Abdominal obesity and adipocyte metabolic activity: criteria for "health" and "neutrality"
- 作者: Serdyukov D.1, Gordiyenko A.1, Sokolov D.1, Dydyshko V.1, Zhirkov I.1
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隶属关系:
- Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
- 期: 卷 23, 编号 2 (2021)
- 页面: 199-206
- 栏目: Reviews
- URL: https://journals.rcsi.science/1682-7392/article/view/71312
- DOI: https://doi.org/10.17816/brmma71312
- ID: 71312
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详细
The last decades of the late 20th and early 21st centuries have seen a rapid growth of non-infectious diseases such as abdominal obesity, prehypertension, hypertension, diabetes mellitus type 2. According to official data, preobesity is diagnosed in 40.1% of the adult population of Russia; 21.6% of Russians are obese; and only 36.3% of our fellow citizens have normal body weight. The combination of obesity, hypertension, diabetes mellitus type 2 and atherogenic dyslipidemia are the criteria for metabolic syndrome — a proven risk factor for progression and complicated course of cardiovascular disease. The scientific community is actively discussing about the appropriateness of singling out a group of patients with “metabolically healthy” obesity and criteria for its diagnosis, but the hormonal activity of adipose tissue is not evaluated. Leptin is involved in the metabolism of glucose and fatty acids, and leptinresistance is an important prognostic marker of the complicated obesity. On the based of our own scientific data results, the concept of “metabolically neutral” obesity - obesity with normal adipokines activity (leptin concentration < 3.5 ng/ml) without signs of insulinresistance was formulated and proposed. It was shown that in this metabolic type of obesity the prevalence of dyslipidemia was 1.7 times, prediabetes — 2 times, atherosclerosis of common carotid arteries — 1.5 times lower than in “metabolically healthy” obesity. Determining the level of leptin in uncomplicated obesity allows stratifying patients into groups with normal and increased adipokines activity. The highlighting of the “metabolically neutral” type of obesity is considered by us to be practically justified, as it allows to determine the stage of the disease at which the frequency of metabolic and cardiovascular disorders is still minimal and non-drug prevention is necessary. Exceeding the threshold of leptin level > 3.5 ng/ml in obesity may require a more aggressive lifestyle correction, and possibly an early start to drug therapy.
作者简介
Dmitry Serdyukov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
编辑信件的主要联系方式.
Email: serdukovdu@yandex.ru
ORCID iD: 0000-0002-3782-1289
SPIN 代码: 1870-8698
doctor of medical sciences
俄罗斯联邦, Saint PetersburgAlexander Gordiyenko
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: gord503@mail.ru
ORCID iD: 0000-0002-6901-6436
SPIN 代码: 5049-3501
doctor of medical sciences, professor
俄罗斯联邦, Saint PetersburgDaniil Sokolov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: serdukovdu@yandex.ru
ORCID iD: 0000-0002-9385-6144
resident
俄罗斯联邦, Saint PetersburgVladislav Dydyshko
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: serdukovdu@yandex.ru
ORCID iD: 0000-0002-0244-8672
candidate of medical sciences
俄罗斯联邦, Saint PetersburgIgor Zhirkov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: igor1403@mail.ru
candidate of medical sciences
俄罗斯联邦, Saint Petersburg参考
- Cardiovascular prevention 2017: Russian national guidelines. Russian Journal of Cardiology. 2018;(6 suppl. 2):40–64. (In Russ.). doi: 10.15829/1560-4071-2018-6-7-122
- National clinical recommendations for diagnosis, treatment, obesity prevention and associated diseases. St. Petersburg; 2017. (In Russ.).
- Kryukov EV, Makeeva TG, Potekhin NP, et al. Profilactica remodelirovaniya sosudistoiy stenki u lits s predgipertenzieiy. Voenno-meditsyinskiy zgurnal. 2020;341(5):82–85. (In Russ.).
- Recommendations of experts of the Russian Society of Cardiology on the diagnosis and treatment of metabolic syndrome. Moscow: 2013. (In Russ.).
- Russian Statistical Yearbook. 2019: Rosstat. Мoscow; 2019. (In Russ.).
- Komova AG, Mayevskaya MV, Ivashkin VT. Printsipy effektivnoy diagnostiki diffuznykh zabolevaniy pecheni na ambulatornom etape. Rossiyskiy zhurnal gastroenterologii. gepatologii. koloproktologii. 2014;24(6):36–41. (In Russ.).
- Nagibovich OA, Smirnova GA, Andriyanov AI, et al. Vozmozgnosti bioimpedancnogo analysiza v diagnostike ozgireniya. Vestnik Rossiiskoi Voenno-meditsyinskoy Academii. 2018;2(62):182–186. (In Russ.).
