medigraphic.com
ISSN 0016-3813 (Print)

2004, Number S2

<< Back Next >>

Gac Med Mex 2004; 140 (S2)

The metabolic syndrome: a concept in evolution

Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Franco A, Olaiz G, Rull JA, Sepúlveda J

Language: Spanish
References: 27
Page: 41-48
PDF size: 601.89 Kb.


ABSTRACT

The concept metabolic syndrome intends to incorporate in a single disorder all biologic consequences of insulin resistance and associated conditions. The objective of this paper was to discuss strengths and limitations of current definitions of the metabolic syndrome, its epidemiology, and its association with non-alcoholic steatohepatitis (NASH). Definitions proposed by the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) are specific but possess low sensitivity for detecting insulin resistance. Cut-off points used in these definitions should be "but are not" adjusted for ethnicity; as a result, in non-Caucasian subjects there is lack of agreement among these. For example, in a Mexican population-based survey prevalence was 13.61% using the WHO definition and 26.6% employing NCEP-III criteria. Cases identified with WHO criteria have a more severe form of the disease. NASH is the most common cause of abnormal levels of serum aminotransferases. It shares some aspects of its pathophysiology with the metabolic syndrome and its prevalence is higher among cases with metabolic syndrome compared to with general population. NASH appears to be the hepatic manifestation of the metabolic syndrome.


REFERENCES

  1. Facchini F, Hua N, Abbasi F, Reaven G. Insulin resistance as a predictor of age related disease. J Clin Endoc Metab 2001;86:3574-8.

  2. Sakkinen P, Wahl P, Cushman M, Lewis M, Tracy R. Clustering of procoagulation, inflammation and fibrinolisis variables with metabolic factors in insulin resistance syndrome. Am J Epidemiol 2000;152;897-907.

  3. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin resistance syndrome (syndrome X). Diabetes 1992;41:715-22.

  4. American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists Position Statement on Insulin Resistance Syndrome. Endocr Pract 2003:9:237-52.

  5. Legro R, Castracane D, Kauffman R. Detecting insulin resistance in polycystic ovary syndrome: purpose and pitfalls. Obstet Gynecol Survey 2004;59:141-54.

  6. Groop L, Orho-Melander M. The dysmetabolic syndrome. J Intern Med 2001;250:105-20.

  7. Alberti FGMM, Zimmet PZ, for the WHO Consultation. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus, Provisional Report of a WHO Consultation. Diabetes Med 1998;15:539-53.

  8. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Cholesterol. JAMA 2001;285:2486-97.

  9. Sánchez-Castillo C, Velázquez-Monroy O, Berber A, et al. Anthropometric cutoff points for predicting chronic diseases in the Mexican National Health Survey 2000. Obes Res 2003;11:442-51.

  10. Tan CE, Ma S, Wai D, Chew SK, Taie ES. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes Care 2004;27:1182-6.

  11. Gómez-Pérez FJ, Aguilar-Salinas CA, López-Alvarenga JC, Guillén LE, Wong B, Rull JA. Lack of agreement between the World Health Organization category of impaired glucose tolerance and the American Diabetes Association category of impaired fasting glucose. Diabetes Care 1998;21:1886-8.

  12. The Expert Committee on Diagnosis and Classification of Diabetes Mellitus: Follow-Up Report on the Diagnosis of Diabetes Mellitus. Diabetes Care 2003;26;3160-7.

  13. Aguilar-Salinas CA, Olaiz G, Valles V, Ríos JM, Gómez-Pérez FJ, Rull JA, Rojas R, Franco A, Sepúlveda J. High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemia in a Mexican nation wide survey. J Lipid Res 2001;42:1298-1307.

  14. Liao Y, Kwon S, Shaughnessy S, Wallace P, Hutto A, Jenkins AJ, Klein RI, Garvey WT. Critical evaluation of the Adult Treatment Panel III criteria in identifying insulin resistance with dyslipidemia. Diabetes Care 2004;27:978-83.

  15. Isomaa Bo, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683-9.

  16. Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 2002;156:1070-7.

  17. Cheal K, Abbasi F, Lamendola C, McLaughlin T, Reaven GM, Ford ES. Relationship to insulin resistance of the Adult Treatment Panel III Diagnostic Criteria for identification of the metabolic syndrome. Diabetes 2004;53:1195-200.

  18. Ford E, Giles W, Dietz W. Prevalence of the metabolic syndrome among US adults. JAMA 2002;287:356-9.

  19. Aguilar-Salinas CA, Rojas R , Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, Olaiz G, Rull JA, Sepúlveda J. High prevalence of the metabolic syndrome in Mexico. Arch Med Res 2004;35:76-81.

  20. Aguilar Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, Olaiz G, Rull JA, Sepúlveda J. 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 populationbased survey. Diabetes Care 2003;26:1635.

  21. Meigs J, Wilson P, Nathan D, D’Agostino R, Williams K, Haffner SM. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes 2003;52:2160-7.

  22. Angulo P. Non-alcoholic fatty liver disease. N Engl J Med 2002;346:1221-30.

  23. Neuschwander-Tetri B, Caldwell S. Non-alcoholic steatohepatitis: summary of an AASLD single topic conference. Hepatology 2003;37:1202-19.

  24. Festi D, Colecchia A, Sacco T, Bondi M, Roda E, Marchesini G. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev 2004;5:27-42.

  25. den Boer M, Voshol PJ, Kuipers F, Havekes LM, Romijn JA. Hepatic steatosis: a mediator of the metabolic syndrome. Lessons from animal models. Arterios Thromb Vasc Biol 2004;24:644-9.

  26. Unger R, Orci L. Diseases of liporegulation: new perpective on obesity and related disorders. FASEB J 2001;15:312-21.

  27. Harrison S, Di Bisceglie A. Advances in the understanding and treatment of Non-alcoholic fatty liver disease. Drugs 2003;63:2379-94.




2020     |     www.medigraphic.com