Nihon rinsho. Japanese journal of clinical medicine
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The field of obesity surgery (bariatric surgery) expands as a consequence of the rapid increase of overweight and obesity not only in the western countries but also in Asia. Japan is still far behind the western progression but the problem of obesity is rising in our country so that necessity for bariatric surgery will also rise in Japan. A few statements of indication of bariatric surgery for Asian are published recently. According to the statements from IFSO-APC (International Federation of Surgery for Obesity and Metabolic Disorders, Asian Pacific Chapter) consensus 2011, bariatric surgery for Asian should be considered for the patient with BMI over 35 without co-morbidity and for the patient with BMI over 30 with co-morbidities.
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Obesity is a heterogeneous pathologic condition that is driven by interactions between multiple genetic and environmental factors. The discovery of leptin has provided the useful clue to the molecular dissection of central pathways involved in the regulation of food intake and body weight. ⋯ The patients who have a mutation of such genes developed early onset of obesity and distinct metabolic abnormalities. Also, several gene mutations have been identified in some syndromes presenting hereditary symptomatic obesity.
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Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction resulting in apneas, hypopneas, oxygen desaturation, and arousal from sleep. Obesity is one of the most significant risk factors for OSA. ⋯ And obesity hypoventilation syndrome (OHS) is defined as chronic daytime hypercapnia in combination with obesity and OSA. OHS patients are more likely to suffer from congestive heart failure, pulmonary hypertension and have worse prognosis than obese eucapnic OSA patients.