#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The terms ‘obesity’ and ‘overweight’ denominate excessive growth of fat in the human body


Authors: R. Krajčovičová;  R. Hudeček
Published in the journal: Prakt Gyn 2008; 12(2): 109-116

Summary

It is a pandemic the incidence of which has increased dramatically over the recent years. 66 % of men and 54 % of women aged 20 to 65 are affected by overweight and obesity in the Czech Republic (data from the Centre for Diagnosis and Therapy of Obesity). Overweight and obesity increase cardiovascular morbidity and mortality, accident rate, the incidence of locomotive system degenerative diseases, of carcinoma of different organs, and contributes to the development of the syndrome of insulin resistance (Reaven’s X syndrome). Overweight and obesity are also associated with serious endocrine disorders. A typical example is increased androgen production and subsequent hirsutism. A frequent additional complication is the polycystic ovary syndrome. Acyclic elevation of LH and estradiol, FSH depression, irregular anovulatory cycles lead to fertility failure [1]. Obesity reduces the success rate of sterility therapy using methods of assisted reproduction [3]. Fat women need to take higher levels of gonadotropins for a longer time [22,23]. Obese women and women with overweight have a lower pregnancy rate on cycle [3]. They also have a lover fertilisation and implantation rate. Endometrial quality is altered as a consequence of metabolic and hormonal changes. These lead to more frequent failure of IVF therapy [3]. Weight reduction by only 5–10 % reduces dramatically all risks and increases the chance for pregnancy and delivery of a healthy child [3]. The therapy of obesity is a complex issue and requires interdisciplinary approach. Special diets, increased physical activity and an overall change of lifestyle with the help of behavioural psychotherapy are essential. Modern pharmacotherapy contributes to quicker and more effective weight reduction. On the other hand, the success achieved with it should encourage the patient to adhere, in the long run, to the diet and lifestyle guidelines as a whole.

Key words:
overweight and obesity – body mass index (BMI) – anovulatory cycles – polycystic ovary syndrome – insulin resistance – Sibutramine – STORM study


Zdroje

1. Ďuriš I, Hulín I, Bernadič M et al. Princípy internej medicíny. Bratislava: SAP 2001: 2218–2228.

2. Vašičková Z. Obezita v gynekologii a porodnictví. Prakt Gyn 2003; 7(3): 16–20.

3. Križanovská K, Ulová-Gallová Z, Bouše V et al. Nadváha negativně ovlivňuje vlasnosti oocytu v programu asistované reprodukce. Asis Repro 1999; 9(1): 27–28.

4. Koppelman PG, Stock M (eds). Clinical Obesity. New York: Blackwell Science 1998.

5. Bongain A, Isnard V, Gillet JI. Obesity in obstetrics and gynaecology. Eur J Obstet Gynecol Reprod Biol 1998; 77(2): 217–228.

6. Hainer V, Kunešová et al. Obezita. Praha: Galén 1997: 126.

7. Svačina Š. Gynekologické komlikace obezity. Prakt Gyn 2001; 2: 47–53.

8. Hainer V. Regulace tělesné hmotnosti a příjmu potravy. In: Krch FD. Poruchy příjmu potravy. Praha: Grada 1999: 81–94.

9. ÚZIS. Aktuální informace č. 48. Výběrové šetření o zdravotním stavu české populace (HIS CR 2002) -Index tělesné hmotnosti (III.díl) [online]. Poslední revize 14. 10. 2002 [cit. 2003– 03–21]. Dostupné na: http://www.uzis.cz

10. Svačina S. Metabolická onemocnění ve 3. tisíciletí. Medicína 3. tisíciletí. Praha: Evolving Studio 2000: 184.

11. Bongain A, Isnard V, Gillet JI. Obesity in obstetrics and gynaecology. Eur J Obstet Gynecol Reprod Biol 1998; 77(2): 217–228.

12. Moller DE (ed). Insulin resistance. Chichester: John Wiley and Sons Ltd 1993.

13. Svačina S, Kvapil M, Haas T et al. Inzulín steroidy a steroidogeneza. Čs Fyziologie 1997; 46: 51–56.

14. Cogswell ME, Perry GS, Schieve LA, Dietz WH. Obesity in women of childbearing age: risks, prevention and treatment. Prim Care Update Ob Gyns 2001; 8: 89–105.

15. Seidenfeld MEK, Rickert VI. Impact of anorexia, bulimia and obesity on the gynecologic health of adolescents. Am Fam Physician 2001; 65(3): 445–450.

16. Toscano V. Polycystic ovary syndrome: What is it? Pathogenetic enigma and therapeutic dilemma. J Endocrinol Invest 1998; 21(9): 546–550.

17. Svačina S. Metabolický syndrom. Praha: Triton 2001: 184.

18. Polotsky D, Rochester D, Jain A et al. Normalisation of reproductive hormones, insulin resistance and adipokine after bariatric surgery occurs in the absence of a rise in reverse T3. Fertil Steril 2007; P–238: 187.

19. Bellver J, Melo MA, Bosh E et al. Obesity and poor reproductive otcome: the potential role of the endometrium. Fertil Steril 1997; 88(2): 446–451.

20. Onalan R, Onlan G, Tonguc E et al. Body mass index is an independet risk factor for development of endometrila polyps in patients undergoing in vitro fertilisation. Fertil Steril 2008; 4: in print.

21. Metwally M, Ong KJ, Lenger WL et al. Does high body mass index icrease the risk of miscarriage after spontaneus and assisted conception? A meta-analysis of the evidence. Fertil Steril 2007; 6.

22. Dokras A, Baredziak L, Blaine J et al. Obstetric outcomes after in vitro fertilisatin in obese and morbidly obese women. Obstet Gynecol 2006; 108(1): 61–69.

23. Ku SY, Kim SD, Jee BC et al. Clinical effi - cacy of body mass index as predictor of in vitro fertilisation and embryo transfer outcomes. Korean Med Sci 2006; 21(2): 300–303.

24. Davies DM, Finn A, Hardy I et al. Are IVF patients with an increased bodz mss index less likely to hzve good quality embryos. Fertil Steril 2007; P–238: 187.

25. Yanovski SZ, Yanovski JA. Obesity. N Engl Med 2002; 346(8): 591–602.

26. Hainer V. Obezita. Praha: Triton 2003.

27. Sucharda P. Sibutramin v léčbě obezity. Med po prom 2004; 5(1): 65–69.

28. Doležal T, Votava M. Sibutraminum. Remedia 2001; 11(4): 239–244.

29. James WPT, Astrup A, Finer N et al. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. Lancet 2000; 356(9248): 2119–2125.

Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#