Metabolic Syndrome (Syndrome X)

The metabolic syndrome (syndrome X, insulin resistance syndrome) is characterized by a large waist circumference (due to excess abdominal fat), high blood pressure, abnormal fasting plasma glucose or insulin resistance and dyslipidemia. Causes, complications, diagnosis and treatment are similar to the symptoms of obesity.

In developed countries, the metabolic syndrome is a serious problem. In the US, it is very common, there have> 40% of people> 50 years. Children and young people can develop a metabolic syndrome, but for this age group is still no definition has been established.

The metabolic syndrome (syndrome X, insulin resistance syndrome) is characterized by a large waist circumference (due to excess abdominal fat), high blood pressure, abnormal fasting plasma glucose or insulin resistance and dyslipidemia. Causes, complications, diagnosis and treatment are similar to the symptoms of obesity. In developed countries, the metabolic syndrome is a serious problem. In the US, it is very common, there have> 40% of people> 50 years. Children and young people can develop a metabolic syndrome, but for this age group is still no definition has been established. The development of the metabolic syndrome depends on the distribution and the amount of body fat. Excess fat in the abdomen (called. Apple shape), especially when the ratio of waist and hip circumference is high (which is a relatively low-fat muscle mass ratio reflects), increases the risk. The syndrome occurs less frequently in individuals, the excess subcutaneous fat deposits around the hips build (so-called. Pear shape) and the ratio of waist and hip circumference is low (which is a relatively high-fat muscle mass ratio reflects). Abdominal fat in excess leads to a high number of free fatty acids in the portal vein and an increasing fat accumulation in the liver. Also in the muscle cells to fat accumulates. It ensteht insulin resistance with hyperinsulinemia. The glucose metabolism is impaired, and it develops a dyslipidemia and hypertension. The serum uric acid level is typically increased (increased risk of gout), a prothrombotic state, with elevated levels of fibrinogen and plasminogen activator inhibitor I (PAI-1) and an inflammatory process develops. The patients have an increased risk of obstructive sleep apnea. Other risks include nonalcoholic steatohepatitis, chronic kidney disease, polycystic ovary syndrome (for women) and low plasma testosterone, erectile dysfunction, or both (for men). Diagnosis waist circumference and blood pressure fasting plasma glucose and lipid profile screening is important. A family history and a measure of waist circumference, and blood pressure are part of routine investigation. If patients with cases of type 2 diabetes in their family, especially those ? have 40 years, a waist circumference above the norm, fasting blood glucose and lipid profile should be determined. For metabolic syndrome, there are many different definitions, it is most often diagnosed when ? 3 of the following factors are present (see Table: Common criteria for diagnosis of metabolic syndrome *): Excess abdominal fat A high fasting blood sugar levels hypertension A high triglyceride level Low High -Density lipoprotein (HDL) cholesterol levels Common criteria for diagnosis of metabolic syndrome criteria * value waist circumference (cm [in]) ? 102 (? 40) Men ? 88 (? 35) Women Fasting glucose (mg / dl [mmol / l]) ? 100 (? 5.6) blood pressure (mmHg) ? 130/85 triglycerides, fasting (mg / dl [mmol / l]) ? 150 (? 1.7) High- density lipoprotein (HDL) cholesterol (mg / dL [mmol / l]) <40 (<1.04) men <50 (<1.29) Women * At least three of the criteria must be present for the diagnosis. Healthy diet and exercise therapy Sometimes metformin management of cardiovascular risk factors Optimally, leading a therapeutic approach that is based on healthy eating and regular physical activity, weight loss. This includes a combination of aerobic activity and strength training, reinforced by behavioral therapy. Metformin, a Insulinssensibilisator, or a thiazolidinedione (z. B. rosiglitazone, pioglitazone) may be effective. A weight loss of about 7% may be sufficient to reverse the syndrome. If this fails, any characteristic of the syndrome must be treated to achieve the recommended goals. The available drug treatment is very effective. Other cardiovascular risk factors also need to be addressed (eg., By smoking) Increased physical activity has benefits for the cardiovascular system, even if it no weight is lost. Important Points excess belly fat leads to abnormal fasting plasma glucose or insulin resistance, dyslipidemia and hypertension. The metabolic syndrome is most common in developed countries (eg. As possibly prevalence> 40% in people> 50 years). Determine waist circumference, blood pressure, fasting plasma glucose and lipid profile. Lift the importance of healthy eating and physical activity appears to treat cardiovascular risk factors, and if these measures are not sufficiently effective, consider the gift of metformin into consideration.

Health Life Media Team

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