2004, Número 3
Síndrome metabólico. Aspectos fisiopatológicos e importancia epidemiológica
Chávez-Tapia NC, Almeda VP, Motola KD, Sánchez K, Méndez-Sánchez N
Idioma: Español
Referencias bibliográficas: 73
Paginas: 160-168
Archivo PDF: 106.43 Kb.
RESUMEN
El síndrome metabólico es una enfermedad que engloba a distintas entidades
que comparten como eje fisiopatológico la obesidad y la resistencia a la
insulina. El incremento acelerado en su prevalencia, nos hace verlo como una
enfermedad emergente que tiene consecuencias importantes en el ámbito
cardiovascular, endocrinológico y gastrointestinal.
La estrategia más útil para tratar este complejo síndrome se basa
principalmente en la reducción de peso y en la realización cotidiana de
ejercicio aeróbico, que en conjunto son las estrategias más útiles para
disminuir la resistencia a la insulina. Este artículo revisa los aspectos
más recientes relacionados con el síndrome metabólico, con principal énfasis
en aspectos fisiopatológicos y epidemiológicos.
REFERENCIAS (EN ESTE ARTÍCULO)
. Archard C, Thiers J. Le virlisme pilaire et son association a l’insuffisance glycolytique (diabe‘te des femmes a barb). Bull Acad Natl Med 1921; 86(51-64).
Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr 1956; 4(1): 20-34.
Welborn TA et al. Serum-insulin in essential hypertension and in peripheral vascular disease. Lancet 1966; 1(7451): 1336-7.
Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37(12): 1595-607.
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287(3): 356-9.
Ford ES, Giles WH. A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabetes Care 2003; 26(3): 575-81.
Aguilar-Salinas CA et al. Analysis of the agreement between the World Health Organization criteria and the National Cholesterol Education Program-III definition of the metabolic syndrome: results from a population-based survey. Diabetes Care 2003; 26(5): 1635.
Wilson PW et al. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999; 159(10): 1104-9.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15(7): 539-53.
Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285(19): 2486-97.
Wilson PW, Grundy SM. The metabolic syndrome: a practical guide to origins and treatment: Part II. Circulation 2003; 108(13): 1537-40.
Wilson PW, Grundy SM. The metabolic syndrome: practical guide to origins and treatment: Part I. Circulation 2003; 108(12): 1422-4.
Sattar N et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003; 108(4): 414-9.
Grundy SM. Inflammation, hypertension, and the metabolic syndrome. JAMA 2003; 290(22): 3000-2.
Bjorntorp P. Abdominal obesity and the metabolic syndrome. Ann Med 1992; 24(6): 465-8.
Yudkin JS. Abnormalities of coagulation and fibrinolysis in insulin resistance. Evidence for a common antecedent? Diabetes Care 1999; 22 Suppl 3: C25-30.
Mendez-Sanchez N et al. Síndrome metabólico como factor de riesgo para litiasis vesicular: estudio de casos y controles. Rev Gastroenterol Mex 2003; 68 (suppl 3): 86.
Godsland IF et al. Plasma total homocysteine concentrations are unrelated to insulin sensitivity and components of the metabolic syndrome in healthy men. J Clin Endocrinol Metab 2001; 86(2): 719-23.
Reaven G. Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 2002; 106(3): 286-8.
McLaughlin T et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003; 139(10): 802-9.
Park YW et al. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003, 163(4): 427-36.
Mokdad AH et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289(1): 76-9.
Hedley AA et al. Prevalence of Overweight and Obesity Among US Children, Adolescents, and Adults, 1999-2002. JAMA 2004; 291(23): 2847-2850.
Alexander CM et al. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52(5): 1210-4.
Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 2003; 88(6): 2404-11.
Liu S, Manson JE. Dietary carbohydrates, physical inactivity, obesity, and the ‘metabolic syndrome’ as predictors of coronary heart disease. Curr Opin Lipidol 2001; 12(4): 395-404.
Ashton WD, Nanchahal K, Wood DA. Body mass index and metabolic risk factors for coronary heart disease in women. Eur Heart J 2001; 22(1): 46-55.
Poehlman ET, Toth MJ, Gardner AW. Changes in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med 1995; 123(9): 673-5.
Razay G, Heaton KW, Bolton CH. Coronary heart disease risk factors in relation to the menopause. Q J Med 1992; 85(307-308): 889-96.
Lynch NA et al. Comparison of VO2max and disease risk factors between perimenopausal and postmenopausal women. Menopause 2002; 9(6): 456-62.
Dallongeville J et al. Multiple coronary heart disease risk factors are associated with menopause and influenced by substitutive hormonal therapy in a cohort of French women. Atherosclerosis 1995; 118(1): 123-33.
Lindheim SR et al. Comparison of estimates of insulin sensitivity in pre- and postmenopausal women using the insulin tolerance test and the frequently sampled intravenous glucose tolerance test. J Soc Gynecol Investig 1994; 1(2): 150-4.
Walton C et al. The effects of the menopause on insulin sensitivity, secretion and elimination in non-obese, healthy women. Eur J Clin Invest 1993; 23(8): 466-73.
Toth MJ et al. Effect of menopausal status on insulin-stimulated glucose disposal: comparison of middle-aged premenopausal and early postmenopausal women. Diabetes Care 2000; 23(6): 801-6.
Juhan-Vague I et al. Fibrinolytic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. ECAT Study Group. European Concerted Action on Thrombosis and Disabilities. Circulation 1996; 94(9): 2057-63.
