Lecture 8.2: Metabolic Syndrome

Question 1

Syndrome Definition

Answer 1

A group or recognisable pattern of symptoms or abnormalities that indicate a particular trait or disease

Question 2

What is Metabolic Syndrome (WHO)?

Answer 2

Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes

These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels

Question 3

Which traits (at least 3) must you have to be recognised as having Metabolic Syndrome?

Answer 3

Large waist: women (35 inches) & men (40 inches)
High triglyceride level
Reduced “good” or HDL cholesterol
Increased blood pressure: 130/85 millimeters of mercury (mm Hg) or higher
Elevated fasting blood sugar: 5.6 mmol/L or higher

Question 4

Glucose Intolerance

Answer 4

• Insulin resistance
• Fasting plasma glucose (>7.8mmol/l)
• Dyslipidemia (TG (>1.7 mmol/l); HDL-cholesterol <1.0 mmol/l)
• Hypertension (>140/90 mmHg)
• Abdominal obesity (BMI>30 kg/m2, waist-hip ratio >0.85)

Question 5

Leptin in treating Obesity

Answer 5

Patients with loss of function leptin gene mutations respond well to leptin injections

But, there is little effect if administered to “common obesity” patients (“leptin resistance”)

Question 6

Genome Wide Association Studies (GWAS) Mapping

Answer 6

Predisposing individuals to obesity in society

So far only MC4 is a more prevalent marker

Question 7

Why are Growth Charts important?

Answer 7

• Measure of health and wellbeing
• Body weight, length, height and head circumference
• Charts describe how big/ heavy healthy children are expected to be
• If they are not in the categories, it could help diagnose disease

Question 8

Determinants of Birth Weight Categories (4)

Answer 8

Environmental
Genetic
Health
Placental

Question 9

Determinants of Birth Weight: Environmental

Answer 9

• Nutrition/caloric intake
• Alcohol, tobacco, drugs
• Foetal hypoxia

Question 10

Determinants of Birth Weight: Genetic

Answer 10

• Maternal pre pregnancy weight
• Maternal birth weight
• Maternal weight gain between pregnancies

Question 11

Determinants of Birth Weight: Health

Answer 11

• Intrauterine infections
• Anaemia
• Gestational diabetes

Question 12

Determinants of Birth Weight: Placental

Answer 12

• Impaired transport

Question 13

Children born during famine

Answer 13

Foetal programming involves insulin and leptin resistance to optimise offspring’s’ survival in harsh environment

Evolutionary favourable mechanism BUT if offspring lives a “life of plenty”, the metabolic adaptations result in obesity, diabetes and metabolic syndrome

Question 14

How environmental factors cause epigenetic changes in early life

Answer 14

Maternal nutrition can alter the foetal epigenetic status

DNA methylation and histone modification dependant on dietary methyl donors methionine and choline eg folic acid, vitamin B12

Question 15

What is Developmental Origins of Adult Health and Disease (DOHaD)?

Answer 15

An approach to medical research emphasising the role of prenatal and perinatal exposure to environmental factors such as undernutrition, in determining the development of human diseases in adulthood

Question 16

Clinical implications of DoHaD Hypothesis

Answer 16

Highlights the importance of antenatal care in terms of adequate and appropriate nutrition

Potentially provides a better understanding of the origins of some adult diseases

Potential socioeconomic issues

Clinical Biomarkers