arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2009-15-6-633-639arthyper-1445Research ArticleПРИГЛАШЕНИЕ К ДИСКУССИИDISCUSSIONИзбыточный вес и недостаток массы тела: между Сциллой и ХарибдойUnderweight and overweight: between Scylla and CharybdisДрапкинаО. М.DrapkinaO. M.drapkina@bk.ruДикурО. Н.DikurO. N.noemail@neicon.ruМосковская медицинская академия имени И.М. СеченоваРоссияI.M. Sechenov Moscow Medical AcademyRussian Federationклиника пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. ВасиленкоРоссияThe V.H.Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and HepatologyRussian Federation200928122009156633639Copyright © Драпкина О.М., Дикур О.Н., 20092009Драпкина О.М., Дикур О.Н.Drapkina O.M., Dikur O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1445

Избыточный вес, как и недостаток массы тела, связан с повышенным риском развития ряда заболеваний. В данной статье обсуждаются наиболее значимые проблемы здоровья, связанные с избыточным весом и недостатком массы тела. Описаны механизмы развития основных метаболических нарушений, лежащих в основе ожирения и сахарного диабета (СД) II типа, - инсулинорезистентности и дислипидемии. Обсуждается связь между генетическими и индивидуальными факторами развития ожирения, объясняются современные теории развития ожирения, такие как теория «сберегающего» фенотипа и теория «мозга-эгоиста». Описаны некоторые случаи развития ожирения в отсутствии инсулинорезистентности. Обсуждается клинический феномен, известный как «парадокс ожирения», при котором пациенты с избыточной массой тела парадоксально имеют более благоприятный прогноз по сравнению с пациентами с нормальным весом и недостатком массы тела.

It is well known that overweight as well as underweight is strongly associated with increased risk of development of many disorders, particularly cardiovascular pathology. The paper discloses the most appreciable problems of health associated with obesity and underweight. Pathophysiological mechanisms of development of the basic metabolic disturbances underlying obesity and diabetes mellitus, such as insulin resistance and dyslipoproteinemia, are described. The interaction of hereditary and environmental factors leading to adiposity is discussed in the light of the novel theories of development of adiposity, such as the hypothesis of a thrifty phenotype and "the selfish brain theory". Particular cases of obesity development in the absence of insulin resistance are described. The clinical phenomenon of paradoxical more favorable prognosis in patients with overweight in comparison with patients with normal weight and underweight (the obesity paradox) is discussed.

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The authors declare that there are no conflicts of interest present.