Metabolic Syndrome
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Metabolic Syndrome Gains Medical Attention Amid growing concerns of the prevalence of obesity in America, the medical community is exploring various ways to alleviate this malady's ill effects; current estimates suggest that obesity is a contributing factor to more than 30 medical conditions including high blood pressure, coronary heart disease and osteoarthritis. It is its contribution to the metabolic syndrome that has generated recent concern among the nation's caregivers. According to the Journal of the American Medical Association, about 47 million Americans are believed to be living with metabolic syndrome. Unfortunately, until recently, diagnosis and treatment of this ailment remained nominal, partly because physicians did not have a working definition of the disorder. "The prevalence of metabolic syndrome, much like obesity, is increasing in this country following cultural trends. As people become more sedentary, eat more calories and gain weight, they begin to develop an increased resistance to insulin, which leads to increases in blood sugar, blood pressure and triglycerides, as well as low HDL (high density lipoprotein) cholesterol. That is the metabolic syndrome." As detailed in the third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, the metabolic syndrome is classified by the presence of three or more of the following symptoms: a waist circumference greater than 40 inches in men and 35 inches in women; triglycerides level of at least 150 mg/dL (1.69 mmol/L); HDL cholesterol level of less than 40 mg/dL (1.04 mmol/L) in men and 50 mg/dL (1.29 mmol/L) in women; blood pressure of at least 130/85 mmHg; or glucose level of at least 110 mg/dL (6.1 mmol/L). |
While genetics is considered the foundation of the disorder, the occurrence of the metabolic syndrome varies with age, sex, ethnicity and body mass index (calculated as weight in kilograms divided by the square of height in meters). That said, there are studies to show that the metabolic syndrome does increase with advancing age in men and women. A cause for additional concern is the epidemic rate at which obesity has increased in the United Stated, especially since obesity is a major component of the metabolic syndrome. Data collected by the National Center for Health Statistics indicates that the prevalence of obesity, defined as a body mass index greater than 30 kg/m2, has increased from 14.4 percent in 1976-1980 to 30.5 percent in 1999-2000. "If you are obese at a younger age, depending on how obese you are, you may lose anywhere from 5 to 8 years, or even up to 13 years of life expectancy if you're morbidly obese," explained Dr. Faillace. "This is particularly worrisome since over the past 10 years, many states are exhibiting a higher prevalence of obesity." Weight issues, however, aren't the only threatening effect of the metabolic syndrome. Synergistic effects of the ailments various components have been recently published in the JAMA, detailing strong evidence to suggest that people with the metabolic syndrome are at an increased risk for the development of type II diabetes and cardiovascular disease (CVD). Approximately 16 million Americans are currently living with type II diabetes and another 62 million have one or more forms of CVD. "As a prelude to type II diabetes and cardiovascular disease, the metabolic syndrome has emerged as a medical condition warranting the attention of America's physicians, especially since over a five year period of time, roughly one-third of people with the metabolic syndrome will develop diabetes." While there currently exists no consensus document regarding treatment of the metabolic syndrome, data is available suggesting that lifestyle modifications such as weight loss, diet and physical activity are effective treatment strategies. "There are several studies that show the way to treat metabolic syndrome is with lifestyle changes," said Dr. Faillace. "Simply reducing body weight by 10 to 15 pounds, exercising 30 minutes a day and eating a diet advocated by the American Heart Association, one rich in fruits, vegetables, whole grains and cold water fish-salmon, tuna, bluefish, herring and mackerel- people with metabolic syndrome can decrease their risk of developing diabetes by nearly 50 percent over 5 years. This is much more powerful than any other medications we have." Unfortunately, as has long been the case, many physicians are faced with the frustrations of getting patients to change diet and physical activity behaviors. In recognition of this problem, many health care organizations have established programs that assist physicians in assuring quality patient care. Such programs include diet and nutrition, smoking cessation and weight management. |
| Metabolic Syndrome is a Cluster of at Least Three of the Following: Abdominal Fat: Waist measurement of more than 40 inches for men, or 35 inches for women High Blood Sugar: 110 mg/dL or greater after fasting High Triglycerides: 150 mg/dL or more in the bloodstream Low HDL:<40 mg/dL in men, <50 mg/dL in women Blood Pressure:130/85 or higher |
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