Metabolic syndrome - DRHC Dubai Endocrinology Clinic

It is called syndrome X also, we talk about this syndrome when you have three out of five medical conditions which are:

               1 – Central obesity,

               2 – High blood pressure,

               3 – High blood glucose,

               4 – High triglyceride (TG),

               5 – Low level of high-density lipoprotein (HDL).

It occurs in 20-25 of the adults worldwide, and in 34% of US adult. It carries a high risk for coronary artery disease and diabetes type 2.

Causes:

• Stress chronic stress may lead to metabolic syndrome by disrupting the hormonal balance of the hypothalamic-pituitary-adrenal axis (HPD- axis) which leads to more circulating cortisol and its effect on increase glucose and insulin level to inter the vicious circle (visceral adiposity, insulin resistance, dyslipidemia, and hypertension) with low turnover of bone by elevated cortisol ended by osteoporosis also.
• Overweight central obesity is a sign and cause.
• Sedentary lifestyle or low physical activity you know it predispose to obesity, low HDL,high TG, hypertension.
• Aging it affect 60% of US people after 50 years age with female more than male.
• Diabetes 2 it is a cause and complication of metabolic syndrome.
• Excess alcohol use.
• High consumption of fast food (Western diet habit).
• Lipodystrophy either genetic or acquired such as HIV-treated by high active antiretroviral therapy.
• Disturbing chronobiology/sleep, like work night shift and sleeping at day time.

Associated conditions:

• Hyperuricemia,
• Fatty liver,
• Polycystic ovary disease in women,
• Erectile dysfunction in men,
• Acanthosis nigricans

Signs and symptoms:

• Central obesity BMI more than 30 kg/m2 or waist circumference more than 102 cm for men and 88 cm for women.
• High triglyceride level more than 150 mg % (1.7 mmol/L).
• High level of high-density lipoprotein (HDL).
• High blood pressure more than 140/90 mm Hg or hypertension under treatment.
• Elevated fasting glucose more than 110 mg/dl (6.1 mmol/L)

For diagnosis we need either Central obesity or Diabetes 2 plus another two elements from above list.

Prevention:

• Increase physical activity 30 minutes’ walk daily.
• Healthy food especially low caloric diet.
• Interventions on sociopolitical required to reduce development of metabolic syndrome.

Management:

• Diet low in carbohydrate healthy foods.
• Medication to treat diabetes mainly metformin, diuretic and ACE inhibitor to treat hypertension, and fibrate for hyperlipidemia.

Dubai Cardiology Clinic - Treatment of various cardiovascular diseases such as Hypertension, Ischemic heart disease, Holter monitoring, Heart failure, Stress test, chest pain and echocardiography are now available in DRHC.