摘要
Metabolic syndrome(Met S) is a term used to denote a combination of selected,widely prevalent cardiovascular disease(CVD)-related risk factors.Despite the ambiguous definition of Met S,it has been clearly associated with chronic kidney disease markers including reduced glomerular filtration rate,proteinuria and/or microalbuminuria,and histopathological markers such as tubular atrophy and interstitial fibrosis.However,the etiological role of Met S in chronic kidney disease(CKD) is less clear.The relationship between MetS and CKD is complex and bidirectional,and so is best understood when CKD is viewed as a common progressive illness along the course of which MetS,another common disease,may intervene and contribute.Possible mechanisms of renal injury include insulin resistance and oxidative stress,increased proinflammatory cytokine production,increased connective tissue growth and profibrotic factor production,increased microvascular injury,and renal ischemia.MetS also portends a higher CVD risk at all stages of CKD from early renal insufficiency to end-stage renal disease.Clinical interventions for MetS in the presence of CKD should include a combination of weight reduction,appropriate dietary modification and increase physical activity,plus targeting of individual CVD-related risk factors such as dysglycemia,hypertension,and dyslipidemia while conforming to relevant national societal guidelines.
Metabolic syndrome (MetS) is a term used to denote a combination of selected, widely prevalent cardiovascular disease (CVD)-related risk factors. Despite the ambiguous definition of MetS, it has been clearly associated with chronic kidney disease markers including reduced glomerular filtration rate, proteinuria and/or microalbuminuria, and histopathological markers such as tubular atrophy and interstitial fibrosis. However, the etiological role of MetS in chronic kidney disease (CKD) is less clear. The relationship between MetS and CKD is complex and bidirectional, and so is best understood when CKD is viewed as a common progressive illness along the course of which MetS, another common disease, may intervene and contribute. Possible mechanisms of renal injury include insulin resistance and oxidative stress, increased proinflammatory cytokine production, increased connective tissue growth and profibrotic factor production, increased microvascular injury, and renal ischemia. MetS also portends a higher CVD risk at all stages of CKD from early renal insufficiency to end-stage renal disease. Clinical interventions for MetS in the presence of CKD should include a combination of weight reduction, appropriate dietary modification and increase physical activity, plus targeting of individual CVD-related risk factors such as dysglycemia, hypertension, and dyslipidemia while conforming to relevant national societal guidelines.
关键词
代谢综合征
心血管疾病
治疗方法
临床分析
Metabolic syndrome
Cardiovascular disease
Diabetes
Dialysis
Hyperlipidemia
Hypertension
Microalbuminuria
Obesity
Progression