Von Diabetes bis Schlafapnoe: Nach welchen Adipositas-Komplikationen sollen wir suchen?

In Anbetracht der steigenden Prävalenz von Übergewicht und Adipositas in Deutschland – und auch weltweit – erhöht sich dementsprechend die Zahl der Patient*innen mit adipositasassoziierten Komorbiditäten [1] [2]. Eine Kenntnis dieser Folgeerkrankungen ist deshalb wesentlich, um gezielt nach ihnen zu suchen, sie zu behandeln und dadurch die Patientenversorgung und letztendlich die Morbidität und Mortalität der Patient*innen mit Adipositas zu verbessern.

Abstract

The prevalence of obesity has increased worldwide. For Germany, according to the “Study on Adult Health in Germany” (DEGS1) of the Robert Koch Institute from the years 2008–2011, the prevalence of a BMI ≥25 kg/m² was 67,1% for men and 53,0% for women, whereby the proportion of obesity, i.e. a BMI ≥30 kg/m² is 23, 3% for men and 23,9% for women. Compared to 1998, the prevalence of obesity in the same group was 18, 8% for men and 21,7% for women. Because of the increasing prevalence of overweight and obesity, the number of patients with obesity-associated comorbidities is correspondingly increasing. There is a close association between obesity and an increased risk of metabolic diseases, cardiovascular diseases, but also musculoskeletal diseases, some types of cancer and mental comorbidities. In addition, obesity might also lead to restrictions in activities of daily living, reduced quality of life, unemployment and early retirement. A knowledge of obesity-associated sequelae is therefore essential in order to specifically look for them, treat them and thereby improve patient care and ultimately morbidity and mortality of patients with obesity.

Kernaussagen

• Adipositas ist mit zahlreichen Folgeerkrankungen und somit einer erhöhten Morbidität und Mortalität assoziiert.

• Vor dem Hintergrund, dass die meisten Todesfälle in Zusammenhang mit hohem BMI auf kardiovaskuläre Erkrankungen zurückzuführen sind, sollten Patienten zur Abschätzung des kardiovaskulären Risikos bei Adipositas hinsichtlich des Vorliegens eines Diabetes mellitus Typ 2 und weiterer Parameter des metabolischen Syndroms, bzw. klassischer kardiovaskulärer Risikofaktoren, untersucht werden.

• Bei Adipositas sollte ein (nicht invasives) Screening mittels Bestimmung der Transaminasen und Sonografie des Abdomens auf NAFLD erfolgen, wenn Risikofaktoren für die Entwicklung einer NASH vorliegen.

• Es besteht eine hohe Prävalenz eines OSAS und OHS bei Übergewicht und Adipositas.

• Es besteht ein klarer Zusammenhang zwischen Adipositas und dem Auftreten bestimmter maligner Erkrankungen, weshalb gerade adipösen Patient*innen die entsprechenden GKV-Krebsvorsorge-Untersuchungen dringlich wahrnehmen sollten.

Schlüsselwörter

Adipositas - metabolisches Syndrom - kardiovaskuläre Erkrankungen - nichtalkoholische Fettlebererkrankung - maligne Erkrankungen

Keywords

obesity - metabolic syndrome - cardiovascular disease - non-alcoholic fatty liver dise - cancer

Publication History

Article published online:
21 July 2023

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