肥胖教学课件.ppt

* Prevalence of the NCEP metabolic syndrome: NHANES III by age This slide shows the prevalence of the metabolic syndrome as defined by NCEP in NHANES III participants by age. It is usually said that the prevalence of the metabolic syndrome in the United States is 23 or 24%. However, this is not a useful statement since the prevalence of the metabolic syndrome markedly increases with age. The prevalence of the metabolic syndrome is 10% in individuals aged 20–29 years, 20% in individuals aged 40–49 years, and 45% in individuals aged 60–69 years. Thus it might be more useful to suggest that the estimated prevalence of the metabolic syndrome is an individuals age minus 20. Speaker’s notes: An analysis of 8814 men and women involved in the 3rd NHANES survey carried out between 1988 and 1994 showed that the age-adjusted prevalence of the metabolic syndrome among Americans 20 years of age or older was 23.7%. This ranged from 6.7% in survey participants between the ages of 20 to 29 to 43.5% for participants between the ages of 60 to 69. The large numbers of US residents with the metabolic syndrome may have important implications for the health care sector. [JAMA. 2002;287:356-9] Reference: Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356-359. * * 临床医学专业八年制卫生部规划教材 《病理生理学》 第2版 代谢综合征 背 景 社会经济的发展，生活方式的改变，导致以肥胖、糖脂代谢紊乱和高血压聚集为一体的代谢综合征（Metabolic Syndrome，MS）发病率急剧升高。 由MS导致的心血管损害明显增多 由MS导致的糖尿病明显增多 MS已成为一种慢性病和公共卫生问题 MS具有预测糖尿病及心血管疾病的价值 MS成为全球多学科研究的热点 MS的概念 概念：由于胰岛素抵抗引发的多种物质代谢失常的症候群。 包括肥胖、高血压、高血糖和IR、血脂异常。 表现：IGT、血脂异常、高血压、超重或肥胖、高尿酸血症、高血凝低纤溶、高酮型半胱氨酸血症、内皮功能异常、低蛋白血症 MS的危害 MS可明显增加心脑血管的患病率（5倍） MS可明显增加糖尿病的患病率（5倍） 增加心脑血管疾病和糖尿病的病死率，称为“死亡四重奏” 又称为CHAOS：C：冠心病；H：高血压、高Ins血症、高血脂；A：成人DM；O：肥胖；S：综合征。 MS流行病学情况 美国患病率：23%（20 ～ 70岁） 1994年 29%（20 ～ 70岁） 2000年 北美及欧洲患病率：20%～25% 中国患病率： 一般人群：13.3% 城市：14 ～20% 上海市：16.9