[Diabetes and multimetabolic syndrome].
The metabolic syndrome is associated with increased morbility and mortality for cardiovascular disease. This syndrome is determined not only by metabolic alterations such as hyperglycemia, and hyperlipidemia but also by a chronic proinflammatory state. Another culprit in the formation and progression of vascular disease is the so-called endothelial dysfunction which is linked to insulin resistance itself. The common denominator of the metabolic syndrome is insulin resistance. The most convincing evidence for the existence of a syndrome comes from the cluster analysis which outlines four main factors: the "metabolic factor", the "pressor factor", the "lipid factor", and the "obesity factor". It is clear that the presence of the metabolic syndrome appears to identify a substantial additional cardiovascular risk above the individual risk factors. The studies available in the literature have pointed out the beneficial effects, in terms of cardiovascular mortality, of the treatment with inhibitors of the 3-hydroxy-3-methylglutaryl coenzyme A reductase (statins): this risk reduction has been observed despite the fact that high triglyceride and low HDL cholesterol levels, but not hypercholesterolemia, are the main features of the dyslipidemia observed in patients with this syndrome. Yet, despite a normal LDL cholesterol level, patients with this syndrome are at high risk for future cardiovascular events: for this reason treatment with statins is mandatory.
Avogaro
Angelo
A
Cattedra di Malattie del Metabolismo, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi, Via Giustiniani, 2 35128 Padova. angelo.avogaro@unipd.it
D003920:Diabetes Mellitus / Q000209:etiology* / Q000628:therapy; D005464:Fluorobenzenes / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000209:etiology; D006949:Hyperlipidemias / Q000188:drug therapy / Q000209:etiology; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications*; D011743:Pyrimidines / Q000627:therapeutic use; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use
D005464:Fluorobenzenes; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium