Metabolic syndrome natural history, complications and prognosis: Difference between revisions
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** [[Heart failure]] | ** [[Heart failure]] | ||
** [[Aortic stenosis]] | ** [[Aortic stenosis]] | ||
** [[Stroke]] <ref name="pmid17848611">{{cite journal| author=Air EL, Kissela BM| title=Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. | journal=Diabetes Care | year= 2007 | volume= 30 | issue= 12 | pages= 3131-40 | pmid=17848611 | doi=10.2337/dc06-1537 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17848611 }} </ref> ( | ** [[Stroke]]<ref name="pmid17848611">{{cite journal| author=Air EL, Kissela BM| title=Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. | journal=Diabetes Care | year= 2007 | volume= 30 | issue= 12 | pages= 3131-40 | pmid=17848611 | doi=10.2337/dc06-1537 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17848611 }} </ref>- Northern Manhattan study in 3298 stroke free subjects showed that metabolic syndrome increases the risk for ischemic stroke is greater in women compared to men and Hispanics compared to Caucasians and African-Americans<ref name="pmid18063821">{{cite journal |author=Boden-Albala B, Sacco RL, Lee HS, ''et al.'' |title=Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study |journal=[[Stroke; a Journal of Cerebral Circulation]] |volume=39 |issue=1 |pages=30–5 |year=2008 |month=January |pmid=18063821 |pmc=2677015 |doi=10.1161/STROKEAHA.107.496588 |url=}}</ref>. Similar study in Japan showed the increased risk of ischemic stroke in women with metabolic syndrome<ref name="pmid17527036">{{cite journal |author=Takahashi K, Bokura H, Kobayashi S, Iijima K, Nagai A, Yamaguchi S |title=Metabolic syndrome increases the risk of ischemic stroke in women |journal=[[Internal Medicine (Tokyo, Japan)]] |volume=46 |issue=10 |pages=643–8 |year=2007 |pmid=17527036 |doi= |url=}}</ref>. | ||
* [[Chronic kidney disease]] | * [[Chronic kidney disease]] | ||
* [[Nonalcoholic fatty liver disease]], [[cirrhosis]] <ref name="pmid17690317">{{cite journal| author=Kotronen A, Yki-Järvinen H| title=Fatty liver: a novel component of the metabolic syndrome. | journal=Arterioscler Thromb Vasc Biol | year= 2008 | volume= 28 | issue= 1 | pages= 27-38 | pmid=17690317 | doi=10.1161/ATVBAHA.107.147538 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17690317 }} </ref> | * [[Nonalcoholic fatty liver disease]], [[cirrhosis]] <ref name="pmid17690317">{{cite journal| author=Kotronen A, Yki-Järvinen H| title=Fatty liver: a novel component of the metabolic syndrome. | journal=Arterioscler Thromb Vasc Biol | year= 2008 | volume= 28 | issue= 1 | pages= 27-38 | pmid=17690317 | doi=10.1161/ATVBAHA.107.147538 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17690317 }} </ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
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Overview
Metabolic syndrome occurs in the presence of insulin resistance and accompanying obesity. It increases the risk for coronary heart disease, type II diabetes, fatty liver, stroke and some cancers. It may manifests as hypertension, hyperglycemia, hypertriglyceridemia, reduced high-density lipoprotein cholesterol and abdominal obesity. It affects a large number of people in a clustered fashion. In some studies, the prevalence in the USA is calculated as being up to 25% of the population.
Complications
The complications found associated with metabolic syndrome are:
- Type II diabetes mellitus: The Framingham Heart Study cohort found that metabolic syndrome is a strong predictor of new-onset diabetes in both men and women. It was also shown that obese people with metabolic syndrome have a 10-fold higher risk for developing new diabetes when compared to obese people without metabolic syndrome. Prospective studies have shown that insulinemia, body size and lipid factors are strongly associated with the development of diabetes in patients with metabolic syndrome. [1][2][3][4][5][6]
- Cardiovascular complications: The Framingham Heart Study showed that obese people with metabolic syndrome have a 2-fold higher risk for cardiovascular disease (CVD) when compared to obese people without metabolic syndrome. The increased risk for CVD can be due to either risk factor clustering or insulin resistance and obesity. Obese patients with insulin resistance have the highest risk for developing CVD.[4][5][6][7]
- Coronary heart disease
- Atrial fibrillation
- Heart failure
- Aortic stenosis
- Stroke[8]- Northern Manhattan study in 3298 stroke free subjects showed that metabolic syndrome increases the risk for ischemic stroke is greater in women compared to men and Hispanics compared to Caucasians and African-Americans[9]. Similar study in Japan showed the increased risk of ischemic stroke in women with metabolic syndrome[10].
- Chronic kidney disease
- Nonalcoholic fatty liver disease, cirrhosis [11]
- Obstructive sleep apnea
- Breast cancer [12]
- Cancers of the liver, colon, gallbladder, kidney, and prostate gland [13]
- Polycystic ovary syndrome
- Hyperuricemia and gout
- Psoriasis [14]
- Accelerated cognitive decline in the elderly [15]
Supportive Trial Data
- SOURCE and YEAR: The American Journal of Cardiology
- OBJECTIVE: Estimate the long-term relative risk of major coronary events (MCEs) associated with the metabolic syndrome
- METHOD: Post hoc determination of placebo data from the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) used to estimate the long-term relative risk of major coronary events (MCEs) associated with the metabolic syndrome.
