代謝症候群的成因主要來自於胰島素抗性(insulin resistence),造成高胰島素血症與接續的血脂過高與代謝問題[1]。在諸多定義中,最常被使用的則是,美國國家膽固醇教育計畫成人治療指引第三版2001年NCEP-ATP III 針對心血管疾病發生風險,向下修正後的診斷標準,我國國民健康局於2004年在專家學者建議下,參酌我國國情,訂定代謝症候群定義,作為我國之臨床診斷準則,接著在2007/1/18作了最新的修正。在以下五個危險因子中,若包含3項或以上者,即可判定為代謝症候群。
勃起功能障礙(Erectile dysfunction)在男性中是常見的問題,影響生活品質巨大,隨著年齡上升,勃起功能障礙的比率也越高[3]。在許多文獻中指出,族群裡勃起功能障礙的盛行率從30-50%不等[3,4,5]。在代謝症候群的病人中,勃起功能障礙的盛行率為79-96%,而有勃起功能障礙的病人,則有29-66%患有代謝症候群[6]。代謝症候群的病人如果心血管危險因子越多,則國際勃起功能指標量表(International Index of Erectile Function,以下簡稱為IIEF)的分數則越低[7,8]。
減肥藥
美國國立衛生研究院National Institutes of Health (NIH)建議BMI大於27~30的病人並有合併症時,需要進行減重,而減肥藥是選項之一。而使用藥物減肥有兩種類型,分別是食慾抑制劑與抑制營養吸收劑。食慾抑制劑的代表是Sibutramine(諾美婷),在一篇統合性分析中發現Sibutramine相較於安慰劑或是其他藥物可以大約多減4公斤[41]。但是諾美婷可能會增加心血管疾病的風險,目前在台灣與世界上多國已被下架而無流通[42,43]。
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