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Ожирение как предиктор сердечно-сосудистых заболеваний: роль локальных жировых депо
Ожирение как предиктор сердечно-сосудистых заболеваний: роль локальных жировых депо
Азимова М.О., Блинова Н.В., Жернакова Ю.В., Чазова И.Е. Ожирение как предиктор сердечно-сосудистых заболеваний: роль локальных жировых депо. Системные гипертензии. 2018; 15 (3): 39–43. DOI: 10.26442/2075-082X_2018.3.39-43
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Аннотация
В настоящее время отмечается неуклонный рост распространенности ожирения во всем мире. Известно, что именно висцеральное ожирение ассоциировано с высоким риском сердечно-сосудистых заболеваний и осложнений, однако доступные методы его верификации неточно отражают истинный объем висцеральной жировой ткани. В обзоре обсуждается значение локальных жировых депо как фактора риска сердечно-сосудистых заболеваний и раненного маркера поражения органов-мишеней у больных с ожирением. Рассматривается вариант использования толщины эпикардиального жира, оцениваемый методом эхокардиографии, как аналог окружности талии для более точной оценки наличия висцерального ожирения в рутинной практике.
Ключевые слова: ожирение, висцеральный эктопический жир, локальные жировые депо, эпикардиальная жировая ткань, паранефральная жировая ткань, сердечно-сосудистые заболевания.
Key words: obesity, visceral ectopic fat, localized fat depot, epicardial adipose tissue, paranephral adipose tissue, cardiovascular disease.
Ключевые слова: ожирение, висцеральный эктопический жир, локальные жировые депо, эпикардиальная жировая ткань, паранефральная жировая ткань, сердечно-сосудистые заболевания.
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Key words: obesity, visceral ectopic fat, localized fat depot, epicardial adipose tissue, paranephral adipose tissue, cardiovascular disease.
Полный текст
Список литературы
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39. Iacobellis G, Ribaudo M, Assael F et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 2003, 88 (11): 5163–8.
2. Ogden CL, Carroll MD, Lawman HG et al. Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA 2016; 315: 2292–9. DOI: 10.1001/jama.2016.6361
3. Ng M, Fleming T, Robinson M et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013, a systematic analysis for the global burden of Disease Study 2013. Lancet 2014; 384: 766–81. DOI: 10.1016/S0140-6736(14)60460-8
4. Global Health Observatory Data Repository. Report WHO [Internet]. Geneva: World Health Organization, 2013 [cited 2015 Feb 12].
5. Efremova Yu.E., Oshchepkova E.V., Zhernakova Yu.V. et al. Cardiovascular risk factors in people with high normal blood pressure in Russian population (based on data obtained in ESSE-RF epidemiological study). Systemic Hypertension. 2017; 14 (1): 6–11. [in Russian]
6. Preventing and Managing the Global Epidemic of Obesity. Report of a WHO Consultation on Obesity. Geneva: WHO Technical report Series, 1997.
7. Flegal KM, Kit BK, Orpana H et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013; 309 (1): 71–82.
8. Gami AS, Witt BJ, Howard DE et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007; 49: 403–14.
9. Hubert HB, Feinleib M, McNamara PM et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham heart study. Circulation 1983; 67: 968–77.
10. Da naei G, Lu Y, Singh GM et al. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. Lancet Diabetes Endocrinol 2014; 2 (8): 634–47. DOI: 10.1016/S2213-8587 (14)70102-0
11. Wassertheil-Smoller S, Fann C, Allman RM et al. Relation of low body mass to death and stroke in the systolic hypertension in the elderly program. The SHEP Cooperative Research Group. Arch Intern Med 2000; 160 (4): 494–500.
12. Romero-Corral A, Montori VM, Somers VK et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet 2006; 368 (9536): 666–78.
