Body fat distribution: the answer to the apparent paradox of obesity in cardiology?
https://doi.org/10.14341/omet201723-8
Abstract
Today, despite all the measures taken, cardiovascular diseases remain the main cause of temporary invalidization, disability and mortality. Obesity is a major risk factor of cardiovascular diseases and complications from them. However, not all fat depots have the same proinflammatory, paracrine and metabolic activity. Recent studies have shown that the accumulation of visceral fat, and not subcutaneous fat, is associated with an increase in cardiometabolic risk. At the same time, there is evidence that an increase in the area of visceral fat is a protective mechanism against lipotoxicity. The purpose of this review is to discuss current literature data reflecting the characteristics of the visceral, epicardial and perivascular fat depots, and also their association with cardiovascular diseases.
About the Authors
Daria A. BorodkinaInstitution Research Institute for Complex Issues of Cardiovascular Diseases; "Kemerovo regional clinical hospital"
Russian Federation
MD
Competing Interests:
Автор декларирует отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Olga V. Gruzdeva
Institution Research Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State Medical University
Russian Federation
ScD
Competing Interests:
Автор декларирует отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Ludmila V. Kvitkova
Kemerovo State Medical University
Russian Federation
ScD, prof.
Competing Interests:
Автор декларирует отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Olga L. Barbarash
Institution Research Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State Medical University
Russian Federation
ScD, prof.
Competing Interests:
Автор декларирует отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
References
1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012;380(9859):2095-2128. doi: 10.1016/s0140-6736(12)61728-0.
2. Roth GA, Forouzanfar MH, Moran AE, et al. Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality. New England Journal of Medicine. 2015;372(14):1333-1341. doi: 10.1056/NEJMoa1406656.
3. Lainscak M, Blue L, Clark AL, et al. Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure. 2011;13(2):115-126. doi: 10.1093/eurjhf/hfq219.
4. Barquera S, Pedroza-Tobías A, Medina C, et al. Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease. Archives of Medical Research. 2015;46(5):328-338. doi: 10.1016/j.arcmed.2015.06.006.
5. Ford ES, Ajani UA, Croft JB, et al. Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980–2000. New England Journal of Medicine. 2007;356(23):2388-2398. doi: 10.1056/NEJMsa053935.
6. Artinian NT, Fletcher GF, Mozaffarian D, et al. Interventions to Promote Physical Activity and Dietary Lifestyle Changes for Cardiovascular Risk Factor Reduction in Adults: A Scientific Statement From the American Heart Association. Circulation. 2010;122(4):406-441. doi: 10.1161/CIR.0b013e3181e8edf1.
7. Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health. 2009;9(1). doi: 10.1186/1471-2458-9-88.
8. Куликов В. А. Фремингемское исследование сердца: 65 лет изучения причин атеросклероза // Вестник Витебского государственного медицинского университета. – 2012. – Т. 11. – №. 2. – С. 16-23. [Kulikov VA. Fremingemskoe issledovanie serdtsa: 65 let izucheniya prichin atero-skleroza. Vestnik Vitebskogo gosudarstvennogo meditsinskogo universiteta. 2012; 11(2): 16-23. (In Russ.)]
9. Brauer P, Gorber SC, Shaw E, et al. Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. Canadian Medical Association Journal. 2015;187(3):184-195. doi: 10.1503/cmaj.140887.
10. World Health Organization. Obesity: preventing and managing the global epidemic. – World Health Organization, 2000. – №. 894. available at: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/# (Ссылка активна на 01.03.2017)
11. Holley TJ, Collins CE, Morgan PJ, et al. Weight expectations, motivations for weight change and perceived factors influencing weight management in young Australian women: a cross-sectional study. Public Health Nutrition. 2015;19(02):275-286. doi: 10.1017/s1368980015000993.
12. Ohlson LO, Larsson B, Svardsudd K, et al. The Influence of Body Fat Distribution on the Incidence of Diabetes Mellitus: 13.5 Years of Follow-up of the Participants in the Study of Men Born in 1913. Diabetes. 1985;34(10):1055-1058. doi: 10.2337/diab.34.10.1055.
13. Messier V, Karelis AD, Prud’homme D, et al. Identifying Metabolically Healthy but Obese Individuals in Sedentary Postmenopausal Women. Obesity. 2009;18(5):911-917. doi: 10.1038/oby.2009.364.
