Materiały źródłowe

• #1 Metabolic Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/165124-overview

  Metabolic syndrome (syndrome X, insulin resistance) is a multifactorial disease with multiple risk factors that arises from insulin resistance accompanying abnormal adipose deposition and function. It comprises a combination of risk factors for coronary heart disease, as well as for diabetes, fatty liver, and several cancers. […] According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), metabolic syndrome is diagnosed when a patient has at least 3 of the following 5 conditions: Fasting glucose 100 mg/dL (or receiving drug therapy for hyperglycemia), Blood pressure 130/85 mm Hg (or receiving drug therapy for hypertension), Triglycerides 150 mg/dL (or receiving drug therapy for hypertriglyceridemia), HDL-C 40 mg/dL in men or 50 mg/dL in women (or receiving drug therapy for reduced HDL-C), Waist circumference 102 cm (40 in) in men or 88 cm (35 in) in women; if Asian American, 90 cm (35 in) in men or 80 cm (32 in) in women.

• #1 AHA and NHLBI Review Diagnosis and Management of the Metabolic Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p1039.html

  The American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) have released joint recommendations on the management and diagnosis of the metabolic syndrome. […] In an effort to introduce the term metabolic syndrome into clinical practice, several organizations, including the World Health Organization, National Cholesterol Education Program, and International Diabetes Foundation, have proposed criteria for its diagnosis. The AHA and NHLBI require at least three of the following criteria for the diagnosis of the metabolic syndrome: […] Waist circumference of at least 40 inches (102 cm) in men or 35 inches (89 cm) in women, measured at the top of the iliac crest at the end of a normal expiration […] Triglyceride level of at least 150 mg per dL (1.70 mmol per L), or receiving pharmacologic therapy for elevated triglyceride levels

• #1 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  Metabolic syndrome (MetS) is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular atherosclerotic diseases and diabetes mellitus type 2. […] In this review, we critically consider existing definitions and evolving information, and conclude that there is still a need to develop uniform criteria to define MetS, so as to enable comparisons between different studies and to better identify patients at risk. […] Currently, several different definitions of MetS exist, causing substantial confusion as to whether they identify the same individuals or represent a surrogate of risk factors. […] Furthermore, there is still debate as to whether this entity represents a specific syndrome or is a surrogate of combined risk factors that put the individual at particular risk.

• #1 Metabolic Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/165124-workup

  Initial laboratory studies in patients suspected of having metabolic syndrome should include standard chemistries to assess for hyperglycemia and renal dysfunction and lipid studies to assess for hypertriglyceridemia or low HDL levels. […] If a family history of early coronary or other atherosclerotic disease is present, consider including, in addition to HDL-C and low-density lipoprotein cholesterol (LDL-C), studies of lipoprotein(a), apolipoprotein-B100, high-sensitivity C-reactive protein (CRP), and (if the patient does not already merit the lowest LDL-C target [ 70]), homocysteine and fractionated LDL-C. […] In view of the various associations between metabolic syndrome and other conditions discussed elsewhere in this article, additional helpful blood tests may include thyroid and liver studies, hemoglobin-A1C levels, and uric acid. Increased thyroid stimulating hormone (TSH) has been linked to a higher prevalence of metabolic syndrome.

• #1 Metabolic Syndrome: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/10783-metabolic-syndrome

  Metabolic syndrome criteria include low HDL cholesterol, excess abdominal fat, high blood sugar and high blood pressure. Metabolic syndrome increases your risk of cardiovascular disease, Type 2 diabetes and stroke. You have metabolic syndrome if you meet at least three of the criteria. […] A healthcare provider will do a physical exam and order blood tests if they think you might be at risk for or have metabolic syndrome. Theyll check your blood pressure and may measure the circumference around your waist. […] If you have at least three of the five criteria based on the results of these tests and the exam, youll have metabolic syndrome. […] The main goals of treating metabolic syndrome are to lower your risk of heart disease and Type 2 diabetes if you dont already have them. Treatment can involve medications and/or lifestyle changes. […] Yes, its possible to reverse metabolic syndrome. Lifestyle changes can do a lot to improve your health. Medications can help as well. Your healthcare provider will work with you to find the best plan for you.

