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Biomedical subjects

Frank G Yanowitz

Publications and source records attributed to Frank G Yanowitz.

7 recordsLinked to original sources
PubMed2005

Design and rationale of the Utah obesity study. A study to assess morbidity following gastric bypass surgery.

PURPOSE: This paper details the design and baseline characteristics of a study on the morbidity associated with Roux-en-Y gastric bypass surgery (GBP) in severely obese adults. This study is designed to assess the effectiveness of GBP in reducing morbidity and maintaining weight loss. A wide array of clinical tests and psycho-behavioral questionnaires are included as part of the study. METHODS: Three groups (n=1156 severely obese) have been recruited for this study: cases who were approved for and participated in surgery (n=415), a control group of GBP seeking individuals who were denied surgery (n=420) and a control group that was randomly chosen from a population of severely obese participants who were not seeking GBP (n=321). Clinical measures include: a physician interview and detailed medical history, resting electro- and echocardiograms, a submaximal exercise treadmill test and electrocardiogram, pulmonary function, limited polysomnography, resting metabolic rate, anthropometrics, resting and exercise blood pressure, comprehensive blood chemistry and urinalysis and dietary, quality of life and physical activity questionnaires. Most participants (76%) were tested following an overnight stay in a clinical research center. Remaining participants underwent less extensive testing in an outpatient clinic. RESULTS: Baseline characteristics of the 1156 participants are available for selected measures. Mean+/-S.D. for BMI was 46+/-7.5 kg/m(2) (range=33 to 92) and for age was 44+/-11.4 years (range=18 to 72). The prevalence of diabetes and hypertension was 19% and 35%, respectively. Of the participants who had an echocardiogram or polysomnogram, 92% had left-ventricular hypertrophy and 85% had mild to severe sleep apnea. The two control groups were similar to the surgical group. At approximately 24 months, all participants will have a second clinical examination. Statistical comparisons of changes in morbidity variables will be made between the surgical and control groups. CONCLUSIONS: This study design facilitates assessment of risks and benefits of GBP to perform recommendations on whether or not to perform surgery on the severely obese patient. Baseline and 2-year exams provide valuable data for comparison to future long-term follow-up data that can be collected at 5 and 10 years.

Adolescent↗
PubMed2005

An accurate VO2max nonexercise regression model for 18-65-year-old adults.

The purpose of this study was to develop a regression equation to predict maximal oxygen uptake (VO2max) based on nonexercise (N-EX) data. All participants (N = 100), ages 18-65 years, successfully completed a maximal graded exercise test (GXT) to assess VO2max (M = 39.96 mL x kg(-1) x min(-1), SD = 9.54). The N-EX data collected just before the maximal GXT included the participant's age; gender; body mass index (BMI); perceived functional ability (PFA) to walk, jog, or run given distances; and current physical activity (PA-R) level. Multiple linear regression generated the following N-EX prediction equation (R = .93, SEE = 3.45 mL x kg(-1) x min(-1), % SEE = 8.62): VO2max (mL x kg(-1) x min(-1)) = 48.0730 + (6.1779 x gender; women = 0, men = 1) - (0. 2463 x age) - (0.6186 x BMI) + (0.7115 x PFA) + (0.6709 x PA-R). Cross validation using PRESS (predicted residual sum of squares) statistics revealed minimal shrinkage (R(p) = .91 and SEE(p) = 3.63 mL x kg(-1) x min(-1)); thus, this model should yield acceptable accuracy when applied to an independent sample of adults (ages 18-65 years) with a similar cardiorespiratory fitness level. Based on standardized beta-weights, the PFA variable (0.41) was the most effective at predicting VO2max followed by age (-0.34), gender (0.33), BMI (-0.27), and PA-R (0.16). This study provides a N-EX regression model that yields relatively accurate results and is a convenient way to predict VO2max in adult men and women.

Adolescent↗
PubMed2005

The diabetes prevention program: a worksite experience.

