«Парадокс ожирения» и степень его доказанности
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Miklisanskaya S.V., Mazur N.A., Solomasova L.V., Chigineva V.V. The "obesity paradox" and its degree of proof. Therapeutic Archive. 2020; 92 (4): 84–90. DOI: 10.26442/00403660.2020.04.000421
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Ключевые слова: «парадокс ожирения», индекс массы тела, факторы риска, сердечно-сосудистые заболевания, группы сравнения, курение.
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The article gives a critical assessment of the so-called "obesity paradox". Methodological errors that occur in the organization of studies that studied the "obesity paradox" and the formation of comparison groups are highlighted. There are also examples of the disappearance of the "obesity paradox" when taking into account additional risk factors. The organization of prospective studies or more careful consideration of all currently known risk factors for cardiovascular diseases (CVD) will significantly improve the results of the study of the effect of overweight and obesity on mortality in patients with CVD. Thus, despite the biological possibility of the existence of a positive effect of adipose tissue in CVD, the presence of a large number of errors identified in the analysis of the work of researchers "obesity paradox" require to reconsider the existence of this phenomenon, it should be taken into account the possibility that the "obesity paradox" may be a consequence of improper design studies to investigate this phenomenon.
Key words: "obesity paradox", body mass index, risk factors, cardiovascular diseases, comparison groups, smoking.
2. Lavie CJ, Sharma A, Alpert MA, et al. Update on obesity and obesity paradox in heart failure. Prog Cardiovasc Dis. 2016;58:393-400. doi: 10.1016/j.pcad.2015.12.003
3. Elagizi A, Kachur S, Lavie CJ, et al. An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Prog Cardiovasc Dis. 2018;61:142-50. doi: 10.1016/j.pcad.2018.07.003
4. Ortega FB, Sui X, Lavie CJ, Blair SN. Body mass index, the most widely used but also widely criticized index Would a criterion standard measure of total body fat be a better predictor of cardiovascular disease mortality? Mayo Clin Proc. 2016;91(4):443-55. doi: 10.1016/j.mayocp.2016.01.008
5. Lavie CJ, McAuley PA, Church TS, et al. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014;63:1345-54. doi: 10.1016/j.jacc.2014.01.022
6. Gruberg L, Weissman NJ, Waksman R, et al. The impact of obesity on the shortterm and long-term outcomes after percutaneous coronary intervention: the obesity paradox? JACC. 2002;39:578-84. doi: 10.1016/s0735-1097(01)01802-2
7. Academic Research Organization Consortium for Continuing Evaluation of Scientific Studies – Cardiovascular (ACCESS CV) Sharing Data from Cardiovascular Clinical Trials – A Proposal. N Engl J Med. 2016;375(5):407-9. doi: 10.1056/NEJMp1605260
8. Uretsky S, Messerli FH, Bangalore S, et al. Obesity paradox in patients with hypertension and coronary artery disease. Am J Med. 2007;120:863-70. doi: 10.1016/j.amjmed.2007.05.011
9. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53:1925-32. doi: 10.1016/j.jacc.2008.12.068
10. Ortega FB, Lee DC, Katzmarzyk PT, et al. The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness. Eur Heart J. 2013;34:389-97. doi: 10.1093/eurheartj/ehs174
11. Mørkedal B, Vatten LJ, Romundstad PR, et al. Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals: a prospective population based study. J Am Coll Cardiol. 2014;63:1071-8. doi: 10.1016/j.jacc.2013.11.035
12. Lavie CJ, Milani RV, Ventura HO. Disparate effects of metabolically healthy obesity in coronary heart disease and heart failure. J Am Coll Cardiol. 2014;63(11):1079-81. doi: 10.1016/j.jacc.2013.10.080
