Metabolic Syndrome Flashcards
What is metabolic syndrome?
Metabolic syndrome is a cluster of risk factors contributing to higher incidence of diabetes, cardiovascular events, and mortality.
Who coined the term “metabolic syndrome” and when?
The term “metabolic syndrome” or “syndrome X” was first coined by Gerald Reaven in 1988.
How does a syndrome differ from a disease?
A syndrome is an aggregate of symptoms and signs associated with an underlying morbid process, producing the picture of a disease.
What are the core components of metabolic syndrome?
The core components include obesity, hypoglycemia, dyslipidemia, and hypertension.
What criteria did the WHO establish for diagnosing metabolic syndrome?
The WHO established criteria based on insulin resistance in the 1990s.
What does the ATPIII recommend for diagnosing metabolic syndrome?
ATPIII recommends that three out of five specific factors must be present for a diagnosis of metabolic syndrome.
What are the diagnostic criteria components for metabolic syndrome?
1) Elevated waist circumference
2) Elevated triglycerides
3) Low HDL cholesterol
4) Elevated blood pressure
5) Elevated fasting glucose levels
How is waist circumference measured for metabolic syndrome diagnosis?
It is measured using a tape around the abdomen at the level of the iliac crest, during expiration.
Why is a single waist circumference definition problematic?
Different races and ethnic groups have varying susceptibility to metabolic syndrome, making a universal cutoff ineffective.
What is the relationship between triglycerides and cardiovascular risk?
Elevated plasma triglycerides are positively and independently associated with cardiovascular risk factors.
What role does HDL cholesterol play in cardiovascular health?
HDL (good cholesterol) helps transport lipids back to the liver for disposal; low levels are a negative marker for cardiovascular health.
What additional factors enhance risk for coronary heart disease and type 2 diabetes?
Chronic proinflammatory states, hormonal dysregulation, excess liver fat, and abnormal fat distribution.
How can hormonal factors affect metabolic syndrome?
Hormonal dysregulation, particularly in the corticosteroid axis, can be strongly associated with metabolic syndrome.
What is a chronic proinflammatory state in the context of metabolic syndrome?
It is indicated by elevated inflammatory cytokines and can enhance the risk for various conditions associated with metabolic syndrome.
Why is understanding metabolic syndrome important for public health?
It helps in the diagnosis, treatment, prognosis, and understanding the prevalence of non-communicable diseases.
What study analyzed the prevalence of metabolic syndrome from 1988 to 2012?
The study by Moore et al., which utilized data from the National Health and Nutrition Examination Survey.
How is metabolic syndrome defined?
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.
What was the prevalence of metabolic syndrome in the 1988-1994 time period?
Approximately 25%.
What is the recent prevalence of metabolic syndrome (2007-2012)?
Around 35%.
Which racial group had a higher prevalence of metabolic syndrome among men?
Non-Hispanic white men compared to non-Hispanic black men.
How does the prevalence of metabolic syndrome vary by age group?
It increases from about 10% in 18-29 year-olds to close to 60-70% in adults over 70.
What is the global concern regarding obesity and metabolic syndrome?
Obesity is increasing in prevalence worldwide, particularly in countries with low socioeconomic status.
How many adults and children are estimated to be obese globally?
Approximately 600 million adults and 100 million children.
How many individuals worldwide have diabetes, according to recent estimates?
About 400 million individuals.
What is the estimated number of people with metabolic syndrome globally?
At least 1 billion people.
How does metabolic syndrome affect children?
There is an increasing prevalence of childhood obesity, leading to an increased risk of metabolic syndrome and associated health problems in adulthood.
What did the Morrison et al. study reveal about childhood metabolic syndrome?
About 70% of children with metabolic syndrome go on to develop metabolic syndrome as adults.
What is the risk factor associated with pediatric metabolic syndrome?
Having a parental history of diabetes significantly increases the risk of developing adult metabolic syndrome.
What is the increased likelihood of developing adult metabolic syndrome for individuals with pediatric metabolic syndrome?
They are 10 times more likely to develop adult metabolic syndrome.
Why is metabolic syndrome a public health concern?
It has a high prevalence in both adults and children, posing significant health risks for future generations.
What factors primarily influence the pathophysiology of metabolic syndrome?
