Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, PO Box 80205, Jeddah 21589, Jeddah, Saudi Arabia.
Ther Adv Endocrinol Metab. 2013 Apr;4(2):51-9. doi: 10.1177/2042018813483165.
The clustering of risk factors predisposing an individual to cardiovascular morbidity and mortality are usually referred to as the 'metabolic syndrome' (MS). Several definitions exist, causing confusion to practicing clinicians. A consensus definition was reached by several major organizations stating that the presence of any three of five risk factors (abdominal obesity, elevated triglyceride, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose) constitutes a diagnosis. Cutoff points for each of the risk factors were defined, taking into account ethnicity in case of abdominal obesity. The prevalence of MS has been reported to be on the rise globally, and was mainly attributed to changes in diet and lifestyle, in addition to genetic factors and metabolic susceptibility. The risk of cardiovascular disease (CVD) has almost doubled and the risk of developing type 2 diabetes mellitus (T2DM) has increased fivefold in individuals diagnosed with MS. The prevalence T2DM in Saudi Arabia is increasing, making it an epidemic health hazard. Intervention programs to decrease the risk of progression from MS to full T2DM, and later CVD have been successful in many countries. Therefore, diagnosing MS is important to address risk factors and to prevent progression to the more serious chronic conditions. The prevalence of MS in Saudi adults varies from 16% to 40% depending on the definition used and the study location. Use of the consensus definition might decrease the number of missed cases. However, in the absence of local cutoff points for various risk factors for MS, the use of ratios such as waist/hip ratio and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio, and family history of diabetes and CVD might aid diagnosis. Priority should be given to establishing national normal ranges, screening programs for hyperglycemia and hypertension, and community-directed programs to combat obesity and inactivity.
个体易患心血管疾病发病率和死亡率的风险因素聚集通常被称为“代谢综合征”(MS)。有几种定义，这给临床医生造成了困惑。几个主要组织达成了共识定义，即存在任何五种风险因素中的三种（腹部肥胖、甘油三酯升高、高密度脂蛋白胆固醇降低、血压升高和空腹血糖升高）即可诊断。每种危险因素的切点都有定义，考虑到腹部肥胖的种族因素。MS 的患病率在全球呈上升趋势，主要归因于饮食和生活方式的改变，以及遗传因素和代谢易感性。患有 MS 的个体患心血管疾病(CVD)的风险几乎增加了一倍，患 2 型糖尿病(T2DM)的风险增加了五倍。沙特阿拉伯的 T2DM 患病率正在上升，成为一种流行的健康危害。在许多国家，减少 MS 向完全 T2DM 发展以及随后 CVD 发展的风险的干预计划已经取得成功。因此，诊断 MS 对于解决风险因素和预防向更严重的慢性疾病进展非常重要。根据使用的定义和研究地点的不同，沙特成年人 MS 的患病率在 16%到 40%之间。使用共识定义可能会减少漏诊病例的数量。然而，在缺乏 MS 各种危险因素的本地切点的情况下，使用腰臀比和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值等比值，以及糖尿病和 CVD 的家族史，可能有助于诊断。应优先建立国家正常范围、高血糖和高血压筛查计划，以及针对肥胖和不活动的社区导向计划。
