Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Nat Rev Dis Primers. 2024 Oct 17;10(1):77. doi: 10.1038/s41572-024-00563-5.
The metabolic syndrome (MetS) is a multiplex modifiable risk factor for cardiovascular disease, type 2 diabetes mellitus and other health outcomes, and is a major challenge to clinical practice and public health. The rising global prevalence of MetS, driven by urbanization, sedentary lifestyles and dietary changes, underlines the urgency of addressing this syndrome. We explore the complex underlying mechanisms, including genetic predisposition, insulin resistance, accumulation of dysfunctional adipose tissue and ectopic lipids in abdominal obesity, systemic inflammation and dyslipidaemia, and how they contribute to the clinical manifestations of MetS. Diagnostic approaches vary but commonly focus on abdominal obesity (assessed using waist circumference), hyperglycaemia, dyslipidaemia and hypertension, highlighting the need for population-specific and phenotype-specific diagnostic strategies. Management of MetS prioritizes lifestyle modifications, such as healthy dietary patterns, physical activity and management of excess visceral and ectopic adiposity, as foundational interventions. We also discuss emerging therapies, including new pharmacological treatments and surgical options, providing a forward-looking perspective on MetS research and care. This Primer aims to inform clinicians, researchers and policymakers about MetS complexities, advocating for a cohesive, patient-centred management and prevention strategy. Emphasizing the multifactorial nature of MetS, this Primer calls for integrated public health efforts, personalized care and innovative research to address this escalating health issue.
代谢综合征（Metabolic Syndrome，MetS）是心血管疾病、2 型糖尿病和其他健康问题的多种可改变的危险因素，是临床实践和公共卫生的主要挑战。城市化、久坐的生活方式和饮食变化推动了 MetS 在全球的患病率不断上升，凸显了解决这一综合征的紧迫性。我们探讨了复杂的潜在机制，包括遗传易感性、胰岛素抵抗、功能失调的脂肪组织在腹部肥胖中的积累、异位脂质、全身炎症和血脂异常，以及它们如何导致 MetS 的临床表现。诊断方法各不相同，但通常集中在腹部肥胖（通过腰围评估）、高血糖、血脂异常和高血压上，突出了需要针对特定人群和表型的诊断策略。MetS 的管理侧重于生活方式的改变，如健康的饮食模式、身体活动和内脏脂肪和异位脂肪的过度管理，作为基础干预措施。我们还讨论了新兴的治疗方法，包括新的药物治疗和手术选择，为 MetS 的研究和护理提供了前瞻性视角。本指南旨在为临床医生、研究人员和政策制定者提供有关 MetS 复杂性的信息，倡导一种协调一致、以患者为中心的管理和预防策略。强调 MetS 的多因素性质，本指南呼吁采取综合的公共卫生措施、个性化护理和创新研究来应对这一不断升级的健康问题。
