Department of Pediatric Cardiac Surgery, Universidad Autonoma de Barcelona, Barcelona, Spain.
Department of Cardiac Surgery, Clinic University Hospital of Valladolid, Valladolid, Spain.
Diabetes Metab Res Rev. 2019 May;35(4):e3135. doi: 10.1002/dmrr.3135. Epub 2019 Feb 20.
Obesity is described in terms of body fat percentage or body mass index (BMI), despite the fact that these measures do not give full insight about the body fat distribution. It is presently a consistently growing universal challenge since it has tripled in the last 10 years, killing approximately 28 million people each year. In this review, we aim to clarify the different results of obesity on the working and physiology of the cardiovascular system and to reveal changes in the obesity "paradox"-a variety of cardiovascular outcomes in typical/overweight people. Central fat build-up in ordinary/overweight populaces has been related to expanded occurrences of myocardial infarction, heart failure, or all-cause mortality when contrasted with the obese populace. These discoveries are additionally clarified as the abundance and prolonged vulnerability to free fatty acids (FFAs) in obesity. This has been believed to cause the myocardial substrate to move from glucose to FFAs digestion, which causes lipid gathering in cardiomyocytes, spilling over to other lean tissues, and prompting a general atherogenic impact. This cardiomyocyte lipid aggregation has been demonstrated to cause insulin resistance and cardiovascular hypertrophy, and to lessen the heart functions in general. There is a proof backing the fact that fat tissue is not only an energy reservoir, it also coordinates hormones and proinflammatory cytokines and deals with the energy transition of the body by putting away abundant lipids in diverse tissues.
肥胖通常用体脂百分比或身体质量指数（BMI）来描述，尽管这些指标并不能全面反映体脂分布情况。目前，肥胖是一个日益严重的全球性挑战，因为在过去的 10 年中，肥胖症的发病率已经增加了两倍，每年导致大约 2800 万人死亡。在这篇综述中，我们旨在阐明肥胖对心血管系统工作和生理学的不同影响，并揭示肥胖“悖论”的变化——即典型/超重人群中各种心血管结局的变化。与肥胖人群相比，普通/超重人群中心脂肪的积累与心肌梗死、心力衰竭或全因死亡率的发生率增加有关。这些发现还可以解释为肥胖症中丰富且长期易受游离脂肪酸（FFAs）影响。这被认为导致心肌底物从葡萄糖向 FFAs 消化转移，从而导致心肌细胞中的脂质堆积，溢出到其他瘦组织，并导致普遍的动脉粥样硬化影响。这种心肌细胞脂质聚集已被证明会导致胰岛素抵抗和心血管肥大，并降低心脏的整体功能。有证据表明，脂肪组织不仅是能量储存库，它还协调激素和促炎细胞因子，并通过在不同组织中储存大量脂肪来调节身体的能量转换。
