Contribution of obesity and cardiometabolic risk factors in developing cardiovascular disease: a population-based cohort study

Abstract

This study aims to assess the effects of central and general adiposity on development of cardiovascular diseases (CVDs) mediated by cardiometabolic risk factors and to analyze their degree of dependency for mediating their effects. To this end, data from the the Tehran Lipid and Glucose Study cohort with 6280 participants were included in this study. The hazard ratios were calculated using a 2-stage regression model in the context of a survival model. Systolic blood pressure (BP), total serum cholesterol, and fasting plasma glucose were designated as mediators. Assessing the interactions revealed that BP was the most important mediator for general ( (HRNIE: 1.11, 95% CI 1.17–1.24) and central obesity (CO) (HRNIE: 1.11, 95% CI 1.07–1.15) with 60% and 36% proportion of the effects mediated in the total population, respectively. The proportion of mediated risk for all three metabolic risk factors was 46% (95% CI 31–75%) for overweight, 66% (45–100%) for general obesity and 52% (39–87%) for central obesity. BP was the most important mediator for overweight and central obesity in men, comprising 29% and 36% of the risk, respectively. The proportion of the risk mediated through all three metabolic risk factors in women was 23% (95% CI 13–50%) for overweight, 36% (21–64%) for general obesity and 52% (39–87%) for central obesity. Based on the results of this study, cardiometabolic mediators have conciliated more than 60% of the adverse effects of high BMI on CVDs in men. Controlling the metabolic risk factors in women does not efficiently contribute to decreasing CVDs as effectively.

Type 2 Diabetes Mellitus Facilitates Shift of Adipose-Derived Stem Cells Ex Vivo Differentiation toward Osteogenesis among Patients with Obesity

“…Modern lifestyle and dietary habits dictate the new challenges for endocrinology and diabetology. Sedentary behavior with overnutrition provokes the development of obesity and consequent metabolic complications such as insulin resistance, dyslipidemia, cardiovascular diseases, and type 2 diabetes mellitus (T2DM) [ 1 , 2 ]. However, some patients with obesity do not have any metabolic abnormalities.…”

Dietary carbohydrates: Pathogenesis and potential therapeutic targets to obesity‐associated metabolic syndrome

“…The prevalence of MetS has markedly increased throughout the world over the past few decades 1 and afflicts anywhere from 10% to 84% of the population depending on age, gender, ethnicity, and lifestyle 2 . This complex disorder consists of a cluster of metabolic dysregulations including central obesity, atherogenic dyslipidemia, insulin resistance (IR), and hypertension, and is associated with an increased risk of multiple chronic diseases 2–5 . It has been demonstrated that people with MetS have a twofold increased risk of cardiovascular diseases (CVD), a fivefold increased risk of diabetes, and a 1.5‐fold increased risk of mortality in general compared to healthy individuals 3,6,7 .…”

How Unawareness of Weight Excess Can Increase Cardiovascular Risk?

“…Long-term obesity increases the risk of dyslipidemia and systemic inflammation, which could be common pathways to complications, arguably the most important of which are diabetes and vascular disease [ 7 ]. There is a link between excess abdominal fat and the risk of cardiovascular disease (CVD) and other cardiometabolic diseases [ 8 , 9 , 10 ]. Obesity and especially abdominal type of fat distribution are also associated with left ventricular dysfunction, quality of life, and a reduction in life expectancy [ 11 , 12 , 13 , 14 ].…”