Departamento de Clínica Médica, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
Programa de Pós-Graduação em Cirurgia, Universidade Federal de Pernambuco, Recife, PE, Brasil.
Arch Endocrinol Metab. 2021 Nov 1;65(1):3-13. doi: 10.20945/2359-3997000000318. Epub 2020 Dec 15.
COVID-19 and obesity are two pandemic diseases that the world is currently facing. Both activate the immune system and mediate inflammation. A sequence of disease phases in patients with severe COVID-19 results in a cytokine storm, which amplifies the subclinical inflammation that already exists in patients with obesity. Pro-inflammatory cytokines and chemotactic factors increase insulin resistance in obesity. Therefore, a greater systemic inflammatory response is establishe, along with an increased risk of thrombotic phenomena and hyperglycemic conditions. These changes further impair pulmonary, cardiac, hepatic, and renal functions, in addition to hindering glycemic control in people with diabetes and pre-diabetes. This review explains the pathophysiological mechanisms of these two pandemic diseases, provides a deeper understanding of this harmful interaction and lists possible therapeutic strategies for this risk group.
COVID-19 和肥胖是目前全球面临的两种大流行疾病。两者均能激活免疫系统并介导炎症。重症 COVID-19 患者的一系列疾病阶段会导致细胞因子风暴，从而放大肥胖患者已经存在的亚临床炎症。促炎细胞因子和趋化因子会增加肥胖患者的胰岛素抵抗。因此，会建立更大的全身性炎症反应，同时增加发生血栓现象和高血糖的风险。这些变化进一步损害了肺部、心脏、肝脏和肾脏功能，除了阻碍糖尿病和糖尿病前期患者的血糖控制。本综述解释了这两种大流行疾病的病理生理机制，更深入地了解了这种有害的相互作用，并列出了针对该风险群体的可能治疗策略。
