on
Syndrome X patients face an increased risk of diabetes and cardiovascular disease due to an abnormal response to insulin. The key to treatment lies in diet and exercise
SYNDROME X, sometimes known as “metabolic syndrome”, is a group of cardiac risk factors that results from insulin resistance — when the body’s tissues do not respond normally to insulin.
The body’s receptors are “deaf” to insulin and one needs to produce more insulin to get the same effects.
A person with metabolic syndrome has a greatly increased risk of diabetes, cardiovascular disease and premature death.
The risk factors of metabolic syndrome include:
• insulin resistance
• obesity (especially abdominal obesity)
• high blood pressure
• abnormalities in blood clotting (the blood is more likely to colt leading to strokes and heart attacks)
• lipid abnormalities
Specifically, metabolic syndrome is diagnosed if any three of the following are present:
1. Elevated waist circumference: 102cm or more for men and 89cm or more for women
2. Elevated triglycerides (150 mg/dL or higher )
3. Reduced HDL (“good”) cholesterol (less than 40 mg/dL in men and less than 50 mg/dL in women)
4. Elevated blood pressure (130/85 mm Hg or higher)
5. Elevated fasting glucose (100 mg/dL or higher)
In the body’s attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated levels. The latter can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications. In fact, another name for metabolic syndrome is “pre-diabetes”.
Genetic
Syndrome X tends to run in families. Members of the family are more prone to type 2 diabetes. Syndrome X will occur in susceptible people who become overweight and sedentary. It can be prevented with exercise and maintaining a healthy body weight.
Treatment of Metabolic Syndrome
Insulin Resistance: To date, there is no drug that directly treats the underlying insulin resistance.
However, diet and exercise can reverse the syndrome. Those with metabolic syndrome should make every attempt to reduce their body weight to within 20 per cent of their “ideal” body weight (calculated for age and height) and incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle.
With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed and the risk for cardiovascular complications can be substantially improved.
Lipid Abnormalities: While high LDL (bad cholesterol) and high triglycerides respond nicely to weight loss and exercise, drug therapy is often required.
Treatment should be aimed primarily at reducing LDL levels. Once reduced, LDL targets are reached and efforts at lowering triglyceride and raising HDL levels should be made.
Successful drug treatment usually requires a statin, a fibrate drug or a combination of a statin with either niacin or a fibrate.
Clotting Disorder
Patients with Syndrome X can have several disorders of coagulation that make it easier for blood clots to form within blood vessels. These blood clots are often a precipitating factor in developing heart attacks.
Patients are generally placed on daily aspirin therapy to prevent clotting. You should speak to a doctor, of course, before starting any new medication regimen. Fish oil has been shown to be useful and safe for this condition.
Hypertension: High blood pressure is present in more than half the people with metabolic syndrome and, in the setting of insulin resistance, hypertension is especially important as a risk factor. Adequate blood pressure treatment in these individuals can substantially improve their outcome.
The key to preventing metabolic syndrome, however, remains in the diet (especially one that is low in carbohydrates) and exercise. Anyone with a strong family history of metabolic syndrome or type 2 diabetes should be especially careful to maintain a healthy lifestyle.
The discovery of a new class of compounds in garlic seems to be effective in managing the lipid disturbance linked to Syndrome X. Using supercritical processes, extractions from certain species of garlic have revealed new and unique compounds, identified by Belgian scientists as vinyldithiins and sulfides. They can powerfully reverse and stall the effects of Syndrome X without known short- or long-term side effects. We shall discuss this in more detail next week.
SYNDROME X, sometimes known as “metabolic syndrome”, is a group of cardiac risk factors that results from insulin resistance — when the body’s tissues do not respond normally to insulin.
The body’s receptors are “deaf” to insulin and one needs to produce more insulin to get the same effects.
A person with metabolic syndrome has a greatly increased risk of diabetes, cardiovascular disease and premature death.
The risk factors of metabolic syndrome include:
• insulin resistance
• obesity (especially abdominal obesity)
• high blood pressure
• abnormalities in blood clotting (the blood is more likely to colt leading to strokes and heart attacks)
• lipid abnormalities
Specifically, metabolic syndrome is diagnosed if any three of the following are present:
1. Elevated waist circumference: 102cm or more for men and 89cm or more for women
2. Elevated triglycerides (150 mg/dL or higher )
3. Reduced HDL (“good”) cholesterol (less than 40 mg/dL in men and less than 50 mg/dL in women)
4. Elevated blood pressure (130/85 mm Hg or higher)
5. Elevated fasting glucose (100 mg/dL or higher)
In the body’s attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated levels. The latter can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications. In fact, another name for metabolic syndrome is “pre-diabetes”.
Genetic
Syndrome X tends to run in families. Members of the family are more prone to type 2 diabetes. Syndrome X will occur in susceptible people who become overweight and sedentary. It can be prevented with exercise and maintaining a healthy body weight.
Treatment of Metabolic Syndrome
Insulin Resistance: To date, there is no drug that directly treats the underlying insulin resistance.
However, diet and exercise can reverse the syndrome. Those with metabolic syndrome should make every attempt to reduce their body weight to within 20 per cent of their “ideal” body weight (calculated for age and height) and incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle.
With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed and the risk for cardiovascular complications can be substantially improved.
Lipid Abnormalities: While high LDL (bad cholesterol) and high triglycerides respond nicely to weight loss and exercise, drug therapy is often required.
Treatment should be aimed primarily at reducing LDL levels. Once reduced, LDL targets are reached and efforts at lowering triglyceride and raising HDL levels should be made.
Successful drug treatment usually requires a statin, a fibrate drug or a combination of a statin with either niacin or a fibrate.
Clotting Disorder
Patients with Syndrome X can have several disorders of coagulation that make it easier for blood clots to form within blood vessels. These blood clots are often a precipitating factor in developing heart attacks.
Patients are generally placed on daily aspirin therapy to prevent clotting. You should speak to a doctor, of course, before starting any new medication regimen. Fish oil has been shown to be useful and safe for this condition.
Hypertension: High blood pressure is present in more than half the people with metabolic syndrome and, in the setting of insulin resistance, hypertension is especially important as a risk factor. Adequate blood pressure treatment in these individuals can substantially improve their outcome.
The key to preventing metabolic syndrome, however, remains in the diet (especially one that is low in carbohydrates) and exercise. Anyone with a strong family history of metabolic syndrome or type 2 diabetes should be especially careful to maintain a healthy lifestyle.
The discovery of a new class of compounds in garlic seems to be effective in managing the lipid disturbance linked to Syndrome X. Using supercritical processes, extractions from certain species of garlic have revealed new and unique compounds, identified by Belgian scientists as vinyldithiins and sulfides. They can powerfully reverse and stall the effects of Syndrome X without known short- or long-term side effects. We shall discuss this in more detail next week.
