Overview

Name: Syndrome X

Description: Obesity, diabetes, heart disease

This casebook is published and has been read 151 times.

The author of this casebook has identified the following medical topics as being highly relevant to this casebook.

• Obesity -- A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
  
  
• Insulin Resistance -- Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS. It can be caused by the presence of INSULIN ANTIBODIES or the abnormalities in insulin receptors (RECEPTOR, INSULIN) on target cell surfaces. It is often associated with OBESITY; DIABETIC KETOACIDOSIS; INFECTION; and certain rare conditions. (from Stedman, 25th ed)
  
  
• Metabolic Syndrome X -- A cluster of metabolic risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome X include excess ABDOMINAL FAT; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state. (from AHA/NHLBI/ADA Conference Proceedings, Circulation 2004; 109:551-556)
  
  
• OBESITY-HYPOVENTILATION SYNDROME -- HYPOVENTILATION syndrome in very obese persons with excessive ADIPOSE TISSUE around the ABDOMEN and DIAPHRAGM. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic HYPOXIA; HYPERCAPNIA; POLYCYTHEMIA; and long periods of sleep during day and night (HYPERSOMNOLENCE). It is a condition often related to OBSTRUCTIVE SLEEP APNEA but can occur separately.
  
  
• Diabetes Mellitus, Non-Insulin-Dependent -- subclass of diabetes mellitus that is not insulin responsive or dependent; characterized initially by insulin resistance and hyperinsulinemia and eventually by glucose intolerance, hyperglycemia, and overt diabetes; type II diabetes mellitus is no longer considered a disease exclusively found in adults; patients seldom develop ketosis but often exhibit obesity.
  
  
• Diabetes Mellitus -- A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.
  
  

Notes

Key Points

• Metabolic syndrome is the name for a group of risk factors that increase your chance for heart disease and other health problems such as diabetes and stroke.
• The diagnosis of metabolic syndrome is made if you have any three out of these five heart disease risk factors: a large waistline, a higher than normal triglyceride level, a lower than normal level of HDL cholesterol (high-density lipoprotein cholesterol), higher than normal blood pressure, and higher than normal fasting blood sugar (glucose).
• About 47 million adults in the United States (almost 25 percent) have metabolic syndrome. The rate of metabolic syndrome continues to rise as obesity levels increase.
• Metabolic syndrome has several causes that act together. Some can be controlled, while others can’t.
• To diagnose metabolic syndrome, your doctor evaluates your risk factors and checks your waist size, cholesterol, blood pressure, triglycerides, and blood sugar.
• The first line of treatment for metabolic syndrome is lifestyle changes, including weight loss, increased physical activity, and a healthy diet. If lifestyle changes can’t control your risk factors, your doctor may recommend medicines.
• Healthy lifestyle choices can help prevent metabolic syndrome. But if you develop metabolic syndrome, healthy lifestyle changes also can help to reverse or reduce the risk of heart disease and diabetes and complications of those conditions.
• If you have metabolic syndrome, follow a healthy eating plan and increase your physical activity to manage your weight; quit smoking; and take all of your medicines as your doctor prescribes.

Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that increase your chance for heart disease and other health problems such as diabetes and stroke. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Risk factors are behaviors or conditions that increase your chance of getting a disease. In this article, “heart disease” refers to coronary heart disease.

The five conditions listed below are metabolic risk factors for heart disease. A person can develop any one of these risk factors by itself, but they tend to occur together. Metabolic syndrome is diagnosed when a person has at least three of these heart disease risk factors:

• A large waistline. This is also called abdominal obesity or “having an apple shape.” Excess fat in the abdominal area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
• A higher than normal triglyceride level in the blood (or you’re on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
• A lower than normal level of HDL cholesterol (high-density lipoprotein cholesterol) in the blood (or you’re on medicine to treat low HDL). HDL is considered “good” cholesterol because it lowers your chances of heart disease. Low levels of HDL increase your chances of heart disease.
• Higher than normal blood pressure (or you’re on medicine to treat high blood pressure). Blood pressure is recorded as two numbers, usually written one on top of or before the other, such as 120/80. The top or first number, called the systolic blood pressure, measures the pressure in the bloodstream when your heart beats. The bottom or second number, called the diastolic blood pressure, measures the pressure in your bloodstream between heartbeats when the heart is relaxed.
• Higher than normal fasting blood sugar (glucose) (or you’re on medicine to treat high blood sugar). Mildly high blood sugar can be an early warning sign of diabetes.

The more of these risk factors you have, the greater your chance of developing heart disease, diabetes, or a stroke. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome.

Other risk factors aside from those of the metabolic syndrome also increase your risk for heart disease. A high level of LDL cholesterol (low-density lipoprotein cholesterol; considered “bad” cholesterol) and smoking, for example, are key risk factors for heart disease, but they aren’t components of metabolic syndrome. Even a single risk factor raises your risk for heart disease, and every risk factor should be lowered to reduce the risk.

The chance of developing metabolic syndrome is closely linked to being overweight or obese and to a lack of physical activity. Another cause is insulin resistance. Insulin resistance is a condition in which the body can’t use its insulin properly. Insulin is a hormone the body uses to help change blood sugar into energy. Insulin resistance can lead to high blood sugar levels and is closely linked with being overweight or obese.

Genetics (ethnicity and family history) and older age are other important underlying causes of metabolic syndrome.

Outlook

About 47 million adults in the United States (almost 25 percent) have metabolic syndrome, and the numbers continue to grow. The increasing number of people with this condition is connected to the rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.

It’s possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome takes a long-term effort and teamwork with your health care providers.

Bookmarks The following information, which has been distilled by the casebook author from this and other websites is particularly relevant to this casebook.