russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2016-6-73-79russjcardiol-847Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWОЖИРЕНИЕ КАК ФАКТОР РИСКА ХРОНИЧЕСКИХ НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙOBESITY AS A RISK FACTOR FOR CHRONIC NON-COMMUNICABLE DISEASESДрапкинаО. М.DrapkinaO. M.

Доктор медицинских наук, профессор, руководитель отдела фундаментальных и прикладных аспектов ожирения, первый заместитель директора по научной и лечебной работе

drapkina@bk.ruЕлиашевичС. О.EliashevichS. O.ШепельР. Н.ShepelR. N.

Младший научный сотрудник  отдела фундаментальных и прикладных аспектов ожирения

Научно-исследовательский центр профилактической медицины, МоскваРоссияNational Research Center for Preventive Medicine, MoscowRussian Federation201628062016067379Copyright © Драпкина О.М., Елиашевич С.О., Шепель Р.Н., 20162016Драпкина О.М., Елиашевич С.О., Шепель Р.Н.Drapkina O.M., Eliashevich S.O., Shepel R.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/847

Среди факторов риска утраты лет жизни с поправкой на инвалидность лидируют артериальная гипертензия, курение и повышенный индекс массы тела. Результаты крупных проспективных исследований подтвердили взаимосвязь избыточной массы тела и ожирения с увеличением сердечно-сосудистого риска (ССР). Относительный риск сердечно-сосудистых заболеваний (ССЗ) у пациентов, страдающих ожирением, сравним с вкладом в суммарный риск повышения уровня АД на20 ммрт.ст. Однако большинство существующих моделей стратификации ССР не включают оценку ожирения как одного из факторов риска. Выделяют несколько фенотипов ожирения. Наличие любого фенотипа ожирения повышает риск развития ССЗ и сахарного диабета 2 типа (СД 2 типа). Однако метаболически здоровое ожирение по сравнению с ситуацией сочетания ожирения с метаболическим синдромом ассоциировано с меньшим риском развития СД 2 типа, в то время как ССР одинаково высок при обоих фенотипах ожирения. Таким образом, метаболически здоровое ожирение не является “доброкачественным” состоянием и требует от нас активных вмешательств по снижению массы тела и жесткому контролю модифицируемых факторов риска

Among the risk factors of years of life loss, with correction for disability, the leading are arterial hypertension, smoking, high body mass index. Results of large prospective studies confirm the relation of excessive body mass with the increase of cardiovascular risk. Relative risk of cardiovascular disorders (CVD) in obese is comparable to the total impact of BP raise by 20 mmHg. However, most of current CV risk stratification models do not include obesity as one of the risk factors. There are several phenotypes of obesity. Presence of any leads to increased cardiovascular and diabetes (type 2, DM) risk. Metabolically healthy obesity comparing to the situation of comorbid obesity with metabolic syndrome is associated with lower DM risk, but cardiovascular risk is high equally in both obesity phenotypes. Hence, metabolically healthy obesity is not “benign” condition and demands the actions from us, interventions for loss of weight and strict control of modifiable risk factors.

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The authors declare that there are no conflicts of interest present.