Palabras clave
Diabetes Mellitus Tipo 2
Hipertensión arterial esencial
Enfermedades Cardiovasculares
Neoplasias
Apnea Obstructiva del Sueño
Osteoartritis
Síndrome Metabólico
Manejo de la Obesidad
Fármacos Antiobesidad
Cómo citar
Resumen
La obesidad es un condicionante para el desarrollo de patologías, como: diabetes mellitus tipo 2, hipertensión arterial, dislipidemias, trastornos respiratorios del sueño, condiciones cardiovasculares e incremento del riesgo de cáncer. En Colombia, cerca del 56,4 % de la población tiene exceso de peso. En razón a esto, entre el 15 de octubre del 2022 y 31 de enero del 2023, se realizó una revisión de tema en las bases de datos Scielo y Pubmed/Medline, dividida en dos partes: la primera, centrada en la relación fisiopatológica de patologías, como hipertensión arterial, diabetes mellitus, cáncer, entre otras, y la obesidad; la segunda, orientada en establecer el abordaje apropiado para la obesidad, incluyendo medidas farmacológicas y no farmacológicas. Con esta revisión se busca remarcar la importancia de un abordaje integral del paciente con obesidad, resaltando la importancia de su identificación como factor de riesgo o desencadenante de diversas condiciones metabólicas y cardiovasculares.
Referencias
Gadde KM, Martin CK, Berthoud HR, Heymsfield SB. Obesity: Pathophysiology and Management. J Am Coll Cardiol. 2018;71(1):69-84.
Instituto Colombiano de Bienestar Familiar (ICBF). ENSIN: Encuesta Nacional de la Situación Nutricional. Bogotá, Colombia. Portal ICBF. 2015. https://www.icbf.gov.co/bienestar/nutricion/ encuesta-nacional-situacion-nutricional.
Jaganathan R, Ravindran R, Dhanasekaran S. Emerging Role of Adipocytokines in Type 2 Diabetes as Mediators of Insulin Resistance and Cardiovascular Disease. Can J Diabetes. 2018;42(4):446-456.
Løvsletten O, Jacobsen BK, Grimsgaard S, Njølstad I, Wilsgaard T, Løchen ML, et al. Prevalence of general and abdominal obesity in 2015-2016 and 8-year longitudinal weight and waist circumference changes in adults and elderly: the Tromsø Study. BMJ Open. 2020;10(11).e038465.
Wensveen FM, Valentić S, Šestan M, Turk Wensveen T, Polić B. The “Big Bang” in obese fat: Events initiating obesity-induced adipose tissue inflammation. Eur J Immunol. 2015;45(9):2446- 2456.
Vega-Robledo GB, Rico-Rosillo MG. Tejido adiposo: función inmune y alteraciones inducidas por obesidad. Rev. alerg. Méx. 2019;66(3):340– 353.
Johnson AR, Milner JJ, Makowski L. The inflammation highway: metabolism accelerates inflammatory traffic in obesity. Immunol Rev. 2012;249(1):218-238.
Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, et al. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of The Obesity Society and the American Society of Hypertension. J Clin Hypertens. 2013;15(1):14-33.
Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116(6):991-1006.
Seravalle G, Grassi G. Obesity and hypertension. Pharmacol Res. 2017; 122:1-7.
Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98-107.
Al-Kaisey AM, Kalman JM. Obesity and atrial fibrillation: Epidemiology, Pathogenesis and Effect of Weight Loss. Arrhythm Electrophysiol Rev. 2021; 10(3):159-164.
Stender S, Nordestgaard BG, Tybjaerg-Hansen A. Elevated body mass index as a causal risk factor for symptomatic gallstone disease: a Mendelian randomization study. Hepatology. 2013; 58(6):2133-2141.
Stokes CS, Lammert F. Excess Body Weight and Gallstone Disease. Visc Med. 2021; 37(4): 254– 260.
Steele CB, Thomas CC, Henley SJ, Massetti GM, Galuska DA, Agurs-Collins T, et al. Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity — United States, 2005–2014. MMWR Morb Mortal Wkly Rep. 2017;66(39):1052–1058.
