Obesity and hyperlipidaemia in adult males in a Semi-urban community in Jordan
Abstract
Objective: To describe the relationship between obesity and hyperlipidaemia.
Methods: Cluster sampling technique-probability of households from Sareeh area. A total of 400 apparently healthy adult males aged 30-50 years were invited to participate in the study, of whom 306 completed the study.
A pilot tested interview questionnaire was designed in the study to collect the dietary history. Height, weight, waist circumference, triglycerides (TRIG) and total cholesterol (CHOL) were measured. Obesity was categorized into three groups as indicated by BMI-C based on WHO (1997) for generalized obesity and for classifications of central obesity using waist circumference categories based on (Lean et al, 1995).
Results: The means of plasma triglycerides and total cholesterol increased significantly with increasing levels of waist circumference and BMI categories (P<0.05).
There was an increase in the prevalence rates (PRs) of hypertriglyceridaemia and hypercholesterolaemia with increasing levels of obesity and its duration. The proportion ratios of hypertriglyceridaemia and hypercholesterolaemia for subjects with high and moderate obesity levels compared with subjects with normal levels were (10.1-11.6) and (6.7 -8.1) times respectively; whereas for subjects with duration of overweight>20 years compared with subjects with duration of obesity <10 years ranged (2.11-2.96) times. Also odds ratios (ORs) of hypertriglyceridaemia and hypercholesterolaemia after controlling for confounded factors were increased with increasing levels of obesity and its duration, the highest (OR) in high obesity levels ranged (11.59-19.18, 95% CI, P<0.001) whereas for duration of obesity >20 years ranged (16.78-20.94, 95% CI, P<0.001). Central obesity had a potential risk on hypertriglyceridaemia and hypercholesterolaemia more than generalized obesity.
Conclusions: amount of body fat, location and duration are the major risk factors on hyper- trigly ceridaemia and hypercholesterolaemia which emphasizes the need for concentrated e-ffort to prevent and treat obesity rather than just any associated co-morbidities.
References
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4.Carey DG, Jenkins AB, Campbell LV, Freund J, Chisholm DJ. Abdominal fat and insulin in normal and overweight men. Diabetes 1996; 45:633-638.
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6. Jaddou H, Batieha A, Ajlouni K. Prevalence and associated factors of hypertension results from a three community based survey- Jordan. Journal of Human Hypertension 1996; 10: 815.
7- Kannel W, D’Agostine R, Cobb J. Effect of weight on cardiovascular disease. American Journal of Clinical Nutrition 1996; 33: 419-422.
8.Anderson AJ, Sobocinsk KA, Freedom DS, Barboriak JJ, Rim AA, Gruchow HW. Body fat distribution, plasma lipids and lipoprotein. Arteriosclerosis1988; 8: 88-94.
9.ISO H, Naito X, Sato S, Kitamura A, Okamura T, Snkai T, Shimamoto T, Lida M, Komach Y .Serum Triglycerides and risk of coronary heart disease among Japanese men and women. Am J. Epidemiol 2001; 153:490-494.
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13. Lindbald U, Langer RD, Wingard DL, Thomas RG, Barret-Connor EL. Metabolic syndrome and ischaemic heart disease in elderly men and women. Am. J. Epidemiol 2001; 153: 481-487.
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15. Reaven GM. Pathophysiology of insulin resistance in human disease. Physiological Reviews 1995;75:473-485.
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29. Pouliot MC, Despres JP, Lemieux S, Moorgani S, Bouchard C, Tremblay A, Nadeau, A, Lupien PJ. Waist circumference and abdominal sagittal diameter, best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. American Journal of Cardiology 1994; 73: 460-468.
30. Shepard RJ . Physical activity and reduction of health risks, How far are the benefits independent of fat loss? J Sport Med phys Fitness1994; 34:91-98.
31. Kissebah AH; Krakower GR. Regional obesity and morbidity. Physiological Reviews 1994; 74: 761-805.
32. Ellison CR, Myers HR, Zhang Y, Djousse L, Knx S, Williams RR, Province AM . Effects of similarities in life style habits on familial aggregation of high density lipoprotein and low density lipoprotein cholesterol. Am J Epidemiol 1990; 150: 910-918.
