Obesity Associated Pathology: Frequency, Character and Some Mechanisms of Formation

There have been considered modern views on the problem of obesity as a widespread disease, which manifests itself as multi-syndrome pathology involving all organs and systems, mostly cardiovascular system. There has been emphasized an unfavorable role of abdomino-visceral (android) obesity as a strong risk factor of cardiovascular pathology and type 2 diabetes mellitus — the diseases that currently are the main causes of lethal outcomes in economically developed countries.

Some mechanisms of organ pathology associated with obesity have been described, in particular, those determined by endocrine function of fat tissue. Unfavorable effects of obesity, chiefly morbid obesity, on respiratory system, gastrointestinal tract, urinary system and musculoskeletal system have been shown.

1. Proekt rekomendatsiy ekspertnogo komiteta Rossiyskoy assotsiatsii endokrinologov. Diagnostika i lechenie ozhireniya u vzroslykh [The project of recommendations of the Expert Committee of Russian Association of Endocrinologists. Obesity diagnostics and management in adults]. Ozhirenie i metabolizm — Obesity and Metabolism 2010; 1: 76–81.
2. Ostroukhova E.N., Krasil’nikova E.I. Ozhirenie [Obesity]. Vrach — Physician 2009; 11: 33–36.
3. Romantsova T.I. Epidemiya ozhireniya: ochevidnye i veroyatnye prichiny [Obesity epidemic: evident and probable causes]. Ozhirenie i metabolizm — Obesity and Metabolism 2011; 1: 5–17.
4. Burkov S.G., Ivleva A.Ya. Izbytochnyy ves i ozhirenie — problema meditsinskaya, a ne kosmeticheskaya [Overweight and obesity — a medical rather than cosmetic problem]. Ozhirenie i metabolizm — Obesity and Metabolism 2010; 3: 15.
5. Mel’nichenko G.A., Komshilova K.A., Berkovskaya M.A. Opyt primeneniya preparata Orsoten (orlistat) u bol’nykh ozhireniem [The experience in application of Orsoten (orlistat) in obese patients]. Ozhirenie i metabolizm — Obesity and Metabolism 2010; 1: 46–49.
6. Savel’eva L.V. Sovremennaya kontseptsiya lecheniya ozhireniya [Modern concept of obesity management]. Ozhirenie i metabolizm — Obesity and Metabolism 2011; 1: 51–55.
7. Kratnov А.Е., Klimacheva О.V., Tretiakov S.V. Vliyanie faktorov metabolicheskogo sindroma na izmenenie variabel’nosti ritma serdtsa [The effect of metabolic syndrome factors on the change in cardiac rhythm variability]. Sovrem Tehnol Med — Modern Technologies in Medicine 2011; 3: 102–105.
8. Petrov A.V. Mekhanizmy vliyaniya ozhireniya na kachestvo zhizni u zhenshchin, boleyushchikh sakharnym diabetom 2 tipa. Dis. … kand. med. nauk [The mechanisms of obesity effect on life quality of women suffering from type 2 diabetes mellitus. Abstract for Dissertation for the degree of Candidate of Medical Science]. Nizhny Novgorod; 2008.
9. Allison D.B., Downey M., Atkinson R.L., Billington C.J., Bray G.A., Eckel R.H., et al. Obesity as a disease: a white paper on evidence and arguments commissioned by the Council of the Obesity Society. Obesity 2008; 16(6): 1161–1177.
10. Klebanova E.M., Balabolkin M.I. Gormony zhirovoy tkani i ikh rol’ v patogeneze sakharnogo diabeta 2-go tipa [Adipokines and their role in the pathogenesis of type 2 diabetes mellitus]. Klin Med — Clinical Medicine 2007; 7: 20–27.
11. Belyaeva O.D., Bazhenova E.A., Berezina A.V., et al. Uroven’ adiponektina, pokazateli lipidnogo i uglevodnogo obmenov u patsientov s abdominal’nym ozhireniem [Adiponectin level, the indices of lipid and carbohydrate metabolism in patients with abdominal obesity]. Arterial’naya gipertenziya — Arterial Hypertension 2009; 15(3): 309–314.
12. Kosygina A.V., Vasyukova O.V. Novoe v patogeneze ozhireniya: adipokiny — gormony zhirovoy tkani [New in obesity pathogenesis: adipokines — adipose tissue hormones]. Problemy endokrinologii — Endocrinology Problems 2009; 1(55): 44–50.
13. Faber D., Groot P., Visseren F. Role of adipose tissue in haemostasis, coagulation and fibrinolysis. Obes Rev 2009; 10: 554–563.
14. Eynatten M., Liu D., Hock C., Oikonomou D., Baumann M., Allolio B., Korosoglou G., Morcos M., Campean V. Urinary adiponectin excretion a novel marker for vascular damage in type 2 diabetes. Diabetes 2009; 58(9): 2093–2099.
