心力衰竭中的肥胖悖论最新研究进展
Recent progress in obesity paradox among patients with heart failure
罗宇琦 1王洋洋 2林洁 3任骏3
作者信息
- 1. 复旦大学上海医学院(上海,200032)
- 2. 空军军医大学西京医院心内科
- 3. 复旦大学上海医学院(上海,200032);复旦大学附属中山医院心内科 上海市心血管病研究所
- 折叠
摘要
肥胖被视为心血管疾病的危险因素,而体重指数(BMI)是临床中衡量肥胖程度的重要指标.然而,大量临床研究显示,与正常体重(BMI 18.5～24.9 kg/m2)及低体重(BMI＜18.5 kg/m2)的心力衰竭患者相比,超重(BMI 25.0～29.9 kg/m2)和肥胖(BMI＞30 kg/m2)的心力衰竭患者却显示出更好的预后,这一现象被称为肥胖悖论,受到广泛的学术关注和讨论.有观点认为,传统采用BMI作为单一指标来评估肥胖可能具有局限性,并可能受到混杂因素和选择偏倚的影响.然而,大量流行病学调查显示,随着BMI指标升高,心力衰竭患者的预后得到显著改善.本文综述了肥胖悖论的影响因素、可能的发生机制以及临床意义的最新研究进展.
Abstract
Uncorrected obesity is considered as a significant independent risk factor for the ever-rising preva-lence for cardiovascular diseases.Body mass index(BMI)is a frequently employed clinical indicator for obesity.Nonetheless,clinical studies have demonstrated that heart failure patients with overweight(BMI 25.0-29.9 kg/m2)or obesity(BMI＞30 kg/m2)possess a surprisingly better prognosis compared with those patients with nor-mal weight(BMI 18.5-24.9 kg/m2)or low weight(BMI＜18.5 kg/m2).This clinical phenomenon is commonly perceived as the obesity paradox,which has drawn much attention by physicians and scientists.It has been sug-gested that conventional clinical evaluation of obesity,relying solely on BMI as a measure,may be subject to limi-tations due to the presence of confounding factors and selection bias.Nevertheless,numerous epidemiological studies have consistently demonstrated a paradoxical improvement in cardiovascular disease prognosis associated with higher BMI levels.In this review,we aim to provide an overview of the factors influencing the obesity para-dox,explore potential underlying mechanisms,and discuss its clinical implications.
关键词
肥胖悖论/心力衰竭/体重指数Key words
obesity paradox/heart failure/body mass index引用本文复制引用
出版年
2024
NETL
NSTL
万方数据