Sarti Cinzia, Gallagher John
Department of Epidemiology and Health promotion, National Public Health Institute, Helsinki, Finland.
J Diabetes Complications. 2006 Mar-Apr;20(2):121-32. doi: 10.1016/j.jdiacomp.2005.06.014.
An increased risk of coronary heart disease (CHD) morbidity and mortality is associated with the metabolic syndrome, a condition characterized by the concomitant presence of several abnormalities, including abdominal obesity, dyslipidemia, hypertension, insulin resistance (with or without glucose intolerance or diabetes), microalbuminuria, prothrombotic, and proinflammatory states. Estimates of the prevalence of the metabolic syndrome indicate that this condition is now common and likely to increase dramatically over the coming decades, in parallel with greater rates of obesity and Type 2 diabetes. Risk factors for the metabolic syndrome are already present in obese children and adolescents. Thus, identifying and treating all affected individuals promptly and optimally are critical to ensure that this potentially challenging healthcare burden is minimized. Here, we review the prevalence of the metabolic syndrome, dyslipidemias, and CHD risk. Although changes in lifestyle are fundamental to reducing many of the CHD risk factors associated with the metabolic syndrome, pharmacologic interventions also play an important role. Retrospective subanalyses of the effects of statins on coronary event rates and lipid levels in patients with the metabolic syndrome included in clinical trials indicate that these agents are beneficial in correcting the extensive lipid abnormalities that are frequently present in these individuals. However, the optimal management of metabolic syndrome dyslipidemia will depend on the outcomes of future prospective clinical trials. This review examines the underlying causes and prevalence of the metabolic syndrome and its impact on CHD morbidity and mortality and discusses the role of statins in optimizing its management.
冠心病（CHD）发病和死亡风险的增加与代谢综合征相关，代谢综合征是一种以多种异常并存为特征的病症，包括腹型肥胖、血脂异常、高血压、胰岛素抵抗（伴或不伴糖耐量异常或糖尿病）、微量白蛋白尿、血栓前状态和促炎状态。代谢综合征患病率的估计表明，这种病症目前很常见，并且在未来几十年可能会急剧增加，这与肥胖率和2型糖尿病发病率的上升同步。肥胖儿童和青少年中已经存在代谢综合征的危险因素。因此，及时且最佳地识别和治疗所有受影响个体对于确保将这种潜在的具有挑战性的医疗负担降至最低至关重要。在此，我们综述代谢综合征、血脂异常和冠心病风险的患病率。尽管生活方式的改变对于降低许多与代谢综合征相关的冠心病危险因素至关重要，但药物干预也起着重要作用。对临床试验中纳入的代谢综合征患者他汀类药物对冠状动脉事件发生率和血脂水平影响的回顾性亚组分析表明，这些药物有助于纠正这些个体中经常出现的广泛血脂异常。然而，代谢综合征血脂异常的最佳管理将取决于未来前瞻性临床试验的结果。本综述探讨了代谢综合征的潜在病因和患病率及其对冠心病发病和死亡的影响，并讨论了他汀类药物在优化其管理中的作用。
