Obesity phenotypes and cardiovascular risk: From pathophysiology to clinical management

Rev Endocr Metab Disord. 2023 Oct;24(5):901-919. doi: 10.1007/s11154-023-09813-5. Epub 2023 Jun 26.

Abstract

Obesity epidemic reached the dimensions of a real global health crisis with more than one billion people worldwide living with obesity. Multiple obesity-related mechanisms cause structural, functional, humoral, and hemodynamic alterations with cardiovascular (CV) deleterious effects. A correct assessment of the cardiovascular risk in people with obesity is critical for reducing mortality and preserving quality of life. The correct identification of the obesity status remains difficult as recent evidence suggest that different phenotypes of obesity exist, each one associated with different degrees of CV risk. Diagnosis of obesity cannot depend only on anthropometric parameters but should include a precise assessment of the metabolic status. Recently, the World Heart Federation and World Obesity Federation provided an action plan for management of obesity-related CV risk and mortality, stressing for the instauration of comprehensive structured programs encompassing multidisciplinary teams. In this review we aim at providing an updated summary regarding the different obesity phenotypes, their specific effects on CV risk and differences in clinical management.

Keywords: Adipose tissue; Cardiovascular risk; Fat; Inflammation; Insulin resistance; Obesity.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases* / epidemiology
  • Heart Disease Risk Factors
  • Humans
  • Obesity / epidemiology
  • Phenotype
  • Quality of Life*
  • Risk Factors