Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation, Journal Year: 2021, Volume and Issue: 143(21)

Published: April 22, 2021

The global obesity epidemic is well established, with increases in prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. also leads development of disease mortality independently other factors. More recent data highlight abdominal obesity, as determined by waist circumference, a marker that independent body mass index. There have been significant advances imaging modalities characterizing composition, visceral adiposity. Studies quantify fat depots, ectopic fat, support excess adiposity an indicator poor outcomes. Lifestyle modification subsequent weight loss improve both metabolic syndrome associated systemic inflammation endothelial dysfunction. However, clinical trials medical not demonstrated reduction coronary artery rates. In contrast, prospective studies comparing patients undergoing bariatric surgery nonsurgical shown reduced surgery. this statement, we summarize impact on diagnosis, management, outcomes atherosclerotic disease, heart failure, arrhythmias, especially sudden cardiac death atrial fibrillation. particular, examine influence noninvasive invasive diagnostic procedures disease. Moreover, review function related failure preserved ejection fraction. Finally, describe effects lifestyle surgical interventions

Language: Английский

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Obesity Phenotypes, Diabetes, and Cardiovascular Diseases

Circulation Research, Journal Year: 2020, Volume and Issue: 126(11), P. 1477 - 1500

Published: May 21, 2020

This review addresses the interplay between obesity, type 2 diabetes mellitus, and cardiovascular diseases. It is proposed that generally defined by an excess of body fat causing prejudice to health, can no longer be evaluated solely mass index (expressed in kg/m ) because it represents a heterogeneous entity. For instance, several cardiometabolic imaging studies have shown some individuals who normal weight or are overweight at high risk if they visceral adipose tissue—a condition often accompanied accumulation normally lean tissues (ectopic deposition liver, heart, skeletal muscle, etc). On other hand, obese nevertheless much lower than expected when faced with energy intake ability expand their subcutaneous tissue mass, particularly gluteal-femoral area. Hence, excessive amounts ectopic largely define disease moderate obesity. There also rapidly expanding subgroup patients characterized (severe obesity). Severe obesity specific additional health issues should receive attention. Because difficulties normalizing content severe more aggressive treatments been studied this such as surgery, referred metabolic surgery. basis above, we propose refer obesities rather

Language: Английский

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Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease

Frontiers in Cardiovascular Medicine, Journal Year: 2020, Volume and Issue: 7

Published: Feb. 25, 2020

Adipose tissue plays essential roles in maintaining lipid and glucose homeostasis. To date several types of adipose have been identified, namely white, brown, beige, that reside various specific anatomical locations throughout the body. The cellular composition, secretome, location these depots define their function health metabolic disease. In obesity, becomes dysfunctional, promoting a pro-inflammatory, hyperlipidemic insulin resistant environment contributes to type 2 diabetes mellitus (T2DM). Concurrently, similar features result from dysfunction also promote cardiovascular disease (CVD) by mechanisms can be augmented T2DM. which dysfunctional simultaneously T2DM CVD, focusing on depot-specific adipokines, inflammatory profiles, metabolism, will focus this review. impact CVD treatment strategies body weight discussed.

Language: Английский

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Metabolically Healthy Obesity

Endocrine Reviews, Journal Year: 2020, Volume and Issue: 41(3)

Published: March 4, 2020

Abstract Obesity contributes to reduced life expectancy, impaired quality of life, and disabilities, mainly in those individuals who develop cardiovascular diseases, type 2 diabetes, osteoarthritis, cancer. However, there is a large variation the individual risk developing obesity-associated comorbid diseases that cannot simply be explained by extent adiposity. Observations proportion with obesity have significantly lower for cardiometabolic abnormalities led concept metabolically healthy (MHO). Although no clear definition, normal glucose lipid metabolism parameters—in addition absence hypertension—usually serve as criteria diagnose MHO. Biological mechanisms underlying MHO amounts ectopic fat (visceral liver), higher leg deposition, expandability subcutaneous adipose tissue, preserved insulin sensitivity, beta-cell function well better cardiorespiratory fitness compared unhealthy obesity. Whereas metabolic may reduce diabetes obesity, it still comparison lean individuals. In addition, seems transient phenotype further justifying therapeutic weight loss attempts—even this subgroup—which might not benefit from reducing body same patients Metabolically represents model study linking complications. should considered safe condition, which does require treatment, but guide decision-making personalized risk-stratified treatment.

