Circulation. 2005;112:2735-2752
Published online before print September 12, 2005, doi: 10.1161/CIRCULATIONAHA.105.169404
Published online before print September 12, 2005, doi: 10.1161/CIRCULATIONAHA.105.169404
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(Circulation. 2005;112:2735-2752.)
© 2005 American Heart Association, Inc.
AHA/NHLBI Scientific Statement |
Diagnosis and Management of the Metabolic Syndrome
An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement
Key Words: AHA/NHLBI Scientific Statements • metabolic syndrome • cardiovascular disease • obesity • diabetes • lifestyle therapy
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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The metabolic syndrome has received increased attention in the past few years. This statement from the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) is intended to provide up-to-date guidance for professionals on the diagnosis and management of the metabolic syndrome in adults.
The metabolic syndrome is a constellation of interrelated risk factors of metabolic origin—metabolic risk factors—that appear to directly promote the development of atherosclerotic cardiovascular disease (ASCVD).1 Patients with the metabolic syndrome also are at increased risk for developing type 2 diabetes mellitus. Another set of conditions, the underlying risk factors, give rise to the metabolic risk factors. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria to be used in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general they include a combination of both underlying and metabolic risk factors.
The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics commonly manifest a prothrombotic state and a pro-inflammatory state as well. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB), increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C). The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it
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L. Lu, Z. Yu, A. Pan, F. B. Hu, O. H. Franco, H. Li, X. Li, X. Yang, Y. Chen, and X. Lin Plasma 25-Hydroxyvitamin D Concentration and Metabolic Syndrome Among Middle-Aged and Elderly Chinese Individuals Diabetes Care, July 1, 2009; 32(7): 1278 - 1283. [Abstract] [Full Text] [PDF]
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H.-p. Gong, Z.-h. Wang, H. Jiang, N.-n. Fang, J.-s. Li, Y.-y. Shang, Y. Zhang, M. Zhong, and W. Zhang TRIB3 Functional Q84R Polymorphism Is a Risk Factor for Metabolic Syndrome and Carotid Atherosclerosis Diabetes Care, July 1, 2009; 32(7): 1311 - 1313. [Abstract] [Full Text] [PDF]
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S. E. Noel, P. K. Newby, J. M. Ordovas, and K. L. Tucker A Traditional Rice and Beans Pattern Is Associated with Metabolic Syndrome in Puerto Rican Older Adults J. Nutr., July 1, 2009; 139(7): 1360 - 1367. [Abstract] [Full Text] [PDF]
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Z. Yu, X. Ye, J. Wang, Q. Qi, O. H. Franco, K. L. Rennie, A. Pan, H. Li, Y. Liu, F. B. Hu, et al. Associations of Physical Activity With Inflammatory Factors, Adipocytokines, and Metabolic Syndrome in Middle-Aged and Older Chinese People Circulation, June 16, 2009; 119(23): 2969 - 2977. [Abstract] [Full Text] [PDF]
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E. M. Lonn, H. C. Gerstein, P. Sheridan, S. Smith, R. Diaz, V. Mohan, J. Bosch, S. Yusuf, G. R. Dagenais, and DREAM (Diabetes REduction Assessment with ramipril Effect of Ramipril and of Rosiglitazone on Carotid Intima-Media Thickness in People With Impaired Glucose Tolerance or Impaired Fasting Glucose STARR (STudy of Atherosclerosis with Ramipril and Rosiglitazone). J. Am. Coll. Cardiol., June 2, 2009; 53(22): 2028 - 2035. [Abstract] [Full Text] [PDF]
