The modern civilization diseases represented by metabolic syndrome are closely related to some modern lifestyles and habits. It is a high-risk factor for type 2 diabetes and cardiovascular disease. Early diagnosis and early intervention of metabolic syndrome can help the prevention and treatment of type 2 diabetes and cardiovascular disease. I. Definition of IDF metabolic syndrome The IDF definition of metabolic syndrome is based on central obesity as the core, combined with elevated blood pressure, blood glucose, triglycerides and/or reduced HDL-C. Among them, the central obesity adopts waist circumference as the diagnostic index. This criterion emphasizes the importance of central obesity (judged by waist circumference). The combination of any two of the following four indicators: elevated triglyceride level: >150 mg/dl (1.7 mmol/L), or treated accordingly reduced HDL-C level: 30 kg/m2 in men) can lead to metabolic syndrome and increase the risk of cardiovascular disease. However, some people with normal BMI or mildly overweight also have several risk factors for metabolic syndrome. This is because BMI does not reflect the abnormal distribution of body fat, such as intra-abdominal fat accumulation. The accumulation of fat around the intra-abdominal organs intervenes directly in the biochemical reactions of the liver and other organs and is more strongly associated with metabolic and cardiovascular diseases. An INTERHEART study conducted in 52 countries found that abdominal obesity was an independent risk factor associated with acute myocardial infarction, and that it was a more accurate predictor of heart disease risk than BMI. Because waist circumference reflects the extent of intra-abdominal fat deposition, measuring waist circumference is the easiest and simplest way to assess the amount of intra-abdominal fat compared to CT or MRI examinations. In April this year, the latest global definition of metabolic syndrome released by the International Diabetes Federation (IDF) clearly stipulates that its diagnostic criteria must include central obesity (waist circumference ≥ 94 cm for European men and ≥ 80 cm for European women; expert analysis of waist circumference ≥ 90 cm for Chinese men and ≥ 80 cm for Chinese women). U.S. National Cholesterol Education Program (NCEP) in the development of metabolic syndrome diagnostic criteria will also be included in the male waist circumference ≥ 102 cm or female waist circumference ≥ 88 cm indicators. In addition to the above indicators, the IDF also recommends the Platinum Model for research studies on the metabolic syndrome, see Figure 1. Now Let’s talk about hypertension. Hypertension is a clinical syndrome characterized by an increase in arterial pressure in the body circulation, and is the most common cardiovascular disease. secondary hypertension. Since the 1950s, China has conducted several censuses of hypertension: in 1959, the incidence of hypertension was 5.11%; in 1979, the incidence of hypertension was 7.73%; in 1991, the incidence of hypertension was 11.88%; in 2004, the incidence of hypertension was 18.8%; from these sets of figures we can find that the high growth of hypertension, in the prevention and treatment of hypertension, there are The phenomenon of “three highs” and “three lows”, three highs is the high incidence, high growth rate and high hazard of hypertension, the high hazard of hypertension in China is stroke, followed by heart attack and kidney damage; three lows is the low awareness rate, low treatment rate and low control rate of hypertension. 04 The census published in 2004 showed that the awareness rate of hypertension was 30.3%, the treatment rate 24.7% and the control rate 6.1%. This indicates a serious lack of awareness of hypertension and the dangers of hypertension. What are the symptoms of hypertension? Some people have dizziness and headache, chest tightness and palpitations, but about half of the people have no symptoms because they occasionally measure their blood pressure or have a physical examination that reveals elevated blood pressure. The 1991 and 2004 Chinese Guidelines for the Prevention and Treatment of Hypertension define normal blood pressure at 140/90 mmHg as hypertension. This is also the standard of the World Health Organization (WHO). The first determination of hypertension is that it must be measured on 2 or more different days in a non-medicated state. A high blood pressure measured once by chance cannot be diagnosed as hypertension, but must be repeated and further observed, with 5-10 minutes of rest before the blood pressure is measured. After determining hypertension, blood pressure levels, risk factors, degree of target organ damage and clinically relevant diseases must also be evaluated for risk stratification, which in turn will provide ways and means of treatment. After determining hypertension take your medication on time and measure your blood pressure regularly. The treatment of hypertension is lifelong. Do not think that if your head is not dizzy, your blood pressure will be normal, or if your head is not dizzy, you can stop taking medication. Do not believe that there is a miracle drug that can cure hypertension after a few courses of treatment without the need to take medication for life. What is diabetes? Diabetes is a metabolic disorder characterized by chronic hyperglycemia caused by a variety of etiologies. Hyperglycemia is caused by defects in insulin secretion or action, or both, and in addition to carbohydrates, there are also abnormalities in protein and fat metabolism. In 1980, the research group of China Diabetes Collaborative Group conducted a survey on 300,000 people in 14 provinces and cities according to the diagnosis standard of China at that time, and found that the prevalence rate was 0.67%, and the prevalence rate increased to 2.53% in people over 40 years old. In 1994, a survey of 213,515 people aged 25-64 years in 19 provinces and cities was conducted according to WHO standards, and the prevalence of diabetes was found to be 2.51%, and the prevalence of impaired glucose tolerance (IGT) was 3.2%. In 1996, an epidemiological survey of 42,751 people aged 20-75 years in 11 provinces and cities was