Lecube Albert
Servicio de Endocrinología y Nutrición, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida (UdL), Lleida, España.
Aten Primaria. 2024 Dec;56(12):103045. doi: 10.1016/j.aprim.2024.103045. Epub 2024 Jul 14.
Obesity and type 2 diabetes mellitus (T2D) significantly increase the risk of cardiovascular diseases such as coronary artery disease, atrial fibrillation, heart failure, and sudden cardiac death. This risk is proportional to body mass index (BMI), is exacerbated by comorbidities such as hypertension and dyslipidemia, and includes emerging risk factors like insulin resistance, low-grade chronic inflammation, and thrombosis tendency. The distribution of adipose tissue, especially visceral fat and ectopic deposition in the heart, is another key factor in the development of cardiovascular diseases in these patients, along with atrial and ventricular remodeling. Bariatric surgery has been shown to be effective in reducing these risks. The prevention and treatment of cardiovascular diseases in obesity and T2D include lifestyle changes, specific pharmacological treatment and management of comorbidities, and attention to cardiovascular risk factors.
肥胖和2型糖尿病(T2D)显著增加了患心血管疾病的风险,如冠状动脉疾病、心房颤动、心力衰竭和心源性猝死。这种风险与体重指数(BMI)成正比,高血压和血脂异常等合并症会加剧这种风险,还包括胰岛素抵抗、低度慢性炎症和血栓形成倾向等新出现的风险因素。脂肪组织的分布,尤其是内脏脂肪以及心脏中的异位沉积,是这些患者发生心血管疾病的另一个关键因素,同时还伴有心房和心室重塑。减肥手术已被证明在降低这些风险方面是有效的。肥胖和T2D患者心血管疾病的预防和治疗包括生活方式改变、特定的药物治疗和合并症管理,以及关注心血管危险因素。