Metabolic syndrome

Metabolic syndrome - symptoms and treatment
The metabolic syndrome (syndrome X, polymetabolic syndrome, insulin resistance syndrome) is considered a key risk factor for the development of cardiovascular diseases. Atherosclerosis, ischemic heart disease, and diabetes mellitus develop very easily in people with metabolic syndrome. The metabolic syndrome is a set of specific parameters, among which the main diagnostic criterion is abdominal obesity. The metabolic syndrome occurs in approximately 20% of the Polish population, more often in women. Syndrome X is typical of people who lead a sedentary lifestyle and consume meals based mainly on simple sugars and fats in excess. If you stay in these habits for many years, you may worsen metabolic disorders and develop complications that are dangerous to your health. The metabolic syndrome is often accompanied by hormonal disorders that require endocrinological consultation. How do you recognize yourself with metabolic syndrome? What can be done to avoid diseases caused by syndrome X?

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What symptoms indicate metabolic syndrome?

The International Diabetes Federation (IDF) provides criteria that qualify for the diagnosis of metabolic syndrome. The condition for diagnosis is the presence of visceral (abdominal) obesity and the coexistence of at least two of the following disorders:
- triglyceride levels above 150 mg / dl or therapy of dyslipidemia,
- low levels of "healthy" HDL cholesterol (<40 mg / dl in men, <50 mg / dl in women),
- blood pressure above 130 / 85mmHg or therapy of arterial hypertension,
- blood glucose level above 100 mg / dl (fasting) or diagnosed type 2 diabetes.

Abdominal obesity (visceral)

Abdominal obesity is associated with the accumulation of fat around the waist. In fact, fat accumulates not only under the skin, but also inside the abdominal cavity. Visceral obesity is equated with a waist circumference exceeding 80 cm in women and 94 cm in men. You can also come across the WHR (waist to hip ratio) index, which is the ratio of the circumference of the waist to the circumference of the hips. If the WHR result is greater than or equal to 0.85 in women and 1.0 in men, abdominal obesity can be diagnosed.
Visceral distribution of adipose tissue is considered the most unfavorable due to the specific hormonal activity of abdominal fat. The production of proinflammatory cytokines (e.g. IL-6) is 2-3 times higher in abdominal adipose tissue than in subcutaneous adipose tissue. Abdominal fat is also a source of glucocorticosteroids (due to the increased expression of receptors for the enzyme converting inactive cortisone to cortisol). Hormones derived from visceral adipose tissue are secreted into the portal vein, which goes to the liver, affecting its function. In general, high levels of IL-6 and glucocorticosteroids promote the development of inflammatory and thrombotic processes and exacerbate metabolic disorders.

Carbohydrate metabolism disorders

Insulin is a hormone produced by the pancreas. Insulin stimulates the transport of glucose to the cells, lowering blood sugar levels. The body's cells contain receptors, the stimulation of which by insulin enables the transport of glucose inside the cell. The sensitivity of cells to insulin is in 50% genetically determined, and in the remaining 50% depends on environmental factors - mainly the type and degree of obesity and the level of physical activity. Some people require a lot more insulin to transport glucose into the cell. Why is this happening?

People who lead a sedentary lifestyle and consume excess calories from meals rich in simple sugars are most likely to suffer from metabolic disorders. When carbohydrates are consumed in excess, their use by muscles and storage as glycogen in muscles and liver may not be sufficient. The excess glucose is then converted into fatty acids, which then form triglycerides and cholesterol. The excess of triglycerides builds adipose tissue, including visceral adipose tissue. Various compounds released from the abdominal fat reach the liver and inhibit the storage of glucose in the liver. Limiting the source of glucose disposal in the liver leaves its level high in the blood, additionally increasing the level of insulin released. Regularly repeated high levels of insulin in the blood result in the hiding of insulin receptors located on the surface of the cells. The above-described mechanism explains the potential mechanism of insulin resistance in overweight and abdominal obese people.
Insulin resistance may be accompanied by an increase in sodium ion retention and a decrease in uric acid filtration by the kidneys. This can result in high blood pressure and an increased level of uric acid in the blood (hyperuricaemia). There are also views that hyperuricemia can cause metabolic syndrome, as some studies have reported chronically elevated blood uric acid levels preceding hyperinsulinemia. It has been proposed that too much uric acid in the blood impairs the muscular blood flow and may thus reduce the transport of glucose to the muscles.

Dyslipidemia

Dyslipidemia means elevated levels of triglycerides and "bad" LDL cholesterol in the blood, with a lower level of "good" HDL cholesterol. Primary dyslipidaemia can be genetically determined, but it can also be associated with a poor diet, sedentary lifestyle, or smoking. Secondary dyslipidaemia develops from other conditions or is a consequence of taking certain medications.
HDL is actually a lipoprotein that transports cholesterol from tissues and plasma to the liver. The effect of HDL function is to lower the total level of cholesterol in the blood. Dyslipidemia (especially HDL reduction, even with relatively normalized LDL levels) leads to the development of atherosclerosis and thus increases the risk of coronary heart disease, heart attack and ischemic stroke.

