Getting Radical About Obesity

Abstract

Visceral obesity has become the most frequent preventable condition accounting for diseases such as hypertension and diabetes, two of the major risk factors for coronary artery disease, stroke, and chronic renal failure.1–3 Despite the awareness aiming to reduce the prevalence of obesity, the number of obese patients continues to rise and now includes even developing countries, and increasingly children are affected.4,5 In fact, if this trend continues, 26 million children in Europe will be overweight or obese by the year 2010, rising by approximately 1.3 million per year.5,6 The annual health costs related to obesity have been estimated close to 100 billion USD in the United States,7,8 illustrating the enormous economic burden the disease obesity carries. See accompanying article in ATVB 2009;29:239–245. What are the mechanisms contributing to the high cardiovascular risk brought about by obesity? Obesity is a low-grade inflammatory condition9 and typically characterized by increase in visceral adipose tissue. Visceral fat is both a source and target of inflammatory cytokines and growth factors, which directly may affect preadipocyte differentiation via signaling cascades implicated in cell growth such as Ras-Raf-ERK-1/2.10 Adipose tissue also contains inflammatory cells, including cytokine-producing macrophages.9 In addition, adipocytes express a fully functional NADPH oxidase …