Institute of Diabetes Research and Metabolic Diseases (IDM), the Helmholtz Center, Munich, Germany.
Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University Hospital of Tübingen, Tübingen, Germany.
Nat Rev Endocrinol. 2021 Mar;17(3):135-149. doi: 10.1038/s41574-020-00462-1. Epub 2021 Jan 21.
Obesity and impaired metabolic health are established risk factors for the non-communicable diseases (NCDs) type 2 diabetes mellitus, cardiovascular disease, neurodegenerative diseases, cancer and nonalcoholic fatty liver disease, otherwise known as metabolic associated fatty liver disease (MAFLD). With the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), obesity and impaired metabolic health also emerged as important determinants of severe coronavirus disease 2019 (COVID-19). Furthermore, novel findings indicate that specifically visceral obesity and characteristics of impaired metabolic health such as hyperglycaemia, hypertension and subclinical inflammation are associated with a high risk of severe COVID-19. In this Review, we highlight how obesity and impaired metabolic health increase complications and mortality in COVID-19. We also summarize the consequences of SARS-CoV-2 infection for organ function and risk of NCDs. In addition, we discuss data indicating that the COVID-19 pandemic could have serious consequences for the obesity epidemic. As obesity and impaired metabolic health are both accelerators and consequences of severe COVID-19, and might adversely influence the efficacy of COVID-19 vaccines, we propose strategies for the prevention and treatment of obesity and impaired metabolic health on a clinical and population level, particularly while the COVID-19 pandemic is present.
肥胖和代谢健康受损是 2 型糖尿病、心血管疾病、神经退行性疾病、癌症和非酒精性脂肪性肝病（也称为代谢相关脂肪性肝病，MAFLD）等非传染性疾病（NCDs）的既定风险因素。随着严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）在全球范围内的传播，肥胖和代谢健康受损也成为严重 2019 冠状病毒病（COVID-19）的重要决定因素。此外，新的研究结果表明，内脏肥胖和代谢健康受损的特征，如高血糖、高血压和亚临床炎症，与 COVID-19 重症的高风险相关。在这篇综述中，我们强调了肥胖和代谢健康受损如何增加 COVID-19 的并发症和死亡率。我们还总结了 SARS-CoV-2 感染对器官功能和 NCDs 风险的影响。此外，我们还讨论了表明 COVID-19 大流行可能对肥胖流行产生严重后果的数据。由于肥胖和代谢健康受损既是 COVID-19 重症的加速因素，也是其后果，并且可能对 COVID-19 疫苗的疗效产生不利影响，因此我们提出了在临床和人群层面预防和治疗肥胖和代谢健康受损的策略，特别是在 COVID-19 大流行期间。
