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Metabolic Syndrome

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Book cover Obesity and Diabetes

Part of the book series: Contemporary Diabetes ((CDI))

Abstract

In the last number of years, a great deal of attention has been given to a cluster of risk factors associated with the development of cardiovascular disease (CVD) identified as metabolic syndrome. Several organizations have issued definitions in an attempt to heighten awareness and identify patients who ultimately may be at increased risk for CVD (14).

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References

  1. Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C, for the conference participants. Definition of metabolic syndrome, report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circulation 2004;109:433–438.

    Article  PubMed  Google Scholar 

  2. World Health Organization. Definition, Diagnosis, and Classification of Diabetes Mellitus and Its Complications: Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. WHO/NCD/NCS/99.2. World Health Organization, Department of Noncommunicable Disease Surveillance, Geneva, 1999.

    Google Scholar 

  3. Einhorn D, Reaven GM, Cobin RH, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003;9(3):237–252.

    PubMed  Google Scholar 

  4. The International Diabetes Foundation. The IDF consensus worldwide definition of the metabolic syndrome. http://www.idf.org

  5. Himsworth HP, Kerr RB. Insulin-sensitive and insulin-insensitive types of diabetes mellitus. Clin Sci 1939;4:119–152.

    CAS  Google Scholar 

  6. Cahill GF. Physiology of insulin in man. Diabetes 1971;20:785–799.

    PubMed  CAS  Google Scholar 

  7. Bagdade JD, Bierman EL, Porte D Jr. The significance of basal insulin levels in the evaluation of the insulin response to glucose and non-diabetic subjects. J Clin Invest 1967;46:1549–1557.

    PubMed  CAS  Google Scholar 

  8. Polonsky KS, Given BD, Hirsch L, et al. Quantitative study of insulin secretion and clearance in normal and obese subjects. J Clin Invest 1988;81:435–441.

    Article  PubMed  CAS  Google Scholar 

  9. Modan M, Halkin H, Fuchs Z, et al. Hyperinsulinemia—a link between glucose intolerance, obesity, hypertension, dyslipoproteinemia, elevated serum uric acid and internal cation imbalance. Diabetes Metab 1987;13:375–380.

    CAS  Google Scholar 

  10. Modan M, Halkin H, Lusky A, Segal P, Fuchs Z, Chetrit A. Hyperinsulinemia is characterized by jointly disturbed plasma VLDL, LDL, and HDL levels. A population-based study. Arteriosclerosis 1988;8:227–236.

    PubMed  CAS  Google Scholar 

  11. Reaven GM. The role of insulin resistance in human disease. Diabetes 1988;37:1595–1607.

    Article  PubMed  CAS  Google Scholar 

  12. WHO Expert Consultation. Appropriate body mass index for Asian poipulations and its implications for policy and intervention strategies. Lancet 2004;363:157–163

    Article  Google Scholar 

  13. Tan C-E, Na S, Wai D, Chew S-K, Tai E-S. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians. Diabetes Care 2004;27:1182–1186.

    Article  PubMed  Google Scholar 

  14. Olefsky JM, Kolterman OG, Scarlett JA. Insulin action and resistance in obesity and non-insulin-dependent type 2 diabetes mellitus. Am J Physiol 1982;243:E15–E30.

    PubMed  CAS  Google Scholar 

  15. Su HY, Sheu WH, Chin HM, Jeng CY, Reaven GM. Effect of weight loss on blood pressure and insulin resistance in normotensive and hypertensive obese individuals. Am J Hypertens 1995;8:1067–1071.

    Article  PubMed  CAS  Google Scholar 

  16. Niskanen L, Uusitupa M, Sarlund H, Siitonen O, Paljarvi L, Laasko M. The effects of weight loss on insulin sensitivity, skeletal muscle composition, and capillary density in obese non-diabetic subjects. Int J Obes 1996;20:154–160.

    CAS  Google Scholar 

  17. Muscelli E, Camastra S, Catalano C, et al. Metabolic and cardiovascular assessment in moderate obesity: effect of weight loss. J Clin Endocrinol Metab 1997;82:2937–2943.

    Article  PubMed  CAS  Google Scholar 

  18. Vague J. The degree of masculine differences of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr 1956;4:20–34.

    PubMed  CAS  Google Scholar 

  19. Kvist H, Sjostrom L, Tylen U. Adipose tissue volume determinations in women by computerized tomography: technical considerations. Int J Obesity 1986;10:53–67.

