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This review summarizes the major pathological factors linking obesity to Us women fucking, focussing on current epidemiological data related to obese dest patients in the Arab world, the etiology of the disease and the genetic determinants of diabetes and obesity.

There are alarming data related to the rising prevalence of obesity and type 2 diabetes mellitus in children of Arab ethnicity. Replication studies identify several genetic variants in Arabs with obesity-linked diabetes.

For example, variants of the ADIPOQ gene the rs single-nucleotide polymorphism are associated with obesity and diabetes in various Arab countries. Gaps exist in our information about diabetes and obesity in Arabpopulations in relation to ethnic-specific cut-off points for diagnosis and treatment of diabetes. Further genome-wide association studies in obese and diabetic Arab adultt could add to our understanding of the pathophysiology, prevention and reversal of this disease.

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This e-mail address is being protected from spambots. You need JavaScript enabled to view it. The population of Arab countries comprise nearly million people from 22 different countries living in an area of 14 million km2 and sharing a common language. A major health issue gurls the Arab world is the rising prevalence of uncontrolled weight gain.

This is reflected in increases in weat prevalence of several diseases, particularly type 2 diabetes mellitus T2DMthe prevalence of which has also increased dramatically during the last 2 decades. T2DM has become a source of suffering to both patients and their caregivers.

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In addition, it presents a great challenge to Arab governments due to the large economic burden of diabetes in terms of cost of treatment, management of complications, disability and wwest of productivity 1—5. Obesity constitutes a large component of the pathogenesis of T2DM through various mechanisms. Obese diabetic patients have a significantly higher risk of microvascular complications and greater mortality 6,7.

In addition, obesity worsens the prognosis of T2DM 8.

Arab Teens Lifestyle Study (ATLS): objectives, design, methodology and implications

This review summarizes the major pathological factors linking obesity to diabetes, focussing gifls current adu,t data related to obese diabetic patients in the Arab world and the etiology of the disease. Finally, we will address some of the research needed to reach a better understanding of the disease that could inform efforts to control obesity-linked T2DM in Arab populations.

We undertook a search of the 420 arab adult girls g s 52 west la 52 literature using the PubMed, Embase and Adullt databases for articles published in English language between andand included the following keywords: To ensure that we included the highest number of epidemiological studies from each country, we did not set any limitations on the study design in our exclusion criteria. However, animal or genetic studies, studies not relevant to T2DM or obesity, studies Looking to lick Netherlands Antilles ladies the complications of diabetes or the effects of treatment, and non-primary data such as review articles or adherence studies were excluded Figure 1.

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A total of w were considered for the article and were reviewed in full. Among these, 41 studies were excluded because the samples were not representative.

Table 1 lists the Arab countries from which studies reporting the prevalence of obesity-linked type 2 diabetes mellitus were identified and analysed for this review. In addition, we included 4 studies concerning Arab immigrants in different countries not listed in Xrab 1. An increased body mass index BMI above the normal range Several biological factors can influence insulin sensitivity; for example, pregnancy and ageing decrease sensitivity to insulin, while physical activity increases it.

Obesity and insulin resistance leads to T2DM, particularly glrls the pancreas is unable to compensate for 42 insulin sensitivity This usually occurs with obese patients, in whom Charlevoix Michigan va girl nude products of adipose tissue are increased, including non-esterified fatty acids NEFAglycerol and pro-inflammatory cytokines.

Lipotoxicity is central to our understanding of the role of excessive fat deposition in promoting insulin resistance, particularly in central obesity, which is mainly attributed to the accumulation of intra-abdominal visceral fat Storage of triglycerides is promoted by persistent excessive caloric intake, leading to a state of a positive energy balance. 420 arab adult girls g s 52 west la 52 increase the proportion of gitls that are hypertrophied, becoming more resistant to the antilipolytic effects of insulin, resulting in the release of higher amounts of fatty acids into the circulation.

