In the context of the so-called civilization diseases are more and more often talked about the state of coexistence of specific symptoms with the term metabolic syndrome. Unfortunately, the general awareness of what this condition is and what its symptoms and consequences are should be considered insufficient. In this article I will try to introduce the essence of this issue, because, as statistics show – the frequency of its occurrence is systematically growing, which has tragic consequences for the health of the general population of developed and developing countries.
The metabolic syndrome
Also known as X-syndrome or Raeven’s syndrome, is defined as the coexistence of several risk factors for atherosclerotic cardiovascular disease and type 2 diabetes. Metabolic syndrome is associated with impaired insulin sensitivity with associated glucose tolerance disorders and / or hyperglycemia and compensating hyperinsulinaemia, as well as hypertriglyceridemia, high density lipoprotein (HDL – good cholesterol), hypertension, as well as proinflammatory and prothrombotic state.
Translating this professional terminology into a generally understandable language, it can be said that in the case of metabolic syndrome energy management of the body begins to work incorrectly, excess glucose and insulin damages tissues and organs, excess lipids accumulates in the blood vessels, narrowing their light and increasing the risk of blockages. There are diseases such as atherosclerosis and diabetes, the risk of sudden death increases (heart attack, stroke).
The World Health Organization (WHO), the European Group of Insulin Resistance Research (EGIR), the International Diabetes Federation (IDF), as other organizations and units dealing with metabolic health have independently created special criteria for the recognition of the metabolic syndrome, which overlap to a large extent, although there are some discrepancies in the way of evaluation and classification. The main indicators are obesity, insulin resistance, dyslipidemia and hypertension.
For example, according to EGIR specialists, an essential condition for the diagnosis of the metabolic syndrome is insulin resistance (insulin concentration in the blood plasma> 75th percentile) and coexistence of at least two factors such as central obesity (waist circumference ≥94 cm, men ≥80 cm women) dyslipidemia (triglycerides) ≥150 mg / dl and / or HDL <39 mg / Dl), hypertension (≥140 / 90 mmHg), hyperglycaemia (fasting glucose ≥110 mg / Dl or IGT).
The criteria proposed by WHO experts are similar, however, it is necessary to consider diabetes or impaired glucose tolerance or abnormal fasting glycemia or insulin resistance and at least two factors such as central obesity, dyslipidemia, hypertension, microalbuminuria ( urinary excretion of small amounts of protein in the amount of 30-300 mg / d or 20-200 mg / l albumin).
As can be seen on the basis of the adopted criteria, the key factor for the diagnosis of the metabolic syndrome is the disorder of insulin-glucose management. In fact, it is recognized that abnormalities in this area may constitute an independent factor for the development of diabetes and cardiovascular disease with atherosclerotic substrates – this issue is evident and needs to be emphasized. If there are additional factors, such as excessive body weight or dyslipidemia, the risk of the aforementioned accidents is correspondingly higher.
Nevertheless, the diagnostic criteria of the metabolic syndrome, and more precisely the methods of measurement and the way of interpreting the results arouse a lot of controversy, and according to some researchers – require quick verification and modification. It is, among others, attention to the problem of low accuracy or lack of standardization of tests used to diagnose insulin resistance. Doubts also arouse the fact that in the diagnosis of abdominal obesity there is no distinction between peripheral and subcutaneous fat. Meanwhile, the importance of visceral and subcutaneous fat for the development of metabolic disorders is different. Similarly, the role of hypertension in the diagnosis of the metabolic syndrome is undermined, noting that this condition can only be significant when it is associated with insulin resistance.
The occurrence of the metabolic syndrome in developing and developed countries should be considered high. This affliction can affect today about 32% of US residents. For comparison, in France, the metabolic syndrome was found only in about 16% of men and 11% of women. Research carried out several years ago in Poland showed that this problem affects about 20% of adult residents of our country. There is no doubt that the rate of occurrence of the metabolic syndrome increases with age, with differences in individual age groups even up to several times.
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