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Komplikace/komorbidity spojené s obezitou

Porozumění komplikacím/komorbiditám spojených s obezitou

Obezita znamená víc než jen nadváhu. Souvisí s více než 200 různými komplikacemi ovlivňujícími zdraví jedince a různé orgánové systémy.1-8

V důsledku toho má obezita významnou souvislost s morbiditou a mortalitou. Těžká obezita je spojena s kratší očekávanou délkou života a zvýšenou mírou úmrtnosti nezávisle na věku, geografické oblasti, vzdělání nebo kouření.Zahrnuje to také větší riziko vzniku cukrovky,10 hypertenze10 a hyperlipidémie11. Srdeční selhání12, metabolický syndrom13 a ischemická CMP14 jsou další významné a jasně doložené komplikace obezity. Obezita také znamená vyšší riziko úmrtnosti způsobené nádorovými onemocněními, včetně například rakoviny prsu10 a rakoviny prostaty10. Podobně u obézních pacientů najdeme vyšší riziko deprese,15 další psychické problémy a celkově nižší kvalitu života.15

Vysoká míra komorbidit souvisejících s obezitou zdůrazňuje, jak důležitý je včasný zásah s cílem zabránit závažným výsledkům.

Spojení mezi obezitou, BMI a rizikem mortality

Nepříznivé důsledky obezity, onemocnění a problémů souvisejících s obezitou napříč všemi oblastmi zdraví znamenají, že tento stav také zkracuje délku života pacientů.46

Výzkum ukazuje, že vysoká hodnota BMI je spojena se snížením očekávané délky života až o 10 let.47Na každých 5 kg/m2 nárůstu BMI nad 22,5–25,0 kg/m2 dochází ke 30% zvýšení celkové mortality.47

Upraveno z práce Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–1096.

Závěr

Zdravotní potíže způsobené obezitou a jejich určující faktory jsou komplexní, což vede k četným komorbiditám a zdravotním komplikacím. Avšak pokroky ve zdravotnictví nám poskytly řadu nástrojů a způsobů, jak obezitu lépe léčit

Kliknutím na tlačítko stáhnout níže si můžete stáhnout praktické průvodce léčbou obezity u dospělých i dětí.

