Day 1 :
Case Western Reserve University, USA
Keynote: Metabolic syndrome, obesity, nafld and insulin resistance: how inflammation and dysmetabolism consort to epidemic levels worldwide
Time : 09:00- 09:40
Andrea Romani obtained his medical degree from the University of Siena, Italy and his PhD from the University of Turin, Italy. Upon completing his postdoctoralrnstudies under Dr. Scarpa, he joined the faculty in the Department of Physiology and Biophysics, Case Western Reserve University, where he is currently Associate Professor. Dr. Romani has published over 90 peer review articles in high profile journals together with numerous invited reviews and book chapters. He is currentlyrnserving as an Editorial Board Member and an ad hoc reviewer for numerous international journals.
The last thirty years have registered a progressive and dramatic increase in the incidence of type 2 diabetes mellitus (T2DM)rnand obesity in the population of USA and developed countries, as well as developing countries. Combined, these twornmedical conditions affect about one-third of the adult population, as well as adolescent and children, with some differences,rnat times significant, in terms of age, race, ethnicity, and gender. Currently, it is estimated that between 500 million to 1 billionrnpeople worldwide are obese, diabetic, or at risk of developing one or both these conditions. The interplay between obesityrnand T2DM onset are not completely understood, making difficult to establish short- and long-term health guidelines andrntherapeutic approaches that can help containing and possibly reversing the incidence and progression of these conditions.More worrisome, the incidence of the metabolic syndrome has also increased in proportion over the same period of time. Thernterm ‘metabolic syndrome’ refers to a group of risk factors that raises significantly the risk for heart disease and other healthrnproblems including stroke, diabetes, and particular forms of cancer. Currently, liver steatosis, with or without inflammationrn(steatohepatitis) and progression to NAFLD is considered pathognomonic of metabolic syndrome, and represents the mostcommon manifestation of the disease. The etiology of these diseases is multi-facet. From the pathological standpoint, metabolicrnsyndrome, NAFLD, obesity and T2DM are characterized by major lipid dysmetabolism both systemic and within liver and adipose tissue. Inflammation is a key component of these pathologies, in that enhanced levels of inflammatory cytokines havernbeen observed both systemically and within specific organs, in which they impair insulin responsiveness and hematic glucosernhomeostasis.Altogether, metabolic syndrome, NAFLD, obesity and insulin resistance pose major financial burdens on the affected individuals, and on the medical and productive systems of the various countries. The predisposition to various complications and the associated financial costs for their treatment point to the necessity to better understand the underlying causes of these diseases and to identify more effective therapeutic approaches and treatments.
University of Novi Sad, Serbia
Keynote: Nontypical points of obesity
Time : 09:40- 10:20
Edita Stokić endocrinologist, Professor of Internal medicine-Endocrinology, employed in the Clinic of Endocrinology, Diabetes and Metabolic Disorders of thernClinical Centre of Vojvodina in Novi Sad, Medical Facukty, Serbia. In 2005. she was appointed as Chief of Department. She is currently the Vice President of Serbian Association for the Study of Obesity and Chairman of the Continuing Education Board (Society of Physicians of Vojvodina of the Medical Society of Serbia).rnShe was President of the Internal Medicine Section and President of Endocrinology Section within same Society. Edita Stokić is an author or co-author of 412rnscientific articles, and publications on obesity, dyslipidemias and diabetes. She has also published monographs - Obesity is a treatable disease and Obesity and adipose tissue distribution – metabolic consequences.
During past few years the prevalence of obesity has increased dramatically Obesity traditionally has been defined as arndisease characterized by body fat accumulation to an extent that causes health disturbances, such as insulin resistance,type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, stroke, sleep apnea, gallbladder disease and somerntypes of cancer. On the other side, obesity isn’t a homogeneous disease - cardiometabolic disturbances which are associatedrnwith obesity, do not, however, affect all obese people.Several studies suggest that “Metabolically healthy but obese” - MHO people show specific phenotype and body composition differences compared with obese patients “at risk”. MHO individuals exhibit lower total and intraabdominal fat mass, lower ectopic fat accumulation and favorable metabolic, hormonal, immune and inflammatory profile. It is not clear what inducesrnpotential transition from metabolically healthy to unhealthy profile, and whether genetic, environmental, lifestyle and psychosocial factors have role. Metabolically obese but normal weight – MONW individuals present a subgroup of individualsrnwith normal BMI, and with insulin resistance, higher risk of developing type 2 diabetes, cardiovascular disease, atherosclerosis and mortality.The early identification of individuals with the MONW phenotype would be beneficial and may have important therapeutic implications. Clinical guidelines should be target more to MHO population, especially to standardization of definition criteria.Future studies should elucidate mechanisms of preserved favorable metabolic profile, and specific dynamics of metabolic and neuroendocrine processes in MHO individuals, which may be helpful in tailoring potential interventions.
University of South Africa, South Africa
Time : 10:20- 11:00
David Mphuthi Current PhD candidate with North West University (SA) and has completed M.Cur, B.Cur (Adm et Ed), Dip. Nephrology, RN. David is a PhD scholarrnin Indigenous Knowledge Systems (IKS) also a lecturer in the Department of Health Studies, University of South Africa. David has published an article in the Journalof Renal Nursing in 2013.
Obesity is the health problem in developing countries as it is in developed countries. The developing countries are mostly affected by this condition as they have few or no resources to cater for obesity predisposed conditions. According to World Health Organisation update (2015) overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. In addition in 2014, more than 1.9 billion adults, were overweight and over 600 million were obese.Africa has not always been associated with obesity and the diseases associated with overweight. Yet in recent years therernhas been a sharp rise in the incidence of obesity and chronic diseases which is a major public health problem in many countriesrn(Asfaw, 2006). The study revealed that obese people suffer from chronic diseases like diabetes, arthritis and also poses high risk for heart diseases. The management of these comorbid conditions due to obesity, results in burden on the governments. It is therefore important to control obesity so as to put stop on the comorbid conditions.Most countries have put measures that are aimed at weight reduction so as to reduce the disease burden related to obesity.Medical aids are also putting on some incentives for healthy living styles as they believe and think that obesity can be controlledrnby lifestyle modification. Management of obesity can include amongst other measures; promoting games and sports at schools,diet and nutrition awareness as well as exercising.Most people are suffering from these conditions and get admitted to provincial hospitals that are funded by governments.Most of the governments cannot support these people in their hospitals due to lack of resources. It is therefore important tornmodify the life styles of the people so as to counteract most of life style diseases and conditions like obesity. In South Africa,rnmost of the public schools do not have play fields, which is also a contributory factor to obesity. Child obesity starts from homernto schools as these children no longer have play grounds at schools and also watches television a lot after school. Therefore,parents, teachers and departments of Health must join hands in trying to control obesity.