МЕТАБОЛИЧЕСКИ ЗДОРОВОЕ ОЖИРЕНИЕ — ЧТО МЫ О НЕМ ЗНАЕМ?
Аннотация
Распространенность ожирения растет во всем мире. Ожирение является важным фактором риска сердечно-сосудистых заболеваний, сахарного диабета 2 типа. Однако не все пациенты с ожирением имеют неблагоприятный кардиометаболический профиль. В последнее время большое внимание уделяется концепции «метаболически здорового ожирения» (МЗО). На сегодняшний день нет единых критериев для идентификации лиц с МЗО, что затрудняет изучение этой подгруппы пациентов и проведения сравнительного анализа различных исследований. В статье представлены данные современной литературы, включающие определение, распространенность и механизмы развития МЗО, также обсуждаются потенциально протективные факторы, участвующие в развитии МЗО и последствия терапевтического воздействия на МЗО.
Об авторах
Н. И. Волкова
Ростовский государственный медицинский университет
Россия
Россия
Волкова Наталья Ивановна – доктор медицинских наук, профессор, проректор по научной работе
Ростов-на-Дону
Л. А. Ганенко
Ростовский государственный медицинский университет
Россия
Россия
Ганенко Лилия Александровна – врач-эндокринолог терапевтического отделения № 2
Ростов-на-Дону
М. И. Поркшеян
Ростовский государственный медицинский университет
Россия
Россия
Поркшеян Мария Игоревна – кандидат медицинских наук, доцент кафедры внутренних болезней № 3
Ростов-на-Дону
Список литературы
1. Non-Communicable Disease Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. // Lancet. – 2016. – V.387(10026). – P.1377–1396. doi: 10.1016/S0140-6736(16)30054-X
2. Kelly T., Yang W., Chen C.S., Reynolds K., He J. Global burden of obesity in 2005 and projections to 2030. // Int J Obes (Lond). – 2008. – V.32. – P.1431-1437. doi: 10.1038/ijo.2008.102
3. Keane E., Kearney P.M., Perry I.J., Kelleher C.C., Harrington J.M.. Trends and prevalence of overweight and obesity in primary school aged children in the Republic of Ireland from 2002–2012: a systematic review. // BMC Public Health. – 2014. – V.14.P.974. doi: 10.1186/1471-2458-14-974
4. Primeau V., Coderre L., Karelis A.D., Brochu M., Lavoie M.E., Messier V., et al. Characterizing the profile of obese patients who are metabolically healthy. // Int J Obes (Lond). – 2011. – V.35(7). – P.971-81. doi: 10.1038/ijo.2010.216
5. Jung C.H., Lee W.J., Song K.H. Metabolically healthy obesity: a friend or foe? // Korean J Intern Med. – 2017. – V.32(4). – P.611-621. doi: 10.3904/kjim.2016.259
6. Karelis, A. Metabolically healthy but obese individuals. // Lancet. – 2008. V.372(9646). – P.1281–1283. doi: 10.1016/S0140-6736(08)61531-7.
7. Wildman R.P., Muntner P., Reynolds K., McGinn A.P., Rajpathak S., Wylie-Rosett J., et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). // Arch Intern Med. – 2008. – V.168 (15). – P.1617-1624. doi:10.1001/ar
8. Roberson L.; Aneni E.; Maziak W., Agatston A., Feldman T.; RouseffM., et al. Beyond BMI: The “Metabolically healthy obese” phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality-A systematic review. // BMC Public Health – 2014. – V.14. – P.1–12.
9. Van Vliet-Ostaptchouk J.; Nuotio M.; Slagter S.; Doiron D.; Fischer K., Foco L.; et al. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: A collaborative analysis of ten large cohort studies. // BMC Endocr. Disord. – 2014. – V.14. – P. 9–22. doi: 10.1186/1472-6823-14-9
10. Phillips C.M. Metabolically healthy obesity across the life course: epidemiology, determinants, and implications. // Ann N Y Acad Sci. – 2017. – V.1391 (1). – P.85-100. Doi:1111/nyas.13230.
