Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Curr Cardiol Rep. 2023 Nov;25(11):1555-1564. doi: 10.1007/s11886-023-01969-5. Epub 2023 Oct 4.
Specific measures of body fat distribution may have particular value in the development and treatment of cardiometabolic conditions, such as cardiovascular disease (CVD) and diabetes mellitus (DM). Here, we review the pathophysiology, epidemiology, and recent advances in the identification and management of body fat distribution as it relates to DM and CVD risk.
Accumulation of visceral and ectopic fat is a major contributor to CVD and DM risk above and beyond the body mass index (BMI), yet implementation of fat distribution assessment into clinical practice remains a challenge. Newer imaging-based methods offer improved sensitivity and specificity for measuring specific fat depots. Lifestyle, pharmacological, and surgical interventions allow a multidisciplinary approach to reduce visceral and ectopic fat. A focus on implementation of body fat distribution measurements into clinical practice should be a priority over the next 5 to 10 years, and clinical assessment of fat distribution can be considered to refine risk evaluation and to develop improved and effective preventive and therapeutic strategies for high-risk obesity.
体脂肪分布的特定测量指标在心血管疾病（CVD）和糖尿病（DM）等代谢性心血管疾病的发生和治疗中可能具有特殊价值。在这里，我们回顾了与 DM 和 CVD 风险相关的体脂肪分布的病理生理学、流行病学和最新进展，包括其识别和管理。
内脏和异位脂肪的堆积是 CVD 和 DM 风险的主要因素，超过了体重指数（BMI），但将脂肪分布评估纳入临床实践仍然是一个挑战。基于新型影像学的方法在测量特定脂肪储量方面具有更高的敏感性和特异性。生活方式、药理学和手术干预措施允许多学科方法来减少内脏和异位脂肪。在未来 5 到 10 年内，应优先将体脂肪分布测量纳入临床实践，并且可以考虑对脂肪分布进行临床评估，以完善风险评估，并为高危肥胖症制定更好、更有效的预防和治疗策略。