33. Tremblay A. Physical activity and the metabolic syndrome. British Journal of Nutrition1998; 80:215- 216.
34. Hooper L, Summerbell CD, Higgins JPT, Thompson RL, Capps NE, Smith GD, Riemersma RA, Ebrahim S. Dietary fat intake and prevention of cardiovascular disease,systematic review. BMJ 2001;31:757-762.
35. Allison B, Saunder E. Obesity in North America, An overview, Medical Clinics of North America 2000; 84: 305-328.
36. Pi-Sunyer XF. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults-the evidence report. Obes Res 1998;6:51-210.
37. Despres JP, Lemieux JP,Prudhomme ID. Treatment of obesity need to focus on high risk of abdominally obese patients. BMJ 2001;322:716-726.
38. Hubbard HE. Overweight and obesity, what are the issues? American Journal of Clinical Nutrition 2000; 72:1067-1068.
39. Lahti-Koski T, Pietinen P, Mannisto P, Vartianen E. Trends in waist to hip ratio and its determinants in adult in Finland from 1987 to 1997. American Journal of Clinical Nutrition 2000; 72:1436-1444.
40. Ajlouni K, Jaddou H, Batieha A. Diabetes and impaired glucose tolerance in Jordan: prevalence and associated risk factors. Journal of Internal Medicine 1998; 243: 1-6.
41. Batieha A, Jaddou H, Ajlouni K. Hyperlipidemia in Jordan: A community based survey. Saudi Arabia Medical Journal1998; 18(3): 279-285.
42. Ammari F, Batieha A, Jaddou H, Okashi M, Ajlouni K. A natural history of impaired glucose tolerance in North Jordan. Practical Diabetes Int 1998; 15: 139-140.
43. Annual Statistical Report. Royal Medical services (RMS) 2000- Jordan.
44. Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ 1995; 311:158-161.
45. Lohman TG, Roche AF, Martorel RI. Anthropometric Standardization Reference Manual (1st ed.) Champaign: III: Human Kinetics Books1988 pp 36-200.
46. Denke MA, Sempos CT, Grundy SM. Excess body weight. An under recognized contributor to high blood cholesterol levels in white American men. Arch Intern Med. 1993;153:1093-1103.
47. Joe K. The cholesterol Lie. Men’s Health 2000; 16:104-110.
48. Marilynn L. Metabolic syndrome targeted in new US cholesterol guidelines. Lancet 2001; 357: 1594-1596.
49. Glueck CJ; Taylor HL; Jacobs D; Morrison JA; Beaglehole R; Williams OD. Plasma high-density lipoprotein cholesterol, association with measurements of body mass, the lipid research clinic program prevalence study. Circulation 1980; 62: 62-69.
50. Walton C, Lees B, Crook D, Worthington M, Goldsland FL, Stevenson CJ. Body fat distribution, rather than overall adiposity influence serum lipids and lipoproteins in healthy men independent of age. Am J Med, 1995; 99: 459-464.
51. Fung TT, Rim EB, Spiegelman D, Rifai N, Tafler GH, Willett WC, Hu FB. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr2001; 73: 61-67
52. Kissebah AH, Vydelingum N, Murray R, Evans DJ; Hartz AJ, Kalkhoff RK; Adams PW. Relation of body fat distri¬bution tto metabolic complicationons of obesity. J Clin En¬docrinol Metab1982; 54:254-260.
53. Bray GA. Health hazards of obesity.J Clin. North Am 1996; 25: 907-919.
54. Hu FB, Wang b, Chen C, Jin Y, Yang J; Stampfer MG, Xu, X. Body mass index and cardiovascular risk factors in a rural Chinese population. Am J. Epidemiol 2000; 151:88-97.
55. Denke MA, Sempos CT, Grundy SM. Excess body weight, An underrecognized contributor to high blood cholesterol levels in white American women. Arch Intern Med 1994; 154: 401-410.
56. Grundy SM, Barnett JP. Metabolic and health complications of obesity. Disease¬ a-Month 1990; 36:645.
57. Arroyo P, Pardio J , Fenandez V, Ancona V, Canul G ,Loria A. Obesity and cultural Environment in the Yucatan Region. Nutrition Reviews1999;57(5): 78-83.
58. Mansfield E, Mcpherson R, Koski KG. Diet and waist to hip ratio, important predictors of lipoprotein levels in sedentary and active young men with no evidence of cardiovascular disease. N Engl J Med 1999; 99:1373-1380.