14. Britton KA, Fox CS. Ectopic Fat Depots and Cardiovascular Disease. Circulation. 2011;124(24):e837-e841. doi: 10.1161/circulationaha.111.077602.
15. Lima MMO, Pareja JC, Alegre SM, et al. Visceral fat resection in humans: Effect on insulin sensitivity, beta-cell function, adipokines, and inflammatory markers. Obesity. 2013;21(3):E182-E189. doi: 10.1002/oby.20030.
16. Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism. 1987;36(1):54-59. doi: 10.1016/0026-0495(87)90063-1.
17. Sjostrom L, Kvist H, Cederblad A, Tylen U. Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium. American Journal of Physiology-Endocrinology And Metabolism. 1986;250(6):E736-E745.
18. Veilleux A, Tchernof A. Sex Differences in Body Fat Distribution. 2012:123-166. doi: 10.1007/978-1-4614-0965-6_5.
19. Ashwell M. Obesity risk: importance of the waist-to-height ratio. Nursing Standard. 2009;23(41):49-54. doi: 10.7748/ns2009.06.23.41.49.c7050.
20. Hall JE, da Silva AA, do Carmo JM, et al. Obesity-induced Hypertension: Role of Sympathetic Nervous System, Leptin, and Melanocortins. Journal of Biological Chemistry. 2010;285(23):17271-17276. doi: 10.1074/jbc.R110.113175.
21. Odegaard JI, Chawla A. Pleiotropic Actions of Insulin Resistance and Inflammation in Metabolic Homeostasis. Science. 2013;339(6116):172-177. doi: 10.1126/science.1230721.
22. Kovalik JP, Slentz D, Stevens RD, et al. Metabolic Remodeling of Human Skeletal Myocytes by Cocultured Adipocytes Depends on the Lipolytic State of the System. Diabetes. 2011;60(7):1882-1893. doi: 10.2337/db10-0427.
23. Литвинова Л.С., Василенко М.А., Затолокин П.А., и др. Роль адипокинов в регуляции метаболических процессов при коррекции ожирения // Сахарный диабет. – 2014. – №3. – С.51-59. [Litvinova LS, Vasilenko MA, Zatolokin PA, et al. Adipokines in metabolic processes regulating during obesity treatment. Diabetes mellitus. 2014;17(3):51-59. (In Russ)] doi: 10.14341/DM2014351-59
24. Könner AC, Brüning Jens C. Selective Insulin and Leptin Resistance in Metabolic Disorders. Cell Metabolism. 2012;16(2):144-152. doi: 10.1016/j.cmet.2012.07.004.
25. Отт А.В., Чумакова Г.А., Веселовская Н.Г. Значение лептинорезистентности в развитии различных метаболических фенотипов ожирения // Российский кардиологический журнал. – 2016. – №4. – С. 4-18. [Ott AV, Chumakova GA, Veselovskaya NG. A Resistance to Leptin in Development of Different Obesity Phenotypes. Russian Journal of Cardiology. 2016(4):14-18. (In Russ).] doi: 10.15829/1560-4071-2016-4-14-18
26. Бутрова С.А., Дзгоева Ф.Х. Висцеральное ожирение — ключевое звено метаболического синдрома // Ожирение и метаболизм. – 2004. – № 1. – С. 10-13. [Butrova SA, Dzgoeva FKh. Vistseral’noe ozhirenie — klyuchevoe zveno metabolicheskogo sindroma. Obesity and metabolism. 2004;1(1):10-13. (In Russ)] doi: 10.14341/2071-8713-5173
27. Anderson PJ, Chan JCN, Chan YL, et al. Visceral Fat and Cardiovascular Risk Factors in Chinese NIDDM Patients. Diabetes Care. 1997;20(12):1854-1858. doi: 10.2337/diacare.20.12.1854.
28. Despres JP. Body Fat Distribution and Risk of Cardiovascular Disease: An Update. Circulation. 2012;126(10):1301-1313. doi: 10.1161/circulationaha.111.067264.
29. Sironi AM, Petz R, De Marchi D, et al. Impact of increased visceral and cardiac fat on cardiometabolic risk and disease. Diabetic Medicine. 2012;29(5):622-627. doi: 10.1111/j.1464-5491.2011.03503.x.