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J. C. Kaski and G. W. Cockerill STARR (STudy of Atherosclerosis with Ramipril and Rosiglitazone) Is the Biggest Big Enough? J. Am. Coll. Cardiol., June 2, 2009; 53(22): 2036 - 2038. [Full Text] [PDF]
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 M. R. Bonsignore and J. Eckel Metabolic aspects of obstructive sleep apnoea syndrome Eur. Respir. Rev., June 1, 2009; 18(112): 113 - 124. [Abstract] [Full Text] [PDF]
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E. Oda and R. Kawai Lower Vital Capacity Is Associated With Diabetes but Not With Metabolic Syndrome in Nonobese Japanese Men Diabetes Care, June 1, 2009; 32(6): e69 - e69. [Full Text] [PDF]
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A. Delavari, M. H. Forouzanfar, S. Alikhani, A. Sharifian, and R. Kelishadi First Nationwide Study of the Prevalence of the Metabolic Syndrome and Optimal Cutoff Points of Waist Circumference in the Middle East: The National Survey of Risk Factors for Noncommunicable Diseases of Iran Diabetes Care, June 1, 2009; 32(6): 1092 - 1097. [Abstract] [Full Text] [PDF]
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P. A. Ades, P. D. Savage, M. J. Toth, J. Harvey-Berino, D. J. Schneider, J. Y. Bunn, M. C. Audelin, and M. Ludlow High-Calorie-Expenditure Exercise: A New Approach to Cardiac Rehabilitation for Overweight Coronary Patients Circulation, May 26, 2009; 119(20): 2671 - 2678. [Abstract] [Full Text] [PDF]
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 P. L. Huang A comprehensive definition for metabolic syndrome Dis. Model. Mech., May 1, 2009; 2(5-6): 231 - 237. [Abstract] [Full Text] [PDF]
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 W. Lieb, R. Safa, E. J. Benjamin, V. Xanthakis, X. Yin, L. M. Sullivan, M. G. Larson, H. M. Smith, J. A. Vita, G. F. Mitchell, et al. Vascular endothelial growth factor, its soluble receptor, and hepatocyte growth factor: clinical and genetic correlates and association with vascular function Eur. Heart J., May 1, 2009; 30(9): 1121 - 1127. [Abstract] [Full Text] [PDF]
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 R. F. Zoeller Jr Physical Activity and Fitness in African Americans: Implications for Cardiovascular Health American Journal of Lifestyle Medicine, May 1, 2009; 3(3): 188 - 194. [Abstract] [PDF]
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N. E. Straznicky, G. W. Lambert, M. T. McGrane, K. Masuo, T. Dawood, P. J. Nestel, N. Eikelis, M. P. Schlaich, M. D. Esler, F. Socratous, et al. Weight Loss May Reverse Blunted Sympathetic Neural Responsiveness to Glucose Ingestion in Obese Subjects With Metabolic Syndrome Diabetes, May 1, 2009; 58(5): 1126 - 1132. [Abstract] [Full Text] [PDF]
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 R. J. Glynn, E. Danielson, F. A.H. Fonseca, J. Genest, A. M. Gotto Jr., J. J.P. Kastelein, W. Koenig, P. Libby, A. J. Lorenzatti, J. G. MacFadyen, et al. A Randomized Trial of Rosuvastatin in the Prevention of Venous Thromboembolism N. Engl. J. Med., April 30, 2009; 360(18): 1851 - 1861. [Abstract] [Full Text] [PDF]
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 D. Mozaffarian, A. Kamineni, M. Carnethon, L. Djousse, K. J. Mukamal, and D. Siscovick Lifestyle Risk Factors and New-Onset Diabetes Mellitus in Older Adults: The Cardiovascular Health Study Arch Intern Med, April 27, 2009; 169(8): 798 - 807. [Abstract] [Full Text] [PDF]
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M. Anselmino, K. Malmberg, L. Ryden, and J. Ohrvik A gluco-metabolic risk index with cardiovascular risk stratification potential in patients with coronary artery disease Diabetes and Vascular Disease Research, April 1, 2009; 6(2): 62 - 70. [Abstract] [PDF]
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J. R. Churilla and E. C. Fitzhugh Relationship between leisure-time physical activity and metabolic syndrome using varying definitions: 1999-2004 NHANES Diabetes and Vascular Disease Research, April 1, 2009; 6(2): 100 - 109. [Abstract] [PDF]