Keum N, Greenwood DC, Lee DH, Kim R, Aune D, Ju W, et al. Adult weight gain and adiposity- related cancers: a dose-response meta-analysis of prospective observational studies. J Natl Cancer Inst. 2015;107(2).
Renehan AG, Zwahlen M, Egger M. Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer. 2015;15(8):484– 498.
Meurling IJ, Shea DO, Garvey JF. Obesity and sleep. Curr Opin Pulm Med. 2019;25(6):602–608.
Páez-Moya S, Vega-Osorio PA. Factores de riesgo y asociados al síndrome de apnea-hipopnea obstructiva del sueño (SAHOS). Rev Fac Med Univ Nac Colomb. 2017;65(1Sup):21–24.
ACR: american college of rheumatology [Internet]. Atlanta, Estados Unidos. Osteoartitis: 2019 Mar; [3]. Disponible en: https://rheumatology.org/patients/osteoartritis
Sellam J, Berenbaum F. Is osteoarthritis a metabolic disease?. Joint Bone Spine. 2013;80(6):568-573.
Mayer SB, Graybill S, Raffa SD, Tracy C, Gaar E, Wisbach G, et al. Synopsis of the 2020 U.S. VA/DoD Clinical Practice Guideline for the Management of Adult Overweight and Obesity. Mil Med. 2021;186(9-10):884-896.
Obesity Management Task Force of the European Association for the Study of Obesity. European Guidelines for Obesity Management in Adults. Alemania. Karger;2015. https://doi.org/10.1159/000442721
Canadian clinical practice guideline. Obesity in adults: a clinical practice guideline. Canadá.CMAJ;2020. https://doi.org/10.1503/cmaj.191707
Wadden T, Tronieri J, Butryn M. Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol. 2020;75(2):235-251.
The obesity Society with de ACC/AHA Task force. Guidelines (2013) for managing overweight and obesity in adults. Estados Unidos. Obesity; 2014. https://doi.org/10.1002/oby.20818.
Gotthelf L, Chen YT, Rajagopalan S, Wu EC, Doshi I, Addy C. High intensity lifestyle intervention and long-term impact on weight and clinical outcomes. PLoS One. 2018;13(4).
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6): 393-403.
Butryn ML, Webb V, Wadden TA. Behavioral treatment of obesity. Psychiatr Clin North Am. 2011;34(4):841-859.
Kushner RF. Weight Loss Strategies for Treatment of Obesity. Lifestyle Management and Pharmacotherapy. Prog Cardiovasc Dis. 2018;61(2):246-252.
McCafferty BJ, Hill JO, Gunn AJ. Obesity: Scope, Lifestyle Interventions, and Medical Management. Tech Vasc Interv Radiol. 2020;23(1).
Thom G, Lean M. Is there an optimal diet for weight management and metabolic health? Gastroenterology. 2017;152(7):1739–1751.
Duque J, Rosero R, Asociación Colombiana de Endocrinología, Diabetes y Metabolismo. Recomendaciones de la Asociación Colombiana de Endocrinología, Diabetes y Metabolismo para el Manejo de la Obesidad. 2023. https://www. endocrino.org.co/sites/default/files/2022-08/Rec.%20Obesidad%20Vol.1.pdf
Webb V, Wadden T. Intensive Lifestyle Intervention for Obesity: Principles, Practices, and Results. Gastroenterology. 2017;152(7):1752– 1764.
Lucas K, Kaplan-Machlis B. Orlistat — a novel weight loss therapy. Annals of Pharmacotherapy. 2001;35(3),314–328.
Kelly A, Auerbach P, Barrientos-Perez M, Gies I, Hale P, Marcus C et al. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. N Engl J Med. 2020;28;382(22):2117-2128.
Wilding J, Batterham R, Calanna S, Davies M, Van Gaal L, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002.
Jastreboff A, Aronne L, Ahmad N, Wharton S, Connery L, Alves B, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205–216.
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