Cardiac adiposity and global cardiometabolic risk: new concept and clinical implication

Area of Science:

• Public Health
• Cardiology
• Endocrinology

Background:

• The global obesity epidemic poses significant public health challenges, increasing morbidity and mortality from metabolic and cardiovascular diseases (CVD).
• Metabolic syndrome (MetS) highlights visceral fat's role in metabolic and CVD development, with waist circumference aiding clinical identification.
• MetS alone is insufficient for global CVD risk assessment; it's one modifiable factor among others.

Purpose of the Study:

• To review the contribution of abdominal obesity to global cardiometabolic risk.
• To discuss underlying mechanisms linking abdominal obesity to cardiometabolic disease.
• To emphasize the importance of individual cardiometabolic risk assessment.

Main Methods:

• Literature review focusing on abdominal obesity and cardiometabolic risk.
• Analysis of mechanisms including adipocytokines, insulin resistance, lipotoxicity, and ectopic fat deposition.
• Examination of different fat depots: circulatory, locally recruited, intra/extramyocellular, perivascular, and pericardial fat.

Main Results:

• Abdominal obesity is a key contributor to global cardiometabolic risk.
• Mechanisms such as adipocytokine dysregulation, insulin resistance, lipotoxicity, and ectopic fat deposition are implicated.
• Specific fat depots (visceral, cardiac) play crucial roles in disease pathogenesis.

Conclusions:

• Global cardiometabolic risk requires individual assessment, integrating traditional factors with the impact of MetS and abdominal obesity.
• Understanding the mechanisms of abdominal obesity is vital for effective prevention and management strategies.
• Targeting abdominal fat and its related pathways may mitigate CVD risk.