University of Arkansas for Medical Sciences and Veterans Affairs Medical Center, Little Rock, AR, USA.
J Am Coll Cardiol. 2011 Jun 7;57(23):2303-8. doi: 10.1016/j.jacc.2011.02.027.
Coronary heart disease remains a major cause of morbidity and mortality in the United States, and its incidence is rising worldwide. Because atherosclerosis is a chronic process, and it is often associated with certain lifestyle and risk factors such as hypertension, dyslipidemia, and insulin resistance, much emphasis is being placed on lifestyle modification and control of risk factors. It is being recognized that some lifestyle patterns such as overeating result in metabolic syndrome, which may play a role in the development of chronic kidney disease and coronary heart disease. Here, we focus on an important relationship between these 3 conditions, and we provide evidence that microalbuminuria develops in many patients with metabolic syndrome, may be an important correlate of chronic kidney disease and coronary heart disease, and may represent an important prognostic marker. Although the pathogenesis of microalbuminuria in metabolic syndrome is not clear, we suggest that microalbuminuria, chronic kidney disease, and coronary heart disease share common pathways involving inflammation and oxidative stress. We also discuss that a healthy lifestyle is essential for preventing and treating chronic kidney disease and coronary heart disease seen in patients with metabolic syndrome.
冠心病仍然是美国发病率和死亡率的主要原因,其发病率在全球范围内呈上升趋势。由于动脉粥样硬化是一个慢性过程,并且常与某些生活方式和危险因素相关,如高血压、血脂异常和胰岛素抵抗,因此非常强调生活方式的改变和危险因素的控制。人们逐渐认识到,某些生活方式,如暴饮暴食,会导致代谢综合征,这可能在慢性肾脏病和冠心病的发展中起作用。在这里,我们重点关注这 3 种情况之间的重要关系,并提供证据表明,代谢综合征患者中许多人会出现微量白蛋白尿,微量白蛋白尿可能是慢性肾脏病和冠心病的一个重要相关因素,并可能代表一个重要的预后标志物。虽然代谢综合征中微量白蛋白尿的发病机制尚不清楚,但我们认为微量白蛋白尿、慢性肾脏病和冠心病共同涉及炎症和氧化应激等途径。我们还讨论了健康的生活方式对于预防和治疗代谢综合征患者的慢性肾脏病和冠心病是至关重要的。