Hypertension

Normal blood pressure in a healthy adult should be below 130 / 85mmHg. Hypertension is diagnosed with regular measurements of 140 / 90mmHg or more. The metabolic syndrome is more common in people with hypertension. The simultaneous presence of arterial hypertension and metabolic disorders significantly increases the risk of cardiovascular diseases. Hypertension accelerates the development of atherosclerosis - the walls of the arteries rebuild, lose their elasticity and are more prone to the formation of atherosclerotic plaques. The atherosclerotic plaque consists of, among others from cholesterol deposits - its high level in the course of metabolic syndrome contributes to faster progression of atherosclerosis.

Complications of the metabolic syndrome

Abdominal obesity, insulin resistance, dyslipidemia, hypertension, and increased activation of inflammatory and thrombotic processes are factors that lead to cardiovascular complications.
Atherosclerotic plaque may cause a narrowing of the vessel's lumen - for example, narrowing of the coronary arteries leads to the development of ischemic heart disease. The sharp closure of the coronary vessel results in a lack of blood supply to a specific part of the heart muscle - this is a heart attack.
Headaches and dizziness may occur when atherosclerotic lesions occur in the vessels that supply blood to the brain (carotid and head arteries). Acute closure of the vessel within the brain results in an ischemic stroke.
Atherosclerotic changes in the arteries of the lower limbs cause pain and fatigue in the limbs when walking (intermittent claudication). It is related to the insufficient supply of oxygen to the working muscles. Stopping in a place and resting will reduce the discomfort. The closure of the artery within the lower limb is associated with its acute ischemia and sometimes even threatens with the amputation of the leg.
Metabolic syndrome in women may be associated with polycystic ovary syndrome (PCOS). This disease is characterized by, inter alia, anovulation, making it much more difficult for women to get pregnant. Symptoms of PCOS are the features of androgenization, caused by elevated levels of male sex hormones (androgens): hirsutism, seborrhea, acne, alopecia in the front of the head, irregular menstruation.

Metabolic syndrome - treatment

Treatment of the metabolic syndrome includes measures to reduce overweight or obesity, mainly by reducing the percentage of visceral fat in the distribution of body weight. The aim of the procedure is also to improve the sensitivity of tissues to insulin, improve the lipid profile and normalize blood pressure.
The mainstay of treatment is lifestyle changes. It is advisable to increase physical activity, and preferably introduce training aimed at reducing body fat with the least possible loss of muscle mass. Such training should be safe for people with arterial hypertension, so in addition to cardiological consultation, in the initial period it is worth using the help of a professional trainer cooperating with a doctor.
Your diet should provide you with all the nutrients you need. Caloric content should be adjusted to the level of activity, thanks to which it will be possible to achieve a safe, gradual reduction of body weight. People with high blood pressure should also reduce the salt intake in the diet.
When carbohydrate metabolism disorders are significant, it is necessary to implement antidiabetic drugs. In case of high blood pressure, your doctor may decide to use antihypertensive drugs.
The metabolic syndrome may be accompanied by hormonal disorders, therefore a person with metabolic syndrome should be under the constant supervision of an endocrinologist. A diagnosis of PCOS may require the use of anti-androgen medications or medications to stimulate ovulation.
A comprehensive look at the processes taking place in the body undoubtedly allows you to take measures to comprehensively improve the health and quality of life of people with metabolic syndrome.
FAQs:
1. What is Metabolic Syndrome?
The metabolic syndrome is a set of symptoms that significantly increase the risk of developing atherosclerosis and its serious complications (stroke, heart attack, acute lower limb ischemia). The metabolic syndrome is characterized by the presence of visceral obesity, i.e. excess fat located inside the abdominal cavity. The following are also associated with the metabolic syndrome: increased blood triglycerides, abnormal HDL to LDL cholesterol ratio, arterial hypertension and type II diabetes. Women with metabolic syndrome are more frequently diagnosed with polycystic ovary syndrome (PCOS).
2. Metabolic syndrome - what are the risk factors?
The factors that increase the risk of metabolic syndrome include: a sedentary lifestyle, a high-calorie diet rich in simple sugars and saturated fats, smoking, stress and hormonal disorders (most often hyperandrogenism).
3. Metabolic syndrome - which doctor should you go to?
Due to the complexity of the disorders, treatment may require consultation with several specialists. The role of an endocrinologist is to recognize the symptoms typical of the metabolic syndrome and to recommend tests necessary for diagnosis. The endocrinologist may also prescribe drugs that improve carbohydrate metabolism and thus facilitate weight reduction. If hypertension is diagnosed, regular visits to a cardiologist and adherence to his recommendations are recommended. A dietitian helps you plan your meals, making losing weight and improving your health a lot easier.