    CAS  Google Scholar 

  20. Kvist H, Chowdhury B, Grangard U, Tylen U, Sjostrom L. Total and visceral adipose tissue volume derived from measurements with computerized tomography in adult men and women: predictive equations. Am J Clin Nutr 1988;48:1351–1361.

    PubMed  CAS  Google Scholar 

  21. Abate N, Burns D, Peshock RM, Garg, Grundy SM. Estimation of adipose tissue mass by magnetic resonance imaging: validation against dissection in human cadavers. J Lipid Res 1994;35:1490–1496.

    PubMed  CAS  Google Scholar 

  22. Tataranni PA, Ravussin E. Use of dual X-ray absorptiometry in obese individuals. Am J Clin Nutr 1995;55:730–734.

    Google Scholar 

  23. Goodpaster BH, Kelley DE, Wing RR, Meier A, Thaete FL. Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. Diabetes 1999;48:839–847.

    Article  PubMed  CAS  Google Scholar 

  24. Banerji MA, Lebovitz HE. Insulin-sensitive and insulin-resistant variants in NIDDM. Diabetes 1989;38:784–792.

    Article  PubMed  CAS  Google Scholar 

  25. Banerji MA, Chaiken RL, Gordon D, Kral JG, Lebovitz HE. Does intra-abdominal adipose tissue in black men determine whether NIDDM is insulin resistant or insulin-sensitive? Diabetes 1995;44:141–146.

    Article  PubMed  CAS  Google Scholar 

  26. Banerji MA, Lebowitz J, Chaiken RL, Gordon D, Kral J, Lebovitz HE. Relationships of visceral adipose tissue and glucose disposal is independent of sex in black NIDDM subjects. Am J Physiol 1997;273:E425–E432.

    PubMed  CAS  Google Scholar 

  27. Banerji MA, Lebovitz HL. Insulin action in black Americans with NIDDM. Diabetes Care 1992;15:1295–1302.

    Article  PubMed  CAS  Google Scholar 

  28. Kahn SE, Prigeon RL, Schwartz RS, et al. Obesity, body fat distribution, insulin sensitivity and islet b-cell function as explanations for metabolic diversity. J Nutr 2001;131:354S–360S.

    PubMed  CAS  Google Scholar 

  29. Cnop M, Landchild MJ, Vidal J, et al. The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations: distinct metabolic effects of to fat compartments. Diabetes 2002;51:1005–1015.

    Article  PubMed  CAS  Google Scholar 

  30. Bergstrom RW, Newell-Morris LL, Leonetti DL. Association of elevated fasting C-peptide level and increased intra-abdominal fat distribution with development of NIDDM in Japanese-American men. Diabetes 1990;39:104–111.

    Article  PubMed  CAS  Google Scholar 

  31. Boyko EJ, Fujimoto WY, Leonetti DL, Newell-Morris L. Visceral adiposity and risk for type 2 diabetes: A prospective study among Japanese-Americans. Diabetes Care 2000;23:465–471.

    Article  PubMed  CAS  Google Scholar 

  32. Brochu M, Tchernof A, Dionne IJ, et al. What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? J Clin Endocrinol Metab 2001;86:1020–1025.

    Article  PubMed  CAS  Google Scholar 

  33. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004;89:2548–2556.

    Article  PubMed  CAS  Google Scholar 

  34. Chandran M, Phillips SA, Ciaraldi T, Henry RR. Adiponectin: more than just another fat cell hormone? Diabetes Care 2003;26:2442–2450.

    Article  PubMed  CAS  Google Scholar 

  35. Hanson RL, Narayan KMV, McCance DR, et al. Rate of weight gain, weight fluctuation, and incidence of NIDDM. Diabetes 1995;44:261–266.

    Article  PubMed  CAS  Google Scholar 

  36. Colditz GA, Willet WC, Stampfer MJ, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 1990;132:501–513.

    PubMed  CAS  Google Scholar 

  37. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laasko M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229–234.

    Article  PubMed  CAS  Google Scholar 

  38. Grundy SM, Cleeman JI, Merz NB, et al., for the Coordinating Committee of the National Cholesterol Educational Program. Implications of the recent clinical trials for the National Cholesterol Educational Program Adult Treatment Panel III Guidelines Circulation 2004;110:227–239.

    Google Scholar 

  39. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2004;27(Suppl 1):S15–S35.

    Google Scholar 

  40. Snow V, Aronson MD, Hornbake ER, Mottur-Pilson C, Weiss KB for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Lipid control in the management of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2004;140:644–649.

