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Is visceral obesity the cause of obesity paradox?

https://doi.org/10.14341/probl201662633-39

Abstract

Obesity is one of the 10 risk factors of death. Many epidemiological studies have shown that overweight and obesity are associated with 44% cases of diabetes type 2, and 23% of cases of coronary heart disease. The body mass index (BMI) is traditionally a diagnostic marker of obesity and overweight are considered. However, in the last 15 years, there has been work on the «paradox» of obesity. So the obese long-term prognosis and stroke are more favorable than individuals without excess weight and obesity. A deeper analysis of the data showed that the highest risk of developing cardiovascular disease and disorders of carbohydrate metabolism associated with visceral obesity. This is largely due to metabolic disorders occurring on the background of visceral obesity, such as insulin resistance, hyperglycemia, dyslipidemia, an imbalance of adipokines and markers of inflammation. These changes in individuals with visceral obesity can occur regardless of the value of BMI.

About the Authors

Daria A. Borodkina
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; Kemerovo regional clinical hospital, Kemerovo
Russian Federation
MD


Olga V. Gruzdeva
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo;
Russian Federation
MD, PhD


Ludmila V. Kvitkova
Kemerovo State Medical University, Kemerovo
Russian Federation
MD, PhD, Professor


Olga L. Barbarash
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; Kemerovo State Medical University, Kemerovo
Russian Federation
MD, PhD, Professor


References

1. Крысанова В.С., Журавлева М.В., Сереброва С.Ю. Социальная и экономическая значимость избыточной массы тела и ожирения в Российской Федерации. Основные подходы к лечению ожирения // Русский медицинский журнал. — 2015. — Т. 23. — №26. — С. 1534-1537. [Krysanova VS, Zhuravleva MV, Serebrova SY. Sotsial’naya i ekonomicheskaya znachimost’ izbytochnoi massy tela i ozhireniya v Rossiiskoi Federatsii. Osnovnye podkhody k lecheniyu ozhireniya. Russkii meditsinskii zhurnal. 2015;23(26):1534-1537. (In Russ.).]

2. Ogden CL, Carroll MD, Lawman HG, et al. Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988—1994 Through 2013—2014. JAMA. 2016;315(21):2292-2299. doi: 10.1001/jama.2016.6361

3. Gallus S, Lugo A, Murisic B, et al. Overweight and obesity in 16 European countries. Eur J Nutr. 2014;54(5):679-689. doi: 10.1007/s00394-014-0746-4

4. Flegal KM. Prevalence and Trends in Obesity Among US Adults, 1999—2008. JAMA. 2010;303(3):235. doi: 10.1001/jama.2009.2014

5. WHO. The top 10 causes of death. Fact sheet N°310. Updated May 2014. Available from: http://www.who.int/mediacentre/factsheets/fs310/ru

6. Барбараш О.Л., Каретникова В.Н., Кашталап В.В. Пациент после инфаркта миокарда: как снизить риск повторного ишемического события? // Сardioсоматика. — 2015. — №. 2. — С. 12-19. [Barbarash OL, Karetnikova VN, Kashtalap VV. Patient after myocardial infarction: how to reduce the risk of recurrent ischemic events? Cardiosomaticа. 2015;(2):12-19. (In Russ.)].

7. Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. N Engl J Med. 2015;373(14):1307-1317. doi: 10.1056/NEJMoa1502821

8. Wong E, Tanamas SK, Wolfe R, et al. The role of obesity duration on the association between obesity and risk of physical disability. Obesity. 2015;23(2):443-447. doi: 10.1002/oby.20936

9. World Health Organization Media Centre. Obesity and overweight. Fact sheet no 311. Geneva: World Health Organization; 2013

10. Куликов В.А. Фремингемское исследование сердца: 65 лет изучения причин атеросклероза. // Вестник Витебского государственного медицинского университета. — 2012. — Т. 11. — №2. — С. 16-23. [Kulikov VA. Fremingemskoe issledovanie serdtsa: 65 let izucheniya prichin atero-skleroza. Vestnik Vitebskogo gosudarstvennogo meditsinskogo universiteta. 2012;11(2):16-23. (In Russ.)].

