ASSIGNMENT NO: 3

NAME: ROMAISHA SIDDIQUI

STUDENT ID: FA20-BSBS-0002
SUBJECT: RESEARCH METHODOLOGY
SUMMARY:
Obesity is a difficult health issue that affects people from a variety of
demographics and sociocultural backgrounds. The World Health Organization's
(WHO) data confirms. The prevalence of this non-communicable disease is
always rising. Around the world, 39% of adults are overweight, and 13% are
obese. According to the WHO, obesity is an increase in fat mass (FM) that has a
negative impact on health. The most often used definition of obesity is a body
mass index (BMI) 30 kg/m2. Class I: BMI between 30.0 and 34.9 kg/m2 is the
next division.
• BMI in Class II: 35.0 to 39.9 kg/m2.
• Class III: A BMI more than 40.0 kg/m2.
When the BMI is below 25 kg/m2, it is regarded to be overweight. Asian
patients should have reduced BMI cutoffs since they have proportionately
greater visceral fat, according to World Health Organisation. Metabolically
healthy obesity in a fit patient. Since not all patients who are overweight or
obese have a higher risk of developing cardiovascular disease (CVD), the term
metabolically healthy obesity (MHO) was coined. Not the bodyweight , but
rather the altered levels of intermediate risk factors, account for the majority of
the association between adiposity indices and CVD. These mediators include a
collection of metabolic abnormalities generally known as the metabolic
syndrome (MS), including insulin resistance leading to type 2 diabetes,
atherogenic dyslipidemia, increased blood pressure (BP), subtly persistent
inflammation, and a prothrombotic profile.A common feature of metabolic
syndrome is the buildup of extra fat in visceral depots. Individuals with excess
abdominal visceral adipose tissue have a lower CVD risk for any given level of
total body fat.Obesity is brought on by a number of reasons, including:
• Behavioural and physiological factors; • Sociocultural and environmental
contexts; • Genetic predisposition.
• Epigenetic danger signs.
Epigenetic pathways are also the source of hereditary predisposition.
Approximately 140 chromosomal loci have been linked to this condition by
research. The susceptibility to obesity has also been linked to the gut
microbiome. An inflammatory cascade is triggered by bacterial
lipopolysaccharide. This has an impact on the brain's behaviour control regions
and alters how fat tissue functions. Weight gain and a higher risk of heart and
metabolic illnesses are the end outcome. Adiposopathy is a pathological change
in adipocytes' normal function that results from energy deprivation.
Additionally, epicardial fat performs other distinct physiological functions. It
serves as an immune "fence" to guard against damage brought on by
inflammation to the cardiomyocytes and coronary arteries. Also,The epicardial
vessels receive a mechanical "cushion" because it creates room for healthy
remodelling to take place. By supplying fatty acids to the heart during a high
energy-demand condition like exercise, this fat also acts as a nutritional store.
Findings from magnetic resonance and spectroscopy demonstrate a substantial
relationship between the myocardial triglyceride level and epicardial fat depots.
When there is an excessive buildup of pericardial fat without a corresponding
rise in blood supply, the physiological characteristics take on a pathogenic form.
The subsequent ischemia causes inflammation and prepares the body for
CVD,data from numerous research, including the Framingham and promote re-
entry of epicardial and sub-endocardial potentials Arrhythmias. Leptin promotes
arrhythmogenicity by lengthening myocyte depolarization duration. ECG is a
result of obesity modifications include lengthened PR intervals, increased P
wave height and duration, and terminal P wave deflection. Obesity may result in
ventricular tachyarrhythmias in addition to AF. Impulse propagation is
electrically disrupted in a ventricle that has undergone remodelling and
concurrent fibrosis. The above-mentioned actions of epicardial fat further
enhance this. Due to changes in potassium channel (voltage-gated) functioning
and sympathetic overdrive, an electrical rearrangement happens.
Arrhythmogenesis is facilitated as a result of QT and QTc (corrected QT
interval) lengthening. Overweight Paradox.Despite the fact that obesity raises
the risk of having CVD, it is important to emphasise that The American Heart
Association has recently emphasised the importance of CRF measurement.
Improved CRF independently, even after adjusting for additional risk variables
like BMI or visceral fat better event profile for patients with CVD is predicted.
This leads to the new idea that CRF should be the aim for improving outcomes
in CVD patients rather than BMI. Due to the possibility that a cardiopulmonary
exercise test may not always be possible, CRF can be calculated from the peak
exercise during a treadmill test (or cycle ergometer test). To enhance CRF for
cardiac rehabilitation, exercise training that is both isotonic and isometric is
used. Aerobic exercise carried out under supervision for an hour at least three
times per week for 20 weeks is beneficial for obese patients with heart failure
with preserved ejection fraction (HFpEF). balance) have revealed, for the first
time, a notable decline in detrimental cardiovascular effects. Bariatric surgery
The criteria for identifying individuals who will likely benefit from bariatric
surgery are suggested by a number of guidelines. According to
recommendations from organisations like The American Diabetes Association
and the International Diabetes Federation, weight-reduction surgery is the only
method that ensures improved prognosis while delivering stable weight loss.
Patients with BMI more than 40 kg/m2 (or 35) are candidates for bariatric
surgery. when all other treatment options have been tried, kg/m2 if associated
OSA, diabetes, hypertension, etc., are present. Restrictive or hybrid procedures
are the two forms of bariatric surgery. In hybrid surgery, the gastrointestinal
tract is mechanically re-routed in both a restrictive and a malabsorptive manner.
The type of surgical modality, the amount of anaesthesia used, and the fatality
rate all affect the frequency of complications.