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Obesity: epidemiology, etiopathogenesis, comorbidity, diagnosis and treatment

Karen Amlaev; Khava Tagirovna Dakhkilgova;

The lecture presents data on the epidemiology, etiology and pathogenesis of obesity. The connection of obesity with other non-infectious diseases has been highlighted, methods of its diagnosis and treatment are considered.


1. Meldrum D., Morris M., Gambone J. Obesity pandemic: causes, consequences, and solutions – but do we have the will? Fertil Steril. 2017;107(4):833-839. https://doi.org/10.1016/j.fertnstert.2017.02.104
2. Damacena F. C., Batista T. J., Ayres L. R., Zandonade E., Sampaio K. N. Obesity prevalence in Brazilian firefighters and the association of central obesity with personal, occupational and cardiovascular risk factors: a cross-sectional study. BMJ Open. 2020;10(3):e032933. https://doi.org/10.1136/bmjopen-2019-032933
3. Robert Lustig M. The real truth about sugar: Dr. Robert Lustig’s lecture «Sugar: The Bitter Truth», 2011. Available at: https://youtube.com/watch?v=dBnniua6-oM. Accessed October 5, 2019.
4. Amlaev K. R., Ashihmina M. A., Krylova E. V., Zagrebina N. V., Gluhova T. L., Shestkova T. E. The results of the study of some lifestyle aspects of youth in a number of Russian cities. Kubanskij nauchnyj medicinskij vestnik. – Kuban Scientific Medical Bulletin. 2012;1:8-11. (In Russ.).
5. Bray G. A., Fruhbeck G., Ryan D. H., Wilding J. P. Management of obesity. Lancet. 2016;387:1947-1956. https://doi.org/10.1016/s0140-6736(16)00271-3
6. Luong Q., Huang J., Lee K. Y. Deciphering white adipose tissue heterogeneity. Biology. 2019;8(2):23. https://doi.org/10.3390/biology8020023
7. Kucharska A. M., Pyrzak B., Demkow U. Regulatory T cells in obesity. Adv. Exp. Med. Biol. 2015;866:35-40. https://doi.org/10.1007/5584_2015_147
8. Poulos S. P., Dodson M. V., Culver M. F., Hausman G. J. The increasingly complex regulateon of adipocyte differentiation. Exp. Biol. Med. 2015;241(5):449-456. https://doi.org/10.1177/1535370215619041
9. Akbari M., Hassan-Zadeh V. IL-6 signalling pathways and the development of type 2 diabetes. Inflammopharmacology. 2018;26(3):685-698. https://doi.org/10.1007/s10787-018-0458-0
10. Hernández-Díaz A., Arana-Martínez J. C., Carbó R., Espinosa-Cervantes R., Sánchez-Muñoz F. Omentina: papel en la resistencia a la insulina, inflamación y protección cardiovascular. Archivos de Cardiología de México. 2016;86(3):233-243. https://doi.org/10.1016/j.acmx.2015.09.010
11. Xu E., Pereira M. M. A., Karakasilioti I. [et al.]. Temporal and tissue-specific requirements for T-lymphocyte IL-6 signalling in obesity-associated inflammation and insulin resistance. Nat. Commun. 2017;8(1). https://doi.org/10.1038/ncomms14803
12. Choe S. S., Huh J. Y., Hwang I. J., Kim J. I., Kim J. B. Adipose tissue remodeling: its role in energy metabolism and metabolic disorders. Front. Endocrinol. 2016;7. https://doi.org/10.3389/fendo.2016.00030
13. 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):1499-1510. https://doi.org/10.1093/ajcn/nqy331
14. Cancello R., Zulian A., Gentilini D. [et al.]. Molecular and morphologic characterization of superficial- and deep-subcutaneous adipose tissue subdivisions in human obesity. Obesity. 2013;21(12):2562-2570. https://doi.org/10.1002/oby.20417
15. Smith U., Kahn B. B. Adipose tissue regulates insulin sensitivity: role of adipogenesis,de novolipogenesis and novel lipids. J. Inter. Med. 2016;280(5):465-475. https://doi.org/10.1111/joim.12540
16. Hafidi M. E., Buelna-Chontal M., Sánchez-Muñoz F., Carbó R. Adipogenesis: a necessary but harmful strategy. Inter. J. Mol. Sci. 2019;20(15):3657. https://doi.org/10.3390/ijms20153657
