Metabolic Syndrome

Question 1

Criteria for diagnosis of metabolic syndrome

Answer 1

Meet 3 of 5 criteria of following
- Elevated waist circumference
- Triglyceride > 1.7mmol/L
- HDL< 1.0mmol/L men or <1.3 in women
- SBP > 130 or DBP > 85
- fasting BSL > 5.5

Waist circumference thresholds vary by gender and race
- Caucasian - Men > 102, Women > 88
- Asian Men > 90, Women > 80.

Question 2

MAFLD Overview

Answer 2

Consequence of increased fat deposition in liver caused by metabolic dysregulation.
- Can progress to liver fibrosis in 10-20% of patients.
- Increased risk of extrahepatic complications such as CVD, T2DM, Cancer.
- Up to 40% of cases have normal BMI!

Question 3

General measures to control Metabolic Syndrome

Answer 3

• Recommend abstaining from alcohol
• Aim 30 mins moderate intensity exercise 5 days a week
• BMI 18-25
• Referral to dietitian for weight loss.
• Referral to psychologist to assist with behavioural changes towards weight loss.

Regular Liver Fibroscan to review for fibrosis
- Recommend UTD Hep A and B Immunisation.

• Consider statin therapy if LDL is increased
• Evidence of liver cirrhosis? Will need Alpha-feto protein and liver ultrasound every 6 months to screen for hepatocellular carcinoma.