Metabolic Syndrome

Alternative Names: metabolic syndrome X, cardiometabolic syndrome, syndrome X, insulin resistance syndrome, Reaven’s syndrome (named for Gerald Reaven), and CHAOS (in Australia).

Definition:
Suddenly, it’s a health condition that everyone’s talking about. While it was only identified less than 20 years ago, metabolic syndrome is as widespread as pimples and the common cold. According to the American Heart Association, 47 million Americans have it. That’s almost a staggering one out of every six people.

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Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. It’s also debated by the experts — not all doctors agree that metabolic syndrome should be viewed as a distinct condition.

So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it?

Understanding Metabolic Syndrome
Metabolic syndrome is not a disease in itself. Instead, it’s a group of risk factors — high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat.

Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for grave problems. These risk factors double your risk of blood vessel and heart disease, which can lead to heart attacks and strokes. They increase your risk of diabetes by five times.

Many people who have either diabetes, high blood pressure or obesity also have one or more of the other conditions, although it may have gone unrecognised.

Individually, each of these conditions can lead to damage to the blood vessels, but together they’re far more likely to do harm. People with these conditions in combination become much more likely to experience heart disease, stroke and other conditions related to problems with the blood vessels.

When a person has such a combination, they’re said to have metabolic syndrome. This is also sometimes called insulin-resistance syndrome (because one of the features is a very high level of the hormone insulin in the blood, which the body doesn’t react to or is ‘resistant’ to) or syndrome X.

There are currently two major definitions for metabolic syndrome provided by the International Diabetes Federation  and 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 state that if BMI > 30 kg/m2, central obesity can be assumed, and waist circumference does not need to be measured. However, this potentially excludes any subject without increased waist circumference if BMI < 30, whereas, 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.

Metabolic syndrome is also becoming more common. But the good news is that it can be controlled, largely with changes to your lifestyle.

Symptoms:
The problems found in metabolic syndrome include:


•Central obesity – fat is laid down around the abdomen rather than spread evenly around the body

•Abnormal fat levels in the blood – specifically, high levels of triglycerides and low levels of HDL (or ‘good’) cholesterol, which can lead to arteriosclerosis (fatty plaques) on the walls of blood vessels

•High blood pressure

•Insulin resistance or glucose intolerance – an inability to use insulin properly or control blood sugar levels very well, which is a very important factor in metabolic syndrome

Prothrombotic state – an increased tendency to make tiny clots in the blood

Proinflammatory state – an increased tendency to inflammation

Having one component of metabolic syndrome means you’re more likely to have others. And the more components you have, the greater are the risks to your health.

Causes:
Experts aren’t sure why metabolic syndrome develops. It’s a collection of risk factors, not a single disease. So it probably has many different causes. Some risk factors are:

*Insulin resistance. Insulin is a hormone that helps your body use glucose — a simple sugar made from the food you eat — as energy. In people with insulin resistance, the insulin doesn’t work as well so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.

*Obesity — especially abdominal obesity. Experts say that metabolic syndrome is becoming more common because of rising obesity rates. In addition, having extra fat in the belly — as opposed to elsewhere in the body — seems to increase your risk.

*Unhealthy lifestyle. Eating a diet high in fats and not getting enough physical activity can play a role.

*Hormonal imbalance. Hormones may play a role. For instance, polycystic ovary syndrome (PCOS) — a condition that affects fertility — is related to hormonal imbalance and metabolic syndrome.

If you’ve just been diagnosed with metabolic syndrome, you might be anxious. But think of it as a wake-up call. It’s time to get serious about improving your health. Making simple changes to your habits now can prevent serious illness in the future.

Risk Factors:
The following factors increase your chances of having metabolic syndrome:

*Age. The risk of metabolic syndrome increases with age, affecting less than 10 percent of people in their 20s and 40 percent of people in their 60s. However, warning signs of metabolic syndrome can appear in childhood.

*Race. Hispanics and Asians seem to be at greater risk of metabolic syndrome than other races are.

*Obesity. A body mass index (BMI) — a measure of your percentage of body fat based on height and weight — greater than 25 increases your risk of metabolic syndrome. So does abdominal obesity — having an apple shape rather than a pear shape.

*History of diabetes. You’re more likely to have metabolic syndrome if you have a family history of type 2 diabetes or a history of diabetes during pregnancy (gestational diabetes).

*Other diseases.A diagnosis of high blood pressure, cardiovascular disease or polycystic ovary syndrome — a similar type of metabolic problem that affects a woman’s hormones and reproductive system — also increases your risk of metabolic syndrome.

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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.

Diagnosis:
Although  doctor does not typically look  for metabolic syndrome, the label may apply if you have three or more of the traits associated with this condition.

Several organizations have criteria for diagnosing metabolic syndrome. These guidelines were created by the National Cholesterol Education Program (NCEP) with modifications by the American Heart Association. According to these guidelines, you have metabolic syndrome if you have three or more of these traits:

*Large waist circumference, greater than 35 inches (89 centimeters, or cm) for women and 40 inches (102 cm) for men. Certain genetic risk factors, such as having a family history of diabetes or being of Asian descent — which increases your risk of insulin resistance — lower the waist circumference limit. If you have one of these genetic risk factors, waist circumference limits are 31 to 35 inches (79 to 89 cm) for women and 37 to 39 inches (94 to 99 cm) for men.

