title: Dyslipidemia in obesity: mechanisms and potential targets.
abstract: Obesity has become a major worldwide health problem. In every single country in the world, the incidence of obesity is rising continuously and therefore, the associated morbidity, mortality and both medical and economical costs are expected to increase as well. The majority of these complications are related to co-morbid conditions that include coronary artery disease, hypertension, type 2 diabetes mellitus, respiratory disorders and dyslipidemia. Obesity increases cardiovascular risk through risk factors such as increased fasting plasma triglycerides, high LDL cholesterol, low HDL cholesterol, elevated blood glucose and insulin levels and high blood pressure. Novel lipid dependent, metabolic risk factors associated to obesity are the presence of the small dense LDL phenotype, postprandial hyperlipidemia with accumulation of atherogenic remnants and hepatic overproduction of apoB containing lipoproteins. All these lipid abnormalities are typical features of the metabolic syndrome and may be associated to a pro-inflammatory gradient which in part may originate in the adipose tissue itself and directly affect the endothelium. An important link between obesity, the metabolic syndrome and dyslipidemia, seems to be the development of insulin resistance in peripheral tissues leading to an enhanced hepatic flux of fatty acids from dietary sources, intravascular lipolysis and from adipose tissue resistant to the antilipolytic effects of insulin. The current review will focus on these aspects of lipid metabolism in obesity and potential interventions to treat the obesity related dyslipidemia.
authors.affiliation: Department of Internal Medicine, Diabetes and Vascular Centre, Sint Franciscus Gasthuis, Rotterdam, P.O. Box 10900, 3004 BA, The Netherlands. m.castrocabezas@sfg.nl
authors.forename: Boudewijn
authors.initials: B
authors.lastname: Klop
authors.forename: Jan Willem F
authors.initials: JW
authors.lastname: Elte
authors.forename: Manuel Castro
authors.initials: MC
authors.lastname: Cabezas
mesh_terms: D015415:Biomarkers / Q000097:blood; D031204:Caloric Restriction; D015897:Comorbidity; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000378:metabolism; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects*; D008055:Lipids / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D000960:Hypolipidemic Agents; D018836:Inflammation Mediators; D008055:Lipids