Metabolic Syndrome

Question 1

Diagnostic Criteria for Metabolic Syndrome

Answer 1

Three of:
Elevated Waist Size (>40 men, >35 women)
Elevated Triglycerides (>150)
Reduced HDL (<40)
Elevated BP (>130 systolic or >85 diastolic)
Elevated fasting glucose (100 or more or being treated for that)

Question 2

New Characteristics of Metabolic Syndrome

Answer 2

elevated C-Reactive protein (CRP) levels, increased plasminogen activator inhibitor 1 (PAI-1), and microalbuminemia

Question 3

Significant sign of Metabolic Syndrome

Answer 3

A physical sign that is suggestive of moderate to severe insulin resistance is the hyperkeratotic condition acanthosis nigricans. This is a diffuse, hyperpigmented, velvety thickening of the skin that is found in the neck and axillae.

Question 4

Metabolic Syndrome Differentials

Answer 4

Rule out isolated obesity, hyperlipidemia, pancreatitis, and PCOS

Question 5

Risks of Metabolic Syndrome

Answer 5

Higher cardiac risk
Higher risk of DM
Higher Stroke risk

Question 6

Managing Metabolic Syndrome

Answer 6

Anti-hypertensives
Statins
Weight loss
Exercise
Pre-Diabetes medication considerations

Question 7

What is important about increased PAI-1 levels in patients with metabolic syndrome?

They lower the risk of hypertension.

They predispose patients to dyslipidemia.

They increase the risk of arterial thrombosis.

They cause increased insulin resistance.

Answer 7

Increased PAI-1 levels increase the risk of thrombosis by inhibiting fibrinolysis, or the breakdown of blood clots.