Obesity. Phenotypes and Comorbidity in the Early Stages of the Cardiometabolic Continuum

Abstracts. Introduction. The increase in the total number of obese individuals worldwide, particularly in Russia, a deeper understanding of adipose tissue metabolism, the emergence of new methods to identify it, the younger age of patients with increased body weight, and the need for developing evidence-based preventive strategies for obesity- related comorbid diseases determine the importance of studies in this area. Aim. The aim of the study was to review medical literature containing information on different types of obesity and their role in formation of comorbidity at the initial stages of the cardiometabolic continuum. Materials and Methods. Review and analysis of articles published between 2013-2024 (PubMed, eLibrary, Google Scholar, and ResearchGate) devoted to the study of heterogeneity of adipose tissue and its association with the early formation of obesity-related comorbidities. Results and Discussion. Complex pathogenic mechanisms for development of certain somatic pathologies in general, abdominal, and visceral obesity are observed due to the heterogeneity of adipose tissue. To date, it has been shown that general obesity mostly associated with the development of arterial hypertension, gastroesophageal reflux disease, osteoarthritis, obstructive sleep apnea mainly through mechanical effects, and visceral obesity is associated with the developmentof dyslipidemia, prediabetes, arterial hypertension, gastroesophageal reflux disease diseases, steatosis of the liver and pancreas, osteoarthritis, obstructive sleep apnea, as manifestations of the influence of adiposopathy. Number of diseases and severity of comorbidity increases in individuals with the simultaneous presence of general, abdominal, and visceral obesity. In individuals with the simultaneous presence of general, abdominal and visceral obesity, the number of diseases and the severity of comorbidity increases. Conclusions. Literature analysis demonstrated the need for a differentiated approach to both identifying the type of obesity and the comorbidity associated with it. Further study of the characteristics of comorbidity status in various obesity phenotypes may be useful for developing personalized, evidence-based prevention strategies.