代謝症候群之診斷及處置

Diagnosis and Management of Metabolic Syndrome

蔡崇煌(Chung-Huang Tsai) ； 林正介(Cheng-Chieh Lin) ； 林高德(Gau-De Lin)

《臺灣家庭醫學研究》 6卷2期 (2008/04) Pp. 53-65

https://doi.org/10.29475/TFMR.200804.0001

摘要

代謝症候群是心血管疾病和第2型糖尿病風險因子之群集，其主因為腹部肥胖、血脂及血糖異常。雖然不斷有証據顯示應對患者早期介入治療，但目前其仍然受到低估，因此有些患者仍未接受治療。Blaha等人之以ABCDE綜括了對代謝症候群之處置，其中A代表對代謝症候群之評估(Assessment)及阿斯匹寧(Aspirin)的治療，B表對血壓之控制(Blood pressure control)，C表對膽固醇之控制(Cholesterol management)，D表對糖尿病預防(Diabetes prevention)和飲食(Diet)治療，E表示運動(Exercise)。為了幫助醫師對代謝症候群診斷，我們參考國外文獻並做整理後，提出ABCD做為美國國家膽固醇教育計劃成人治療第三次小組之報告(NCEP ATP III)對代謝症候群之診斷準則，其中A代表腹部肥胖(Abdominal obesity)和/或致粥狀硬化異常血脂(Atherogenicdyslipidemia)之三酸甘油酯，B表示血壓(Blood pressure)異常，C表致粥狀硬化異常血脂之高密度脂蛋白膽固醇(HDL-cholesterol)，D表血糖異常(Dysglycemia)。ABCD提供診斷代謝症候群之指標，ABCDE提供實用和有系統、完整之治療計劃，希望借助本文提供對代謝症候群之辨識及Blaha提供整體性之治療計劃，對降低心血管的風險和第2型糖尿病的發生及教學和研究有所幫助。

並列摘要

The metabolic syndrome is a cluster of risk factors for cardiovascular disease and type 2 diabetes that are constellation of abdominal obesity, dyslipidemia and dysglycemia. Despite growing evidences support early intervention is critical for patients with the metabolic syndrome, it was under-recognized by many physicians and failed to be treated to earlier. Blaha et al proposed a comprehensive management plan assembled through an ”ABCDE” approach: ”A” for assessment of cardiovascular risk and aspirin therapy, ”B” for blood pressure control, ”C” for cholesterol management, ”D” for diabetes prevention and diet therapy, and ”E” for exercise therapy. To aid physicians in their approach to metabolic syndrome, after assessing and synthesizing the literatures, we addressed an ”ABCD” approach for NCEP ATP III criteria of metabolic syndrome: ”A” means Abdominal obesity and/or Atherogenic dyslipidemia (triglyceride), ”B” for Blood pressure abnormality, ”C” for elevated high density lipoprotein- Cholesterol (Atherogenic dyslipidemia) and ”D” for Dysglycemia. The ABCD diagnosis can enhance metabolic syndrome recognition. Together with the ABCDE approaches, they can provide a practical and systematic framework for implementing a comprehensive, evidencebased management plan for the reduction of cardiovascular risk and type 2 diabetes. We hope this article may offer as a reference for education and research of metabolic syndrome.

並列關鍵字

metabolic syndrome ； AHA/NHLBI ； NCEP ATP Ⅲ