Introduction to the metabolic syndrome problematics
Authors:
M. Souček
Authors‘ workplace:
II. interní klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Miroslav Souček, CSc.
Published in:
Vnitř Lék 2005; 51(1): 48-52
Category:
Reviews
Overview
Metabolic syndrome is easily diagnosable but in each individual patient it should be evaluated in all its relationships. Metabolic syndrome is determined according to the presence of hypertension, obesity, dyslipidemia and the presence of type 2 diabetes mellitus. In addition to the combination of basic clinical disorders, we can find some other metabolic abnormalities, indicating the seriousness of pathophysiologic changes caused by the syndrome. In recent years, the syndrome was widened by other metabolic and fibronolysis disorders. The causes of metabolic syndrome remain unclear. Landsberg et al. determined as a primary pathogenetic mechanism insulinresistance, Julius et al. consider increased activity of central sympethetic nervous system to be crucial. Prevalence ranges from 20 to 40% according to diagnostic criteria. The clinical importance of metabolic syndrome lies in his role in aterosclerosis development. Therefore it is clear that metabolic syndrome therapy should be a complex one, based on non-pharmacologic measures and in majority of cases supplemented by pharmacoltherapy considering all the aspects of metabolic syndrome, in order to achieve a really long-term cardiovasular benefit.
Key words:
metabolic syndrome – insulinresistance – dyslipidemy – hypertension – obesity – cardiovascular diseases
Sources
1. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.
2. Kereiakes DJ, Willerson JT. Metabolic syndrome epidemic. Circulation 2003; 108: 1552–1553.
3. Anand SS, Yi Q, Gerstein H et al. Relationship of metabolic syndrome and fibrinolytic dysfunction to cardiovascular disease. Circulation 2003; 108: 420–425.
4. Pelikánová T. Metabolický syndrom. Vnitř lék 2003; 49(12): 900–906
5. Svačina Š. Metabolický syndrom. Praha: Triton 2001.
6. Reaven GM. Banting lecture 1988: Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–1607.
7. Despres JP. Abdominal obesity and risk of coronary Artery disease. Can J Cardiol 1992; 8: 561–562.
8. Despres JP. Abdominal obesity as an important component of insulin-resistance syndrome. Nutrition 1993; 9: 452–459.
9. Hokanson JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoproteid cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk 1996; 3: 213–219.
10. Vaverková H. Dyslipoproteinemie a diabetes mellitus. Vnitř Lék 2000; 46: 532–538.
11. Vega GL, Clark LT, Tang A et al. Hepatic lipase activity is lower in African American men than in white American men: effects of 5 flanking polymorphism in the hepatic lipase gene. J Lipid Res 1998; 39: 228–232.
12. Couture P, Otvos JD, Cupples LA et al. Absence of association between genetic variation in the promoter of the microsomal triglyceride transfer protein gene and plasma lipoproteins in the Framingham
Offspring Study. Atherosclerosis 2000; 148: 337–343.
13. Greiner DZ, Personius BE, Andrew TC. Effect of withdrawal of chronic estrogen therapy on brachial artery vasoreactivity in women with coronary artery disease. Am J Cardiol 1999; 83(2): 247–249.
14. Lobo RA, Carmina E. The importance of diagnosing the polycystic ovary syndrome. Ann Intern Med 2000; 132: 989–993.
15. Wilson PW, D’Agostino RB, Sullivan L et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002; 162: 1867–1872.
16. Wilson PW, Kannel WB, Silbershatz H et al. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999; 159: 1104–1109.
17. Češka R. Metabolický syndrom, HDL–cholesterol, diabetická dyslipidemie a kardiovaskulární riziko. Souč Klin Pr 2002; 1: 5–14.
18. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998; 351: 1755–1762.
19. Pasternak RC. The ALLHAT lipid lowering trial: less is less. JAMA 2002: 288: 3042–3044.
20. Wilson WF, Grundy SM. The metabolic syndrome. Practical guide to origins and treatment. Circulation 2003; 108: 1537–1540.
21. Cífková R. Prevence ischemické choroby srdeční v dospělém věku. Kapitoly z kardiologie 2002; 2(4): 122–139.
22. Svačina Š, Owen K, Bretšnajderová A. Syndrom inzulínové rezistence. Praha: Triton 2003.
23. Vaverková H, Ficker I, Vlachová I et al. Reavenův metabolický syndrom X v rodinách osob po předčasné ischemické cévní mozkové příhodě. Vnitř Lék 1993; 39: 745–754.
24. Perušičová J. Trendy soudobé diabetologie. Praha: Galén 2001; 9. vol.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2005 Issue 1
Most read in this issue
- Liver disease at alpha-1-antitrypsin deficiency
- Myelodysplastic syndrome in the new millennium. How to classify and cure patients?
- Hypertension and hyperuricemy
- Extramedullary plasmacytoma of the thyroid gland – a rare vause of a solitary struma nodosa and hyperthyroidism