1. METABOLIC SYNDROME From PubMed Health A service of the National Library of Medicine, National Institutes of Health. A.D.A.M. Medical Encyclopedia, Atlanta, GA 2011

2. Metabolic Syndrome Also known as: – Insulin Resistance Syndrome – Syndrome X A name for a group of risk factors that occur together and increase the risk for CAD, stroke, and type 2 diabetes.

3. Causes, Incidence, Risk Factors Researchers are not sure whether the syndrome is due to one single cause All of the risk for the syndrome are related to obesity

4. Metabolic Syndrome Metabolic syndrome is primarily caused by obesity and inactivity. Metabolic syndrome is linked to a condition called insulin resistance. Normally, your digestive system breaks down the foods you eat into sugar (glucose). Insulin is a hormone made by your pancreas that helps sugar enter your cells to be used as fuel. In people with insulin resistance, cells don't respond normally to insulin, and glucose can't enter the cells as easily. As a result, glucose levels in your blood rise despite your body's attempt to control the glucose by churning out more and more insulin. This can eventually lead to diabetes when your body is unable to make enough insulin to keep the blood glucose within the normal range.

5. Metabolic Syndrome Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.

6. Causes, Incidence, Risk Factors 2 most important risk factors are: – 1. Extra weight around the middle and upper parts of the body (central obesity) The body may described as “apple-shaped” – 2. Insulin resistance. The body uses insulin less effectively than normal. As a result, the blood sugar and fat levels rise.

7. Causes, Incidence, Risk Factors Age. Your risk of metabolic syndrome increases with age, affecting 40 percent of people over the age of 60. Race. Hispanics and Asians seem to be at greater risk of metabolic syndrome than are people of other races. Obesity. Carrying too much weight increases your risk of metabolic syndrome — particularly if you have an apple shape rather than a pear shape. Diabetes. You're more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes. Other diseases. Your risk of metabolic syndrome is higher if you've ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome

8. Causes, Incidence, Risk Factors 2 other problems that can either cause the condition or make it worse: – Excess blood clotting – Increased levels of blood substances that are a sign of inflammation throughout the body

9. Metabolic Syndrome Most of the disorders associated with metabolic syndrome have no symptoms, although a large waist circumference is a visible sign. If your blood sugar is very high, you might experience signs and symptoms of diabetes — including increased thirst and urination, fatigue, and blurred vision. When to see a doctor If you know you have at least one component of metabolic syndrome, ask your doctor whether you need testing for other components of the syndrome.

10. Clinical Manifestations BP =/> 130/85 mm/Hg FBS =/> 100 mg./dL Large waist circumference: – Men: 40+ inches – Women: 35+ inches Low HDL cholesterol: – Men: < 40 mg/dL – Women: <50 mg/dL Triglycerides =/> 150 mg/dL

11. Treatment GOAL: reduce YOUR risk of heart disease and diabetes – Lifestyle changes Lose weight (7-10% of your current weight. Eat 500 – 1000 fewer calories per day) 30 min moderate intensity exercise 5- 7days/week Stop smoking – Medication – for cholesterol, BP control Some people benefit from low-dose daily ASA

12. Complications Having metabolic syndrome can increase your risk of developing these conditions: Diabetes. If you don't make lifestyle changes to control your insulin resistance, your glucose levels will continue to increase. You may develop diabetes as a result of metabolic syndrome. Cardiovascular disease. High cholesterol and high blood pressure can contribute to the buildup of plaques in your arteries. These plaques can cause your arteries to narrow and harden, which can lead to a heart attack or stroke.

13. Prognosis People with metabolic syndrome have an increased long-term risk for: – Developing heart disease – Type 2 diabetes – Stroke – Kidney disease – Poor blood supply to the legs