| What is Metabolic Syndrome? Metabolic Syndrome was first defined by an endocrinologist, Dr. Raven, who associated obesity with insulin resistance. This defining association led other physician researchers in the field of cardiology to recognize the significantly increased risk in cardiac disease in diabetic patients. Hence, Metabolic Syndrome was revealed formally in 2001 as a constellation of risk factors that accelerate atherosclerotic cardiovascular disease (ASCVD). Cardiac Risk in Metabolic Syndrome is Greater than the Sum of its Parts Epidemiological studies strongly show that multiple risk factors raise risk more than the sum of accompanying single risk factors; risk rises geometrically instead of linearly. This phenomenon is called multiplicative risk. This does not include several metabolic risk factors in standard risk algorithms; which continue to increase your risk. These are a prothrombotic state, a proinflammatory state, and elevated triglyceride. This additional risk exceeds that which can be explained by standard risk factors. Remember that because metabolic syndrome often progresses and culminates in type 2 diabetes, the syndrome's long-term risk is underestimated at any one time. Thus several lines of evidence indicate that the risk accompanying the metabolic syndrome is greater than the sum of its measured components. In 2002, the National Health and Nutrition Examination Survey (NHANES) data published a prevalence rate of 20% to 24% for metabolic syndrome in the US adult population. The range of Metabolic Syndrome is 5% for the age group 20-29 years old to a high of 45% for both males and females age 60 – 69 years old. The graph clearly illustrates the increase in Metabolic Syndrome with age. Metabolic Syndrome accelerates and worsens abnormal cholesterol levels or ratios, elevated blood pressure, elevated fasting blood sugars, the prothrombotic state (clotting), and the proinflammatory state. For instance: Cholesterol: abnormal cholesterol levels or ratios consists of elevated triglycerides, low levels of high-density lipoproteins (HDL), and increased levels of low density lipoproteins (LDL). Glucose: Elevated fasting glucose falling in the range of either pre-diabetes or diabetes. Clotting: A prothrombotic (clotting) state signifies anomalies in procoagulant (clot forming) factors (i.e., increases in fibrinogen and factor VII), anti-fibrinolytic (clot dissolving) factors (i.e., increases in plasminogen activator inhibitor-1), platelet aberrations, and endothelial (blood vessel)dysfunction. Inflammation: A proinflammatory state is characterized by elevations of circulating acute and chronic phase reactant proteins (e.g., HS-CRP, ESR, etc). This age adjusted graph demonstrates the metabolic diseases found as a percentage in the diagnosis of Metabolic Syndrome (Diabetes, Hypertension, Cholesterol abnormalities: HDL/TG, and increased abdominal girth). The major underlying risk factors are obesity and insulin resistance. The risk associated with obesity is best identified by increased waist circumference (visceral obesity). Insulin resistance can be secondary to obesity. The increasing prevalence of metabolic syndrome in the U.S. and worldwide, seems to be driven largely by more obesity exacerbated by sedentary lifestyles. Losing 10% of your body weight significantly IMPROVES your Metabolic Syndrome risk profile. |
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| Aesthetic Medicine Today |
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