Description of Metabolic Syndrome

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Metabolic Syndrome (syndrome X, insulin resistance syndrome) is the name for a group of risk factors that raises your risk for diabetes mellitus (DM), cardiovascular disease (CVD), and other health problems, such as diabetes and stroke.2 It is characterized by abdominal obesity, insulin resistance, hypertension, low HDL, and elevated triglycerides. Some hallmarks of metabolic syndromes are dyslipidemia, central adiposity, and a predisposition to atherosclerotic cardiovascular disease, certain cancers, hypertension, and type 2 diabetes mellitus. Genetics appears to play an important role in predisposing certain individuals and populations to the development of metabolic syndrome.1 Multiple environmental factors modify this genetic predisposition and include physical inactivity, advancing age, cigarette smoking, and endocrine dysfunction. The presence of one or either of these signs should alert the clinician to search for other biochemical abnormalities that may be associated with the metabolic syndrome.

There needs to be at least 3 of the 5 risk factors to be diagnosed with metabolic syndrome.3 There are 3 etiological categories for metabolic syndrome, disorders that deal with adipose tissue; insulin resistance, and a many independent factors that mediate different aspects of the metabolic syndrome. The medical history should include evaluation of symptoms for OSA (obstructive sleep apnea) in all patients.1 OSA is commonly associated with obesity, HTN, increased circulating cytokines and insulin resistance.1 Medical history should include evaluation of symptoms for PCOS in premenopausal women. PCOS is prevalent in 40-50% of women with metabolic syndrome and is 2-4 times more likely to occur than women without PCOS.1 Family hist...

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Some ways to fight of this syndrome include regular diet and exercise and various bariatric surgeries. Long range BMI target/goal is less than 25. If life style change is not enough than drugs that help lower cholesterol level high blood pressure and blood sugar can be used such as statins, fibrates or nicotinic acid. 4Other things that can be done include trying to fight the insulin resistance by starting thiazolidinediones. Also, treating the different risk factors like elevated blood pressure, prothrombotic and proinflammatory state independently.

Our patient has 4 of the 5 risk factors: low HDL, high triglycerides, high fasting blood glucose, and central obesity. Because of this, she does seem to have metabolic syndrome. With metabolic syndrome concomitant disease states occur that the patient may have, including PCOS, and hypothyroidism.

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