• #1 Metabolic Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/165124-workup

  Hyperuricemia appears to be much more common in patients with metabolic syndrome than in the general population, and this is attributed to the inflammatory effects of metabolic syndrome. […] Imaging studies are not routinely indicated in the diagnosis of metabolic syndrome. […] However, they may be appropriate for patients with symptoms or signs of the many complications of the syndrome, including cardiovascular disease. […] Investigation into other causes or exacerbating factors should be considered. […] For example, sleep-related breathing disorders, such as obstructive sleep apnea, are becoming increasingly relevant and novel risk factors for metabolic syndrome. […] The difficulty in clarifying the associations between obstructive sleep apnea and metabolic syndrome lie in part with the confounding effect of obesity.

• #1 Metabolic Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/165124-workup

  Nevertheless, patients reporting significant sleep disturbances, snoring, possible pauses, and/or daytime drowsiness may benefit from further investigation for a treatable sleep-related breathing disorder, including through polysomnography. […] New guidelines on the assessment of cardiovascular risk, released in late 2013 by the American Heart Association/American College of Cardiology (AHA/ACC), recommend use of a revised calculator for the risk of developing a first atherosclerotic cardiovascular disease (ASCVD) event, which is defined as one of the following in a person who was initially free from ASCVD. […] The calculator uses 9 clinical and laboratory risk factors to determine 10-year and lifetime risk. […] For patients 20-79 years of age who do not have existing clinical ASCVD, the guidelines recommend assessing clinical risk factors every 4-6 years.

• #1 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  The aim of this new definition was to enable comparisons between study results, in the hope that it would be a better predictor of risk particularly for CHD, stroke and DMT2. […] Currently, the two most widely used definitions are those of the NCEP:ATP III and IDF focusing specifically on waist circumference, which is a surrogate measure of central obesity. […] In view of these difficulties and until more evidence that can elucidate the cause of MetS accumulate, the Joint Interim Statement (consensus definition in Appendix 1) highlighting that there should be no obligatory component for MetS but rather all individual components should be considered important on risk prediction, is currently mostly accepted. […] Although prevalence estimates for the syndrome have been mostly similar in any given population regardless of the definition used, different individuals are identified.

• #1 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  This is attributed to the different focus of each definition, from the glucocentric WHO definition to an obesity-centric IDF one, and to a collection of statistically related CVD risk factors by the NCEP:ATPIII definition. […] The need to precisely define MetS stems from the need to detect accurately individuals at high risk for CVD and DMT2. […] All the components of the various MetS definitions are involved in conferring risk for CVD and DMT2. […] The presence of MetS predicting the incidence of DMT2 also varies depending on how MetS is defined. […] The application of the MetS model has not been fully validated in children and adolescents as yet, suggesting that prevention and treatment in childhood and adolescence should better focus on established risk factors rather than the diagnosis of MetS.

• #1 Metabolic syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Metabolic_syndrome

  The World Health Organization (1999) requires the presence of any one of diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance, AND two of the following. […] The European Group for the Study of Insulin Resistance (1999) requires that subjects have insulin resistance AND two or more of the following. […] The Cardiometabolic index (CMI) is a tool used to calculate risk of type 2 diabetes, non-alcoholic fatty liver disease, and metabolic issues. […] High-sensitivity C-reactive protein has been developed and used as a marker to predict coronary vascular diseases in metabolic syndrome.

• #1 Criteria in the diagnosis of Metabolic Syndrome | DMSO

  https://www.dovepress.com/criteria-in-the-diagnosis-of-metabolic-syndrome-in-children-a-scoping–peer-reviewed-fulltext-article-DMSO

  Currently, there is no consensus on the criteria for identifying metabolic syndrome in children, as observed in the diversity of research developed. […] The most commonly used criteria for identifying MetS since 2015 are those of Cook et al, IDF, NCEP ATPIII, and De Ferranti et al, in that order. Specific criteria, such as those proposed by Cook et al, are being chosen to enhance the accuracy of identifying MetS in children. […] The NCEP-ATP III considered as criteria for MetS in children central obesity with WC 90th percentile in both sexes, TGs 110 mg/dL, cHDL 40 mg/dL; Blood pressure (systolic or diastolic) 90th percentile and fasting blood glucose (FBG) 110 mg/dl. […] The existing information since 2015 was reviewed in relation to the criteria used for the diagnosis of MetS in children, to know the trends of its application; determine the general averages for the risk factors of MetS in children within the included studies, the average percentage for each of the risk factors of MetS in children diagnosed with MetS, and finally determine the prevalence of MetS in children according to diagnostic criterion, age and sex.

