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[The importance of syndrome X in daily practice]
1Service d'Endocrinologie, Diabète et Maladies métaboliques, C.H.U. de Charleroi, Site de Charleroi, U.L.B.
Insights
Metabolic syndrome X, characterized by insulin resistance, involves multiple cardiovascular risk factors. Lifestyle changes like diet and exercise are primary treatments, with medication as a secondary option.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Metabolic syndrome X encompasses glucose intolerance or type 2 diabetes, dyslipidemia, and arterial hypertension.
- Additional cardiovascular risk factors include rheological alterations, endothelial dysfunction, and coagulation anomalies.
- Insulin resistance and secondary hyperinsulinism are central to metabolic syndrome X, often associated with upper body obesity.
Purpose of the Study:
- To outline the components and cardiovascular risks associated with metabolic syndrome X.
- To emphasize the role of insulin resistance and obesity.
- To discuss diagnostic utility of waist measurements and therapeutic strategies.
Main Methods:
- Review of established clinical definitions and risk factors for metabolic syndrome X.
- Discussion of diagnostic criteria, including waist circumference measurements.
- Overview of lifestyle modifications and pharmacological interventions.
Main Results:
- Waist measurements effectively identify individuals (10-15% of population) at increased cardiovascular risk with 70% sensitivity.
- Dietary changes include caloric reduction, replacing saturated fats, and choosing low glycemic index carbohydrates.
- Regular physical activity is a key component of management.
Conclusions:
- Metabolic syndrome X is a cluster of cardiovascular risk factors centered on insulin resistance.
- Lifestyle modifications, including diet and exercise, are the first line of treatment.
- Pharmacological options exist, but drugs exacerbating insulin resistance should be avoided.
Abstract:
Metabolic syndrome X includes glucose intolerance or type 2 diabetes, dyslipidemia and arterial hypertension which are classical cardiovascular (CV) risk factors. In course of time, other CV risk factors have been added to the syndrome: rheological alterations, endothelial dysfunction, anomalies in the coagulation/fibrinolysis system, microalbuminuria and so on.... Insulin resistance is the cornerstone of metabolic syndrome X, with secondary hyperinsulinism. Upper body obesity is associated with metabolic syndrome X. Simple waist measurements can detect the subjects (10-15% of the population) at increased CV risk with a sensitivity of 70%. This is invaluable for such a simple and cheap test. Diet is the first step in treating these patients and reducing caloric intake is necessary in most of them. Saturated fats will be replaced by polyunsaturated and mono-unsaturated ones. Long-chain carbohydrates with low glycemic index will be suggested. Regular physical activity will be promoted. If these life style modifications fail, drugs can be added: biguanide and glitazone are good candidates. Orlistat has improved metabolic syndrome X on a long-term basis. Drugs that could increase insulin resistance are to be avoided.