Obesity: Key Factor for Cardiometabolic Risk

Abstract

Metabolic syndrome (MS) is a clinical entity characterized by the presence of insulin
resistance, compensatory hyperinsulinism, glucose intolerance, hypertension, dyslipidaemia
and obesity, which increases cardiovascular risk. The prevalence of this clinical condition
has increased in the last decade in the western world, being very common in Europe and in
the United States (it may reach around 25% in people over 20-years-old and 50% in people
over 60-years-old).1
Unlike the WHO or European Group for the study of Insulin Resistance
(EGIR) group criteria, abdominal obesity/waist circumference (men >102 cm and women
>88 cm) gains importance in the Adult Treatment Panel III (ATPIII) which is recognised as
similar as other main criteria; not being necessary the presence of insulin resistance, diabetes
or hydrocarbon intolerance. These convenience standards make useful the anthropometric and
laboratory accessible tests in primary and hospital care. Overall, there are three kinds of risk
factors (underlying, major and emerging) in the MS, some of them have proved relation to the
obesity.2
Firstly, obesity (especially visceral or abdominal obesity) is considered one of the
main underlying risk factors, along with a lack of physical activity and an atherogenic diet.
Secondly, elevated blood pressure is strongly associated with obesity, more frequently with
insulin resistance people, as a metabolic risk factor. Another emerging risk factor to consider
is the frequent proinflammatory state in the MS, which is clinically detected by an increase of
C-reactive protein (CRP) levels. One of the principal cause among the multiple mechanisms
underlying of this is the obesity due to the excess adipose tissue releases inflammatory cytokines
that can produce high-levels of CRP.