• #1 Metabolic syndrome: Symptoms, diagnosis, and causes

  https://www.medicalnewstoday.com/articles/263834

  Due to concerns about the rise in obesity among young people in recent years, some have called for early screening to identify those with a higher cardiovascular risk. […] How and when to screen for and diagnose metabolic syndrome and obesity in children, however, remains controversial. […] Metabolic syndrome is a collection of risk factors, so there is not a single cause. […] However, symptoms such as insulin resistance do not necessarily accompany obesity or indicate metabolic syndrome. […] Insulin resistance, is a feature of metabolic syndrome and obesity, and it can lead to cardiovascular disease and type 2 diabetes, but it can also be a sign of other conditions. […] The following factors increase the risk of developing metabolic syndrome: a large waistline, a family history of metabolic syndrome, a lack of exercise combined with a high-calorie diet, insulin resistance, the use of some medications.

• #1 Biological age and lifestyle in the diagnosis of metabolic syndrome: the NHIS health screening data, 2014–2015 | Scientific Reports

  https://www.nature.com/articles/s41598-020-79256-4

  Metabolic syndrome (MS) is diagnosed using absolute criteria that do not consider age and sex, but most studies have shown that the prevalence of MS increases with age in both sexes. […] Thus, the evaluation of MS should consider sex and age. […] The MS-biological age model can be a supplementary tool for evaluating and managing MS, quantitatively measuring the effect of lifestyle changes on MS, and motivating patients to maintain a healthy lifestyle. […] MS is associated with a high risk of morbidity and mortality owing to cardiovascular disease (CVD) and type 2 diabetes. […] The conventional diagnosis of MS utilizes absolute criteria that does not consider the subjects age and sex despite most studies showing that the prevalence of MS increases with age in both men and women. […] Thus, MS diagnosis should consider biological age to overall evaluate and manage the health status and aging state in MS.

• #1 Metabolic syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/212

  Metabolic syndrome is a cluster of common abnormalities, including insulin resistance, impaired glucose tolerance, abdominal obesity, reduced high-density lipoprotein (HDL)-cholesterol levels, elevated triglycerides, and hypertension. […] The main utility of diagnosing metabolic syndrome is the identification of people at high risk of CVD beyond low-density lipoprotein (LDL)-cholesterol levels. […] Multiple criteria, all with slight differences, exist to define metabolic syndrome; no single definition is accepted as the international standard. […] The precise pathogenetic mechanisms unifying all of its components are as yet unknown, although insulin resistance certainly plays a key role. […] Key diagnostic factors include presence of risk factors, hypertension, increased BMI, and increased waist and hip circumferences. […] Other diagnostic factors include hyperglycaemia, metabolic dysfunction-associated steatotic liver disease (MASLD), and angina. […] 1st investigations to order include fasting blood glucose, fasting triglycerides, fasting total cholesterol, fasting HDL-cholesterol, and fasting LDL-cholesterol.

• #1 Metabolic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459248/

  Metabolic syndrome, characterized by a constellation of metabolic abnormalities, including central obesity, insulin resistance, hypertension, and dyslipidemia, poses a significant risk for the development of atherosclerotic cardiovascular diseases and type II diabetes mellitus. The diagnosis of metabolic syndrome necessitates the presence of 3 or more of these metabolic abnormalities, signaling an urgent need for proactive identification and intervention strategies. […] The diagnosis of metabolic syndrome requires the presence of 3 or more metabolic abnormalities: […] Patients with metabolic syndrome are estimated to have a 2-fold increased risk of atherosclerotic cardiovascular diseases and a 5-fold increased risk of diabetes mellitus, as compared to the general population. […] The clinical presentation of metabolic syndrome is variable and depends on the underlying atherosclerotic cardiovascular disease.

