The developed world is facing a silent killer without a high profile. Many people suffer from the Metabolic Syndrome without even knowing that there is something wrong with them. A combination of disorders will bring about this condition. In the end the patient runs the risk of developing diabetes and cardiovascular disease. About 20% of people in the USA are affected by this condition. Other studies have put that level right up to 25%. Other classifications include the cardiometabolic syndrome, syndrome X, Reavens syndrome, insulin resistance and CHAOS. Overweight horses will suffer similar symptoms and it is known as equine metabolic syndrome.
- The definition and diagnosis of this syndrome: A couple of sets have been constructed in order to define the principal symptoms. The International Diabetes Federation and the National Cholesterol Education Program have attempted to oversee the principal indicators of the Metabolic Syndrome. According to the IDF a BMI which is greater than 30 kg/m2 indicates central obesity. At that point there is no practical pint in measuring the waist circumference in order to identify the syndrome. However some experts have argued that someone with a low weight can actually have obesity around the middle. The NCEP formula is slightly different. The IDF is particularly specific about the geography of the obesity when defining the syndrome.
- The differences in people: It is important to note that ethnicity, gender and genetics can play a role in the definitions. For example some studies have shown that Afro-Caribbean people have a high concentration of muscle tissue which may occasionally render the BMI meaningless. Many top athletes would be considered to be overweight if it were not for the fact that there are other factors which override the BMI. The incidence of raised triglycerides is taken to be a risk factor. Specifically anything greater than 150 mg/dl or 1.7mmol/L is considered to be problematic. A lipid abnormality is easier to treat if there is early diagnosis. Reduced levels of HDL can also be problematic. You should not have readings that are lower than 40 mg/dL or 1.03mmol/L in males. The minimum for women is 50 mg/Dl or 1.29mmol/L.
- Hypertension and other related illnesses: If the patient has a systolic BP which is greater than 130 or a diastolic reading which is greater than 88 mm/Hg then they run a high risk of developing the Metabolic Syndrome. Any history of hypertension should be taken into consideration when making a positive diagnosis. One of the other indicators that the patient may be in danger is if they have a raised level of plasma glucose. A FPG reading that is greater than 100 mg/dL or 5.6mmol/L is uncommonly high. It might also be followed by indicators of diabetes. An OGTT Glucose Tolerance test is required if the FPG is greater than 5.6mmol/L. Of course in all these circumstances a BMI that is greater than 30 km/m2 is clearly an indicator that the circumference or girth would be in the danger zone.
- Definitions that are sanctioned by the World Health Organization: Given the level of disagreements amongst the professionals, it is sometimes useful to look at the data being provided by the WHO. The factors that are considered to be indicative of this condition include diabetes mellitus, low fasting glucose, impaired glucose tolerance and insulin resistance. The trigger blood pressure reading is more than 140/90 mmHg. Patients will also suffer from dyslipidemia which has a reading of triglycerides over 1.695mmol/L. A high-density lipoprotein cholesterol reading of 0.9mmol/L in males is also problematic while female members of the community have to watch out for readings of at least 1.0mmol/L. Central obesity is characterized by a waist to hip ratio of 0.90 in males and 0.85 in females. At this point the BMI is normally 30kg/m2 or more. Another possible test is that of Microalbuminuria which is characterized by urinary albumin excretion at a ratio of more than 20 g/min or albumin to creatinine ratio of at least 30 mg/g.
- The sedentary lifestyle: There is no doubt that the sedentary lifestyle which many people in the developed world lead is partly to blame for the high incidence of the Metabolic Syndrome. Some of the signs include an increase in adipose tissue within the central region as well as reduced HDL. The solution is to get active especially right from an early age. Age is another factor. For example it has been estimated that by the age of 50, 44% of Americans will be affected. Women have a higher propensity to develop the condition when compared to men. Of the 40 million patients suffering from type II diabetes worldwide, 75% of them have an impaired glucose tolerance as well as the Metabolic Syndrome. In any case CVD and Hypoadiponectinemia have been known to increase insulin resistance.
- Coronary Heart Disease: There is a multiplicity of conditions that are associated with the Metabolic Syndrome. Even where a causative effect has not been established, the presence of these conditions is an indicator of an unhealthy lifestyle. CHD patients have a prevalence of 50% while those with premature (occurring below the age of 45) CHD have a prevalence of 37%. The responses recommended include better nutrition and increased physical activity. In due course the patient will experience a certain amount of control over their weight.
The Metabolic Syndrome has also been associated with Lipodystrophic disorders: Patients that are getting treatment for HIV may develop the Metabolic Syndrome. There is a genetic variety that is known as Berardinelli-Seip congenital lipodystrophy or Dunnigan familial partial lipodystrophy. The acquired variety is a result of antiretroviral therapy. This could lead to a severe form of insulin resistance. It has also been discovered that patients with schizoaffective disorders or those who are bipolar have a high risk of this condition. Their sedentary lifestyle makes matters worse. Moreover it is expected that their unstable mental health will lead them into poor dietary habits as well as limited access to help. A holistic approach is required in order to improve the quality of life that the patient leads.
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