13. Oliveros E, Somers VK, Sochor O, et al. The concept of normal weight obesity. Prog Cardiovasc Dis. 2014;56:426-33. doi: 10.1016/j.pcad.2013.10.003
14. 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;368:666-78. doi: 10.1016/S0140-6736(06)69251-9
15. Lavie CJ, De Schutter A, Patel D, et al. Body composition and coronary heart disease mortality: an obesity or a lean paradox? Mayo Clin Proc. 2011;86:857-64. doi: 10.4065/mcp.2011.0092
16. McAuley PA, Artero EG, Sui X, et al. The obesity paradox, cardiorespiratory fitness, and coronary heart disease. Mayo Clin Proc. 2012;87:443-51. doi: 10.1016/j.mayocp.2012.01.013
17. Lavie CJ, De Schutter A, Patel DA, et al. Body composition and survival in stable coronary heart disease: impact of lean mass index and body fat in the “obesity paradox”. J Am Coll Cardiol. 2012;60:1374-80. doi: 10.1016/j.jacc.2012.05.037
18. Coutinho T, Goel K, Corrêa de Sá D, et al. Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data. J Am Coll Cardiol. 2011;57:1877-86. doi: 10.1016/j.jacc.2010.11.058
19. Coutinho T, Goel K, Corrêa de Sá D, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of “normal weight central obesity”. J Am Coll Cardiol. 2013;61:553-60. doi: 10.1016/j.jacc.2012.10.035
20. Azimi A, Charlot MG, Torp-Pedersen C, et al. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease. Heart. 2013;99:655-60. doi: 10.1136/heartjnl-2012-303066
21. Lavie CJ, De Schutter A, Milani RV. Is there an obesity, overweight or lean paradox in coronary heart disease? Getting to the ‘fat’ of the matter. Heart. 2013;99:596-8. doi: 10.1136/heartjnl-2012-303487
22. Lavie CJ, Milani RV, Artham SM, et al. The obesity paradox, weight loss, and coronary disease. Am J Med. 2009;122:1106-14. doi: 10.1016/j.amjmed.2009.06.006
23. De Schutter A, Lavie CJ, Milani RV. The impact of obesity on risk factors and prevalence of coronary heart disease: the obesity paradox. Prog Cardiovasc Dis. 2014;56:401-8. doi: 10.1016/j.pcad.2013.08.003
24. Lavie CJ, Alpert MA, Arena R, et al. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. J Am Coll Cardiol HF. 2013;1:93-102. doi: 10.1016/j.jchf.2013.01.006
25. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305-13. doi: 10.1056/NEJMoa020245
26. Voulgari C, Tentolouris N, Dilaveris P, et al. Increased heart failure risk in normal-weight people with metabolic syndrome compared with metabolically healthy obese individuals. J Am Coll Cardiol. 2011;58:1343-50. doi: 10.1016/j.jacc.2011.04.047
27. Alpert MA, Terry BE, Mulekar M, et al. Cardiac morphology and left ventricular function in morbidly obese patients with and without congestive heart failure and effect of weight loss. Am J Cardiol. 1997;80:736-40. doi: 10.1016/s0002-9149(97)00505-5
28. Oreopoulos A, Padwal R, Kalantar-Zadeh K, et al. Body mass index and mortality in heart failure: a meta-analysis. Am Heart J. 2008;156:13-22. doi: 10.1016/j.ahj.2008.02.014
29. Lavie CJ, Osman AF, Milani RV, Mehra MR. Body composition and prognosis in chronic systolic heart failure: the obesity paradox. Am
J Cardiol. 2003;91:891-4. doi: 10.1016/s0002-9149(03)00031-6
30. Clark AL, Chyu J, Horwich TB. The obesity paradox in men versus women with systolic heart failure. Am J Cardiol. 2012;110:77-82. doi: 10.1016/j.amjcard.2012.02.050
31. Clark AL, Fonarow GC, Horwich TB. Obesity and obesity paradox in heart failure. Prog Cardiovasc Dis. 2014;56:409-14. doi: 10.1016/j.pcad.2013.10.004
32. Lavie CJ, Sharma A, Alpert MA, et al. Update on Obesity and Obesity Paradox in Heart Failure. Prog Cardiovasc Dis. 2016;58(4):393-400. doi: 10.1016/j.pcad.2015.12.003
33. Patel DA, Lavie CJ, Milani RV, et al. Association of left ventricular geometry with left atrial enlargement in patients with preserved ejection fraction. Congest Heart Fail. 2012;18:4-8. doi: 10.1111/j.1751-7133.2011.00264.x
