代谢综合征-926—培训课件.ppt

* 近期发表的对1209名男性随访12年的Kuopio缺血性心脏疾病危险因素研究结果表明，无论使用ATPIII还是WHO的代谢综合征定义，代谢综合征都与CHD，CVD及总死亡率显著相关。 * Numerous factors contribute to development of the metabolic syndrome. Excessive weight is one important cause, and physical inactivity and genetic predisposition may also have important causative roles. The metabolic syndrome is also closely associated with insulin resistance, which carries additional risk due to its involvement in the evolution of diabetes and independent association with reduced HDL cholesterol, elevated triglycerides, hypertension, and abdominal obesity. Third Report of the National Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-3421. * Once a diagnosis of the metabolic syndrome is made, the future management of the condition should be aggressive and uncompromising in its aim to reduce the risk of CVD and type 2 diabetes. Patients should undergo a full cardiovascular risk assessment (including smoking status) in conjunction with the following: ? Primary intervention IDF recommends that primary management for the metabolic syndrome is healthy lifestyle promotion. This includes: o moderate calorie restriction (to achieve a 5–10 per cent loss of body weight in the first year) o moderate increase in physical activity o change in dietary composition The results of Finnish and American prevention of diabetes studies have shown the marked clinical benefits associated with a small weight loss in terms of preventing (or at least delaying by several years) the conversion to type 2 diabetes among high-risk individuals with glucose intolerance who were, generally, obese.12,13 ? Secondary intervention In people for whom lifestyle change is not enough and who are considered to be at high risk for CVD, drug therapy may be required to treat the metabolic syndrome. While there is a definite need for a treatment that can m