Metabolic syndrome
Metabolic syndrome is a combination of medical disorders that affect a large number of people in a clustered fashion. In some studies, the prevalence in the USA is calculated as being up to 25% of the population.
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2 Signs and symptoms 3 Diagnosis 4 Pathophysiology 5 Therapy 6 References |
Nomenclature
Other names for this syndrome are:
It is not related to:
Signs and symptoms
Symptoms and features are:
Associated diseases are:
Diagnosis
The above diseases are all diagnosed separately; please see the relevant articles. The Adult Treatment Panel III of the National Cholesterol Education Program defined the diagnosis as three or more of the following five:
- Increased waist circumference (>=102 cm in men and >=88 cm in women), indicating central obesity
- Elevated triglycerides (>=150 mg/dL or 1.7 mmol/l)
- Decreased HDL cholesterol (<40 mg/dL for men, <50 mg/dL for women)
- Blood pressure above 130/85 or active treatment for hypertension
- Glucose levels above 100 mg/dL
Pathophysiology
The causes of metabolic syndrome are extremely complex and have only been partially elucidated. Most patients have a degree of insulin resistance, but there is debate whether this is the cause of the metabolic syndrome or a byproduct of a more far-reaching metabolic derangement. There is a role for systemic inflammation, as a number of inflammatory markers (including C-reactive protein) is often increased, as are fibrinogen, IL-6, TNF&alpha and others.
Therapy
Generally, the individual diseases that comprise Syndrome X are treated separately (e.g. diuretics and ACE inhibitors for hypertension). A remarkable finding is, however, that drugs that decrease insulin resistance (metformin and thiazolidinediones) not only reduce hyperglycemia but generally lead to in improvement in blood pressure and cholesterol (lipid profile) as well.