Metabolic Syndrome & Macrovascular Complications PDF
Document Details
Uploaded by EasierCotangent
Tags
Summary
This document provides an overview of metabolic syndrome and its connection to macrovascular complications. It covers definitions, associated factors, pathophysiology, and management strategies. The document is well-organized, with clear explanations of different aspects related to metabolic syndrome and macrovascular complications.
Full Transcript
12.5 metabolic syndrome and macrovascular complications A. Metabolic Syndrome 1. Introduction & Background Definition: Metabolic Syndrome (MeS) is a cluster of cardiovascular disease risk factors linked to insulin resistance.  between d...
12.5 metabolic syndrome and macrovascular complications A. Metabolic Syndrome 1. Introduction & Background Definition: Metabolic Syndrome (MeS) is a cluster of cardiovascular disease risk factors linked to insulin resistance.  between diabetes, gout, and hypertension. 1990s: Recognition of visceral obesity as a key component of insulin resistance syndrome (also known as Syndrome X or the Deadly Quartet). 2. Definitions -ATP III (2005): Diagnosis requires any 3 of the following 5 criteria: a. Obesity: Waist circumference Men: ≥ 102 cm Women: ≥ 88 cm b. Glucose: Fasting glucose ≥ 5.6 mmol/L or known diabetes. c. Lipids: Triglycerides: ≥ 1.7 mmol/L HDL: Men ≤ 1 mmol/L; Women ≤ 1.3 mmol/L. d. Blood Pressure: ≥ 130/85 mm Hg or known hypertension. IDF (2006): Requires visceral obesity + 2 or more criteria from above. 3. Associated Conditions Polycystic ovarian disease Fatty liver disease Chronic kidney disease Obstructive sleep apnoea Hyperuricemia/gout Low-grade inflammation and endothelial dysfunction 4. Pathophysiology of Metabolic Syndrome Visceral Obesity: Central to the development of MeS; fat cells secrete hormones that disrupt insulin action. Insulin Resistance: Impairs glucose uptake and promotes lipolysis, leading to increased free fatty acids (FFAs). Neurohormonal Activation: Adipose tissue secretes hormones like Angiotensin II, contributing to hypertension. Chronic Inflammation: Adipocytokines (e.g., TNFα, IL-6) lead to endothelial dysfunction and vascular disease. Dysglycemia: Impaired glucose homeostasis; pre-diabetes is a significant risk factor for Type 2 diabetes. Dyslipidaemia: Characterized by high triglycerides and VLDL, low HDL, and small dense LDL particles. Hypertension: Resulting from insulin resistance and activation of the Renin-Angiotensin System (RAS). Endothelial Dysfunction: Increases risk of atherosclerosis and thrombotic events. 6. Management of Metabolic Syndrome Recognition: Identify patients with visceral obesity and associated metabolic abnormalities. -Lifestyle Interventions: Diet and weight reduction. Regular exercise Smoking cessation -Pharmacological Therapy: Treat each risk factor if lifestyle changes are insufficient (e.g., glucose abnormalities, hypertension, dyslipidaemia). B. Macrovascular Complications Macrovascular disease risk factors in diabetic patients · hypertension · dyslipidaemia · diabetic kidney disease · insulin resistance · obesity 1. Types of Macrovascular Disease Cerebrovascular Disease: Ischemic events (thrombosis, embolism) and haemorrhagic strokes. Transient Ischemic Attacks (TIAs). Ischemic Heart Disease: Angina Pectoris and Acute Coronary Syndrome. Symptoms include central crushing chest pain and autonomic symptoms. -Peripheral Vascular Disease: Atherosclerosis affecting peripheral vessels leading to reduced blood and oxygen supply. Symptoms include intermittent claudication, rest pain, and potential gangrene. 
