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Metabolic SyndromeMetabolic syndrome is a combination of medical disorders that affect a large number of people in a clustered fashion. In some studies, the prevalence in the USA is calculated as being up to 25% of the population. Nomenclature Other names for this syndrome are: It is not related to: Signs and symptoms Symptoms and features are: Associated diseases are: Diagnosis The above diseases are all diagnosed separately; please see the relevant articles. The Adult Treatment Panel III of the National Cholesterol Education Program defined the diagnosis as three or more of the following five: Pathophysiology The causes of metabolic syndrome are extremely complex and have only been partially elucidated. Most patients have a degree of insulin resistance, but there is debate whether this is the cause of the metabolic syndrome or a byproduct of a more far-reaching metabolic derangement. There is a role for systemic inflammation, as a number of inflammatory markers (including C-reactive protein) is often increased, as are fibrinogen, IL-6, TNFα and others. Therapy Generally, the individual diseases that comprise Syndrome X are treated separately (e.g. diuretics and ACE inhibitors for hypertension). A remarkable finding is, however, that drugs that decrease insulin resistance (metformin and thiazolidinediones) not only reduce hyperglycemia but generally lead to in improvement in blood pressure and cholesterol (lipid profile) as well. Exercise and weight loss may be helpful, particularly in preventing progression to diabetes mellitus. References - Grundy SM. Obesity, Metabolic Syndrome and Cardiovascular Disease. J Clin Endocrinol Metab 2004;89:2595-600. PMID 15181029.
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