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      Relationship Between Otorhinolaryngologic Diseases and Obesity

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          Abstract

          Objectives

          Obesity rates have been increasing for all population groups worldwide, leading to the increased development of various diseases. This study was designed is to identify the relationships between obesity and several important otorhinolaryngologic diseases, including chronic otitis media (COM), chronic rhinosinusitis, and chronic tonsillitis.

          Methods

          Mean body mass index (BMI) was compared in patients with COM, rhinosinusitis, and tonsillitis and in a control group. The relationships among the prevalence rates of overweight and obesity, morbidity period, and BMI were assessed in each group.

          Results

          Mean BMIs in the COM, rhinosinusitis, and tonsillitis groups were 24.45±2.72 kg/m 2, 24.68±3.25 kg/m 2, and 24.67±3.82 kg/m 2, respectively, with each significantly higher than in the control group (23.22±3.01 kg/m 2, P<0.05). The rates of obesity in the COM, rhinosinusitis, and tonsillitis groups were 37.5%, 42.9%, and 40.1%, respectively, each significantly higher than in the control group (24.3%, P<0.05). However, the rates of overweight did not differ significantly in the COM, rhinosinusitis, and tonsillitis compared with the control group ( P>0.05 each).

          Conclusion

          Mean BMI and the prevalence of obesity were elevated in the three groups of patients with representative otorhinolaryngologic inflammatory diseases, including COM, chronic rhinosinusitis, and chronic tonsillitis.

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          Most cited references 21

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          The occurrence of sleep-disordered breathing among middle-aged adults.

          Limited data have suggested that sleep-disordered breathing, a condition of repeated episodes of apnea and hypopnea during sleep, is prevalent among adults. Data from the Wisconsin Sleep Cohort Study, a longitudinal study of the natural history of cardiopulmonary disorders of sleep, were used to estimate the prevalence of undiagnosed sleep-disordered breathing among adults and address its importance to the public health. A random sample of 602 employed men and women 30 to 60 years old were studied by overnight polysomnography to determine the frequency of episodes of apnea and hypopnea per hour of sleep (the apnea-hypopnea score). We measured the age- and sex-specific prevalence of sleep-disordered breathing in this group using three cutoff points for the apnea-hypopnea score (> or = 5, > or = 10, and > or = 15); we used logistic regression to investigate risk factors. The estimated prevalence of sleep-disordered breathing, defined as an apnea-hypopnea score of 5 or higher, was 9 percent for women and 24 percent for men. We estimated that 2 percent of women and 4 percent of men in the middle-aged work force meet the minimal diagnostic criteria for the sleep apnea syndrome (an apnea-hypopnea score of 5 or higher and daytime hypersomnolence). Male sex and obesity were strongly associated with the presence of sleep-disordered breathing. Habitual snorers, both men and women, tended to have a higher prevalence of apnea-hypopnea scores of 15 or higher. The prevalence of undiagnosed sleep-disordered breathing is high among men and is much higher than previously suspected among women. Undiagnosed sleep-disordered breathing is associated with daytime hypersomnolence.
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            Adipose tissue, adipokines, and inflammation.

            White adipose tissue is no longer considered an inert tissue mainly devoted to energy storage but is emerging as an active participant in regulating physiologic and pathologic processes, including immunity and inflammation. Macrophages are components of adipose tissue and actively participate in its activities. Furthermore, cross-talk between lymphocytes and adipocytes can lead to immune regulation. Adipose tissue produces and releases a variety of proinflammatory and anti-inflammatory factors, including the adipokines leptin, adiponectin, resistin, and visfatin, as well as cytokines and chemokines, such as TNF-alpha, IL-6, monocyte chemoattractant protein 1, and others. Proinflammatory molecules produced by adipose tissue have been implicated as active participants in the development of insulin resistance and the increased risk of cardiovascular disease associated with obesity. In contrast, reduced leptin levels might predispose to increased susceptibility to infection caused by reduced T-cell responses in malnourished individuals. Altered adipokine levels have been observed in a variety of inflammatory conditions, although their pathogenic role has not been completely clarified.
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              Cause-specific excess deaths associated with underweight, overweight, and obesity.

              The association of body mass index (BMI) with cause-specific mortality has not been reported for the US population. To estimate cause-specific excess deaths associated with underweight (BMI or =30). Cause-specific relative risks of mortality from the National Health and Nutrition Examination Survey (NHANES) I, 1971-1975; II, 1976-1980; and III, 1988-1994, with mortality follow-up through 2000 (571,042 person-years of follow-up) were combined with data on BMI and other covariates from NHANES 1999-2002 with underlying cause of death information for 2.3 million adults 25 years and older from 2004 vital statistics data for the United States. Cause-specific excess deaths in 2004 by BMI levels for categories of cardiovascular disease (CVD), cancer, and all other causes (noncancer, non-CVD causes). Based on total follow-up, underweight was associated with significantly increased mortality from noncancer, non-CVD causes (23,455 excess deaths; 95% confidence interval [CI], 11,848 to 35,061) but not associated with cancer or CVD mortality. Overweight was associated with significantly decreased mortality from noncancer, non-CVD causes (-69 299 excess deaths; 95% CI, -100 702 to -37 897) but not associated with cancer or CVD mortality. Obesity was associated with significantly increased CVD mortality (112,159 excess deaths; 95% CI, 87,842 to 136,476) but not associated with cancer mortality or with noncancer, non-CVD mortality. In further analyses, overweight and obesity combined were associated with increased mortality from diabetes and kidney disease (61 248 excess deaths; 95% CI, 49 685 to 72,811) and decreased mortality from other noncancer, non-CVD causes (-105,572 excess deaths; 95% CI, -161 816 to -49,328). Obesity was associated with increased mortality from cancers considered obesity-related (13,839 excess deaths; 95% CI, 1920 to 25,758) but not associated with mortality from other cancers. Comparisons across surveys suggested a decrease in the association of obesity with CVD mortality over time. The BMI-mortality association varies by cause of death. These results help to clarify the associations of BMI with all-cause mortality.
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                Author and article information

                Affiliations
                [1 ]Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea.
                [2 ]Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
                Author notes
                Corresponding author: Seung Geun Yeo. Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Korea. Tel: +82-2-958-8474, Fax: +82-2-958-8470, yeo2park@ 123456gmail.com
                Journal
                Clin Exp Otorhinolaryngol
                Clin Exp Otorhinolaryngol
                CEO
                Clinical and Experimental Otorhinolaryngology
                Korean Society of Otorhinolaryngology-Head and Neck Surgery
                1976-8710
                2005-0720
                September 2015
                13 August 2015
                : 8
                : 3
                : 194-197
                4553346 10.3342/ceo.2015.8.3.194
                Copyright © 2015 by Korean Society of Otorhinolaryngology-Head and Neck Surgery.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Funding
                Funded by: National Research Foundation of Korea
                Award ID: No. 2011-0030072
                Categories
                Original Article

                Otolaryngology

                tonsillitis, sinusitis, rhinitis, otitis media, obesity

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