30. St-Pierre J, Lemieux I, Vohl M-C, et al. Contribution of abdominal obesity and hypertriglyceridemia to impaired fasting glucose and coronary artery disease. The American Journal of Cardiology. 2002;90(1):15-18. doi: 10.1016/s0002-9149(02)02378-0.
31. Lavie CJ, Milani RV, Ventura HO. Obesity and Cardiovascular Disease. Journal of the American College of Cardiology. 2009;53(21):1925-1932. doi: 10.1016/j.jacc.2008.12.068.
32. Klöting N, Blüher M. Adipocyte dysfunction, inflammation and metabolic syndrome. Reviews in Endocrine and Metabolic Disorders. 2014;15(4):277-287. doi: 10.1007/s11154-014-9301-0.
33. Frühbeck G, Toplak H, Woodward E, et al. Obesity: The Gateway to Ill Health – an EASO Position Statement on a Rising Public Health, Clinical and Scientific Challenge in Europe. Obesity Facts. 2013;6(2):117-120. doi: 10.1159/000350627.
34. Capeau J. Insulin resistance and steatosis in humans. Diabetes & Metabolism. 2008;34(6):649-657. doi: 10.1016/s1262-3636(08)74600-7.
35. Kotronen A, Yki-Jarvinen H. Fatty Liver: A Novel Component of the Metabolic Syndrome. Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;28(1):27-38. doi: 10.1161/atvbaha.107.147538.
36. Абдулкадирова Ф. Р., Аметов А. С., Доскина Е. В., Покровская Р.А.. Роль липотоксичности в патогенезе сахарного диабета 2 типа и ожирении //Ожирение и метаболизм. – 2014. – №. 2. – С. – 8-12. [Abdulkadirova FR, Ametov AS, Doskina EV, Pokrovskaya RA. The role of the lipotoxicity in the pathogenesis of type 2 diabetes mellitus and obesity. Obesity and metabolism. 2014;11(2):8-12. (In Russ.)] doi: 10.14341/omet201428-12
37. Sung KC, Wild SH, Kwag HJ, Byrne CD. Fatty Liver, Insulin Resistance, and Features of Metabolic Syndrome: Relationships with coronary artery calcium in 10,153 people. Diabetes Care. 2012;35(11):2359-2364. doi: 10.2337/dc12-0515.
38. Gastaldelli A, Cusi K, Pettiti M, et al. Relationship Between Hepatic/Visceral Fat and Hepatic Insulin Resistance in Nondiabetic and Type 2 Diabetic Subjects. Gastroenterology. 2007;133(2):496-506. doi: 10.1053/j.gastro.2007.04.068.
39. Targher G, Zoppini G, Day CP. Risk of all-cause and cardiovascular mortality in patients with chronic liver disease. Gut. 2010;60(11):1602-1603. doi: 10.1136/gut.2010.230656.
40. Kozakova M, Palombo C, Paterni Eng M, et al. Fatty liver index, gamma-glutamyltransferase, and early carotid plaques. Hepatology. 2012;55(5):1406-1415. doi: 10.1002/hep.25555.
41. Bonapace S, Perseghin G, Molon G, et al. Nonalcoholic Fatty Liver Disease Is Associated With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes. Diabetes Care. 2011;35(2):389-395. doi: 10.2337/dc11-1820.
42. Assy N, Djibre A, Farah R, et al. Presence of Coronary Plaques in Patients with Nonalcoholic Fatty Liver Disease. Radiology. 2010;254(2):393-400. doi: 10.1148/radiol.09090769.
43. Pezeshkian M, Noori M, Najjarpour-Jabbari H, et al. Fatty Acid Composition of Epicardial and Subcutaneous Human Adipose Tissue. Metabolic Syndrome and Related Disorders. 2009;7(2):125-132. doi: 10.1089/met.2008.0056.
44. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nature Clinical Practice Cardiovascular Medicine. 2005;2(10):536-543. doi: 10.1038/ncpcardio0319.
45. Lohn M. Periadventitial fat releases a vascular relaxing factor. The FASEB Journal. 2002;16(9):1057-1063. doi: 10.1096/fj.02-0024com.
