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Review
. 2006 Feb;22 Suppl B(Suppl B):85B-90B.
doi: 10.1016/s0828-282x(06)70992-8.

Metabolic syndrome: a marker of patients at high cardiovascular risk

David C W Lau  1 , Hongyun Yan, Bikramjit Dhillon
Affiliations
Review

Metabolic syndrome: a marker of patients at high cardiovascular risk

David C W Lau et al. Can J Cardiol. 2006 Feb.

Abstract
in English, French

The metabolic syndrome is a constellation of metabolic abnormalities associated with an increased risk for cardiovascular disease (CVD). It is present in one of four adults, and its prevalence is markedly increased in obese adults and adolescents. The plasma concentration of C-reactive protein (CRP), a marker of inflammation, is elevated in obese patients, is correlated with the metabolic syndrome and decreases with weight loss. CRP is produced by mature adipocytes in adipose tissue, and may contribute to the elevated circulating plasma CRP concentrations present in obese patients and people with the metabolic syndrome. Treatment of the metabolic syndrome is aimed at improving insulin resistance through lifestyle changes, namely weight loss and regular physical activity. In patients with abnormal glucose concentrations, dyslipidemia or hypertension, treatment of the individual components of the syndrome may result in greater impact on reducing overall CVD risks. Given the prevalence of the metabolic syndrome and the exaggerated CVD risks, innovative therapeutic approaches continue to evolve.

Le syndrome métabolique regroupe une constellation d’anomalies métaboliques associées à un risque accru de maladie cardiovasculaire (MCV). On observe ce syndrome chez un adulte sur quatre et sa prévalence est nettement en hausse chez les adultes et adolescents obèses. Le taux plasmatique de protéine C réactive (PCR), un marqueur de l’inflammation, est élevé chez les patients obèses, il est en corrélation avec le syndrome métabolique et diminue avec la perte de poids. La PCR est fabriquée par les adipocytes à maturité dans les tissus adipeux, ce qui contribuerait à l’augmentation des taux de PCR circulants chez les patients obèses et chez ceux qui souffrent du syndrome métabolique. Le traitement du syndrome métabolique vise à améliorer l’insulinorésistance par le biais d’une meilleure hygiène de vie, notamment par la perte de poids et la pratique régulière d’exercices physiques. Chez les patients dont la glycémie est anormale, qui souffrent de dyslipidémie ou d’hypertension, le traitement de chaque composante individuelle du syndrome peut exercer un impact plus grand sur la réduction globale des risques de MCV. Compte tenu de la prévalence du syndrome métabolique et des importants risques de MCV qui lui sont associés, les nouvelles approches thérapeutiques doivent continuer d’évoluer.

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Figures

Figure 1)
Figure 1)
Current concept of the metabolic syndrome. Central obesity is the principal abnormality that predisposes to the development of the metabolic syndrome, which also includes insulin resistance (hyperglycemia and/or type II diabetes), atherogenic dyslipidemia characterized by hypertriglyceridemia and decreased high density lipoprotein cholesterol concentrations, hypertension, along with proinflammatory and prothrombotic states (increased circulating plasma concentrations of plasminogen activator inhibitor-1, fibrinogen and C-reactive protein). CVD Cardiovascular disease
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