Visceral Adiposity as a Global Factor of Cardiovascular Risk

Чумакова, Г. А.; Кузнецова, Т. Ю.; Дружилов, М. А.; Веселовская, Н. Г.

doi:10.15829/1560-4071-2018-5-7-14

Cited by 29 publications

(22 citation statements)

References 41 publications

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“…Наиболее изученным с точки зрения наличия взаимосвязи с сердечно-сосудистыми заболеваниями является эпикардиальное висцеральное жировое депо. В целом ряде работ была продемонстрирована ассоциация эпикардиального жира (ЭЖ) с гипертрофией и фиброзом миокарда, доклиническим снижением диастолической и систолической функции ЛЖ [7]. В связи с этим основной целью лечения ожирения является не только снижение веса, но и уменьшение риска развития сопутствующих заболеваний, увеличение продолжительности жизни.…”

Section: обоснованиеunclassified

“…На фоне приема сибутрамина в суточной дозе 10 мг в течение 1 мес было выявлено таблица 1. 2,7 . При анализе динамики этого показателя было выявлено более существенное снижение, ставшее достоверным у женщин.…”

Section: этическая экспертизаunclassified

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The experience of sibutramine administration in patients with obesity and controlled arterial hypertension

Shupenina¹,

Yushchuk²,

Vasyuk³

et al. 2019

Obes. metabol.

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BACKGROUND: Obesity is a metabolic disorder that becomes epidemic. Visceral adiposity increases the risk of arterial hypertension, diabetes mellitus and other comorbidities. According to this, the main aim of obesity treatment is not only a weight loss but also a decrease of the risk of comorbidities. AIMS: to assess the efficiency and safety of sibutramine in patients with obesity and arterial hypertension, to evaluate the drug influence on epicardial fat thickness. MATERIALS AND METHODS: 57 patients aged 35-60 with obesity and arterial hypertension were included in the study. All patients at the beginning and after 7 months of follow-up underwent complex examination including anthropometric measurement, ECG, office and ambulatory blood pressure measurement, echocardiography. Patients with controlled arterial hypertension were included. During the first month of follow-up patients were given general weight loss recommendations. Then sibutramine was added. Control visits to assess efficiency and safety of drug treatment were held after 1 and 6 months of follow-up. RESULTS: Women predominated among the study participants. Visceral adiposity was approved by anthropometric measurements among all patients. Most patients had impaired left ventricle geometry: concentric remodeling or hypertrophy. During the first month of follow-up the weight loss was mild: 2 kg (less than 2%) in average. Sibutramine for 1 month the weight loss increased: 3.7 kg (more than 2%) in average. After 6 months of drug administration the weight loss of patients consisted 8.6 kg (6.2%) in average. According to echocardiography results indexed mass of LV myocardium decreased in all patients more significantly in women. Also in this group of patients significant decrease of epicardial fat thickness was revealed. Adverse events of sibutramine were revealed in 26.3% of patients. The most frequent were constipation (12.3%) and dry mouth (10.6%). The severity of symptoms persisted for 1 month and then decreased, additional therapy was not required. CONCLUSIONS: Sibutramine treatment of obesity promotes effective weight loss, influences the adipose tissue distribution, decreases the progress of associated comorbidities. Sibutramine is an effective and safe drug that can be used in patients with visceral adiposity and controlled arterial hypertension.

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Section: обоснованиеunclassified

Section: этическая экспертизаunclassified

The experience of sibutramine administration in patients with obesity and controlled arterial hypertension

Shupenina¹,

Yushchuk²,

Vasyuk³

et al. 2019

Obes. metabol.