15. Hivert M.F., Sullivan L.M., Fox C.S., Nathan D.M., D’Agostino R.B.Sr., Wilson P.W., Meigs J.B. Associations of adiponectin, resistin, and tumor necrosis factor alpha with insulin resistance. J Clin Endocrinol Metab 2008; 93(8): 3165–3172.
16. Vasyuk Yu.A., Sadulaeva I.A., Yushchuk E.N. i dr. Metabolicheskiy sindrom: novye aspekty staroy problemy [Metabolic syndrome: new aspects of an old problem]. Arterial’naya gipertenziya — Arterial Hypertension 2007; 13(2): 113–118.
17. Krasil’nikova E.I., Blagosklonnaya Ya.V., Bystrova A.A. i dr. Metabolicheskiy serdechno-sosudistyy sindrom [Metabolic cardiovascular syndrome]. Profilakticheskaya i klinicheskaya meditsina — Preventive and Clinical Medicine 2010; 3–4: 15–26.
18. Shlyakhto E.V., Konradi A.O. Epidemiologiya metabolicheskogo sindroma v razlichnykh regionakh. Zavisimost’ ot ispol’zuemykh kriteriev i prognosticheskoe znachenie [The epidemiology of metabolic syndrome in different regions. The dependence on the criteria used and prognostic significance]. Arterial’naya gipertenziya — Arterial Hypertension 2007; 13(2): 95–112.
19. Demidova T.Yu., Selivanova A.B., Ametov A.C. Rol’ zhirovoy tkani v razvitii metabolicheskikh narusheniy u bol’nykh sakharnym diabetom 2 tipa v sochetanii s ozhireniem [The role of adipose tissue in the development of metabolic disorders in patients with type 2 diabetes mellitus combined with obesity]. Ter Arh — Therapeutic Archive 2006; 11: 64–69.
20. Juhan-Vague I., Alessi M.C. Abdominal obesity, insulin resistance, and alterations in hemostasis. Official J Int Chair on Cardiometab Risk 2008; 1(2): 11–16.
21. Mojiminiyi O.A., Abdella N.A. Associations of resistin with inflammation and insulin resistance in patients with type 2 diabetes mellitus. Scand J Clin Lab Invest 2007; 67(2): 215–225.
22. Bakker W., Eringa E.C., Sipkema P., Van Hinsbergh V.W.M. Endothelial dysfunction and diabetes: roles of hyperglycemia, impaired insulin signaling and obesity. Cell Tissue Res 2009; 335: 165–189.
23. Kurukulasuriya L.R., Stas S., Lastra G., Manrique C., Sowers J.R. Hypertension in obesity. Endocrinol Metab Clin N Am 2008; 37: 647–662.
24. Zhdankina N.V. Osobennosti arterial’noy gipertonii u bol’nykh gipotalamicheskim sindromom pubertatnogo perioda i puti optimizatsii ee terapii. Dis. … kand. med. nauk [The peculiarities of arterial hypertension in patients with diencephalic syndrome of puberty and the ways of its therapy optimization. Abstract for Dissertation for the degree of Candidate of Medical Science]. Nizhny Novgorod; 2012.
25. Petrov A.V., Korneva K.G. Vliyanie ozhireniya na remodelirovanie levogo zheludochka pri nalichii i otsutstvii sakharnogo diabeta 2-go tipa. V kn.: Aktual’nye problemy endokrinologii [The effect of obesity on left ventricular remodeling in patients with or without type 2 diabetes mellitus. In: Urgent problems of endocrinology]. Nizhny Novgorod: Nizhegorodskiy gumanitarnyy tsentr; 2005; p. 42–49.
26. Strongin L.G., Petrov A.V. Vliyanie ozhireniya na remodelirovanie miokarda u zhenshchin s sakharnym diabetom 2-go tipa. V kn.: Voprosy diagnostiki i lecheniya endokrinnykh zabolevaniy [The effect of obesity on myocardial remodeling in women with type 2 diabetes mellitus. In: The problems of diagnosis and therapy of endocrine diseases]. Strongin L.G. (editor). Nizhny Novgorod: Izd-vo NGMA; 2007; p. 133–138.
27. Mitsuhashi H., Yatsuya H., Tamakoshi K., Matsushita K., Otsuka R., Wada K., Sugiura K., Takefuji S., Hotta Y., Kondo T., Murohara T., Toyoshima H. Adiponectin level and left ventricular hypertrophy in Japanese men. Hypertension 2007; 49: 1448.
28. Gustafsson S., Lind L., Zethelius B., Venge P., Flyvbjerg A., Soderberg S., Ingelsson E. Adiponectin and cardiac geometry and function in elderly: results from two community-based cohort studies. Eur J Endocrinol 2010; 162(3): 543–550.
