The relationship between obesity and heart disease, stroke, adrenal cortex dysfunction, and osteoarthritis

What is the relationship between obesity and heart disease?

According to reports, the incidence of coronary heart disease among obese individuals is 34.1%, and the main mechanism by which obesity causes heart disease is:

① Excessive fat accumulation increases circulating blood volume, leading to increased psychological stress and elevated blood pressure.

② Coexisting abnormal lipid metabolism and high-calorie diet, with intake exceeding consumption, cause hyperlipidemia, leading to coronary atherosclerosis and fat deposition in myocardial cells, thickening of the ventricular wall, and decreased myocardial compliance.

③ The accompanying increase in blood sugar and blood lipids increases blood viscosity, weakens the oxygen-carrying capacity of red blood cells, and leads to insufficient oxygen supply to myocardial cells.

④ Obese people often dislike exercise, and excessive obesity also limits their activity levels, which leads to weakened or insufficient coronary collateral circulation and decreased cardiac compensatory capacity.

Therefore, some scholars have pointed out that a weight gain of more than 30% above the standard weight is a signal that one will develop coronary heart disease within 10 years, and that coronary heart disease in obese patients is more difficult to treat and more dangerous than that in non-obese patients.

Therefore, it can be said that weight loss is, in a sense, also a way to prevent coronary heart disease.

What is the relationship between obesity and stroke recovery?

Obese people are more prone to stroke and have a harder time recovering from it. The reasons are as follows: First, obese people tend to have higher blood lipids and blood viscosity, making it more difficult to completely clear blood vessels during stroke treatment. Second, because of their excessive weight, when the sluggish nerve conduction finally awakens the paralyzed limb, the lack of nerve nutrition, coupled with the effect of gravity, slows down the recovery of the limb. Third, due to psychological barriers, obese people have a natural contraction action when they experience limb pain, making it difficult to relax the tense skin.

The patient was not fond of exercise, and after suffering a stroke, his opportunities for activity were greatly reduced, which made it difficult for him to recover his limb movement.

In summary, to help obese stroke patients recover as soon as possible, it is necessary to strengthen drug treatment, adjust their diet, and engage in functional exercises within their capabilities to aid in their recovery.

What is the relationship between obesity and adrenal cortex function?

The adrenal gland is an important endocrine gland in the human body, consisting of two main parts: the cortex and the medulla.

The three zones of the adrenal cortex each have different secretory functions.

These are mineralocorticoids, glucocorticoids, and sex corticosteroids.

Hormones secreted by zona glomerulosa cells are mainly involved in salt (sodium) metabolism in the body.

Therefore, it is called mineralocorticoid.

The cells of the zona fasciculata secrete the largest amount of hormones, which have a wide range of effects and participate in the three major metabolic processes in the body, mainly glucose metabolism, hence they are called glucocorticoids.

Hormones secreted by the reticular cells have similar structure and function to those secreted by the human gonads (testes in men and ovaries in women), hence they are called sex cortical hormones.

Glucocorticoids can promote protein breakdown and inhibit its synthesis. They can cause the broken-down amino acids to move to the liver, enhance gluconeogenesis, and antagonize insulin, inhibiting the binding of insulin to its receptors. This reduces peripheral glucose utilization, as well as fat and muscle tissue, leading to a decrease in glucose uptake and an increase in blood sugar.

Glucocorticoids increase the breakdown of fat tissue in the limbs, while increasing the synthesis of fat in the abdomen, face, shoulders, and back. This is what people call "central obesity"-Cushing's syndrome.

Glucocorticoids can also cause water intoxication in people with adrenal insufficiency, leading to drainage problems.

In addition, it can increase the number of red blood cells, platelets and neutrophils in the blood, and decrease lymphocytes and eosinophils. It also has some effects on nerves, muscles and blood vessels.

Sexual corticosteroids are mainly aldosterone, which can promote the retention of water and electrolytes in the body.

Androgens can promote the development and growth of internal and external genitalia, promote male secondary sexual function, promote protein synthesis, and develop muscles.

Adrenal medullary hormones have a significant effect on blood pressure and blood vessels.

The main measures for understanding adrenal function are 17-ketosteroids and 17-hydroxysteroids.

In patients with simple obesity, the production and metabolism of adrenal glucocorticoids are increased, and the excretion of 17-hydroxysteroids and 17-ketosteroids in urine is also increased.

Hirsutism and amenorrhea in obese patients are related to the secretion of adrenocortical hormones.

However, the dexamethasone (low dose) suppression test and the normal diurnal cycle changes suggest that the adrenal cortex function associated with obesity is not hyperactive.

Hyperadrenocortical function manifests as the aforementioned "central obesity".

Obese individuals have characteristics of osteoarthritis.

There are many reasons why obese people develop osteoarthritis. Being overweight increases the pressure on the weight-bearing articular cartilage, leading to greater wear and tear and changes in the internal structure of the joint, which in turn causes disease.

The heavier the body weight and the thicker the subcutaneous fat, the more severe the damage to the joints, especially weight-bearing bones and joints such as the knees and feet are more susceptible to injury.

The occurrence of osteoarthritis is also related to metabolic disorders, arteriosclerosis, and other factors that cause ischemic bone nutritional deficiencies.

Diabetic osteoarthritis is closely related to diabetic neuropathy and trauma.

Neuropathy causes loss of deep and superficial sensation and impaired joint movement reflexes. The body's sensation and pain are weakened or lost, leading to excessive joint load and lack of protection against trauma, resulting in bone and joint damage.

Gouty osteoarthritis is closely related to overeating in obese patients. Long-term excessive intake of high-protein and high-purine foods leads to an increase in exogenous uric acid in the body that exceeds the excretion capacity of the kidneys, resulting in hyperuricemia.

Uric acid deposits in the joints and cartilage as urate crystals, causing inflammation and foreign body reactions at the site of the lesion, resulting in damage to the joints.

Weight gain inevitably puts a heavy burden on bones and joints. Many obese people develop bone and joint diseases at a young age, which is related to metabolic disorders caused by obesity.

There are three main types of bone and joint diseases in obese people.

① Obesity accompanied by degenerative osteoarthritis has an incidence rate of 12%-43%, while obese patients account for 12%-45% of osteoarthritis patients; ② Obesity accompanied by diabetic osteoarthritis accounts for 1%-2%, while diabetes accounts for approximately 6%-7% of osteoarthritis patients; ③ Obesity accompanied by gouty osteoarthritis has an incidence rate of 15%-30%, while obese patients account for 50% of gouty osteoarthritis patients.

Weight loss therapy is an important measure to control osteoarthritis. Local treatment helps to relieve pain, and medicated bath therapy is beneficial for both weight loss and disease treatment.