Department of Community Medicine, WHO Collaborating Centre, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
Int J Obes (Lond). 2010 Dec;34 Suppl 2:S18-23. doi: 10.1038/ijo.2010.235.
Subsets of obese subjects without any cardiometabolic risk factors have been repeatedly described. This raises questions whether obesity 'per se' enhances the risk for cardiovascular or metabolic diseases and whether healthy obese subjects would benefit from a medical treatment. In order to answer these questions, as a first step, an expert consensus should be reached for the definition of metabolic normality. In fact, up to now, different parameters related to the metabolic syndrome and/or to insulin sensitivity have been utilized across studies. Once an agreement is reached, population-based studies should be undertaken to establish the incidence of metabolic normality among obese subjects. Furthermore, many other parameters such as age, sex, race, fat distribution and physical activity should be monitored to obtain results representative of a general population. Longitudinal studies aimed at investigating the evolution of the cardiometabolic profile of healthy obese subjects are also needed. In conclusion, data from the literature strongly suggest that a regular surveillance of the cardiometabolic parameters and a prevention of any further weight gain should be applied to healthy obese individuals, whereas possible benefits of a weight loss treatment are still a matter of debate.
已经反复描述了没有任何心血管代谢风险因素的肥胖亚组。这引发了一些疑问，即肥胖“本身”是否会增加心血管或代谢疾病的风险，以及健康肥胖者是否会从医学治疗中受益。为了回答这些问题，首先应该就代谢正常的定义达成专家共识。事实上，到目前为止，不同的研究中使用了与代谢综合征和/或胰岛素敏感性相关的不同参数。一旦达成一致，就应该进行基于人群的研究，以确定肥胖人群中代谢正常的发生率。此外，还应监测许多其他参数，如年龄、性别、种族、脂肪分布和体力活动，以获得具有代表性的一般人群的结果。还需要进行旨在研究健康肥胖者的心血管代谢特征演变的纵向研究。总之，文献中的数据强烈表明，应该对健康肥胖者进行心血管代谢参数的常规监测，并防止体重进一步增加，而减肥治疗的可能益处仍存在争议。
