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Mechanisms linking obesity with cardiovascular disease

Abstract

Obesity increases the risk of cardiovascular disease and premature death. Adipose tissue releases a large number of bioactive mediators that influence not only body weight homeostasis but also insulin resistance — the core feature of type 2 diabetes — as well as alterations in lipids, blood pressure, coagulation, fibrinolysis and inflammation, leading to endothelial dysfunction and atherosclerosis. We are now beginning to understand the underlying mechanisms as well as the ways in which smoking and dyslipidaemia increase, and physical activity attenuates, the adverse effects of obesity on cardiovascular health.

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Figure 1: Schematic representation of how smoking might add to several mechanisms linking obesity to cardiovascular disease.
Figure 2: Disturbances in haemostasis and fibrinolysis as additional cardiovascular risk factors in relation to metabolic syndrome.
Figure 3: Both abdominal (visceral) fat and insulin resistance may contribute to cardiovascular disease in obesity.

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Acknowledgements

The authors thank A. Verrijken and P.-J. Van Gaal from the Metabolic Unit for their help with literature searches.

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Van Gaal, L., Mertens, I. & De Block, C. Mechanisms linking obesity with cardiovascular disease. Nature 444, 875–880 (2006). https://doi.org/10.1038/nature05487

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