【醫(yī)學(xué)課件】代謝綜合征ppt課件-閱讀頁
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【正文】 al. JAMA 2021。52:A221A222. * Those without diabetes, cardiovascular disease, or cancer. Adjusted for age, gender, and ethnic group. Comparison of NCEP and 1999 WHO Metabolic Syndrome to Identify InsulinResistant Subjects: IRAS % in Lowest Quartile of Si Hanley AJ et al. Diabetes 2021。347:15571565. 10+ 5–9 2–4 0–1 0510152025Copyright 169。102:42–47. *P, ?P, ?P CRP=Creactive protein。 WBC=white blood cell count. 0 Mean Values of CRP by Number of Metabolic Disorders (Dyslipidemia, Upper Body Adiposity, Insulin Resistance, Hypertension): IRAS Festa A et al. Circulation 2021。51:11311137. 2nd 3rd 4th Quartiles: P= P= P= 0510152025The Effect of Rosiglitazone on CRP Haffner SM et al. Circulation 2021。106:679684. Rosiglitazone 8 mg/d Rosiglitazone 4 mg/d Difference = – (95% CI: –, ) Placebo Difference = (95% CI: –, ) Change from Baseline to Week 26, % 5 0 4 0 3 0 2 0 1 00n=91 n=120 n=132 0123456Reduction of CRP Levels with Statin Therapy (n=22) Jialal I et al. Circulation 2021。279:16151622. | HPS Collaborative Group. Lancet 2021。98:25132519. | Py246。l228。20:614620. | LIPID Study Group. N Engl J Med 1998。159:26612667. Completed Clinical Trials with Antihypertensive Agents in Diabetes Trial Diabetic/Total Results SHEP 583/4736 Beneficial GISSI3 2790/18,131 Beneficial SystEur 492/4695 Beneficial HOT 1501/18,790 Beneficial UKPDS 1148 Beneficial CAPPP 572/10,985 Beneficial Curb JD et al. JAMA 1996。96:42394245. | Staessen JA et al. Am J Cardiol 1998。351:17551762. | UKPDS Group. BMJ 1998。353:611616. Isolated ? LDLC RR= (–) 010203040221 “ Metabolic Syndrome” in 4S Event Rate, % Ballantyne CM et al. Circulation 2021。de P et al. N Engl J Med 2021。 2021 Massachusetts Medical Society. All rights reserved. 0102030405060Composite Endpoint of Death from CV Causes, Nonfatal MI, CABG, PCI, Nonfatal Stroke, Amputation, or Surgery for PAD: STENO2 Primary Composite Endpoint (%) Months of Followup G230。348:383393. 0 24 48 60 96 36 84 72 12 Conventional Therapy Intensive Therapy P= Hazard ratio = (95% CI, –。 2021 Massachusetts Medical Society. All rights reserved. Summary: Metabolic Syndrome ? The metabolic syndrome predicts the development of both diabetes and CHD ? Insulin resistance and obesity characterize most individuals subjects with the metabolic syndrome, although not required features of the NCEP metabolic syndrome ? Initial therapy for the metabolic syndrome should consist of caloric restriction and increased physical activity ? Conventional cardiovascular risk factors such as lipids and blood pressure should be treated in individuals with the metabolic syndrome, although no remendations have so far suggested intensification of risk factor management ? No consensus exists on whether insulin sensitizers should be used in nondiabetic individuals with the metabolic syndrome
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