Prepared by :Dr. Latifa Mari’e Metabolic Syndrome Prepared by :Dr. Latifa Mari’e PBRC 2009

Metabolic Syndrome: Overview Metabolic Syndrome is not a disease, but rather a cluster of disorders of your body’s metabolism, including: High blood pressure High insulin levels Excess body weight Abnormal cholesterol levels Each of these disorders is by itself a risk factor for other diseases. In combination, however, these disorders dramatically boost the chances of developing potentially life-threatening illnesses, such as diabetes, heart disease or stroke. PBRC 2009

Signs and Symptoms The more components of the syndrome that you have, the greater the risks to your health. PBRC 2009

Metabolic Syndrome The syndrome is closely related to a generalized metabolic disorder called insulin resistance, in which the body can’t use insulin efficiently. Metabolic syndrome has been called many names, including: Syndrome X The deadly quartet Insulin Resistance Syndrome PBRC 2009

National Health and Nutrition Examination Survey III, 1988-1994. Prevalence Affects as many as one in four American adults (25%) For adults over the age of 40, more than 40% are affected. Metabolic syndrome prevalence has increased by 61% over the past decade. Rates differ among races and genders. PBRC 2009 National Health and Nutrition Examination Survey III, 1988-1994.

Risk Factors The following factors increase your risk of developing Metabolic Syndrome: Apple Pear Age The prevalence of metabolic syndrome increases with age, affecting less than 10% of people in their 20s and 40% of people in their 60s. Race Metabolic syndrome is generally more common among blacks and Mexican-Americans than among Caucasians. Obesity A body mass index (BMI) greater than 25 increases your risk of metabolic syndrome and abdominal obesity increase the risk of MS. Abdominal obesity refers to having an apple shape rather than a pear. History of diabetes Having a family history of type 2 diabetes or diabetes during pregnancy (gestational diabetes) increases the risk for developing metabolic syndrome. Other diseases A diagnosis of hypertension, cardiovascular disease (CVD) or polycystic ovary syndrome (a hormonal disorder in which a woman’s body produces an excess of male hormones) also increases the risk for metabolic syndrome. PBRC 2009

When is it time to seek medical advice? The presence of one feature of metabolic syndrome, such as high blood pressure, high cholesterol or an apple-shaped body, increases the risk. An individual may already have the condition and not know it. It is important to talk with your doctor about testing for other components of the syndrome and developing a plan to avoid serious diseases. PBRC 2009

Diagnosing Metabolic Syndrome According to the National Cholesterol Education Program (NCEP), the presence of three or more of the following traits indicates metabolic syndrome: Waist Circumference Greater than 35 inches (89 cm) in women and 40 inches (102cm) in men (abdominal obesity) Triglyceride Levels of 150 milligrams per deciliter (mg/dl) or higher Blood Pressure 130/85 millimeters of mercury or higher Fasting blood glucose Level of 110 mg/dl or higher High-density lipoprotein cholesterol (HDL) Lower than 50 mg/dl in women and 40 mg/dl for men PBRC 2009

PBRC 2005

Healthy lifestyle changes can prevent the onset of the syndrome. Prevention Healthy lifestyle changes can prevent the onset of the syndrome. Commit to a healthy diet A healthy diet includes plenty of fruits and vegetables, choosing lean cuts of white meat and fish over red meat, avoiding processed or deep-fried dinners, and eliminating table salt by experimenting with other herbs and spices. Get moving It is important to stay active. Get at least 30 minutes of moderately strenuous activity on most days of the week is recommended. Schedule regular check-ups This includes assessing blood pressure, cholesterol and blood sugar levels annually. Early detection of problems can help with formulating lifestyle modifications. PBRC 2009

Treatment The underlying insulin resistant state is the primary target of therapy. The primary goal of treatment is to prevent: Type 2 diabetes Heart attack Stroke PBRC 2009

Treatment To reduce insulin resistance in overweight and obese individuals, the preferred method is an aggressive regimen of self-care strategies focusing on diet and exercise. It is common for your doctor to routinely monitor the following to ensure that lifestyle modifications are working: Weight Blood glucose Cholesterol Blood pressure PBRC 2009

Self-care Although metabolic syndrome creates a real risk for developing diabetes, stroke or heart disease, these conditions can be prevented. Insulin resistance can be controlled by the following: Lose weight Losing as little as 5 to 10% of your body weight can reduce insulin levels and high blood pressure, thus reducing your risk of diabetes. Exercise Walking just 30 minutes a day or engaging in other aerobic activities can help prevent the serious diseases associated with MS. Stop smoking Smoking cigarettes increases insulin resistance and worsens health consequences associated with MS. Eat fiber-rich foods Whole grains, beans, fruits and vegetables are high in dietary fiber. These are important foods to eat since dietary fiber is known to lower insulin levels. PBRC 2009

Medications to control the syndrome’s individual risk factors include: Treatment Medications to control the syndrome’s individual risk factors include: Weight loss drugs Along with diet and exercise, it may be necessary to prescribe weight loss drugs. orlistat (Xenical) Insulin sensitizers In individuals with diabetes, doctors often prescribe thiazolidinediones and metformin (Glucophage, Glucophage XR) to decrease insulin resistance. These medications may also be useful in improving insulin metabolism in individuals with MS. PBRC 2009

Treatment Medications to control the syndrome’s individual risk factors include: Aspirin Aspirin is often prescribed to help reduce the risk for a heart attack. Medications to lower blood pressure Major types of medications used to control high blood pressure include diuretics, angiotensin-converting enzymes (ACE) inhibitors, calcium channel blockers and beta blockers. Medications to regulate cholesterol Medications such as niacin, statins and fibrates can help improve cholesterol in the following ways: By reducing the level of low-density lipoprotein (LDL) cholesterol (“bad” cholesterol) By increasing the level of high-density (HDL) cholesterol (“good” cholesterol) By decreasing the level of triglycerides (Another “bad” component of cholesterol) PBRC 2009

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