Associations of Chronic Inflammation, Insulin Resistance, and Severe Obesity With Mortality, Myocardial Infarction, Cancer, and Chronic Pulmonary Disease

Abstract

Key Points Question Is the association of severe obesity with adverse outcomes modified by the presence or absence of systemic inflammation? Findings In this cohort study of 420 636 Canadian adults, severe obesity was associated with a lower mortality risk in women with chronic inflammation, but there was no difference in risk in men with inflammation. In contrast, severe obesity was associated with a higher mortality risk in men without inflammation, but not with mortality risk in women without inflammation. Meaning Severe obesity in the presence of systemic inflammation is associated with a different prognosis compared with severe obesity in the absence of inflammation.

COVID-19 severity in obese patients: Potential mechanisms and molecular targets for clinical intervention

“…Obesity is driven by excessive intake of calorie-rich diet, sedentary lifestyle and in some cases genetic predisposition which promotes positive energy balance and subsequently dis-balanced adipocyte homeostasis [ 43 , 44 ]. Low-grade systemic chronic inflammation during obesity has been identified as an underlying feature of the MS and can influence the clinical outcome of other pathogenetic conditions in the patients including COVID-19 [ 45 ]. Increased visceral adipose tissue mass affects the resident adipocytes, pre-adipocytes, residential immune cells, and endothelial cells [ 46 ].…”

“…MS can be defined as a combination of clinical features such as insulin resistance and elevated levels of blood glucose, cholesterol or triglycerides, and blood pressure that converge to a poor clinical condition in obese [ 56 ]. Obesity is now considered as a defining factor for the progression of MS where the underlying low-grade chronic inflammation predisposes the obese to develop MS-associated comorbidities [ 45 ]. In obese patients, the pro-inflammatory cytokines may destabilize insulin receptor substrate (IRS) signaling leading to the development of insulin resistance.…”

ACE2andTMPRSS2expression by clinical, HLA, immune, and microbial correlates across 34 human cancers and matched normal tissues: implications for SARS-CoV-2 COVID-19

“…30 In our analysis of ACE2 / TMPRSS2 gene expression in tumors and matched normal tissues, we observe no consistent association for these factors. Further work would be required to investigate other variables associated with these disease states, such as chronic inflammatory conditions, immunosuppression, and other disparities that may be contributing factors, 44 45 and cellular context is important to interpret the complexity of those associations. 46 …”

Obesity, the Cinderella of Clinical Medicine

“…BMI is a transversal determination which does not properly consider that the metabolic calamity is a continuous process that has been affecting cells, tissues, systems, and organs for many years. It is because of these attributes that obesity still is the largest health issue today and the most devastating and lethal pandemics in the history of mankind ( 2 ).…”