1 2 3 4 5 1983 Wingard (cluster) 1988 Reaven X (insulin resistance)
(coronary heart disease)
1998 WHO
(metabolic syndrome)
( ) WHO
( T h i r d report of the National Cholesterol Education Program, NCEP, Expert Panel on Detection,
Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III, ATP- III)
( ) ATP-III
( p r o i n f l a m m a t o r y state) (prothrombotic state)
16% 37% 50% 91 359 15 7500 15 % 16.9% 13.3%
( p o l y c y s t i c ovary syndrome) (1) (2) (110-126 mg/d L) (3) (140-200 mg/d L) (4) (1) ( >=140mmHg >=90mmHg) (2) >=150mg/d L(1.7 mmol/L) (3) HDL cholesterol <35mg/d L(0.9mmol/L) <39mg/d L(1.0mmol/L) (4) BMI>30kg/m2 >0.90 >0.85 (5) creatinine >=30mg/g >=20mcg/min WHO ( ) >102 >88 ( >90 >80 ) >=150 mg/dL HDL cholesterol <40mg/dL <50 mg/dL > =130/85mmHg > =110mg/dL ATP-III ( )
LDL-C LDL-C L D L -C LDL-C 5 0 0 m g / d L L D L - C Friedewald LDL-C(mg/dL)= - (HDL-C) - ( )/5 ( h i g h - d e n s i t y lipoprotein cholesterol, HDL-C) HDL-C HDL-C HDL-C (anti-cytolytic) HDL-C " " 24 30-300mg 7.2% 6.6% GFR(glomerular filtration rate ) ACE-I(angiotension-converting enzyme inhibitors ) (endothelium dependant vasodilatation) (monocytes) CRP(C-reactive protein,C-) BMI
(waist-hip circumference ratio)
adipocytokines tumor necrosis factor-alpha interleukin-6 resistin
plasminogen activator inhibitor I
10 1mmol/L(88.3mg/dL) 32% 76% (HDL-C )
24-48 3-5
J N C 7(The Seventh Report of the Joint National C o m m i t t e e o n P r e v e n t i o n , D e t e c t i o n , Evaluation, and Treatment of High Blood
Pressure) 120 139mmHg
80 89 mmHg
2001 Vollmer
(Dietary Approaches to Stop Hypertension, DASH) 0 1 <100 <130 <160 >=100 >=130 >=160 >=130 >=160 >=190 LDL-C LDL-C (mg/dL) BMI(body mass index (kg)/ (m) ) CRP (1) ( ) (2) CRP HDL-C
DASH ( ) A T P - I I I L D L -C+VLDL non-HDL cholesterol(total cholesterol minus HDL-C) L D L - C 30( ) 0 1 non-HDL cholesterol (mg/dL) <130 <160 <190 ATP-III 200-400mg/dL non-HDL cholesterol
1. Reaven GM: Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-607.
2. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Final report. Circulation 2002; 106:3143-421.
3. Grundy SM, Brewer HB , Cleeman JI, Smith S C , L e f a n t C : D e f i n i t i o n o f M e t a b o l i c Syndrome: Report of the National Heart, Lung, and Blood Institute/ American Heart Association Conference on Scientific Issues Related to Definition. Circulation 2004; 109: 433-8.
6. 1995 6 228- 39 7. http://health91.bhp.doh.gov.tw/study.htm HDL-C ( 30 ) 30 30 ( ) 30 30 2.4 6 5 30 ( ) ( )