代谢综合征患者心血管疾病的病理生理及治疗进展

Pathophysiology and therapeutics in cardiovascular disease of patients with metabolic syndrome:research progress

代谢综合征(Met S)是多种代谢成分异常聚集的病理状态,是一组表现为一系列与心血管疾病(CVD)相关联的症候群,包括像向心性肥胖、高糖血症、血脂异常和高血压等等,这些特征与近年来不断增长的CVD的发病率和死亡率有着非常密切的联系。多重因素导致的代谢紊乱与CVD发生之间相互关联,其中胰岛素抵抗(IR)、氧化应激、低水平的炎症和血管功能不良被认为是最大的成因。因此,临床上多管齐下的综合治疗方案被用来治疗Met S患者,并且叮嘱患者应注意生活方式的改变,如健康的饮食、合理的锻炼。此外,改进胰岛素抵抗和葡萄糖的代谢,控制血压和调节血脂异常也能延缓或者逆转Met S患者的CVD进程。本综述旨在阐述Met S与CVD之间复杂的联系,讨论关于Met S患者心血管并发症的预防以及治疗的最佳方案,并介绍目前临床试验中最新的研究成果。

Metabolic syndrome （MetS） is the pathological state of abnormal accumulation of various metabolites that always manifest a series of syndromes characterized by cardiovascular risk factors including central obesity, hyperglycemia, dyslipidemia and hypertension, which are highly correlated with the growing morbidity and mortality rates for cardiovascular diseases （CVD）. The correlation between these metabolic disorders and the development of CVD is identified to be complex and multifactorial in which insulin resistance （IR）, oxidative stress, low-grade inflammation and vascular maladaptation are consid- ered to be the leading causes. Hence, multifaceted comprehensive treatment scheme should be used to treat patients with MetS. Lifestyle changes such as weight control, healthy heart diet and regular exercises have been recommended as the first line measures to reduce the risks of CVD in MetS individuals. Improving insulin resistance and glucose metabolism, controlling blood pressure and adjusting dyslipidemia can also reverse or slow down the process of CVD in MetS. This review aims to elaborate the complex relationship between MetS and CVD, to discuss the optimal treatment regimens to prevent and treat cardiovascu- lar complications in MetS patients and to introduce the updated results from newly released clinical trials.