34. Wanahita N, Messerli FH, Bangalore S, et al. Atrial fibrillation and obesity results of a meta-analysis. Am Heart J. 2008;155:310-5. doi: 10.1016/j.ahj.2007.10.004
35. Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med. 2017;5(7):161. doi: 10.21037/atm.2017.03.107
36. Kwon Y, Kim HJ, Park S, et al. Body Mass Index-Related Mortality in Patients with Type 2 Diabetes and Heterogeneity in Obesity Paradox Studies: A Dose-Response Meta-Analysis. PLoS One. 2017;12:e0168247. doi: 10.1371/journal.pone.0168247
37. Lv W, Li S, Liao Y, et al. The ‘obesity paradox’ does exist in patients undergoing transcatheter aortic valve implantation for aortic stenosis: a systematic review and meta-analysis. Interact Cardio Vasc Thorac Surg. 2017;25:633-42. doi: 10.1093/icvts/ivx191
38. Stokes A, Preston SH. Smoking and Reverse Causation Create an Obesity Paradox in Cardiovascular Disease. Obesity. 2015;23:2485-90. doi: 10.1002/oby.21239
39. Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96-102. doi: 10.1016/j.ypmed.2014.02.003
40. Lechi A. The obesity paradox: is it really a paradox? Hypertension Eat Weight Disord. 2017;22:43-8. doi: 10.1007/s40519-016-0330-4
41. Iliodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J. 2018;39(17):1514-20. doi: 10.1093/eurheartj/ehy057
42. Khan SS, Ning H, Wilkins JT, et al. Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity. JAMA Cardiol. 2018;3(4):280-7. doi: 10.1001/jamacardio.2018.0022
43. Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96-102. doi: 10.1016/j.ypmed.2014.02.003
44. Banack H, Kaufman J. The “obesity paradox” explained. Epidemiology. 2013;24:461-2. doi: 10.1097/EDE.0b013e31828c776c
45. Ferreira I, Stehouwer CD. Obesity paradox or inappropriate study designs? Time for life-course epidemiology. J Hypertens. 2012;30:2271-5. doi: 10.1097/HJH.0b013e32835b4fe0
46. Lajous M, Bijon A, Fagherazzi G, et al. Body mass index, diabetes, and mortality in French women: explaining away a “paradox.” Epidemiology. 2014;25:10-4. doi: 10.1097/EDE.0000000000000031
47. Robinson WR, Furberg H, Banack HR. Selection bias: a missing
factor in the obesity paradox debate. Obesity. 2014;22:625.
PMID: 24738156
48. Nguyen U-SDT, Niu J, Choi HK, Zhang Y. Commentary: effect of obesity on mortality: comment on article by Banack and Kaufman. Epidemiology. 2014;25:2-3. doi: 10.1097/EDE.0000000000000010
49. Habbu A, Lakkis NM, Dokainish H. The obesity paradox: fact or fiction? Am J Cardiol. 2006;98:944-8. doi: 10.1016/j.amjcard.2006.04.039
50. Hu F. Obesity and mortality. In: Hu FB, ed. Obesity Epidemiology. New York: Oxford University Press, 2008; p. 216-33.
51. Flegal KM, Graubard BI, Williamson DF, Cooper RS. Reverse causation and illness-related weight loss in observational studies of body weight and mortality. Am J Epidemiol. 2011;173:1-9. doi: 10.1093/aje/kwq341
52. Stokes A. Using maximum weight to redefine body mass index categories in studies of the mortality risks of obesity. Popul Health Metr. 2014;12:6. doi: 10.1186/1478-7954-12-6
53. McAuley P, Beavers KM. Contribution of cardiorespiratory fitness to the obesity paradox. Prog Cardiovasc Dis. 2014;56:434-40. doi: 10.1016/j.pcad.2013.09.006
54. De Borba AT, Jost RT, Gass R, et al. The influence of active and passive smoking on the cardiorespiratory fitness of adults. Multidiscip Respir Med. 2014;9:34. doi: 10.1186/2049-6958-9-34
55. Barth RF, Maximilian Buja L, Cao L, Brodsky SV. An Obesity Paradox: Increased Body Mass Index Is Associated with Decreased Aortic Atherosclerosis. Curr Hypertens Rep. 2017;19:55. doi: 10.1007/s11906-017-0753-y
56. Kortelainen ML, Porvari K. Extreme obesity and associated cardiovascular disease verified at autopsy: time trends over 3 decades. Am J Forensic Med Pathol. 2011;32:372-7. doi: 10.1097/PAF.
