Abstract：
BACKGROUND: This joint expert review by the Obesity Medicine Association (OMA) and National Lipid Association (NLA) provides clinicians an overview of the pathophysiologic and clinical considerations regarding obesity, dyslipidemia, and cardiovascular disease (CVD) risk.
METHODS: This joint expert review is based upon scientific evidence, clinical perspectives of the authors, and peer review by the OMA and NLA leadership.
RESULTS: Among individuals with obesity, adipose tissue may store over 50% of the total body free cholesterol. Triglycerides may represent up to 99% of lipid species in adipose tissue. The potential for adipose tissue expansion accounts for the greatest weight variance among most individuals, with percent body fat ranging from less than 5% to over 60%. While population studies suggest a modest increase in blood low-density lipoprotein cholesterol (LDL-C) levels with excess adiposity, the adiposopathic dyslipidemia pattern most often described with an increase in adiposity includes elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-C), increased non-HDL-C, elevated apolipoprotein B, increased LDL particle concentration, and increased small, dense LDL particles.
CONCLUSIONS: Obesity increases CVD risk, at least partially due to promotion of an adiposopathic, atherogenic lipid profile. Obesity also worsens other cardiometabolic risk factors. Among patients with obesity, interventions that reduce body weight and improve CVD outcomes are generally associated with improved lipid levels. Given the modest improvement in blood LDL-C with weight reduction in patients with overweight or obesity, early interventions to treat both excess adiposity and elevated atherogenic cholesterol (LDL-C and/or non-HDL-C) levels represent priorities in reducing the risk of CVD.
METHODS: This joint expert review is based upon scientific evidence, clinical perspectives of the authors, and peer review by the OMA and NLA leadership.
RESULTS: Among individuals with obesity, adipose tissue may store over 50% of the total body free cholesterol. Triglycerides may represent up to 99% of lipid species in adipose tissue. The potential for adipose tissue expansion accounts for the greatest weight variance among most individuals, with percent body fat ranging from less than 5% to over 60%. While population studies suggest a modest increase in blood low-density lipoprotein cholesterol (LDL-C) levels with excess adiposity, the adiposopathic dyslipidemia pattern most often described with an increase in adiposity includes elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-C), increased non-HDL-C, elevated apolipoprotein B, increased LDL particle concentration, and increased small, dense LDL particles.
CONCLUSIONS: Obesity increases CVD risk, at least partially due to promotion of an adiposopathic, atherogenic lipid profile. Obesity also worsens other cardiometabolic risk factors. Among patients with obesity, interventions that reduce body weight and improve CVD outcomes are generally associated with improved lipid levels. Given the modest improvement in blood LDL-C with weight reduction in patients with overweight or obesity, early interventions to treat both excess adiposity and elevated atherogenic cholesterol (LDL-C and/or non-HDL-C) levels represent priorities in reducing the risk of CVD.
摘要：
背景：肥胖医学协会（OMA）和美国国家脂质协会（NLA）的联合专家审查为临床医生提供了有关肥胖的病理生理和临床考虑因素的概述，血脂异常,和心血管疾病（CVD）的风险。
方法：这项联合专家审查是基于科学证据，作者的临床观点，以及OMA和NLA领导层的同行评审。
结果：在肥胖个体中，脂肪组织可以储存超过50%的全身游离胆固醇。甘油三酯可以代表脂肪组织中高达99%的脂质种类。脂肪组织扩张的可能性是大多数个体体重差异最大的原因，身体脂肪百分比从不到5%到超过60%。虽然人群研究表明，过度肥胖会导致血液低密度脂蛋白胆固醇（LDL-C）水平适度增加，最常描述为肥胖增加的脂肪病性血脂异常模式包括甘油三酯升高，降低高密度脂蛋白胆固醇（HDL-C），增加非HDL-C，载脂蛋白B升高，LDL颗粒浓度增加，并且增加得很小，高密度低密度脂蛋白颗粒。
结论：肥胖会增加心血管疾病的风险，至少部分是由于促进了一种脂肪病，致动脉粥样硬化的脂质分布。肥胖还会使其他心脏代谢危险因素恶化。在肥胖患者中，降低体重和改善CVD结局的干预措施通常与改善血脂水平相关.鉴于超重或肥胖患者的血液LDL-C随着体重的减少而适度改善，早期干预治疗过度肥胖和动脉粥样硬化胆固醇(LDL-C和/或非HDL-C)水平升高是降低CVD风险的优先事项.
方法：这项联合专家审查是基于科学证据，作者的临床观点，以及OMA和NLA领导层的同行评审。
结果：在肥胖个体中，脂肪组织可以储存超过50%的全身游离胆固醇。甘油三酯可以代表脂肪组织中高达99%的脂质种类。脂肪组织扩张的可能性是大多数个体体重差异最大的原因，身体脂肪百分比从不到5%到超过60%。虽然人群研究表明，过度肥胖会导致血液低密度脂蛋白胆固醇（LDL-C）水平适度增加，最常描述为肥胖增加的脂肪病性血脂异常模式包括甘油三酯升高，降低高密度脂蛋白胆固醇（HDL-C），增加非HDL-C，载脂蛋白B升高，LDL颗粒浓度增加，并且增加得很小，高密度低密度脂蛋白颗粒。
结论：肥胖会增加心血管疾病的风险，至少部分是由于促进了一种脂肪病，致动脉粥样硬化的脂质分布。肥胖还会使其他心脏代谢危险因素恶化。在肥胖患者中，降低体重和改善CVD结局的干预措施通常与改善血脂水平相关.鉴于超重或肥胖患者的血液LDL-C随着体重的减少而适度改善，早期干预治疗过度肥胖和动脉粥样硬化胆固醇(LDL-C和/或非HDL-C)水平升高是降低CVD风险的优先事项.
