Khafagy Rana, Dash Satya
Department of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada.
Banting & Best Diabetes Centre, University of Toronto, Toronto, ON, Canada.
Front Cardiovasc Med. 2021 Oct 25;8:768119. doi: 10.3389/fcvm.2021.768119. eCollection 2021.
Obesity is a growing public health challenge across the globe. It is associated with increased morbidity and mortality. Cardiovascular disease (CVD) is the leading cause of mortality for people with obesity. Current strategies to reduce CVD are largely focused on addressing traditional risk factors such as dyslipidemia, type 2 diabetes (T2D) and hypertension. Although this approach is proven to reduce CVD, substantial residual risk remains for people with obesity. This necessitates a better understanding of the etiology of CVD in people with obesity and alternate therapeutic approaches. Reducing inflammation may be one such strategy. A wealth of animal and human data indicates that obesity is associated with adipose tissue and systemic inflammation. Inflammation is a known contributor to CVD in humans and can be successfully targeted to reduce CVD. Here we will review the etiology and pathogenesis of inflammation in obesity associated metabolic disease as well as CVD. We will review to what extent these associations are causal based on human genetic studies and pharmacological studies. The available data suggests that anti-inflammatory treatments can be used to reduce CVD, but off-target effects such as increased infection have precluded its broad therapeutic application to date. The role of anti-inflammatory therapies in improving glycaemia and metabolic parameters is less established. A number of clinical trials are currently ongoing which are evaluating anti-inflammatory agents to lower CVD. These studies will further clarify whether anti-inflammatory agents can safely reduce CVD.
肥胖是全球日益严峻的公共卫生挑战。它与发病率和死亡率的增加相关。心血管疾病（CVD）是肥胖人群的主要死因。当前降低心血管疾病的策略主要集中在解决传统风险因素，如血脂异常、2型糖尿病（T2D）和高血压。尽管这种方法已被证明可降低心血管疾病，但肥胖人群仍存在大量残余风险。这需要更好地理清肥胖人群心血管疾病的病因以及替代治疗方法。减轻炎症可能是这样一种策略。大量动物和人类数据表明，肥胖与脂肪组织和全身炎症有关。炎症是已知导致人类心血管疾病的因素，可以通过针对性治疗来降低心血管疾病风险因素从而降低心血管疾病。在此处，我们将综述肥胖相关代谢疾病以及心血管疾病中炎症的病因和发病机制。基于人类遗传学研究及药理学研究，我们将探讨这些关联在多大程度上具有因果关系。现有证据表明，抗炎治疗可用于降低心血管疾病风险因素从而降低心血管疾病风险因素，但诸如感染增加等脱靶效应迄今阻碍了其广泛的治疗应用。抗炎疗法在改善血糖和代谢参数方面作用尚未明确证实。目前有多项正在进行的临床试验评估抗炎药物对降低心血管疾病风险因素从而降低心血管疾病风险因素的作用。这些研究将进一步阐明抗炎药物是否能安全地降低心血管疾病风险因素从而降低心血管疾病风险因素。
