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Metabolic Syndrome/ Insulin resistance syndrome

metabolic syndrome

Metabolic syndrome is also called “syndrome X” and “insulin resistance syndrome”.

It consists of metabolic abnormalities that increase the risks of cardiovascular diseases (CVD) and diabetes mellitus.


The main features of the metabolic syndrome are:


Prevalence of Metabolic syndrome:

The highest recorded prevalence worldwide is among the Native Americans, with nearly 60% of women ages 45-49 and 45% of men ages 45-49.

The National Health and Nutrition Examination Survey (NHANES) 2003-2006 suggests the age-adjusted prevalence of the metabolic syndrome in U.S. adults without diabetes is 28% for men and 30% for women.


Risk factors for metabolic syndrome:

Obesity:

Central adiposity is a key feature of the syndrome, and there is a strong relationship between waist circumference and increasing adiposity.

However, patients who are of normal weight may also be insulin resistant and may have metabolic syndrome.

Sedentary lifestyle:

A sedentary lifestyle is associated with increased adipose tissue (predominantly central), reduced HDL cholesterol, and increased triglycerides, blood pressure, and glucose in genetically susceptible persons.

Compared with individuals who watch television or videos or use the computer for less than one hour daily, those who do so for more than four hours daily have a twofold increased risk of metabolic syndrome.

Advancing Age:

The metabolic syndrome affects nearly 50% of the U.S. population older than age 50 years.

At the ages of more than 60 years, women are more often affected than men.

Diabetes Mellitus:

It is estimated that the great majority ( about 75%) of patients with type 2 diabetes or impaired glucose tolerance have metabolic syndrome.

The presence of the metabolic syndrome in diabetics relates to a higher prevalence of CVD than in patients who have type 2 diabetes or impaired glucose tolerance.

Cardiovascular diseases:

Individuals with metabolic syndrome are twice as likely to die of cardiovascular disease as those who do not.

The approximate prevalence of the metabolic syndrome among patients with coronary heart disease (CHD) is 50%, with a prevalence of about 35% among patients with premature coronary artery disease (before or at age 45).

Lipodystrophy:

Lipodystrophy may predispose a person to metabolic syndrome. It can be either genetic or acquired.

Genetic lipodystrophy:-
Acquired:-

Etiology of metabolic syndrome:


Clinical Features of metabolic syndrome:


Associated conditions:


Diagnosis of metabolic syndrome:


Treatment of metabolic syndrome:

Diet:
Lifestyle modifications:
Weight loss drugs
Bariatric surgery (Gastric bypass surgeries and sleeve gastrectomy)
LDL cholesterol:
Hypertriglyceridemia:
HDL cholesterol:
Blood Pressure:

ln patients who have the metabolic syndrome without diabetes, the best choice for the initial antihypertensive medication is either an ACE inhibitor or the Angiotensin II receptor blocker

General instructions:-

Impaired fasting glucose:

Type 2 diabetes:-

Non-diabetics:-

Insulin resistance:

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