Takahara Mitsuyoshi, Shimomura Iichiro
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Rev Endocr Metab Disord. 2014 Dec;15(4):317-27. doi: 10.1007/s11154-014-9294-8.
A clustering of metabolic abnormalities such as dyslipidemia, hypertension, and diabetes mellitus, all of which are major risk factors for cardiovascular disease (CVD), occurs more often than by chance. Numerous epidemiological studies, as well as basic researches, have revealed that visceral fat accumulation is closely involved in this risk clustering. This morbid condition is now well recognized as the metabolic syndrome. The concept of the metabolic syndrome, i.e., the involvement of visceral adiposity in the clustering of CVD risk factors, implies that an effective CVD risk reduction will be accomplished by an intervention to reduce visceral fat deposits. The primary strategy of the intervention is lifestyle modification, which can be put into practice in healthcare fields, without necessity of medical treatment. Now that CVD is a leading global health burden, the metabolic syndrome attracts increasing attention in the world. To take global action against the syndrome, several working groups developed its internationally unified diagnostic criteria. Most recently, the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) jointly proposed the criteria, although some cautions will be needed in their practical use. In this review, we mainly focus on the findings observed in clinical and epidemiological studies, to discuss a practical strategy of the management of the metabolic syndrome in healthcare fields.
血脂异常、高血压和糖尿病等代谢异常聚集现象比偶然情况更常发生，而这些都是心血管疾病（CVD）的主要危险因素。众多流行病学研究以及基础研究均表明，内脏脂肪堆积与这种风险聚集密切相关。这种病态状况如今已被公认为代谢综合征。代谢综合征的概念，即内脏肥胖与CVD危险因素聚集相关，意味着通过干预减少内脏脂肪堆积可有效降低CVD风险。干预的主要策略是生活方式改变，这在医疗保健领域无需药物治疗即可实施。鉴于CVD是全球主要的健康负担，代谢综合征在全球受到越来越多的关注。为了针对该综合征采取全球行动，多个工作组制定了其国际统一诊断标准。最近，国际糖尿病联盟（IDF）和美国心脏协会/国家心肺血液研究所（AHA/NHLBI）联合提出了这些标准，不过在实际应用中仍需一些注意事项。在本综述中，我们主要关注临床和流行病学研究中的发现，以探讨医疗保健领域中代谢综合征管理的实用策略。
