Author/Editor		Medvešček, Marko
Title		Zdravljenje presnovnega sindroma z zdravili
Type		članek
Source		Slov Kardiol
Vol. and No.		Letnik 1, št. 2
Publication year		2004
Volume		str. 34-41
Language		slo
Abstract		Metabolic syndrome is a cluster of obesity, hypertension, dislipidemia, and hyperglycemia. It is is closely linked to visceral adiposity and insulin resistance, accompanied by procoagulant, proinflammatory state, endothelial dysfunction and other atherogenic abnormalities. Individuals with the metabolic syndrome are at higher risk for cardiovascular disease and type 2 diabetes. Therapeutic lifestyle modification and treatment of all cardiovascular risk factors is the strategy to prevent cardiovascular diseas and diabetes. LDL cholesterol lowering is the primary goal in indivuiduals with the metabolic syndrome and dislipidemia. As far as antihypertensive treatment is concerned, the choice of the agent should avoid the clearly diabetogenic drugs. Among the drugs, which can improve insulin resistance, are thiazolidinediones, which also have numerous other antiatherogenic effects, separate from their antihyperglicemic effect. Results of longlasting controlled clinical studies with these drugs on the risk of cardiovascular diseas are being awaited, and the decision of their use in metabolic syndrome is depending largely on the outcome of these studies.
Summary		Presnovni (metabolični) sindrom opredeljuje hkratno pojavljanje debelosti, hipertenzije, dislipidemije in hiperglikemije. Sindrom je v tesni zvezi s trebušno debelostjo in neodzivnostjo (rezistenco) za insulin, ki jo spremljajo prokoagulacijska in provnetna stanja, endotelijska disfunkcija ter druge aterogene motnje. Osebe s presnovnim sindromom imajo zvečano tveganje za srčno-žilne bolezni in sladkorno bolezen tipa 2, zato je strategija zdravljenja usmerjena v zmanjšanje tveganja za aterosklerozo in hkrati v preprečevanje sladkorne bolezni tipa 2. Zdravljenje temelji na spremembi življenjskega sloga in celostni obravnavi dejavnikov tveganja za aterosklerozo. Pri obravnavi dislipidemije je prvi cilj znižanje ravni LDL-holesterola, dodatno pa lahko tveganje za srčno-žilne bolezni zmanjšamo z zvišanjem nizkih ravni HDL-holesterola in znižanjem ravni trigliceridov. V zdravljenju hipertenzije imajo prednost antihipertenzivna zdravila, ki niso diabetogena. Med potencialnimi zdravili, ki izboljšajo občutljivost na insulin, so najbolj obetavni tiazolidindioni, ki imajo širok antiaterogen potencial. V naslednjih letih pričakujemo rezultate dolgotrajnih kontroliranih raziskav o njihovem učinku na tveganje za srčno-žilne bolezni, ki bodo olajšale odločitev za zdravljenje s tiazolindindioni pri osebah z presnovnim sindromom.
Descriptors		INSULIN RESISTANCE OBESITY HYPERTENSION HYPERLIPIDEMIA HYPOGLYCEMIA METFORMIN THIAZOLES ANTIHYPERTENSIVE AGENTS ANTILIPEMIC AGENTS PROCETOFEN NIACIN