Douketis James D, Sharma Arya M
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Semin Vasc Med. 2005 Feb;5(1):25-33. doi: 10.1055/s-2005-871739.
The prevalence of obesity in industrialized countries has reached epidemic proportions, with about one in three people being obese and another one in three people being overweight and at risk of developing obesity. In recent years, obesity has gained the traditional tetrad of cardiovascular risk factors of smoking: hypertension, dyslipidemia, and dysglycemia. Attention has also focused on the importance of abdominal (or central) obesity as a determinant of cardiovascular risk, independent of the body mass index. In addition to effects on coronary artery disease, obesity has an effect on cardiovascular disease, including stroke, ventricular function, peripheral arterial disease, and venous thromboembolism. The objectives of this review are to summarize the effects of obesity on cardiovascular disease, and the possible mechanisms for these associations, and to investigate the effects of weight-loss interventions on the burden of cardiovascular disease. Large ongoing clinical outcome trials, such as the SOS study, the Look-AHEAD trial, or the SCOUT study, should provide important information on the effects of surgical and nonsurgical obesity treatment on cardiovascular morbidity and mortality.
在工业化国家，肥胖的流行已达到流行程度，约三分之一的人肥胖，另有三分之一的人超重且有患肥胖症的风险。近年来，肥胖已具备吸烟这一传统心血管危险因素的四大特征：高血压、血脂异常和血糖异常。人们也开始关注腹部（或中心性）肥胖作为心血管风险决定因素的重要性，这一因素独立于体重指数。除了对冠状动脉疾病有影响外，肥胖还会影响心血管疾病，包括中风、心室功能、外周动脉疾病和静脉血栓栓塞。本综述的目的是总结肥胖对心血管疾病的影响、这些关联的可能机制，并研究减肥干预措施对心血管疾病负担的影响。正在进行的大型临床结局试验，如SOS研究、Look-AHEAD试验或SCOUT研究，应能提供有关手术和非手术肥胖治疗对心血管发病率和死亡率影响的重要信息。
