Metabolic syndrome is a symptom complex manifested by a violation of the metabolism of fats and carbohydrates, an increase in blood pressure. Patients develop hypertension, obesity, insulin resistance and ischemia of the heart muscle. Diagnostics includes examination by an endocrinologist, determination of body mass index and waist circumference, assessment of the lipid spectrum, blood glucose. If necessary, ultrasound examination of the heart and daily measurement of blood pressure are carried out. Treatment consists in lifestyle changes: active sports, a special diet, normalization of weight and hormonal status.
Meaning
Metabolic syndrome (syndrome X) is a comorbid disease that includes several pathologies at once: diabetes mellitus, hypertension, obesity, coronary heart disease. The term “syndrome X” was first introduced at the end of the twentieth century by the American scientist Gerald Riven. The prevalence of the disease ranges from 20 to 40%. The disease most often affects people aged 35 to 65 years, mainly male patients suffer. In women, the risk of developing the syndrome after menopause increases by 5 times. Over the past 25 years, the number of children with this disorder has increased to 7% and continues to increase.
Causes
Syndrome X is a pathological condition that develops under the simultaneous influence of several factors. The main reason is a violation of the sensitivity of cells to insulin. Insulin resistance is based on a genetic predisposition, diseases of the pancreas. Other factors contributing to the appearance of a symptom complex include:
- Eating disorders. Increased consumption of carbohydrates and fats, as well as overeating, lead to weight gain. If the amount of calories consumed exceeds energy costs, fat deposits accumulate.
- Adynamia. A low-activity lifestyle, “sedentary” work, lack of sports activity contribute to slowing down metabolism, obesity and the appearance of insulin resistance.
- Hypertension. Prolonged uncontrolled episodes of hypertension cause circulatory disorders in arterioles and capillaries, vascular spasm occurs, and metabolism in tissues is disrupted.
- Nervous tension. Stress, intense experiences lead to endocrine disorders and overeating.
- Hormonal imbalance in women. During menopause, testosterone levels increase, estrogen production decreases. This causes a slowdown in the metabolism in the body and an increase in fat deposits according to the android type.
- Hormonal imbalance in men. A decrease in testosterone levels after 45 years contributes to weight gain, impaired insulin metabolism and increased blood pressure.
Metabolic syndrome symptoms
The first signs of metabolic disorders are fatigue, apathy, unmotivated aggression and a bad mood in a hungry state. Usually patients are selective in the choice of food, prefer “fast” carbohydrates (cakes, bread, sweets). The consumption of sweets causes short-term mood swings. Further development of the disease and atherosclerotic changes in the vessels lead to periodic pain in the heart, palpitations. High levels of insulin and obesity provoke disorders of the digestive system, the appearance of constipation. The function of the parasympathetic and sympathetic nervous systems is disrupted, tachycardia develops, tremor of the extremities.
The disease is characterized by an increase in the fat layer not only in the chest, abdomen, upper extremities, but also around the internal organs (visceral fat). A sharp weight gain contributes to the appearance of burgundy striae (stretch marks) on the skin of the abdomen and thighs. There are frequent episodes of increased blood pressure above 139/89 mm Hg, accompanied by nausea, headache, dry mouth and dizziness. Hyperemia of the upper half of the trunk is noted, due to a violation of the tone of peripheral vessels, increased sweating due to malfunctions of the autonomic nervous system.
Complications
Metabolic syndrome leads to hypertension, atherosclerosis of the coronary arteries and blood vessels of the brain and, as a consequence, heart attack and stroke. The state of insulin resistance causes the development of type 2 diabetes mellitus and its complications – retinopathy and diabetic nephropathy. In men, the symptom complex contributes to the weakening of potency and violation of erectile function. In women, syndrome X is the cause of polycystic ovaries, endometriosis, decreased libido. At the reproductive age, menstrual cycle disorders and the development of infertility are possible.
Diagnostics
Metabolic syndrome has no obvious clinical symptoms, pathology is often diagnosed at a late stage after complications occur. Diagnostics include:
- Examination by a specialist. The endocrinologist studies the anamnesis of life and disease (heredity, daily routine, diet, concomitant diseases, living conditions), conducts a general examination (blood pressure parameters, weighing). If necessary, the patient is referred for consultation to a nutritionist, cardiologist, gynecologist or andrologist.
- Determination of anthropometric indicators. The android type of obesity is diagnosed by measuring the waist circumference. With syndrome X, this indicator in men is more than 102 cm, in women – 88 cm. Excess weight is detected by calculating the body mass index (BMI) according to the formula BMI = weight (kg)/height (m)2. The diagnosis of “obesity” is made with a BMI of more than 30.
- Laboratory tests. Lipid metabolism is disrupted: the level of cholesterol, LDL, triglycerides increases, the level of HDL decreases. A disorder of carbohydrate metabolism leads to an increase in glucose and insulin in the blood.
- Additional research. According to the indications, daily monitoring of blood pressure, ECG, EchoCG, ultrasound of the liver and kidneys, glycemic profile and glucose tolerance test are prescribed.
Metabolic disorders should be differentiated with the disease and the Cushing syndrome. If difficulties arise, the determination of the daily excretion of cortisol in the urine, dexamethasone test, tomography of the adrenal glands or pituitary gland is performed. Differential diagnosis of metabolic disorder is also performed with autoimmune thyroiditis, hypothyroidism, pheochromocytoma and ovarian stromal hyperplasia syndrome. In this case, the level of ACTH, prolactin, FSH, LH, and thyroid-stimulating hormone is additionally determined.
Metabolic syndrome treatment
Treatment of syndrome X involves complex therapy aimed at normalizing weight, blood pressure parameters, laboratory parameters and hormonal background.
- Power mode. Patients need to exclude easily digestible carbohydrates (pastries, sweets, sugary drinks), fast food, canned foods, limit the amount of salt and pasta consumed. The daily diet should include fresh vegetables, seasonal fruits, cereals, low-fat varieties of fish and meat. Food should be consumed 5-6 times a day in small portions, chewing thoroughly and not drinking water. From drinks it is better to choose unsweetened green or white tea, fruit drinks and compotes without added sugar.
- Physical activity. In the absence of contraindications from the musculoskeletal system, jogging, swimming, Nordic walking, pilates and aerobics are recommended. Physical activity should be regular, at least 2-3 times a week. Morning exercises, daily walks in the park or forest belt are useful.
- Drug therapy. Medications are prescribed to treat obesity, reduce blood pressure, normalize the metabolism of fats and carbohydrates. When glucose tolerance is violated, metformin preparations are used. Correction of dyslipidemia in case of ineffectiveness of dietary nutrition is carried out with statins. For hypertension, ACE inhibitors, calcium channel blockers, diuretics, beta blockers are used. To normalize weight, drugs are prescribed that reduce the absorption of fats in the intestine.
Prognosis and prevention
With timely diagnosis and treatment of metabolic syndrome, the prognosis is favorable. Late detection of pathology and the absence of complex therapy causes serious complications from the kidneys and cardiovascular system. Prevention of the syndrome includes rational nutrition, rejection of bad habits, regular sports. It is necessary to control not only the weight, but also the parameters of the figure (waist circumference). In the presence of concomitant endocrine diseases (hypothyroidism, diabetes mellitus) it is recommended that a dispensary follow-up by an endocrinologist and a study of the hormonal background.