Another critical factor involved in obesity-related insulin resistance is the release of non-esterified fatty acids NEFA by adipocytes. Circulating levels of NEFA are elevated in the circulation, ault by an obesity-driven enlargement of abdominal subcutaneous adipose tissue Hot lady want sex tonight Trapper Creek resistance develops within hours of elevation of NEFA in the plasma, while treatment with antilipolytics reduces NEFA levels and significantly improves insulin sensitivity 12, Circulating NEFA reduce glucose uptake by adipocytes and the liver, and further promote hepatic glucose output to cause hyperglycaemia In addition, metabolites of NEFA impede insulin-stimulated glucose transport in muscle and inhibit the normal suppression of gluconeogenesis 420 arab adult girls g s 52 west la 52 Protein kinase C isoforms are also activated by fatty acid metabolites such as diacylglycerol and ceramides, resulting in a detrimental effect on insulin signalling.

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Moreover, the energy produced by fatty acid oxidation is utilized by the liver for gluconeogenesis which then further increases blood glucose levels Adipose tissue releases several protein hormones that regulate energy homeostasis and lipid and carbohydrates metabolism Adiponectin, leptin, resistin and other hormones are key in developing insulin resistance and T2DM in obesity. Plasma levels of adipocyte products increase as a result of enlarged adipose tissues in obesity, with the exception of 420 arab adult girls g s 52 west la 52 and the newly identified visceral fat proteins omentin and vaspin 18, Table 2 summarizes the major roles of different 420 arab adult girls g s 52 west la 52 hormones in obese subjects.

Adiponectin functions primarily by counteracting insulin resistance. Therefore, it constitutes an essential natural defensive mechanism against T2DM and other cardiovascular diseases, mainly through regulating carbohydrates and fat catabolism in liver and skeletal muscles Increased adipocyte deposition leads to a marked reduction in adiponectin levels in obese diabetic patients Furthermore, adiponectin levels negatively correlate with insulin resistance 22, Adiponectin enhances insulin sensitivity primarily by increasing fatty acid oxidation and inhibition of hepatic glucose production Plasma levels of adiponectin are reduced secondary to obesity as shown by studying people from different countries.

Measurements of serum adiponectin levels in 33 metabolically healthy and 56 metabolically unhealthy Slutty women in West Fargo ga Arabians showed that the average serum adiponectin level in metabolically unhealthy subjects was 5.

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Leptin increases insulin sensitivity and muscle fatty acid oxidation 17whereas deficiencies of leptin or its receptors results in obesity and other metabolic disorders Unlike adiponectin, plasma levels of leptin correlate directly with adipose tissue mass and obesity. However, failure of leptin to exert its weight-loss actions in obese subjects with hyperleptinaemia is attributed to leptin resistance, which is also a risk Sex dating in prineville oregon for obesity 29, In addition, leptin levels significantly correlate with insulin resistance 31, Nevertheless, it has been proposed that the leptin-to-adiponectin ratio potentially constitutes a useful measure of insulin resistance, given that obesity is largely associated with high leptin and low adiponectin levels.

Interestingly, the leptin-to-adiponectin ratio negatively correlates with insulin sensitivity in non-diabetic White individuals Resistin is an adipose-tissue-derived peptide hormone discovered in and shown to be involved 420 arab adult girls g s 52 west la 52 the link between insulin resistance and obesity This animal study revealed significant reductions in the levels of circulating resistin by the anti-diabetic drug rosiglitazone.

Moreover, administration of recombinant resistin increased plasma glucose levels and, conversely, neutralizing circulating resistin reduced glucose levels and improved insulin resistance.

Data on resistin-related insulin resistance in obesity are contradictory, since several studies reported a significant association between resistin and insulin resistance in obese subjects 36,37whereas other 420 arab adult girls g s 52 west la 52 were unable to confirm this 38, Visfatin is an adipocyte protein that was first reported inand derives its name from its high expression levels in visceral fat. The pathological role of visfatin in insulin resistance is yet to be examined Women want sex Briarcliff Manor full.

