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Dtsch Med Wochenschr 2006; 131(20): 1167-1172
DOI: 10.1055/s-2006-941745
Übersicht | Review article
Diabetologie, Endokrinologie, Hypertensiologie
© Georg Thieme Verlag KG Stuttgart · New York

Das metabolische Syndrom - Mythen, Mechanismen, Management

Metabolic syndrome - myths, mechanisms, managementM. Blüher1 , M. Stumvoll1
  • 1Medizinische Klinik und Poliklinik III, Universitätsklinikum Leipzig
Further Information

Publication History

eingereicht: 27.1.2006

akzeptiert: 6.4.2006

Publication Date:
17 May 2006 (online)

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Schlüsselwörter

Metabolisches Syndrom - kardiovaskuläre Risikofaktoren - Diabetes mellitus - Hypertonie - Adipositas - Hyperlipidämie

Key words

syndrome X - metabolic syndrome - cardiovascular risk factors - diabetes mellitus - hypertension - obesity - hyperlipidaemia

Literatur

  • 1 Alberti K G, Zimmet P Z. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.  Diabet Med. 1998;  15 539-553
    Google Scholar
  • 2 Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study.  Circulation. 2002;  105 310-315
    Google Scholar
  • 3 Balkau B, Charles M A. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR).  Diabet Med. 1999;  16 442-443
    Google Scholar
  • 4 Blüher M, Paschke R. Visceral adipose tissue and metabolic syndrome.  Dtsch Med Wochenschr. 2003;  128 2319-2323
    Google Scholar
  • 5 Chiasson J L, Josse R G, Gomis R, Hanefeld M, Karasik A, Laakso M. STOP-NIDDM Trail Research Group . Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial.  Lancet. 2002;  359 2072-2077
    Google Scholar
  • 6 Chiasson J L, Josse R G, Gomis R, Hanefeld M, Karasik A, Laakso M. STOP-NIDDM Trial Research Group . Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial.  JAMA. 2003;  290 486-494
    Google Scholar
  • 7 Colwell J A. Antiplatelet agents for the prevention of cardiovascular disease in diabetes mellitus.  Am J Cardiovasc Drugs. 2004;  4 87-106
    Google Scholar
  • 8 DeFronzo R A, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease.  Diabetes Care. 1991;  14 173-194
    Google Scholar
  • 9 Despres J P, Golay A, Sjostrom L. Rimonabant in Obesity-Lipids Study Group . Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia.  N Engl J Med. 2005;  353 2121-2134
    Google Scholar
  • 10 Dormandy J A, Charbonnel B, Eckland D J, Erdmann E, Massi-Benedetti M, Moules I K, Skene A M, Tan M H, Lefebvre P J, Murray G D, Standl E, Wilcox R G, Wilhelmsen L, Betteridge J, Birkeland K, Golay A, Heine R J, Koranyi L, Laakso M, Mokan M, Norkus A, Pirags V, Podar T, Scheen A, Scherbaum W, Schernthaner G, Schmitz O, Skrha J, Smith U, Taton J. PROactive investigators . Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial.  Lancet. 2005;  366 1279-1289
    Google Scholar
  • 11 Eckel R H, Grundy S M, Zimmet P Z. The metabolic syndrome.  Lancet. 2005;  365 1415-1428
    Google Scholar
  • 12 Einhorn D, Reaven G M, Cobin R H, Ford E, Ganda O P, Handelsman Y, Hellman R, Jellinger P S, Kendall D, Krauss R M, Neufeld N D, Petak S M, Rodbard H W, Seibel J A, Smith D A, Wilson P W. American College of Endocrinology position statement on the insulin resistance syndrome.  Endocr Pract. 2003;  9 237-252
    Google Scholar
  • 13 Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D’Armiento M, D’Andrea F, Giugliano D. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial.  JAMA. 2004;  92 1440-1446
    Google Scholar
  • 14 Ferrannini E, Buzzigoli G, Bonadonna R, Giorico M A, Oleggini M, Graziadei L, Pedrinelli R, Brandi L, Bevilacqua S. Insulin resistance in essential hypertension.  N Engl J Med. 1987;  317 350-357
    Google Scholar
  • 15 Festa A, D’Agostino R, Howard G, Mykkanen L, Tracy R P, Haffner S M. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS).  Circulation. 2000;  102 42-47
    Google Scholar
  • 16 Gale E AM. The myth of the metabolic syndrome.  Diabetologia. 2005;  48 1679-1683
    Google Scholar
