Harrington Heart and Vascular Institute, University Hospitals Cleveland and Case Western Reserve University, Cleveland, OH, USA.
Department of Medicine, University Hospitals Cleveland and Case Western Reserve University, 11100 Euclid Ave. Mailstop Lakeside, Cleveland, OH, USA.
Curr Cardiol Rep. 2024 Nov;26(11):1297-1307. doi: 10.1007/s11886-024-02127-1. Epub 2024 Sep 5.
Body fat distribution plays a significant role in the cardiometabolic consequences of obesity. We review the impact of visceral and hepatic fat and highlight important interventions.
Several epidemiologic studies have established a clear association between visceral fat and cardiovascular disease. The association between hepatic fat and cardiovascular disease is less clear with discordant results. Novel evidence demonstrates sodium glucose co-transporter-2 (SGLT2) inhibitors facilitate modest weight loss and reductions in ectopic fat depots in patient with type 2 diabetes. Glucagon-like peptide-1 (GLP-1) receptor agonists have been associated with decreased visceral/hepatic fat and reductions in MACE in populations with type 2 diabetes and with overweight/obesity. Clear associations between visceral fat and cardiometabolic outcomes have been established, whereas the impact of hepatic fat remains less clear. Lifestyle modification and pharmacologic interventions remain the initial therapies, while surgical intervention is associated with improved long-term outcomes. Emerging therapies have demonstrated a profound impact on body fat distribution and cardiometabolic risk.
体脂分布在肥胖的心血管代谢后果中起着重要作用。我们综述了内脏脂肪和肝脂肪的影响，并强调了重要的干预措施。
几项流行病学研究已经明确确立了内脏脂肪与心血管疾病之间的关联。肝脂肪与心血管疾病之间的关联不太明确，结果存在差异。新的证据表明，钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂可促进 2 型糖尿病患者适度减重和减少异位脂肪沉积。胰高血糖素样肽-1（GLP-1）受体激动剂与 2 型糖尿病和超重/肥胖人群内脏/肝脂肪减少和主要心血管不良事件减少相关。已经明确确立了内脏脂肪与心血管代谢结局之间的关联，而肝脂肪的影响仍不明确。生活方式改变和药物干预仍然是初始治疗方法，而手术干预与改善长期结局相关。新兴疗法已证明对体脂分布和心血管代谢风险有深远影响。
