Lizicárová D, Hirnerová E, Krahulec B
II. Interná klinika Lekárskej fakulty UK a FN Staré Mesto Bratislava, Slovenská republika.
Vnitr Lek. 2010 Oct;56(10):1088-92.
In general population obesity is regarded as a predisposing factor for chronic disease such as type 2 diabetes and cardiovascular disease. Obesity increases the risk of kidney disease and adversely affects the progress of kidney disease among patients with diagnosed kidney disease. The main reason of mortality in chronic kidney disease patients is cardiovascular disease, however, the real meaning of obesity as a risk factor of cardiovascular diseases is still uncertain. While in a general population obesity causes higher cardiovascular mortality, many studies reflect inverse association in chronic kidney disease patients. Obesity is associated with better survival, contrary to general population obesity appears to be a protective factor of cardiovascular disease. The name of this phenomenon is "reverse epidemiology" or "obesity paradox", in dialysis patients known as a "risk-factor-paradox". Some studies do not confirm this paradox association in patients with chronic kidney disease.
在一般人群中,肥胖被视为慢性疾病(如2型糖尿病和心血管疾病)的诱发因素。肥胖会增加患肾病的风险,并对已确诊肾病患者的肾病进展产生不利影响。慢性肾病患者的主要死亡原因是心血管疾病,然而,肥胖作为心血管疾病风险因素的真正意义仍不明确。虽然在一般人群中肥胖会导致更高的心血管死亡率,但许多研究表明在慢性肾病患者中存在相反的关联。肥胖与更好的生存率相关,与一般人群相反,肥胖似乎是心血管疾病的保护因素。这种现象被称为“逆流行病学”或“肥胖悖论”,在透析患者中被称为“风险因素悖论”。一些研究并未证实慢性肾病患者存在这种悖论关联。