Hormonal
Obesity-associated cardiovascular risk is driven by adipose tissue dysfunction and altered adipokine secretion (specifically increased leptin/resistin and decreased adiponectin/omentin-1), rather than body mass index (BMI) alone.
If you have obesity, your risk for heart disease is heavily influenced by the hormones your fat cells release, not just your weight. Visceral fat is particularly harmful because it releases pro-inflammatory signals (like leptin and resistin) and fewer protective signals (like adiponectin). While weight loss helps, interventions that improve metabolic health (like bariatric surgery) work partly by restoring this hormonal balance, not just by reducing mass.
Obesity is associated with an altered secretion of adipokines that, in fact, translates into increased cardiovascular risk in patients with an excess of dysfunctional adiposity.
Why this rating
The paper is a comprehensive review citing numerous prospective studies and mechanistic data, though it does not present new primary clinical trial data itself.
Source
Relevance of Leptin and Other Adipokines in Obesity-Associated Cardiovascular Risk
Manuel F. Landecho et al. · Nutrients · 2019
DOI 10.3390/nu11112664
More from this paper
- Leptin resistance in obesity reverses its protective vascular effects, contributing to a pro-oxidative state, endothelial dysfunction, and accelerated biological senescence.Good
- Bariatric surgery improves cardiovascular risk profiles by significantly altering adipokine secretion profiles, specifically decreasing leptin and increasing adiponectin, independent of simple caloric restriction.Good
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