11. Karelis A.; Rabasa-Lhoret R. Obesity: Can inflammatory status define metabolic health? // Nat. Rev. Endocrinol. – 2013. – V.9 (12). – P.694–695. doi: 10.1038/nrendo.2013.198
12. Stefan N.; Kantartzis K.; Machann J.; Schick F.; Thamer C.; Rittig K. et al. Identification and characterization of metabolically benign obesity in humans. // Arch. Intern. Med. – 2008. – V. 168(15). – P. 1609–1616. doi: 10.1001/archinte.168.15.1609
13. Phillips CM , Dillon C., Harrington JM, McCarthy V.J., Kearney P.M., Fitzgerald A.P., et al . Defining metabolically healthy obesity: role of dietary and lifestyle factors. // PLoS One. – 2013. – V.8 (10). – P. e76188. doi:10.1371/journal.pone.0076188
14. Yoo H.K., Choi E.Y., Park E.W., Cheong Y.S., Bae R.A. Comparison of metabolic characteristics of metabolically healthy but obese (MHO) middle-aged men according to different criteria. // Korean J. Fam. Med. – 2013. – V.34(1). – P.19-26. doi: 10.4082/kjfm.2013.34.1.19
15. Velho S., Paccaud F., Waeber G., Vollenweider P., MarquesVidal P. Metabolically healthy obesity: different prevalences using different criteria. // Eur. J. Clin. Nutr. – 2010. – V. 64 (10). – P.1043–1051. doi: 10.1038/ejcn.2010.114
16. Phillips C.M. Metabolically healthy obesity across the life course: epidemiology, determinants, and implications. // Ann N Y Acad Sci. – 2017. – V.139(1). – P.85-100. doi: 10.1111/nyas.13230
17. Arsenault B.J., Lachance D., Lemieux I., Alméras N., Tremblay A., Bouchard C. et al. Visceral adipose tissue accumulation, cardiorespiratory fitness, and features of the metabolic syndrome. // Arch Intern Med. – 2007. – V.167(14). – P.15181520. doi: 10.1001/archinte.167.14.1518
18. Després J.P., Lemieux I. Abdominal obesity and metabolic syndrome. // Nature. – 2006. – V.444(7121). – P. 881-887. doi: 10.1038/nature05488
19. Kunnas T., Lahtio R., Kortelainen M.L., Kalela A., Nikkari S.T. Gln27Glu variant of Beta2-adrenoceptor gene affects male type fat accumulation in women. // Lipids Health Dis. – 2009. – V.8. – P.43. doi: 10.1186/1476-511X-8-43
20. Ferguson J.F., Phillips C.M., Tierney A.C., Pérez-Martínez P., Defoort C., Helal O. et al. Gene–nutrient interactions in the metabolic syndrome: single nucleotide polymorphisms in ADIPOQ and ADIPOR1 interact with plasma saturated fatty acids to modulate insulin resistance. // Am. J. Clin. Nutr. – 2010. – V.91(3). – P.794–801. doi: 10.3945/ajcn.2009.28255
21. Phillips C.M., Goumidi L., Bertrais S., Field M.R., Ordovas J.M., Cupples L.A., et al. Leptin receptor polymorphisms interact with polyunsaturated fatty acids to augment risk of insulin resistance and metabolic syndrome in adults. // J. Nutr. – 2010. – V.140(2). – P.238–244. doi: 10.3945/jn.109.115329
22. Kvaloy K., Holmen J., Hveem K., Holmen T.L. Genetic effects on longitudinal changes from healthy to adverse weight and metabolic status—the HUNT study. // PLoS One. -2015. – V.10(10). – P.e0139632. doi: 10.1371/journal.pone.0139632
23. Sutherland J., McKinley B., Eckel R. The metabolic syndrome and inflammation. // Metab. Syndr. Relat. Disord. – 2004. – V.2(2). – P.82–104. doi: 10.1089/met.2004.2.82
24. Karelis A.D., Faraj M., Bastard J.P., St-Pierre D.H., Brochu M., Prud’homme D. et al. The metabolically healthy but obese individual presents a favorable inflammation profile. // J Clin Endocrinol Metab. – 2005. – V.90(7). – P.4145–4150. doi: 10.1210/jc.2005-0482
25. Gomez-Ambrosi J., Catalan V., Rodriguez A., Andrada P., Ramírez B., Ibáñez P. et al. Increased cardiometabolic risk factors and inflammation in adipose tissue in obese subjects classified as metabolically healthy. // Diabetes Care. – 2014. – V.37(10). – P.2813–2821. doi: 10.2337/dc14-0937
26. Ahl S., Guenther M., Zhao S., James R., Marks J., Szabo A. et al. Adiponectin Levels Differentiate Metabolically Healthy vs Unhealthy Among Obese and Nonobese White Individuals. // J Clin Endocrinol Metab. – 2015. – V.100(11). – P.4172– 4180. doi: 10.1210/jc.2015-2765
