The metabolic syndrome
The metabolic syndrome
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DOI：
10.1016/s0140-6736(05)67777-x
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发表时间：
2005-12
期刊：
影响因子：
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通讯作者：
B. Balkau;E. Eschwège
中科院分区：
文献类型：
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作者：
B. Balkau;E. Eschwège
我们欢迎国际糖尿病联合会流行病学共识工作组正式发布代谢综合征的全球定义（9 月 24 日，第 1059 页）。 1 目的是提供一个实用的定义来取代现有的定义。将高腰围作为必要的异常现象很有吸引力，因为有许多关于内脏脂肪在糖尿病和心血管疾病的病因中的作用的假设。该小组强调的要点之一是，该综合征“有助于识别患有 2 型糖尿病和心血管疾病的高风险个体”。 1 然而，通过专门针对这些各自目的确定的其他风险因素可以更好地预测糖尿病和心血管疾病。 2 对于糖尿病，如果患者血糖不高，患糖尿病的风险就会大大降低。 3 对于心血管疾病，一个可取之处是，该综合征确实根据传统风险因素（年龄、性别、吸烟、血压、胆固醇）将具有心血管死亡风险的男性识别为低风险人群。 4IDF 定义（及其他定义）的两个易于使用的特征是综合征中危险因素的二分法以及综合征本身的二分法。对异常情况的简单求和假设每个二分危险因素都具有相同的风险。然而，心血管风险是每个风险因素的线性函数（并且不遵循任何共识阈值），并且风险根据患者可能具有的特定风险因素而变化。
We welcome the official publication of the worldwide definition of the metabolic syndrome by the International Diabetes Federation Epidemiology Consensus Task Force Group (Sept 24, p 1059). 1 The aim was to provide one practical definition to replace the existing ones. The inclusion of a high waist circumference as a required abnormality is appealing because there are many hypotheses about the role of visceral fat in the causes of diabetes and cardiovascular disease. One of the essential points emphasised by the group is that the syndrome “helps identify individuals at high risk for both type 2 diabetes and cardiovascular disease”. 1 However, diabetes and cardiovascular disease are better predicted by other risk factors specifically determined for these respective purposes. 2 For diabetes, if a patient is not hyperglycaemic, the risk of diabetes is greatly diminished. 3 For cardiovascular disease, a saving grace is that the syndrome does identify men at risk of cardiovascular mortality among those at low risk according to conventional risk factors (age, sex, smoking, blood pressure, cholesterol). 4The two characteristics of the IDF definition (and others) that make it simple to use are the dichotomisation of the risk factors in the syndrome as well as the dichotomisation of the syndrome itself. The simple summing of the abnormalities assumes that each dichotomised risk factor carries the same risk. However, cardiovascular risk is a linear function of each of the risk factors (and does not obey any consensual thresholds), and the risk changes according to the specific risk factors a patient may have.