Zarich S W
Division of Cardiovascular Medicine, Department of Medicine, Bridgeport Hospital, Bridgeport, CT 06610, USA.
Minerva Cardioangiol. 2006 Apr;54(2):195-214.
Metabolic syndrome is now present in up to 40% of the United States adult population and is associated with a nearly a two fold increase in cardiovascular events, independent of the presence of diabetes mellitus. The concept of the metabolic syndrome as clinical syndrome has recently been challenged, however, and controversy exists as to whether the metabolic syndrome adds to cardiovascular risk above and beyond the sum of its independent metabolic components. Given the epidemic of obesity in both industrialized and third world countries, this issue is of great importance. The current article puts this controversy into perspective and explores the association of metabolic syndrome with both accelerated cardiovascular risk and the risk of development of type 2 diabetes. The pathophysiology of the increased risk of cardiovascular disease in diabetes associated with metabolic syndrome is discussed and the importance of early recognition of metabolic syndrome and potential role of addressing insulin resistance is stressed. Clearly more data is needed, but it is safe to say that metabolic syndrome is a worldwide epidemic in association with central obesity and underlying insulin resistance, which will propel a marked increase in cardiovascular events and diabetes mellitus in the years to come. Further research is needed to understand the role of more aggressive therapy in preventing type 2 diabetes and cardiovascular events in the population.
代谢综合征目前在美国高达40%的成年人口中存在，并且与心血管事件增加近两倍相关，这与糖尿病的存在无关。然而，代谢综合征作为一种临床综合征的概念最近受到了挑战，对于代谢综合征是否会增加超出其独立代谢成分总和的心血管风险存在争议。鉴于肥胖在工业化国家和第三世界国家的流行，这个问题非常重要。本文阐述了这一争议，并探讨了代谢综合征与心血管风险加速以及2型糖尿病发生风险之间的关联。讨论了与代谢综合征相关的糖尿病中心血管疾病风险增加的病理生理学，并强调了早期识别代谢综合征的重要性以及解决胰岛素抵抗的潜在作用。显然还需要更多数据，但可以肯定地说，代谢综合征是一种与中心性肥胖和潜在胰岛素抵抗相关的全球流行病，这将在未来几年推动心血管事件和糖尿病的显著增加。需要进一步研究以了解更积极的治疗在预防人群中2型糖尿病和心血管事件方面的作用。
