第四章 脂质和脂蛋白代谢紊乱的生物化学检验

?四、高密度脂蛋白的抗动脉粥样硬化功能主要机制为：对LDL氧化抑制中和修饰LDL配基活性抑制内皮细胞粘附分子的表达?五、代谢综合征（metabolic syndrome，MS）

?MS是一组复杂的代谢紊乱症候群，包括中心性肥胖、TG水平升高、HDL-C减低、高血压、空腹血糖升高，是导致糖尿病(DM)和心脑血管疾病(CVD)的危险因素。

?2005年，IDF综合了来自世界六大洲糖尿病学、心血管病学、血脂

学、公共卫生、流行病学、遗传学、营养和代谢学专家的意见，颁布了代谢综合征的定义，和以往区别的是此次代谢综合征的定义强调以中心性肥胖为核心，采纳腰围作为诊断指标。其中中心性肥胖为必须，加上甘油三酯（TG）升高、HDL-C减低、血压升高、空腹血糖（FPG）升高或已诊断为2型糖尿病（T2DM）四项中的任意两项。

Panel:International Diabetes Federation: metabolic syndrome de?nition (2005)?Central obesity?Waist circumference*—ethnicity speci?c (see table below)?Plus any two:?Raised triglycerides?>150 mg/dL (1.7 mmol/L)?Speci?c treatment for this lipid abnormality?Reduced HDL-cholesterol?<40 mg/dL (1.03 mmol/L) in men?<50 mg/dL (1.29 mmol/L) in women?Speci?c treatment for this lipid abnormality?Raised blood pressure?Systolic≥130 mm Hg?Diastolic≥85 mm Hg?Treatment of previously diagnosed hypertension?Raised fasting plasma glucose??Fasting plasma glucose 100 mg/dL (5.6 mmol/L)?Previously diagnosed type 2 diabetesEthnic-speci?c values for waist circumference

Ethnic groupEuropids*MenWomenSouth AsiansMenWomenWaist circumference (as measure of central obesity)≥94 cm≥80 cm≥90 cm≥80 cmChineseMenWomenJapaneseMenWomenEthnic south and central AmericansSub-Saharan AfricansEastern Mediterranean and middle east (Arab) populations ≥90 cm≥80 cm≥85cm≥90 cmUse south Asian recommendations until more speci?c data are availableUse European data until more speci?c data are availableUse European data until more speci?c data are available