59. FungTT, Hu FB, Yu J, Chu N, Spiegelman D, Tofler GH, Willet WC, Rimm EB).Leisure- time physical activbity, television watching, and plasma biomarkers of obesity ad cardiovascular disease risk.American Journal of Epidemiology 2000;152(12): 1171-1178.
60 Maffeis C. Childhood obesity. Balliere’s Clinical Endocrinology and Metabolism 1999; 13: 31-46.
61 Must A, Jacques PF, Dallai GE, Bajema CJ, Dietz WH. Long term morbidity and mortality of overweight adolescents, a follow-up of the Harvard Growth Study of 1922- 1935. N Engl J Med 1992; 327: 1350-1355.
62 Srinivasan R, Ehnholm C, Wattigney WA, Berenson GS). Relationship between obesity and serum lipoproteins in children with different apolipoprotein E phenotypes, The Bogalusa Heart Study. Metabolism1994; 43; 470-475.
63.Goran M. Metabolic response to experimental over feeding in young adult men .Metabolism, clinical and experimental 1995; 332:621-628.
64. Dietz WH. Periods of risk in childhood for the development of adult obesity- what we need to learn? J. Nutr 1998; 127:1884-1886.
65. Bottini N, MacMurray J, Peters W, Rostamkhani M, Comings DE. Assotiation of the acid phosphatase (ACP1) gene with triglyeride levels in obese women.Mol Genet Metab 2002; 77(3): 226-229.
66. Mitwali AH, Al-Maatouq MA, Al-Wakeel J. Hypercholesterolemia in
healthy adult males a puplic health survey in central Saudi Arabia. Annal Saudi Med 1994;15:499-502.
67. Khoja SM, Salem AM, Taha AM. Plasma lipid levels of a selected Saudia Arabian population in the Western region. Saudi Med J 1993;14:315 -321.
68.Must A, Spadano J, Coakley H, Field AE, Coditz,G, Dietz H.The disease burden associated with overweight and obesity. JAMA Middle East 2000;10:63-70.
69. Steinberger J, Moorehead C, Katch V, Rocchini AP. Relationship between insulin resistance and abdominal profile in obese adolescences. J Pediatr 1995; 126: 290-295.
70.McMurray RG, Harrell JS, Levine AA, Gransky SA. Childhood obesity elevates blood pressure and total cholesterol independent of physical activity. Int J Obes 1995;19;881-886.
71. Simopoulos AP, Van Itallie TH. Body weight, health, and longevity. Annals of Internal Medicine1984; 100: 285-295.
72.Rabkin SW, Mathewson FA, Hsu PH .Relation of body weight to development of ischaemic heart disease in a cohort of young North American men after a 26 year observation period, the Manitoba Study. Am J Cardiol 1977; 39:452-458.
73. Hubert HB, Feinleib M, McNamara PM, Castelli WP.Obe¬sity as an independent risk factor for cardiovascular dis¬ease. A 26-year follow-up of participants in the Framing¬ham Heart Study. Circulation 1983; 67:968-977.
74. Feinleib M . Epidemiology of obesity in relation to health hazards. Ann Intern Med 1985; 103:1019-1024.
2.World Health Organization. Report of a WHO consultation on obesity. Preventing and managing the Global Epidemic1997, Geneva, WHO.
3.Abbas A, Khoury SA, Mas’ad DF ,Kharabsheh S. Prevalence of overweight and obesity in adult Jordanians aged 25years and over, result of a national survey. Journal of the Arab Board of Medical Specializations 2002; 4(1): 90-97.
4.Carey DG, Jenkins AB, Campbell LV, Freund J, Chisholm DJ. Abdominal fat and insulin in normal and overweight men. Diabetes 1996; 45:633-638.
5.Elmasry A, Janson C, Lindberg E, Gislason T, Tagerldin MA, Boman G. The role of habitual snoring and obesity in the development of diabetes : a 10 year follow up study in male population, Journal of Internal Medicine 2000; 248 :13-20.
6. Jaddou H, Batieha A, Ajlouni K. Prevalence and associated factors of hypertension results from a three community based survey- Jordan. Journal of Human Hypertension 1996; 10: 815.
7- Kannel W, D’Agostine R, Cobb J. Effect of weight on cardiovascular disease. American Journal of Clinical Nutrition 1996; 33: 419-422.
