Peterseim Carolyn Mae, Jabbour Katarzyna, Kamath Mulki Ashwini
Lehigh Valley Health Network Family Medicine Residency, Allentown, PA, USA.
University of South Florida Morsani College of Medicine, Tampa, FL, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241309168. doi: 10.1177/21501319241309168.
Metabolic syndrome is a cluster of cardiovascular risk factors (central obesity, hypertension, dyslipidemia, and insulin resistance) that affects between 12.5% and 31.4% of adults worldwide. It correlates with increased risks of cardiovascular disease, diabetes, cancer, and overall mortality in a dose-dependent fashion. This review aims to provide primary care clinicians an updated review of the evidence on metabolic syndrome, with a focus on treatment.
Scoping evidence review.
English-language studies of evidence Level I or II that focused on defining, diagnosing, and treating metabolic syndrome or its components.
PubMed and Cochrane Database of Systematic Reviews.
Though evidence is still lacking for improved outcomes with treating the syndrome per se, addressing its individual components reduces risks. Lifestyle changes like weight loss and increased physical activity are first line. Surgical options assist with weight loss for certain patients. Pharmacotherapies like glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, statins, and antihypertensives also have efficacy.
Metabolic syndrome is an independent risk factor for many poor health outcomes. Its individual components should be treated with medication and behavioral changes to reduce cardiovascular risk and prevent diabetes and its complications. More research is needed on how to treat the syndrome itself. A diagnosis of metabolic syndrome may be useful for motivating patients toward lifestyle changes, though more research is needed on how to treat the syndrome versus its components.
代谢综合征是一组心血管危险因素(中心性肥胖、高血压、血脂异常和胰岛素抵抗),全球12.5%至31.4%的成年人受其影响。它与心血管疾病、糖尿病、癌症及全因死亡率风险增加呈剂量依赖性相关。本综述旨在为基层医疗临床医生提供关于代谢综合征证据的最新综述,重点是治疗。
范围性证据综述。
聚焦于代谢综合征及其组成部分的定义、诊断和治疗的I级或II级英文研究。
PubMed和Cochrane系统评价数据库。
尽管目前仍缺乏证据表明治疗代谢综合征本身能改善预后,但针对其各个组成部分进行治疗可降低风险。诸如减肥和增加体育活动等生活方式改变是一线治疗方法。手术方案可帮助某些患者减轻体重。胰高血糖素样肽-1受体激动剂、钠-葡萄糖协同转运蛋白-2抑制剂、他汀类药物和抗高血压药物等药物治疗也有疗效。
代谢综合征是许多不良健康结局的独立危险因素。应通过药物治疗和行为改变来治疗其各个组成部分,以降低心血管风险并预防糖尿病及其并发症。关于如何治疗代谢综合征本身,还需要更多研究。代谢综合征的诊断可能有助于促使患者改变生活方式,不过关于如何治疗该综合征及其组成部分,还需要更多研究。