Metabolic Syndrome
The metabolic syndrome (MetS) is a cluster of the most dangerous heart attack risk factors, and up to a quarter of the world’s adults might have MetS. In general, cardiovascular diseases (CVD) are the most common cause of death in the world. As most patie
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Introduction to Metabolic Syndrome The metabolic syndrome (MetS) is a cluster of the most dangerous heart attack risk factors, and up to a quarter of the world’s adults might have MetS. In general, cardiovascular diseases (CVD) are the most common cause of death in the world. As most patients show no obvious symptoms prior to the first incident, identification of risk factors and early intervention are important. Hypercholesterolemia is a well-established strong risk factor and is a primary target for the prevention of CVD (Fig. 1, see chapter “Hyperlipidemia”). MetS has been identified as the second target. It was previously called syndrome X [1] and insulin resistance syndrome [2], as low insulin sensitivity occurs frequently in this condition (Fig. 1). Multiple definitions for the diagnosis of MetS exist, yet all require at least three of the following: (1) obesity, especially abdominal obesity (expressed by increased waist circumference); (2) dyslipidemia, expressed by raised serum levels of K. Inoue • N. Maeda Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan e-mail: [email protected]; [email protected] T. Funahashi (*) Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University, Osaka, Japan e-mail: [email protected]
triglycerides or lowered high-density lipoprotein cholesterol (HDLc); (3) elevated blood pressure; (4) and raised fasting plasma glucose (see also chapters “Hyperlipidemia”, “Hypertension”, and “Diabetes mellitus”, respectively) [3]. Moreover, subjects with MetS often show impaired glucose tolerance, insulin resistance, and postprandial abnormalities in lipids. Abdominal obesity (also termed android obesity [4] or upper body obesity [5]), glucose intolerance, dyslipidemia, and hypertension form “the deadly quartet for CVD” [6]. Studies of abdominal body fat distribution using computed tomography (CT) have revealed that the accumulation of visceral fat in intra-abdominal cavity is more closely related to lipid, glucose, and blood pressure abnormalities rather than absolute body weight or abdominal subcutaneous fat [7]. Thus, the increase of visceral fat area correlates with a cluster of obesity-related risk factors even in mildly obese subjects and is a critical step in MetS development [8]. Finally, from a diagnostic point of view, the waist circumference is an easy-to-measure surrogate marker of visceral fat. MetS usually occurs in association with sedentary lifestyle (overeating and physical inactivity). It has become a global health problem all over the world and is also increasing in Asian countries, where large numbers of people are living. Although the frequency of people with body mass index (BMI) above 30 is still lower in Asians compared to Caucasians and Africans, MetS, type 2 diabetes, and CVD have also become a serious health problem in Asia.
E. Lammert, M. Zeeb (eds.), Metabolism of Human Diseases, DOI 10.1007/978-3-7091-0715-7_30, © Springer-Verlag Wien
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