The metabolic syndrome (MetS), first introduced by Haller in 1975, was sometimes also known as insulin resistance syndrome, syndrome X, and plurimetabolic syndrome. In 1989, it was rechristened by Kaplan as the “Deadly Quartet” based on a consolidation of central obesity, impaired glucose tolerance, dyslipidemia, and systemic hypertension. MetS is positively associated with a pro-inflammatory and pro-thrombotic state, attributed to increased pro-thrombotic and inflammatory marker activity. Moreover, MetS is frequently associated with increased atherosclerotic cardiovascular disease, impaired glucose tolerance, hyperuricemia, obstructive sleep apnea, and chronic kidney disease. Despite concerted endeavors worldwide, the complexity of the pathophysiology of metabolic syndrome still needs to be clearly understood. Currently, therapeutic possibilities are confined to individual therapy for hyperglycemia, hypertension, hypertriglyceridemia, hyperuricemia, regular physical exercise, and a restricted diet. In this review, progress regarding the understanding and pathophysiology of MetS; recent emerging technologies, such as metabolomics and proteomics; the relation of MetS with obesity, diabetes, and cardiovascular diseases; and the association of MetS with COVID-19 are discussed.
Background: Urbanization, surplus energy uptake, decreased physical activities are general risk factors of metabolic syndrome However, it’s status, and associated components remain unexplored in the Terai region of Nepal. This study evaluated the prevalence of metabolic syndrome and its components among adults with central obesity of Terai region of Nepal using International Diabetes Federation criteria.Methods: Community based cross-sectional study was conducted in three Terai districts of Janakpur Zone, Nepal. A total of 378 adults having central obesity were selected using cluster sampling by camp approach. Interview, physical and clinical examination, measurement of fasting blood sugar, and lipid profile were conducted for all participants. The prevalence of metabolic syndrome and its components with 95% CI were estimated.Results: The metabolic syndrome prevalence was 74.9% (95% CI:70.2-79.2%), with no significant differences between male (77.7%, 95% CI:71.0-83.5%) and female (72.2%, 95% CI: 65.2-78.3%). The most common factors observed were low high density lipoproteins with highly significant differences between male (77.7%, 95% CI:71.0-83.5%)) and female (90.2%, 95% CI: 85.094.0%-; p=0.001) and hypertriglyceridemia with significant differences between male (57.6%, 95% CI: 50.1-64.5%) and female (46.9%, 95% CI: 39.7-54.2%; p=0.037). Conclusions: Higher prevalence of metabolic syndrome and its risk factors in Janakpur of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate an urgency for a public health program to maintain quality of life. Keywords: Metabolic syndrome; Nepal; prevalence; risk factors; terai
Non-communicable chronic diseases (NCD) are contributing 46% to the global diseases burden and account for 59% of annual death. Tobacco and alcohol consumptions are reported as major factors associated with growing burden of NCDs and account for 11.5% of global death with around 80% of these deaths are reported in low middle-income countries.Nepal, a low middle-income county, is also facing an increasing prevalence (31%) of NCDs with a significant prevalence of smoking (37.1%) and alcohol consumption (15%-57%). To explore the physiological and biochemical parameters of smoker and alcohol consuming subjects of Terai region of Nepal. We conducted a community based cross-sectional study during August to November 2019, 282 adult participants were selected from Terai region of Janakpur Zone, Nepal, After obtaining written consent and clinical examination, fasting venous blood was collected from study subjects and examined for triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol and fasting blood sugar.We observed significantly increased triglycerides (p<0.05), and waist circumference (p<0.05) in current smoking and alcohol consuming subjects, however diastolic blood pressure was found to be significantly higher among alcohol consuming subjects only (p=0.05). We did not observe any significant correlation between fasting blood sugar, total-cholesterol and LDL-cholesterol among smoking or alcohol consuming subjects.Significantly increased triglycerides, waist circumference and diastolic blood pressure in smoking and alcohol consuming subjects likely suggest lack of public awareness and heath promotion activities in Teari region of Nepal and indicate an urgent public health awareness programs in this region to maintain quality of life.
The metabolic syndrome, first introduced by Hermann Haller in 1975, was sometimes also known as insulin resistance syndrome, syndrome X, and plurimetabolic syndrome. In 1989 it was rechristened by Kaplan as "Deadly Quartet" based on a consolidation of central obesity, impaired glucose tolerance, dyslipidemia, and systemic hypertension. Metabolic syndrome is positively associated with a pro-inflammatory and pro-thrombotic state, attributed to increased pro-thrombotic and inflammatory markers activity. Moreover, Metabolic syndrome is frequently associated with increased atherosclerotic cardiovascular disease, impaired glucose tolerance, hyperuricemia, obstructive sleep apnea, and chronic kidney disease. Despite concerted endeavors worldwide, the complexity of the pathophysiology of metabolic syndrome is still not clearly understood. Currently, therapeutic possibilities are confined to individual therapy of hyperglycemia, hypertension, hypertriglyceridemia, hyperuricemia, regular physical exercise, and a restricted diet.
Introduction: The Metabolic Syndrome (MS) is a multifactorial disease associated with central obesity, hypertension, atherogenic dyslipidemia and impaired glucose tolerance. Low grade inflammatory and a prothrombotic state are also involved in MS. Aim: To explore the demographic and biochemical parameters of participants with MS in Terai region of Nepal using community based cross-sectional study. Materials and Methods: A cross-sectional study was carried out during September 2019-December 2019 in adult participants with central obesity (n=378) selected from three districts of Terai region of Nepal. International Diabetes Federation (IDF) criteria were used to define MS. The C-reactive protein-ultra sensitive, fibrinogen, and apolipoprotein-B were estimated as inflammatory, prothrombotic, and atherogenic dyslipidemia markers, respectively. Results: The MS was present in 283 participants with central obesity. The mean (±SD) age, height, weight, and BMI of the participants with MS were 46.36±12.52 years, 5.56±0.11 feet, 66.54±13.45 kg and 27.28±4.98 kg/m2, respectively. The mean (±SD) of biochemical factors were significantly different than their respective normal ranges: decreased serum High Density Lipoprotein (HDL) cholesterol in mg/dL (male: 34.50±9.93, p<0.001, female: 36.77±7.28, p<0.001), raised serum triglycerides level- 184.96±85.72 mg/dL (p<0.001), and impaired fasting serum glucose level 108.14±48.27 mg/dL (p=0.002). Significant increase in inflammatory (CRP-US: 1.12±2.17 mg/L, p<0.001), prothrombotic (fibrinogen: 3.42±1.04 gm/L, p<0.001) and atherogenic dyslipidemia marker (Apo-B: 149.35±59.13 mg/dL, p=0.003) from normal values were observed in subjects with MS. Conclusion: Lowered serum HDL cholesterol, increased triglycerides followed with impaired fasting glucose tolerance were observed as the major abnormal biochemical parameters and increased inflammatory and prothrombotic activities were present among participants with MS.
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