27. Ortega F.B., Lee D.C., Katzmarzyk P.T., Ruiz J.R., Sui X., Church T.S. et al. The intriguing metabolically healthy but obese phenotype: Cardiovascular prognosis and role of fitness. // Eur. Heart J. – 2013.V.34(5). – P.389–397. doi: 10.1093/eurheartj/ehs174
28. Jennings C.L., Lambert E.V., Collins M., Joffe Y., Levitt N.S., Goedecke J.H. Determinants of insulin-resistant phenotypes in normal-weight and obese Black African women. // Obesity (Silver Spring). – 2008. – V.16(7). – P.16029. doi: 10.1038/oby.2008.233
29. Camhi S.M., Whitney Evans E., Hayman L.L., Lichtenstein A.H., Must A. Healthy eating index and metabolically healthy obesity in U.S. adolescents and adults. // Prev. Med. – 2015. – V.77. – P.23–27. doi: 10.1016/j.ypmed.2015.04.023
30. Pujia A., Gazzaruso C., Ferro Y., Mazza E., Maurotti S., Russo C. et al. Individuals with Metabolically Нealthy Overweight/Obesity Have Higher Fat Utilization than Metabolically Unhealthy Individuals. // Nutrients. – 2016. – V.8(1). – P.2. doi:10.3390/nu8010002
31. Park Y.M., Steck S.E., Fung T.T., Zhang J., Hazlett L.J., Han K. et al. Mediterranean diet and mortality risk in metabolically healthy obese and metabolically unhealthy obese phenotypes. // Int. J. Obes. – 2016. – V.40(10). – P.1541-1549. doi: 10.1038/ijo.2016.114
32. Phillips C.M., Perry I.J. Does inflammation determine metabolic health status in obese and nonobese adults? // J Clin Endocrinol Metab. – 2013. – V.98(10). – P.E1610–E1619. doi: 10.1210/jc.2013-2038
33. Flint H.J., Scott K.P., Louis P., Duncan S.H. The role of the gut microbiota in nutrition and health. // Nature Reviews. Gastroenterology and Hepatology. – 2012. – V.9(10). – P.577– 589. doi:10.1038/nrgastro.2012.156
34. Aung K., Lorenzo C., Hinojosa M.A., Haffner S.M. Risk of developing diabetes and cardiovascular disease in metabolically unhealthy normal-weight and metabolically healthy obese individuals. // J Clin Endocrinol Metab. – 2014. – V.99(2). – P.462–468. doi: 10.1210/jc.2013-2832
35. Hinnouho G.M., Czernichow S., Dugravot A., Nabi H., Brunner E.J., Kivimaki M. et al. Metabolically healthy obesity and the risk of cardiovascular disease and type 2 diabetes: the Whitehall II cohort study. // Eur Heart J. – 2015. – V.36(9). – P.551–559. doi: 10.1093/eurheartj/ehu123
36. Hamer M., Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. // J. Clin. Endocrinol. Metab. – 2012. – 97(7). – P.2482–2488. doi: 10.1210/jc.2011-3475
37. Flint A.J., Hu F.B., Glynn R.J., Caspard H., Manson J.E., Willett W.C. et al. Excess weight and the risk of incident coronary heart disease among men and women. // Obesity (Silver Spring). – 2010. – V.18(2). – P. 377–383. doi: 10.1038/oby.2009.223 38.
38. Kang Y.M., Jung C.H., Jang J.E., Hwang J.Y., Kim E.H., Park J.Y. et al. The association of incident hypertension with metabolic health and obesity status: definition of metabolic health does not matter. // Clin Endocrinol (Oxf). – 2016. – V.85(2). – P.207–215. doi: 10.1111/cen.13074
39. Arnlov J., Sundstrom J., Ingelsson E., Lind L. Impact of BMI and the metabolic syndrome on the risk of diabetes in middle-aged men. // Diabetes Care. – 2011. V.34(1). – P.61–65. doi: 10.2337/dc10-0955
40. Lassale C., Tzoulaki I., MoonsK.G.M., Sweeting M., Boer J., Johnson L. et al. Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis. // European Heart Journal. -2017. ehx448. doi: 10.1093/eurheartj/ehx448
41. Zheng R., Zhou D., Zhu Y. The long-term prognosis of cardiovascular disease and all-cause mortality for metabolically healthy obesity: a systematic review and metaanalysis. // J Epidemiol Community Health. – 2016. – V.70(10). – P.1024-31. doi: 10.1136/jech-2015-206948
42. Hashimoto Y., Tanaka M., Okada H., Senmaru T., Hamaguchi M., Asano M. et al. Metabolically healthy obesity and risk of incident CKD. // Clin J Am Soc Nephrol – 2015. – V.10(4). – P.578–583. doi: 10.2215/CJN.08980914
43. Chang Y., Ryu S., Choi Y., Zhang Y., Cho J., Kwon M.J. et al. Metabolically healthy obesity and development of chronic kidney disease: a cohort study. // Ann Intern Med – 2016. – V.164(5). – P.305–312. doi: 10.7326/M15-1323
