Metabolic syndrome
Type 2 diabetes is associated with central obesity, hypertension, hypertriglyceridaemia, a decreased high-density lipoprotein (HDL) cholesterol, disturbed haemostatic variables and modest increases in several pro-inflammatory markers. Insulin resistance is strongly associated with many of these variables. Non-¬alcoholic fatty liver disease and, in women, a polycystic ovarian syndrome is found in this cluster. This group or cluster of conditions is referred to as the metabolic syndrome. AKA Insulin resistance syndrome; AKA Syndrome X
Classification systems for metabolic syndrome:
It has two classification systems which have their criteria for diagnosing the syndrome;
- ATP III NCEP (the Adult Treatment Panel 3 National Cholesterol Education Programme) and
- IDF (International Diabetes Federation)
Both classification systems consider five variables or risk factors for diagnosing metabolic syndrome:
- Waist circumference
- TG
- HDL cholesterol
- BP and
- Fasting glucose
A large waist is an absolute requirement for the International Diabetes Federation (IDF) but not for the Adult Treatment Panel 3 National Cholesterol Education Programme (ATP III NCEP).
The IDF criteria use lower cut-off values for waist circumference (close to values for people with a BMI of 25 kg/m2) and lower fasting blood glucose concentrations. This means that the prevalence of metabolic syndrome will be higher using the IDF criteria and that the IDF criteria will identify at-risk patients at an earlier stage. This could lead to further investigations following on from the initial screening, and the earlier institution of preventative as well as therapeutic measures.
Overweight/central obesity and insulin resistance, which causes glucose and lipid disturbances, including non-alcoholic fatty liver disease, seem to form the basis of many features of the metabolic syndrome. Early treatment of obesity and metabolic syndrome can prevent the development of clinical diabetes and its complications.
Source:
- Kumar & Clark’s Clinical Medicine 9e (2016); pages 209, 1248-1249
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