肥満患者における心血管疾患リスクの高さを明らかに(High risk of cardiovascular disease in obesity)

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2026-06-24 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所の研究チームは、肥満と心血管疾患リスクの関連を大規模データで解析し、肥満では心筋梗塞、脳卒中、心不全などの心血管疾患リスクが有意に高まることを明らかにした。さらに、肥満に伴う高血圧、糖尿病、脂質異常症などの代謝異常がリスク増加に大きく関与する一方、これらの危険因子だけでは説明できない肥満そのものの影響も認められた。研究では、肥満を単なる生活習慣上の問題ではなく、心血管疾患の独立した危険因子として早期から管理する必要性を指摘している。また、減量に加え、血圧・血糖・脂質の適切な管理を組み合わせることが重篤な心血管イベントの予防に重要であると結論付けた。今回の成果は、肥満患者に対するリスク評価や予防医療の充実、生活習慣改善と薬物療法を組み合わせた包括的な治療戦略の重要性を示す知見となる。

<関連情報>

診断不足と治療不足:スウェーデンの臨床現場における肥満とその心血管代謝への負担―AROSデータベースからの知見 Underdiagnosed and Undertreated: Obesity and Its Cardiometabolic Burden in Swedish Clinical Practice—Insights From the AROS Database

Viveca Ritsinger, Magnus Sundbom, Jonatan Dereke, Åsa Ericsson, Thomas Cars, Maria K. Svensson, Anna Norhammar
Diabetes, Obesity and Metabolism  Published: 13 May 2026
DOI:https://doi.org/10.1111/dom.70845

肥満患者における心血管疾患リスクの高さを明らかに(High risk of cardiovascular disease in obesity)

ABSTRACT

Aims

To quantify real-world diagnosis and treatment of obesity in Sweden, describe cardiometabolic comorbidity burden across obesity classes, and compare long-term cardiovascular outcomes with the general population.

Materials and Methods

This population-based cohort study used the AROS (Analysis of Real-world data of patients with Obesity in Sweden) database to identify adults with a recorded BMI ≥ 30 kg/m2 between January 2013 and June 2023. Individuals were stratified by obesity class. Baseline demographics, comorbidities, medications and laboratory values were described. Outcomes included recorded obesity prevalence, obesity diagnosis (ICD-10: E66), healthcare setting at first BMI ≥ 30 kg/m2, cardiometabolic comorbidity profiles, treatment patterns and long-term cardiovascular outcomes. Cardiovascular outcomes were compared with a matched general population.

Results

In 2022, recorded obesity prevalence was 13.6%. Amongst 328 094 individuals with obesity (mean age 53.5 years; 55.0% women), 67.6% had at least one cardiometabolic comorbidity. At the first observed BMI ≥ 30 kg/m2 (index), 28.8% had a recorded obesity diagnosis, increasing to 48.0% 5 years later. Index BMI was most often recorded in primary care (39.7%). Within 5 years after index, 7.8% had received obesity-management medication and 4.2% had undergone bariatric surgery. Compared with matched population representatives, the obesity cohort had higher cumulative incidence across all cardiovascular outcomes, with the largest relative difference for heart failure hospitalisation (HR 2.34, 95% CI 2.29–2.40).

Conclusions

Obesity remains underdiagnosed and undertreated in Swedish healthcare, despite a high burden of cardiometabolic comorbidities and substantially higher long-term cardiovascular risk compared with the general population.

医療・健康
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