EC Clinical and Medical Case Reports

The adiposity, and the risks associated with this altered metabolic state, with acute cardiovascular events are poorly understood, and the relationship is a complex one. Abdominal obesity is known to cause alterations in adipocyte biology, leading to inflammation, dysglycemia, insulin resistance, increased blood pressure, endothelial dysfunction and atherogenesis. Compared with Europeans, people of South Asian and East Asian ethnicity develop type-2 diabetes, with a lower body mass index. Genome Wide Association Studies (GWAS) have identified 400 genetic variations associated with the risks for type-2 diabetes. Adiposity per se, does not explain excess risk for type-2 diabetes. Visceral fat and ectopic fat accumulation in or around the liver, pancreas, and muscle, are causally related to insulin resistance, impaired glucose tolerance and type-2 diabetes. Body fat distribution across the population is not uniform. South Asian phenotype predominantly accumulates fat in the abdominal region, and this type of obesity has been referred as central abdominal obesity, as compared to the increase in the overall body mass index (BMI), observed in western populations. No matter what the pattern of fat distribution, increases in white fat seem to promote weight gain, and leads to the development of obesity. Excess fat is associated with higher concentration of the hormones of the renin-angiotensin system, which may initiate oxidative stress by generating reactive oxygen species. Visceral fat also may play a role in lipid peroxidation and promote damage through production of cytokines. These reactions may further activate nuclear factor kB (NF-kB) and induce inflammation. Such metabolic disturbances, promote increases in blood pressure, insulin resistance, arterial stiffness, and endothelial dysfunction. Some studies have demonstrated the relationship between leptins and adiposity. Leptin resistance elevates cytokines and tumor necrosis factor, promotes inflammation, and increases risk for CVDs. Physical fitness reduces leptin concentrations, increases satiety, lowers inflammation, and improves vascular functions. Obesity in general, childhood obesity in particular, is a global public health crisis. Although there is lots of speculation, there is no single definitive cause of obesity, which means there is no definite cure for this condition. In this overview, we have discussed few novel approaches for the early diagnosis of this metabolic condition, as well as for developing appropriate preventive interventions. Obesity is speculated to emerge as the fastest growing, and leading metabolic risk factor, underlying acute myocardial infarction.

Keywords: Obesity; Metabolic Disease; Acute Myocardial Infarction; Genome Wide Association Studies (GWAS); Body Mass Index (BMI); Nuclear Factor kB (NF-kB)

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