Key result
Obesity alters respiratory disease progression via systemic inflammation and biomechanical changes.
Why the study?
Adipose tissue plays an important role beyond cardiometabolic diseases and oncogenesis, including in respiratory diseases, prompting a review of current data on the phenotype combining respiratory diseases with overweight and obesity.
Obesity is not just a comorbidity but a key pathogenetic driver in respiratory diseases, necessitating weight management as a central therapeutic strategy.
Obesity warrants consideration as a modifiable driver in respiratory diseases; leaves open whether weight loss alters outcomes without prospective trials.
A combination of factors, including Western European eating habits, physical inactivity and genetic predisposition, lead to a dramatic increase in adipose tissue mass. A special place is occupied by abdominal obesity, in which there is an accumulation of adipose tissue in the mesentery of the small intestine and the omentum. Developing in conditions of visceral obesity, insulin resistance, dyslipidemia and systemic inflammation are one of the key components of the pathogenesis of type 2 diabetes mellitus, cardiovascular diseases, non-alcoholic fatty liver and pancreas disease, polycystic ovary disease, some forms of cancer (breast cancer, endometrial cancer, colonic and direct intestines). At the same time, the pathogenetic role of adipose tissue is not limited to its participation in the formation of the cardiometabolic continuum and oncogenesis. The most important role of metabolically active fat in the pathogenesis of many respiratory diseases is known, including bronchial asthma, obstructive sleep apnea and pulmonary hypertension. This paper presents an overview of current data on immunological, pathophysiological and clinical features of the phenotype of the combination of respiratory diseases with overweight and obesity.
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Shchepikhin et al. (2022) conducted a review in Respiratory diseases and obesity. Obesity significantly alters the natural course of respiratory diseases such as asthma, COPD, and interstitial lung diseases through systemic inflammation and changes in respiratory biomechanics.
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