46. Yamaguchi Y, Cavallero S, Patterson M, et al. Adipogenesis and epicardial adipose tissue: A novel fate of the epicardium induced by mesenchymal transformation and PPARγ activation. Proceedings of the National Academy of Sciences. 2015;112(7):2070-2075. doi: 10.1073/pnas.1417232112.
47. Manzella D, Barbieri M, Rizzo MR, et al. Role of Free Fatty Acids on Cardiac Autonomic Nervous System in Noninsulin-Dependent Diabetic Patients: Effects of Metabolic Control. The Journal of Clinical Endocrinology & Metabolism. 2001;86(6):2769-2774. doi: 10.1210/jcem.86.6.7553.
48. Mahabadi AA, Massaro JM, Rosito GA, et al. Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. European Heart Journal. 2008;30(7):850-856. doi: 10.1093/eurheartj/ehn573.
49. Corradi D, Maestri R, Callegari S, et al. The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts. Cardiovascular Pathology. 2004;13(6):313-316. doi: 10.1016/j.carpath.2004.08.005.
50. Eroglu S, Sade LE, Yildirir A, et al. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutrition, Metabolism and Cardiovascular Diseases. 2009;19(3):211-217. doi: 10.1016/j.numecd.2008.05.002.
51. Wang C-P, Hsu H-L, Hung W-C, et al. Increased epicardial adipose tissue (EAT) volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis. Clinical Endocrinology. 2009;70(6):876-882. doi: 10.1111/j.1365-2265.2008.03411.x.
52. Романцова Т.И., Овсянникова А.В. Периваскулярная жировая ткань: роль в патогенезе ожирения, сахарного диабета 2 типа и сердечно-сосудистой патологии //Ожирение и метаболизм. – 2015. – Т. 12. – № 4. – С. 5-13. [Romantsova TI Ovsyannikovna AV. Perivascular adipose tissue: role in the pathogenesis of obesity, type 2 diabetes mellitus and cardiovascular pathology. Obesity and metabolism. 2015;12(4):5-13. (In Russ.)] doi: 10.14341/omet201545-13
53. Miao C-Y, Li Z-Y. The role of perivascular adipose tissue in vascular smooth muscle cell growth. British Journal of Pharmacology. 2012;165(3):643-658. doi: 10.1111/j.1476-5381.2011.01404.x.
54. Fitzgibbons TP, Czech MP. Epicardial and Perivascular Adipose Tissues and Their Influence on Cardiovascular Disease: Basic Mechanisms and Clinical Associations. Journal of the American Heart Association. 2014;3(2):e000582-e000582. doi: 10.1161/jaha.113.000582.
55. Brown NK, Zhou Z, Zhang J, et al. Perivascular Adipose Tissue in Vascular Function and Disease: A Review of Current Research and Animal Models. Arteriosclerosis, Thrombosis, and Vascular Biology. 2014;34(8):1621-1630. doi: 10.1161/atvbaha.114.303029.
56. Li T, Liu X, Ni L, et al. Perivascular adipose tissue alleviates inflammatory factors and stenosis in diabetic blood vessels. Biochemical and Biophysical Research Communications. 2016;480(2):147-152. doi: 10.1016/j.bbrc.2016.09.106.
57. Schlett CL, Massaro JM, Lehman SJ, et al. Novel measurements of periaortic adipose tissue in comparison to anthropometric measures of obesity, and abdominal adipose tissue. International Journal of Obesity. 2009;33(2):226-232. doi: 10.1038/ijo.2008.267.
58. Rittig K, Staib K, Machann J, et al. Perivascular fatty tissue at the brachial artery is linked to insulin resistance but not to local endothelial dysfunction. Diabetologia. 2008;51(11):2093-2099. doi: 10.1007/s00125-008-1128-3.
59. Lehman SJ, Massaro JM, Schlett CL, et al. Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: The Framingham Heart Study. Atherosclerosis. 2010;210(2):656-661. doi: 10.1016/j.atherosclerosis.2010.01.007.
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Borodkina D.A., Gruzdeva O.V., Kvitkova L.V., Barbarash O.L. Body fat distribution: the answer to the apparent paradox of obesity in cardiology? Obesity and metabolism. 2017;14(2):3-8. (In Russ.) https://doi.org/10.14341/omet201723-8
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