44. Janiszewski P.M., Ross R. Effects of weight loss among metabolically healthy obese men and women. // Diabetes Care. – 2010. – V.33(9). – P.1957–1959. doi: 10.2337/dc10-0547
45. Kantartzis K., Machann J., Schick F., Rittig K., Machicao F., Fritsche A., et al. Effects of a lifestyle intervention in metabolically benign and malign obesity. // Diabetologia. – 2011. – V.54(5). – P.864–868. doi: 10.1007/s00125-010-2006-3
46. Shin M.J., Hyun Y.J., Kim O.Y., Kim J.Y., Jang Y., Lee J.H. Weight loss effect on inflammation and LDL oxidation in metabolically healthy but obese (MHO) individuals: low inflammation and LDL oxidation in MHO women. // Int J Obes (London). – 2006. – V.30(10). – P.1529–1534. DOI: 10.1038/ sj.ijo.0803304
47. Karelis A.D., Messier V., Brochu M., Rabasa-Lhoret R. Metabolically healthy but obese women: effect of an energy-restricted diet. // Diabetologia. – 2008. – V.51(9). – P.1752-4. doi: 10.1007/s00125-008-1038-4
48. Liu R.H., Wharton S., Sharma A.M., Ardern C.I., Kuk J.L. Influence of a clinical lifestyle-based weight loss program on the metabolic risk profile of metabolically normal and abnormal obese adults. // Obesity (Silver Spring) – 2013. – V.21(8). – P.1533–1539. doi: 10.1002/oby.20219
49. Dalleck L.C., Van Guilder G.P., Richardson T.B., Bredle D.L., Janot J.M. A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype. // Diabetes Metab. Syndr. Obes. – 2014. – V.7. – P.369–380. doi: 10.2147/DMSO. S67441
50. Soriguer F., Gutiérrez-Repiso C., Rubio-Martín E., GarcíaFuentes E., Almaraz M.C., Colomo N., et al. Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study. // J Clin Endocrinol Metab – 2013. – V.98(6). – P.2318–2325. doi: 10.1210/jc.2012-4253
51. Li S., Chen W., Srinivasan S.R., Xu J., Berenson G.S. Relation of childhood obesity/cardiometabolic phenotypes to adult cardiometabolic profile: the Bogalusa Heart Study. // Am. J. Epidemiol. – 2012. – V.176(7). – P.S142–S149. doi: 10.1093/aje/kws236
52. Appleton S.L., Seaborn C.J., Visvanathan R., Hill C.L., Gill T.K., Taylor A.W. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. // Diabetes Care. – 2013. – V.36(8). – P.2388– 2394. doi: 10.2337/dc12-1971
53. Eshtiaghi R., Keihani S., Hosseinpanah F., Barzin M., Azizi F. Natural course of metabolically healthy abdominal obese adults aft er 10 years of follow-up: the Tehran Lipid and Glucose Study. // Int. J. Obes. – 2015. – V.39(3). – P.514–519. doi: 10.1038/ijo.2014.176
54. Hamer M., Bell J.A., Sabia S., Batty G.D., Kivimäki M. Stability of metabolically healthy obesity over 8 years: the English Longitudinal Study of Ageing. // Eur. J. Endocrinol. – 2015. – V.173(5). – P.703–708. doi: 10.1530/EJE-15-0449
55. Schröder H., Ramos R., Baena-Díez J.M., Mendez M.A., Canal D.J., Fíto M. et al. Determinants of the transition from a cardiometabolic normal to abnormal overweight/obese phenotype in a Spanish population. // Eur J Nutr. – 2014. – V.53(6). – P.1345–1353. doi: 10.1007/s00394-013-0635-2
56. Bluher M. The distinction of metabolically ‘healthy’ from ‘unhealthy’ obese individuals. // Curr Opin Lipidol. – 2010. – V.21(1). – P.38–43. doi: 10.1097/MOL.0b013e3283346ccc
57. Волкова Н.И., Поркшеян М.И., Гюльмагомедова А.Н. Лечение ожирения: история взлетов и падений. // Медицинский вестник Юга России. – 2015. – №1. – С.21-26. doi: 10.21886/2219-8075-2015-1-21-26
58. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Bethesda (MD): National Heart, Lung, and Blood Institute; 1998.
Рецензия
Для цитирования:
Волкова Н.И., Ганенко Л.А., Поркшеян М.И. МЕТАБОЛИЧЕСКИ ЗДОРОВОЕ ОЖИРЕНИЕ — ЧТО МЫ О НЕМ ЗНАЕМ? Медицинский вестник Юга России. 2017;8(3):6-16. https://doi.org/10.21886/2219-8075-2017-8-3-6-16
For citation:
Volkova N.I., Ganenko L.A., Porksheyan M.I. METABOLIC HEALTHY OBESITY, WHAT DO WE KNOW ABOUT IT? Medical Herald of the South of Russia. 2017;8(3):6-16. (In Russ.) https://doi.org/10.21886/2219-8075-2017-8-3-6-16
Просмотров: 541
Послать статью по эл. почте 
