代谢综合症临床设置的第一时间准备课件.ppt

The Metabolic Syndrome: Ready for Prime Time in Clinical Settings? Yuling Hong, MD, PhD, FAHA* Director, Biostatistics and Epidemiology Senior Science and Medicine Advisor American Heart Association The presentation does not necessarily represent the official position of the American Heart Association Outline Evolution of the the Metabolic Syndrome( MetS). Clinical definitions and the implications. Major health consequences of the MetS. Is the metabolic syndrome a useful marker of CHD above and beyond the risk associated with its individual components and other major CVD risk factors? Underlying mechanisms behind the MetS and factors associated with it. Management of the MetS? Future research directions The Metabolic Syndrome, also referred to as Syndrome X, Syndrome X Plus the Insulin Resistance Syndrome, Diabesity, the Big 4, the Deadly Quartet, the, the Reaven Syndrome, is a term for constellation of endogenous risk factors that increase the risk of developing both atherosclerostic vascular disease (ASCVD) and type 2 diabetes mellitus. What is the MetS 1923: Kylin described clustering of hypertension, gout, and hyperglycemia 1988: Reaven’s Banting lecture at ADA Annual Conference described the term of Syndrome X. 1998: World Health Organization first defined the MetS for clinicians and researchers. 2001: US NCEP ATP III definition for the MetS was released 2005: IDF and AHA/NHLBI definition of the MetS for worldwide use was released Evolution of the MetS Major abnormalities for Syndrome X in Dr. Reaven 1988 Banting Lecture 1.  Hypertension 2.  Hyperglycemia 3.  Glucose intolerance 4.  Elevated serum triglycerides 5. Low serum HDL cholesterol Obesity was included and no cut-off points for these abnormalities. Proposed MetS Definitions WHO (1998) Insulin resistance DM / IGT / IFG 2 or more of 1)Obesity W/H ratio:0.9(m), 0.85(w);BMI: 30 2)Dyslipidemia TG 150; HDL-c35(m)/39(w) 3)Blood pressure ≥140/90 4)High glucose 5)Microalbuminura