The Metabolic Syndrome

Abstract

The "metabolic syndrome" (MetS) is a clustering of components that reflect overnutrition, sedentary lifestyles, and resultant excess adiposity. The MetS includes the clustering of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure and is associated with other comorbidities including the prothrombotic state, proinflammatory state, nonalcoholic fatty liver disease, and reproductive disorders. Because the MetS is a cluster of different conditions, and not a single disease, the development of multiple concurrent definitions has resulted. The prevalence of the MetS is increasing to epidemic proportions not only in the United States and the remainder of the urbanized world but also in developing nations. Most studies show that the MetS is associated with an approximate doubling of cardiovascular disease risk and a 5-fold increased risk for incident type 2 diabetes mellitus. Although it is unclear whether there is a unifying pathophysiological mechanism resulting in the MetS, abdominal adiposity and insulin resistance appear to be central to the MetS and its individual components. Lifestyle modification and weight loss should, therefore, be at the core of treating or preventing the MetS and its components. In addition, there is a general consensus that other cardiac risk factors should be aggressively managed in individuals with the MetS. Finally, in 2008 the MetS is an evolving concept that continues to be data driven and evidence based with revisions forthcoming.

Angiotensin II type 1 receptor-independent beneficial effects of telmisartan on dietary-induced obesity, insulin resistance and fatty liver in mice

“…Common components of the metabolic syndrome include abdominal obesity, insulin resistance, hypertension and dyslipidaemia. Additional comorbidities may also be present, such as hepatic steatosis leading to non-alcoholic fatty liver disease, proinflammatory and prothrombotic states, and reproductive disorders [1]. Insulin resistance is the key component of the metabolic syndrome.…”

Childhood underweight, weight gain during childhood to adolescence/young adulthood and incidence of adult metabolic syndrome in the SUN (Seguimiento Universidad de Navarra) Project

“…Nevertheless, MetS can be considered a prestage of diabetes (1) . In that French study, body silhouettes at 8 years, at menarche and in young adulthood (20 to 25 years) were inversely associated with the risk of diabetes, independently of adult BMI during follow-up.…”

“…yP from Pearson's x and insulin resistance. Moreover, the NEFA overflow to the liver stimulating glyconeogenesis, TAG production, VLDL cholesterol secretion and decreases insulin hepatic clearance (1,8) .…”

“…These alterations cause an increased HDL-C renal clearance, diminishing its levels in plasma (1,8) .…”

“…Metabolic syndrome (MetS) is characterized by the clustering of cardiovascular risk factors such as obesity, dyslipidaemia, insulin resistance, hyperinsulinaemia, glucose intolerance and hypertension (1) . This syndrome is recognized as an important public health concern worldwide, owing to its prevalence of over 20 % in adult populations around the world (1)(2)(3)(4) and also to its strong association with CVD and type 2 diabetes, both main causes of death on a global scale (1,5,6) .…”