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Identifying and Treating the Metabolic Syndrome

  • Caroline A. AndrewEmail author
Chapter

Abstract

A 45-year-old male presents to an obesity medicine specialist for evaluation. His body mass index (BMI) is 40 kg/m2. His past medical history is significant for hypertension (HTN) and dyslipidemia. Medications include hydrochlorothiazide, losartan, rosuvastatin, and a daily aspirin. Blood pressure has been difficult to control despite his medications, and his cardiologist is considering adding a third agent. Family history is notable for both parents with obesity and HTN; his father had bariatric surgery. One of his sisters is overweight and has type 2 diabetes. He works as the manager of a construction company and is on his feet most of the day. He denies any use of tobacco and drinks one to two beers every night. His typical diet consists of a breakfast of eggs and toast, and then he will typically eat out for lunch and dinner, often stopping for dinner at fast-food restaurants on his way home.

Keywords

Metabolic syndrome Obesity Body mass index Insulin resistance LDL-C Diet 

References

  1. 1.
    Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–52.  https://doi.org/10.1161/circulationaha.105.169404.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults. J Am Coll Cardiol. 2014;63:2985–3023.  https://doi.org/10.1016/j.jacc.2013.11.004.CrossRefGoogle Scholar
  3. 3.
    National Institute for Health and Clinical Excellence (NICE) guidelines. BMI: preventing ill health and premature death in black, Asian and other minority ethnic groups. July 2013. https://www.nice.org.uk/advice/lgb13.
  4. 4.
    National Institutes of Health/National Heart, Lung, and Blood Institute. Managing overweight and obesity in adults: systematic evidence review from the obesity expert panel. Nov 2013. https://www.nhlbi.nih.gov/health-topics/managing-overweight-obesity-in-adults.
  5. 5.
    International Diabetes Foundation. The IDF consensus worldwide definition of the metabolic syndrome. 2016.Google Scholar
  6. 6.
    Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Almeras N, Bergeron J, Gaudet D, Tremblay G, Prud’homme D, Nadeau A, Despres JP. Hypertriglyceridemic waist: a marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation. 2000;102:179.CrossRefGoogle Scholar
  7. 7.
    Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, Shofer JB, Fish BE, Knopp RH, Kahn SE. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes. 2004;53:2087–94.CrossRefGoogle Scholar
  8. 8.
    Park Y, Zhu S, Palaniappan L, 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.CrossRefGoogle Scholar
  9. 9.
    Palaniappan L, Carnethon M, Wang Y, et al. Predictors of the incident metabolic syndrome in adults: the insulin resistance atherosclerosis study. Diabetes Care. 2004;27(3):788–93.CrossRefGoogle Scholar
  10. 10.
    Gennuso K, Gangnon R, Thraen-Borowski K, et al. Dose-response relationships between sedentary behaviour and the metabolic syndrome and its components. Diabetologia. 2015;58(3):485–92.CrossRefGoogle Scholar
  11. 11.
    Green A, Jacques P, Rogers G, et al. Sugar-sweetened beverages and prevalence of the metabolically abnormal phenotype in the Framingham heart study. Obesity (Silver Spring). 2014;22(5):E157–63.  https://doi.org/10.1002/oby.20724.CrossRefGoogle Scholar
  12. 12.
    Pankow J, Jacobs D, Steinberger J, et al. Insulin resistance and cardiovascular disease risk factors in children of parents with the insulin resistance (metabolic) syndrome. Diabetes Care. 2004;27(3):775–80.CrossRefGoogle Scholar
  13. 13.
    Mills G, Avery P, McCarthy M, et al. Heritability estimates for beta cell function and features of the insulin resistance syndrome in UK families with an increased susceptibility to type 2 diabetes. Diabetologia. 2004;47(4):732–8.CrossRefGoogle Scholar
  14. 14.
    Van Tilburg J, Wijmenga C, van Haeften T, et al. A genome scan for loci linked to quantitative insulin traits in persons without diabetes: the Framingham offspring study. Diabetologia. 2003;46(11):1588.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Hospital for Special SurgeryNew YorkUSA

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