VITAM-Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Québec, Québec, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Québec, Canada; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada.
Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada; Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Québec, Canada. Electronic address: https://twitter.com/CarpentierAndr3.
J Am Coll Cardiol. 2021 Aug 3;78(5):513-531. doi: 10.1016/j.jacc.2021.05.035.
Obesity contributes to reduced life expectancy because of its link with type 2 diabetes and cardiovascular disease. Yet, targeting this poorly diagnosed, ill-defined, and underaddressed modifiable risk factor remains a challenge. In this review, we emphasize that the tendency among health care professionals to amalgam all forms of obesity altogether as a single entity may contribute to such difficulties and discrepancies. Obesity is a heterogeneous condition both in terms of causes and health consequences. Attention should be given to 2 prevalent subgroups of individuals: 1) patients who are overweight or moderately obese with excess visceral adipose tissue; and 2) patients with severe obesity, the latter group having distinct additional health issues related to their large body fat mass. The challenge of tackling high-cardiovascular-risk forms of obesity through a combination of personalized clinical approaches and population-based solutions is compounded by the current obesogenic environment and economy.
肥胖与 2 型糖尿病和心血管疾病有关,因此导致预期寿命缩短。然而,针对这种诊断不佳、定义不明确且未得到充分重视的可改变危险因素仍然是一个挑战。在这篇综述中,我们强调,医疗保健专业人员将所有形式的肥胖一概而论地视为单一实体的趋势可能是造成这种困难和差异的原因之一。肥胖在病因和健康后果方面都是一种异质性疾病。应该关注 2 个常见的亚组人群:1)超重或中度肥胖且内脏脂肪过多的患者;2)严重肥胖的患者,后者群体由于其大量体脂而存在明显的其他健康问题。当前肥胖的环境和经济状况使得通过个性化临床方法和基于人群的解决方案来解决高心血管风险肥胖形式的挑战变得更加复杂。