Metabolic Syndrome - Information Overview

Metabolic syndrome is a group of diseases and pathological conditions based on insulin resistance.

The following synonyms for metabolic syndrome are used in the literature: insulin resistance syndrome, multiple metabolic disorders syndrome, plurimetabolic syndrome, hormonal metabolic syndrome, syndrome X, deadly quartet, affluence syndrome.

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Epidemiology of metabolic syndrome

In industrialized countries, 15-30% of the adult population has metabolic syndrome. Among middle-aged people, there are many who constitute a risk group. The risk group for metabolic syndrome includes middle-aged people with visceral obesity, borderline arterial hypertension and lipid triad (moderate hypercholesterolemia, hypertriglyceridemia and low levels of HDL-C in the blood serum). In this population, premature atherosclerotic changes in the vascular intima are determined with high frequency.

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Causes of Metabolic Syndrome

The main cause of metabolic syndrome is congenital or acquired insulin resistance, i.e. insensitivity of peripheral tissues (liver, muscles, adipose tissue, etc.) to insulin. Genetic predisposition to insulin resistance is associated with mutations in many genes. At the same time, a hypothesis is put forward that insulin resistance is not the cause of metabolic syndrome, but another component of it. This conclusion was made based on a study of the prevalence of metabolic syndrome components in different ethnic groups (blacks, whites in the United States, and Mexican Americans). Analysis of the data obtained allowed us to assume the presence of another genetic factor in the etiology of metabolic syndrome. This hypothetical factor was called factor Z. It interacts with insulin-sensitive tissues, endothelium, the regulatory system of arterial pressure, lipid and lipoprotein metabolism, and causes, accordingly, the development of insulin resistance, atherosclerosis, arterial hypertension, and dyslipidemia. Hyperinsulinemia in metabolic syndrome is considered a compensatory state of the body against the background of insulin resistance.

Causes and pathogenesis of metabolic syndrome

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Clinical signs and symptoms of metabolic syndrome

Metabolic syndrome is a polysymptomatic condition, and the patient's complaints depend on the presence and severity of clinical components. Symptoms of metabolic syndrome include:

• periodic headaches (due to arterial hypertension);
• weakness and fatigue;
• shortness of breath with little physical exertion, and in moderate forms - even at rest;
• appoe in a dream,
• chest pain (due to coronary heart disease);
• itching of the skin, maceration of the skin in the groin and armpit areas;
• increased appetite (due to hyperinsulinemia);
• excess body weight with predominant abdominal deposition of adipose tissue;
• dry mouth, thirst, polyuria (due to type 2 diabetes).

Symptoms of Metabolic Syndrome

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Classification of metabolic syndrome

A distinction is made between complete and incomplete metabolic syndrome. If a patient has two or three of the following disorders, then they speak of incomplete metabolic syndrome, while four or more components of metabolic syndrome allow diagnosing complete (complex) metabolic syndrome.

Components of metabolic syndrome:

• visceral (abdominal) obesity;
• impaired glucose tolerance / type 2 diabetes mellitus;
• arterial hypertension;
• dyslipidemia;
• hypercoagulability syndrome;
• hyperuricemia and gout;
• fatty hepatosis;
• premature atherosclerosis/ischemic heart disease;
• microalbuminuria;
• sleep apnea.

The widely used term "Syndrome X" proposed by Riven includes insulin resistance/hyperinsulinemia, the presence of impaired glucose tolerance/type 2 diabetes mellitus, dyslipidemia, and hypertension. It is now clear that Syndrome X is only a subset of the metabolic syndrome.

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Diagnosis of metabolic syndrome

The diagnosis of metabolic syndrome is based on the presence of clinical components of metabolic syndrome.

The main external manifestation of insulin resistance is abdominal obesity. This type of fat deposition is easily determined by calculating the waist to hip ratio (WHR). An indicator exceeding 1.0 in both men and women indicates abdominal obesity. BMI reflects the degree of obesity and is calculated using the following formula:

BMI = weight (kg) / height (m2)

A BMI of more than 25 kg/m2 indicates overweight.

Diagnosis of metabolic syndrome

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Treatment of metabolic syndrome

There is no generally accepted algorithm for treating metabolic syndrome. The main goal of treatment is to normalize metabolic disorders. The recommended treatment algorithm requires, first of all, a weight loss of 10-15% of the initial weight, which is an effective means of combating insulin resistance.

To achieve the goal, it is necessary to follow a low-calorie rational diet and perform a set of physical exercises. The proportion of fats should not exceed 25-30% of the daily calorie intake. It is necessary to exclude easily digestible carbohydrates, increase the consumption of products containing hard-to-digest carbohydrates (starch) and indigestible carbohydrates (dietary fiber).

Treatment of metabolic syndrome

Forecast

With a comprehensive approach to the treatment of metabolic syndrome (taking into account lifestyle changes), the prognosis is favorable.

If a healthy lifestyle (rational nutrition, physical exercise) and drug treatment are not followed, there remains a high risk of developing myocardial infarction, stroke, type 2 diabetes and diabetic complications, musculoskeletal disorders, pulmonary heart failure, and sleep apnea.

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