The Obesity Paradox of Cardiovascular Outcomes in Patients with Diabetes Mellitus.

IF 6.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Current Diabetes Reports Pub Date : 2025-06-07 DOI:10.1007/s11892-025-01592-4

Janki Thakker, Isna Khaliq, Nelish S Ardeshna, Carl J Lavie, Ahmet Afsin Oktay

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引用次数: 0

Abstract

Purpose of review: The "obesity paradox" describes the counterintuitive observation that overweight and mildly obese individuals with cardiovascular disease (CVD) may have better outcomes than those with normal weight. This paradox is particularly intriguing in patients with type-2 diabetes (T2D), where obesity is a well-established risk factor for cardiometabolic complications.

Recent findings: Evidence from some epidemiological studies suggested an obesity paradox in mortality risk among patients with T2D. However, confounding factors may influence this association, including reverse causality, differences in risk factor profiles, and adipose tissue distribution. Recent research also questions the reliance on body mass index as an accurate measure of metabolic health, emphasizing the role of alternative anthropometric indices. This review critically evaluates the evidence for the obesity paradox in T2D, explores potential mechanistic explanations, and discusses clinical implications. Understanding the complex interaction between diabetes and obesity in CVD risk is essential for refining obesity management strategies in individuals with T2D and CVD.

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糖尿病患者心血管结局的肥胖悖论

综述目的：“肥胖悖论”描述了一种反直觉的观察结果，即超重和轻度肥胖的心血管疾病（CVD）患者可能比正常体重的患者有更好的预后。这种矛盾在2型糖尿病（T2D）患者中尤其有趣，肥胖是公认的心脏代谢并发症的危险因素。最近的发现：一些流行病学研究的证据表明，肥胖悖论与T2D患者的死亡风险有关。然而，混杂因素可能影响这种关联，包括反向因果关系、风险因素概况的差异和脂肪组织分布。最近的研究也质疑依赖身体质量指数作为代谢健康的准确衡量标准，强调了其他人体测量指标的作用。这篇综述批判性地评估了肥胖悖论在T2D中的证据，探讨了潜在的机制解释，并讨论了临床意义。了解糖尿病和肥胖在心血管疾病风险中的复杂相互作用，对于完善t2cvd患者的肥胖管理策略至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Diabetes Reports 医学 -

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The goal of this journal is to publish cutting-edge reviews on subjects pertinent to all aspects of diabetes epidemiology, pathophysiology, and management. We aim to provide incisive, insightful, and balanced contributions from leading experts in each relevant domain that will be of immediate interest to a wide readership of clinicians, basic scientists, and translational investigators. We accomplish this aim by appointing major authorities to serve as Section Editors in key subject areas across the discipline. Section Editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year on their topics, in a crisp and readable format. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.