2004, Número S2
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Gac Med Mex 2004; 140 (S2)
Obesidad y dislipidemias
Troyo-Barriga P
Idioma: Español
Referencias bibliográficas: 30
Paginas: 49-58
Archivo PDF: 1028.62 Kb.
RESUMEN
La obesidad es un problema importante de salud pública
mundial. Una de las alteraciones metabólicas más deletéreas
de este padecimiento es la dislipidemia que con frecuencia
la acompaña, misma que es altamente aterogénica. Su
patrón fenotípico habitual es la hipertrigliceridemia
preprandial, la hiperlipidemia no HDL postprandial, el
aumento real en la producción de partículas densas y
pequeñas de LDL, así como la baja producción de colesterol
HDL. El tratamiento integral de la dislipidemia en el
paciente obeso deberá de incluir siempre la identificación
y manejo de factores de riesgo que interactúan en el
padecimiento, además de la valoración del riesgo contra el
beneficio farmacológico. En el futuro, las nuevas
herramientas terapéuticas tales como la farmacogenómica,
podrán corregir en cadena otros estados comórbidos que
con frecuencia se encuentran en la obesidad.
REFERENCIAS (EN ESTE ARTÍCULO)
Albrink MJ, Meigs JW. The relationship between serum triglycerides and skinfold thickness in obese subjects. Ann NY Acad Sci 1965;131(1):673-83.
Berber A, Gómez-Santos R, Fanghanel G, et al. Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidaemia in a Mexican population. Int J Obes Relat Metab Disord 2001;25(12):1794-9.
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 2002;287(3):356-9.
Nielsen S, Guo Z, Johnson CM, et al. Splachnic lipolysis in human obesity. J Clin Invest 2004;113(11):1582-8.
Howard BV, Rutolo G, Robbins DC. Obesity and dyslipidemia. Endocrinol Metab Clin North Am 2003;32(4):855-67.
Freedman DS, Khan LK, Serdula MK, et al. Inter-relationships among childhood BMI, childhood height, and adult obesity: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 2004;28(1):10-6.
Walden CC, Hegele RA. Apolipoprotein E in hyperlipidemia. Ann Intern Med 1994;120(12):1026-36.
Okosun IS, Choi ST, Boltri JM, et al. Trends of abdominal adiposity in white, black, and American adults, 1988 to 2000. Obes Res 2003;11(8):1010-7.
Packard CJ, Shepherd J. Lipoprotein heterogeneity and apolipoprotein B metabolism. Arterioscler Thromb Vasc Biol 1997;17(12):3542-56.
Magill P, Rao SN, Miller NE, et al. Relationships between the metabolism of high density and very low-density lipoproteins in man: studies of apolipoprotein kinetics and adipose tissue lipoprotein lipase activity. Eur J Clin Invest 1982;12(2):113-20.
Brinton EA, Eisenberg S, Breslow JL. Elevated high density lipoprotein cholesterol levels correlate with decreased apo A-I and apo A-II fractional catabolic rate in women. J Clin Invest 1989;84(1):262-9.
Desprès J-P, Ferland M, Moorjani S, et al. Role of hepatictriglyceride lipase activity in the association between intraabdominal fat and plasma HDL cholesterol in obese women. Arteriosclerosis 1989;9:485-92.
Deckelbaum RJ, Granot E, Oschry Y, et al. Plasma triglyceride determines structure-composition in low and high density lipoproteins. Arteriosclerosis 1984;4:225-31.
Houmard JA, Wheeler WS, McCammon MR, et al. An evaluation of waist to hip ratio measurement methods in relation to lipid and carbohydrate metabolism in men. Int J Obes 1991;15(3):181-88.
Peeples LH, Carpenter JW, Israel RG, et al. Alterations in lowdensity lipoproteins in subjects with abdominal adiposity. Metabolism 1989;38(10):1029-36.
Perusse L, Rice T, Desprès J-P, et al. Familial resemblance of plasma lipids, lipoproteins and postheparin lipoprotein and hepatic lipases in the Heritage Family Study. Arterioscler Thromb Vasc Biol 1997;17(11):3263-9.
Austin MA, Edwards KL. Small, dense low density lipoproteins, the insulin resistance syndrome and noninsulin-dependent diabetes. Curr Opin Lipidol 1996;7(3):167-71.
Lamarche B, Tchernof A, Moorjani S, et al. Small, dense lowdensity lipoprotein particles as a predictor of the risk of ischemic heart disease in men: prospective results from the Quebec Cardiovascular Study. Circulation 1997;95(1):69-75.
Applebaum-Bowden DM, Haffner SM, Wahl PW, et al. Postheparin plasma triglyceride lipases: relationships with very low density lipoprotein triglyceride and high density lipoprotein2 cholesterol. Arteriosclerosis 1985;5:273-82.
Auwerx JH, Marzetta CA, Hokanson JE, et al. Large buoyant LDL-like particles in hepatic lipase deficiency. Arteriosclerosis 1989;9:319-25.
Zambon A, Austin MA, Brown BG, et al. Effect of hepatic lipase on LDL in normal men and those with coronary heart disease. Arterioscler Thromb 1993;13(2):147-153.
Watson TD, Caslake MJ, Freeman DJ, et al. Determinants of LDL subfraction distribution and concentrations in young normolipidemic subjects. Arterioscler Thromb 1994;14(6):902-10.
Bergman RN. New concepts in extracellular signaling for insulin action: the single gateway hypothesis. Recent Prog Horm Res 1997;52:359-85.
Bredie SJH, van Drongelen J, Kiemeney LA, et al. Segregation analysis of plasma apolipoprotein B levels in familial combined hyperlipidemia. Arterioscler Thromb Vasc Biol 1997;17(5):834-40.
Jarvik GP, Brunzell JD, Austin MA, et al. Genetic predictors of FCHL in four large pedigrees: influence of apolipoprotein B level major locus predicted genotype and LDL subclass phenotype. Arterioscler Thromb Vasc Biol 1994;14(11):1687-94.
Purnell JQ, Kahn SE, Schwartz RS, et al. Evidence for genetic control of elevated lipid and apo B levels, in addition to visceral obesity/insulin resistance in FCHL. J Invest Med 1997;45:105A.
Guerra R, Wang J, Grundy SM, et al. A hepatic lipase (LIPC) allele associated with high plasma concentrations of high density lipoprotein cholesterol. Proc Natl Acad Sci USA 1997;94(9):4532-7.
Chasman DI, Posada D, Subrahmanvan L, et al. Pharmacogenetic study of statin therapy and cholesterol reduction. JAMA 2004;291(23):2821-7.
Brewer HB Jr. Focus on high-density lipoproteins in reducing cardiovascular risk. Am Heart J 2004;48(Suppl 1):S14-S18.
Brousseau ME, Shaefer EJ, Wolfe ML, et al. Effects of an inhibitor of cholesteryl ester transfer protein on HDL cholesterol. N Engl J Med 2004;350(15):1505-15.