Metabolic syndrome update☆,☆☆
Section snippets
Definition of metabolic syndrome
The metabolic syndrome consists of five factors for ASCVD: atherogenic dyslipidemia, elevated blood pressure, dysglycemia, a pro-thrombotic state, and a pro-inflammatory state [5] (Fig. 1). They occur most commonly in obese persons. Atherogenic dyslipidemia comprises elevations in plasma triglycerides and apolipoprotein B (apo B), and reductions in high-density lipoproteins (HDL). Elevated blood pressure includes both overt and borderline hypertension. Dysglycemia consists of either prediabetes
Pathogenesis
An early hypothesis was that insulin resistance is the cause of metabolic syndrome [6], [7]. Without question, insulin resistance contributes to hyperglycemia. Its role in causing other metabolic risk factors is uncertain.
Another view sees obesity (or energy imbalance) as the main cause. Since obesity strongly associates with all metabolic risk factors, its role is plausible. A related view contends that positive caloric balance underlies the metabolic syndrome (Fig. 1). Obesity is a useful
Upper-body obesity
Most persons with the metabolic syndrome are categorically obese (BMI ≥ 30 kg/m2) [10]. Among them, individuals with predominant upper-body obesity are most prone to metabolic syndrome. Fat in the upper body can be either intraperitoneal (visceral) or subcutaneous. Excess visceral fat associates strongly with the metabolic syndrome [11], [12]. But in addition, excessive amounts of upper-body subcutaneous fat are accompanied by greater risk for metabolic syndrome [13], [14], [15], [16]. In
Lifestyle intervention
Most persons with metabolic syndrome are obese and sedentary. Urbanization and access to inexpensive foods are creating a metabolic syndrome pandemic [3]. Thus, primary intervention should be lifestyle change, i.e., caloric restriction, improved health quality of foods, and increased physical activity.
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Cited by (0)
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This work was financially supported by the Center for Human Nutrition, UT Southwestern Medical Center, United States.
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The author has indicated that there are no conflicts of interest.