Recently CNN.co.jp reported the following:
減量で新型コロナのリスク低減か 新たな研究報告も
2022.01.09 Sun posted at 11:11 JST
（ＣＮＮ） 新型コロナウイルスの感染、重症化、死亡リスクは太りすぎの人ほど高いことが知られている。減量によってそのリスクが低減することを示す、新たな研究結果も報告された。
新型コロナ感染症のパンデミック（世界的大流行）が始まる前から長年、肥満は米国人の健康を脅かしてきた。米国人の予防可能な死因として、喫煙に続く２位に位置している。
その危険性は、新型コロナによってさらに高まる。新型コロナによる入院患者の３割が肥満だとする研究報告もある。
ボストン市内の肥満治療クリニックでは、パンデミックで待機リストの患者が大幅に増え、すでに１０００人を超えた。十数人の専門スタッフでも手が回らない状態だ。
米疾病対策センター（ＣＤＣ）の研究でも、重症化リスクが最も低いのはＢＭＩが正常と過体重の境目に近いグループで、そこからＢＭＩが上がるにつれてリスクが増大するという結果が出た。英国で６９０万人あまりのデータを分析した研究でも、同様の結果が報告されている。
減量で新型コロナのリスクは低減するのか
減量でリスクを低減できるかどうかを比較する臨床試験は倫理上、ほぼ不可能とされるが、減量の効果を過去にさかのぼって調べた大規模な研究の結果が先ごろ、米医師会の外科専門誌「ＪＡＭＡサージャリー」に発表された。
減量手術用の医療機器を扱うメドトロニック社の出資で、２万人あまりの対象者を６年間以上、追跡した研究だ。
そのデータによると、新型コロナの検査で陽性反応を示す率は、減量手術を受けたグループが９．１％、受けていないグループが８．７％だった。手術したグループは新型コロナで入院したり、酸素吸入が必要になったり、重い症状を示したりする率が低いことも分かった。
研究チームは、新型コロナの重症化に対し、肥満は「修正可能なリスク要因」だと指摘。重要なのは減量手術そのものでなく、体重を減らすことだとしたうえで、体重が減れば重症化や死亡のリスクが大幅に抑えられると結論付けた。
なぜ肥満が脅威なのか
専門家によれば、肥満がリスク要因となる理由はいくつか考えられる。
脂肪細胞が蓄積すると体内の免疫システムに悪影響を及ぼし、慢性的な炎症が起きる。血液も固まりやすくなり、横隔膜の下に脂肪がたまって心臓が動きにくくなる。脂肪が胸郭を圧迫して、普段から呼吸が浅くなっているのも、重症化の一因となり得る。
特に、腹部にたまる内臓脂肪が増えるとコレステロール値が上がりやすく、動脈硬化の原因にもなる。体重が何キロ減ったかより、腹囲が何センチ減ったかが重要とされるのは、このためだ。
専門家らはまた、太り過ぎの人が２～３キロ減量しただけで、糖尿病や高血圧が改善することもあると強調。新型コロナ対策として、減量にワクチン接種ほどの効果はないものの、メリットがあることは確かだと訴えている。
Translation
2022.01.09 Sun posted at 11:11 JST
(CNN) It was known
that the risk of infection, aggravation, and death of the new coronavirus was
higher among overweight people. New finding reports had showed that a weight loss
could reduce the risk.
Obesity had threatened the health of Americans for many years before the new coronavirus pandemic infection began. It ranked second only to smoking as a preventable cause of death for Americans.
That danger was further enhanced by the new Corona. There was also a research reporting that 30% of hospitalized patients with the new corona were obese.
At the Obesity Clinic in Boston the number of patients on the waiting list had increased significantly due to a pandemic, and had already exceeded 1,000. Even with a dozen professional staff the situation could not be handled.
According to a study published last August, people who were classified as obese by body mass index (BMI), which was the weight (kilograms) divided by the squared height (meters), were more infected with the new corona than those who were not, and the risk was as high as 46%. The risk of hospitalization increased by 113%, the risk of being admitted to the intensive care unit (ICU) increased by 74% while the risk of death reached 48%. According to the research team, the risk increased for every 1 point of BMI.
A study by the Centers for Disease Control and Prevention (CDC) also found that the group with the lowest risk of aggravation was those people near the boundary between normal and overweight, and the risk increased as the BMI increased. A study that analyzed data from more than 6.9 million people in the United Kingdom reported similar results.
Would weight loss reduce the risk of the new corona?
Clinical experiments to compare whether weight loss could
reduce risk were ethically almost impossible to do, but the results of a large
study retroactively examined the effects of weight loss was published in the American
Medical Association’s surgical specialist magazine "JAMA Surgery" recently.
The study was funded by Medtronic which handled medical equipment for weight loss surgery had followed more than 20,000 subjects for more than 6 years.
According to the data, the rate of positive test for the new corona was 9.1% in the group who underwent weight loss surgery and was 8.7% in the group who did not. The group with surgery performed were found to be less likely to be hospitalized with the new corona, or require oxygen inhalation, or had severe symptoms.
The research team pointed out that obesity was a
"correctable risk factor" for the aggravation of the new corona. It
came to the conclusion that not the weight loss surgery itself was important,
and it was the losing weight that could significantly reduce the risk of aggravation
and death.
Why obesity would be a threat
According to experts, there were several possible reasons
why obesity would be a risk factor.
Accumulation of fat cells adversely affected the body's immune system and causes chronic inflammation. Blood also tended to clot, and fat accumulated under the diaphragm, making it difficult for the heart to move. The fact that fat pressed on the thorax and made breathing shallower than usual could also contribute to the aggravation.
In particular, when the amount of visceral fat accumulated in the abdomen increases, the cholesterol level tended to rise, which also caused arteriosclerosis. This is why it would be more important to lose a few centimeters waist circumference than the amount of kilograms body weight you had lost.
Experts also emphasized that overweight people who lost a few kilograms could improve their diabetes and high blood pressure, and stressed that as a measure against the new corona, weight loss would not be as effective as vaccination, but it certainly had a merit.
So, the
research team points out that obesity is a "correctable risk factor"
for the aggravation of the new corona. Accumulation of fat cells can adversely affect
the body's immune system and causes chronic inflammation. Blood also tends to
clot, and fat accumulates under the diaphragm can make the heart difficult to
move. The fact that fat presses on the thorax and thus making breathing
shallower than usual can also contribute to the aggravation.
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