conducted according to WHO standards using natural population stratified whole-group sampling, and it was found that the prevalence of diabetes was 3.21% and IGT was 4.76%. Diabetes has become the third largest non-communicable disease after cardiovascular disease and tumor in developed countries. Normal blood glucose was 3.9-5.6 mmol/L. Fasting blood glucose (FPG) was 5%. In both studies, the incidence of diabetes decreased by 58%. In particular, he noted that the Chinese Daqing study, although smaller (570 cases), was unique in having an exercise only intervention group with no mandatory weight loss and showed a 40% weight loss in the exercise group compared to the non-intervention group. With the increased understanding of the dangers of the metabolic syndrome, scientists conducting lifestyle interventions have looked beyond the prevention of diabetes to the effects on the metabolic syndrome and its multiple components. Recently, a 30% reduction in hypertension, a decrease in blood triglycerides and an increase in HDL cholesterol have been reported in the DPP study. 53% (1711/3234 cases) of the population included in the DPP trial had metabolic syndrome before the trial; this percentage increased by 6% in the non-intervention group, decreased by 9% in the lifestyle intervention group and decreased by 2% in the drug intervention group after the trial. Quit smoking and limit alcohol. The amount of alcohol consumed daily should be less than one or two bottles of white wine, and 50-100ml of red wine can be consumed in moderation. smoking can increase the risk of myocardial infarction and lung cancer, so it is advisable to quit, and those who cannot quit should smoke less than 5 cigarettes a day. Psychological balance: psychological balance is the most critical one, maintaining a good and happy state of mind can antagonize almost all other internal and external adverse factors, so that the body’s immunity in the best state, to resist viruses, bacteria and tumors are important. In the survey of longevity population in Beijing, it is also found that among the long-lived people over 90 years old, although their diets, hobbies and living habits are different, there are two things in common: firstly, the long-lived people are cheerful, easy-going, kind-hearted and helpful; secondly, there are no lazy people among the long-lived people, they all love to work, love to exercise and live a regular life. So the concept of health is not only the absence of disease and not weak, but also good psychological and social adaptability. Long-term bad psychological emotions can lead to immune disorders in the body, and are risk factors for the development of hypertension, hyperlipidemia, diabetes and tumors. As the saying goes, “a sad, white head”, “a smile, ten years less”. Chinese medicine also believes that excessive emotions and moods are detrimental to health, such as: “anger hurts the liver, joy and sadness, thinking hurts the spleen, sadness and lung, fear hurts the kidneys”, “Huangdi Neijing” said: “false evil and thief wind, avoid the time, calmness and emptiness, the true energy from it, the spirit within the guard, the disease is safe from. So the will of leisure and less desire, peace of mind and not afraid, the shape of labor and not tired, gas from to obey, each from their desires, all get what they want, so the beauty of its food, any of its clothing, happy with its customs, high and low do not adore each other, its people are said to be simple, so the desire can not labor its eyes, lust and evil can not confuse its mind, foolish, wise, virtuous and unworthy, not afraid of things, so in line with the Tao, so can all the years of a hundred years, and the movement does not decline, because its virtue is not dangerous. . It is important to pay attention to the way of health according to the different yin and yang of the four seasons. For people at high risk for normalization of the components of the metabolic syndrome or for combined cardiovascular disease even after adequate lifestyle treatment, secondary intervention with pharmacotherapy is required. This includes: Lipid regulation Lowering triglyceride levels (and ApoB and non-HDL-C) Raising HDL-C Lowering LDL-C (elevated LDL-C is a risk factor reflecting metabolic syndrome) Lowering blood pressure According to the US JNC-7 recommendations, blood pressure ≥140/90 mmHg should be treated If the patient has comorbid diabetes, blood pressure lowering should be initiated when blood pressure is ≥130/80 mmHg Treatment Insulin resistance and hyperglycemia There is growing academic interest in drugs that can improve insulin resistance, delay the onset of type 2 diabetes, and reduce cardiovascular risk. The US DPP study showed that the use of metformin in the metabolic syndrome population prevented or delayed the onset of diabetes; in addition, recent studies have confirmed the role of thiazolidinediones in reducing the risk of developing diabetes in people with IGT and insulin resistance. Similarly, similar studies have confirmed that acarbose and orlistat may also delay the progression to type 2 diabetes in people with IGT. The IDF and WHO jointly launched the Diabetes Action Now program in October 2003. The program is aimed at low- and middle-income countries and aims to raise the profile of diabetes prevention and treatment. Encouraging news is expected from the launch of comprehensive lifestyle-focused diabetes prevention programs involving more than one million people in Europe, Finland and Germany, with simultaneous interventions in different age groups (Figure 2). We look forward to taking this release of the unified definition of metabolic syndrome as an opportunity to “do the right thing at the right time and in the right place”, as Prof. Pierre Lefebvre, President of the IDF Congress, said in his closing speech, and to work to raise awareness of cardiovascular disease and type 2 diabetes prevention and treatment among all sectors of the country in Before cardiovascular disease and type 2 diabetes become widespread epidemics and develop into social and economic challenges, high priority will be given to prevention efforts to jointly address the challenges of the metabolic syndrome.