  • 17 Grundy S M, Cleeman J I, Daniels S R, Donato K A, Eckel R H, Franklin B A, Gordon D J, Krauss R M, Savage P J, Smith S C, Spertus J A, Costa F. American Heart Association; National Heart, Lung, and Blood Institute . Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement.  Circulation. 2005;  112 2735-2752
    Google Scholar
  • 18 Hanefeld M, Leonhardt W. Das metabolische Syndrom.  Dt Gesundheitswesen. 1981;  36 545-551
    Google Scholar
  • 19 Hanefeld M, Scriba P. Metabolic syndrome.  Internist. 1996;  37 679-680
    Google Scholar
  • 20 Hanefeld M. Postprandial hyperglycaemia: noxious effects on the vessel wall.  Int J Clin Pract. 2002;  129 45-50
    Google Scholar
  • 21 Hauner H. Insulin resistance and the metabolic syndrome - a challenge of the new millennium.  Eur J Clin Nutr. 2002;  56 S25-29
    Google Scholar
  • 22 Ibrahim H A, Vora J P. Hypertension in diabetes: a good opportunity to practise evidence-based medicine? A commentary on the UKPDS. United Kingdom Prospective Diabetes Study.  J Hum Hypertens. 1999;  13 221-223
    Google Scholar
  • 23 International Diabetes Federation .Worldwide definition of the metabolic syndrome. (www.idf.org/webdata/docs/IDF_Metasyndrome_definition.pdf) 2005
    Google Scholar
  • 24 Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen M R, Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome.  Diabetes Care. 2001;  24 683-689
    Google Scholar
  • 25 Kahn R, Buse J, Ferrannini E, Stern M. American Diabetes Association; European Association for the Study of Diabetes . The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes.  Diabetes Care. 2005;  28 2289-2304
    Google Scholar
  • 26 King H, Aubert R E, Hermann W H. Global burden of diabetes, 1995 - 2025: prevalence, numerical estimates, and projections.  Diabetes Care. 1998;  21 1414-1431
    Google Scholar
  • 27 Klein S, Fontana L, Young V L, Coggan A R, Kilo C, Patterson B W, Mohammed B S. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease.  N Engl J Med. 2004;  350 2549-2557
    Google Scholar
  • 28 Kylien E. Studien Hypertonie - Hyperglykämie - Hyperurikämiesyndrome.  Zentralblatt für Innere Medizin. 1923;  44 22-29
    Google Scholar
  • 29 Lakka H M, Laaksonen D E, Lakka T A, Niskanen L K, Kumpusalo E, Tuomilehto J, Salonen J T. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men.  JAMA. 2002;  288 2709-2716
    Google Scholar
  • 30 LaMonte M J, Barlow C E, Jurca R, Kampert J B, Church T S, Blair S N. Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women.  Circulation. 2005;  112 505-512
    Google Scholar
  • 31 Malik S, Wong N D, Franklin S S, Kamath T V, L’Italien G J, Pio J R, Williams G R. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults.  Circulation. 2004;  110 1245-1250
    Google Scholar
  • 32 McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant.  Ann Intern Med. 2003;  139 802-809
    Google Scholar
  • 33 Meigs J B, D’Agostino R B, Wilson P W, Cupples L A, Nathan D M, Singer D E. Risk variable clustering in the insulin resistance syndrome. The Framingham Offspring Study.  Diabetes. 1997;  46 1594-1600
    Google Scholar
  • 34 Meigs J B, Mittleman M A, Nathan D M, Tofler G H, Singer D E, Murphy-Sheehy P M, Lipinska I, D’Agostino R B, Wilson P W. Hyperinsulinemia, hyperglycemia, and impaired hemostasis: the Framingham Offspring Study.  JAMA. 2000;  283 221-228
    Google Scholar
  • 35 Meigs J B. Metabolic syndrome and risk for type 2 diabetes.  Exp Rev Endocrinol Metab. 2006;  1 57-66
    Google Scholar
  • 36 Orchard T J, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, Fowler S. Diabetes Prevention Program Research Group . The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial.  Ann Intern Med. 2005;  142 611-619
    Google Scholar
  • 37 Pearson T A, Blair S N, Daniels S R, Eckel R H, Fair J M, Fortmann S P, Franklin B A, Goldstein L B, Greenland P, Grundy S M, Hong Y, Miller N H, Lauer R M, Okkene I S, Sacco R L, Sallis J F, Smith S C, Stone N J, Taubert K A. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee.  Circulation. 2002;  106 388-391
