Ожирение: современный взгляд на проблему

DOI: https://doi.org/10.29296/25877305-2020-03-01
Скачать статью в PDF
Номер журнала: 
3
Год издания: 
2020

К.Р. Амлаев, доктор медицинских наук, профессор, Л.Н. Блинкова, кандидат медицинских наук, Х.Т. Дахкильгова Ставропольский государственный медицинский университет E-mail: kum672002@mail.ru

Ожирение – одна из важнейших проблем современного здравоохранения; число страдающих ожирением людей ежегодно возрастает. Авторами представлены эпидемиология, этиология, патогенез данного заболевания; особое внимание уделено гормональным функциям жировой ткани и производимым ей адипокинам. Отдельно рассматриваются модифицируемые и немодифицируемые факторы риска данного заболевания. Освещается связь ожирения с коморбидной патологией (болезни системы кровообращения, онкологические заболевания, сахарный диабет, неалкогольная жировая болезнь печени, синдром ночного апноэ, бесплодие). Описывается влияние кишечной микрофлоры на развитие данного заболевания. Рассматриваются способы диагностики ожирения, немедикаментозная и медикаментозная терапия пациентов с ожирением.

Ключевые слова: 
эндокринология
ожирение
образ жизни
жировая ткань
оксидативный стресс
коморбидность
гиподинамия

Для цитирования
К.Р. Амлаев, Л.Н. Блинкова, Х.Т. Дахкильгова Ожирение: современный взгляд на проблему . Врач, 2020; (3): 3-10 https://doi.org/10.29296/25877305-2020-03-01


It appears your Web browser is not configured to display PDF files. Download adobe Acrobat или click here to download the PDF file.