13. Rakel D. Integrative Medicine – E-Book. Elsevier Health Sciences, 2017.
14. Zhernakova Yu.V., Chazova I.E., Oshchepkova E.V. et al. The prevalence of diabetes mellitus in population of hypertensive patients according to ESSE RF study results. Systemic Hypertension. 2018; 15 (1): 56–62. DOI: 10.26442/2075-082X_15.1.56-62 [in Russian]
15. Cornier MA, Després JP, Davis N et al. Assessing Adiposity: A Scientific Statement From the American Heart Association. Circulation 2011; 124 (18): 1996–2019. DOI: 10.1161/CIR.0b013e318233bc6a
16. Butorova E.A., Elfimova E.M., Shariya M.A. i dr. Vozmozhnosti magnitno-rezonansnoj tomografii v ocenke myagkih tkanej vokrug verhnih dyhatelnyh putej u bolnyh s ozhireniem i sindromom obstruktivnogo apnoe vo vremya sna. Vestn. rentgenologii i radiologii. 2017; 98 (2): 79–85. https: //doi.org/10.20862/0042-4676-2017-98-2-79-85 [in Russian]
17. Santanasto AJ, Goodpaster BH, Kritchevsky SB. Body Composition Remodeling and Mortality: The Health Aging and Body Composition Study Journals of Gerontology: Medical Sciences cite as. J Gerontol A Biol Sci Med Sci 2017; 72 (4): 513–9. DOI: 10.1093/gerona/glw163
18. Chazova I.E., Zhernakova Yu.V., Oshepkova E.V. i dr. Rasprostranennost faktorov riska serdechno- sosudistyh zabolevanij v rossijskoj populyacii bolnyh arterialnoj gipertoniej. Kardiologiya. 2014; 54 (10): 4–10. DOI: https://dx.doi.org/10.18565/cardio.2014.10.4-12
19. Yui H, Otagiri K, Nakamura C еt al. Impact of gender difference on abdominal fat accumulation and coronary artery disease severity stratified by computed tomography-derived SYNTAX score. Eur Heart J 2017.
20. Starodubova A.V., Kislyak O.A. Ozhirenie kak faktor riska serdechno-sosudistyh zabolevanij. Obzor literatury. Farmateka. 2015; 17 (310): 28–35. [in Russian]
21. Xia N, Li H. The role of perivascular adipose tissue in obesity-induced vascular dysfunction. Br J Pharmacol 2017; 174 (20): 3425–42. DOI: 10.1111/bph.13650
22. Fernández-Alfonso MS, Gil-Ortega M, García-Prieto CF et al. Mechanisms of Perivascular Adipose Tissue Dysfunction in Obesity. Int J Endocrinol 2013; 2013: 1–8. DOI: 10.1155/2013/402053
23. Narayan KM, Boyle JP, Geiss LS et al. Impact of recent increase in incidence on future diabetes burden: U.S. 2005–2050. Diabetes Care 2006; 29 (9): 2114–6.
24. Kopelman P.G. Obesity as a medical problem. Nature 2000; 404 (6778): 635–43.
25. Montani JP, Carroll JF, Dwyer TM et al. Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Dis 2004; 28 (Suppl. 4): S58–65. DOI: 10.1038/sj.ijo.0802858
26. Axelsson J, Moller HJ, Witasp A et al. Changes in fat mass correlate with changes in soluble sCD163, a marker of mature macrophages, in patients with CKD. Am J Kidney Dis 2006; 48: 916–25.
27. Kurella M, Luan J, Lash JP et al. Self-assessed sleep quality in chronic kidney disease. Int Urol Nephrol 2005; 37 (1): 159–65. DOI: 10.1007/s11255-004-4654-z
28. Knight SF, Imig JD. Obesity, insulin resistance, and renal function. Microcirculation 2007; 14: 349–62.
29. Iacobellis G. Epicardial and pericardial fat: close, but very different. Obesity 2009; 17: 625.
30. Owan TE, Redfield MM. Epidemiology of diastolic heart failure. Prog Cardiovasc Dis 2005; 47: 320–32.
31. Kossaify A, Nicolas N. Impact of overweight and obesity on left ventricular diastolic function and value of tissue Doppler echocardiography. Clin Med Insights Cardiol 2013; 7: 43–50.
32. Hatem SN, Sanders P. Epicardial adipose tissue and atrial fibrillation. Cardiovasc Res 2014; 102: 205–13.
33. Mahmood SS, Levy D, Vasan RS et al. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet 2014; 383 (9921): 999–1008. DOI: 10.1016/S0140-6736 (13)61752-3
34. Mazurek T, Zhang LF, Zalewski A et al. Human epicardial adipose tissue is a source of inflammatory markers. Circulation 2003; 108: 2460–6.
35. Baker AR, Silva NF, Quinn DW et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabet 2006; 5: 1.
36. Hirata Y, Tabata M, Kurobe H et al. Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 2011; 58: 248–55.
37. Park H, Choi S et al. Association of epicardial fat with left ventricular diastolic function in subjects with metabolic syndrome: assessment using 2 dimensional echocardiography. BMC Cardiovasc Dis 2014; 14: 3.
38. Druzhilov M.A., Beteleva Yu. E., Kuznecova T.Yu. Tolshina epikardialnogo zhira – alternativa okruzhnosti talii kak samostoyatelnyj ili vtoroj osnovnoj kriterij metabolicheskogo sindroma? Ros. kardiol. zhurn. 2014; 3 (107): 76–81. [in Russian]
39. Iacobellis G, Ribaudo M, Assael F et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 2003, 88 (11): 5163–8.
2. Ogden CL, Carroll MD, Lawman HG et al. Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA 2016; 315: 2292–9. DOI: 10.1001/jama.2016.6361
3. Ng M, Fleming T, Robinson M et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013, a systematic analysis for the global burden of Disease Study 2013. Lancet 2014; 384: 766–81. DOI: 10.1016/S0140-6736(14)60460-8
4. Global Health Observatory Data Repository. Report WHO [Internet]. Geneva: World Health Organization, 2013 [cited 2015 Feb 12].
5. Ефремова Ю.Е., Ощепкова Е.В., Жернакова Ю.В. и др. Факторы риска сердечно-сосудистых заболеваний у лиц с высоким нормальным артериальным давлением в Российской Федерации (по данным эпидемиологического исследования ЭССЕ-РФ). Системные гипертензии. 2017; 14 (1): 6–11. / Efremova Yu.E., Oshchepkova E.V., Zhernakova Yu.V. et al. Cardiovascular risk factors in people with high normal blood pressure in Russian population (based on data obtained in ESSE-RF epidemiological study). Systemic Hypertension. 2017; 14 (1): 6–11. [in Russian]
6. Preventing and Managing the Global Epidemic of Obesity. Report of a WHO Consultation on Obesity. Geneva: WHO Technical report Series, 1997.
7. Flegal KM, Kit BK, Orpana H et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013; 309 (1): 71–82.
8. Gami AS, Witt BJ, Howard DE et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007; 49: 403–14.
9. Hubert HB, Feinleib M, McNamara PM et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham heart study. Circulation 1983; 67: 968–77.
10. Da naei G, Lu Y, Singh GM et al. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. Lancet Diabetes Endocrinol 2014; 2 (8): 634–47. DOI: 10.1016/S2213-8587 (14)70102-0
11. Wassertheil-Smoller S, Fann C, Allman RM et al. Relation of low body mass to death and stroke in the systolic hypertension in the elderly program. The SHEP Cooperative Research Group. Arch Intern Med 2000; 160 (4): 494–500.
12. Romero-Corral A, Montori VM, Somers VK et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet 2006; 368 (9536): 666–78.
13. Rakel D. Integrative Medicine – E-Book. Elsevier Health Sciences, 2017.
14. Жернакова Ю.В., Чазова И.Е., Ощепкова Е.В. и др. Распространенность сахарного диабета в популяции больных артериальной гипертонией. По данным исследования ЭССЕ-РФ. Системные гипертензии. 2018. 15 (1): 56–62. DOI: 10.26442/2075-082X_15.1.56-62 / Zhernakova Yu.V., Chazova I.E., Oshchepkova E.V. et al. The prevalence of diabetes mellitus in population of hypertensive patients according to ESSE RF study results. Systemic Hypertension. 2018; 15 (1): 56–62. DOI: 10.26442/2075-082X_15.1.56-62 [in Russian]
15. Cornier MA, Després JP, Davis N et al. Assessing Adiposity: A Scientific Statement From the American Heart Association. Circulation 2011; 124 (18): 1996–2019. DOI: 10.1161/CIR.0b013e318233bc6a
16. Буторова Е.А., Елфимова Е.М., Шария М.А. и др. Возможности магнитно-резонансной томографии в оценке мягких тканей вокруг верхних дыхательных путей у больных с ожирением и синдромом обструктивного апноэ во время сна. Вестн. рентгенологии и радиологии. 2017; 98 (2): 79–85. https: //doi.org/10.20862/0042-4676-2017-98-2-79-85 / Butorova E.A., Elfimova E.M., Shariya M.A. i dr. Vozmozhnosti magnitno-rezonansnoj tomografii v ocenke myagkih tkanej vokrug verhnih dyhatelnyh putej u bolnyh s ozhireniem i sindromom obstruktivnogo apnoe vo vremya sna. Vestn. rentgenologii i radiologii. 2017; 98 (2): 79–85. https: //doi.org/10.20862/0042-4676-2017-98-2-79-85 [in Russian]
17. Santanasto AJ, Goodpaster BH, Kritchevsky SB. Body Composition Remodeling and Mortality: The Health Aging and Body Composition Study Journals of Gerontology: Medical Sciences cite as. J Gerontol A Biol Sci Med Sci 2017; 72 (4): 513–9. DOI: 10.1093/gerona/glw163
18. Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность факторов риска сердечно- сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014; 54 (10): 4–10. DOI: https://dx.doi.org/10.18565/cardio.2014.10.4-12 / Chazova I.E., Zhernakova Yu.V., Oshepkova E.V. i dr. Rasprostranennost faktorov riska serdechno- sosudistyh zabolevanij v rossijskoj populyacii bolnyh arterialnoj gipertoniej. Kardiologiya. 2014; 54 (10): 4–10. DOI: https://dx.doi.org/10.18565/cardio.2014.10.4-12
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18. Chazova I.E., Zhernakova Yu.V., Oshepkova E.V. i dr. Rasprostranennost faktorov riska serdechno- sosudistyh zabolevanij v rossijskoj populyacii bolnyh arterialnoj gipertoniej. Kardiologiya. 2014; 54 (10): 4–10. DOI: https://dx.doi.org/10.18565/cardio.2014.10.4-12
19. Yui H, Otagiri K, Nakamura C еt al. Impact of gender difference on abdominal fat accumulation and coronary artery disease severity stratified by computed tomography-derived SYNTAX score. Eur Heart J 2017.