• #1 The metabolic syndrome

  https://www.racgp.org.au/afp/2013/august/the-metabolic-syndrome

  Diagnosis of the MetSy is useful in focusing attention on central adiposity and insulin resistance as risk factors both for the syndrome, and cardiovascular and diabetes morbidity and mortality. […] The presence of any three of the five risk factors described in Table 1 is diagnostic of the MetSy. […] The MetSy is important because it identifies patients at increased risk of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD). […] The diagnosis of the MetSy needs to be explained in the context of broader assessments of CVD or diabetes risk and can provide additional information, which may help in targeting particular risk factors such as central obesity or loss of muscle tone or muscle mass. […] The MetSy can be prevented by interventions that modify diet and physical activity and control weight.

• #1 Metabolic Syndrome: What is it, Screening, & Treatment Tips | Aetna

  https://www.aetna.com/health-guide/metabolic-syndrome.html

  Metabolic syndrome refers to the group of conditions that lead to an increased risk of heart disease, diabetes and stroke. Nearly one in four Americans is at high risk and many of us dont even know it. […] The screening measures five things: your waistline, blood pressure, HDL cholesterol level, triglyceride level and fasting blood sugar. If three or more factors are outside the normal range, you have metabolic syndrome. […] A diagnosis of metabolic syndrome is your early warning alarm. By acting now, you may avoid a serious health crisis like a heart attack or stroke. […] If you get a metabolic syndrome screening through work, youll receive a report listing your risk factors and discussing what you can do to lessen those risks in easy-to-understand terms.

• #1 Diagnosis of Metabolic Syndrome using Machine Learning, Statistical and Risk Quantification Techniques: A Systematic Literature Review | medRxiv

  https://www.medrxiv.org/content/10.1101/2020.06.01.20119339v1

  Metabolic syndrome (MetS), known to substantially lower the quality of life is associated with the increased incidence of non-communicable diseases (NCDs) such as type II diabetes mellitus, cardiovascular diseases and cancer. […] For the early and accurate diagnosis of MetS, various statistical and ML techniques have been developed to support its clinical diagnosis. […] Evidence suggests that evaluated ML techniques, with accuracy ranging from 75.5% to 98.9%, can more accurately diagnose MetS than both statistical and risk quantification techniques. […] However, highlighted proof based on performance measures indicate that the decision tree and artificial neural network ML techniques have the highest predictive performance for the prediction of MetS. […] Evidence suggests that more accurate diagnosis of MetS is required to evaluate the predictive performance of the statistical and ML techniques.

• #1 Metabolic syndrome: uncovering a biological signature to guide diagnosis | INRAE

  https://www.inrae.fr/en/news/metabolic-syndrome-uncovering-biological-signature-guide-diagnosis

  Developing tools to assist in diagnosing metabolic syndrome (a cluster of metabolic abnormalities that increase the risk of cardiovascular disease or type-2 diabetes) was the goal of INRAE researchers working in collaboration with the CEA, University of Montreal and McGill University. Their three-year study allowed them to identify 26 metabolite modulations, characteristic of this syndrome. The results, published in the 5 July issue of EBioMedicine – The Lancet, offer a powerful tool for better diagnosing the syndrome, which affects more than 20% of the French population. […] Improving diagnosis of metabolic syndrome is essential to improve how it is managed. This syndrome is characterised by a cluster of associated metabolic abnormalities, which are risk factors for developing cardiovascular diseases or type-2 diabetes.

• #1 Laboratory markers of metabolic syndrome

  https://www.explorationpub.com/Journals/ec/Article/101226

  MetS is associated with a range of cardiovascular disorders, including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. […] The connection between IR and hypertension is intricate and influenced by various factors, encompassing genetic predisposition and environmental elements. […] MetS is characterized by a distinctive clinical feature: a persistent low-grade inflammatory condition resulting from the clustering of various metabolic risk factors. […] This research has allowed us to select possible markers for the diagnosis of MetS. […] According to the research carried out, lipid profile markers include: an increase of the TG/HDL-C ratio and an increase in SdLDL-C. […] The markers associated with ROS are xanthine oxidase, GGT, MPO, NOX, and NOS. Serum ferritin levels are also important in the diagnosis of MetS. […] In any case, more research into the pathophysiology of this syndrome is needed to definitively confirm these markers and select/discover new ones.