29. Guerra F., Mancinelli L., Angelini L. The association of left ventricular hypertrophy with metabolic syndrome is dependent on body mass index in hypertensive overweight or obese patients. PLoS One 2011; 6(1): e16630.
30. Kozakova M., Muscelli E., Flyvbjerg A., Frystyk J., Morizzo C., Palombo C., Ferrannini E. Adiponectin and left ventricular structure and function in healthy adults. J Clin Endocrinol Metab 2008; 93(7): 2811–2818.
31. Faber D., Groot P., Visseren F. Role of adipose tissue in haemostasis, coagulation and fibrinolysis. Obes Rev 2009; 10: 554–563.
32. Towfighi A., Ovbiagele B. Partial peroxisome proliferator-activated receptor agonist angiotensin receptor blockers. Cerebrovasc Dis 2008; 26: 106–112.
33. Li W., Bai Y., Sun K. Patients with metabolic syndrome have prolonged corrected QT interval (QTс). Clin Cardiol 2009; 32: E93–E99.
34. Paksoy F., Ula? T., Bes C. Corrected QT interval in patients with metabolic syndrome. Dicle Med J 2011; 38: 274–277.
35. Petrov A.V. Vliyanie ozhireniya na variabel’nost’ serdechnogo ritma u zhenshchin s sakharnym diabetom 2 tipa. V kn.: Sbornik statey X mezhregional’nogo kardiologicheskogo foruma [The impact of obesity on cardiac rhythm variability in women with type 2 diabetes mellitus. In: Collected works of the X Interregional Cardiological Forum]. Nizhny Novgorod: Izd-vo NGMA; 2006; p. 120–122.
36. Watanabe H., Tanabe N., Watanabe T., Darbar D., Roden D.M., Sasaki S., et al. Metabolic syndrome and risk development of atrial fibrillation. The Niigata preventive medicine study. Circulation 2008; 117: 1255–1266.
37. Mozaffarian D., Kamineni A., Prineas R.J., Siscovick D.S. Metabolic syndrome and mortality in older adults: the Cardiovascular Health Study. Arch Intern Med 2008; 168: 969–978.
38. Hubert H.B., Feinleib M., McNamara P.M., Castelli W.P. Obesity as an independent risk factor for cardiovascular disease: a 26 year follow up of participants in the Framingham heart study. Circulation 1983; 67: 968–977.
39. Mokhlesi B., Tulaimat A., Faibussowitsch I., Wang Y., Evans A.T. Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea. Sleep Breath 2007; 11: 117–124.
40. Poulain M., Doucet M., Major G.C., Drapeau V., Sériès F., Boulet L.P., Tremblay A., Maltais F. The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. Can Med Assoc J 2006; 174(9): 1293–1299.
41. Chinn S., Downs S.H., Anto J.M., Gerbase M.W., Leynaert B., de Marco R., et al. Incidence of asthma and net change in symptoms in relation to changes in obesity. Eur Respir J 2006 Oct; 28(4): 763–771.
42. Mineev V.N., Sorokina L.N., Berestovskaya V.S., Nema M.A., Petrovskaya N.V. Osobennosti soderzhaniya leptina v plazme krovi pri bronkhial’noy astme [The characteristics of leptin content in blood plasma in bronchial asthma]. Klin Med — Clinical Medicine 2009; 7: 33–37.
43. Kattan M., Kumar R., Bloomberg G.R., Mitchell H.E., Calatroni A., Gergen P.J., Kercsmar С.M., et al. Asthma control, adiposity, and adipokines among inner-city adolescents. J Allergy Clin Immunol 2010; 125: 584–592.
44. Shore S. Obesity and asthma: possible mechanisms. J Allergy Clin Immunol 2008; 121: 1087–1093.
45. Larochelle J., Freiler J., Dice J., Hagan L. Plasma resistin levels in asthmatics as a marker of disease state. J Asthma 2007; 44: 509–513.
46. Sharma S.K., Agrawal S., Damodaran D., Sreenivas V., Kadhiravan T., Lakshmy R., et al. CPAP for the metabolic syndrome in patients with obstructive sleep apnea. N Engl J Med 2011; 365: 2277–2286.
47. Mokhlesi B., Tulaimat A., Faibussowitch I., Wang Y., Evans A.T. Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea. Sleep Breath 2007; 11: 117–124.
48. Marshall N.S., Wong K.K.H., Liu P.Y., Cullen S.R.J., Knuiman M.W., Grunstein R.R. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 2008; 31(8): 1079–1085.
