Adipositas und bewegungsmangel als kardiovaskuläre risikofaktoren

Obesity as well as low physical fitness and physical activity have been established as independent cardiovascular risk factors. Recent data have added that even moderate obesity is associated with an increased risk and that this relationship is evident for men and women across all age groups. Particularly abdominal obesity has been found to play a pathophysiological role because of its close relationship to insulin resistance and metabolic cardiovascular risk factors. This association is explained by the synthesis of leptin and tumor necrosis factor-α (TNF-α) in abdominal adipocytes. Leptin is responsible for the feed-back regulation of body weight control between peripheral fat tissue and the central nervous system whereas TNF-α is thought to be an important mediator triggering the expression of metabolic risk factors. Recent studies have shown that physical activity and weight reduction can reduce systemic leptin levels as well as the expression of TNF-α in adipocytes. Whether these findings will eventually explain the inverse relationship between physical activity and cardiovascular morbidity and mortalily even in obese subjects is an interesting hypothesis and remains subject for future research.