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  Centr. eur. J. publ. Hlth 7, 1999, No 3, p. 122–129
 
ISCHAEMIC HEART DISEASE AS AN EFFECT OF OBESITY-RELATED METABOLIC DISTURBANCES 
Indulski J. A., Lutz W. 

The Nofer Institute of Occupational Medicine, Lodz, Poland
 


Summary:

       Obesity results from excessive accumulation of fats in adipose tissue and constitutes one of the essential sources of increased incidence of some diseases harassing the highly industrialized and urbanized societies. Obesity-related metabolic disorders may be associated with the risk of circulatory diseases. The mechanism causing that obesity enhances the incidence of the metabolic disorders have not been explained to the full extent. Hyperinsulinaemia is one of effects of obesity and of the associated presence of excessive blood fatty acid levels. Overloading of the organism with fatty acids changes the function pancreatic b cells. Insulin resistance and hyperglycaemia caused by high peripheral fatty acid levels trigger increased insulin secretion. Hyperinsulinaemia affects hepatic metabolism so as to make it hyperanabolic. Liver increases triacylglycerol and cholesterol synthesis and raises the rate of very low density lipoproteins (VLDL) secretion to the blood. Increased VLDL concentration contributes to increased LDL and is associated with reduced HDL cholesterol concentrations. Atherogenic dyslipidemia in obese people results, to a large extent, from increased VLDL secretion. Data collected heretofore point to an undoubtedly essential role of the adipose tissue in the pathogenesis of metabolic disorders in obese people. There are many causes of disturbed adipose tissue function which result in high blood fatty acid levels, excessive fat accumulation in other tissues and organs, or both. Another factor which may aggravate the metabolic disorders is the diet. It is worth noting that genetic determinants may cause that some individuals reveal a specified set of factors increasing the risk of ischaemic heart disease.

        Key words: obesity, metabolic disturbances, hyperinsulinaemia, cholesterol, triacylglycerols, fatty acids, heart diseases
       

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