Definition of metabolic syndrome - Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition
Definition of metabolic syndrome - Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition
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DOI：
10.1161/01.cir.0000112379.88385.67
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发表时间：
2004-01-27
期刊：
影响因子：
37.8
通讯作者：
Lenfant, C
中科院分区：
文献类型：
--
作者：
Grundy, SM;Brewer, HB;Lenfant, C
证候随年龄增长而增多。在老年人中观察到的患病率最高，尽管中年人的患病率迅速上升，与之平行的是，人口中肥胖症的发展有一段滞后的时间。在美国，根据ATP III诊断标准，大约三分之一的超重/肥胖者表现出代谢综合征。5几个种族群体，包括西班牙裔和南亚人(例如，来自印度次大陆)，似乎特别容易患上这种综合症。黑人男性患这种综合征的频率低于白人男性，这可能是因为致动脉粥样硬化性血脂异常的患病率较低；然而，黑人男性异常容易患高血压，患糖尿病的风险更高。代谢综合征的基因基础是一个越来越感兴趣的话题。在极少数情况下，患者有严重的代谢综合征，因为单基因疾病，如脂肪组织疾病(例如，由层蛋白A/C、AGPAT和Seipin突变引起的脂肪营养不良)。据报道，多种基因的多态与代谢综合征有关，但它们在普通公众中对该综合征的贡献仍有待确定。代谢综合征越来越多地被认为是几种常用药物的副作用，主要是因为其中一些药物(如皮质类固醇、抗抑郁药、抗精神病药物、抗组胺药)可以导致体重增加，这容易导致代谢综合征的两个特征：肥胖和葡萄糖耐量减低。用于治疗HIV的蛋白酶抑制剂经常会导致继发于脂肪营养不良和胰岛素抵抗的代谢综合征。更常见的是，代谢综合征与腹型肥胖症有关，腹型肥胖症是一种肥胖症，通常在中年出现。内脏脂肪过多可能特别致病，但腹部皮下脂肪组织可能也是致病因素，全身脂肪也可能是致病因素。
syndrome increases with age. The highest prevalence is observed in older persons, although frequency rises rapidly in middle age and parallels, with some lag time, the development of obesity in the population. In the United States, approximately one third of overweight/obese persons manifest the metabolic syndrome according to ATP III diagnosis criteria. 5 Several ethnic groups, including Hispanics and South Asians (eg, from the Indian subcontinent), seem to be particularly susceptible to the syndrome. Black men have a lower frequency of the syndrome than do white men, likely because of a lower prevalence of atherogenic dyslipidemia; nonetheless, black men are unusually susceptible to hypertension and carry a greater risk for diabetes. The genetic underpinning of metabolic syndrome is a topic of growing interest. In rare instances, patients have severe metabolic syndrome because of monogenic disorders such as adipose tissue disorders (eg, lipodystrophy caused by mutations in lamin A/C, AGPAT, and seipin). Polymorphisms in a variety of genes have been reported to associate with the metabolic syndrome, but their contributions to the syndrome in the general public remain to be determined. The metabolic syndrome increasingly is being recognized as a side effect of several commonly used drugs, mainly because some of these drugs (eg, corticosteroids, antidepressants, antipsychotics, antihistamines) can produce weight gain, which predisposes to 2 of the features of the metabolic syndrome: obesity and glucose intolerance. Protease inhibitors used in the treatment of HIV very often induce a metabolic syndrome secondary to lipodystrophy and insulin resistance. More commonly, the metabolic syndrome associates with abdominal obesity, the form of obesity that often develops in middle age. An excess of visceral fat may be particularly pathogenic, but abdominal subcutaneous adipose tissue likely contributes as well, as can total body fat.