Language: Английский

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2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea

Journal of Obesity & Metabolic Syndrome, Journal Year: 2019, Volume and Issue: 28(1), P. 40 - 45

Published: March 30, 2019

Obesity increases the risks of diabetes, hypertension, and cardiovascular diseases, ultimately contributing to mortality. Korean Society for Study (KSSO) was established improve management obesity through research education; that end, Committee Clinical Practice Guidelines KSSO reviews systemic evidence using expert panels develop clinical guidelines. The practice guidelines were revised in 2018 National Health Insurance Service checkup data from 2006 2015. Following these guidelines, we added a category, class III obesity, which includes individuals with body mass index (BMI) ≥35 kg/m2. Agreeing International Federation Surgery Metabolic Disorders, Asian Pacific Chapter consensus, determined bariatric surgery is indicated patients BMI kg/m2 ≥30 who have comorbidities. new focus on guiding clinicians manage more effectively. Our recommendations treatment algorithms can serve as guide evaluation, prevention, overweight obesity.

Language: Английский

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Contemporary medical, device, and surgical therapies for obesity in adults

The Lancet, Journal Year: 2023, Volume and Issue: 401(10382), P. 1116 - 1130

Published: Feb. 9, 2023

Language: Английский

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Obesity as a Disease: The Obesity Society 2018 Position Statement

Obesity, Journal Year: 2018, Volume and Issue: 27(1), P. 7 - 9

Published: Dec. 20, 2018

The emerging obesity epidemic and accompanying health consequences led Obesity Society (TOS) in 2008 to publish a position paper defining as disease. Since then, new information has emerged on the underlying mechanisms leading excess adiposity associated structural, cardiometabolic, functional disturbances. This report presents updated TOS 2018 statement noncommunicable chronic

Language: Английский

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The Carbohydrate-Insulin Model of Obesity

JAMA Internal Medicine, Journal Year: 2018, Volume and Issue: 178(8), P. 1098 - 1098

Published: July 2, 2018

Despite intensive research, the causes of obesity epidemic remain incompletely understood and conventional calorie-restricted diets continue to lack long-term efficacy. According carbohydrate-insulin model (CIM) obesity, recent increases in consumption processed, high-glycemic-load carbohydrates produce hormonal changes that promote calorie deposition adipose tissue, exacerbate hunger, lower energy expenditure. Basic genetic research provides mechanistic evidence support CIM. In animals, dietary composition has been clearly demonstrated affect metabolism body composition, independently intake, consistent with CIM predictions. Meta-analyses behavioral trials report greater weight loss reduced-glycemic load vs low-fat diets, though these studies characteristically suffer from poor compliance. Feeding have lacked rigor duration test CIM, but longest such tend show metabolic advantages for low-glycemic diets. Beyond type amount carbohydrate consumed, a conceptual framework understanding how many nondietary exposures might alter hormones, metabolism, adipocyte biology ways could predispose obesity. Pending definitive studies, principles diet offer practical alternative focus on fat restriction.

Language: Английский

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Why primary obesity is a disease?

Journal of Translational Medicine, Journal Year: 2019, Volume and Issue: 17(1)

Published: May 22, 2019

Obesity must be considered a real pathology. In the world wide, obesity represent one of major public health issue associated with increased morbidity and mortality. Overweight or obesity, in fact, significantly increases risk contracting diseases, such as: arterial hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease, cerebral vasculopathy, gallbladder lithiasis, arthropathy, ovarian polycytosis, sleep apnea syndrome, some neoplasms. Despite numerous informative campaigns, unfortunately, fight against does not seem to work: last years, prevalence continued increase. The progressive rapid increase incidence which has characterized most economically advanced countries decade, been main stimulus for research mechanisms underlying this pathology related disorders. aims review is provide revision literature order define as secondly highlight limits inaccuracy common tools used diagnosis third thing strengthen concept complexity disease among political care providers. may viewed multifactorial chronic low-grade inflammatory disease. people affected by have greater developing comorbility morbility, respect healthy. Hence, absolute therapeutic benefit directly proportional basic risk. So, internationally interest on early growing avoid under- overdiagnosis consequences. Therefore, consequences are an aggravation like diabetes, cardiovascular cancer. widely parameter diagnosis, body mass index (BMI) suitable assessing fat. several studies demonstrate that BMI alone cannot consists so much weight gain excess fat mass. use assessment percentage combined clinical genetic analysis allowed identify different phenotypes explain various paradoxes obesity. It essential adopt all possible strategies able combat ameliorate suffering patients, reduce social treatment costs

Language: Английский

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Metabolism and Metabolic Disorders and the Microbiome: The Intestinal Microbiota Associated With Obesity, Lipid Metabolism, and Metabolic Health—Pathophysiology and Therapeutic Strategies

Gastroenterology, Journal Year: 2020, Volume and Issue: 160(2), P. 573 - 599

Published: Nov. 27, 2020

Language: Английский

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