Metabolic syndrome as a risk factor for diabetes

Javeriana University, Avenida 15, Bogotá, Colombia.
Expert Review of Cardiovascular Therapy 03/2010; 8(3):407-12. DOI: 10.1586/erc.10.13
Source: PubMed

ABSTRACT The metabolic syndrome was initially described as an insulin-resistance syndrome characterized by the clustering of metabolic traits such as high triglycerides, low high-density lipoprotein cholesterol, high blood pressure, abdominal obesity and different degrees of impaired glucose regulation. Although different definitions have been developed by various consensus groups, epidemiological studies demonstrate that they all associate the metabolic syndrome with a similar cardiometabolic risk, which is high for diabetes (ranging between three- and 20-fold), depending on the number of components and the inclusion of impaired fasting glucose, impaired glucose tolerance or both. The latter appear to indicate the failure of the beta cell to produce enough insulin to compensate for the increased demand due to insulin resistance. There is a hyperbolic relationship between insulin production and insulin sensitivity, which can be calculated by the disposition index. When this is altered there is a higher risk of developing Type 2 diabetes. There have been no clinical trials in subjects selected by the diagnosis of metabolic syndrome, but structured lifestyle changes have been tested in people with impaired fasting glucose/impaired glucose tolerance and have been able to reduce incident Type 2 diabetes by almost 50%, as long as a weight loss of at least 5% is achieved. Oral antidiabetic and anti-obesity drugs have also been successful to a lesser degree. Some fibrates have reduced or delayed incident diabetes. Extended-release niacin has a neutral effect and statins are controversial. ACE inhibitors and ARBs are the antihypertensive agents least associated with incident diabetes.

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    • "Some have questioned if diagnosing metabolic syndrome is useful to patient care (Kahn et al., 2005; Anscombe et al., 2006). The presence of metabolic syndrome has been associated with a significant risk of cardiovascular disease (Mottillo et al., 2010), stroke (Gupta et al., 2010), and type 2 diabetes (Aschner, 2010). Obesity may also be a risk factor for migraine, especially chronic migraine. "
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    ABSTRACT: Migraine and metabolic syndrome are highly prevalent and costly conditions. The two conditions coexist, but it is unclear what relationship may exist between the two processes. Metabolic syndrome involves a number of findings, including insulin resistance, systemic hypertension, obesity, a proinflammatory state, and a prothrombotic state. Only one study addresses migraine in metabolic syndrome, finding significant differences in the presentation of metabolic syndrome in migraineurs. However, controversy exists regarding the contribution of each individual risk factor to migraine pathogenesis and prevalence. It is unclear what treatment implications, if any, exist as a result of the concomitant diagnosis of migraine and metabolic syndrome. The cornerstone of migraine and metabolic syndrome treatments is prevention, relying heavily on diet modification, sleep hygiene, medication use, and exercise.
    Frontiers in Neurology 11/2012; 3(article 161):161. DOI:10.3389/fneur.2012.00161
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    • "The metabolic syndrome is characterized by the presence of at least three of five symptoms: central obesity, insulin resistance, impaired glucose tolerance, dyslipidemia (increased triglyceridemia and low plasma high-density lipoproteins (HDL) cholesterol), and/or hypertension [1] [2] [3] [4] [5]. Moreover, metabolic syndrome is the main risk factor for developing type 2 diabetes [6] [7]. From these considerations, there is an urgent necessity for increasing knowledge about obesity and its effects. "
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    ABSTRACT: The objective of the present study was to determine the suitability of a swine breed with leptin resistance and predisposition to obesity (the Iberian pig) as model for studies on metabolic syndrome and type 2 diabetes. Thus, six Iberian sows had ad libitum access to food enriched with saturated fat (SFAD group; food consumption was estimated to be 4.5 kg/animal/day) whilst four females acted as controls and were fed with 2 kg/animal/day of a commercial maintenance diet. After three months of differential feeding, SFAD animals developed central obesity, dyslipidemia, insulin resistance and impaired glucose tolerance, and elevated blood pressure; the five parameters associated with the metabolic syndrome. Thus, the current study characterizes the Iberian pig as a robust, amenable, and reliable translational model for studies on nutrition-associated diseases.
    The Scientific World Journal 05/2012; 2012:510149. DOI:10.1100/2012/510149 · 1.73 Impact Factor
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    • "E-mail: syndromes (MS/CMS) are related syndromes of global concern [2] that identify individuals at greatest risk for developing cardiovascular diseases (CVD) and predispose to type2 diabetes mellitus (DM2) worldwide [1] [2] [3] [4] [5] [6] [7]. MS, a concurrence of disturbed glucose and insulin metabolism, overweight and DA VID PUBLISHING D abdominal fat distribution, mild dyslipideamia, and hypertension, is associated with subsequent development of DM2 and CVD(8). "
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