• #1 How to Test Your Patients for Metabolic Syndrome

  https://www.rupahealth.com/post/how-to-test-your-patients-for-metabolic-syndrome-a-functional-medicie-approach

  A physical exam can screen for many signs of metabolic syndrome, such as an increased waist circumference or waist-to-hip ratio and elevated blood pressure. Laboratory testing can further elucidate metabolic health by looking at blood sugar balance and insulin levels, evaluating gut health and the microbiome’s composition, and measuring cholesterol levels in the blood. […] Blood work can detect abnormalities in insulin, blood glucose processing, and cholesterol. Testing can also evaluate imbalances in the gut microbiome and any resulting detrimental metabolic changes, such as increased inflammatory markers, insulin, and glucose levels.

• #1 A Systematic Review of Metabolic Syndrome: Key Correlated Pathologies and Non-Invasive Diagnostic Approaches

  https://www.mdpi.com/2077-0383/13/19/5880

  A Systematic Review of Metabolic Syndrome: Key Correlated Pathologies and Non-Invasive Diagnostic Approaches […] Background and Objectives: Metabolic syndrome (MetS) is a condition marked by a complex array of physiological, biochemical, and metabolic abnormalities, including central obesity, insulin resistance, high blood pressure, and dyslipidemia (characterized by elevated triglycerides and reduced levels of high-density lipoproteins). […] The purpose of this narrative review is to examine metabolic syndrome as a “systemic disease” and its interaction with major internal medicine conditions such as CVD, diabetes, renal failure, and respiratory failure. […] Additionally, it is important to be aware of the non-invasive tools available for assessing this condition. […] Results: The findings revealed a clear correlation between metabolic syndrome and all the pathologies above described, indicating that non-invasive assessments of hepatic fibrosis and steatosis could potentially serve as markers for the severity and progression of the diseases. […] Notably, it is linked to a higher incidence of cardiovascular diseases, independent of traditional cardiovascular risk factors. Non-invasive assessments of hepatic fibrosis and fibrosis allow clinicians to evaluate cardiovascular risk. […] The aim of this narrative review is to examine metabolic syndrome as a “systemic disease” and its interactions with key internal medicine conditions, such as cardiovascular diseases (hypertension, heart failure, arrhythmias, etc.), diabetes, renal failure, and respiratory failure. […] The aim of this review is to understand the knowledge of this systemic pathology, its related pathologies at the level of practically all body districts and, above all, the awareness that metabolic syndrome can be diagnosed, studied, and followed over time thanks to non-invasive, laboratory, and imaging methods.

• #1 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  In the present work we discuss the importance of establishing clear criteria to define MetS, highlighting the latest research, which we use to provide a critical review of currently existing controversies in this field and expand on the childhood and adulthood aspect of the syndrome. […] The first attempt was made in 1998 by the WHO, which proposed that MetS may be defined by the presence of IR or its surrogates, impaired glucose tolerance (IGT) or DMT2, as essential components of the syndrome, along with at least two of the following parameters: raised BP, hypertriglyceridemia and/or low HDL-cholesterol, obesity (as measured by waist/hip ratio or body mass index (BMI)), and microalbuminuria. […] In 2005, the International Diabetes Federation (IDF) published newer criteria in an attempt to define the syndrome more precisely so that it could be used by different clinical and research groups.

• #1 Metabolic Risk Panel | Test Summary | Quest Diagnostics Metabolic Risk PanelMetabolic Risk Panel

  https://testdirectory.questdiagnostics.com/test/test-guides/TS_MetabolicRiskPnl/metabolic-risk-panel

  This panel is used to assess metabolic dysfunction and cardiometabolic risk. […] Metabolic syndrome (MetS), which affects almost half of adults in the United States, is a cluster of clinical features that reflect an underlying state of IR. […] Early identification of metabolic dysfunction leading to IR and MetS provides an opportunity for early intervention to prevent disease progression and associated complications. […] Quest Diagnostics and Cleveland HeartLab offer the Metabolic Risk Panel (test code 39447) to assess metabolic dysfunction. […] Individuals at risk of early metabolic dysfunction including those undergoing CVD risk assessment. […] Individuals at risk of insulin resistance, which can lead to prediabetes or type 2 DM (eg, overweight/obese; have a family history of DM; history of gestational DM, polycystic ovary syndrome [PCOS], or acanthosis nigricans).

