Targeting inflammation in metabolic syndrome.
Targeting inflammation in metabolic syndrome.
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DOI：
10.1016/j.trsl.2015.06.017
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Elajami TK
中科院分区：
文献类型：
--
作者：
Welty FK;Alfaddagh A;Elajami TK
代谢综合征（MetS）由一系列密切相关的危险因素组成，包括内脏脂肪、胰岛素抵抗、高血压、高甘油三酯和低HDL-C，所有这些因素都增加了2型糖尿病和心血管（CV）疾病的发生风险。慢性炎症状态似乎是胰岛素抵抗和代谢代谢的病理生理基础的中心机制。在这篇综述中，我们总结了最近的研究，这些研究提供了关于炎症在代谢代谢的各个组成部分的病理生理机制的见解，包括内脏脂肪，高血糖和胰岛素抵抗，血脂异常和高血压。在这些机制的基础上，我们总结了治疗方式，以靶炎症在MetS及其个别组成部分。目前的治疗方式可以调节MetS的各个成分，并具有直接的抗炎作用。生活方式的改变，包括锻炼，减肥，多吃水果，蔬菜，纤维，全谷物和低脂乳制品，低饱和脂肪和葡萄糖，被推荐作为一线治疗方法。地中海饮食和DASH饮食特别有益，并已被证明可以预防met的发展。此外，地中海饮食与总死亡率和心血管疾病死亡率的降低有关。Omega-3脂肪酸和过氧化物酶体增殖物激活受体α激动剂降低高水平的甘油三酯；综述了它们在靶向炎症中的作用。血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂和醛固酮阻滞剂包括高血压的药物治疗，但也针对MetS的其他方面，包括炎症。他汀类药物靶向许多与MetS相关的潜在炎症途径。
The metabolic syndrome (MetS) is comprised of a cluster of closely related risk factors, including visceral adiposity, insulin resistance, hypertension, high triglyceride and low HDL-C, all of which increase the risk for the development of type 2 diabetes and cardiovascular (CV) disease. A chronic state of inflammation appears to be a central mechanism underlying the pathophysiology of insulin resistance and MetS. In this review, we summarize recent research which has provided insight into the mechanisms by which inflammation underlies the pathophysiology of the individual components of MetS including visceral adiposity, hyperglycemia and insulin resistance, dyslipidemia and hypertension. On the basis of these mechanisms, we summarize therapeutic modalities to target inflammation in the MetS and its individual components. Current therapeutic modalities can modulate the individual components of MetS as well as have a direct anti-inflammatory effect. Lifestyle modifications including exercise, weight loss and diets high in fruits, vegetables, fiber, whole grains and low-fat dairy and low in saturated fat and glucose are recommended as first line therapy. The Mediterranean and DASH diets are especially beneficial and have been shown to prevent development of MetS. Moreover, the Mediterranean diet has been associated with reductions in total and CV mortality. Omega-3 fatty acids and peroxisome proliferator-activated receptor α agonists lower high levels of triglyceride; their role in targeting inflammation is reviewed. Angiotensin converting enzyme inhibitors, angiotensin receptor blockers and aldosterone blockers comprise pharmacologic therapies for hypertension but also target other aspects of MetS including inflammation. Statin drugs target many of the underlying inflammatory pathways involved in MetS.
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