Hormonal Regulation of Lipoprotein Metabolism in Obesity
Severe obesity leads to an increased risk for coronary heart disease. Although the relative increase of risk is low (from 1.0 in normal weight subjects to 1.55 in persons with an overweight >40%) in comparison to other diseases (e. g. increase in mortality rate for diabetes mellitus from 1.0 to 7.55 in obese women) it has great importance for public health . The factors leading to the increased risk include a higher frequency of hypertension and other cardiovascular risk factors. A positive eilergy balance and especially a high fat intake during weight gain negatively influences serum lipoproteins. But also under a weight maintaining diet distinctlipoprotein alterations are present in obesity. Characteristic are an increase of serum triglycerides, VLDL-triglycerides and VLDL-cholesterol, and decreased HDL-cholesterol concentrations. Table 1 illustrates these findings in 158 men also indicating that there is no correlation between BMI and total or LDL-cholesterol. In moderate obesity there may be a slight increase of total cholesterol but in severe obesity (BMI >36 kg/m2) often low cholesterol concentrations can be observed (Fig. 1).
KeywordsInsulin Sensitivity Pancreatic Polypeptide Lipoprotein Metabolism Serum Lipoprotein Oral Glucose Load
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