Metabolic Syndrome: An Overview of Information

Metabolic syndrome - a group of diseases and pathological conditions, which are based on insulin resistance.

The following synonyms of the metabolic syndrome are used in the literature: insulin resistance syndrome, multiple metabolic syndrome syndrome, plurimetabolic syndrome, hormonal metabolic syndrome, X syndrome, lethal quartet, abundance syndrome.

[1], [2], [3], [4]

Epidemiology of Metabolic Syndrome

In industrialized countries, 15-30% of the adult population has a metabolic syndrome. Among those of middle age there are many who are at risk. The risk group for the metabolic syndrome is middle-aged people with visceral obesity, borderline arterial hypertension and lipid triad (moderate hypercholesterolemia, hypertriglyceridemia and a lower level of HDL-C in the blood serum). In this population, premature atherosclerotic changes in the intima of the vessels are detected with a high frequency.

[5], [6], [7], [8], [9], [10], [11], [12], [13], [14]

Causes of Metabolic Syndrome

The main cause of the development of metabolic syndrome is congenital or acquired insunoresistance, i.e. Insensitivity of peripheral tissues (liver, muscles, adipose tissue, etc.) to insulin. The genetic predisposition to insulin resistance is associated with the mutation of many genes. At the same time, a hypothesis is advanced according to which insulin resistance is not the cause of the development of the metabolic syndrome, but also its one component. This conclusion came from the study of the prevalence of metabolic syndrome components in different ethnic groups (blacks, white Americans and Americans of Mexican descent). The analysis of the data obtained suggested the presence of a different genetic factor in the etiology of the metabolic syndrome. This hypothetical factor was called factor Z. It interacts with insulin with sensitive tissues, endothelium, regulating system of arterial pressure, lipid and lipoprotein exchange, and causes respectively the development of insulin resistance, atherosclerosis, arterial hypertension, dyslipidemia. Hyperinsulinemia in metabolic syndrome is considered as a compensatory state of the body against the background of insulin resistance.

Causes and pathogenesis of metabolic syndrome

[15], [16], [17]

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 the clinical components. Symptoms of metabolic syndrome include:

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

Symptoms of Metabolic Syndrome

[18], [19]

Classification of metabolic syndrome

There is a complete and incomplete metabolic syndrome. If the patient has two or three of the following disorders, they talk about an incomplete metabolic syndrome, while four or more components of the metabolic syndrome can diagnose a complete (complete) metabolic syndrome.

Components of the metabolic syndrome:

• visceral (abdominal) obesity;
• violation of glucose tolerance / type 2 diabetes mellitus;
• arterial hypertension;
• dyslipidemia;
• hypercoagulable syndrome;
• hyperuricemia and gout;
• fatty hepatosis;
• premature atherosclerosis / ischemic heart disease;
• microalbuminuria;
• apnea in a dream.

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

[20], [21], [22]

Diagnosis of Metabolic Syndrome

Diagnosis of the metabolic syndrome is based on the presence of clinical components of the metabolic syndrome.

The main external manifestation of insulin resistance is abdominal obesity. This type of adipose tissue is easily determined by calculating the ratio of the circumference of the waist to the hip circumference (OT / OB). The index, exceeding 1.0 in men and women, indicates an abdominal type of obesity. BMI reflects the degree of obesity and is calculated by the following formula:

BMI = weight (kg) / height (m2)

A BMI greater than 25 kg / m2 indicates an excess body weight.

Diagnosis of Metabolic Syndrome

[23], [24]

Treatment of metabolic syndrome

There is no generally accepted algorithm for the treatment of metabolic syndrome. The main goal of the treatment is the normalization of metabolic disorders. The recommended algorithm of treatment requires, first of all, weight reduction of 10-15% of the initial, which is an affective agent in the fight against 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 daily calorie intake. It is necessary to exclude digestible carbohydrates, to increase the intake of foods containing hard-to-digest carbohydrates (starch) and non-digestible carbohydrates (dietary fibers).

Treatment of metabolic syndrome

Forecast

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

If the correct way of life is not observed (rational nutrition, exercise complex) and drug treatment, there is a high risk of developing myocardial infarction, stroke, type 2 diabetes and diabetic complications, musculoskeletal disorders, pulmonary heart failure, sleep apnea.

[25], [26], [27], [28], [29],