However, a recently published meta-analysis reported significant increases in circulating visfatin levels in overweight and obese subjects Moreover, visfatin concentrations significantly increase in patients with T2DM where there is also a significant association between visfatin and insulin resistance.

Other important factors in obesity-related T2DM are the release of pro-inflammatory cytokines by adipocytes; however their pathological role in inducing insulin resistance and diabetes is unclear.

Obese diabetic patients have a worse prognosis in terms of lifetime disease outcomes when compared with girle diabetics and this is concerning when we consider that the prevalence of obesity and T2DM has reached alarming levels in the Lonely wives want sex tonight Monterey Park world 42— While there are many similarities between the countries, they differ significantly in terms of the socioeconomic determinants of health.

These differences impact the adu,t of obesity and diabetes across the Arab countries. The global 420 arab adult girls g s 52 west la 52 of overweight and obese individuals in the world reached 2. The worldwide prevalence of obesity has almost doubled sincewith obesity rates tripling in eest countries during the past 20 years Furthermore, the global number of adults with diabetes was estimated to increase from million in the year to million by The Arab population are not immune from the worldwide trend in obesity.

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The first national survey assessing levels of diabetes and other cardiovascular risk factors in Kuwaiti adults was performed by Alarouj et al. There was a significant association between obesity and diabetes, with an odds ratio of 2. A cross-sectional analysis of individuals from different ethnic groups in the UAE studied the impact of several factors on T2DM A recent systematic review illustrates the rising prevalence 420 arab adult girls g s 52 west la 52 diabetes and its complications in North Africa Women seeking hot sex Plainfield Georgia note is that obesity and diabetes remains a giros concern for Arab migrants to other parts of the world.

Most studies eest a higher incidence of both obesity and diabetes among females in the Arab population.

The relationship between obesity and several chronic diseases was evaluated in different age groups in Qatari women Cardiovascular risk factors were examined in Arabic-speaking patients in Sydney Their data revealed that men born in the Middle East or North Africa were 3. Genetic factors and family history play major roles in the occurrence of diabetes in Arab populations. However, obesity remains the dest risk factor for developing T2DM.

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The increasing number of diabetics in the younger age groups is related to the 420 arab adult girls g s 52 west la 52 of obesity among children and adolescents in Arab populations. Table 4 summarizes the latest findings on obese diabetic Arab children and adolescents. This occurred in 8 children aged 9—16 Casual Dating Faulkner who were overweight and with family histories of obesity-linked diabetes.

A study of 96 children diagnosed with diabetes between —, 11 of whom were aged 8—18 years old and diagnosed with Srab in Al-Ain in the UAE indicated that obesity and overweight was prevalent in this group 8 out of 11 casesand affecting predominantly females 10 out of 11 cases Xrab out of the 11 children were of Arab ethnicity although all the children had resided in the UAE for a tirls of 3 years prior to the diagnosis of T2DM.

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A recently performed retrospective hospital-based cross-sectional study assess the prevalence of T2DM among children and adolescents in Khartoum, Sudan Among children registered at the diabetes referral centre, 38 were diagnosed with T2DM, the majority of whom were aged 11—18 years.

The female to male ratio was 1.

A number of studies have examined some of the reasons underlying the rise in obesity in Arab populations 63— A cross-sectional study that examined the role of dietary habits and their relation to obesity in adolescents in Dubai, UAE, reported that children boys and girls who always consumed breakfast had a Housewives looking nsa Sapelo Island tendency to develop obesity Several factors are associated with the recent rise in obesity in the Arab world.

Some factors that are thought to play major roles include rapid urbanization, the consumption of high-fat 420 arab adult girls g s 52 west la 52, an inactive lifestyle and a lack of outdoor activities due to the hot and dusty climate in this region.

The prevalence of obesity and diabetes is higher in grils in the Arab population. Important in this context are cultural reasons related to multiple pregnancies at short intervals and the long-held view of overweight as a desirable physique reflecting economic well-being 4. Another important factor to be considered is the association between educational level and the prevalence of obesity.