Der Internist

, Volume 48, Issue 2, pp 164–172

Komplexe diätetische und Pharmakotherapie beim metabolischen Syndrom

Schwerpunkt: Metabolisches Syndrom


Das metabolische Syndrom bezeichnet einen Risikocluster (Adipositas, Glukosestoffwechselstörung, Dyslipidämie, Hypertonie), der durch adipositasbedingte Mechanismen der zellulären Stoffwechselregulation und der systemischen Energiebalance zu entstehen scheint. Eine ballaststoffarme, fettreiche Ernährung und Bewegungsmangel sind wichtige Ursachen. Eine entsprechende Ernährungsumstellung kombiniert mit regelmäßiger körperlicher Aktivität und moderater Gewichtsabnahme um etwa 5% führte zu einer massiven Reduktion der Folgekrankheit Typ-2-Diabetes um 60% bei Prädiabetikern und reduzierte Risikomerkmale des metabolischen Syndroms. Pharmakologische Therapieansätze mit Metformin oder Acarbose waren etwa halb so wirksam in der Reduktion neuer Diabetesfälle, während Thiazolidindione ebenfalls eine etwa 60%ige Diabetesreduktion bei Prädiabetikern trotz Gewichtszunahme erreichten. Eine vernünftige und realisierbare Änderung des Lebensstils erlaubt eine hoch effiziente Therapie des metabolischen Syndroms, neben der auch wirksame pharmakologische Optionen bestehen.


Stoffwechselerkrankungen Ernährungsmedizin Adipositas Atherosklerose Pharmakologische Prävention 

Complex dietary measures and pharmacotherapy for metabolic syndrome


Metabolic syndrome is characterized by a group of risk factors (obesity, glucose metabolism disorders, dyslipidemia and hypertension) which appear to be caused by obesity related mechanisms of cellular metabolism and the systemic energy balance. A fibre poor diet rich in fat combined with lack of physical activity are important causative factors. A suitable change in diet combined with regular physical exercise and a moderate weight loss of about 5% leads to a massive reduction in the consequential disease diabetes type 2 by 60% in prediabetics and reduces the risk factors for metabolic syndrome. Pharmacological therapies using metformin or acarbose were about half as effective in reducing new cases of diabetes, while thiazolidinedione also led to a 60% reduction in new diabetes cases in prediabetics in spite of a weight increase. A sensible and realisable change in lifestyle provides a highly efficient therapy of metabolic syndrome, in addition to effective pharmacological options.


Metabolic diseases Nutritional medicine Obesity Atherosclerosis Pharmacological prevention 


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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Abt. Klinische ErnährungDeutsches Institut für Ernährungsforschung Potsdam-RehbrückeNuthetalDeutschland
  2. 2.Abt. Endokrinologie, Diabetes und ErnährungsmedizinCampus Benjamin Franklin, Charité Universitätsmedizin BerlinBerlinDeutschland

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