دورية أكاديمية

Risk factor paradox in wasting diseases

التفاصيل البيبلوغرافية
العنوان: Risk factor paradox in wasting diseases
المؤلفون: Kalantar-Zadeh, Kamyar, Horwich, Tamara B, Oreopoulos, Antigone, Kovesdy, Csaba P, Younessi, Houman, Anker, Stefan D, Morley, John E
المصدر: Current Opinion in Clinical Nutrition & Metabolic Care, vol 10, iss 4
بيانات النشر: eScholarship, University of California
سنة النشر: 2007
المجموعة: University of California: eScholarship
مصطلحات موضوعية: Nutrition, Cardiovascular, Obesity, Aging, Prevention, Aetiology, 2.1 Biological and endogenous factors, Zero Hunger, Good Health and Well Being, Cachexia, Cardiovascular Diseases, Chronic Disease, Humans, Neoplasms, Risk Factors, Survival Analysis, Wasting Syndrome, chronic disease states, malnutrition-inflammation-cachexia syndrome, paradigm shift, reverse epidemiology, wasting disease, Medical and Health Sciences, Nutrition & Dietetics
جغرافية الموضوع: 433 - 442
الوصف: Purpose of reviewEmerging data indicate that conventional cardiovascular risk factors (e.g. hypercholesterolemia and obesity) are paradoxically associated with better survival in distinct populations with wasting. We identify these populations and review survival paradoxes and common pathophysiologic mechanisms.Recent findingsA 'reverse epidemiology' of cardiovascular risk is observed in chronic kidney disease, chronic heart failure, chronic obstructive lung disease, cancer, AIDS and rheumatoid arthritis, and in the elderly. These populations apparently have slowly progressive to full-blown wasting and significantly greater short-term mortality than the general population. The survival paradoxes may result from the time differential between the two competing risk factors [i.e. over-nutrition (long-term killer but short-term protective) versus undernutrition (short-term killer)]. Hemodynamic stability of obesity, protective adipokine profile, endotoxin-lipoprotein interaction, toxin sequestration of fat, antioxidation of muscle, reverse causation, and survival selection may also contribute.SummaryThe seemingly counterintuitive risk factor paradox is the hallmark of chronic disease states or conditions associated with wasting disease at the population level. Studying similarities among these populations may help reveal common pathophysiologic mechanisms of wasting disease, leading to a major shift in clinical medicine and public health beyond the conventional Framingham paradigm and to novel therapeutic approaches related to wasting and short-term mortality.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: unknown
العلاقة: qt24j753cr; https://escholarship.org/uc/item/24j753crTest
الإتاحة: https://escholarship.org/uc/item/24j753crTest
حقوق: CC-BY
رقم الانضمام: edsbas.125F8026
قاعدة البيانات: BASE