Després J P, Moorjani S, Lupien P J, Tremblay A, Nadeau A, Bouchard C
Physical Activity Sciences Laboratory, Laval University, Ste-Foy, Québec, Canada.
Arteriosclerosis. 1990 Jul-Aug;10(4):497-511. doi: 10.1161/01.atv.10.4.497.
Several epidemiological studies have reported that the regional distribution of body fat is a significant and independent risk factor for cardiovascular disease (CVD) and related mortality. Although these associations are well established, the causal mechanisms are not fully understood. Numerous studies have, however, shown that specific topographic features of adipose tissue are associated with metabolic complications that are considered as risk factors for CVD such as insulin resistance, hyperinsulinemia, glucose intolerance and type II diabetes mellitus, hypertension, and changes in the concentration of plasma lipids and lipoproteins. The present article summarizes the evidence on the metabolic correlates of body fat distribution. Potential mechanisms for the association between body fat distribution, metabolic complications, and CVD are reviewed, with an emphasis on plasma lipoprotein levels and plasma lipid transport. From the evidence available, it seems likely that subjects with visceral obesity represent the subgroup of obese individuals with the highest risk for CVD. Although body fat distribution is now considered as a more significant risk factor for CVD and related death rate than obesity per se, further research is clearly needed to identify the determinants of body fat distribution and the causal mechanisms involved in the metabolic alterations. It appears certain, however, that an altered plasma lipid transport is a significant component of the relation between body fat distribution and CVD.
多项流行病学研究报告称，身体脂肪的区域分布是心血管疾病（CVD）及相关死亡率的一个重要且独立的危险因素。尽管这些关联已得到充分证实，但其因果机制尚未完全明确。然而，众多研究表明，脂肪组织的特定形态特征与被视为CVD危险因素的代谢并发症相关，如胰岛素抵抗、高胰岛素血症、葡萄糖耐量异常和II型糖尿病、高血压以及血浆脂质和脂蛋白浓度的变化。本文总结了关于身体脂肪分布代谢相关性的证据。回顾了身体脂肪分布、代谢并发症和CVD之间关联的潜在机制，重点关注血浆脂蛋白水平和血浆脂质转运。从现有证据来看，内脏型肥胖的个体似乎是肥胖个体中患CVD风险最高的亚组。尽管现在身体脂肪分布被认为是比肥胖本身更重要的CVD及相关死亡率的危险因素，但显然还需要进一步研究以确定身体脂肪分布的决定因素以及代谢改变所涉及的因果机制。然而，可以确定的是，血浆脂质转运改变是身体脂肪分布与CVD关系中的一个重要组成部分。
