代谢综合症：预防心脏病的前景PPT.ppt

Metabolic Syndrome: A Perspective in Preventive Cardiology Zhao Dong Department of Epidemiology Beijing Institute of Heart, Lung Blood Vessel Diseases Beijing Anzhen Hospital Focuses of Current Debates in Metabolic Syndrome Definitions?????? Etiology and pathophysiology ?????? Clinical importance ??????? Importance for CVD prevention ??????? Clinical Perspectives for MS ● Who are the MS patients ?? (Diagnostic issue) ● Who need the clinical treatment among the MS patients and ?? ● How to treat the MS patients ?? (Treatment issue) ● The effectiveness of treatment strategies??( Treatment issue) The Proportion of MS by Different Criteria for Central Obesity Male Female If the components in MS have common pathophysiological pathway ??? Human obesity …… is due to an excess production of free fatty acids from these lipolytically active depots. This, in turn, might cause hyperinsulinemia via reduced hepatic insulin uptake, followed by peripheral hyper- insulinemia, insulin resistance and, perhaps, diabetes mellitus and hypertension. Bjorntorp P J Clin Hypertension 1986 2:163 …….These data strongly support the view that insulin play an important role in regulation of HDL metabolism. Golay A J Lipid Res 1987 28:10-18 Atherosclerotic CVD IGT Type 2 DM dyslipidemia FFA ? TG? HDL-C? BP? Insulin resistance Banting Lecture: Reaven GM 1988 Diabetes 37:1595 Hyperinsulinaemia % The Prevalence of Hyperinsulinaemia by Increasing Numbers of Components in Metabolic Syndrome (CMCS Study, 2002) % Percentages of Only One Component of Metabolic Syndrome in People with and without Hyperinsulinaemia HTG Hypertension Low HDL High Glucose (CMCS Study,