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K. I. Cheang, J. M. Huszar, A. M. Best, S. Sharma, P. A. Essah, and J. E. Nestler Long-term effect of metformin on metabolic parameters in the polycystic ovary syndrome Diabetes and Vascular Disease Research, April 1, 2009; 6(2): 110 - 119. [Abstract] [PDF]
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 H. Sasmaz and M. B. Yilmaz Coronary Collaterals in Obese Patients: Impact of Metabolic Syndrome Angiology, April 1, 2009; 60(2): 164 - 168. [Abstract] [PDF]
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J. A. Nettleton, P. L. Lutsey, Y. Wang, J. A. Lima, E. D. Michos, and D. R. Jacobs Jr. Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA) Diabetes Care, April 1, 2009; 32(4): 688 - 694. [Abstract] [Full Text] [PDF]
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R. Katz, M. J. Budoff, J. Takasu, D. M. Shavelle, A. Bertoni, R. S. Blumenthal, P. Ouyang, N. D. Wong, and K. D. O'Brien Relationship of Metabolic Syndrome With Incident Aortic Valve Calcium and Aortic Valve Calcium Progression: The Multi-Ethnic Study of Atherosclerosis (MESA) Diabetes, April 1, 2009; 58(4): 813 - 819. [Abstract] [Full Text] [PDF]
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E. M. Goldbacher, J. Bromberger, and K. A. Matthews Lifetime History of Major Depression Predicts the Development of the Metabolic Syndrome in Middle-Aged Women Psychosom Med, April 1, 2009; 71(3): 266 - 272. [Abstract] [Full Text] [PDF]
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 P. Enright Overindulgence -> Overweight -> Reduced Vital Capacity -> Reduced Longevity Am. J. Respir. Crit. Care Med., March 15, 2009; 179(6): 432 - 433. [Full Text] [PDF]
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N. Leone, D. Courbon, F. Thomas, K. Bean, B. Jego, B. Leynaert, L. Guize, and M. Zureik Lung Function Impairment and Metabolic Syndrome: The Critical Role of Abdominal Obesity Am. J. Respir. Crit. Care Med., March 15, 2009; 179(6): 509 - 516. [Abstract] [Full Text] [PDF]
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J. Sierra-Johnson, R. M. Fisher, A. Romero-Corral, V. K. Somers, F. Lopez-Jimenez, J. Ohrvik, G. Walldius, M.-L. Hellenius, and A. Hamsten Concentration of apolipoprotein B is comparable with the apolipoprotein B/apolipoprotein A-I ratio and better than routine clinical lipid measurements in predicting coronary heart disease mortality: findings from a multi-ethnic US population Eur. Heart J., March 2, 2009; 30(6): 710 - 717. [Abstract] [Full Text] [PDF]
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 K. Kajimoto, K. Miyauchi, T. Kasai, N. Yanagisawa, T. Yamamoto, K. Kikuchi, T. Nakatomi, H. Iwamura, H. Daida, and A. Amano Metabolic syndrome is an independent risk factor for stroke and acute renal failure after coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 658 - 663. [Abstract] [Full Text] [PDF]
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 D. Rendina, G. Mossetti, G. De Filippo, D. Benvenuto, C. L. Vivona, A. Imbroinise, G. Zampa, S. Ricchio, and P. Strazzullo Association between metabolic syndrome and nephrolithiasis in an inpatient population in southern Italy: role of gender, hypertension and abdominal obesity Nephrol. Dial. Transplant., March 1, 2009; 24(3): 900 - 906. [Abstract] [Full Text] [PDF]
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M. Troseid, I. Seljeflot, E. M. Hjerkinn, and H. Arnesen Interleukin-18 Is a Strong Predictor of Cardiovascular Events in Elderly Men With the Metabolic Syndrome: Synergistic effect of inflammation and hyperglycemia Diabetes Care, March 1, 2009; 32(3): 486 - 492. [Abstract] [Full Text] [PDF]
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