17. Cohen P., Spiegelman B. M. Brown and beige fat: olecular parts of a thermogenic machine. Diabetes. 2015;64(7):2346-2351. https://doi.org/10.2337/db15-0318
18. Diels S., Vanden Berghe W., Van Hul W. Insights into the multifactorial causation of obesity by integrated genetic and epigenetic analysis. Obesity Rev. March 2020. https://doi.org/10.1111/obr.13019
19. Hilton C., Karpe F., Pinnick K. E. 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):686-696. https://doi.org/10.1016/j.bbalip.2015.02.003
20. Pinnick K. E., Nicholson G., Manolopoulos K. N. [et al.]. Distinct developmental profile of lower-body adipose tissue defines resistance against obesity-associated metabolic complications. Diabetes. 2014;63(11):3785-3797. https://doi.org/10.2337/db14-0385
21. Sulc J., Mounier N., Günther F. [et al.]. Quantification of the overall contribution of gene-environment interaction for obesity-related traits. Nature Commun. 2020;11(1). https://doi.org/10.1038/s41467-020-15107-0
22. Goossens G. H. The metabolic phenotype in obesity: fat mass, body fat distribution, and adipose tissue function. Obesity facts. 2017;10(3):207-215. https://doi.org/10.1159/000471488
23. Stinkens R., Goossens G. H., Jocken J. W. E., Blaak E. E. Targeting fatty acid metabolism to improve glucose metabolism. Obesity Rev. 2015;16(9):715-757. https://doi.org/10.1111/obr.12298
24. Karpe F., Pinnick K. E. Biology of upper-body and lower-body adipose tissue – link to whole-body phenotypes. Nat. Rev. Endocrinol. 2014;11(2):90-100. https://doi.org/10.1038/nrendo.2014.185
25. van Vliet-Ostaptchouk J. V., Nuotio M.-L., Slagter S. N. [et al.]. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocrine Disorders. 2014;14(1). https://doi.org/10.1186/1472-6823-14-9
26. Blüher M. Are metabolically healthy obese individuals really healthy? Eur. J. Endocrinol. 2014;171(6):R209-19. https://doi.org/10.1530/EJE-14-0540
27. Stefan N., Häring H.-U., Hu F. B., Schulze M. B. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. Lancet Diabetes Endocrinol. 2013;1(2):152-162. https://doi.org/10.1016/s2213-8587(13)70062-7
28. Blüher M. Adipose tissue dysfunction contributes to obesity related metabolic diseases. Best Pract. Res. Clin. Endocrinol. Metabol. 2013;27(2):163-177. https://doi.org/10.1016/j.beem.2013.02.005
29. Bell J. A., 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):504-515. https://doi.org/10.1111/obr.12157
30. Eckel N., Meidtner K., Kalle-Uhlmann T., Stefan N., Schulze M. B. Metabolically healthy obesity and cardiovascular events: a systematic review and meta-analysis. Eur. J. Preventive Cardiol. 2015;23(9):956-966. https://doi.org/10.1177/2047487315623884
31. Kramer C. K., Zinman B., Retnakaran R. Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis. Ann. Inter. Med. 2013;159(11):758-769. https://doi.org/10.7326/0003-4819-159-11-201312030-00008
32. Appleton S. L., Seaborn C. J., Visvanathan R. [et al.]. Diabetes and cardiovascular disease outcomes in the metabolically healthy obese phenotype: a cohort study. Diabetes Care. 2013;36(8):2388-2394. https://doi.org/10.2337/dc12-1971
33. Jokela M., Hamer M., Singh-Manoux A., Batty G. D., Kivimäki M. Association of metabolically healthy obesity with depressive symptoms: pooled analysis of eight studies. Molecular Psychiatry. 2013;19(8):910-914. https://doi.org/10.1038/mp.2013.162
34. Grover S. A., 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 Endocrinol. 2015;3(2):114-122. https://doi.org/10.1016/s2213-8587(14)70229-3
35. 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;120:536-546. https://doi.org/10.1016/j.appet.2017.10.013
36. Boulangé C. L., Neves A. L., Chilloux J., Nicholson J. K., Dumas M.-E. Impact of the gut microbiota on inflammation, obesity, and metabolic disease. Genome Medicine. 2016;8(1). https://doi.org/10.1186/s13073-016-0303-2