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1. Lavie CJ, De Schutter A, Parto P, et al. Obesity and prevalence of cardiovascular diseases and prognosis-the obesity paradox updated. Prog Cardiovasc Dis. 2016;58:537-47. doi: 10.1016/j.pcad.2016.01.008
2. Lavie CJ, Sharma A, Alpert MA, et al. Update on obesity and obesity paradox in heart failure. Prog Cardiovasc Dis. 2016;58:393-400. doi: 10.1016/j.pcad.2015.12.003
3. Elagizi A, Kachur S, Lavie CJ, et al. An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Prog Cardiovasc Dis. 2018;61:142-50. doi: 10.1016/j.pcad.2018.07.003
4. Ortega FB, Sui X, Lavie CJ, Blair SN. Body mass index, the most widely used but also widely criticized index Would a criterion standard measure of total body fat be a better predictor of cardiovascular disease mortality? Mayo Clin Proc. 2016;91(4):443-55. doi: 10.1016/j.mayocp.2016.01.008
5. Lavie CJ, McAuley PA, Church TS, et al. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014;63:1345-54. doi: 10.1016/j.jacc.2014.01.022
6. Gruberg L, Weissman NJ, Waksman R, et al. The impact of obesity on the shortterm and long-term outcomes after percutaneous coronary intervention: the obesity paradox? JACC. 2002;39:578-84. doi: 10.1016/s0735-1097(01)01802-2
7. Academic Research Organization Consortium for Continuing Evaluation of Scientific Studies – Cardiovascular (ACCESS CV) Sharing Data from Cardiovascular Clinical Trials – A Proposal. N Engl J Med. 2016;375(5):407-9. doi: 10.1056/NEJMp1605260
8. Uretsky S, Messerli FH, Bangalore S, et al. Obesity paradox in patients with hypertension and coronary artery disease. Am J Med. 2007;120:863-70. doi: 10.1016/j.amjmed.2007.05.011
9. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53:1925-32. doi: 10.1016/j.jacc.2008.12.068
10. Ortega FB, Lee DC, Katzmarzyk PT, et al. The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness. Eur Heart J. 2013;34:389-97. doi: 10.1093/eurheartj/ehs174
11. Mørkedal B, Vatten LJ, Romundstad PR, et al. Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals: a prospective population based study. J Am Coll Cardiol. 2014;63:1071-8. doi: 10.1016/j.jacc.2013.11.035
12. Lavie CJ, Milani RV, Ventura HO. Disparate effects of metabolically healthy obesity in coronary heart disease and heart failure. J Am Coll Cardiol. 2014;63(11):1079-81. doi: 10.1016/j.jacc.2013.10.080
13. Oliveros E, Somers VK, Sochor O, et al. The concept of normal weight obesity. Prog Cardiovasc Dis. 2014;56:426-33. doi: 10.1016/j.pcad.2013.10.003
14. 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;368:666-78. doi: 10.1016/S0140-6736(06)69251-9
15. Lavie CJ, De Schutter A, Patel D, et al. Body composition and coronary heart disease mortality: an obesity or a lean paradox? Mayo Clin Proc. 2011;86:857-64. doi: 10.4065/mcp.2011.0092
16. McAuley PA, Artero EG, Sui X, et al. The obesity paradox, cardiorespiratory fitness, and coronary heart disease. Mayo Clin Proc. 2012;87:443-51. doi: 10.1016/j.mayocp.2012.01.013
17. Lavie CJ, De Schutter A, Patel DA, et al. Body composition and survival in stable coronary heart disease: impact of lean mass index and body fat in the “obesity paradox”. J Am Coll Cardiol. 2012;60:1374-80. doi: 10.1016/j.jacc.2012.05.037
18. Coutinho T, Goel K, Corrêa de Sá D, et al. Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data. J Am Coll Cardiol. 2011;57:1877-86. doi: 10.1016/j.jacc.2010.11.058