    PubMed  Google Scholar 

  41. Balku B, Shipley M, Jarrett RJ, et al. High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men. Diabetes Care 1998;21:360–367.

    Article  Google Scholar 

  42. Khaw K, Wareham N, Luben R, et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk). BMJ 2001;322:1–6.

    Article  Google Scholar 

  43. Carr M, Brunzell J. Abdominal obesity and dyslipidemia in the Metabolic Syndrome: Importance of type 2 diabetes and familial combined hyperlipidemia in coronary artery disease risk. J Clin Endocrinol Metab 2004;89:2601–2607.

    Article  PubMed  CAS  Google Scholar 

  44. Nieves DJ, Cnop M, Retzlaff B, et al. The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat. Diabetes 2003;52:172–179.

    Article  PubMed  CAS  Google Scholar 

  45. Holvoet P, Kritchevsky SB, Tracy RP, et al. The metabolic syndrome, circulating oxidized LDL, and risk of myocardial infarction in well-functioning elderly people in the Health, Aging, and Body Composition Cohort. Diabetes 2004;53:1068–1073.

    Article  PubMed  CAS  Google Scholar 

  46. Hajjar I, Kotchen T. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA 2003;290:199–2051.

    Article  PubMed  Google Scholar 

  47. Reaven G. Insulin resistance/compensatory hyperinsulinemia, essential hypertension, and cardiovascular disease. J Clin Endocrinol Metab 2003;88:2399–2403.

    Article  PubMed  CAS  Google Scholar 

  48. Sesso H, Buring J, Rifai N, Blake G, Gaziano J, Ridker P. C-reactive protein and the risk of developing hypertension. JAMA 2003;290:2945–2951.

    Article  PubMed  CAS  Google Scholar 

  49. Visser M, Bouter L, McQuillan G, Wener M, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999;282:2131–2135.

    Article  PubMed  CAS  Google Scholar 

  50. Pradhan A, Manson J, Rifai N, Buring J, Ridker P. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001;286:327–334.

    Article  PubMed  CAS  Google Scholar 

  51. Stehouwer CD, Gall MA, Twisk JW, Knudsen E, Emies JJ, Parving HH. Increased urinary albumin excretion, endothelial dysfunction and chronic low grade inflammation in type 2 diabetes: progressive, interrelated and independently associated with risk of death. Diabetes 2002;51:1157–1165.

    Article  PubMed  CAS  Google Scholar 

  52. Marchesini G, Forlani G, Cerrelli F, et al. WHO and ATP III proposals for the definition of the metabolic syndrome in patients with type 2 diabetes. Diab Med 2004;21:383–387.

    Article  CAS  Google Scholar 

  53. Everson SA, Goldberg DE, Helmrich SP, et al. Weight gain and the risk of developing insulin resistance syndrome. Diabetes Care 1998;21:1637–1643.

    Article  PubMed  CAS  Google Scholar 

  54. Bonora E, Kiechl S, Willeit J, et al. Prevalence of insulin resistance in metabolic disorders. The Bruneck Study. Diabetes 1998;47:1643–1649.

    Article  PubMed  CAS  Google Scholar 

  55. Ford E, Giles W, Dietz W. Prevalence of the metabolic syndrome among US adults-Findings from the Third National Health and Nutrition Examination Survey. JAMA 2002;87:356–359.

    Article  Google Scholar 

  56. Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM. The metabolic syndrome as predictor of type 2 diabetes-The San Antonio Heart Study. Diabetes Care 2003;26:3153–3159.

    Article  PubMed  Google Scholar 

  57. Flegal KM. The obesity epidemic in children and adults: current evidence and research issues. Med Sci Sports Exer 1999;31(Suppl 11):S509–S514.

    CAS  Google Scholar 

  58. American Diabetes Association. Type 2 diabetes in children and adolescents (Consensus Statement) Diabetes Care 2000;23:381–389.

    Article  Google Scholar 

  59. Young-Hyman D, Schlundt DG, Herman L, De Luca F, Counts D. Evaluation of the insulin resistance syndrome in 5-to 10-year-old overweight/obese African-American children. Diabetes Care 2001;24:1359–1364.

    Article  PubMed  CAS  Google Scholar 

  60. Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–2374.

    Article  PubMed  CAS  Google Scholar 

  61. Yajnik CS, Fall CH, Coyaji KJ, et al. Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study. Int J Obes Relat Metab Disord 2003;27:173–180.