- RESULTS: In the Scandinavian Simvastatin Survival Study and AFCAPS/TexCAPS, respectively, placebo-treated patients with the metabolic syndrome were-
- 1.5 (95% confidence interval 1.2 to 1.8) times more likely to have MCEs than those without it in 4S
- 1.4 (95% confidence interval 1.04 to 1.9) times more likely to have MCEs than those without it in 4S
- CONCLUSION: The following risks factors increased the relative risk for MACE
- Low high-density lipoprotein levels were associated with elevated risk of MCEs in both studies
- High triglycerides in the Scandinavian Simvastatin Survival Study
- Elevated blood pressure and obesity in AFCAPS/TexCAPS were associated with significantly increased relative risk
References
- ↑ Hanson RL, Imperatore G, Bennett PH, Knowler WC (2002). "Components of the "metabolic syndrome" and incidence of type 2 diabetes". Diabetes. 51 (10): 3120–7. PMID 12351457. Unknown parameter
|month=ignored (help) - ↑ Resnick HE, Jones K, Ruotolo G; et al. (2003). "Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease in nondiabetic american indians: the Strong Heart Study". Diabetes Care. 26 (3): 861–7. PMID 12610050. Unknown parameter
|month=ignored (help) - ↑ Klein BE, Klein R, Lee KE (2002). "Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam". Diabetes Care. 25 (10): 1790–4. PMID 12351479. Unknown parameter
|month=ignored (help) - ↑ 4.0 4.1 Sattar N, Gaw A, Scherbakova O; et al. (2003). "Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study". Circulation. 108 (4): 414–9. doi:10.1161/01.CIR.0000080897.52664.94. PMID 12860911. Unknown parameter
|month=ignored (help) - ↑ 5.0 5.1 Sattar N, McConnachie A, Shaper AG; et al. (2008). "Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies". Lancet. 371 (9628): 1927–35. doi:10.1016/S0140-6736(08)60602-9. PMID 18501419. Unknown parameter
|month=ignored (help) - ↑ 6.0 6.1 Ford ES (2005). "Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence". Diabetes Care. 28 (7): 1769–78. PMID 15983333. Unknown parameter
|month=ignored (help) - ↑ Galassi A, Reynolds K, He J (2006). "Metabolic syndrome and risk of cardiovascular disease: a meta-analysis". The American Journal of Medicine. 119 (10): 812–9. doi:10.1016/j.amjmed.2006.02.031. PMID 17000207. Unknown parameter
|month=ignored (help) - ↑ Air EL, Kissela BM (2007). "Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms". Diabetes Care. 30 (12): 3131–40. doi:10.2337/dc06-1537. PMID 17848611.
- ↑ Boden-Albala B, Sacco RL, Lee HS; et al. (2008). "Metabolic syndrome and ischemic stroke risk: Northern Manhattan Study". Stroke; a Journal of Cerebral Circulation. 39 (1): 30–5. doi:10.1161/STROKEAHA.107.496588. PMC 2677015. PMID 18063821. Unknown parameter
|month=ignored (help) - ↑ Takahashi K, Bokura H, Kobayashi S, Iijima K, Nagai A, Yamaguchi S (2007). "Metabolic syndrome increases the risk of ischemic stroke in women". Internal Medicine (Tokyo, Japan). 46 (10): 643–8. PMID 17527036.
- ↑ Kotronen A, Yki-Järvinen H (2008). "Fatty liver: a novel component of the metabolic syndrome". Arterioscler Thromb Vasc Biol. 28 (1): 27–38. doi:10.1161/ATVBAHA.107.147538. PMID 17690317.
- ↑ Beaulieu LM, Whitley BR, Wiesner TF, Rehault SM, Palmieri D, Elkahloun AG; et al. (2007). "Breast cancer and metabolic syndrome linked through the plasminogen activator inhibitor-1 cycle". Bioessays. 29 (10): 1029–38. doi:10.1002/bies.20640. PMID 17876797.
- ↑ Hsing AW, Sakoda LC, Chua S (2007). "Obesity, metabolic syndrome, and prostate cancer". Am J Clin Nutr. 86 (3): s843–57. PMID 18265478.
- ↑ Gottlieb AB, Dann F, Menter A (2008). "Psoriasis and the metabolic syndrome". J Drugs Dermatol. 7 (6): 563–72. PMID 18561588.
- ↑ Yaffe K (2007). "Metabolic syndrome and cognitive decline". Curr Alzheimer Res. 4 (2): 123–6. PMID 17430234.
- ↑ Girman CJ, Rhodes T, Mercuri M, Pyörälä K, Kjekshus J, Pedersen TR; et al. (2004). "The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)". Am J Cardiol. 93 (2): 136–41. PMID 14715336.