49. Mukhin N.A., Fomin V.V., Rodina A.V., Ermakov N.V., Severova M.M., Saginova E.A., Gallyamov M.G., Surkova O.A. Rol’ leptina, adiponektina i markerov insulinorezistentnosti v razvitii rannikh stadiy khronicheskoy bolezni pochek i ateroskleroza sonnykh arteriy u bol’nykh s ozhireniem [The role of leptin, adiponectin and insulin resistance markers in the development of early stages of chronic renal disease and coronary artery atherosclerosis in patients with obesity]. Ter Arh — Therapeutic Archive 2011; 6: 47–53.
50. Kutyrina I.M., Mukhin N.A., Moiseev S.V., Gitel’ E.P., Fomin V.V., Samokhodskaya L.M., Minakova E.G., Saginova E.A., Fedorova E.Yu. Formirovanie porazheniya pochek u bol’nykh s ozhireniem [Renal irritation formation in obese patients]. Ter Arh — Therapeutic Archive 2006; 5: 36–42.
51. Rexford S. Linking adiponectin to proteinuria. J Clin Invest 2008; 118(5): 1619–1622.
52. Thoenes M., Reil J.-C., Khan B.V., Bramlage P., Volpe M., Kirch W., Michael B. Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension. Vasc Health Risk Manag 2009; 5: 577–585.
53. Novikova M.S., Titova Yu.A., Shilov E.M., Kalinchenko S.Yu. Skorost’ klubochkovoy fil’tratsii u muzhchin s metabolicheskim sindromom [Glomerular filtration rate in men with metabolic syndrome]. Nefrologiya i dializ — Nephrology and Dialysis 2007; 3(9): 341.
54. Kambham N., Markowitz G.S., Valeri A.M. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 2001; 59: 1498–1509.
55. Darouich S., Goucha R., Jaafoura M.H., Zekri S., Ben Maiz H., Kheder A. Clinicopathological characteristics of obesity-associated focal segmental glomerulosclerosis. Ultrastruct Pathol 2011 Aug; 35(4): 176–182.
56. Wahba I.M., Mak R.H. Obesity and obesity-initiated metabolic syndrome: mechanistic links to chronic kidney disease. Clin J Am Soc Nephrol 2007; 2(3): 550–562.
57. Scholze A., Rattensperger D., Zidek W., Tepel M. Low serum leptin concentration predicts mortality in patients with chronic kidney disease stage 5 on hemodialysis therapy. Obesity (Silver Spring) 2007; 15: 1617–1622.
58. Fujita H., Morii T., Koshimura J. Possible relationship between adiponectin and renal tubular injury in diabetic nephropathy. Endocrine Journal 2006; 6: 745–752.
59. Marchesini G., Moscatiello S., Di Domizio S., et al. Obesity-associated liver disease. JCEM 2008; 11(1): 74.
60. Malhi H., Geros J.G. Molecular mechanisms of lipotoxity in nonalcoholic fatty liver disease. Semin Liver Dis 2008 Nov; 28(4): 360–369.
61. Lazebnik L.B., Zvenigorodskaya L.A., Egorova E.G. Metabolicheskiy sindrom s pozitsii gastroenterologa [Metabolic syndrome: a gastroenterologist’s viewpoint]. Rus Med Z — Russian Medical Journal 2005; 13(26): 1706–1712.
62. Zvenigorodskaya L.A., Bondarenko E.Yu., Khomeriki S.G. Kliniko-morfologicheskie osobennosti gastroezofageal’noy reflyuksnoy bolezni u patsientov sabdominal’nym ozhireniem [Clinical and morphological characteristics of gastroesophageal reflux disease in patients with abdominal obesity]. Consilium Medicum 2010; 8(12): 5–10.
63. Anandacoomarasamy A., Caterson I., Sambrook P., Fransen M., March L. The impact of obesity on the musculoskeletal system. Int J Obes (Lond) 2008; 32: 211–222.
64. Liu B., Balkwill A., Banks E., Cooper C., Green J., Beral V. On behalf of the million women study collaborators. Relationship of height, weight and body mass index to the risk of hip and knee replacements in middle-aged women. Rheumatology 2007; 46: 861–867.
65. Noskova A.S., Krasivina I.G., Dolgova L.N., Lavrukhina A.A. Abdominal’noe ozhirenie — faktor, sposobstvuyushchiy osteoartrozu kolennykh sustavov [Abdominal obesity — a factor contributing to osteoarthrosis of the knee]. Ter Arh — Therapeutic Archive 2007; 5(79): 29–32.
66. Denisov L.N., Nasonova V.A., Koreshkov G.G., Kashevarova N.G. Rol’ ozhireniya v razvitii osteoartroza i soputstvuyushchikh zabolevaniy [The role of obesity in the development of osteoarthrosis and comorbidities]. Ter Arh — Therapeutic Archive 2010; 10(82): 34–39.

Panova Е.I., Martyshina О.V., Danilov V.А. Obesity Associated Pathology: Frequency, Character and Some Mechanisms of Formation. Sovremennye tehnologii v medicine 2013; 5(2): 108