THE ROLE OF METABOLIC SYNDROME IN THE DEVELOPMENT OF ATHEROSCLEROSIS

Metabolic syndrome represents a cluster of interconnected metabolic abnormalities that collectively substantially elevate the risk of atherosclerotic cardiovascular disease. This comprehensive review examines the pathophysiological mechanisms through which metabolic syndrome contributes to the development and progression of atherosclerosis. The syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, creates a pro-inflammatory and pro-thrombotic environment that accelerates endothelial dysfunction and plaque formation. Current evidence demonstrates that each component of metabolic syndrome independently contributes to vascular damage, while their combination produces synergistic deleterious effects. The prevalence of metabolic syndrome continues to increase globally, reaching approximately twenty five percent of the world adult population, creating an urgent public health challenge . This review synthesizes current understanding of the molecular pathways linking metabolic syndrome to atherosclerosis, including insulin resistance signaling disruption, adipokine imbalance, endoplasmic reticulum stress, oxidative stress, and chronic low-grade inflammation. Additionally, this paper examines clinical evidence from epidemiological studies and intervention trials, discusses diagnostic challenges, and explores therapeutic strategies targeting both individual components and shared underlying mechanisms. Understanding these complex interactions is essential for developing effective prevention and treatment approaches for the growing population at risk.代谢综合征（Metabolic syndrome）是一组相互关联的代谢异常症候群，可共同显著升高动脉粥样硬化性心血管疾病（atherosclerotic cardiovascular disease）的发病风险。本综述探讨了代谢综合征促进动脉粥样硬化发生发展的病理生理机制。该综合征以中心性肥胖、胰岛素抵抗、血脂异常及高血压为特征，可构建促炎、促血栓形成的微环境，加速内皮功能障碍与斑块形成。当前研究证据表明，代谢综合征的各组分可独立造成血管损伤，而多种组分联合时则会产生协同性有害效应。全球代谢综合征患病率持续攀升，目前已累及全球约25%的成年人群，成为亟待应对的公共卫生难题。本综述整合了当前学界对代谢综合征与动脉粥样硬化关联分子通路的认知，涵盖胰岛素抵抗信号通路紊乱、脂肪因子失衡、内质网应激、氧化应激及慢性低度炎症等机制。此外，本文梳理了流行病学研究与干预试验的临床证据，探讨了代谢综合征的诊断难点，并探索了针对单一病症组分及共享潜在病理机制的治疗策略。明晰上述复杂的相互作用，对于为日益庞大的高危人群制定高效的预防与治疗方案至关重要。