Metabolic Syndrome Flashcards
Metabolic syndrome impact on DM type 2 and cvd dx
5-fold increase in the risk of type 2 diabetes mellitus
2-fold increase the risk of developing cardiovascular disease (CVD)
What is metabolic syndrome
interconnected physiolo biochemical, clinical, and metabolic factors that directly increase risk of atherosclerotic cardiovascular disease (ASCVD), T2DM, an cause mortality.
Presents with Unhealthy body measurements and abnormal laboratory test
Type of abnormal test and measurement found in metabolic syndrome
atherogenic dyslipidemia
hypertension
Impaired glucos intolerance
proinflammatory state
prothrombotic state
Factor to diagnose metabolic syndrome according to the the international diabetes federation
Central Obesity (Waist circumference or more than 30 BMI)
+
Any two of the following:
1. Raised triglycerides: > 150 mg/dL
2. Reduced HDL Cholesterol: < 40 mg/dL in males, < 50 mg/dL in females.
3. Raised Blood Pressure: Systolic BP > 130 or diastolic BP > 85 mm Hg
4. Raised fasting plasma glucose: FBG > 100 mg/dL
Proportion of world population with metabolic syndrome
1/4
Risk factors of metabolic syndrome
High socioeconomic status
Seeentary lifestyle
High BMI
Genetic
Diet
Physical inactivity
Smoking
Family hx of diabetes
Education
Low grade inflammation due to factors like
- • Insulin resistance
visceral adiposity
atherogenic dyslipidemia
endothelial dysfunction
genetic susceptibility
elevated blood pressure
hypercoagulable state
chronic stress
If physiology of abdominal obesity or metabolic syndrome
Nutrient excess,-> had adipocytes, hypertrophy and hyperplasia-> blood supply reduced to adipocytes-> hypoxia -> necrosis and macrophage infiltration into adipose tissue-> adipocytokines -> localized inflammation, which becomes systemic
Pathophysiology of ffa in met s
High Splanchic FFA levels -> liver fat accumulation -> Acute exposure of skeletal muscle to high FFA -> insulin resistance by inhibiting the insulin-mediated glucose uptake.
Chronic exposure of pancreas to high FFA -> impairs pancreatic
B-cell function.
FFAs increase fibrinogen and PAI-1 production.
TNF alpha action in met s
induces adipocytes apoptosis and promotes insulin resistance by inhibition of insulin receptor substrate 1 (IRS-1) signalling pathway.
Which inflammatory Marker is high in patient with obesity and insulin resistance
CRP
Which is a marker of fibrinolysis and atherothrombosis by inhibiting the tissue plasminogen activator
PAI1
Action of leptin in obesity
adipokinin involved in the regulation of satiety and energy intake which increases during the development of obesity and decreases during weight loss.
Also increase the blood pressure through activation of sympathetic nervous system.
Main pathology behind syndrome x
Insulin resistance
Factors influencing insulin resistance
Diet - high fat low fiber
Advanced glycated end product