19. Coutinho T, Goel K, Corrêa de Sá D, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of “normal weight central obesity”. J Am Coll Cardiol. 2013;61:553-60. doi: 10.1016/j.jacc.2012.10.035
20. Azimi A, Charlot MG, Torp-Pedersen C, et al. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease. Heart. 2013;99:655-60. doi: 10.1136/heartjnl-2012-303066
21. Lavie CJ, De Schutter A, Milani RV. Is there an obesity, overweight or lean paradox in coronary heart disease? Getting to the ‘fat’ of the matter. Heart. 2013;99:596-8. doi: 10.1136/heartjnl-2012-303487
22. Lavie CJ, Milani RV, Artham SM, et al. The obesity paradox, weight loss, and coronary disease. Am J Med. 2009;122:1106-14. doi: 10.1016/j.amjmed.2009.06.006
23. De Schutter A, Lavie CJ, Milani RV. The impact of obesity on risk factors and prevalence of coronary heart disease: the obesity paradox. Prog Cardiovasc Dis. 2014;56:401-8. doi: 10.1016/j.pcad.2013.08.003
24. Lavie CJ, Alpert MA, Arena R, et al. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. J Am Coll Cardiol HF. 2013;1:93-102. doi: 10.1016/j.jchf.2013.01.006
25. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305-13. doi: 10.1056/NEJMoa020245
26. Voulgari C, Tentolouris N, Dilaveris P, et al. Increased heart failure risk in normal-weight people with metabolic syndrome compared with metabolically healthy obese individuals. J Am Coll Cardiol. 2011;58:1343-50. doi: 10.1016/j.jacc.2011.04.047
27. Alpert MA, Terry BE, Mulekar M, et al. Cardiac morphology and left ventricular function in morbidly obese patients with and without congestive heart failure and effect of weight loss. Am J Cardiol. 1997;80:736-40. doi: 10.1016/s0002-9149(97)00505-5
28. Oreopoulos A, Padwal R, Kalantar-Zadeh K, et al. Body mass index and mortality in heart failure: a meta-analysis. Am Heart J. 2008;156:13-22. doi: 10.1016/j.ahj.2008.02.014
29. Lavie CJ, Osman AF, Milani RV, Mehra MR. Body composition and prognosis in chronic systolic heart failure: the obesity paradox. Am
J Cardiol. 2003;91:891-4. doi: 10.1016/s0002-9149(03)00031-6
30. Clark AL, Chyu J, Horwich TB. The obesity paradox in men versus women with systolic heart failure. Am J Cardiol. 2012;110:77-82. doi: 10.1016/j.amjcard.2012.02.050
31. Clark AL, Fonarow GC, Horwich TB. Obesity and obesity paradox in heart failure. Prog Cardiovasc Dis. 2014;56:409-14. doi: 10.1016/j.pcad.2013.10.004
32. Lavie CJ, Sharma A, Alpert MA, et al. Update on Obesity and Obesity Paradox in Heart Failure. Prog Cardiovasc Dis. 2016;58(4):393-400. doi: 10.1016/j.pcad.2015.12.003
33. Patel DA, Lavie CJ, Milani RV, et al. Association of left ventricular geometry with left atrial enlargement in patients with preserved ejection fraction. Congest Heart Fail. 2012;18:4-8. doi: 10.1111/j.1751-7133.2011.00264.x
34. Wanahita N, Messerli FH, Bangalore S, et al. Atrial fibrillation and obesity results of a meta-analysis. Am Heart J. 2008;155:310-5. doi: 10.1016/j.ahj.2007.10.004
35. Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med. 2017;5(7):161. doi: 10.21037/atm.2017.03.107
36. Kwon Y, Kim HJ, Park S, et al. Body Mass Index-Related Mortality in Patients with Type 2 Diabetes and Heterogeneity in Obesity Paradox Studies: A Dose-Response Meta-Analysis. PLoS One. 2017;12:e0168247. doi: 10.1371/journal.pone.0168247
37. Lv W, Li S, Liao Y, et al. The ‘obesity paradox’ does exist in patients undergoing transcatheter aortic valve implantation for aortic stenosis: a systematic review and meta-analysis. Interact Cardio Vasc Thorac Surg. 2017;25:633-42. doi: 10.1093/icvts/ivx191