8.Anderson AJ, Sobocinsk KA, Freedom DS, Barboriak JJ, Rim AA, Gruchow HW. Body fat distribution, plasma lipids and lipoprotein. Arteriosclerosis1988; 8: 88-94.
9.ISO H, Naito X, Sato S, Kitamura A, Okamura T, Snkai T, Shimamoto T, Lida M, Komach Y .Serum Triglycerides and risk of coronary heart disease among Japanese men and women. Am J. Epidemiol 2001; 153:490-494.
10. Kastarinen M, Thuomilellto J, Vartianen E, Jousilallti A, Sundvall J, Pisk P. Trends in Lipid levels and hypercholesterolemia in hypertensive and normotensive Finis adults from 1982 –1997. Journal of Internal Medicine2000; 247: 53-62.
11.Carrol S, Cooke CB, Butterly RJ. Plasma viscosity fibrinogen and the metabolic syndrome: effect of obesity and cardiorespiratory fitness. Journal announcements 2000; 11:71-78.
12.Tuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H. Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. Am J Epidemiol 1988; 127: 321-336.
13. Lindbald U, Langer RD, Wingard DL, Thomas RG, Barret-Connor EL. Metabolic syndrome and ischaemic heart disease in elderly men and women. Am. J. Epidemiol 2001; 153: 481-487.
14. Kopelman PG. Obesity as a medical problem. Nature 2000; 404: 633-645.
15. Reaven GM. Pathophysiology of insulin resistance in human disease. Physiological Reviews 1995;75:473-485.
16. Ferrannini E, Haffner SM, Stern M. High blood pressure and insulin resis¬tance: influence of ethnic background. Eur J Clin Invest 1991; 21:280.
17. Stern M. Disease risk: evidence for a role of uric acid in the obesity-insulin resistance syndrome. Am J Epidemiol 1995; 142: 288-294.
18. Acheson RM, Collart AB. New Haven Survey of joint disease: relationship between some systemic characteristics and Osteoarthritis in a general population. Ann Rheum Dis 1975; 34:379-384.
19. Loenen HM, Eshius H, Lowik MR, Schouten RA, Hulshof KF, Odink J, Kok FJ. Serum uric acid correlates in elderly men and women with special reference to body composition and dietary intake (Dutch Nutrition Surveillance system). J Clin Epidemiol 1990; 43:1297- 1303.
20. Joe K. The cholesterol Lie. Men’s Health 2001; 16:104-110.
21. Anderson AJ , Sobocinsk KA, Freedom DS, Barboriak JJ, Rim AA, Gruchow, HW. Body fat distribution, plasma lipids and lipoprotein. Arteriosclerosis 1988; 8: 88-94.
22. Han TS, Van Leer EM; Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors, prevalence study in a random sample. BMJ 1995; 311:1401-1405.
23. Lemieux I, Pascot A, Couillard D, Tremblay G, Prudhome D, Nadeau A, Despres J. Hypertriglyceridemic waist, A marker of the atherogenic metabolic trail (hyperinsulinemia, hyperapolipoprotein B, small, dense LDL) in men. Circulation 2000; 102: 179-184.
24. Bao W, Srinivasan SR, Wattingney WA, Brenson G. Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood. Arch Intern Med 1994; 164: 1842-1847.
25. Flaim E, Ferreri FL, Thye WF, Hill EJ; Ritchey JS. Plasma lipid and lipoprotein cholesterol concentrations in adults males consuming normal and high cholesterol diet under controlled conditions. Am J Clin Nutr 1981; 34: 1103-1108.
26. Tran VZ, Weltman Arthur A. Differential effects of exercise on serum lipid and lipoprotein levels seen with changes in body weight. JAMA 1985; 254:919-924.
27. Haffner MS; Stern PM; Hazuda PH; Rosethal M; Knapp AJ. The role of behavioral variables and fat patterning in explaining ethnic differences in serum lipids and lipoprotein. Am J Epidemiol 1986; 123: 830-839.
28. Nanas S, Pan W, Stamler J, Liu K, Dyer A; Stamler R, Schoenberger AJ, Shekelle, BR. The role of relative weight in the positive association between age and serum cholesterol in men and women. J Chron Dis1986; 46: 887-892.
29. Pouliot MC, Despres JP, Lemieux S, Moorgani S, Bouchard C, Tremblay A, Nadeau, A, Lupien PJ. Waist circumference and abdominal sagittal diameter, best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. American Journal of Cardiology 1994; 73: 460-468.