11. Бутрова С.А., Дзгоева Ф.Х. Висцеральное ожирение — ключевое звено метаболического синдрома. // Ожирение и метаболизм. — 2004. — № 1. — С. 10-16. [Butrova SA, Dzgoeva FK. Vistseral’noe ozhirenie — klyuchevoe zveno metabolicheskogo sindroma. Obesity and metabolism. 2004;(1);10-13. (In Russ.)]. doi: 10.14341/2071-8713-5173

12. Аметов А.С., Демидова Т.Ю., Целиковская А.Л. Ожирение и сердечно-сосудистые заболевания. // Терапевтический архив. — 2001. — №8. — С. 69-72. [Ametov AS, Demidova TY, Tselikovskaya AL Ozhirenie i serdechnososudistye zabolevaniya. Terapevticheskii arkhiv. 2001;(8):69-72. (In Russ.)].

13. WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization. 1995.

14. Lavie CJ, De Schutter A, Milani RV. Body composition and the obesity paradox in coronary heart disease: can heavier really be healthier? Heart. 2015;101(20):1610-1611. doi: 10.1136/heartjnl-2015-307966

15. Bucholz EM, Beckman AL, Krumholz HA, Krumholz HM. Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined. Am Heart J. 2016;172:173-181. doi: 10.1016/j.ahj.2015.10.024

16. Karrowni W, Kennedy K, Jones P, et al. Obesity Paradox among Survivors of Acute Myocardial Infarction and Its Interaction with Time. J Am Coll Cardiol. 2015;65(10):A31. doi: 10.1016/s0735-1097(15)60031-6

17. Aparicio HJ, Himali J, Beiser A, et al. Body Weight and Survival after Stroke: Exploring the «Obesity Paradox» in the Framingham Study (I12-2A). Neurology. 2015;84(14Suppl 1):I12-2A.

18. Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions?: A systematic review and metaanalysis. Ann Intern Med. 2013;159(11):758-769. doi: 10.7326/0003-4819-159-11-201312030-00008

19. Brisbois TD, Farmer AP, McCargar LJ. Early markers of adult obesity: a review. Obes Rev. 2012;13(4):347-367. doi: 10.1111/j.1467-789X.2011.00965.x

20. Lopes HF, Corrêa-Giannella ML, Consolim-Colombo FM, Egan BM. Visceral adiposity syndrome. Diabetol Metab Syndr. 2016;8(1). doi: 10.1186/s13098-016-0156-2

21. Vague J. La differénciation sexuelle, facteur determinant des formes de l’obésité. Presse Med. 1947;30:339-340.

22. Okosun IS, Seale JP, Lyn R. Commingling effect of gynoid and android fat patterns on cardiometabolic dysregulation in normal weight American adults. Nutrition & Diabetes. 2015;5(5):e155. doi: 10.1038/nutd.2015.5

23. Кузнецова А.В., Тепляков А.Т. Оценка роли инсулинорезистентности у больных сахарным диабетом после эндоваскулярных вмешательств // Международный журнал прикладных и фундаментальных исследований. — 2011. — №9. — С. 97. [Kuznetsova AV, Teplyakov AT. Otsenka roli insulinorezistentnosti u bol’nykh sakhar-nym diabetom posle endovaskulyarnykh vmeshatel’stv. Mezhdunarodnyi zhurnal prikladnykh i fundamental’nykh issledovanii. 2011;(9):97. (In Russ.)].

24. Усов В.Ю. От традиционной рентгенологии к лучевой диагностике. // Медицинская визуализация. — 2008. — №1. — С. 138. [Usov VYu. Conventional X-ray to Diagnostic Radiology. Medical Visualization. 2008;1:138. (In Russ.)].

25. Завадовский К.В., Лишманов Ю.Б. Отчет о проведении научно-практического семинара «современные методы лучевой диагностики ишемической болезни сердца». // Сибирский медицинский журнал. — 2015. — Т. 30. — №4. — С. 75-76. [Zavadovsky KV, Lishmanov YB. Summary report: scientific-practical seminar modern methods of radiation diagnosis of coronary heart disease. Sibirskii meditsinskii zhurnal. 2015;30(4):75-75. (In Russ.)].

26. Окороков П.Л., Васюкова О.В., Воронцов А.В. Методы оценки количества и распределения жировой ткани в организме и их клиническое значение. // Проблемы эндокринологии. — 2014. — Т. 60. — №. 3. — С. 53-58. [Okorokov PL, Vasyukova OV, Vorontsov AV. The methods for the characteristic of adipose tissue in the organism and their clinical significance. Problems of Endocrinology. 2014;60(3):53-58. (In Russ.)]. doi: 10.14341/probl201460353-58

27. Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism. 1987;36(1):54-59. doi: 10.1016/0026-0495(87)90063-1

28. Sjostrom L, Kvist H, Cederblad A, Tylen U. Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium. Am J Physiol. 1986;250(6 Pt 1):E736-E745.

