鄭剛（綜述） 天津老年病研究所、天津市第三醫院（天津，300250，中國）  
張承宗2（審校）天津心臟病研究所、天津市醫科大學第二附屬醫院（天津，300100，中國）

摘要  肥胖是心血管疾病的獨立危險因素，肥胖與高血壓、高脂血症、糖尿病密切相關，使心臟病發生率增加。但肥胖的心臟病患者較體重正常或偏低者的死亡率低，這似乎也保護著肥胖的心臟病患者。這種現象被稱之爲肥胖矛盾幷引發了人們的關注和思考。雖然肥胖矛盾的確切機制有待進一步的研究和發現，但如果最終探明其中的機制，將會爲心臟病患者的治療增加一種新的思路。
關鍵詞  肥胖矛盾  心血管疾病  體重指數  臨床研究

Obesity paradox: body mass index and mortality

ZHENG Gang1. Tianjin third hospital（Tianjin，300250，China）
ZHANG Chengzhong2. Deptment of internal medicine of heart（Tianjin，300100，China）

Abstract  The obesity is an independent risk factor of cardiovascular disease.The obesity is closely related with hypertension,high blood lipid and diabetes,and induce occurrence rate increment of heart disease.But there is a lower mortality in patients of obesity with heart disease than in those patients the weight is normal or low,this also protects the patients of obesity with heart disease.This kind of phenomenon were called it as obesity paradox and caused people concern with consider.Although obesity paradox further really slice the research that mechanism treat with discovers,if end explore clear among them of mechanism,will increase a kind of new way of thinking for heart disease treatment.
Keywords  obesity paradox；cardiovascular disease；body mass index；clinial study

超重和肥胖是心血管疾病（cardiovascular disease，CVD）的獨立危險因素，肥胖與高血壓、高脂血症、糖尿病密切相關，從而導致CVD的高發。近年研究發現超重和肥胖可以降低CVD患者死亡的風險。這種矛盾現象被稱之爲肥胖矛盾，幷引發了人們的關注和思考。回顧這一矛盾現象，探討出現肥胖矛盾現象的可能機制，尋找CVD治療的新思路。