Deakin University, Centre for Physical Activity and Nutrition Research, 221 Burwood Hwy, Burwood, Victoria 3125, Australia.
Maturitas. 2010 Feb;65(2):117-21. doi: 10.1016/j.maturitas.2009.11.026. Epub 2009 Dec 23.
The purpose of clinical definitions of the metabolic syndrome is frequently misunderstood. While the metabolic syndrome as a physiological process describes a clustering of numerous age-related metabolic abnormalities that together increase the risk for cardiovascular disease and type 2 diabetes, clinical definitions include obesity which is thought to be a cause rather than a consequence of metabolic disturbance, and several elements that are routinely measured in clinical practice, including high blood pressure, high blood glucose and dyslipidaemia. Obesity is frequently a central player in the development of the metabolic syndrome and should be considered a key component of clinical definitions. Previous clinical definitions have differed in the priority given to obesity. Perhaps more importantly than its role in a clinical definition, however, is obesity in isolation before the hallmarks of metabolic dysfunction that typify the syndrome have developed. This should be treated seriously as an opportunity to prevent the consequences of the global diabetes epidemic now apparent. Clinical definitions were designed to identify a population at high lifetime CVD and type 2 diabetes risk, but in the absence of several major risk factors for each condition, are not optimal risk prediction devices for either. Despite this, the metabolic syndrome has several properties that make it a useful construct, in conjunction with short-term risk prediction algorithms and sound clinical judgement, for the identification of those at high lifetime risk of CVD and diabetes. A recently published consensus definition provides some much needed clarity about what a clinical definition entails. Even this, however, remains a work in progress until more evidence becomes available, particularly in the area of ethnicity-specific waist cut-points.
代谢综合征的临床定义常常被误解。代谢综合征作为一种生理过程，描述了一系列与年龄相关的代谢异常，这些异常共同增加了心血管疾病和 2 型糖尿病的风险，而临床定义则包括肥胖，肥胖被认为是代谢紊乱的原因而不是结果，以及在临床实践中常规测量的几个元素，包括高血压、高血糖和血脂异常。肥胖症常常是代谢综合征发展的核心因素，应被视为临床定义的关键组成部分。以前的临床定义在肥胖症的优先级上有所不同。然而，比其在临床定义中的作用更重要的是，在代谢功能障碍的特征发展之前，孤立的肥胖症。这应该被认真对待，作为一个预防目前明显的全球糖尿病流行后果的机会。临床定义旨在识别一生中患心血管疾病和 2 型糖尿病风险高的人群，但由于缺乏每种疾病的几个主要危险因素，它们并不是这两种疾病的最佳风险预测工具。尽管如此，代谢综合征具有一些特性，使其与短期风险预测算法和合理的临床判断相结合，成为识别那些一生中患心血管疾病和糖尿病风险高的人的有用结构。最近发布的共识定义为临床定义所需要的内容提供了一些急需的清晰度。然而，即使是这样，在更多证据出现之前，它仍然是一个正在进行的工作，特别是在特定种族腰围切点方面。
