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ALL / Endocrinology

Metabolic syndrome

Metabolic syndrome

Metabolic syndrome is a cluster of cardiovascular risk factors linked by insulin resistance and central obesity. It increases the risk of type 2 diabetes and atherosclerotic cardiovascular disease.

Diagnosis
  • there is no single universal definition; in UK practice, AHA/NHLBI- or IDF-based criteria are commonly used
  • AHA/NHLBI: diagnose if any 3 of the following are present
    • waist circumference: men > 102 cm, women > 88 cm
    • triglycerides > 1.7 mmol/L, or treatment for hypertriglyceridaemia
    • HDL cholesterol: men < 1.03 mmol/L, women < 1.29 mmol/L, or treatment for low HDL
    • blood pressure >= 130/85 mmHg, or treatment for hypertension
    • fasting plasma glucose >= 5.6 mmol/L, or established type 2 diabetes
  • IDF: central obesity is required
    • Europid waist circumference: men > 94 cm, women > 80 cm
    • plus any 2 of the other 4 criteria above

Associated features
-non-alcoholic fatty liver disease
  • polycystic ovary syndrome
  • hyperuricaemia

Management
  • weight loss and regular exercise are first-line
  • treat individual risk factors aggressively: smoking cessation, BP control, lipid lowering (usually statin), and management of impaired glucose tolerance/diabetes
+PassMedicine Notes

Metabolic syndrome is a cluster of cardiovascular risk factors linked by insulin resistance and central obesity. It increases the risk of type 2 diabetes and atherosclerotic cardiovascular disease.

Diagnosis
  • there is no single universal definition; in UK practice, AHA/NHLBI- or IDF-based criteria are commonly used
  • AHA/NHLBI: diagnose if any 3 of the following are present
    • waist circumference: men > 102 cm, women > 88 cm
    • triglycerides > 1.7 mmol/L, or treatment for hypertriglyceridaemia
    • HDL cholesterol: men < 1.03 mmol/L, women < 1.29 mmol/L, or treatment for low HDL
    • blood pressure >= 130/85 mmHg, or treatment for hypertension
    • fasting plasma glucose >= 5.6 mmol/L, or established type 2 diabetes
  • IDF: central obesity is required
    • Europid waist circumference: men > 94 cm, women > 80 cm
    • plus any 2 of the other 4 criteria above
Associated features -non-alcoholic fatty liver disease
  • polycystic ovary syndrome
  • hyperuricaemia
Management
  • weight loss and regular exercise are first-line
  • treat individual risk factors aggressively: smoking cessation, BP control, lipid lowering (usually statin), and management of impaired glucose tolerance/diabetes


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