Crintea Iulia Najette, Cindrea Alexandru Cristian, Mederle Ovidiu Alexandru, Trebuian Cosmin Iosif, Timar Romulus
Department of Surgery, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Emergency Department, Emergency Clinical Municipal Hospital, 300079 Timisoara, Romania.
Diseases. 2025 Feb 24;13(3):69. doi: 10.3390/diseases13030069.
Electrolyte imbalances are a frequently overlooked yet critical component of obesity-related metabolic dysfunction, contributing to an increased risk of cardiovascular disease, kidney impairment, and metabolic emergencies such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and acute kidney injury (AKI). These disturbances arise from insulin resistance, chronic inflammation, hormonal dysregulation, and renal dysfunction, leading to sodium retention, potassium depletion, and deficiencies in calcium and magnesium homeostasis. Managing electrolyte imbalances is essential in obesity management, as imbalances exacerbate hypertension, metabolic acidosis, neuromuscular complications, and insulin resistance. This review explores the pathophysiology of electrolyte disturbances in obesity and their impact on fluid balance, acid-base status, and metabolic health. Effective management strategies include individualized electrolyte monitoring, dietary sodium restriction, potassium supplementation, vitamin D and magnesium correction, and pharmacologic interventions targeting renin-angiotensin-aldosterone system (RAAS) activity and insulin resistance. Additionally, lifestyle interventions, including dietary modification, weight loss strategies, and hydration optimization, play a key role in preventing metabolic complications. Future research should investigate the long-term impact of electrolyte imbalances in obesity, the role of emerging therapies, and how lifestyle interventions can optimize electrolyte homeostasis and metabolic outcomes. A personalized, multidisciplinary approach integrating endocrinology, nephrology, and clinical nutrition is essential to improving the prevention and management of electrolyte imbalances in obese individuals.
电解质失衡是肥胖相关代谢功能障碍中一个经常被忽视但至关重要的组成部分，会增加心血管疾病、肾脏损害以及糖尿病酮症酸中毒（DKA）、高渗高血糖状态（HHS）和急性肾损伤（AKI）等代谢急症的风险。这些紊乱源于胰岛素抵抗、慢性炎症、激素失调和肾功能障碍，导致钠潴留、钾耗竭以及钙和镁稳态的缺乏。在肥胖管理中，控制电解质失衡至关重要，因为失衡会加剧高血压、代谢性酸中毒、神经肌肉并发症和胰岛素抵抗。本文综述探讨了肥胖中电解质紊乱的病理生理学及其对液体平衡、酸碱状态和代谢健康的影响。有效的管理策略包括个体化的电解质监测、饮食限钠、补钾、纠正维生素D和镁缺乏，以及针对肾素-血管紧张素-醛固酮系统（RAAS）活性和胰岛素抵抗的药物干预。此外，生活方式干预，包括饮食调整、减肥策略和优化水合作用，在预防代谢并发症方面起着关键作用。未来的研究应调查肥胖中电解质失衡的长期影响、新兴疗法的作用，以及生活方式干预如何优化电解质稳态和代谢结果。采用内分泌学、肾脏病学和临床营养相结合的个性化多学科方法，对于改善肥胖个体电解质失衡的预防和管理至关重要。