    Google Scholar
  • 38 Pischon T, Girman C J, Hotamisligil G S, Rifai N, Hu F B, Rimm E B. Plasma adiponectin levels and risk of myocardial infarction in men.  JAMA. 2004;  291 1730-1737
    Google Scholar
  • 39 Pyorala K, Pedersen T R, Kjekshus J, Faergeman O, Olsson A G, Thorgeirsson G. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S).  Diabetes Care. 1997;  20 614-620
    Google Scholar
  • 40 Reaven G M. Banting lecture 1988. Role of insulin resistance in human disease.  Diabetes. 1988;  37 1595-1607
    Google Scholar
  • 41 Reaven G M. Why Syndrome X? From Harold Himsworth to the insulin resistance syndrome.  Cell Metab. 2005;  1 9-14
    Google Scholar
  • 42 Rubins H B. Triglycerides and coronary heart disease: implications of recent clinical trials.  J Cardiovasc Risk. 2000;  7 339-345
    Google Scholar
  • 43 Scheen A J. Renin-angiotensin system inhibition prevents type 2 diabetes mellitus. Part 1. A meta-analysis of randomised clinical trials.  Diabetes Metab. 2004;  30 487-496
    Google Scholar
  • 44 Shen B J, Todaro J F, Niaura R, McCaffery J M, Zhang J, Spiro A, Ward K D. Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X.  Am J Epidemiol. 2003;  157 701-711
    Google Scholar
  • 45 Smyth S, Heron A. Diabetes and obesity. The twin epidemics: Market Analysis.  Nat Med. 2006;  12 75-80
    Google Scholar
  • 46 Spranger J, Kroke A, Mohlig M, Bergmann M M, Ristow M, Boeing H, Pfeiffer A F. Adiponectin and protection against type 2 diabetes mellitus.  Lancet. 2003;  361 226-228
    Google Scholar
  • 47 Staiger H, Häring H U. Adipocytokines: fat-derived humoral mediators of metabolic homeostasis.  Exp Clin Endocrinol Diabetes. 2005;  113 67-79
    Google Scholar
  • 48 Taylor A J, Sullenberger L E, Lee H J, Lee J K, Grace K A. Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins.  Circulation. 2004;  110 3512-3517
    Google Scholar
  • 49 Thamer C, Machann J, Haap M, Stefan N, Heller E, Schnodt B, Stumvoll M, Claussen C, Fritsche A, Schick F, Haring H. Intrahepatic lipids are predicted by visceral adipose tissue mass in healthy subjects.  Diabetes Care. 2004;  27 2726-2729
    Google Scholar
  • 50 The HOPE study investigators . Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators.  Lancet. 2000;  355 253-259
    Google Scholar
  • 51 Torgerson J S, Hauptman J, Boldrin M N, Sjostrom L. Xenical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients.  Diabetes Care. 2004;  27 155-161
    Google Scholar
  • 52 Tuomilehto J, Lindstrom J, Eriksson J G, Valle T T, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M. Finnish Diabetes Prevention Study Group . Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.  N Engl J Med. 2001;  344 1343-1350
    Google Scholar
  • 53 Vague J. The degree of masculine differentiation of obesities, a factor determining predisposition to diabetes, atherosclerosis, gout and uric calculous disease.  Am J Clin Nutr. 1956;  4 20-34
    Google Scholar
  • 54 Van Gaal L F, Rissanen A M, Scheen A J, Ziegler O, Rossner S. RIO-Europe Study Group . Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study.  Lancet. 2005;  365 1389-1397
    Google Scholar
  • 55 Vettor R, Serra R, Fabris R, Pagano C, Federspil G. Effect of sibutramine on weight management and metabolic control in type 2 diabetes: a meta-analysis of clinical studies.  Diabetes Care. 2005;  28 942-949
    Google Scholar
  • 56 Wajchenberg B L. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome.  Endocrine Reviews. 2000;  21 697-738
    Google Scholar
  • 57 Wilson P W, D’Agostino R B, Parise H, Sullivan L, Meigs J B. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus.  Circulation. 2005;  112 3066-3072
    Google Scholar

Prof. Dr. med. M. Stumvoll

Universität Leipzig, Medizinische Klinik und Poliklinik III

Philipp-Rosenthal-Straße 27

04103 Leipzig

Phone: 0341/9713380

Fax: 0341/9713389

Email: michael.stumvoll@medizin.uni-leipzig.de