Visceral adipose tissue and residual cardiovascular risk: a pathological link and new therapeutic options

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Cristina Mennitti¹  Olga Scudiero²  Giuseppe Raucci³  Gianmaria Scherillo³  Francesco Paolo Rotolo³  Gianantonio De Michele³  Felice Gragnano³  Arturo Cesaro³  Francesco Scialla³  Vincenzo Acerbo³  Giovanni Signore³  Elisabetta Moscarella³  Paolo Calabrò³  Domenico Panico³  Fabio Fimiani⁴ 

[1] Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy;Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy;Ceinge Biotecnologie Avanzate Franco Salvatore S. C. a R. L., Naples, Italy;Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy;Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy;Division of Cardiology, A.O.R.N. “Sant'Anna e San Sebastiano”, Caserta, Italy;Unit of Inherited and Rare Cardiovascular Diseases, A.O.R.N. Dei Colli “V. Monaldi”, Naples, Italy;

关键词: obesity;    visceral adipose tissue;    residual cardiovascular risk;    GLP-1 agonists;    liraglutide;    semaglutide;   

DOI  :  10.3389/fcvm.2023.1187735

 received in 2023-03-16, accepted in 2023-07-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

Obesity is a heterogeneous disease that affects almost one-third of the global population. A clear association has been established between obesity and cardiovascular disease (CVD). However, CVD risk is known to be related more to the local distribution of fat than to total body fat. Visceral adipose tissue (VAT) in particular has a high impact on CVD risk. This manuscript reviews the role of VAT in residual CV risk and the available therapeutic strategies for decreasing residual CV risk related to VAT accumulation. Among the many pathways involved in residual CV risk, obesity and particularly VAT accumulation play a major role by generating low-grade systemic inflammation, which in turn has a high prognostic impact on all-cause mortality and myocardial infarction. In recent years, many therapeutic approaches have been developed to reduce body weight. Orlistat was shown to reduce both weight and VAT but has low tolerability and many drug-drug interactions. Naltrexone-bupropion combination lowers body weight but has frequent side effects and is contraindicated in patients with uncontrolled hypertension. Liraglutide and semaglutide, glucagon-like peptide 1 (GLP-1) agonists, are the latest drugs approved for the treatment of obesity, and both have been shown to induce significant body weight loss. Liraglutide, semaglutide and other GLP-1 agonists also showed a positive effect on CV outcomes in diabetic patients. In addition, liraglutide showed to specifically reduce VAT and inflammatory biomarkers in obese patients without diabetes. GLP-1 agonists are promising compounds to limit inflammation in human visceral adipocytes.

【 授权许可】

Unknown   
© 2023 Cesaro, De Michele, Fimiani, Acerbo, Scherillo, Signore, Rotolo, Scialla, Raucci, Panico, Gragnano, Moscarella, Scudiero, Mennitti and Calabrò.