30. Shepard RJ . Physical activity and reduction of health risks, How far are the benefits independent of fat loss? J Sport Med phys Fitness1994; 34:91-98.
31. Kissebah AH; Krakower GR. Regional obesity and morbidity. Physiological Reviews 1994; 74: 761-805.
32. Ellison CR, Myers HR, Zhang Y, Djousse L, Knx S, Williams RR, Province AM . Effects of similarities in life style habits on familial aggregation of high density lipoprotein and low density lipoprotein cholesterol. Am J Epidemiol 1990; 150: 910-918.
33. Tremblay A. Physical activity and the metabolic syndrome. British Journal of Nutrition1998; 80:215- 216.
34. Hooper L, Summerbell CD, Higgins JPT, Thompson RL, Capps NE, Smith GD, Riemersma RA, Ebrahim S. Dietary fat intake and prevention of cardiovascular disease,systematic review. BMJ 2001;31:757-762.
35. Allison B, Saunder E. Obesity in North America, An overview, Medical Clinics of North America 2000; 84: 305-328.
36. Pi-Sunyer XF. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults-the evidence report. Obes Res 1998;6:51-210.
37. Despres JP, Lemieux JP,Prudhomme ID. Treatment of obesity need to focus on high risk of abdominally obese patients. BMJ 2001;322:716-726.
38. Hubbard HE. Overweight and obesity, what are the issues? American Journal of Clinical Nutrition 2000; 72:1067-1068.
39. Lahti-Koski T, Pietinen P, Mannisto P, Vartianen E. Trends in waist to hip ratio and its determinants in adult in Finland from 1987 to 1997. American Journal of Clinical Nutrition 2000; 72:1436-1444.
40. Ajlouni K, Jaddou H, Batieha A. Diabetes and impaired glucose tolerance in Jordan: prevalence and associated risk factors. Journal of Internal Medicine 1998; 243: 1-6.
41. Batieha A, Jaddou H, Ajlouni K. Hyperlipidemia in Jordan: A community based survey. Saudi Arabia Medical Journal1998; 18(3): 279-285.
42. Ammari F, Batieha A, Jaddou H, Okashi M, Ajlouni K. A natural history of impaired glucose tolerance in North Jordan. Practical Diabetes Int 1998; 15: 139-140.
43. Annual Statistical Report. Royal Medical services (RMS) 2000- Jordan.
44. Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ 1995; 311:158-161.
45. Lohman TG, Roche AF, Martorel RI. Anthropometric Standardization Reference Manual (1st ed.) Champaign: III: Human Kinetics Books1988 pp 36-200.
46. Denke MA, Sempos CT, Grundy SM. Excess body weight. An under recognized contributor to high blood cholesterol levels in white American men. Arch Intern Med. 1993;153:1093-1103.
47. Joe K. The cholesterol Lie. Men’s Health 2000; 16:104-110.
48. Marilynn L. Metabolic syndrome targeted in new US cholesterol guidelines. Lancet 2001; 357: 1594-1596.
49. Glueck CJ; Taylor HL; Jacobs D; Morrison JA; Beaglehole R; Williams OD. Plasma high-density lipoprotein cholesterol, association with measurements of body mass, the lipid research clinic program prevalence study. Circulation 1980; 62: 62-69.
50. Walton C, Lees B, Crook D, Worthington M, Goldsland FL, Stevenson CJ. Body fat distribution, rather than overall adiposity influence serum lipids and lipoproteins in healthy men independent of age. Am J Med, 1995; 99: 459-464.
51. Fung TT, Rim EB, Spiegelman D, Rifai N, Tafler GH, Willett WC, Hu FB. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr2001; 73: 61-67
52. Kissebah AH, Vydelingum N, Murray R, Evans DJ; Hartz AJ, Kalkhoff RK; Adams PW. Relation of body fat distri¬bution tto metabolic complicationons of obesity. J Clin En¬docrinol Metab1982; 54:254-260.
53. Bray GA. Health hazards of obesity.J Clin. North Am 1996; 25: 907-919.
54. Hu FB, Wang b, Chen C, Jin Y, Yang J; Stampfer MG, Xu, X. Body mass index and cardiovascular risk factors in a rural Chinese population. Am J. Epidemiol 2000; 151:88-97.
