Bianchi Cristina, Penno Giuseppe, Romero Fabiola, Del Prato Stefano, Miccoli Roberto
University of Pisa, Department of Endocrinology and Metabolism, Cisanello University Hospital, Pisa, Italy.
Expert Rev Cardiovasc Ther. 2007 May;5(3):491-506. doi: 10.1586/14779072.5.3.491.
The metabolic syndrome (MS), a cluster of metabolic abnormalities with insulin resistance as its central component, is increasing in prevalence and is associated with an increased risk of cardiovascular disease and Type 2 diabetes mellitus (T2DM). Current evidence supports an aggressive intervention approach that comprises lifestyle modification in conjunction with drug treatment of the MS components. Healthier eating and regular exercise greatly reduce waistline and body mass index, lower blood pressure and improve lipid profile. Lifestyle modification has been proven to prevent T2DM development. Nevertheless, appropriate treatment of MS components often requires pharmacologic intervention with insulin-sensitizing agents, such as metformin and thiazolidinediones, while statins and fibrates, or angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are the first-line lipid-modifying or antihypertensive drugs. Only severely obese patients require specific drug treatments. Very often, drug combinations will be necessary to manage multiple risk factors. As we progress in the understanding of the pathophysiology of the MS, new targets for therapies will probably be identified and new treatments will prove to be even more efficacious than those currently available for the management of this life-threatening condition.
代谢综合征（MS）是以胰岛素抵抗为核心成分的一组代谢异常，其患病率正在上升，且与心血管疾病和2型糖尿病（T2DM）风险增加相关。目前的证据支持一种积极的干预方法，该方法包括生活方式改变以及对MS各组分进行药物治疗。更健康的饮食和规律运动可大幅减小腰围、降低体重指数、降低血压并改善血脂谱。生活方式改变已被证明可预防T2DM的发生。然而，对MS各组分进行适当治疗通常需要使用胰岛素增敏剂进行药物干预，如二甲双胍和噻唑烷二酮类药物，而他汀类药物和贝特类药物，或血管紧张素转换酶抑制剂和血管紧张素II受体阻滞剂是一线的调脂或降压药物。只有严重肥胖患者需要特定的药物治疗。通常，需要联合用药来控制多种危险因素。随着我们对MS病理生理学的认识不断深入，可能会确定新的治疗靶点，新的治疗方法将被证明比目前用于治疗这种危及生命疾病的方法更有效。
