Bhalwar Rajvir
Dean, Rural Medical College, Pravara Institute of Medical Sciences (Deemed University), Loni, Ahmednagar, Maharashtra, 413736, India.
Med J Armed Forces India. 2020 Jan;76(1):8-16. doi: 10.1016/j.mjafi.2019.12.001. Epub 2020 Jan 13.
Metabolic Syndrome (MetS) is a clustering of specific risk factors, namely, central obesity, raised blood pressure, impaired fasting glucose, raised triglycerides, and low levels of high-density lipoprotein-cholesterol (HDL-C). This constellation is triggered by insulin resistance and its resultant hyperinsulinemia. The two most important and universally agreed causes of insulin resistance are increased body fat (particularly central obesity) and physical inactivity. Other causes include certain genetic/pro-genetic factors, unhealthy atherogenic diet, tobacco use, and excessive alcohol intake. Within 3 decades of the initial description of MetS by Reaven, various defining criteria have been developed by now, by leading international professional bodies, the most commonly used being the one given by the Adult Treatment Panel III (ATP III) report of the National Cholesterol Education Program (NCEP) [NCEP-ATP-III], the updated guidelines recently released by the American College of Cardiology (ACC) and the American Heart Association (AHA). MetS has been well documented to increase the risk of ischemic heart disease (IHD) by two to three times and of type 2 diabetes mellitus (T2DM) by five times. The world-wide prevalence is on the increase, with the overall global prevalence estimated to be 20%-25% of the adult population. In our country, various epidemiological studies undertaken across the country have consistently shown a high prevalence, which is likely to be as much as one-quarter of the adult population, with increasing age and female gender being at higher risk. The occurrence has also been recorded among the Armed Forces personnel as well as in adolescents. MetS has therefore become a priority issue for both, the public health providers as well as for the clinicians in our country, and needs concerted, all-round efforts for its prevention, early detection, management, and research. Against this background, the various public health measures for prevention and control of MetS have been suggested in this review.
代谢综合征（MetS）是一组特定风险因素的聚集，即中心性肥胖、血压升高、空腹血糖受损、甘油三酯升高以及高密度脂蛋白胆固醇（HDL-C）水平降低。这一症候群由胰岛素抵抗及其导致的高胰岛素血症引发。胰岛素抵抗两个最重要且被普遍认可的原因是体脂增加（尤其是中心性肥胖）和身体活动不足。其他原因包括某些遗传/前遗传因素、不健康的致动脉粥样硬化饮食、吸烟以及过量饮酒。在雷文首次描述代谢综合征后的30年里，目前国际领先的专业机构已经制定了各种定义标准，最常用的是美国国家胆固醇教育计划（NCEP）的成人治疗小组第三次报告（ATP III）[NCEP-ATP-III]、美国心脏病学会（ACC）和美国心脏协会（AHA）最近发布的更新指南。有充分文献记载，代谢综合征会使缺血性心脏病（IHD）的风险增加两到三倍，使2型糖尿病（T2DM）的风险增加五倍。全球患病率呈上升趋势，全球总体患病率估计为成年人口的20%-25%。在我国，全国各地进行的各种流行病学研究一致显示患病率很高，可能高达成年人口的四分之一，年龄增长和女性患病风险更高。武装部队人员以及青少年中也有发病记录。因此，代谢综合征已成为我国公共卫生服务提供者和临床医生的优先问题，需要各方齐心协力、全面开展预防、早期发现、管理和研究工作。在此背景下，本综述提出了各种预防和控制代谢综合征的公共卫生措施。
