Hutcheson Rebecca, Rocic Petra
Department of Biochemistry and Molecular Biology, College of Medicine, University of South Alabama, 307 North University Boulevard, Mobile, AL 36688, USA.
Exp Diabetes Res. 2012;2012:271028. doi: 10.1155/2012/271028. Epub 2012 Jul 9.
The metabolic syndrome affects 30% of the US population with increasing prevalence. In this paper, we explore the relationship between the metabolic syndrome and the incidence and severity of cardiovascular disease in general and coronary artery disease (CAD) in particular. Furthermore, we look at the impact of metabolic syndrome on outcomes of coronary revascularization therapies including CABG, PTCA, and coronary collateral development. We also examine the association between the metabolic syndrome and its individual component pathologies and oxidative stress. Related, we explore the interaction between the main external sources of oxidative stress, cigarette smoke and air pollution, and metabolic syndrome and the effect of this interaction on CAD. We discuss the apparent lack of positive effect of antioxidants on cardiovascular outcomes in large clinical trials with emphasis on some of the limitations of these trials. Finally, we present evidence for successful use of antioxidant properties of pharmacological agents, including metformin, statins, angiotensin II type I receptor blockers (ARBs), and angiotensin II converting enzyme (ACE) inhibitors, for prevention and treatment of the cardiovascular complications of the metabolic syndrome.
代谢综合征影响着30%的美国人口，且患病率不断上升。在本文中，我们探讨了代谢综合征与一般心血管疾病尤其是冠状动脉疾病（CAD）的发病率及严重程度之间的关系。此外，我们研究了代谢综合征对包括冠状动脉旁路移植术（CABG）、经皮冠状动脉腔内血管成形术（PTCA）以及冠状动脉侧支循环发育等冠状动脉血运重建治疗结果的影响。我们还考察了代谢综合征与其各个组成部分的病理状况及氧化应激之间的关联。相关地，我们探究了氧化应激的主要外部来源——香烟烟雾和空气污染——与代谢综合征之间的相互作用以及这种相互作用对CAD的影响。我们讨论了大型临床试验中抗氧化剂对心血管结局明显缺乏积极作用的情况，并着重阐述了这些试验的一些局限性。最后，我们展示了药理学药物（包括二甲双胍、他汀类药物、血管紧张素II 1型受体阻滞剂（ARB）以及血管紧张素II转换酶（ACE）抑制剂）利用其抗氧化特性成功预防和治疗代谢综合征心血管并发症的证据。