The purpose of this study was to determine if the U.S. National Institutes of Health Diabetes Prevention Program (DPP) could be successfully implemented in a worksite setting. Thirty-seven adult employees of BD Medical Systems of Sandy, Utah were enrolled in a single-group time-series study using the DPP. Two-hour oral glucose tolerance tests (OGTT) and other outcomes were measured at baseline, 6 months, and 12 months. Weight, body mass index, waist circumference, 2-hour OGTT, very low density lipoproteins, triglycerides, and aerobic fitness were significantly improved at 6 and 12 months and showed overall significant improvement across time. Fasting blood insulin, total cholesterol, low density lipoproteins, and total cholesterol/high density lipoproteins ratio were significantly improved at 6 months, but not at 12 months. Eighteen of the program participants (51%) were no longer in the pre-diabetes and diabetes categories after 1 year. Existing worksite health promotion and occupational health professionals can successfully offer the DPP and help employees improve glucose tolerance.

Analysis of Variance↗
PubMed2003

The hypertriglyceridemic waist phenotype among women.

BACKGROUND: Elevated plasma triglycerides (TG) and waist girth (hypertriglyceridemic waist (HTGW)) has been associated with elevated insulin, small dense low-density lipoprotein (sLDL) particles, and Apo B in men. The HTGW has not been reported for women and the effect of cardiorespiratory fitness ("fitness") on associations between HTGW and coronary risk factors is unknown. PURPOSE: To determine the prevalence of HTGW and the influence of fitness on the relationship between HTGW and coronary risk among 137 healthy women (54+/-9 year; body mass index (BMI)=28+/-6 kg/m(2)). METHODS: HTGW was defined as waist girth >88 cm and TG >150 mg/dl. The metabolic triad was defined as insulin >31 pmol/l, Apo B >69 mg/dl and LDL-C >84 mg/dl. Fitness was assessed with a maximal treadmill exercise test. RESULTS: The sample prevalence of HTGW (n=15) was 11% (95% CI=5.7-16.0%). Apo B (P=0.04) and insulin (P=0.0001) increased across quintiles of waist girth, and LDL-C (P=0.004) increased across quintiles of TG. Metabolic triad prevalence was highest (67%, n=10) among HTGW women and lowest (22%, n=26) among non-HTGW women. A trend for higher coronary heart disease CHD risk factors was observed among HTGW compared with non-HTGW women. Among the HTGW group, a trend for lower CHD risk factors was observed among fit (>or=6.5 METs, n=7) versus unfit women (<6.5 METs, n=8). Sample size limitations prohibited meaningful tests of significant differences in CHD risk factors when stratified simultaneously on HTGW and fitness status. CONCLUSIONS: HTGW is associated with increased coronary risk factors similarly among women as reported for men. Higher fitness may improve the CHD risk profile among women with HTGW.

Apolipoproteins B↗
PubMed2002

Cardiorespiratory fitness and C-reactive protein among a tri-ethnic sample of women.

BACKGROUND: Elevated C-reactive protein (CRP) is associated with increased coronary heart disease (CHD) risk. Cardiorespiratory fitness ("fitness") is related with lower CHD risk; however, its relationship with CRP is relatively unknown. METHODS AND RESULTS: Cross-sectional associations between fitness and plasma CRP were examined among 135 African American (AA), Native American (NA), and Caucasian (CA) women (55+/-11 year; 28+/-6 kg/m2). Fitness was assessed with a maximal treadmill exercise test. Plasma CRP concentrations were determined with the Dade Behring high-sensitivity immunoassay. Geometric mean CRP levels were 0.43, 0.25, and 0.23 mg/dL, and average maximal MET levels of fitness were 7.2, 9.1, and 10 METs for AA, NA, and CA, respectively. CRP decreased across tertiles of fitness (P=0.002), increased across tertiles of BMI (P=0.0007), and varied by race (P=0.002). After adjustment for covariates, lower CRP (P<0.05) was observed across tertiles of fitness among NA and CA, but not AA. Among all women, after adjusting for race and covariates, the odds of high-risk CRP (>0.19 mg/dL) were 0.67 (95% CI=0.19 to 2.4) among fit (>6.5 METs) versus unfit women. CONCLUSIONS: The health benefits from enhanced fitness may have an antiinflammatory mechanism.

Black People↗
PubMed2002

Physical activity and health in the elderly.

Adults 65 years and older constitute the most rapidly growing segment of the US population. Sedentary lifestyle is a major risk factor for chronic disease and disability in the elderly. Physical activity levels among most older adults are insufficient to confer health benefits. This paper reviews recent evidence that physical activity and exercise training can positively modify the pathophysiology and outcomes of two leading causes of death and disability in the elderly: cardiovascular disease and fall-related injuries.

Accidental Falls↗