Aguilar-Salinas Carlos A, Viveros-Ruiz Tannia
Unidad de Investigación en Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14008, Mexico.
Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14008, Mexico.
F1000Res. 2019 Apr 3;8. doi: 10.12688/f1000research.17122.1. eCollection 2019.
The metabolic syndrome (MetS) concept gathers in a single entity a set of metabolic abnormalities that have in common a close relationship with ectopic deposit of lipids, insulin resistance, and chronic low-grade inflammation. It is a valuable teaching tool to help health professionals to understand and integrate the consequences of lipotoxicity and the adverse metabolic consequences of insulin resistance. Also, it is useful to identify subjects with a high risk for having incident type 2 diabetes. Systems biology studies have gained a prominent role in understanding the interaction between adipose tissue dysfunction, insulin action, and the MetS traits and co-morbidities (that is, non-alcoholic steatohepatitis, or NASH). This approach may allow the identification of new therapeutic targets (that is, lipogenesis inhibitors for NASH). Treatment targets on MetS are the adoption of a healthy lifestyle, weight loss, and the control of the co-morbidities (hyperglycemia, dyslipidemia, arterial hypertension, among others). The long-term goals are the prevention of type 2 diabetes, cardiovascular events, and other MetS-related outcomes. In the last few decades, new drugs derived from the identification of innovative treatment targets have come on the market. These drugs have positive effects on more than one MetS component (that is, hyperglycemia and weight control). New potential treatment targets are under study.
代谢综合征(MetS)的概念将一组代谢异常归为一个单一的实体,这些异常的共同之处在于与脂质异位沉积、胰岛素抵抗和慢性低度炎症密切相关。它是一种有价值的教学工具,有助于卫生专业人员理解和整合脂毒性的后果以及胰岛素抵抗的不良代谢后果。此外,它对于识别发生2型糖尿病风险高的个体也很有用。系统生物学研究在理解脂肪组织功能障碍、胰岛素作用以及代谢综合征特征和合并症(即非酒精性脂肪性肝炎,或NASH)之间的相互作用方面发挥了重要作用。这种方法可能有助于识别新的治疗靶点(即用于NASH的脂肪生成抑制剂)。代谢综合征的治疗目标是采取健康的生活方式、减轻体重以及控制合并症(高血糖、血脂异常、动脉高血压等)。长期目标是预防2型糖尿病、心血管事件以及其他与代谢综合征相关的后果。在过去几十年中,基于新发现的治疗靶点研发的新药已上市。这些药物对不止一种代谢综合征成分有积极作用(即高血糖和体重控制)。新的潜在治疗靶点正在研究中。