Cheung Bernard M Y
J Cardiovasc Pharmacol. 2005 Aug;46(2):125-9. doi: 10.1097/01.fjc.0000171752.43564.35.
Atherosclerosis, myocardial infarction, and heart failure are cardiovascular complications in a continuum that begins with risk factors such as hypertension, diabetes, and dyslipidemia. These particular cardiovascular risk factors commonly occur together in obese individuals as components of the metabolic syndrome. In Asia, there is a trend toward an increase in the prevalence of the metabolic syndrome and cardiovascular disease. Abdominal adiposity is arguably the key factor underlying the development of insulin resistance and the metabolic syndrome. It is now known that adipose tissues secrete adipokines, and in obese subjects, there is a chronic low-grade inflammation. The inflammation and the associated endothelial dysfunction are reversible in the early stages. The Asian diet is low in animal fat but high in carbohydrates. Recent studies suggest that low-carbohydrate diets are more effective than low fat diets in inducing weight loss, suggesting that excessive carbohydrate rather than fat is the cause of obesity. Strategies to combat cardiovascular disease should now focus on tackling the epidemic of obesity and developing innovative and effective lifestyle and pharmacological interventions.
动脉粥样硬化、心肌梗死和心力衰竭是一系列心血管并发症，其始于高血压、糖尿病和血脂异常等风险因素。这些特定的心血管风险因素在肥胖个体中通常作为代谢综合征的组成部分共同出现。在亚洲，代谢综合征和心血管疾病的患病率呈上升趋势。腹部肥胖可以说是胰岛素抵抗和代谢综合征发展的关键因素。现在已知脂肪组织会分泌脂肪因子，在肥胖受试者中存在慢性低度炎症。炎症及相关的内皮功能障碍在早期是可逆的。亚洲饮食中动物脂肪含量低但碳水化合物含量高。最近的研究表明，低碳水化合物饮食在诱导体重减轻方面比低脂肪饮食更有效，这表明过量的碳水化合物而非脂肪是肥胖的原因。对抗心血管疾病的策略现在应侧重于应对肥胖流行，并开发创新有效的生活方式和药物干预措施。
