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METABOLIC SYNDROME- TAKE A WALK THROUGH IT

Posted by Monisha vijay on Mon, Apr 23, 2018  
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Introduction

Metabolic syndrome or syndrome X or resistance syndrome comprises of features such as central obesity, increased levels of triglycerides, low levels of high density lipoproteins, increased blood pressure, increased glucose levels.

Risk factors 

  • Obesity
  • Sedentary lifestyle
  • Aging
  • Diabetes mellitus
  • Cardiovascular diseases
  • Lipodystrophy

Etiology

  • Insulin resistance
  • Increased waist circumference
  • Hypertension
  • Dyslipidemia
  • Glucose intolerance
  • Adiponectin
  • Proinflammatory cytokines

Diagnosis

  • Symptoms of obstructive sleep apnea and polycystic ovarian syndrome
  • Check blood pressure
  • Measurement of waist circumference
  • Lipoatrophy, acanthosis nigricans
  • Family history of cardiovascular diseases and diabetes mellitus
  • Investigations- lipid profile, FBS, PPBS sugar levels, liver function tests, Apo B, fibrinogen, hsCRP, uric acid, urine microalbumin levels, sleep study, testosterone, FSH, LH levels.

Treatment 

  • Drugs to reduce lipid levels - fenofibrate, gemfibrozil, rosuvastatin, atorvastatin, Omega 3 fatty acids, nicotinic acids, ezetimibe, diet restriction of saturated and trans fats.
  • Lifestyle modification - weight reduction through increased physical activity for 30 to 60 min per day , calorie restriction where diet rich in fruits, vegetables, fish, whole grains, lean poultry and behavioural changes for weight maintainence
  • Obesity reducing drugs that can be tried are Phentermine (3 months only), Phentermine/ topiramate combination and locaserin. Orlistat is another drug that can be tried. Bariatric Surgery suggested when BMI > 40kg/m2
  • Impaired glucose tolerance and type 2 diabetes mellitus- metformin and thiazolidinediones, lifestyle modification can control glucose levels in blood.


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