From the BMI paradox to the obesity paradox: the obesity-mortality association in coronary heart disease

被引:204
作者
Antonopoulos, A. S. [1 ,2 ]
Oikonomou, E. K. [1 ,2 ]
Antoniades, C. [2 ]
Tousoulis, D. [1 ]
机构
[1] Hippokrateion Hosp, Athens Med Sch, Cardiol Dept 1, Athens, Greece
[2] Univ Oxford, Div Cardiovasc Med, Oxford, England
关键词
Adipose tissue; body mass index; coronary heart disease; obesity; BODY-MASS INDEX; ACUTE MYOCARDIAL-INFARCTION; ALL-CAUSE MORTALITY; PERIVASCULAR ADIPOSE-TISSUE; IN-HOSPITAL OUTCOMES; CARDIOVASCULAR-DISEASE; CARDIORESPIRATORY FITNESS; ARTERY-DISEASE; METABOLICALLY HEALTHY; PROSPECTIVE COHORT;
D O I
10.1111/obr.12440
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Despite a strong association between body weight and mortality in the general population, clinical evidence suggests better clinical outcome of overweight or obese individuals with established coronary heart disease. This finding has been termed the 'obesity paradox', but its existence remains a point of debate, because it is mostly observed when body mass index (BMI) is used to define obesity. Inherent limitations of BMI as an index of adiposity, as well as methodological biases and the presence of confounding factors, may account for the observed findings of clinical studies. In this review, our aim is to present the data that support the presence of a BMI paradox in coronary heart disease and then explore whether next to a BMI paradox a true obesity paradox exists as well. We conclude by attempting to link the obesity paradox notion to available translational research data supporting a 'healthy', protective adipose tissue phenotype. (C) 2016 World Obesity
引用
收藏
页码:989 / 1000
页数:12
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