38. Stokes A, Preston SH. Smoking and Reverse Causation Create an Obesity Paradox in Cardiovascular Disease. Obesity. 2015;23:2485-90. doi: 10.1002/oby.21239
39. Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96-102. doi: 10.1016/j.ypmed.2014.02.003
40. Lechi A. The obesity paradox: is it really a paradox? Hypertension Eat Weight Disord. 2017;22:43-8. doi: 10.1007/s40519-016-0330-4
41. Iliodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J. 2018;39(17):1514-20. doi: 10.1093/eurheartj/ehy057
42. Khan SS, Ning H, Wilkins JT, et al. Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity. JAMA Cardiol. 2018;3(4):280-7. doi: 10.1001/jamacardio.2018.0022
43. Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96-102. doi: 10.1016/j.ypmed.2014.02.003
44. Banack H, Kaufman J. The “obesity paradox” explained. Epidemiology. 2013;24:461-2. doi: 10.1097/EDE.0b013e31828c776c
45. Ferreira I, Stehouwer CD. Obesity paradox or inappropriate study designs? Time for life-course epidemiology. J Hypertens. 2012;30:2271-5. doi: 10.1097/HJH.0b013e32835b4fe0
46. Lajous M, Bijon A, Fagherazzi G, et al. Body mass index, diabetes, and mortality in French women: explaining away a “paradox.” Epidemiology. 2014;25:10-4. doi: 10.1097/EDE.0000000000000031
47. Robinson WR, Furberg H, Banack HR. Selection bias: a missing
factor in the obesity paradox debate. Obesity. 2014;22:625.
PMID: 24738156
48. Nguyen U-SDT, Niu J, Choi HK, Zhang Y. Commentary: effect of obesity on mortality: comment on article by Banack and Kaufman. Epidemiology. 2014;25:2-3. doi: 10.1097/EDE.0000000000000010
49. Habbu A, Lakkis NM, Dokainish H. The obesity paradox: fact or fiction? Am J Cardiol. 2006;98:944-8. doi: 10.1016/j.amjcard.2006.04.039
50. Hu F. Obesity and mortality. In: Hu FB, ed. Obesity Epidemiology. New York: Oxford University Press, 2008; p. 216-33.
51. Flegal KM, Graubard BI, Williamson DF, Cooper RS. Reverse causation and illness-related weight loss in observational studies of body weight and mortality. Am J Epidemiol. 2011;173:1-9. doi: 10.1093/aje/kwq341
52. Stokes A. Using maximum weight to redefine body mass index categories in studies of the mortality risks of obesity. Popul Health Metr. 2014;12:6. doi: 10.1186/1478-7954-12-6
53. McAuley P, Beavers KM. Contribution of cardiorespiratory fitness to the obesity paradox. Prog Cardiovasc Dis. 2014;56:434-40. doi: 10.1016/j.pcad.2013.09.006
54. De Borba AT, Jost RT, Gass R, et al. The influence of active and passive smoking on the cardiorespiratory fitness of adults. Multidiscip Respir Med. 2014;9:34. doi: 10.1186/2049-6958-9-34
55. Barth RF, Maximilian Buja L, Cao L, Brodsky SV. An Obesity Paradox: Increased Body Mass Index Is Associated with Decreased Aortic Atherosclerosis. Curr Hypertens Rep. 2017;19:55. doi: 10.1007/s11906-017-0753-y
56. Kortelainen ML, Porvari K. Extreme obesity and associated cardiovascular disease verified at autopsy: time trends over 3 decades. Am J Forensic Med Pathol. 2011;32:372-7. doi: 10.1097/PAF.
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ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
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S.V. Miklisanskaya, N.A. Mazur, L.V. Solomasova, V.V. Chigineva
Russian Medical Academy of Continuous Professional Education, Moscow, Russia