Ridker PM et al. Endogenous tissue-type plasminogen activator and risk of myocardial infarction. Lancet 1993; 341(8854): 1165-8.
Landin K et al. Abdominal obesity is associated with an impaired fibrinolytic activity and elevated plasminogen activator inhibitor-1. Metabolism 1990; 39(10): 1044-8.
Lindoff C et al. Passage of the menopause is followed by haemostatic changes. Maturitas 1993; 17(1): 17-22.
Gebara OC et al. Association between increased estrogen status and increased fibrinolytic potential in the Framingham Offspring Study. Circulation 1995; 91(7): 1952-8.
Pradhan AD et al. Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: prospective analysis from the Women’s Health Initiative observational study. JAMA 2002; 288(8): 980-7.
Isomaa B et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24(4): 683-9.
Vessby B. Dietary fat, fatty acid composition in plasma and the metabolic syndrome. Curr Opin Lipidol 2003; 14(1): 15-9.
Pelikanova T et al. Serum phospholipid fatty acid composition and insulin action in type 2 diabetic patients. Metabolism 2001; 50(12): 1472-8.
Lovejoy JC et al. Relationship of dietary fat and serum cholesterol ester and phospholipid fatty acids to markers of insulin resistance in men and women with a range of glucose tolerance. Metabolism 2001; 50(1): 86-92.
Vessby B et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia 2001; 44(3): 312-9.
Perez-Jimenez F et al. A Mediterranean and a high-carbohydrate diet improve glucose metabolism in healthy young persons. Diabetologia 2001; 44(11): 2038-43.
Summers LK et al. Substituting dietary saturated fat with polyunsaturated fat changes abdominal fat distribution and improves insulin sensitivity. Diabetologia 2002; 45(3): 369-77.
Barnard RJ et al. Diet-induced insulin resistance precedes other aspects of the metabolic syndrome. J Appl Physiol 1998; 84(4): 1311-5.
Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest 2000; 106(4): 473-81.
Schoonjans K et al. Peroxisome proliferator-activated receptors, orphans with ligands and functions. Curr Opin Lipidol 1997; 8(3): 159-66.
Auwerx J. PPARgamma, the ultimate thrifty gene. Diabetologia 1999; 42(9): 1033-49.
Ginsberg HN, Stalenhoef AF. The metabolic syndrome: targeting dyslipidaemia to reduce coronary risk. J Cardiovasc Risk 2003; 10(2): 121-8.
White MF. The IRS-signaling system: a network of docking proteins that mediate insulin and cytokine action. Recent Prog Horm Res 1998; 53: 119-38.
Wang Q et al. Protein kinase B/Akt participates in GLUT4 translocation by insulin in L6 myoblasts. Mol Cell Biol 1999; 19(6): 4008-18.
Kitamura T et al. Requirement for activation of the serine-threonine kinase Akt (protein kinase B) in insulin stimulation of protein synthesis but not of glucose transport. Mol Cell Biol 1998; 18(7): 3708-17.
Kotani K et al. Requirement of atypical protein kinase clambda for insulin stimulation of glucose uptake but not for Akt activation in 3T3-L1 adipocytes. Mol Cell Biol 1998; 18(12): 6971-82.
Shepherd PR, Kahn BB. Glucose transporters and insulin action—implications for insulin resistance and diabetes mellitus. N Engl J Med 1999; 341(4): 248-57.
Chavez-Tapia NC, Vidal-Tamayo RR, Lizardi-Cervera J. Factores de riesgo en diabetes mellitus tipo 2. Med Int Mex 2003; 19(5): 301-310.
Baron AD et al. Insulin-mediated skeletal muscle vasodilation contributes to both insulin sensitivity and responsiveness in lean humans. J Clin Invest 1995; 96(2): 786-92.
Reaven GM. Insulin resistance/compensatory hyperinsulinemia, essential hypertension, and cardiovascular disease. J Clin Endocrinol Metab 2003; 88(6): 2399-403.
Pradhan AD et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001; 286(3): 327-34.
Ford ES. Body mass index, diabetes, and C-reactive protein among U.S. adults. Diabetes Care 1999; 22(12): 1971-7.
Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999; 340(2): 115-26.
Dandona P et al. Tumor necrosis factor-alpha in sera of obese patients: fall with weight loss. J Clin Endocrinol Metab 1998; 83(8): 2907-10.
Pickup JC, Crook MA. Is type II diabetes mellitus a disease of the innate immune system? Diabetologia 1998; 41(10): 1241-8.
Wakabayashi I. Age-related change in relationship between body-mass index, serum sialic acid, and atherogenic risk factors. J Atheroscler Thromb 1998; 5(2): 60-5.
Festa A et al. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000; 102(1): 42-7.
Koenig W et al. C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation 1999; 99(2): 237-42.
Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105(9): 1135-43.
Ridker PM et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336(14): 973-9.
Blackburn R et al. Elevated C-reactive protein constitutes an independent predictor of advanced carotid plaques in dyslipidemic subjects. Arterioscler Thromb Vasc Biol 2001; 21(12): 1962-8.
Robitaille J et al. Association between the PPARalpha-L162V polymorphism and components of the metabolic syndrome. J Hum Genet 2004: p. Epub ahead of print. Aug 10.
Popkin BM. The Nutrition Transition and Obesity in the Developing World. J Nutr 2001; 131(3): 871S-873.