肥胖和代谢综合征PPT课件.ppt

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1、ObesityandMetabolicSyndromeStevenM.Haffner,MDConceptualFrameworkfortheMetabolicSyndromeEnvironmentalcausesareresponsiblefortheepidemicofthemetabolicsyndrome(NCEP)Treatment:reduceobesityandincreaseactivityInsulinresistanceistheunderlyingcauseofthemetabolicsyndrome(WHO)Treatment:a)reduceob

2、esityandincreaseactivityb)insulinsensitizersInflammationistheunderlyingcauseofthemetabolicsyndromeTreatment:a)reduceobesityandincreaseactivityb)insulinsensitizersc)statins,ACEInhibitors,ARBsMetabolicSyndromeIncreasesRiskforCHDandType2DiabetesExpertPanelonDetection,Evaluation,andTreatm

3、entofHighBloodCholesterolinAdults.JAMA2001;285:2486-2497.CoronaryHeartDiseaseType2DiabetesHighLDL-CMetabolicSyndromeTheMetabolicSyndrome:HistoricalPerspectiveReavenG.Diabetes.1988;37:1565-1607.InsulinResistanceGlucoseIntoleranceHyperinsulinemiaTGHDL-CHypertension1988:SyndromeXCORO

4、NARYHEARTDISEASETheMetabolicSyndrome:CurrentPerspectiveAdaptedfromReavenG.Drugs.1999;58(suppl):19-20BodySizeBMICentralAdiposityGlucoseMetabolismUricAcidMetabolismDyslipidemiaHemodynamicNovelRiskFactorsCORONARYHEARTDISEASEInsulinResistanceHyperinsulinemia+TGPPlipemiaHDL-CPHLASmal

5、l,denseLDL±GlucoseintoleranceUricacidUrinaryuricacidclearanceSNSactivityNaretentionHypertensionCRPPAI-1FibrinogenATPIII:TheMetabolicSyndrome**Diagnosisisestablishedwhen>3oftheseriskfactorsarepresent*TheExpertPanelonDetection,Evaluation,andTreatmentofHighBloodCholesterolinAdults

6、.JAMA.2001;285:2486-2497.**TheExpertCommitteeontheDiagnosisandClassificationofDiabetesMellitus:Follow-upreportonthediagnosisofdiabetesmellitus.DiabetesCare26:3160-3167,2003RiskFactorDefiningLevelAbdominalobesity†(Waistcircumference‡)Men>102cm(>40in)Women>88cm(>35in)TG>150mg/dLHDL-CMen<

7、40mg/dLWomen<50mg/dLBloodPressure>130/>85mmHgFastingglucose>110(>100)**mg/dL**2003NewADAIFGcriteria(ExpertPanel…,DiabetesCare26:3160-3167,2003)WHOMetabolicSyndromeDefinition1999:BasedonClinicalCriteriaInsulinresistance(type2diabetes,IFG,IGT)*Plusany2ofthefollowing:Elevate