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La obesidad se define como un aumento de la grasa corporal aunque en la práctica clínica utilizamos el índice de masa corporal (IMC) para identificar a los pacientes con obesidad. Se dice que hay obesidad abdominal cuando la grasa intraabdominal es igual o superior a 130 cm2; sin embargo, en la práctica clínica, la definición de la obesidad central se basa en el perímetro de la cintura ya que existe una buena correlación entre el perímetro de la cintura y la grasa intraabdominal. Aunque no hay un consenso definitivo sobre los puntos de corte, los valores más utilizados son los propuestos por el NCEP-ATP-III.
La obesidad central tiene más trascendencia clínica que la obesidad periférica ya que el tejido adiposo intraabdominal es metabólicamente más activo que el periférico. Así, libera ácidos grasos y citocinas que son la causa de las alteraciones en el metabolismo lipídico y de los hidratos de carbono, lo que facilita la resistencia insulínica. La obesidad central es un componente esencial del síndrome metabólico y un factor de riesgo para el desarrollo de la diabetes mellitus tipo 2 y de la enfermedad cardiovascular.
Palabras clave:
Obesidad central
Diabetes mellitus
Dislipemia
Riesgo cardiometabólico
Obesity is defined as a pathologic increase in the body's adipose content. In clinical practice, obesity is usually estimated by calculating the body mass index (BMI). Central (or abdominal) obesity is defined as an intraabdominal fat area of = 130 cm2, but in clinical practice calculation is based on waist perimeter, which has been shown to correlate with intraabdominal fat area. Although agreement is lacking on cut-off points, the most widely used criteria are those of the NCEP-ATP-III.
Central obesity is clinically more important than peripheral obesity, because intraabdominal fat is more metabolically active than peripheral fat. Intraabdominal fat releases free fatty acids and adipokines, which cause lipid and carbohydrate metabolism disorders, facilitating insulin resistance and chronic inflammation. Central obesity is an essential component of the metabolic syndrome and a major risk factor for the development of both type 2 diabetes mellitus and cardiovascular disease.
Key words:
Central obesity
Diabetes mellitus
Dyslipemia
Cardiometabolic risk
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