55. Denke MA, Sempos CT, Grundy SM. Excess body weight, An underrecognized contributor to high blood cholesterol levels in white American women. Arch Intern Med 1994; 154: 401-410.
56. Grundy SM, Barnett JP. Metabolic and health complications of obesity. Disease¬ a-Month 1990; 36:645.
57. Arroyo P, Pardio J , Fenandez V, Ancona V, Canul G ,Loria A. Obesity and cultural Environment in the Yucatan Region. Nutrition Reviews1999;57(5): 78-83.
58. Mansfield E, Mcpherson R, Koski KG. Diet and waist to hip ratio, important predictors of lipoprotein levels in sedentary and active young men with no evidence of cardiovascular disease. N Engl J Med 1999; 99:1373-1380.
59. FungTT, Hu FB, Yu J, Chu N, Spiegelman D, Tofler GH, Willet WC, Rimm EB).Leisure- time physical activbity, television watching, and plasma biomarkers of obesity ad cardiovascular disease risk.American Journal of Epidemiology 2000;152(12): 1171-1178.
60 Maffeis C. Childhood obesity. Balliere’s Clinical Endocrinology and Metabolism 1999; 13: 31-46.
61 Must A, Jacques PF, Dallai GE, Bajema CJ, Dietz WH. Long term morbidity and mortality of overweight adolescents, a follow-up of the Harvard Growth Study of 1922- 1935. N Engl J Med 1992; 327: 1350-1355.
62 Srinivasan R, Ehnholm C, Wattigney WA, Berenson GS). Relationship between obesity and serum lipoproteins in children with different apolipoprotein E phenotypes, The Bogalusa Heart Study. Metabolism1994; 43; 470-475.
63.Goran M. Metabolic response to experimental over feeding in young adult men .Metabolism, clinical and experimental 1995; 332:621-628.
64. Dietz WH. Periods of risk in childhood for the development of adult obesity- what we need to learn? J. Nutr 1998; 127:1884-1886.
65. Bottini N, MacMurray J, Peters W, Rostamkhani M, Comings DE. Assotiation of the acid phosphatase (ACP1) gene with triglyeride levels in obese women.Mol Genet Metab 2002; 77(3): 226-229.
66. Mitwali AH, Al-Maatouq MA, Al-Wakeel J. Hypercholesterolemia in
healthy adult males a puplic health survey in central Saudi Arabia. Annal Saudi Med 1994;15:499-502.
67. Khoja SM, Salem AM, Taha AM. Plasma lipid levels of a selected Saudia Arabian population in the Western region. Saudi Med J 1993;14:315 -321.
68.Must A, Spadano J, Coakley H, Field AE, Coditz,G, Dietz H.The disease burden associated with overweight and obesity. JAMA Middle East 2000;10:63-70.
69. Steinberger J, Moorehead C, Katch V, Rocchini AP. Relationship between insulin resistance and abdominal profile in obese adolescences. J Pediatr 1995; 126: 290-295.
70.McMurray RG, Harrell JS, Levine AA, Gransky SA. Childhood obesity elevates blood pressure and total cholesterol independent of physical activity. Int J Obes 1995;19;881-886.
71. Simopoulos AP, Van Itallie TH. Body weight, health, and longevity. Annals of Internal Medicine1984; 100: 285-295.
72.Rabkin SW, Mathewson FA, Hsu PH .Relation of body weight to development of ischaemic heart disease in a cohort of young North American men after a 26 year observation period, the Manitoba Study. Am J Cardiol 1977; 39:452-458.
73. Hubert HB, Feinleib M, McNamara PM, Castelli WP.Obe¬sity as an independent risk factor for cardiovascular dis¬ease. A 26-year follow-up of participants in the Framing¬ham Heart Study. Circulation 1983; 67:968-977.
74. Feinleib M . Epidemiology of obesity in relation to health hazards. Ann Intern Med 1985; 103:1019-1024.
Published
2003-01-01
How to Cite
AL BOQAI, Omar; ALI, Khalid Eltom; ABUIRMELLEH, Naji.
Obesity and hyperlipidaemia in adult males in a Semi-urban community in Jordan.
Gezira Journal of Health Sciences, [S.l.], v. 1, n. 1, jan. 2003.
ISSN 1810-5386. Available at: <http://37.60.236.48/index.php/gjhs/article/view/149>. Date accessed: 03 june 2026.
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