在有些代谢综合征患者中,体重是正常的,但是内脏的脂肪含量较多,这会影响人体代谢。传统上,我们认为代谢综合征包括肥胖、高血压、高血糖和高甘油三脂血症,但对一些看起来没有代谢综合征的体重正常的患者,却存在他们有所谓的内脏肥胖(visceral obesity)。
Ming Fong Chen(陈明丰),台湾大学医院附设医院院长,台湾内科医学会理事长,台湾动脉硬化暨血管病医学会理事长,第八届亚太高血压学会会长。
International Circulation: With regard to epicardial adipose tissue, it has been a research hotspot in recent years. Is it more like a marker or a pathogenic factor in the progression of cardiovascular disease? What is the relevance of epicardial adipose tissue in clinical practice?
《国际循环》:心外膜脂肪组织,一直是近年来研究的热点。它是不是在心血管疾病的进展中更像是一个标志物或致病因子?心外膜脂肪组织在临床实践中的作用如何?
Dr Ming Fong Chen: Traditionally, we think of metabolic syndrome as obesity, high blood pressure, high sugar and high triglycerides, but in some patients with normal body weight and apparently no metabolic syndrome they actually they have visceral obesity. Epicardial fat is one type of visceral fat. In our study from Dr Wong from National Taiwan University Hospital, he found that epicardial adipose tissue is correlated with the anthropometric index and related to atherosclerosis and to hypertension and cardiovascular disease. So even though a person may appear slim, they can be at risk of metabolic syndrome. And conversely, some overweight people have very little visceral adipose tissue.
Ming Fong Chen教授:在有些代谢综合征患者中,体重是正常的,但是内脏的脂肪含量较多,这会影响人体代谢。传统上,我们认为代谢综合征包括肥胖、高血压、高血糖和高甘油三脂血症,但对一些看起来没有代谢综合征的体重正常的患者,却存在他们有所谓的内脏肥胖(visceral obesity)。心外膜脂肪是内脏脂肪的一种。黄医生在台大医院的研究发现,心外膜脂肪组织不仅与人体测量指标有关,还和动脉粥样硬化、高血压、心血管疾病有关。所以,即使一个人看起来很苗条,还是有患代谢综合征的风险。与此相反,一些超重的人可能内脏脂肪组织很少。
International Circulation: Given the excellent control of traditional risk factors, there is still a residual risk of cardiovascular events. Does this suggest there are still unidentified risk factors?
《国际循环》:即使对传统危险因素进行控制,但仍然有心血管事件的残余风险,这是不是意味着仍有尚未明确的危险因素?
Dr Ming Fong Chen: There are two considerations. One is that maybe there are risk factors we don’t yet know about. The other is that the current factors are not controlled well enough. The current risk factors such as hypercholesterolemia, smoking, high blood pressure and diabetes are not controlled that well so at congresses like this we always want to emphasize the importance of treatment and control of hypertension. Hypertension is very important and related to many other conditions such as metabolic syndrome and diabetes. Many other diseases have some relationship with hypertension. In my opinion, currently existing risk factors should be controlled properly first. New research might find additional risk factors.
Ming Fong Chen教授:这有两方面的考虑。一方面,也许存在我们还不知道的危险因素;另一方面,目前已知的危险因素(如高胆固醇血症、吸烟、高血压和糖尿病)我们控制得还不够好。新的研究可能会发现其它的危险因素,我们首先要做的是将目前已知的危险因素控制好。所以,我们在大型会议上总是希望强调治疗和控制高血压的重要性。高血压,和代谢综合征、糖尿病等许多其它疾病都有关系,所以控制高血压非常重要。
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