20. Starodubova A.V., Kislyak O.A. Ozhirenie kak faktor riska serdechno-sosudistyh zabolevanij. Obzor literatury. Farmateka. 2015; 17 (310): 28–35. [in Russian]
21. Xia N, Li H. The role of perivascular adipose tissue in obesity-induced vascular dysfunction. Br J Pharmacol 2017; 174 (20): 3425–42. DOI: 10.1111/bph.13650
22. Fernández-Alfonso MS, Gil-Ortega M, García-Prieto CF et al. Mechanisms of Perivascular Adipose Tissue Dysfunction in Obesity. Int J Endocrinol 2013; 2013: 1–8. DOI: 10.1155/2013/402053
23. Narayan KM, Boyle JP, Geiss LS et al. Impact of recent increase in incidence on future diabetes burden: U.S. 2005–2050. Diabetes Care 2006; 29 (9): 2114–6.
24. Kopelman P.G. Obesity as a medical problem. Nature 2000; 404 (6778): 635–43.
25. Montani JP, Carroll JF, Dwyer TM et al. Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Dis 2004; 28 (Suppl. 4): S58–65. DOI: 10.1038/sj.ijo.0802858
26. Axelsson J, Moller HJ, Witasp A et al. Changes in fat mass correlate with changes in soluble sCD163, a marker of mature macrophages, in patients with CKD. Am J Kidney Dis 2006; 48: 916–25.
27. Kurella M, Luan J, Lash JP et al. Self-assessed sleep quality in chronic kidney disease. Int Urol Nephrol 2005; 37 (1): 159–65. DOI: 10.1007/s11255-004-4654-z
28. Knight SF, Imig JD. Obesity, insulin resistance, and renal function. Microcirculation 2007; 14: 349–62.
29. Iacobellis G. Epicardial and pericardial fat: close, but very different. Obesity 2009; 17: 625.
30. Owan TE, Redfield MM. Epidemiology of diastolic heart failure. Prog Cardiovasc Dis 2005; 47: 320–32.
31. Kossaify A, Nicolas N. Impact of overweight and obesity on left ventricular diastolic function and value of tissue Doppler echocardiography. Clin Med Insights Cardiol 2013; 7: 43–50.
32. Hatem SN, Sanders P. Epicardial adipose tissue and atrial fibrillation. Cardiovasc Res 2014; 102: 205–13.
33. Mahmood SS, Levy D, Vasan RS et al. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet 2014; 383 (9921): 999–1008. DOI: 10.1016/S0140-6736 (13)61752-3
34. Mazurek T, Zhang LF, Zalewski A et al. Human epicardial adipose tissue is a source of inflammatory markers. Circulation 2003; 108: 2460–6.
35. Baker AR, Silva NF, Quinn DW et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabet 2006; 5: 1.
36. Hirata Y, Tabata M, Kurobe H et al. Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 2011; 58: 248–55.
37. Park H, Choi S et al. Association of epicardial fat with left ventricular diastolic function in subjects with metabolic syndrome: assessment using 2 dimensional echocardiography. BMC Cardiovasc Dis 2014; 14: 3.
38. Druzhilov M.A., Beteleva Yu. E., Kuznecova T.Yu. Tolshina epikardialnogo zhira – alternativa okruzhnosti talii kak samostoyatelnyj ili vtoroj osnovnoj kriterij metabolicheskogo sindroma? Ros. kardiol. zhurn. 2014; 3 (107): 76–81. [in Russian]
39. Iacobellis G, Ribaudo M, Assael F et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 2003, 88 (11): 5163–8.
Авторы
М.О.Азимова*, Н.В.Блинова, Ю.В.Жернакова, И.Е.Чазова
ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15А
*m.azimova@doconcall.ru
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*m.azimova@doconcall.ru
ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15А
*m.azimova@doconcall.ru
________________________________________________
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*m.azimova@doconcall.ru
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