Obesity and
Metabolic Syndrome by Cheryl Winter, M.S., R.D., R.N.In recent years, scientists have found that some of complications of obesity, which include diabetes, hypertension, insulin resistance, and heart disease, were more clearly related to central distribution of fat (excessive fat tissue in abdominal region), than to overall level of obesity.
This central location of fat and release of fatty acids and cytokines (powerful chemical substances secreted by cells) from enlarged fat cells in this area, provide major agents that define Metabolic Syndrome.
What is Metabolic Syndrome?
Metabolic Syndrome, also called dysmetabolic syndrome or Syndrome X, is a collection of factors that individually are risks for cardiovascular disease, number one cause of death in United States. Some of these factors that can be included in syndrome are •hyperinsulinemia •hypertension •abnormal blood lipids •increased coagulant state (abnormal blood clotting) •and other clinical features
What causes Metabolic Syndrome?
Metabolic Syndrome is caused from a genetic predisposition that involves insulin resistance and environmental factors, such as obesity and a sedentary lifestyle. The National Cholesterol Education Program (NCEP) through Adult Treatment Panel III (ATP III), has provided criteria for diagnosing presence of Metabolic Syndrome. At least 3 of criteria listed below must be present for a diagnosis:
Clinical Features of Metabolic Syndrome:
Abdominal obesity (waist circumference): Men: greater than 102 cm (40 in) Women: greater than 88 cm (35 in) HDL cholesterol: Men: less than 50 mg/dL Women: less than 60 mg/dL Triglycerides: greater than or equal to 150 mg/dL Fasting glucose: greater than 110 mg/dL Blood Pressure(SBP/DBP): greater than or equal to 130/85 mmHg
What are Risk Factors for Metabolic Syndrome?
The most likely risk factors observed are abdominal obesity, elevated triglycerides, decreased HDL cholesterol, and elevated blood pressure. Once elevated fasting blood glucose is observed, then likelihood of having diabetes is greatly increased, therefore, intervention prior to observance of elevated fasting blood glucose is desired.
As mentioned above, Metabolic Syndrome is closely linked to insulin resistance. According to American Heart Association, one group of such people are those with diabetes who have a defect in insulin action and can’t maintain a proper level of glucose in their blood. Another is people, mainly those with high blood pressure, who are nondiabetic and insulin-resistant, but who compensate by secreting large amounts of insulin. This condition is known as hyperinsulinemia. A third group is heart attack survivors who, unlike hypertensives, have hyperinsulinemia without having abnormal glucose levels.
