Adipositas und kardiovaskuläres Risiko – mehr als nur der BMI

Zusammenfassung

Adipositas ist eine multifaktorielle Erkrankung mit global steigender Prävalenz, die durch biologische, psychosoziale und umweltbedingte Faktoren begünstigt wird. Neben dem Body-Mass-Index sind auch der Taillenumfang und das Verhältnis von Taillenumfang zu Hüft- oder Körpergröße wichtige Prädiktoren für kardiovaskuläre Risiken. Insbesondere viszerales Fettgewebe spielt eine zentrale Rolle bei der Entwicklung von Atherosklerose und koronarer Herzkrankheit durch Vermittlung von Entzündungsprozessen und Insulinresistenz. Neue Ansätze fordern eine differenzierte Betrachtung von präklinischer und klinisch manifester Adipositas, um eine Übertherapie zu vermeiden. Während Lebensstilinterventionen essenziell bleiben, zeigen medikamentöse und operative Ansätze Potenzial zur Reduktion kardiovaskulärer Ereignisse. Eine langfristige Risikominimierung erfordert jedoch nachhaltige Maßnahmen, die über kurzfristige Gewichtskontrolle hinausgehen.

Abstract

Obesity is a multifactorial disease with a globally increasing prevalence that is promoted by biological, psychosocial and environmental factors. In addition to body mass index, waist circumference and waist-to-hip ratio are also important predictors of cardiovascular risk. Visceral adipose tissue in particular plays a central role in the development of atherosclerosis and coronary heart disease through mediation of inflammatory processes and insulin resistance. New approaches call for a differentiated view of preclinical and clinically manifest obesity in order to avoid overtreatment. While lifestyle interventions remain essential, drug and surgical approaches show potential for reducing cardiovascular events. However, long-term risk minimization requires sustainable measures that go beyond short-term weight control.

Was ist wichtig?

• Adipositas ist eine multifaktorielle Erkrankung mit global steigender Prävalenz, die durch biologische, psychosoziale und umweltbedingte Faktoren begünstigt wird. Viszerales Fettgewebe fördert durch Entzündungsprozesse und Insulinresistenz die Entwicklung von Atherosklerose und koronarer Herzkrankheit.

• Neue Ansätze in der Diagnostik einer Adipositas fordern eine differenzierte Betrachtung von präklinischer und klinisch manifester Adipositas, um Übertherapie zu vermeiden. Neben dem Body-Mass-Index sind weitere anthropometrische Größen wichtige Prädiktoren einer klinisch relevanten Adipositas und für kardiovaskuläre Risiken.

• Während Lebensstilinterventionen die Basis der Adipositastherapie bilden, bieten medikamentöse und operative Ansätze vielversprechende Möglichkeiten zur Reduktion kardiovaskulärer Ereignisse.

Schlüsselwörter

Adipositas - Body-Mass-Index - Inflammation

Keywords

obesity - body mass index - inflammation

Publication History

Article published online:
06 August 2025

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