Metabolic Syndrome

Introduction

• Syndrome characterized by insulin resistance with hyperinsulinemia and obesity
• Associated conditions
• polycystic ovarian syndrome

Presentation

• Physical exam
  • acanthosis nigricans
    • sign of hyperinsulinemia
  • hypertension (>130/85 mmHg)
  • obesity
• as evaluated by waist circumference 

Evaluation

• Serology
  • hypertriglyceridemia (>150 mg/dL)
  • hyperglycemia (>110 mg/dL fasting)
  • decreased HDL cholesterol (<40 mg/dL in men, <50 mg/dL in women)
• BMI = weight in kg / (height in meters)2 
  

Treatment

• Medical with lifestyle changes
  • weight loss will 
    • increase insulin sensitivity
    • decrease blood pressure
    • increase ghrelin level
    • decrease leptin level
  • diabetic medications (metformin)
  • antihypertensive agents (ACE-inhibitors or thiazides)
• cholesterol-loweing agents (statins)

Prognosis, Prevention, and Complications

•  ↑ risk of Alzheimers, coronary artery disease