_18  
Background and Objectives: Stroke is a major community problem with a high incidence, causing major neurological disability. Among the related risk factors, metabolic syndrome (MetS) is gaining a concern. Its relation to stroke has been suggested. We measured its frequency and described its following components among patients who had acute stroke: hypertension (HTN), diabetes mellitus (DM), waist circumference (WC), raised levels of serum triglycerides (TGs), and low levels of serum high-density lipoproteins. Materials and Methods: A prospective hospital-based case series study was conducted from October 2014 to April 2015. A total of 130 patients who had acute stroke, admitted in the medical department at Ibnseena Hospital, were recruited to this study. Clinical data, the results of investigations, and final diagnosis were collected. The patients were considered positive for MetS when they had ≥3 of the components according to the Adult Treatment Panel III. Results: The MetS frequency was 46.9% among all patients who had stroke, and 52.3% when restricted to patients who had ischemic stroke only. There were neither significant age nor gender differences. HTN was the most common component of the syndrome (98.4% of MetS among patients who had stroke), but without significant difference between patients with MetS and those who were non-MetS [OR 3.69 (95%CI 0.4–33.97), P = 0.22], followed by significantly higher WC measurements and levels of TGs among patients with MetS (77% each) than in those who were non-MetS [OR 112.5 (95%CI 24.41–518.5), P < 0.0001 and OR 29.73 (95%CI 11.12–79.5), P < 0.0001, respectively]. Forty-four percent of the patients with MetS had three MetS components, 31.1% had four, and 24.6% had all the five MetS components. Conclusion: MetS was present in a considerable percentage of patients who had stroke; it was more related to ischemic stroke. HTN was the most prevalent MetS components. There was a high frequency of patients having all the five MetS components.
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Effect of laparoscopic sleeve gastrectomy on metabolic and nutritional changes at King Abdulaziz University Hospital, Saudi Arabia p. 25
Rawan Alsolami, Wisam H Jamal, Yara A Fayoumi, Sarah A Almaghrabi, Murad M Aljiffry, Mohammad M Zagzoog
DOI:10.4103/sjo.sjo_14_18  
Introduction: Bariatric surgery has been shown to be the most effective way to treat obesity. The outcome of weight-loss surgeries primarily focuses on reducing weight, and improving comorbidities and quality of life of patients. Postoperative nutritional deficiencies are well known complications of sleeve gastrectomy. Deficiencies of protein, iron, and vitamins B12 and D are often reported and may occur despite supplementation. Aim: The aim of this study was to assess the effect of laparoscopic sleeve gastrectomy on metabolic and nutritional changes among obese patients at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods and Subjects: This is a retrospective review of patients who underwent sleeve gastrectomy surgery between January 2013 and January 2016 at KAUH, Jeddah, Saudi Arabia. Perioperative characteristics, biochemical profile [glycated hemoglobin (HbA1c), calcium, parathyroid (PTH), albumin, B12, lipid, and iron profile], and details on subsequent weight loss in terms of body mass index (BMI) and weight loss (kg) of the patients were obtained. Results: Sixty-six patients were included in the study. Forty-two (63.4%) were female with a mean age of 35.1 ± 10.3 years. Our results demonstrated a significant statistical reduction in weight and BMI with improvement in HbA1c, high-density lipoprotein, triglycerides, and low-density lipoprotein, and decrease in cholesterol level. On the contrary, other metabolic elements such as ferritin and vitamin B12 showed a significant decrease, whereas calcium, PTH hormone, and albumin showed no change. Conclusion: This study showed that sleeve gastrectomy had significant improvements of some biochemical markers in addition to reduction in weight and BMI.
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Central obesity among adult Saudi males in Riyadh city: Prevalence, risk factors, and associated morbidities p. 29
Mohammed Alsheef, Hassan Alassiry, Emad Alotaibi, Nawaf Alamri, Amar Halwani, Tariq A Wani, Hala Aljishi
DOI:10.4103/sjo.sjo_11_17  
Background Obesity is increasing in the Saudi population with a prevalence of 35.5%. Data on the prevalence and risk factors of central obesity are lacking. Numerous studies demonstrate that mortality is higher among individuals with central obesity compared to a generalized pattern. Central obesity is considered as the cornerstone for metabolic syndrome and is associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus (T2DM). Objectives The objectives of this study were to determine the prevalence, risk factors, and associated morbidities of central obesity among adult Saudi males attending primary healthcare centers (PHCCs) in Riyadh, Saudi Arabia. Materials and Methods This cross-sectional study collected data from seven healthcare sectors in Riyadh city from May to August 2015. A multistage stratified random sampling technique was used; data were collected from 269 male adults attending nine PHCCs. The questionnaire enquired about demographic information, tobacco use, dietary habits, physical activity, a history of hypertension (HTN) and diabetes mellitus, family history, and anthropometric measurements. Central obesity was defined as waist-to-height ratio >0.5, waist-to-hip ratio (WHR) >0.90, and waist circumference (WC) >102 cm. Data entry and analysis were managed using the Statistical Package for the Social Sciences version 20.0 software (SPSS). Results Based on body mass index (BMI), this study revealed that 37.9% of the participants were overweight or obese (32.7%). The prevalence of central obesity was 42.4%. Diabetes mellitus, HTN, and coronary heart disease were found among 36.1, 26.0, and 8.2% of the participants, respectively. Linear regression analysis demonstrated that T2DM [odds ratio (OR) 2.48], a family history of obesity (OR 2.79), a family history of T2DM (OR 1.80), current smoking (OR 5.78), ever smoking (OR 5.15), physical inactivity (OR 4.85), drinking energy beverages (OR 0.45), consuming more fried food (OR 2.20), and consuming fast food (OR 3.03) were significantly associated with central obesity. Conclusion The prevalence of central obesity when determined using WC was higher when compared to its prevalence determined using BMI. WC is recommended to be included as another important tool to assess for obesity and predict for other risk factors of cardiovascular diseases for patients attending PHCCs. Health education programs should be adopted to increase awareness about the risks of central obesity and encourage a healthy diet and active lifestyle. Further studies need to be performed with a larger sample size and in different regions of Saudi Arabia.
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Weight status and related factors in medical students of King Khalid University, Saudi Arabia p. 35
Ali Al Bshabshe, Mushabab A Al-Ghamdi, Masoud I Elkhalifa, Mohammad T Ahmad, Ibrahim A Eljack, Yara M Assiri, Bashayer Fahad, Sara A Hadi, Rahaf S.O Bukhari, Mubarak Al Saif, Yazeed Alqahtani, Hossien M.M Al Qahtani, Mohammed Alshehri, Abdulelah Alqahtani
DOI:10.4103/sjo.sjo_18_18  
Introduction and Objective: The purpose of this study was to find out the prevalence of obesity and related factors among students of College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia. Materials and Methods: A total of 560 medical students of different levels participated in this cross-sectional study. The study was conducted in the period between January 2016 and January 2017. The data were collected through a validated, self-administered questionnaire. Weight and height readings were taken using a calibrated manual scale. Results: Out of 560 respondents, 54.8% were females, whereas 45.2% were males. Mean ± standard deviation was 22.05 ± 1.8. The body mass index was calculated from the weight (kg) and height (m2) of the participants. Underweight was found in 16% of the participants, normoweight in 55%, overweight in 21%, and obese in 8%. Conclusion: The prevalence of overweight and obesity was found to be high among medical students of College of Medicine, King Khalid University, particularly among female students. There is a need for a program to promote healthy eating and exercise among the students.
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