Список литературы: 
  1. GHO. Prevalence of overweight among adults, BMI ≥25, age-standardized – Estimates by country. [online] Available at: http://apps.who.int/gho/data/node.main.A897A?lang=en [Accessed 12 Oct. 2019].
  2. Амлаев К.Р., Бжезовская М.М. Результаты социологического исследования образа жизни молодежи Ставрополя // Профилактическая медицина. – 2010; 1: 17–21 [Amlaev K.R., Bzhezovskaya M.M. Results of sociological survey of lifestyle in the youth of Stavropol // Profilakticheskaja medicina. – 2010; 1: 17–21 (in Russ.)].
  3. Bray G., Frühbeck G., Ryan D. et al. Management of obesity // Lancet. – 2016; 387 (10031): 1947–56. DOI: 10.1016/s0140-6736(16)00271-3.
  4. Haczeyni F., Bell-Anderson K., Farrell G. Causes and mechanisms of adipocyte enlargement and adipose expansion // Obesity Rev. – 2017; 19 (3): 406–20. DOI: 10.1111/obr.12646.
  5. Jordan B., Gourgue F., Cani P. Adipose Tissue Metabolism and Cancer Progression: Novel Insights from Gut Microbiota? // Curr. Pathobiol. Rep. – 2017; 5 (4): 315–22. DOI: 10.1007/s40139-017-0154-6.
  6. Luong Q., Huang J., Lee K. Deciphering White Adipose Tissue Heterogeneity // Biology. – 2019; 8 (2): 23. DOI: 10.3390/biology8020023.
  7. Akbari M., Hassan-Zadeh V. IL-6 signalling pathways and the development of type 2 diabetes // Inflammopharmacology. – 2018; 26 (3): 685–98. DOI: 10.1007/s10787-018-0458-0.
  8. Xu E., Pereira M., Karakasilioti I. et al. Temporal and tissue-specific requirements for T-lymphocyte IL-6 signalling in obesity-associated inflammation and insulin resistance // Nature Communications. – 2017; 8 (1): 14803. DOI: 10.1038/ncomms14803
  9. Choe S., Huh J., Hwang I. et al. Adipose Tissue Remodeling: Its Role in Energy Metabolism and Metabolic Disorders // Front. Endocrinol. – 2016; 7: 30. DOI: 10.3389/fendo.2016.00030.
  10. Sramkova V., Berend S., Siklova M. et al. Apolipoprotein M: a novel adipokine decreasing with obesity and upregulated by calorie restriction // Am. J. Clin. Nutr. – 2019; 109 (6): 1499–510. DOI: 10.1093/ajcn/nqy331.
  11. Smith U., Kahn B. Adipose tissue regulates insulin sensitivity: role of adipogenesis,de novolipogenesis and novel lipids // J. Int. Med. – 2016; 280 (5): 465–75. DOI:10.1111/joim.12540.
  12. Hafidi M., Buelna-Chontal M., Sánchez-Muñoz F. et al. Adipogenesis: A Necessary but Harmful Strategy // Int. J. Mol. Sci. – 2019; 20 (15): 3657. DOI: 10.3390/ijms20153657.
  13. Cohen P., Spiegelman B. Brown and Beige Fat: Molecular Parts of a Thermogenic Machine // Diabetes. – 2015; 64 (7): 2346–51. DOI: 10.2337/db15-0318.
  14. Hilton C., Karpe F., Pinnick K. Role of developmental transcription factors in white, brown and beige adipose tissues // Biochimica et Biophysica Acta (BBA) – Molecular and Cell Biology of Lipids. – 2015; 1851 (5): 686–96. DOI: 10.1016/j.bbalip.2015.02.003.
  15. Stinkens R., Goossens G., Jocken J. et al. Targeting fatty acid metabolism to improve glucose metabolism // Obesity Rev. – 2015; 16 (9): 715–57. DOI: 10.1111/obr.12298.
  16. Goossens G. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function // Obesity facts. – 2017; 10 (3): 207–15. DOI: 10.1159/000471488.
  17. Karpe F., Pinnick K. Biology of upper-body and lower-body adipose tissue – link to whole-body phenotypes // Nat. Rev. Endocrinol. – 2014; 11 (2): 90–100. DOI:10.1038/nrendo.2014.185.
  18. Blüher M. Are metabolically healthy obese individuals really healthy? // Eur. J. Endocrinol. – 2014; 171 (6): R209–19. DOI: 10.1530/EJE-14-0540.
  19. Bell J., Kivimaki M., Hamer M. Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies // Obesity Rev. – 2014; 15 (6): 504–15. DOI: 10.1111/obr.12157.
  20. Eckel N., Meidtner K., Kalle-Uhlmann T. et al. Metabolically healthy obesity and cardiovascular events: A systematic review and meta-analysis // Eur. J. Prev. Cardiol. – 2015; 23 (9): 956–66. DOI: 10.1177/2047487315623884.
  21. Appleton S., Seaborn C., Visvanathan R. et al. Diabetes and Cardiovascular Disease Outcomes in the Metabolically Healthy Obese Phenotype: A cohort study // Diabetes Care. – 2013; 36 (8): 2388–94. DOI: 10.2337/dc12-1971.
  22. Grover S., Kaouache M., Rempel P. et al. Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study // Lancet. Diabetes & Endocrinology. – 2015; 3 (2): 114–22. DOI: 10.1016/s2213-8587(14)70229-3.
  23. Bourdier L., Orri M., Carre A. et al. Are emotionally driven and addictive-like eating behaviors the missing links between psychological distress and greater body weight? // Appetite. – 2018; 120: 536–46. DOI: 10.1016/j.appet.2017.10.013.
  24. Meldrum D., Morris M., Gambone J. Obesity pandemic: causes, consequences, and solutions – but do we have the will? // Fertility and Sterility. – 2017; 107 (4): 833–9. DOI: 10.1016/j.fertnstert.2017.02.104.
  25. Boulangé C., Neves A., Chilloux J. et al. Impact of the gut microbiota on inflammation, obesity, and metabolic disease // Genome Medicine. – 2016; 8 (1): 42. DOI: 10.1186/s13073-016-0303-2.
  26. Rosenquist K., Massaro J., Pedley A. et al. Fat Quality and Incident Cardiovascular Disease, All-Cause Mortality, and Cancer Mortality // J. Clin. Endocrinol. Metab. – 2015; 100 (1): 227–34. DOI: 10.1210/jc.2013-4296.
  27. Abraham T., Pedley A., Massaro J. et al. Association Between Visceral and Subcutaneous Adipose Depots and Incident Cardiovascular Disease Risk Factors // Circulation. – 2015; 132 (17): 1639–47. DOI: 10.1161/circulationaha.114.015000.
  28. Nakamura K., Fuster J., Walsh K. Adipokines: A link between obesity and cardiovascular disease // J. Cardiol. – 2014; 63 (4): 250–9. DOI: 10.1016/j.jjcc.2013.11.006.
  29. 29. Matsuo K., Shibata R., Ohashi K. et al. Omentin functions to attenuate cardiac hypertrophic response // J. Mol. Cell. Cardiol. – 2015; 79: 195–202. DOI: 10.1016/j.yjmcc.2014.11.019.
  30. Fuster J., Ouchi N., Gokce N. et al. Obesity-Induced Changes in Adipose Tissue Microenvironment and Their Impact on Cardiovascular Disease // Circulation Research. – 2016; 118 (11): 1786–807. DOI: 10.1161/circresaha.115.306885.
  31. Manna P., Jain S. Obesity, Oxidative Stress, Adipose Tissue Dysfunction, and the Associated Health Risks: Causes and Therapeutic Strategies // Metab. Syndr. Relat. Disord. – 2015; 13 (10): 423–44. DOI: 10.1089/met.2015.0095.
  32. Aune D., Sen A., Prasad M. et al. BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants // BMJ. – 2016; 353: i2156. DOI: 10.1136/bmj.i2156.
  33. Di Angelantonio E., Bhupathiraju S., Wormser D. et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents // Lancet. – 2016; 388 (10046): 776–86. DOI: 10.1016/s0140-6736(16)30175.
  34. Wang J., Jia Y., Wang L. et al. Vasodilator-Stimulated Phosphoprotein: Regulators of Adipokines Resistin and Phenotype Conversion of Epicardial Adipocytes // Med. Sci. Monit. – 2018; 24: 6010–20. DOI: 10.12659/MSM.908111.
  35. Milić S., Lulić D., Štimac D. Non-alcoholic fatty liver disease and obesity: biochemical, metabolic and clinical presentations // World J. Gastroenterol. – 2014; 20 (28): 9330–7. DOI: 10.3748/wjg.v20.i28.9330.
  36. Marchi J., Berg M., Dencker A. et al. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews // Obesity Rev. – 2015; 16 (8): 621–38. DOI: 10.1111/obr.12288.
  37. Boeing H., Bechthold A., Bub A. et al. Critical review: vegetables and fruit in the prevention of chronic diseases // Eur. J. Nutr. – 2012; 51 (6): 637–63. DOI: 10.1007/s00394-012-0380-y.
  38. Tchernof A., Després J.-P. Pathophysiology of human visceral obesity: an update // Physiol. Rev. – 2013; 93 (1): 359–404. DOI: 10.1152/physrev.00033.2011.
  39. Martin C., Redman L., Zhang J. et al. Lorcaserin, A 5-HT2CReceptor Agonist, Reduces Body Weight by Decreasing Energy Intake without Influencing Energy Expenditure // J. Clin. Endocrinol. Metab. – 2011; 96 (3): 837–45. DOI: 10.1210/jc.2010-1848.
  40. Kang Y., Cai Y. The development of probiotics therapy to obesity: a therapy that has gained considerable momentum // Hormones. – 2018; 17 (2): 141–51. DOI: 10.1007/s42000-018-0003-y.