Wyne Kathleen L
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8857, USA.
Diabetes Obes Metab. 2006 Jul;8(4):365-80. doi: 10.1111/j.1463-1326.2005.00522.x.
The metabolic syndrome, also known as the dysmetabolic syndrome, syndrome X or the insulin resistance syndrome, refers to the clustering of cardiovascular disease risk factors that are present in many individuals who are at increased risk for both cardiovascular events and type 2 diabetes. Prediabetic subjects typically exhibit an atherogenic pattern of cardiovascular risks that is associated with hyperinsulinaemia. Thus, identification of components of the metabolic syndrome is important if patients are to be treated early enough to prevent cardiovascular events and other complications related to diabetes. Therapies targeted to specific components of the metabolic syndrome such as improving glycaemic control, managing dyslipidaemia and reducing the prothrombotic state should help to minimize cardiovascular risk, particularly if initiated early. Traditional pharmacologic agents used to manage the individual components of the metabolic syndrome do not typically impact the other components. The thiazolidinediones, a new class of agents that improve insulin resistance, have the ability, in addition to their glucose-lowering effects, to exert several powerful anti-atherogenic properties, including anti-inflammatory effects in the vascular endothelium, redistribution of visceral fat and reduction of insulin resistance, hyperinsulinaemia and hyperproinsulinaemia. This makes the thiazolidinediones ideal candidates for the early treatment of many components associated with the metabolic syndrome.
代谢综合征，也称为代谢紊乱综合征、X综合征或胰岛素抵抗综合征，指的是在许多心血管事件风险和2型糖尿病风险均增加的个体中出现的心血管疾病危险因素的聚集。糖尿病前期受试者通常表现出与高胰岛素血症相关的致动脉粥样硬化心血管风险模式。因此，如果要尽早治疗患者以预防心血管事件和其他与糖尿病相关的并发症，识别代谢综合征的组成部分很重要。针对代谢综合征特定组成部分的治疗方法，如改善血糖控制、管理血脂异常和降低血栓前状态，应有助于将心血管风险降至最低，特别是如果早期启动治疗。用于管理代谢综合征各个组成部分的传统药物通常不会影响其他组成部分。噻唑烷二酮类药物是一类新型的改善胰岛素抵抗的药物，除了具有降糖作用外，还具有多种强大的抗动脉粥样硬化特性，包括血管内皮的抗炎作用、内脏脂肪的重新分布以及胰岛素抵抗、高胰岛素血症和高胰岛素原血症的降低。这使得噻唑烷二酮类药物成为早期治疗与代谢综合征相关的许多组成部分的理想选择。
