Koirala Sushant, Sunnaa Michael, Bernier Thomas, Oktay Ahmet Afsin
Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
Division of Cardiology, Rush University Medical Center, Chicago, IL, 60612, USA.
Curr Cardiol Rep. 2024 Nov;26(11):1309-1320. doi: 10.1007/s11886-024-02129-z. Epub 2024 Sep 5.
Cardiovascular disease (CVD) is the leading cause of death globally and is closely associated with obesity and type 2 diabetes mellitus (T2DM). This review examines the interplay between obesity, T2DM, and CVD, highlighting the increasing prevalence and economic burden of these conditions.
Pharmacologic therapies, particularly glucagon-like peptide-1 receptor agonists, show promise in substantial weight loss and subsequent reduction of adverse cardiovascular events in obese individuals with and without diabetes. Obesity significantly contributes to the development of insulin resistance and T2DM, further escalating CVD risk. The common co-occurrence of these three conditions may involve several other pathophysiological mechanisms, such as chronic inflammation, increased visceral adiposity, and endothelial dysfunction. Until recently, lifestyle modifications and bariatric surgery had been the primary methods for weight loss and mitigating obesity-associated cardiovascular risk. Newer pharmacological options have led to a paradigm shift in our approach to obesity management as they provide substantial benefits in weight loss, glycemic control, and cardiovascular risk reduction.
心血管疾病(CVD)是全球主要的死亡原因,与肥胖和2型糖尿病(T2DM)密切相关。本综述探讨肥胖、T2DM和CVD之间的相互作用,强调这些疾病日益增加的患病率和经济负担。
药物治疗,尤其是胰高血糖素样肽-1受体激动剂,在有或没有糖尿病的肥胖个体中,在显著减轻体重以及随后减少不良心血管事件方面显示出前景。肥胖显著促进胰岛素抵抗和T2DM的发展,进一步增加CVD风险。这三种疾病的共同出现可能涉及其他几种病理生理机制,如慢性炎症、内脏脂肪增多和内皮功能障碍。直到最近,生活方式改变和减肥手术一直是减肥和减轻肥胖相关心血管风险的主要方法。新的药物选择导致了我们肥胖管理方法的范式转变,因为它们在减肥、血糖控制和降低心血管风险方面提供了实质性益处。