29. Veilleux A, Cote JA, Blouin K, et al. Glucocorticoid-induced androgen inactivation by aldo-keto reductase 1C2 promotes adipogenesis in human preadipocytes. AJP: Endocrinology and Metabolism. 2012;302(8):E941-E949. doi: 10.1152/ajpendo.00069.2011

30. Bjorntorp P. Metabolic Implications of Body Fat Distribution. Diabetes Care. 1991;14(12):1132-1143. doi: 10.2337/diacare.14.12.1132

31. Petrus P, Rosqvist F, Edholm D, et al. Saturated fatty acids in human visceral adipose tissue are associated with increased 11-β-hydroxysteroid-dehydrogenase type 1 expression. Lipids Health Dis. 2015;14(1). doi: 10.1186/s12944-015-0042-1

32. Tchernof A, Despres JP. Pathophysiology of Human Visceral Obesity: An Update. Physiol Rev. 2013;93(1):359-404. doi: 10.1152/physrev.00033.2011

33. Masuzaki H, Flier JS. Tissue-specific glucocorticoid reactivating enzyme, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1)—a promising drug target for the treatment of metabolic syndrome.Curr Drug Targets Immune Endocr Metabol Disord.2003;3(4):255-262. doi: 10.2174/1568008033340135

34. Britton KA, Fox CS. Ectopic Fat Depots and Cardiovascular Disease. Circulation. 2011;124(24):e837-e841. doi: 10.1161/circulationaha.111.077602

35. Mahabadi AA, Massaro JM, Rosito GA, et al. Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. Eur Heart J. 2008;30(7):850-856. doi: 10.1093/eurheartj/ehn573

36. Lima MMO, Pareja JC, Alegre SM, et al. Visceral fat resection in humans: Effect on insulin sensitivity, beta-cell function, adipokines, and inflammatory markers. Obesity. 2013;21(3):E182-E189. doi: 10.1002/oby.20030

37. Bergman RN, Kim SP, Catalano KJ, et al. Why Visceral Fat is Bad: Mechanisms of the Metabolic Syndrome. Obesity. 2006;14(2S):16S-19S. doi: 10.1038/oby.2006.277

38. Jensen MD. Is Visceral Fat Involved in the Pathogenesis of the Metabolic Syndrome? Human Model. Obesity. 2006;14(2S):20S-24S. doi: 10.1038/oby.2006.278

39. Hall JE, da Silva AA, do Carmo JM, et al. Obesity-induced Hypertension: Role of Sympathetic Nervous System, Leptin, and Melanocortins. J Biol Chem. 2010;285(23):17271-17276. doi: 10.1074/jbc.R110.113175

40. Odegaard JI, Chawla A. Pleiotropic Actions of Insulin Resistance and Inflammation in Metabolic Homeostasis. Science. 2013;339(6116):172-177. doi: 10.1126/science.1230721

41. Hardy OT, Czech MP, Corvera S. What causes the insulin resistance underlying obesity? Current Opinion in Endocrinology & Diabetes and Obesity. 2012;19(2):81-87. doi: 10.1097/MED.0b013e3283514e13

42. Kim JI, Huh JY, Sohn JH, et al. Lipid-Overloaded Enlarged Adipocytes Provoke Insulin Resistance Independent of Inflammation. Mol Cell Biol. 2015;35(10):1686-1699. doi: 10.1128/mcb.01321-14

43. Kovalik JP, Slentz D, Stevens RD, et al. Metabolic Remodeling of Human Skeletal Myocytes by Cocultured Adipocytes Depends on the Lipolytic State of the System. Diabetes. 2011;60(7):1882-1893. doi: 10.2337/db10-0427

44. Bornfeldt Karin E, Tabas I. Insulin Resistance, Hyperglycemia, and Atherosclerosis. Cell Metabolism. 2011;14(5):575-585. doi: 10.1016/j.cmet.2011.07.015

45. Matsuda M, Shimomura I. Increased oxidative stress in obesity: Implications for metabolic syndrome, diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Obes Res Clin Pract. 2013;7(5):e330-e341. doi: 10.1016/j.orcp.2013.05.004

46. Литвинова Л.С., Василенко М.А., Затолокин П.А., и др. Роль адипокинов в регуляции метаболических процессов при коррекции ожирения. // Сахарный диабет. — 2014. — Т. 17. — № 3. — С. 51-59. [Litvinova LS, Vasilenko MA, Zatolokin PA, et al. Adipokines in metabolic processes regulating during obesity treatment. Diabetes mellitus. 2014;17(3):51-59. (In Russ.)]. doi: 10.14341/DM2014351-5947.

