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Can the Obesity Paradox Be Explained by the Protective Effects of Peripheral Adiposity?
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The study by Curtis et al1(p55) reported interesting data from the Digitalis Investigation Group trial indicating that,
In a cohort of outpatients with established HF [heart failure], higher BMIs [body mass indexes; calculated as weight in kilograms divided by the square of height in meters] were associated with lower mortality risks; overweight and obese patients had lower risk of death compared with those at a healthy weight.
The underlying mechanisms of this paradox remain obscure.
Associations between aortic calcification (a surrogate marker of the atherosclerotic burden) and the risk of morbidity and mortality due to cardiac failure have been recently demonstrated by the Framingham study group.2 Our previous studies pointed out that generally obese women (BMI >30) enjoy cardiovascular benefits of their excessive peripheral fat mass owing to the excessive secretion of adiponectin from subcutaneous adipocytes, which provides insulin-sensitizing, anti-inflammatory, and antiatherogenic effects.3-4 Thus, high BMI, together with the gynoid-type . . . [Full Text of this Article]
AUTHOR INFORMATION
László B. Tankó, MD, PhD;
Claus Christiansen, MD
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