Oda Eiji
Medical Check-up Center, Tachikawa Medical Center, Nagamachi 2-2-16, Nagaoka 940-0053, Japan.
Hypertens Res. 2008 Jul;31(7):1283-91. doi: 10.1291/hypres.31.1283.
The metabolic syndrome is a constellation of interrelated metabolic risk factors that appear to directly promote the development of diabetes and cardiovascular disease. However, in 2005, the American Diabetes Association and the European Association for the Study of Diabetes jointly stated that no existing definition of the metabolic syndrome meets the criteria of a syndrome, and there have been endless debates on the pros and cons of using the concept of this syndrome. The controversy may stem from confusion between the syndrome and obesity. Obesity is an epidemic, essentially contagious disease caused by an environment of excess nutritional energy and reinforced by deeply rooted social norms. The epidemic of obesity should be prevented or controlled by social and political means, similar to the approaches now being taken to combat global warming. The diagnosis of metabolic syndrome is useless for this public purpose. The purpose of establishing criteria for diagnosing metabolic syndrome is to find individuals who are at increased risk of diabetes and cardiovascular disease and who require specific therapy including diet and exercise. The syndrome may be an adipose tissue disease different from obesity; in that case, it would be characterized by inflammation clinically detected through systemic inflammatory markers such as high-sensitivity C-reactive protein and insulin resistance reflecting histological changes in adipose tissue. However, many problems in defining the optimal diagnostic criteria remain unresolved.
代谢综合征是一组相互关联的代谢危险因素，似乎直接促进糖尿病和心血管疾病的发展。然而，2005年，美国糖尿病协会和欧洲糖尿病研究协会联合声明，现有的代谢综合征定义均不符合综合征的标准，对于使用该综合征概念的利弊一直存在无休止的争论。争议可能源于对综合征与肥胖症的混淆。肥胖是一种由营养能量过剩环境引起，并因根深蒂固的社会规范而加剧的流行性、本质上具有传染性的疾病。肥胖症的流行应通过社会和政治手段加以预防或控制，类似于目前应对全球变暖所采取的方法。代谢综合征的诊断对于这一公共目的并无用处。建立代谢综合征诊断标准的目的是找出糖尿病和心血管疾病风险增加且需要包括饮食和运动在内的特定治疗的个体。该综合征可能是一种不同于肥胖症的脂肪组织疾病；在这种情况下，其临床特征可能是通过高敏C反应蛋白等全身炎症标志物检测到的炎症以及反映脂肪组织组织学变化的胰岛素抵抗。然而，在确定最佳诊断标准方面仍有许多问题尚未解决。
