The associations between obesity, adipose tissue distribution and disease.
The associations between obesity, adipose tissue distribution and disease.
复制标题
肥胖、脂肪组织分布与疾病之间的关联。
DOI：
10.1111/j.0954-6820.1987.tb05935.x
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
P. Björntorp
中科院分区：
文献类型：
--
作者：
P. Björntorp
最近的研究表明，腹部肥胖与臀股肥胖在与疾病的关系上存在显著差异。本综述系统分析了肥胖（身体质量指数，BMI）或腹部肥胖（腰臀比增加）与许多疾病终点及其危险因素之间的关系，以及其他因素，腰臀比与心血管疾病、过早死亡、中风、非胰岛素依赖型糖尿病和女性癌相关。相反，BMI与心血管疾病、过早死亡和中风呈负相关，但与糖尿病呈正相关。这些终点的既定危险因素被发现与腰宽比相关，而BMI通常并非如此。BMI仅与胰岛素、甘油三酯和血压呈正相关。与糖尿病一起，这似乎构成了代谢组的条件，因此与BMI有关。雄激素（女性），或许还有皮质醇，似乎与腰宽比呈正相关，而黄体酮与腰宽比呈负相关。WHR还与病假、几种心理失调、心身疾病和精神疾病呈正相关。人们试图解释这些发现。在第一种选择中，腹部脂肪组织产生的FFA浓度升高被认为是与腹部脂肪分布相关的病理畸变的触发因素。如果再加上肥胖，代谢异常可能会被夸大。在第二个备选方案中，肾上腺皮质过度活跃被认为是病因。当结合FFA假说时，这可能解释了许多但不是全部的发现。在灵长类动物中，通过定义实验压力似乎可以产生几乎相同的综合征。研究发现，WHR高的女性在应对压力方面有很多症状。因此，有人认为这种综合征的部分背景可能是下丘脑觉醒综合征随着压力而发展。结论肥胖和腹部脂肪组织分布是两个独立的实体，具有不同的发病机制、临床后果和可能的治疗方法。
Recent research has shown the marked differences in association with disease between obesity localized to the abdominal respectively to the gluteal-femoral regions. In this review systematic analyses were performed of the associations between obesity (body mass index, BMI) or abdominal obesity (increased waist-over-hip circumference ratio, WHR) on the one hand, and a number of disease end points, and their risk factors, as well as other factors on the other, WHR was associated with cardiovascular disease, premature death, stroke, non-insulin-dependent diabetes mellitus and female carcinomas. In contrast, BMI tended to be negatively correlated to cardiovascular disease, premature death, and stroke, but positively to diabetes. The established risk factors for these end points were found to correlate to WHR, while this was often not the case with BMI. BMI was positively correlated only to insulin, triglycerides and blood pressure. Together with diabetes mellitus, this seems to constitute a metabolic group of conditions which are thus associated with BMI. Androgens (in women), and perhaps cortisol, seem to be positively, and progesterone negatively correlated to WHR. The WHR was also positively associated with sick leave, several psychological maladjustments, psychosomatic and psychiatric disease. Attempts were made to interpret these findings. In a first alternative an elevation of FFA concentration, produced from abdominal adipose tissue, was considered to be the trigger factor for the pathologic aberrations associated with abdominal distribution of body fat. When obesity is added, the metabolic aberrations may be exaggerated. In a second alternative adrenal cortex hyperactivity was tested as the cause. When combined with the FFA hypothesis, this might explain many but not all of the findings. It seems possible to produce an almost identical syndrome in primates by defined experimental stress. Women with high WHR were found to have a number of symptoms of poor coping to stress. It was therefore suggested that part of the background to this syndrome might be a hypothalamic arousal syndrome developing with stress. It was concluded that obesity and abdominal distribution of adipose tissue constitute two separate entities with different pathogenesis, clinical consequences and probably treatment.
影响因子：
15.9
作者：
FERRANNINI, E;BARRETT, EJ;DEFRONZO, RA
通讯作者：
DEFRONZO, RA
影响因子：
37.8
作者：
BARRETTCONNOR, E;KHAW, KT
通讯作者：
KHAW, KT
影响因子：
5.8
作者：
EVANS, DJ;HOFFMANN, RG;KISSEBAH, AH
通讯作者：
KISSEBAH, AH