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Dysmetabolic Syndrome X

What is Dysmetabolic Syndrome X?

Insulin resistance is a primary reason which associated with other metabolic dysfunction including glucose tolerance impairment, dyslipidemia, obesity, and fibrinolysis impairmentAll these conditions grouped together and increase the risk of cardiovascular and hypertensive disorders. Cumulative effect of endocrinal dysfunction and metabolic disorder termed as Dysmetabolic Syndrome X¹.

Risk factors

Obesity is one of the major risk factors for Dysmetabolic Syndrome X. Typically it has been observed that central obesity, in which excessive adiposity concentrated at the abdominal and waist region (circumference of waist in men is more than 102 cm and in women greater than 88 cm) is harmful.

Insulin resistance is the condition when targeted cells are not responding towards the insulin effect. The effect of this cause increase blood sugar level (fasting blood sugar test is more than 110 mg/dl)
Cholesterol level misbalance, in which high-density lipoprotein (HDL: good cholesterol) level become decrease and Serum triglycerides level increase more than 150 mg/dl.
Patient has a tendency to become hypertensive and measured Blood pressure is greater than 130/85 mm Hg.

Hypertension or blood pressure increase (Systolic pressure > 130 mm Hg and Diastolic pressure > 85 mm Hg).
Blood sugar level enhancement (onset of diabetes)
Triglyceride level enhancement
Lowering of High-Density Lipoprotein (HDL) level.

Although every individual with one of these risk factors does not confirm that is due to metabolic dysfunction, but one has three or more than three above mention complications increase the tendency to cardiac dysfunction^2,3.

Other factors

Increasing Age
Hereditary background of Dysmetabolic Syndrome X
Sedentary lifestyle
Polycystic ovary syndrome for women
Postmenopausal complication for women
Smoking^2,3

Symptoms

The symptoms depend upon the affected component, like in hypertension condition mainly asymptomatic, but may associate with headache, and blurred vision. Other symptoms are difficult to weight management, food craving, and feeling of weakness and fatigue⁴.

Causes

The precise etiology of the Dysmetabolic Syndrome X is unknown. Depending upon different findings the presence of “insulin resistance” is a common factor. In this condition physiological system of the body unable to utilize insulin for controlling sugar and triglyceride level.

Insulin resistance develops due to genetic abnormality and irregular lifestyle. The factors which are included in lifestyle are improper diet (mostly carbohydrate containing food consumption), lack of physical activity and irregular sleep habit³.

Diagnosis

Dysmetabolic Syndrome X diagnosis is based on physical examination, symptomatic analysis, and laboratory tests. During the physical examination, doctor assesses the blood pressure level and weight of the patient. The circumference of the waist also measures.

In the laboratory, blood sugar, cholesterol level, triglyceride level tests are conducted. In the case of, higher blood sugar level finding, doctor further checks insulin level and conduct hemoglobin A1c and oral glucose tolerance testing.

Cardiac functioning can be assessed by lipid level measurement, ECG, stress level measurement, angiograms, and if require or any abnormal findings need further detail assessment^2,3,4.

Treatment

The primary management of Dysmetabolic Syndrome X is based on weight reduction. According to experts, 7 to 10 percent weight reduction from current weight by altering lifestyle, including diet control and sufficient physical activities are must for individuals who have Dysmetabolic Syndrome X. Doctor also suggesting quitting smoking for smokers.

Lifestyle Changes

Lifestyle management is essential for treating Dysmetabolic Syndrome X.

Mediterranean diet, which is a rich source of HDL and this diet is also helpful to manage body weight, blood pressure, and glucose level.
Low salt diet is specifically recommended for patient with hypertension
Low carbohydrate foods are suggested for controlling blood sugar level.
Low protein diet is prescribed for patients with compromised kidney functioning.
For weight management regular exercise is essential

Medications

The medications, which are prescribed usually assist in controlling blood sugar, blood pressure and cholesterol level.

Angiotensin converting enzyme inhibitors are prescribed for blood pressure controlling
Sulfonylureas, Metformin etc are prescribed to control blood sugar level in type 2 diabetes patient.
Statin group of drugs like Atorvastatin is prescribed for the patient to control cholesterol level.
Low dose aspirin can be prescribed for higher risk patient with cardiovascular disease to minimize the risk of cardiac attack or stroke^2,3,4.

Complications

Multiple health complications are associated with Dysmetabolic Syndrome X, included metabolic dysfunctions are:

Epithelial layer of the coronary arteries and other peripheral arteries become damaged, which can lead to heart disease or cardiac stroke.
Compromised renal functionality and that cause accumulation of salt and water. Resultant of this leads to hypertension, cardiac disease, and onset of stroke.
Triglyceride level enhancement also cause cardiovascular disease risk
Blood clot formation and that obstruct systemic blood flow, which leads to cardiac attacks and stroke.
Lowering of insulin production is a signaling of type2 diabetes. Diabetes has several health hazards including neuropathy, renal failure, eyesight damage and also enhance the risk of cardiac attack^2,3.

References

Eschwège E. The dysmetabolic syndrome, insulin resistance and increased cardiovascular (CV) morbidity and mortality in type 2 diabetes: aetiological factors in the development of CV complications. Diabetes Metab. 2003 Sep;29(4 Pt 2):6S19-27. Retrieve from https://www.ncbi.nlm.nih.gov/pubmed/14502097
Darla Burke.; Metabolic Syndrome; Retrieve from http://www.healthline.com/health/metabolic-syndrome#Overview1
Ruchi Mathur, Metabolic Syndrome; emedicinehealth ; Retrieve from http://www.emedicinehealth.com/metabolic_syndrome/page3_em.htm
Metabolic Syndrome; Retrieve from http://my.clevelandclinic.org/health/articles/metabolic-syndrome