Does the metabolic syndrome add to the diagnosis and treatment of cardiovascular disease?
Does the metabolic syndrome add to the diagnosis and treatment of cardiovascular disease?
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DOI：
10.1038/ncpcardio1271
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发表时间：
2008-07-01
期刊：
影响因子：
--
通讯作者：
Bakker, Stephan J. L.
中科院分区：
文献类型：
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作者：
de Zeeuw, Dick;Bakker, Stephan J. L.
围绕代谢综合征的病理基础和临床应用存在许多争议。关键的问题仍然围绕着这种综合征的定义，其作为心血管风险预测因子的效用，以及诊断的治疗意义。代谢综合征与心血管风险增加有关。然而，与其他已建立的预测方程相比，代谢综合征明显表现不佳，如Frachial风险评分和SCORE（全身冠状动脉风险评估）。差异的出现是因为这些成分高度相关（而其他工具特别包括独立的预测因子），因为诊断是基于二分变量。这些事实，加上不确定的病理生理学，意味着代谢综合征在其目前的表现形式，心血管疾病的诊断和治疗的效用有限。然而，该综合征已经并将继续在提高人们对肥胖代谢后果的认识方面发挥有益的作用，并促进对代谢危险因素相互作用的研究。
Much controversy has surrounded both the pathological basis and the clinical utility of the metabolic syndrome. Key questions still revolve around the definition of this syndrome, its utility as a predictor of cardiovascular risk, and the treatment implications of diagnosis. The metabolic syndrome is associated with increased cardiovascular risk. However, the metabolic syndrome clearly underperforms compared with other, established prediction equations, such as the Framingham Risk Score and SCORE (Systemic COronary Risk Evaluation). Differences arise because the components are highly correlated (whereas other tools specifically include independent predictors) and because diagnosis is based on dichotomized variables. These facts, together with uncertain pathophysiology, mean that the metabolic syndrome in its current manifestation has limited utility for the diagnosis and treatment of cardiovascular disease. The syndrome has, however, served and continues to serve a useful purpose in raising awareness of the metabolic consequences of obesity, and as a spur for research into metabolic risk factor interactions.