47. Könner AC, Brüning JC. Selective Insulin and Leptin Resistance in Metabolic Disorders. Cell Metabolism. 2012;16(2):144-152. doi: 10.1016/j.cmet.2012.07.004

48. Отт А.В., Чумакова Г.А., Веселовская Н.Г. Значение лептинорезистентности в развитии различных метаболических фенотипов ожирения. // Российский кардиологический журнал. — 2016. — № 4. — С. 4-18. [Ott AV, Chumakova GA, Veselovskaya NG. Znachenie leptinorezistentnosti v razvitii razlichnykh metabolicheskikh fenotipov ozhireniya. Rossiiskii kardiologicheskii zhurnal. 2016;(4):4-18. (In Russ.)]. doi: 10.15829/1560-4071-2016-4-14-18

49. Grundy SM. Metabolic syndrome update. Trends Cardiovasc Med. 2016;26(4):364-373. doi: 10.1016/j.tcm.2015.10.004

50. Yokota T, Meka CSR, Medina KL, et al. Paracrine regulation of fat cell formation in bone marrow cultures via adiponectin and prostaglandins. J Clin Invest. 2002;109(10):1303-1310. doi: 10.1172/jci0214506

51. Hardy OT, Perugini RA, Nicoloro SM, et al. Body mass index-independent inflammation in omental adipose tissue associated with insulin resistance in morbid obesity. Surg Obes Relat Dis. 2011;7(1):60-67. doi: 10.1016/j.soard.2010.05.013

52. Hui X, Feng T, Liu Q, et al. The FGF21-adiponectin axis in controlling energy and vascular homeostasis. J Mol Cell Biol. 2016;8(2):110-119. doi: 10.1093/jmcb/mjw013

53. Квиткова Л.В., Бородкина Д.А., Груздева О.В., и др. Уровень лептина, адипонектина и свободных жирных кислот у пациентов с различной массой тела на фоне инфаркта миокарда с подъемом сегмента ST. // Проблемы Эндокринологии. — 2013. — Т. 59. — № 3. — C. 8-12. [Kvitkova LV, Borodkina DA, Gruzdeva OV, Barbarash OL, Silonova AA, Terletskaia OS. The levels of leptin, adiponectin, and free fatty acids in the patients of different body weight presenting with myocardial infarction and elevated ST segment. Problems of Endocrinology. 2013;59(3):8-12. (In Russ.)]. doi: 10.14341/probl20135938-12

54. Alexopoulos N, Katritsis D, Raggi P. Visceral adipose tissue as a source of inflammation and promoter of atherosclerosis. Atherosclerosis. 2014;233(1):104-112. doi: 10.1016/j.atherosclerosis.2013.12.023

55. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol. 2011;11(2):85-97. doi: 10.1038/nri2921

56. Michaud M, Balardy L, Moulis G, et al. Proinflammatory cytokines, aging, and age-related diseases. J Am Med Dir Assoc. 2013;14(12):877-882. doi: 10.1016/j.jamda.2013.05.009

57. Esser N, Legrand-Poels S, Piette J, et al. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Res Clin Pract. 2014;105(2):141-150. doi: 10.1016/j.diabres.2014.04.006

58. Fuentes E, Fuentes F, Vilahur G, et al. Mechanisms of Chronic State of Inflammation as Mediators That Link Obese Adipose Tissue and Metabolic Syndrome. Mediators Inflamm. 2013;2013:1-11. doi: 10.1155/2013/136584


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For citations:


Borodkina D.A., Gruzdeva O.V., Kvitkova L.V., Barbarash O.L. Is visceral obesity the cause of obesity paradox? Problems of Endocrinology. 2016;62(6):33-39. https://doi.org/10.14341/probl201662633-39

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