Metabolic Syndrome – A Mississippi Epidemic
08/16/2004.
The metabolic syndrome (also referred to as “insulin resistance syndrome” and “syndrome X”) has become a serious medical problem in the US, affecting both men and women, old and young. Presently, 20-25 percent of Americans and as many as 40 percent of Mississippians have the metabolic syndrome.
In a recent survey of overweight children, the prevalence of metabolic syndrome reached nearly 50 percent. Every amount of weight gain increases risk for type 2 diabetes and cardiovascular disease in children.
- Abdominal/central obesity
- Waist circumference: >102 cm (40”) in men, >88 cm (35”) in women
- Hypertriglyceridemia
- >=150 mg per dL
- Low HDL cholesterol
- <40 mg per dL for men, <50 mg per dL for women
- High blood pressure
- >=130/85 mm Hg or documented use of antihypertensive therapy
- High fasting glucose
- >=110 mg per dL
Metabolic syndrome has been defined by the ATP as the presence of any 3 of the following:
The individual components of the metabolic syndrome can lead to complications including hardening of the arteries and an increased risk for cardiovascular and kidney disease. The cardiovascular risk, however, is exponentially increased when the “metabolic syndrome” is present.
Metabolic syndrome is treated by addressing each of the risk elements.
Lose Weight. Obesity is a major contributor to many of the components of the metabolic syndrome. Losing weight and keeping it off, even ten, pounds can make a difference. The physician and patient should plan a diet that will help the patient lose excess weight and maintain a healthy weight.
Increase Physical Activity. Physical activity burns excess fat and increases muscle mass, helping the body burn calories much more efficiently. Walking at least one mile daily is desirable.
Lower Blood Pressure. Losing weight and increasing physical activity can lower the blood pressure. Medication may be required to help lower blood pressure to desirable ranges. ACE-inhibitors should be considered as initial drugs of choice.
Lower Cholesterol. Regular physical activity, a diet low in saturated fats and high in fiber, and medications can help normalize blood lipid levels. Aggressive use of “statins” is also beneficial.
Stop Smoking. Smoking is known to greatly worsen the health consequences of the metabolic syndrome. Many cessation plans are available to smokers; the State of Mississippi offers help at 1-800-244-9100.
Currently, there have been no randomized clinical trials directed specifically at treating metabolic syndrome. However, based on presently available clinical trials, aggressive management of the individual components of the syndrome should make it possible to prevent or delay the onset of diabetes mellitus, hypertension, and cardiovascular disease.