Metabolic Syndrome and Obesity

Question 1

what is metabolic syndrome?

Answer 1

Group of medical conditions that present together in an individual leading to significant increased risk for CVD, cerebrovascular accident, and T2DM

Question 2

The WHO Criteria for diagnosis requires at least 3 of the ___________ criteria. what are the 5 criteria points?

Answer 2

1. increased waist circumference (≥102cm for men; ≥88cm for women)
2. Elevated TG and/or use of TG lowering medicines (≥1.7mmol/L)
3. Reduced HDL-C and/or use of HDL-C increasing medicines (<1.0 mmol/L for men; <1.3 mmol/L for women)
4. Hypertension (systolic ≥130 and/or diastolic ≥85)
5. Elevated fasting plasma glucose (FPG) and/or use of hyperglycemia medicines (≥5.6 mmol/L)

Question 3

what are some causes of metabolic syndrome?

Answer 3

obesity, lack of physical activity, genetic predisposition, insulin resistance

Question 4

what are factors that influence developing obesity? Name 3-4, there are 10 listed

Answer 4

1. environmental - household obesity, poor diet, sedentary lifestyle
2. prior childhood obesity
3. gestational diabetes
4. genetic disorders (prader-willi syndrome, bardet-beidl syndrome)
5. low access to healthy foods/ses
6. hypothyroidism
7. Cushings
8. PCOS
9. medications - SSRIs, steroids, contraceptives
10. immune disorders

Question 5

what bloodwork would be important to monitor a person with metabolic syndrome?

Answer 5

1. lipid panel ➔ for potential hypercholesterolemia
2. fasting plasma glucose or HbA1c ➔ for potential DM
3. creatinine and urea ➔ kidney function/disease
4. liver biochemistry - ALT/AST/ALP/GGT
5. TSH
6. ECG - potential CAD

Question 6

what are the BMI numbers to classify overweight and obesity in adults?

Answer 6

25-29.9 kg/m2 ➔ overweight
30-34.9 ➔ obese class 1
35-39.9 ➔ obese class 2
>40 ➔ obese class 3

Question 7

what ix/exams would you need to do to use the WHO criteria to diagnose metabolic syndrome? (5)

Answer 7

1/2. Lipid panel ➔ TG and HDL-C specifically
3. waist circumference
4. blood pressure
5. Fasting plasma glucose

Question 8

How would you classify overweight and obesity in children using the WHO criteria?

Answer 8

5-19 years old

overweight: > 85th percentile
obese: >97th percentile
severely obese: >99.9th percentile

Question 9

how would you manage/treat metabolic syndrome?

Answer 9

some treatments available for wt loss:
1. GLP1 agonist
2. Lipase inhibitors ➔ decreased break down of fats from diet so decrease absorption of fat into the body
3. opioid antagonist ➔ appetite suppressant
4. bariatric surgery ➔ last resort of meds didn’t work and obesity is main issue

A lot of treatment to target s/s

emphasis is placed on pt education on a healthy life style to reduce risk factors (diet, exercise, sleep hygiene)

Question 10

Name 5 cx that could occur due to metabolic syndrome

Answer 10

1. OSA
2. CVD or CHF
3. T2DM
4. increased risk of malignancies
5. chronic renal insufficiency