Any combination of hypercholesterolemia, hypertriglyceridemia, impaired glucose tolerance, diabetes, hyperuricemia, HTN
- Syndrome X or Metabolic Syndrome
- Group of risk factors for heart and stroke disease
- Diabetes, Obesity and hypertension and cholesterol
- Seen in 1/3rd of US population
- Underlying factor is Insulin resistance (due to obesity)
- Insulin resistance, visceral adiposity, atherogenic dyslipidemia
- Endothelial dysfunction, genetic susceptibility, elevated blood pressure
- Hypercoagulable state, and chronic stress
- Increased production of abnormal adipocytokines
- Increased tumour necrosis factor, interleukin-1 (IL-1), IL-6, leptin, and adiponectin.
Definition: Central obesity (waist circumference > 94 cm for men and 80 cm for Europid women) plus any two of the following four factors
- Raised TG level > 150 mg/dL (1.7 mmol/L) or specific treatment for this
- reduced HDL cholesterol: < 40 mg/dL (1.0 mmol/L) in males and < 50 mg/dL
(1.3 mmol/L) in females, or specific treatment for this lipid abnormality
- raised blood pressure: systolic BP = 130 or diastolic BP = 85 mmHg, or
treatment of previously diagnosed hypertension
- raised fasting plasma glucose (FPG) = 100 mg/dL (5.6 mmol/L), or
previously diagnosed type 2 diabetes
If above 5.6 mmol/L or 100 mg/dL, OGTT is strongly recommended but is not
necessary to define the presence of the syndrome.
- Insulin resistance + older + sedentary
- Complex physiology poorly understood
- Increased waistline, High BP, Diabetes, central obesity
- Cardiovascular disease
- Increased Risk of Type 2 DM
- Prescribed reduction in dietary fat intake
- Smoking cessation
- Restricting the overall dietary carbohydrate intake is more effective in reducing the most common symptoms of metabolic syndrome than the more commonly
- Lifestyle modification remains the initial intervention of choice for such a population. Modern lifestyle modification therapy combines specific recommendations on diet and exercise with behavioural strategies.
- Pharmacological treatment should be considered for those whose risk factors are not adequately reduced with lifestyle changes.
- This review provides a summary of the literature related to the syndrome's definition, epidemiology, underlying pathogenesis, and treatment approaches of each of the risk factors comprising metabolic syndrome.