(MS),

MSCVD(ASCVD) 2(T2DM) Kashyap SR, DeFronzo RA. The insulin resistance syndrome: physiological considerations. Diabetes Vasc Dis Res, 2007, 4: 13-19.

1998WHO IGT / IFG, 2 :BP140/90mmHgTG1.7mmol/L HDL-C0.85 BMI>30kg/m2(20g/min): PAI-1

2002ATPIII

53:>6.1mmol/L(T2DM) 130/85mmHgTG1.65mmol/LHDL-C:

2005IDF

: 102cm/88cm; 94cm/80cm; 90cm/80cm 42:TG1.65mmol/LHDL-C: 5.6mmol/L,OGTT,

2004

: BMI25.0kg/m2: BP>140/90mmHg: TG1.65mmol/L/HDL-C:

MS: TNFNEFA ROS/ROS:

, . : : HDL LDL/ : -

: PAI-1 : , : CRPWBC ()

Bakris GL. Current Perspectives on Hypertension and MetabolicSyndrome. J Manag Care Pharm.2007;13 (5):S3-S5 LDL TG HDLASCVDT2DM

(MS) 2 CVD (50%) () () () , MS

MS:WHO140/90mmHgATPIIIIDF130/85mmHg(, )MS140/90mmHg MS,84.2%,76.7%

MS/ MS:()

/

1. RAAS RAAS, ,,

2. (SNS), ; RAAS,

3. , ,

4. , NO, , , ,

1.5 RAAS RAAS, , ,

6. BMI,, BMI,,

1.7 , ,

1.8 FFA, TG, , ,

MS MS, ATP MS:

,,

1. 1.1 78%65% (kg)=cm 105(110)

1.2 , TZDsPI3PI3

1.3 ,60min/d

2.

MS, MS, : (TZDs, PPAR ).

2.1 MS: ; /, CV, TZDs; B(), +, T2DMCV; , MS

2.2 TZDs()(): PPAR-, T2DM, MI, Nissen24: CV43%, 64%, RECORD: 2001~2008, CV, FDA, ,

3. ACEI/ARB: :( ) Opie580104: ACEIARBsDM 20% 16% /DM4

35% 13% 10% -17% -21% -22% -33% -40 -30 -20 -10 0 10 20 30 40

ARBsPPAR(Benson SC, et al. Hypertension, 2004, 43:993-1002)23 14

50100150200250300350400 ARBs () 450500

: PPARmmol/L25201510500.1110100Luciferase (x-fold induction over vehicle treated cells)Circulation, 2004109:2054-2057

4. MS, 40%~60%

OGTTMS,IFGOGTTT2DM

FPG: 48~64%ADA 2003.11 FPG6.1mmol/L5.6mmol/L6.1mmol/L: 64%5.6mmol/L: 48%

FPG,OGTT

UKPDS, HbA1c1%, DM21%,14%

DM : 5.1~6.1mmol/L 2h: 7.0~7.8mmol/L HbA1c

MSASCVD ,MS: CHO

MS-1(PAI-1)

--6hs-CRPACEITZDsCRP