Dec 1, diabetes mellitus; hyperinsulinism; hyperlipidemia; hypertension; insulin resistance; obesity . Baseline visits were conducted between and and The association of the metabolic syndrome with the risk of. Mar 6, Metabolic syndrome — Comprehensive overview covers symptoms, treatment of diabetes) or if you have a family history of type 2 diabetes. (2) the relationship between insulin resistance and cardiovascular disease (CVD) , (3) prevention of type 2 diabetes, (4) metabolic syndrome and cardiovascular.
Although the waist-hip ratio may carry information relevant to disease endpoints independently of waist girth or body mass index 10waist circumference correlates better with visceral fat deposits as measured by computerized tomography Furthermore, the euglycemic hyperinsulinemic clamp is not practical for epidemiologic research.
The EGIR recommended use of fasting insulin levels to estimate insulin resistance and impaired fasting glycemia as a substitute for impaired glucose tolerance in epidemiologic studies 9. The metabolic syndrome was defined as three or more of the following: Although type 2 diabetes is a heterogeneous disease, most type 2 diabetes patients are insulin resistant and also have the metabolic syndrome before onset of type 2 diabetes 12 Application of definitions to predicting diabetes in prospective cohort studies can serve to validate definitions of the metabolic syndrome.
We compared the sensitivity, specificity, and prevalent and incident diabetes risk of definitions of the metabolic syndrome based on the WHO consultation 4 and NCEP 5 recommendations in a cohort of middle-aged nondiabetic men who were followed for 4 years.
The two modified WHO definitions waist vs.
All subjects gave their written informed consent. The Kuopio Ischemic Heart Disease Risk Factor Study 4-year follow-up study included 1, subjects who had undergone carotid ultrasound examination during the original study.
What Is 'Metabolic Syndrome,' How Is It Related To Diabetes, And How Should It Be Treated?
Baseline visits were conducted between and and follow-up visits between and Both the baseline and the 4-year follow-up studies have been described in detail previously 15 For the present study, analyses were limited to the 1, men participating in the 4-year follow-up for whom complete data for assessment of the metabolic syndrome were available. Waist-hip ratio was defined as the ratio of waist girth to the circumference of the hips measured at the trochanter major.
The measurement protocol included, after a supine rest of 5 minutes, three measurements in the supine position, one in the standing position, and two in the sitting position at 5-minute intervals. The mean of all six measurements was used as the systolic and diastolic blood pressures. Biochemical determinations Subjects were asked to fast for 12 hours before blood sampling. They were also asked to refrain from smoking for 12 hours and from consuming alcohol for 3 days before blood draws.
Blood glucose was measured at baseline and 4-year follow-up by using a glucose dehydrogenase method after precipitation of proteins by trichloroacetic acid. Fractions of low density lipoprotein and HDL cholesterol were separated from fresh serum by combined ultracentrifugation and precipitation. The cholesterol contents of lipoprotein fractions and serum triglycerides were measured enzymatically.
Metabolic syndrome For men, the metabolic syndrome according to the WHO definition was modified for epidemiologic studies in part as proposed by the EGIR 9 and was defined as hyperinsulinemia fasting insulin levels in the top 25 percent of the nondiabetic populationimpaired fasting glycemia or diabetes, and the presence of at least two of the following: Insulin resistance was estimated as hyperinsulinemia based on fasting insulin concentrations in the upper 25 percent 9.
Microalbuminuria was not included in the definition 9. Abdominal obesity was defined on the basis of two definitions—1 according to the original WHO definition: The metabolic syndrome as defined by the NCEP included three or more of the following: Inclusion of a measure of hyperglycemia in the definitions of the metabolic syndrome will obviously affect the prediction of diabetes. Therefore, we also repeated the analyses by excluding impaired fasting glycemia from the definitions.
Statistical analysis Differences in baseline clinical and biochemical characteristics among men who had diabetes at baseline, who developed diabetes during follow-up, and who remained nondiabetic were tested for statistical significance with one-way analysis of variance and, where indicated, the chi-square test.
The association of the metabolic syndrome with the risk of developing diabetes was estimated by using logistic regression analysis, adjusting for age. In this paper, data are presented as means and standard deviations, medians interquartile rangesor simple percentages.
Triglyceride and insulin concentrations were corrected for skewing by log transformation but are presented here as medians interquartile ranges by using untransformed values. All statistical analyses were performed with SPSS RESULTS Baseline Compared with men who were nondiabetic throughout the study, men who had diabetes at baseline and men who developed diabetes during the 4-year follow-up were heavier and more dyslipidemic, hypertensive, and insulin resistant at baseline table 1.
Use of the insulin sensitivity index QUICKI to estimate insulin resistance resulted in a slightly higher sensitivity 0. Use of the NCEP definition of the metabolic syndrome detected only 61 percent of prevalent and 41 percent of incident diabetes, although specificity was quite high 0.
The likelihood of men with the metabolic syndrome, as defined by the NCEP, to develop diabetes was high figure 1.
Prevalence increased from 11 percent to 18 percent, with an odds ratio of 5. Sensitivity for prevalent 0. Prevalence increased to 23 percent, and, with waist as 87 cm, the sensitivity, specificity, and odds ratio for predicting diabetes were 0. Clustering of insulin resistance and components of the metabolic syndrome Over 95 percent of men with the metabolic syndrome as defined by the WHO had hyperinsulinemia.
Conversely, over 80 percent of the men with insulin resistance had the metabolic syndrome with adiposity as defined by the WHO, emphasizing the clustering of insulin resistance and other components of the metabolic syndrome. All four definitions identified subjects at high risk for developing diabetes during follow-up in this population-based cohort of middle-aged men. The original WHO definition included insulin resistance as measured by the euglycemic hyperinsulinemic clamp and impaired glucose tolerance 4.
Having just one of these conditions doesn't mean you have metabolic syndrome. However, any of these conditions increase your risk of serious disease. Having more than one of these might increase your risk even more.
Metabolic syndrome - Symptoms and causes - Mayo Clinic
If you have metabolic syndrome or any of its components, aggressive lifestyle changes can delay or even prevent the development of serious health problems. Symptoms Most of the disorders associated with metabolic syndrome have no symptoms, although a large waist circumference is a visible sign.
If your blood sugar is very high, you might have signs and symptoms of diabetes — including increased thirst and urination, fatigue, and blurred vision.
When to see a doctor If you know you have at least one component of metabolic syndrome, ask your doctor whether you need testing for other components of the syndrome. Causes Metabolic syndrome is closely linked to overweight or obesity and inactivity. It's also linked to a condition called insulin resistance. Normally, your digestive system breaks down the foods you eat into sugar glucose. Insulin is a hormone made by your pancreas that helps sugar enter your cells to be used as fuel.
In people with insulin resistance, cells don't respond normally to insulin, and glucose can't enter the cells as easily. As a result, glucose levels in your blood rise despite your body's attempt to control the glucose by churning out more and more insulin.