Position paper of the European Society of Cardiology-working group of coronary pathophysiology andmicrocirculation: obesity and heart disease
Position paper of the European Society of Cardiology-working group of coronary pathophysiology andmicrocirculation: obesity and heart disease
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DOI：
10.1093/eurheartj/ehx181
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发表时间：
2017-07-01
影响因子：
39.3
通讯作者：
Koller, Akos
中科院分区：
文献类型：
--
作者：
Badimon, Lina;Bugiardini, Raffaele;Koller, Akos
肥胖症的流行被认为是当今世界面临的最重要的公共卫生问题之一。根据2014年世界卫生组织（WHO）的数据，全球139%的成年人超重（身体质量指数，BMI>_25kg/m2），13%的成年人肥胖（BMI> _30kg/m2）。因此，全世界超过5亿成年人被归类为肥胖。肥胖症的流行率因地理区域、性别和收入水平而异。患病率最高的是美国（61%超重，27%肥胖），紧随其后的是欧洲（59%超重，23%肥胖），患病率最低的是东南亚（22%超重，5%肥胖）。在欧洲，绝大多数国家的超重率超过60%。1亚洲人的身体脂肪百分比通常高于相同年龄，性别和BMI的白人。即使低于BMI= 25 kg/m2的通常临界值，亚洲人患2型糖尿病的风险似乎也会增加。2这可能对肥胖诊断标准有影响。事实上，世卫组织在亚洲人群中提出的最佳BMI临界值似乎因种族背景而异，范围为22至25 kg/m2。亚洲印度人肥胖、腹部肥胖和代谢综合征诊断共识声明建议以下BMI截止值：正常BMI= 18.0-22.9 kg/m2;超重= 23.0-24.9 kg/m2;肥胖> 25 kg/m2。3因此，统一的BMI临界值是否可以在全球范围内用于诊断肥胖和/或心血管风险分层，确实存在争议。使用额外的人体测量，如腰围或基于CT的腹部/皮下脂肪体积定量，可以帮助更好地描述肥胖和风险参数，并在每个特定的种族情况下实施预防肥胖的策略。见在线补充材料，附录。
The epidemic of obesity is recognized as one of the most important public health problems facing the world today. According to 2014 World Health Organization (WHO) data, 1 39% of adults worldwide are overweight (body mass index, BMI> _ 25 kg/m2) and 13% of adults are obese (BMI> _30kg/m2). Thus, more than half a billion adults worldwide are classified as obese. The prevalence of obesity varies by geographical region, gender and income level. The highest prevalence is found in the USA (61% overweight, 27% obese), closely followed by Europe (59% overweight, 23% obese), with the lowest prevalence in South–East Asia (22% overweight, and 5% obese). In Europe, the vast majority of countries have an overweight prevalence of more than 60%. 1 Asians generally have a higher percentage of body fat than Caucasians of the same age, sex and BMI. Even below the usual cut-off of BMI= 25 kg/m2 Asian people seem to be at increased risk for type 2 diabetes. 2 This may have implications for obesity diagnostic criteria. Indeed, the proposed optimal BMI cut-off values by WHO in Asian populations seems to vary from 22 to 25 kg/m2 based on the ethnic background. A Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians has suggested the following BMI cut-off values: normal BMI= 18.0–22.9 kg/m2; overweight= 23.0–24.9 kg/m2; and obesity> 25kg/m2. 3 Thus it is indeed debatable whether uniform BMI cut-off values to diagnose obesity and/or for cardiovascular risk stratification purposes can be use worldwide. The use of additional anthropometric measurements eg waist-circumference or CT based quantification of abdominal/subcutaneous fat volume could help to better delineate obesity and risk parameters and to implement preventive strategies against obesity in each specific ethnic scenario. See Supplementary material online, Appendix.