*A triglyceride level higher than 150 milligrams per deciliter (mg/dL), or 1.7 millimoles per liter (mmol/L), or you’re receiving treatment for high triglycerides.

*Reduced HDL (“good”) cholesterol — less than 40 mg/dL (1 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women — or you’re receiving treatment for low HDL.

*Blood pressure higher than 120 millimeters of mercury (mm Hg) systolic or higher than 80 mm Hg diastolic, or you’re receiving treatment for high blood pressure.

*Elevated fasting blood sugar (blood glucose) of 100 mg/dL (5.6 mmol/L) or higher, or you’re receiving treatment for high blood sugar.

Treatment:
The first line treatment is change of lifestyle (e.g., Dietary Guidelines for Americans and physical activity). However, if in three to six months of efforts at remedying risk factors prove insufficient, then drug treatment is frequently required. Generally, the individual disorders that comprise the metabolic syndrome are treated separately. Diuretics and ACE inhibitors may be used to treat hypertension. Cholesterol drugs may be used to lower LDL cholesterol and triglyceride levels, if they are elevated, and to raise HDL levels if they are low. Use of drugs that decrease insulin resistance, e.g., metformin and thiazolidinediones, is controversial; this treatment is not approved by the U.S. Food and Drug Administration.

A 2003 study indicated that cardiovascular exercise was therapeutic in approximately 31% of cases. The most probable benefit was to triglyceride levels, with 43% showing improvement; but fasting plasma glucose and insulin resistance of 91% of test subjects did not improve.   Many other studies have supported the value of increased physical activity and restricted caloric intake (exercise and diet) to treat metabolic syndrome.

Restricting the overall dietary carbohydrate intake is more effective in reducing the most common symptoms of metabolic syndrome than the more commonly prescribed reduction in dietary fat intake

Controversy:
The clinical value of using “metabolic syndrome” as a diagnosis has recently come under fire. It is asserted that different sets of conflicting and incomplete diagnostic criteria are in existence, and that when confounding factors such as obesity are accounted for, diagnosis of the metabolic syndrome has a negligible association with the risk of heart disease.

These concerns have led to the American Diabetes Association and the European Association for the Study of Diabetes to issue a joint statement identifying eight major concerns on the clinical utility of the metabolic syndrome.

It is not contested that cardiovascular risk factors tend to cluster together, but what is contested is the assertion that the metabolic syndrome is anything more than the sum of its constituent parts.

Lifestyle and home remedies:
You can do something about your risk of metabolic syndrome and its complications — diabetes, stroke and heart disease. Start by making these lifestyle changes:

Lose weight. Losing as little as 5 to 10 percent of your body weight can reduce insulin levels and blood pressure, and decrease your risk of diabetes.

Exercise. Doctors recommend getting 30 to 60 minutes of moderate-intensity exercise, such as brisk walking, every day.

Doing Yoga :Doing Yoga exercise, meditation etc. under the guideline of a good yoga teacher

Stop smoking.Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.

Eat fiber-rich foods. Make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels.

Prevention:
Various strategies have been proposed to prevent the development of metabolic syndrome. These include increased physical activity (such as walking 30 minutes every day),   and a healthy, reduced calorie diet.   There are many studies that support the value of a healthy lifestyle as above. However, one study stated that these potentially beneficial measures are effective in only a minority of people, primarily due to a lack of compliance with lifestyle and diet changes.   The International Obesity Taskforce states that interventions on a sociopolitical level are required to reduce development of the metabolic syndrome in populations.

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Although much more research has to be done to work out the relationship between different factors in metabolic syndrome, and how drug treatments might be used to help people, there are steps you can take to reduce your risk.

Lifestyle changes can make a big difference, preventing or delaying the development of serious disease. Losing weight and getting active are the top priority. But make sure you get proper advice and support – research has shown that people who join a weight-loss group, for example, are more likely to lose weight and keep it off.

In terms of getting fit, join a gym or find a sport you enjoy. You’re more likely to stick at it if you like what you’re doing.

Some preventive treatments are also available from your GP. It’s important to keep your blood pressure under control, and blood fat (cholesterol) and blood sugar (glucose) at healthy levels. But some blood pressure treatments, such as diuretics and beta blockers, can actually make metabolic syndrome worse.

A 2007 study of 2,375 male subjects over 20 years suggested that daily intake of a pint (~568 ml) of milk or equivalent dairy products more than halved the risk of metabolic syndrome. Some subsequent studies support the authors’ findings, while others dispute them.

Check with your doctor if you’re concerned. Drugs to control blood fat and cholesterol levels, and blood glucose levels, are often needed.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/metabolicsyndrome1.shtml
http://www.webmd.com/heart/metabolic-syndrome/metabolic-syndrome-what-is-it
http://www.mayoclinic.com/health/metabolic%20syndrome/DS00522
http://en.wikipedia.org/wiki/Metabolic_syndrome
http://www.healthfocus.net.au/what-is-metabolic-syndrome/

http://www.myoptumhealth.com/portal/ADAM/item/Weight+control+and+diet

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