Paoletti Rodolfo, Bolego Chiara, Poli Andrea, Cignarella Andrea
Department of Pharmacological Sciences, University of Milan, Italy.
Vasc Health Risk Manag. 2006;2(2):145-52. doi: 10.2147/vhrm.2006.2.2.145.
The inflammatory component of atherogenesis has been increasingly recognized over the last decade. Inflammation participates in all stages of atherosclerosis, not only during initiation and during evolution of lesions, but also with precipitation of acute thrombotic complications. The metabolic syndrome is associated with increased risk for development of both cardiovascular disease and type-2 diabetes in humans. Central obesity and insulin resistance are thought to represent common underlying factors of the syndrome, which features a chronic low-grade inflammatory state. Diagnosis of the metabolic syndrome occurs using defined threshold values for waist circumference, blood pressure, fasting glucose and dyslipidemia. The metabolic syndrome appears to affect a significant proportion of the population. Therapeutic approaches that reduce the levels of proinflammatory biomarkers and address traditional risk factors are particularly important in preventing cardiovascular disease and, potentially, diabetes. The primary management of metabolic syndrome involves healthy lifestyle promotion through moderate calorie restriction, moderate increase in physical activity and change in dietary composition. Treatment of individual components aims to control atherogenic dyslipidemia using fibrates and statins, elevated blood pressure, and hyperglycemia. While no single treatment for the metabolic syndrome as a whole yet exists, emerging therapies offer potential as future therapeutic approaches.
在过去十年中，动脉粥样硬化形成过程中的炎症成分越来越受到重视。炎症参与动脉粥样硬化的各个阶段，不仅在病变的起始和发展过程中，而且在急性血栓并发症的发生中也发挥作用。代谢综合征与人类心血管疾病和2型糖尿病的发病风险增加有关。中心性肥胖和胰岛素抵抗被认为是该综合征的共同潜在因素，其特征是慢性低度炎症状态。代谢综合征的诊断是通过腰围、血压、空腹血糖和血脂异常的明确阈值来进行的。代谢综合征似乎影响着相当一部分人群。降低促炎生物标志物水平并解决传统危险因素的治疗方法对于预防心血管疾病以及可能预防糖尿病尤为重要。代谢综合征的主要管理措施包括通过适度限制热量摄入、适度增加体力活动和改变饮食结构来促进健康的生活方式。对各个组成部分的治疗旨在使用贝特类药物和他汀类药物控制致动脉粥样硬化性血脂异常、高血压和高血糖。虽然目前还没有针对整个代谢综合征的单一治疗方法，但新兴疗法有望成为未来的治疗手段。
