肥胖悖论的逆流行病学:事实还是虚构?
1Division of Nephrology and Hypertension, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, USA.
Physiological reports
|October 29, 2024
概括
肥胖悖论表明,肥胖的人可能更好地存活急性心血管事件,挑战典型的肥胖风险. 这篇评论探讨了证据,体重指数和心肺呼吸能力,以了解这种复杂的关系.
科学领域:
- 心脏病学 心脏病学
- 代谢健康 代谢健康
- 流行病学 流行病学
背景情况:
- 肥胖悖论描述了在急性心血管失补偿期间肥胖患者的生存益处,与肥胖对非传染性疾病 (NCD) 的已知的风险形成鲜明对比.
- 科学界对肥胖悖论的有效性进行辩论,有些人主张它,有些人更喜欢用BMI悖论这个术语.
研究的目的:
- 定义肥胖悖论及其对非传染性疾病死亡率的影响.
- 审查支持和反驳肥胖悖论的证据.
- 检查体质指数,代谢健康的肥胖和心肺呼吸能力 (CRF) 在心血管疾病 (CVD) 风险和死亡率中的作用.
主要方法:
- 文献综述分析肥胖悖论,BMI悖论和相关概念.
- 检查有关肥胖,非传染性疾病,心血管疾病风险和全因死亡率的证据.
- 讨论影响肥胖和胰岛素抵抗的因素,包括遗传学,饮食和胎儿发育.
主要成果:
- 提出了支持和反对肥胖悖论的证据,强调了相互矛盾的发现.
- 无论肥胖状况如何,心肺呼吸能力 (CRF) 成为心血管疾病风险和死亡率的关键独立预测因素.
- 研究了新陈代谢健康的肥胖在悖论中的作用,以及瘦身糖尿病的概念,其死亡率高于肥胖糖尿病患者.
结论:
- 肥胖悖论在临床观察中仍然是一个复杂和有争议的现象.
- 心肺健康和遗传/文化因素显著影响心脏代谢风险和死亡率.
- 了解肥胖在死亡率中的作用需要考虑除了简单的BMI之外的各种因素,这可能会改变肥胖研究的范式.
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