metabolic syndrome

METABOLIC SYNDROME

LEARNING OBJECTIVES
At the end of lecture students should know
– Definition of Metabolic Syndrome
– Visceral obesity is an indicator of the syndrome and an independent marker for CVD
– Current and some potential future treatment options.

METABOLIC SYNDROME CONCEPT

(Not New)

• 1923 - Kylin first to describe the clustering of hypertension, hyperglycemia, hyperuricemia
• 1936 - Himsworth first reported Insulin insensitivity in diabetics • 1965 - Yalow and Berson developed insulin assay and correlated insulin levels & glucose lowering effects in resistant and non-resistant individuals

METABOLIC SYNDROME CONCEPT
• 1988 - Reaven in his Banting lecture at the ADA meeting coined the term Syndrome X and brought into focus the clustering of features of Metabolic Syndrome
• Reaven prefers the name, Insulin-Resistance
Syndrome feels insulin resistance is the common denominator for Metabolic Syndrome

OTHER NAMES USED
• Syndrome X
• Cardiometabolic Syndrome
• Cardiovascular Dysmetabolic Syndrome
• Insulin-Resistance Syndrome
• Metabolic Syndrome
• Beer Belly Syndrome
• Reaven’s Syndrome etc.

COMPONENTS OF METABOLIC SYNDROME
CRITERIA FOR DIAGNOSIS
• World Health Organization
• International Diabetes Federation (IDF)
• European Association for the Study of Diabetes (EASD)
• National Cholesterol Education Project
• Adult Treatment Panel (NCEP-ATP III)
• Others

DEFINITION
 Hypertension:
• IDF:
– BP >130/85 or on Rx for previously diagnosed hypertension • WHO:
– BP >140/90

• NCEP ATP III:
– BP >130/80.

 OBESITY:
•

IDF:Central obesity
• waist circumference >94 cm for Europid men
>83 cm for Europid women

•

WHO:
• waist - hip ratio :

>0.9 – men
>0.85 - women

•

ATP III:
• waist circumference:>40 in. - men
>35 in. – women.

 Glucose Abnormalities:
• IDF:
– FPG >100 mg/dL (5.6 mmol/L) or previously diagnosed type II diabetes • WHO:
– Presence of diabetes, IGT,