Metabolic Syndrome Flashcards
What is metabolic syndrome?
Accumulation of several disorders that, together, increase the risk of an individual developing atherosclerotic cardiovascular disease and T2DM
What six disorders can make up metabolic syndrome?
- Prothrombotic state
- Proinflammatory state
- Nonalcoholic fatty liver disease
- Cholesterol gallstones
- Obstructive sleep apnea
- Gout
What is the main driver of metabolic syndrome?
Obesity (especially abdominal or upper-body obesity)
What is the bottom line pathophysiology for metabolic syndrome?
- Obesity
- Tissue dysfunction
- Insulin resistance/neurohormonal activation/chronic inflammation
- Metabolic syndrome
What risk factors are associated with metabolic syndrome?
- Insulin resistance
- Physical inactivity
- Older age
- Hormonal imbalance
- Genetics
- Race/ethnicity
- Abdominal obesity
What is the abdominal obesity criteria for metabolic syndrome?
- Waist ≥102 cm (40 inches) in men
- Waist ≥88 cm (35 inches) in women
What are the triglyceride requirements for metabolic syndrome?
≥150 mg/dl or drug treatment
What is the HDL-C range required for diagnosis of metabolic syndrome?
- <40 mg/dl in men or drug treatment
- <50 mg/dl in women or drug treatment
What is the blood pressure requirement for metabolic syndrome diagnosis?
≥130/85 or drug treatment
What is the elevated fasting plasma glucose requirement for metabolic syndrome diagnosis?
≥100 mg/dl or drug treatment
What are the three primary treatment goals of metabolic syndrome?
- Decrease ASCVD/T2DM risk
- Treat underlying disease states
- Improve lifestyle factors
What is the initial weight loss goal for metabolic syndrome?
7-10% weight reduction over 6-12 months
What is the ultimate weight loss goal for metabolic syndrome?
- BMI <25
- Waist <40 inches in men and <35 in women
By how much should metabolic syndrome patients decrease their caloric intake?
500-1000 calories per day
How much aerobic exercise should metabolic syndrome patients get per week?
>150 minutes
What resistance training should metabolic syndrome patients do?
Single-set repetitions involving major muscle groups on 2-3 days/week
What BMI range in underweight?
<18.5
What is a normal BMI range?
18.5-24.9
What is an overweight BMI range?
25-29.9
What BMI range is considered obese?
≥30
How do you calculate BMI?
- (Weight in lbs x 703) / (height in inches)2
- (Weight in kg) / (height in meters)2
When is weight-loss medication indicated?
- BMI ≥30
- BMI ≥27 with one of the following: T2DM, CVD, HTN, dyslipidemia, sleep apnea
What is the prescription form of Orlistat?
Xenical
What is the OTC form of Orlistat?
Alli
What is Orlistat’s mechanism of action?
Lipase inhibitor: decreases dietary fat absorption by 30%
What adverse drug reactions are associated with Orlistat?
- Cramps
- Oily stool
- Flatulence
- Urgency
- Diarrhea
What is Orlistat contraindicated for?
- Pregnancy
- Malabsorption syndrome
- Cholestasis
- Nephropathy
How much weight loss does Orlistat typically yield?
2.6 kg
List two pearls about Orlistat.
- Take within 1 hour of each meal and skip dose if skipping a meal/meal does not contain fat
- Decreases absorption of fat-soluble vitamins and contraceptives
What sympathomimetics can be used for weight loss?
- Phendimetrazine (Bontril)
- Diethylpropion (Tenuate)
- Phentermine (Adipex-P, Lomaira)
What are sympathomimetics’ mechanism of action?
Release NE to decrease appetite and enhance satiety
What adverse drug reactions are associated with sympathomimetics?
- HTN
- Palpitations
- Arrhythmias
- Insomnia
What are sympathomimetics contraindicated for?
- Within 14 days of MAO-I
- Drug abuse history
- Cardiovascular disease
- Glaucoma
- Hyperthyroidism
- Pregnancy
- Nursing/lactation
List two clinical pearls for sympathomimetics.
- Increase the effect of anti-diabetics
- Monitor waist and weight every month for 3 months
