Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy.
Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy; Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK.
Heart Fail Clin. 2019 Jul;15(3):349-358. doi: 10.1016/j.hfc.2019.02.004. Epub 2019 Apr 5.
The interplay between metabolic syndrome (MetS) and heart failure (HF) is intricate. Population studies show that MetS confers an increased risk to develop HF and this effect is mediated by insulin resistance (IR). However, obesity, a key component in MetS and common partner of IR, is protective in patients with established HF, although IR confers an increased risk of dying by HF. Such phenomenon, known as "obesity paradox," accounts for the complexity of the HF-MetS relationship. Because IR impacts more on outcomes than MetS itself, the former may be considered the actual target for MetS in HF patients.
代谢综合征 (MetS) 和心力衰竭 (HF) 之间的相互作用很复杂。人群研究表明，MetS 会增加患 HF 的风险，这种作用是通过胰岛素抵抗 (IR) 介导的。然而，肥胖是 MetS 的一个关键组成部分，也是 IR 的常见伴发因素，在已确诊 HF 的患者中却是保护性的，尽管 IR 会增加 HF 死亡的风险。这种现象被称为“肥胖悖论”，说明了 HF-MetS 关系的复杂性。由于 IR 对预后的影响大于 MetS 本身，因此前者可能被认为是 HF 患者 MetS 的实际靶点。