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“…Гетерогенность фенотипов ожирения с позиции глобального или кардиоренометаболического риска, основу которой составляют, в первую очередь, различия структурно-функциональных свойств самой жировой ткани, стала вектором формирования новой риск-стратификационной парадигмы и эволюции классификационных критериев ожирения с точки зрения влияния на прогноз [4,5].…”

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Strategies and methods for the correction of obesity and associated cardiovascular risk

et al. 2019

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Today, there is a need to study obesity from the perspective of associated with it cardiovascular risk correcting. Future researches will have to study the pathophysiology of adipose tissue in greater detail, including tissue, cellular and molecular levels, in order to develop the most effective strategies for therapeutic and preventive measures. At the same time, taking into account the basic ideas about the role of cardiorespiratory fitness in the etiopathogenesis of cardiovascular diseases, the ratio of fat free and fat mass, white and brown adipose tissue, subcutaneous fat and visceral adipose tissue, main directions of these measures becomes obvious. This article discusses strategies for correcting obesity and associated cardiovascular risk as part of primary and secondary prevention of cardiovascular diseases and suggests an algorithm for developing an individual program of preventive measures for an obese patient.

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“…Вместе с тем, в настоящее время, когда становится максимально очевидной роль в увеличении кардиометаболического риска при ожирении определенного характера распределения жировой ткани, преобладания висцерального жира, морфологических изменений ВЖТ в рамках процессов ремоделирования и воспаления с последующим развитием ее дисфункции, наиболее актуальной при прогнозировании сердечнососудистого риска, определении объема и интенсивности профилактических мероприятий является диагностика именно висцерального ожирения [13,14].…”

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“…При этом исходно невысокие чувствительность и специфичность пороговых значений ОТ в отношении абдоминального висцерального ожирения сопровождаются его гипо-и гипердиагностикой, что определяет необходимость изучения и более активного внедрения в клиническую практику методов прямой верификации абдоминальной, а также эктопической ВЖТ [11][12][13][14].…”

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Internal obesity as a risk factor for arterial hypertension

Дружилов

Кузнецова

2019

Russ J Cardiol

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Aim. To assess the role of ultrasound parameters of the extent of abdominal and epicardial visceral adipose tissue (VAT) as prognostic tools for determining the probability of arterial hypertension (AH) development in normotensive patients with obesity.Material and methods. We studied 526 normotensive (according to the results of daily monitoring of blood pressure (BP)) men (age 45,1±5,0 years) without cardiovascular diseases and type 2 diabetes mellitus, with a SCORE risk <5% and abdominal obesity (waist circumference >94 cm). We analyzed glycemia, lipid spectrum, blood creatinine and urine albumin level. Echocardiography with an assessment of epicardial fat thickness (EFT), triplex scanning of the brachiocephalic arteries, ultrasound assessment of the thickness of abdominal VAT and subcutaneous fat (SCF) were carried out. At the end of the observational phase of the study (duration 46,3±5,1 months), repeated daily monitoring of blood pressure was performed.Results. Of the 406 available patients, hypertension was detected in 157 (38,7%), including 72 (31,7%) of the initial age group of 35-45 years and 85 (47,5%) of the initial age group 46-55 years. These patients were characterized by initially higher values of EFT (5,2±0,7 mm vs 4,4±1,0 mm, p<0,001) and the ratio of the thickness of abdominal VAT to the thickness of the SCF (2,9±0,6 vs 2,5±0,6, p<0,001). In the group of individuals with developed AH, the initial incidence of epicardial and abdominal visceral obesity was higher (58,0% vs 23,4%, p<0,001 and 44,6% vs 25,1%, p<0,001, respectively). Ultrasound parameters of abdominal and ectopic (epicardial) VAT were included in mathematical models of the probability of development of AH with a high level of statistical significance and maximum standardized coefficients of regression equations.Conclusion. Ultrasonic parameters of the severity of abdominal and epicardial VAT can be an additional tools for AH predicting in normotensive people with overweight and obesity.

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Visceral Adiposity as a Global Factor of Cardiovascular Risk

Cited by 29 publications

References 41 publications

The experience of sibutramine administration in patients with obesity and controlled arterial hypertension

The experience of sibutramine administration in patients with obesity and controlled arterial hypertension

Strategies and methods for the correction of obesity and associated cardiovascular risk

Internal obesity as a risk factor for arterial hypertension

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