Genetic factors and environmental factors, including diet, lifestyle, and activity levels.
What effect does an unhealthy lifestyle have on body composition related to metabolic syndrome?
It can lead to an increase in adipose tissue and visceral obesity.
What are some circulating pro-inflammatory cytokines associated with metabolic syndrome?
Interleukin 6 and TNF alpha.
How does stress contribute to metabolic syndrome?
Stress can increase appetite, lead to visceral obesity, raise cortisol levels, and dysregulate the renin-angiotensin system.
What is insulin resistance?
A condition where peripheral tissues (like muscles and fat) are unable to utilize insulin effectively, leading to elevated blood glucose levels.
What are the long-term consequences of insulin resistance?
It can lead to increased oxidative stress, the release of reactive oxygen species, and dysregulation of protein synthesis at the cellular level.
What diseases can result from the cluster of factors associated with metabolic syndrome?
Dyslipidemia, type 2 diabetes, and hypertension.
What is the connection between metabolic syndrome and cardiovascular disease?
The cluster of conditions associated with metabolic syndrome significantly increases the risk for cardiovascular diseases.
What are common risk factors for metabolic syndrome?
High BMI, central obesity, poor eating habits, smoking, and decreased activity levels.
Why is early identification important in the management of metabolic syndrome?
Many risk factors are preventable and manageable with early intervention, reducing the risk of developing serious health issues.
What is the overall conclusion regarding the pathophysiology of metabolic syndrome?
It is a complex process with multiple underlying mechanisms contributing to its development, highlighting the need for early identification and management.
What is the primary emphasis in managing metabolic syndrome?
To mitigate modifiable underlying risk factors related to obesity, lack of physical activity, and necessary dietary changes through aggressive lifestyle changes.
What is the effect of effective lifestyle changes on metabolic risk factors?
They reduce overall metabolic risk factors and may lead to the consideration of drug therapy if risks are high enough.
What is the general philosophy regarding exercise for individuals with metabolic syndrome?
Some exercise is good; more is better, with no ceiling effect—individuals should be encouraged to stay active as frequently as possible.
How should advice on physical activity be tailored to patients?
It should be done with sensitivity and a patient-centered approach, incorporating examples that fit the patient’s life circumstances and motivations.
What is the initial weight loss goal for individuals with metabolic syndrome?
A weight loss of 7% to 10% is associated with significant health benefits.
What is the recommended dose of exercise for individuals with type 2 diabetes?
150 minutes of moderate to high-intensity activity per week, with no more than two consecutive days off.
What types of exercise should be included for high-functioning individuals with type 2 diabetes?
Aerobic exercise, interval training, strength training (at 50% to 75% of one-rep max), and balance/flexibility exercises.
What exercise modifications are recommended for lower-functioning individuals with type 2 diabetes?
Non-weight-bearing exercises (e.g., stationary bicycling) and seated or lying down strength training.
What are the goals for managing dyslipidemia in metabolic syndrome?
Decrease LDL and triglycerides and increase HDL levels.
How much exercise is recommended for individuals with dyslipidemia?
At least 30 minutes of moderate to high-intensity exercise five times a week.
What is the target blood pressure reduction goal with exercise for individuals with hypertension?
Aerobic exercise can decrease systolic blood pressure by about 5 to 7 mmHg, while resistance exercise can lower it by 2 to 7 mmHg.
What is the long-term commitment required for effective management of metabolic syndrome?
Patients need to commit to aerobic and strength training exercises as a part of their lifestyle, not just for a short period.
What systemic effects does regular exercise have on metabolic syndrome?
It reduces chronic low-grade systemic inflammation, increases adiponectin levels, improves glucose uptake, and enhances vasculature function.
How does exercise specifically help reduce hypertension?
By improving vascular structure and function, enhancing baroreceptor sensitivity, decreasing norepinephrine levels, and increasing insulin sensitivity.
What is the role of lifestyle changes in the management of metabolic syndrome?
Lifestyle changes, alongside exercise, are crucial for effective management and can be supported by resources from national organizations focusing on prevention.
What is the key takeaway regarding exercise and lifestyle changes in metabolic syndrome management?
They play a significant role in managing the complex disease process of metabolic syndrome.