- Diabetes Canada Clinical Practice Guidelines Expert Committee; Punthakee Z, Goldenberg R, Katz P. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes. 2018;42 Suppl 1:S10–S15. doi: 10.1016/j.jcjd.2017.10.003
- Galagoudza MM, Borshchev YY, Ivanov SV. Abdominal’noe visceral’noe ozgirenie kak osnova formirovaniya metabolicheskogo syndrome. Sovremennoe sostoyanie problemyi. University therapeutic journal. 2021;2(1):30–36. (In Russ.).
- Leskova IV, Ershova EV, Nikitina EA, et al. Ozgirenie v Rossii: sovremennyiiy vzglyad pod uglom sotsial’nyih problem. Obesity and metabolism. 2019;16(1):20–26. (In Russ.). doi: 10.14341/omet9988
- Boyarinova MA, Orlov AV, Rotar OP, et al. Adipokinyi i methabolicheskoe zdorovoe ozgirenie u zgiteleiy Saint Petersburg inhabitans (ESSE-RF). Cardiology. 2016;56(8):40–45. (In Russ.). doi: 10.18565/cardio.2016.8.40-45
- Mustafina SV, Shcherbakova LV, Kozupeeva DA, et al. Rasprostranennost’ metabolicheski zdorovogo ozgireniya po dannyim epidemiologicheskogo obsledovaniya vyiborki 45–69 let g. Novosibirska. Obesity and metabolism. 2018;15(4):31–37. (In Russ.). doi: 10.14341/omet9615
- Romantsova TI, Ostrovskaya EV. Metabolicheski zdorovoe ozgirenie: protektivnyie factory, clinicheskaya znacimost’. Almanac of Clinical Medicine. 2015;1(1):75–86. (In Russ.). doi: 10.18786/2072-0505-2015-1-75-86
- Rotar O, Boyarinova M, Orlov A, et al. Metabolically healthy obese and metabolically unhealthy non-obese phenotypes in a Russian population. Eur J Epidemiol. 2017;32(3):251–254. doi: 10.1007/s10654-016-0221-z
- Lavrenova EA, Drapkina OM. Insulinoresistetnost pri ozgirenii: prichinyi i posledstviya. Obesity and metabolism. 2020;17(1):48–55. (In Russ.). doi: 10.14341/omet9759
- Ray I, Mahata SK, De RK. Obesity: An immunometabolic perspective. Front Endocrinol (Lausanne). 2016;7:157. doi: 10.3389/fendo.2016.00157
- Cui H, López M, Rahmouni K. The cellular and molecular bases of leptin and ghrelin resistance in obesity. Nat Rev Endocrinol. 2017;13(6):338–351. doi: 10.1038/nrendo.2016.222
- Chulkov VS, Vereina NK, Chulkov VS, et al. Adipokinyi, polymorphismyi genov renin-angiotenzinovoiy systemyi i porazgenie organov misheneiy u molodyih patsyientov arterial’noiy gypertenzieiy i abdominal’nyim ozgireniem. Therapy. 2019;1(26):82–86. (In Russ.).
- Ott AV, Chumakova GA, Veselovskaya NG. Znachenie leptinrezistentnosti v razvitii razlichnyih metabolicheskih fenotipov ozgireniya. Russ J Cardiol. 2016;4(132):14–18. (In Russ.). doi: 10.15829/1560-4071-2016-4-14-18
- Statsenko ME, Derevyanchenko MV. Sostoyanie magistral’nyih arteriy, sosudistyii vozrast u bol’nyih arterial’noiy gipertenzieiy: rol’ leptina i adiponektina. Russian Journal of Cardiology. 2019;24(1):7–11. (In Russ.). doi: 10.15829/1560-4071-2019-1-7-11
- Huby AC, Antonova G, Groenendyk J, et al. Adipocyte-derived hormone leptin is a direct regulator of aldosterone secretion, which promotes endothelial dysfunction and cardiac fibrosis. Circulation. 2015;132(22):2134–2145. doi: 10.1161/CIRCULATIONAHA.115.018226
- Sokolov DA, Serdyukov DYu. Characteristica lipidnogo, uglevodnogo i adipokinovogo obmena pri razlichnyih metabolicheskih tipah ozgireniya u voennosluzgashchih-muzgchin. Izvestia of the Russian Military Medical Academy. 2020;1(Suppl 1):155–158. (In Russ.).
- Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke Statistics-2019 update: A Report From the American Heart Association. Circulation. 2019;139(10):e56–e528. Corrected and republished from: Circulation. 2020;141(2):e33. doi: 10.1161/CIR.0000000000000659
- Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323. doi: 10.1093/eurheartj/ehz486