Blomhoff J P
Medical Department A, National Hospital, Oslo, Norway.
J Cardiovasc Pharmacol. 1992;20 Suppl 8:S22-5.
High levels of plasma triglycerides and very-low-density lipoproteins and low levels of high-density lipoproteins are consistently found in the metabolic cardiovascular syndrome. These changes are exaggerated postprandially. In the liver, synthesis and secretion of triglyceride-rich particles are increased. In addition, the removal capacity of plasma triglycerides is decreased, due to downregulation of lipoprotein lipase in skeletal muscles by hyperinsulinemia. Resistance to insulin-stimulated glucose uptake is believed to be the main pathogenetic factor. However, increased flux of free fatty acids from abdominally localized adipose tissue must also be considered when discussing pathogenesis. Treatment is primarily nonpharmacological, with diet and increased physical activity.
在代谢性心血管综合征中，始终会发现血浆甘油三酯和极低密度脂蛋白水平升高，而高密度脂蛋白水平降低。这些变化在餐后会更加明显。在肝脏中，富含甘油三酯颗粒的合成和分泌增加。此外，由于高胰岛素血症导致骨骼肌中脂蛋白脂肪酶下调，血浆甘油三酯的清除能力降低。胰岛素刺激的葡萄糖摄取抵抗被认为是主要的致病因素。然而，在讨论发病机制时，也必须考虑来自腹部局部脂肪组织的游离脂肪酸通量增加的情况。治疗主要是非药物性的，包括饮食和增加体育活动。
