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PT663 > Metabolic Syndrome > Flashcards

Metabolic Syndrome Flashcards

1
Q

What is metabolic syndrome?

A

Metabolic syndrome is a cluster of risk factors contributing to higher incidence of diabetes, cardiovascular events, and mortality.

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2
Q

Who coined the term “metabolic syndrome” and when?

A

The term “metabolic syndrome” or “syndrome X” was first coined by Gerald Reaven in 1988.

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3
Q

How does a syndrome differ from a disease?

A

A syndrome is an aggregate of symptoms and signs associated with an underlying morbid process, producing the picture of a disease.

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4
Q

What are the core components of metabolic syndrome?

A

The core components include obesity, hypoglycemia, dyslipidemia, and hypertension.

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5
Q

What criteria did the WHO establish for diagnosing metabolic syndrome?

A

The WHO established criteria based on insulin resistance in the 1990s.

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6
Q

What does the ATPIII recommend for diagnosing metabolic syndrome?

A

ATPIII recommends that three out of five specific factors must be present for a diagnosis of metabolic syndrome.

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7
Q

What are the diagnostic criteria components for metabolic syndrome?

A

1) Elevated waist circumference
2) Elevated triglycerides
3) Low HDL cholesterol
4) Elevated blood pressure
5) Elevated fasting glucose levels

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8
Q

How is waist circumference measured for metabolic syndrome diagnosis?

A

It is measured using a tape around the abdomen at the level of the iliac crest, during expiration.

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9
Q

Why is a single waist circumference definition problematic?

A

Different races and ethnic groups have varying susceptibility to metabolic syndrome, making a universal cutoff ineffective.

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10
Q

What is the relationship between triglycerides and cardiovascular risk?

A

Elevated plasma triglycerides are positively and independently associated with cardiovascular risk factors.

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11
Q

What role does HDL cholesterol play in cardiovascular health?

A

HDL (good cholesterol) helps transport lipids back to the liver for disposal; low levels are a negative marker for cardiovascular health.

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12
Q

What additional factors enhance risk for coronary heart disease and type 2 diabetes?

A

Chronic proinflammatory states, hormonal dysregulation, excess liver fat, and abnormal fat distribution.

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13
Q

How can hormonal factors affect metabolic syndrome?

A

Hormonal dysregulation, particularly in the corticosteroid axis, can be strongly associated with metabolic syndrome.

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14
Q

What is a chronic proinflammatory state in the context of metabolic syndrome?

A

It is indicated by elevated inflammatory cytokines and can enhance the risk for various conditions associated with metabolic syndrome.

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15
Q

Why is understanding metabolic syndrome important for public health?

A

It helps in the diagnosis, treatment, prognosis, and understanding the prevalence of non-communicable diseases.

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16
Q

What study analyzed the prevalence of metabolic syndrome from 1988 to 2012?

A

The study by Moore et al., which utilized data from the National Health and Nutrition Examination Survey.

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17
Q

How is metabolic syndrome defined?

A

A diagnosis requires the presence of three out of five components: elevated waist circumference, elevated triglycerides, low HDL, high blood pressure, and elevated fasting glucose.

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18
Q

What was the prevalence of metabolic syndrome in the 1988-1994 time period?

A

Approximately 25%.

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19
Q

What is the recent prevalence of metabolic syndrome (2007-2012)?

A

Around 35%.

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20
Q

Which racial group had a higher prevalence of metabolic syndrome among men?

A

Non-Hispanic white men compared to non-Hispanic black men.

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21
Q

How does the prevalence of metabolic syndrome vary by age group?

A

It increases from about 10% in 18-29 year-olds to close to 60-70% in adults over 70.

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22
Q

What is the global concern regarding obesity and metabolic syndrome?

A

Obesity is increasing in prevalence worldwide, particularly in countries with low socioeconomic status.

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23
Q

How many adults and children are estimated to be obese globally?

A

Approximately 600 million adults and 100 million children.

24
Q

How many individuals worldwide have diabetes, according to recent estimates?

A

About 400 million individuals.

25
Q

What is the estimated number of people with metabolic syndrome globally?

A

At least 1 billion people.

26
Q

How does metabolic syndrome affect children?

A

There is an increasing prevalence of childhood obesity, leading to an increased risk of metabolic syndrome and associated health problems in adulthood.

27
Q

What did the Morrison et al. study reveal about childhood metabolic syndrome?

A

About 70% of children with metabolic syndrome go on to develop metabolic syndrome as adults.

28
Q

What is the risk factor associated with pediatric metabolic syndrome?

A

Having a parental history of diabetes significantly increases the risk of developing adult metabolic syndrome.

29
Q

What is the increased likelihood of developing adult metabolic syndrome for individuals with pediatric metabolic syndrome?

A

They are 10 times more likely to develop adult metabolic syndrome.

30
Q

Why is metabolic syndrome a public health concern?