37. Ngo D. T. M., Farb M. G., Kikuchi R. [et al.]. Antiangiogenic actions of vascular endothelial growth factor-a 165 b, an inhibitory isoform of vascular endothelial growth factor-a, in human obesity. Circulation. 2014;130(13):1072-1080. https://doi.org/10.1161/circulationaha.113.008171
38. Arnold M., Leitzmann M., Freisling H. [et al.]. Obesity and
cancer: An update of the global impact. Cancer Epidemiol. 2016;41:8-15. https://doi.org/10.1016/j.canep.2016.01.003
39. Antonopoulos A. S., Tousoulis D. The molecular mechanisms of obesity paradox. Cardiovascular Res. 2017;113(9):1074-1086. https://doi.org/10.1093/cvr/cvx106
40. De Pergola G., Silvestris F. Obesity as a major risk factor for cancer. J. Obesity. 2013;2013:1-11. https://doi.org/10.1155/2013/291546
41. Huo J., Smith B. D., Giordano S. H., Reece G. P., Shih Y.-C. T. Post-mastectomy breast reconstruction and its subsequent complications: a comparison between obese and non-obese women with breast cancer. Breast Cancer Res. Treatment. 2016;157(2):373-383. https://doi.org/10.1007/s10549-016-3832-x
42. Yavas G., Yavas C., Kerimoglu O. S., Celik C. The impact of body mass index on radiotherapy technique in patients with early-stage endometrial cancer. Inter. J. Gynecol. Cancer. 2014;24(9):1607-1615. https://doi.org/10.1097/igc.0000000000000298
43. Sutherland E. R. Linking obesity and asthma. Annals New York Acad. Sci. 2014;1311(1):31-41. https://doi.org/10.1111/nyas.12357
44. Boulet L.-P. Asthma and obesity. Clin. Exper. Allergy. 2013;43(1):8-21.
45. Milić S., Lulić D., Štimac D. Non-alcoholic fatty liver disease and obesity: biochemical, metabolic and clinical presentations. World J. Gastroenterol. 2014;20(28):9330-9337. https://doi.org/10.3748/wjg.v20.i28.9330
46. Thijssen E., van Caam A., van der Kraan P. M. Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesityinduced osteoarthritis. Rheumatology. 2014;54(4):588-600. https://doi.org/10.1093/rheumatology/keu464
47. Liu X., Ding G., Yang W. [et al.]. Maternal body mass index and risk of congenital heart defects in infants: a dose-response meta-analysis. BioMed Res. International. 2019;2019:1-14. https://doi.org/10.1155/2019/1315796
48. Antonopoulos A. S., Tousoulis D. The molecular mechanisms of obesity paradox. Cardiovascular Res. 2017;113(9):1074-1086. https://doi.org/10.1093/cvr/cvx106
49. Itani O., Jike M., Watanabe N., Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Medicine. 2017;32:246-256. https://doi.org/10.1016/j.sleep.2016.08.006
50. Gozal D., Dumin M., Koren D. Role of sleep quality in the metabolic syndrome. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2016;9:281-310. https://doi.org/10.2147/dmso.s95120
51. Wang H., Chen Y. E., Eitzman D. T. Imaging body fat. Arteriosclerosis Thromb. Vasc. Biol. 2014;34(10):2217-2223. https://doi.org/10.1161/atvbaha.114.303036
52. Arora T., Singh S., Sharma R. K. Probiotics: interaction with gut microbiome and antiobesity potential. Nutrition. 2013;29(4):591-596. https://doi.org/10.1016/j.nut.2012.07.017
53. Fonseca-Junior S. J., Sá B., Rodrigues P. A. F., Oliveira A. J., Fernandes-Filho J. Physical exercise and morbid obesity: a systematic review. Brazilian Archives Digestive Surgery. 2013;26(1):67-73. https://www.ncbi.nlm.nih.gov/pubmed/24463903
54. Vetter M. L., Faulconbridge L. F., Webb V. L., Wadden T. A. Behavioral and pharmacologic therapies for obesity. Nat. Rev. Endocrinol. 2010;6(10):578-588. https://doi.org/10.1038/nrendo.2010.121

Keywords: obesity, lifestyle, adipose tissue, oxidative stress, comorbidity, diet, physical activity

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy