Статья
“Парадоксы ожирения”: основные причины формирования “обратной” кардиоваскулярной эпидемиологии
С учетом продолжающегося роста распространенности ожирения, в большинстве стран мира оно становится одной из главных проблем общественного здравоохранения. В структуре нозологических единиц, ассоциированных с наличием избыточной массы тела и ожирения, лидирует кардиоваскулярная патология. Вместе с тем, в исследованиях и мета-анализах последних десятилетий стали выявлять обратную взаимосвязь индекса массы тела и клинических исходов, характеризующуюся лучшей выживаемостью и меньшей частотой событий у лиц, имеющих более высокую величину показателя, с хроническими заболеваниями. Такие факты способствовали появлению многочисленных дискуссий в отношении прогностического влияния избыточной массы тела и ожирения и целесообразности их коррекции у лиц с сердечно-сосудистыми заболеваниями в рамках вторичной профилактики. В настоящей статье обсуждаются основные возможные причины формирования “обратной” кардиоваскулярной эпидемиологии при избыточном весе и ожирении.
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