Odkazy

  1. Yuen M. ER, Kadambi N. A systematic review and evaluation of current evidence reveals 236 obesity-associated disorders. The obesity society 2016.
  2. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
  3. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481-6.
  4. Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56(2):320-8.
  5. Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001;25(5):622-7.
  6. Christensen R, Bartels EM, Astrup A, Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2007;66(4):433-9.
  7. Zelber-Sagi S, Godos J, Salomone F. Lifestyle changes for the treatment of nonalcoholic fatty liver disease: a review of observational studies and intervention trials. Therap Adv Gastroenterol. 2016;9(3):392-407.
  8. Glass LM, Dickson RC, Anderson JC, Suriawinata AA, Putra J, Berk BS, et al. Total body weight loss of >/= 10 % is associated with improved hepatic fibrosis in patients with nonalcoholic steatohepatitis. Dig Dis Sci. 2015;60(4):1024-30.
  9. Jarolimova J, Tagoni J, Stern TA. Obesity: its epidemiology, comorbidities, and management. Prim Care Companion CNS Disord. 2013;15(5).
  10. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.
  11. Klop B, Elte JW, Cabezas MC. Dyslipidemia in obesity: mechanisms and potential targets. Nutrients. 2013;5(4):1218-40.
  12. Adair T, Lopez AD. The role of overweight and obesity in adverse cardiovascular disease mortality trends: an analysis of multiple cause of death data from Australia and the USA. BMC Med. 2020;18(1):199.
  13. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881-7.
  14. Mitchell AB, Cole JW, McArdle PF, Cheng YC, Ryan KA, Sparks MJ, et al. Obesity increases risk of ischemic stroke in young adults. Stroke. 2015;46(6):1690-2.
  15. Dong C, Sanchez LE, Price RA. Relationship of obesity to depression: a family-based study. Int J Obes Relat Metab Disord. 2004;28(6):790-5.
  16. Collaborators GBDO, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27.
  17. Gelber RP, Gaziano JM, Manson JE, Buring JE, Sesso HD. A prospective study of body mass index and the risk of developing hypertension in men. Am J Hypertens. 2007;20(4):370-7.
  18. Landi F, Calvani R, Picca A, Tosato M, Martone AM, Ortolani E, et al. Body Mass Index is Strongly Associated with Hypertension: Results from the Longevity Check-up 7+ Study. Nutrients. 2018;10(12).
  19. Feingold K. Obesity and Dyslipidemia. [Aktualizováno 2. listopadu 2020]. Endotext [Internet]. K dispozici na stránce: https://www.ncbi.nlm.nih.gov/books/NBK305895/. Poslední přístup: září 2021.
  20. Tadic M, Cuspidi C. Obesity and heart failure with preserved ejection fraction: a paradox or something else? Heart Fail Rev. 2019;24(3):379-85.
  21. Lee HJ, Choi EK, Lee SH, Kim YJ, Han KD, Oh S. Risk of ischemic stroke in metabolically healthy obesity: A nationwide population-based study. PLoS One. 2018;13(3):e0195210.
  22. Kotsis V, Jordan J, Micic D, Finer N, Leitner DR, Toplak H, et al. Obesity and cardiovascular risk: a call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity: part A: mechanisms of obesity induced hypertension, diabetes and dyslipidemia and practice guidelines for treatment. J Hypertens. 2018;36(7):1427-40.
  23. Barnes AS. The epidemic of obesity and diabetes: trends and treatments. Tex Heart Inst J. 2011;38(2):142-4.
  24. Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015;33(7):673-89.
  25. Lean MEJ, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol. 2019;7(5):344-55.
  26. Diabetes Prevention Program Research G, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677-86.
  27. Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683-93.
  28. Bliddal H, Leeds AR, Christensen R. Osteoarthritis, obesity and weight loss: evidence, hypotheses and horizons - a scoping review. Obes Rev. 2014;15(7):578-86.
  29. Webber J. The comorbidities of obesity. Practical Diabetes International. 2001;18(8):293-6.
  30. Glyn-Jones S, Palmer AJ, Agricola R, Price AJ, Vincent TL, Weinans H, et al. Osteoarthritis. Lancet. 2015;386(9991):376-87.
  31. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012;97(1):28-38 e25.
  32. Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertil Steril. 2008;89(4):899-906.
  33. Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010;95(5):2038-49.
  34. Thomson RL, Buckley JD, Brinkworth GD. Exercise for the treatment and management of overweight women with polycystic ovary syndrome: a review of the literature. Obes Rev. 2011;12(5):e202-10.
  35. Mrinal Kanti Kundu MR, Prakritis Ranjan Sasmal, Kamalika Das. A randomized prospective study of menstrual irregularities in relation to obesity in terms of body mass index. International Journal of Scientific Research. 2018;7(10).
  36. Tolino A, Gambardella V, Caccavale C, D'Ettore A, Giannotti F, D'Anto V, et al. Evaluation of ovarian functionality after a dietary treatment in obese women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2005;119(1):87-93.
  37. Dokras A, Sarwer DB, Allison KC, Milman L, Kris-Etherton PM, Kunselman AR, et al. Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS. J Clin Endocrinol Metab. 2016;101(8):2966-74.
  38. Modena DAO, Cazzo E, Candido EC, Baltieri L, Silveira L, Almeida AMN, et al. Obstructive sleep apnea syndrome among obese individuals: A cross-sectional study. Rev Assoc Med Bras (1992). 2017;63(10):862-8.
  39. Masa JF, Pepin JL, Borel JC, Mokhlesi B, Murphy PB, Sanchez-Quiroga MA. Obesity hypoventilation syndrome. Eur Respir Rev. 2019;28(151).
  40. Everaere L, Ait Yahia S, Boute M, Audousset C, Chenivesse C, Tsicopoulos A. Innate lymphoid cells at the interface between obesity and asthma. Immunology. 2018;153(1):21-30.
  41. Durrer Schutz D, Busetto L, Dicker D, Farpour-Lambert N, Pryke R, Toplak H, et al. European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care. Obes Facts. 2019;12(1):40-66.
  42. Feng Gao KIZ, Xiao-Bo Wang , Qing-Feng Sun , Ke-Hua Pan , Ting-Yao Wang , Yong-Ping Chen, Giovanni Targher, Christopher D Byrne, Jacob George, Ming-Hua Zheng. Obesity Is a Risk Factor for Greater COVID-19 Severity. Diabetes Care. 2020;43(7).
  43. Min Gao CP, Nerys M Astbury, Julia Hippisley-Cox, Stephen O'Rahilly, Paul Aveyard, Susan A Jebb. Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study. The Lancet Diabetes & Endocrinology. 2021;9(6):350-9.
  44. Bennett KE, Mullooly M, O'Loughlin M, Fitzgerald M, O'Donnell J, O'Connor L, et al. Underlying conditions and risk of hospitalisation, ICU admission and mortality among those with COVID-19 in Ireland: A national surveillance study. Lancet Reg Health Eur. 2021;5:100097.
  45. Kwok S, Adam S, Ho JH, Iqbal Z, Turkington P, Razvi S, et al. Obezita: A critical risk factor in the COVID-19 pandemic. Clin Obes. 2020;10(6):e12403.
  46. Global BMIMC, Di Angelantonio E, Bhupathiraju Sh N, Wormser D, Gao P, Kaptoge S, 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.
  47. Prospective Studies C, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083-96.

CZ22OB00030

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