Miller Wendy M, Nori-Janosz Katherine E, Lillystone Martin, Yanez Jose, McCullough Peter A
Department of Internal Medicine, Division of Nutrition and Preventive Medicine, William Beaumont Hospital, 4949 Coolidge, Royal Oak, MI 48073, USA.
Curr Cardiol Rep. 2005 Nov;7(6):465-70. doi: 10.1007/s11886-005-0065-8.
Obesity increases cardiovascular risk through multiple mechanisms. Abdominal (visceral) adiposity is metabolically active and is largely responsible for the atherogenic dyslipidemia, hyperinsulinemia, hypertension, chronic inflammatory state, and prothrombotic state that constitute the metabolic syndrome, and the subsequent increased risk for cardiovascular disease and acute coronary events. Cholesterol guidelines for assessing cardiovascular risk have traditionally focused on low-density lipoprotein (LDL) levels, and reduction of plasma LDL has been shown to reduce cardiovascular events and total mortality. However, the cardiovascular risks associated with the dyslipidemia of obesity--characterized by low levels of high-density lipoprotein; increased triglycerides; increased subfractions of small, dense LDL; and increased levels of apolipoprotein B-100--are also now well recognized.
肥胖通过多种机制增加心血管疾病风险。腹部（内脏）肥胖具有代谢活性，在很大程度上导致了构成代谢综合征的致动脉粥样硬化血脂异常、高胰岛素血症、高血压、慢性炎症状态和血栓前状态，以及随后心血管疾病和急性冠脉事件风险的增加。传统上，评估心血管疾病风险的胆固醇指南主要关注低密度脂蛋白（LDL）水平，降低血浆LDL已被证明可减少心血管事件和总死亡率。然而，与肥胖相关血脂异常（其特征为高密度脂蛋白水平低、甘油三酯升高、小而密LDL亚组分增加以及载脂蛋白B-100水平升高）相关的心血管疾病风险目前也已得到充分认识。