    Article  PubMed  CAS  Google Scholar 

  62. Bhargava SK, Sachdev HS, Fall CH, et al. Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004;350(9):865–875.

    Article  PubMed  CAS  Google Scholar 

  63. Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life. Diabetologia 2003;46:190–194.

    PubMed  CAS  Google Scholar 

  64. Stern MP, Bartley M, Duggirala R, Bradshaw B. Birth weight and the metabolic syndrome: thrifty phenotype or thrifty genotype? Diabetes Metab Res Rev 2000;16:88–93.

    Article  PubMed  CAS  Google Scholar 

  65. Ducimetiere P, Eschwege E, Papoz L, Richard JL, Claude JR, Rosselin G. Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease in middle aged men. Diabetologia 1980;19:205–210.

    Article  PubMed  CAS  Google Scholar 

  66. Fontbonne A, Charles MA, Thibult N, et al. Hyperinsulinemia as a predictor of coronary heart disease mortality in a healthy population: the Paris Prospective Study, 15-year follow-up. Diabetologia 1991;34:356–361.

    Article  PubMed  CAS  Google Scholar 

  67. Depres J-P, Lamarche B, Mauriege P, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease N Engl J Med 1996;334:952–957.

    Article  Google Scholar 

  68. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683–689.

    Article  PubMed  CAS  Google Scholar 

  69. Haffner SM, Mykkanen L, Festa A, Burke JP, Stern MP. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects. Circulation 2000;101:975–980.

    PubMed  CAS  Google Scholar 

  70. Greenlund KJ, Valdez R, Casper ML, Rith-Najarian S, Croft JB. Prevalence and correlates of the insulin resistance syndrome among Native Americans. The Inter-Tribal Heart Project. Diabetes Care 1999;22:441–447.

    Article  PubMed  CAS  Google Scholar 

  71. Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709–2716.

    Article  PubMed  Google Scholar 

  72. Ninomiya JK, L’ Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation 2004;109:42–46.

    Article  PubMed  Google Scholar 

  73. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003;52:210–1214.

    Article  Google Scholar 

  74. Robins SJ, Rubins HB, Faas FH, et al. Veterans Affairs HDL Intervention Trial (VA-HIT). Insulin resistance and cardiovascular events with low HDL cholesterol: the Veterans Affairs HDL Intervention Trial (VA-HIT). Diabetes Care 2003;26:1513–1517.

    Article  PubMed  CAS  Google Scholar 

  75. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA 2002;288:2998–3007.

    Article  Google Scholar 

  76. Colwell JA and the American Diabetes Association Aspirin therapy in diabetes. Diabetes Care 2004;27(Suppl 1):S72–S73.

    PubMed  Google Scholar 

  77. Tuomilehto J, Lindstrom J, Eriksson JG, et al., for the Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343–1350.

    Article  PubMed  CAS  Google Scholar 

  78. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403.

    Article  Google Scholar 

  79. McAuley KA, Williams SM, Mann JI, et al. Intensive lifestyle changes are necessary to improve insulin sensitivity. Diabetes Care 2002;25:445–452.

    Article  PubMed  Google Scholar 

  80. Manson JE, Nathan DM, Krolewski AS, Stampfer MJ, Willett WC, Hennekens CH. A prospective study of exercise and the incidence of diabetes among US male physicians. JAMA 1992;268:63–67.

    Article  PubMed  CAS  Google Scholar 

  81. Laaksonen DE, Lakka HM, Salonen JT, Niskanen LK, Rauramaa R, Lakka TA. Low levels of leisure time physical activity and cardiorespiratory fitness predict the development of the Metabolic Syndrome. Diabetes Care 2002;25:1612–1618.

    Article  PubMed  Google Scholar 

  82. Klein S, Fontana L, Young VL, Coggan AR, Kilo C, Patterson BW, Mohammed BS. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 2004;350:2549–2557.

    Article  PubMed  CAS  Google Scholar 

  83. Lebovitz HE, Banerji MA. Treatment of insulin resistance in diabetes mellitus. Eur J Pharmacol 2004;490:135–146.

    Article  PubMed  CAS  Google Scholar 

  84. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical reappraisal. Diabetes Care 2005;28:2289–2304.

    Article  PubMed  Google Scholar 

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Chaiken, R.L., Banerji, M.A. (2006). Metabolic Syndrome. In: Mantzoros, C.S. (eds) Obesity and Diabetes. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-59259-985-1_9

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  • DOI: https://doi.org/10.1007/978-1-59259-985-1_9

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