Department of Clinical Biochemistry, Royal Free Hospital campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG, London, UK.
Curr Vasc Pharmacol. 2013 Nov;11(6):880-905. doi: 10.2174/15701611113116660171.
Metabolic syndrome (MetS) is associated with increased risk of both atherothrombotic cardiovascular events and venous thromboembolism. The pro-thrombotic potential of MetS, may explain this association. In this review we discuss the relationship of MetS with hemostasis focusing on endothelial function, platelet activity, coagulation, fibrinolysis and hemorheologic markers. Endothelial-dependent vasodilatation is impaired in MetS. This is mostly mediated by a reduced expression of vasodilators (nitric oxide and prostacyclin) with a concomitant increase of vasoconstrictors (endothelin- 1, angiotensin II and thromboxane A2). Platelet activity is enhanced in MetS. A cross-talk between activated endothelium and platelets results in a pro-thrombotic vicious cycle. Enhanced coagulation together with impaired fibrinolysis is also present in MetS. This is mirrored by high fibrinogen and plasminogen activator inhibitor-1 levels. Endothelial dysfunction, expressed by high von Willebrand factor and tissue plasminogen factor levels, also contributes to this abnormality. Whole blood and plasma viscosity is increased in MetS. Lifestyle intervention can improve the MetS-related pro-thrombotic state. These measures include weight reduction and improved composition of the diet. A Mediterranean-style diet rich in olive oil, as a source of monounsaturated fat, and low saturated fat consumption may also be beneficial.
代谢综合征（MetS）与动脉粥样血栓性心血管事件和静脉血栓栓塞的风险增加有关。MetS 的促血栓形成潜能可能解释了这种关联。在这篇综述中，我们讨论了 MetS 与止血的关系，重点是内皮功能、血小板活性、凝血、纤溶和血液流变学标志物。MetS 中内皮依赖性血管舒张受损。这主要是通过减少血管扩张剂（一氧化氮和前列环素）的表达，同时增加血管收缩剂（内皮素-1、血管紧张素 II 和血栓素 A2）来介导的。MetS 中血小板活性增强。激活的内皮细胞和血小板之间的相互作用导致促血栓形成的恶性循环。增强的凝血和受损的纤溶也存在于 MetS 中。这反映在纤维蛋白原和纤溶酶原激活物抑制剂-1 水平升高。内皮功能障碍，表现为高血管性血友病因子和组织型纤溶酶原激活物水平升高，也促成了这种异常。MetS 中全血和血浆粘度增加。生活方式干预可以改善 MetS 相关的促血栓形成状态。这些措施包括减轻体重和改善饮食结构。富含橄榄油的地中海式饮食作为单不饱和脂肪的来源，以及低饱和脂肪的摄入，也可能有益。