A

It has a high prevalence in both adults and children, posing significant health risks for future generations.

31
Q

What factors primarily influence the pathophysiology of metabolic syndrome?

A

Genetic factors and environmental factors, including diet, lifestyle, and activity levels.

32
Q

What effect does an unhealthy lifestyle have on body composition related to metabolic syndrome?

A

It can lead to an increase in adipose tissue and visceral obesity.

33
Q

What are some circulating pro-inflammatory cytokines associated with metabolic syndrome?

A

Interleukin 6 and TNF alpha.

34
Q

How does stress contribute to metabolic syndrome?

A

Stress can increase appetite, lead to visceral obesity, raise cortisol levels, and dysregulate the renin-angiotensin system.

35
Q

What is insulin resistance?

A

A condition where peripheral tissues (like muscles and fat) are unable to utilize insulin effectively, leading to elevated blood glucose levels.

36
Q

What are the long-term consequences of insulin resistance?

A

It can lead to increased oxidative stress, the release of reactive oxygen species, and dysregulation of protein synthesis at the cellular level.

37
Q

What diseases can result from the cluster of factors associated with metabolic syndrome?

A

Dyslipidemia, type 2 diabetes, and hypertension.

38
Q

What is the connection between metabolic syndrome and cardiovascular disease?

A

The cluster of conditions associated with metabolic syndrome significantly increases the risk for cardiovascular diseases.

39
Q

What are common risk factors for metabolic syndrome?

A

High BMI, central obesity, poor eating habits, smoking, and decreased activity levels.

40
Q

Why is early identification important in the management of metabolic syndrome?

A

Many risk factors are preventable and manageable with early intervention, reducing the risk of developing serious health issues.

41
Q

What is the overall conclusion regarding the pathophysiology of metabolic syndrome?

A

It is a complex process with multiple underlying mechanisms contributing to its development, highlighting the need for early identification and management.

42
Q

What is the primary emphasis in managing metabolic syndrome?

A

To mitigate modifiable underlying risk factors related to obesity, lack of physical activity, and necessary dietary changes through aggressive lifestyle changes.

43
Q

What is the effect of effective lifestyle changes on metabolic risk factors?

A

They reduce overall metabolic risk factors and may lead to the consideration of drug therapy if risks are high enough.

44
Q

What is the general philosophy regarding exercise for individuals with metabolic syndrome?

A

Some exercise is good; more is better, with no ceiling effect—individuals should be encouraged to stay active as frequently as possible.

45
Q

How should advice on physical activity be tailored to patients?

A

It should be done with sensitivity and a patient-centered approach, incorporating examples that fit the patient’s life circumstances and motivations.

46
Q

What is the initial weight loss goal for individuals with metabolic syndrome?

A

A weight loss of 7% to 10% is associated with significant health benefits.

47
Q

What is the recommended dose of exercise for individuals with type 2 diabetes?

A

150 minutes of moderate to high-intensity activity per week, with no more than two consecutive days off.

48
Q

What types of exercise should be included for high-functioning individuals with type 2 diabetes?

A

Aerobic exercise, interval training, strength training (at 50% to 75% of one-rep max), and balance/flexibility exercises.

49
Q

What exercise modifications are recommended for lower-functioning individuals with type 2 diabetes?

A

Non-weight-bearing exercises (e.g., stationary bicycling) and seated or lying down strength training.

50
Q

What are the goals for managing dyslipidemia in metabolic syndrome?

A

Decrease LDL and triglycerides and increase HDL levels.

51
Q

How much exercise is recommended for individuals with dyslipidemia?

A

At least 30 minutes of moderate to high-intensity exercise five times a week.

52
Q

What is the target blood pressure reduction goal with exercise for individuals with hypertension?

A

Aerobic exercise can decrease systolic blood pressure by about 5 to 7 mmHg, while resistance exercise can lower it by 2 to 7 mmHg.

53
Q

What is the long-term commitment required for effective management of metabolic syndrome?

A

Patients need to commit to aerobic and strength training exercises as a part of their lifestyle, not just for a short period.

54
Q

What systemic effects does regular exercise have on metabolic syndrome?

A

It reduces chronic low-grade systemic inflammation, increases adiponectin levels, improves glucose uptake, and enhances vasculature function.

55
Q

How does exercise specifically help reduce hypertension?

A

By improving vascular structure and function, enhancing baroreceptor sensitivity, decreasing norepinephrine levels, and increasing insulin sensitivity.

56
Q

What is the role of lifestyle changes in the management of metabolic syndrome?

A

Lifestyle changes, alongside exercise, are crucial for effective management and can be supported by resources from national organizations focusing on prevention.

57
Q

What is the key takeaway regarding exercise and lifestyle changes in metabolic syndrome management?

A

They play a significant role in managing the complex disease process of metabolic syndrome.

PT663 (22 decks)

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