Metabolic syndrome overview: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
Most common risk factors include central [[obesity]], [[insulin resistance]] and [[aging]]. | Most common risk factors include central [[obesity]], [[insulin resistance]] and [[aging]]. | ||
==Natural History, Complications and Prognosis== | |||
[[Metabolic syndrome]] occurs in the presence of [[insulin]] resistance and accompanying [[obesity]]. It increases the risk for [[coronary heart disease]],[[diabetes]], [[fatty liver]], [[stroke]] and some [[cancer]]s. It may manifests as [[hypertension]], [[hyperglycemia]], [[hypertriglyceridemia]], reduced high-density lipoprotein cholesterol and abdominal obesity. | |||
==Diagnostic Criteria== | |||
There are currently two major definitions for metabolic syndrome provided by 1) [[International Diabetes Federation]]<ref>The IDF consensus worldwide definition of the metabolic syndrome. [http://www.idf.org/webdata/docs/IDF_Metasyndrome_definition.pdf PDF]</ref> and 2) the revised [[National Cholesterol Education Program]], respectively. The revised NCEP and IDF definitions of metabolic syndrome are very similar and it can be expected that they will identify many of the same individuals as having metabolic syndrome. The two differences are that IDF excludes any subject without increased waist circumference, while in the NCEP definition metabolic syndrome can be diagnosed based on other criteria and the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference regardless of geography. These two definitions are much closer to each other than the original NCEP and WHO definitions. | |||
==History and Symptoms== | |||
The diagnosis of metabolic syndrome is mostly based on physical examination and lab tests. The symptoms seen in [[metabolic syndrome]] are indicative of the component disorder like [[hypertension]], [[diabetes]], [[dyslipidemia]] and [[polycystic ovarian syndrome]]. Also, dietary, family, social and medical history are important tools in the diagnosis. | |||
==Laboratory Findings== | |||
Common laboratory tests performed while evaluating metabolic syndrome include fasting, post-prandial blood glucose, [[HbA1C]], [[lipid profile]] and [[liver function test]]s. | |||
==References== | ==References== |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
Overview
Metabolic syndrome are characterized by a cluster of conditions that greatly increases the risk of a person to develop heart diseases, diabetes and stroke. By definition one is said to have a metabolic syndrome if they have 3 of the following 5 conditions: high blood pressure (>130/85), abnormal fasting blood glucose > 100 mg/dl, increased weight around the waist (women > 35 inches, male > 40 inches), triglycerides > 150 mg/dl and a low HDL (female < 50, male < 40).
Historical Perspective
The term "metabolic syndrome" dates back to at least the late 1950s, but came into common usage in the late 1970s to describe various associations of risk factors with diabetes, that had been noted as early as the 1920s.
Pathophysiology
The pathophysiology is extremely complex and has only been partially elucidated. Most patients are older, obese, sedentary, and have a degree of insulin resistance. The most important factors in order are 1) aging, 2) genetics and 3) lifestyle (i.e., decreased physical activity and excess caloric intake).
Causes
Metabolic syndrome is becoming more and more common in the United States. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity.
Differentiating Metabolic Syndrome from other Diseases
Metabolic syndrome occurs in the presence of insulin resistance and accompanying obesity. It increases the risk for coronary heart disease,diabetes, fatty liver, stroke and some cancers. It may manifests as hypertension, hyperglycemia, hypertriglyceridemia, reducedhigh-density lipoprotein cholesterol. The differential diagnosis includes chronic liver disease, cushing syndrome and congenital adrenal hyperplasia with overlapping presentations.
Epidemiology and Demographics
The prevalence of metabolic syndrome has increased over the decades. The prevalence are higher in western countries, with increasing ages and in certain races like Mexican-Americans and African-Americans.
Risk Factors
Most common risk factors include central obesity, insulin resistance and aging.
Natural History, Complications and Prognosis
Metabolic syndrome occurs in the presence of insulin resistance and accompanying obesity. It increases the risk for coronary heart disease,diabetes, fatty liver, stroke and some cancers. It may manifests as hypertension, hyperglycemia, hypertriglyceridemia, reduced high-density lipoprotein cholesterol and abdominal obesity.
Diagnostic Criteria
There are currently two major definitions for metabolic syndrome provided by 1) International Diabetes Federation[1] and 2) the revised National Cholesterol Education Program, respectively. The revised NCEP and IDF definitions of metabolic syndrome are very similar and it can be expected that they will identify many of the same individuals as having metabolic syndrome. The two differences are that IDF excludes any subject without increased waist circumference, while in the NCEP definition metabolic syndrome can be diagnosed based on other criteria and the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference regardless of geography. These two definitions are much closer to each other than the original NCEP and WHO definitions.
History and Symptoms
The diagnosis of metabolic syndrome is mostly based on physical examination and lab tests. The symptoms seen in metabolic syndrome are indicative of the component disorder like hypertension, diabetes, dyslipidemia and polycystic ovarian syndrome. Also, dietary, family, social and medical history are important tools in the diagnosis.
Laboratory Findings
Common laboratory tests performed while evaluating metabolic syndrome include fasting, post-prandial blood glucose, HbA1C, lipid profile and liver function tests.