Obesity, diabetes mellitus and cardiovascular disease: dangerous metabolic triad

Czech version

Authors: Ubomíra Fábryová ^1,2
Authors‘ workplace: Metabol KLINIK, s. r. o. – Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, Špecializovaná lipidologická ambulancia, MED PED centrum, Bratislava ¹; Biomedicínske centrum SAV, Bratislava ²
Published in: Forum Diab 2019; 8(3): 178-183
Category: Review Article

Overview

Obesity and type 2 diabetes mellitus are chronic, preventable, relapsing and the most common metabolic diseases that currently reach the dimensions of the epidemic (pandemic). It affects not only adults but also children and adolescents. In most European countries, the prevalence of overweight and obesity is around 50% in the adult population and is responsible for developing up to 80% of cases of type 2 diabetes, resulting in increased morbidity and mortality. Diabesity is becoming a huge problem, not only health, but also social and economic. At the population level, there is no doubt that overweight / obesity/diabesity is very closely related to the increase in cardiovascular morbidity and mortality associated with shortening life expectancy. Obesity/diabesity is mainly associated with the development of atherosclerosis-related cardiovascular diseases, including coronary artery disease, peripheral arterial disease, stroke, atrial fibrillation. However, patients with type 2 diabetes have a greater than 3-fold increase in the risk of heart failure. Currently, we understand the prevention of overweight/obesity as a parallel prevention of the development of type 2 diabetes and other chronic cardio metabolic, cancer and some neurodegenerative diseases. However, from a complex perspective it should be noted that obesity is often associated with an improvement in survival in some cardiovascular diseases, which led to the creation of the term “paradox of obesity”.

Keywords:

obesity – adiposopathy – adiposopathic dyslipidemia – cardiovascular diseases – diabesity – ectopic adipose tissue – heart failure – obesity paradox – type 2 diabetes mellitus

Sources

[WHO. Obesity and overweight]. Dostupné z WWW: <https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight>.
Smatana M, Pažitný P, Kandilaki D et al. Slovakia: Health system review. Health Health Syst Transit 2016; 18(6):1–210. Dostupné z WWW: <http://www.healthobservatory.eu>.
Avdičová M et al. Monitorovanie rizikových faktorov chronických chorôb v SR. RÚVZ so sídlom v Banskej Bystrici za podpory WHO – regionálnej úradovne v Kodani. 2012. Svidník: Slovenská spoločnosť praktickej obezitológie 2013. ISBN 978–80–971460–0-9.
Fábryová Ľ. Epidemiológia diabezity. In: Fábryová Ľ., Holéczy P (eds). Diabezita. Diabetes a obezita: nerozlučné dvojičky. Facta Medica, Brno 2019: 27–40. ISBN 9788088056096.
[Národné centrum zdravotníckych informácií]. Činnosť diabetologických ambulancií 2017. Bratislava 2018: ZŠ-11/2018. Dostupné z WWW: <http://www.nczisk.sk/Documents/publikacie/2017/zs1811.pdf>.
Barák Ľ, Tichá Ľ. Diabezita v detskom a adolescentnom veku. In: Fábryová Ľ, Holéczy P (eds). Diabezita. Diabetes a obezita: nerozlučné dvojičky. Facta Medica, Brno 2019: 79–288. ISBN 9788088056096.
Tichá Ľ, Regecová V, Šebeková K et al. Prevalence of overweight/obesity among 7-year-old children—WHO Childhood Obesity Surveillance Initiative in Slovakia, trends and differences between selected European countries. Eur J Pediatr 2018; 177(6): 945–953. Dostupné z DOI: <https://doi.org/10.1007/s00431–018–3137–7>.
Fábryová Ľ. Kardiometabolické riziká obezity. In: Krahulec B, Fábryová Ľ, Holéczy P et al (eds). Klinická obezitológia. Facta Medica:, Brno 2013: 166–177. ISBN 978–80–904731–7-1.
Mandviwala T, Khalid U, Deswal A. Obesity and Cardiovascular Disease: a Risk Factor or a Risk Marker? Curr Atheroscler Rep 2016; 18(5): 21. Dostupné z DOI: <http://dx.doi.org/10.1007/s11883–016–0575–4>.
Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism 2019; 92: 98–107. Dostupné z DOI: <http://dx.doi.org/10.1016/j.metabol.2018.10.011>.
Lim S, Quon MJ, Koh KK. Modulation of adiponectin as a potential therapeutic strategy. Atherosclerosis 2014; 233(2): 721–728. Dostupné z DOI: <http://dx.doi.org/10.1016/j.atherosclerosis.2014.01.051>.
Quercioli A, Pataky Z, Montecucco F et al. Coronary vasomotor control in obesity and morbid obesity: contrasting flow responses with endocannabinoids, leptin, and inflammation. JACC Cardiovasc Imaging 2012; 5(8): 805–815. Dostupné z DOI: <http://10.1016/j.jcmg.2012.01.020>.
Kim SH, Despres JP, Kon KK. Obesity and cardiovascular disease: friend or foe? Eur Heart J 2016; 37(48): 3560–3568. Dostupné z DOI: <http://10.1093/eurheartj/ehv509>.
Fábryová Ľ. Aterogénna dyslipidémia – nový cieľ v kardiovaskulárnej prevencii. AtheroRev 2016; 1(3): 126–137.
Chapman MJ, Ginsberg HN, Amarenco P et al. [European Atherosclerosis Society Consensus Panel]. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: eveidence and guidance for management. Eur Heart J 2011; 32(11): 1345–61. Dostupné z DOI: http://dx.doi.org/10.1093/eurheartj/ehr112>.
Mach F, Baigent C, Chapman Catapano AL et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. [The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)]. Eur Heart J 2019: ehz455. Dostupné z DOI: <https://doi.org/10.1093/eurheartj/ehz455>.
Fábryová Ľ. Adipozopatická dyslipidémia. In: Fábryová Ľ, Holéczy P (eds). Diabezita. Diabetes a obezita: nerozlučné dvojičky. Facta Medica, Brno 2019: 209–223. ISBN 9788088056096.
Murín J. Diabezita a srdcové zlyhávanie. In: Fábryová Ľ, Holéczy P (eds). Diabezita. Diabetes a obezita: nerozlučné dvojičky. Facta Medica, Brno 2019: 183–187. ISBN 9788088056096.
Elagizi A, Kachur S, Milani V et al. An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Prog Cardiovasc Dis 2018; 61(2): 142–150. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pcad.2018.07.003>.
Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.
Zelniker TA, Wiviott S, Raz et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcomes trial. Lancet 2019; 393(10166): 31–39. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(18)32590-X>.
Bastien M. Poirier P, Lemieux I et al. Overview of Epidemiology and Contribution of Obesity to Cardiovascular Disease. Prog Cardiovasc Dis 2014; 56(4):369–381. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pcad.2013.10.016>.
Velazquez A, Apovian CM. Updates on obesity pharmacotherapy. Ann N Y Acad Sci 2018; 1411(1): 106–119. Dostupné z DOI: <http://dx.doi.org/10.1111/nyas.13542>.

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Article was published in

Forum Diabetologicum

2019 Issue 3