• #1 Metabolic Syndrome: Risk Factors, Diagnosis, and More

  https://www.healthline.com/health/metabolic-syndrome

  Metabolic syndrome is a group of five risk factors, that when left untreated, increase the likelihood of developing heart disease, diabetes, and stroke. […] Having three or more of these factors will result in a diagnosis of metabolic syndrome and will increase your risk of health complications including type 2 diabetes. […] To diagnose metabolic syndrome, a doctor will need to perform several different tests. The results of these tests will be used to look for three or more signs of the disorder. […] You may have metabolic syndrome if three or more of these tests come back with a reading within the above ranges. […] If you are diagnosed with metabolic syndrome, the goal of treatment will be to reduce your risk of developing further health complications. […] If symptoms are managed, people with metabolic syndrome can reduce their risks of developing serious health problems such as heart attack or stroke. […] Regular physical exams may also help prevent metabolic syndrome. A doctor can measure your blood pressure and complete blood work. This may help detect the condition in the early stages, and prompt treatment can help reduce health complications over the long term.

• #1 Metabolic Syndrome: Symptoms, Causes, Diagnosis, and More

  https://www.verywellhealth.com/metabolic-syndrome-1745266

  Metabolic syndrome is a constellation of conditions that together increase the risk of type 2 diabetes, stroke, and cardiovascular problems, including heart attack. […] It’s rare to have metabolic syndrome symptoms so the diagnosis depends on blood tests and other clinical measures. […] The diagnosis of metabolic syndrome is straightforward and based on specific criteria. Screening for the components of metabolic syndrome is part of a routine medical check-up. If you regularly keep up with your health maintenance appointments, your tests would likely show signs of the condition at an early stage. […] If you have three or more of these five clinical markers, you would be diagnosed with metabolic syndrome: A waist circumference of 40 inches or more for people assigned male at birth; 35 inches or more for people assigned female at birth; Triglyceride level of 150 milligrams per deciliter (mg/dL) or higher; High-density lipoprotein (HDL) levels (good cholesterol) lower than 40 mg/dL for assigned male at birth; lower than 50 mg/dL for assigned female at birth; Blood pressure of 130/85 mmHg or higher; Fasting glucose of 100 mg/dL or higher. […] Note that even if you have only one or two of these criteria, you may be at risk of metabolic syndrome and its complications. Getting treatment before you meet the criteria for metabolic syndrome can help prevent health issues from developing.

• #1 Metabolic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459248/

  The initial blood work should include fasting blood glucose and hemoglobin A1c to screen for insulin resistance and diabetes mellitus. […] The contemporary guidelines recommend the estimation of atherosclerotic cardiovascular disease (ASCVD) risk in all patients with metabolic syndrome to devise the primary prevention strategy. […] The primary goal of the management is to identify and treat the risk factors and reduce the cardiovascular complications of metabolic syndrome. […] The management of metabolic syndrome can be divided into lifestyle modifications and medical management. […] It is imperative to ensure the implementation of a healthy lifestyle before considering pharmacologic options for managing metabolic syndrome. […] The prognosis of patients with metabolic syndrome is determined by the severity of its components and cardiovascular complications. […] The management of metabolic syndrome requires a multidisciplinary team.

• #1 Patient education: Metabolic syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/metabolic-syndrome-beyond-the-basics

  Metabolic syndrome is diagnosed based upon a physical examination and a blood test of your blood sugar (either fasting [before breakfast] blood sugar or a test any time of glycated hemoglobin), cholesterol, and triglyceride levels. A description of how blood glucose and cholesterol levels are measured is available separately. […] The goals of treatment for metabolic syndrome are to: […] Reduce or eliminate underlying problems (eg, obesity, lack of activity) by losing weight and becoming more active. […] Treat cardiovascular risk factors, such as high blood pressure and cholesterol, if these problems persist despite losing weight and exercising.

• #2 Metabolic Syndrome: Symptoms, Causes, Diagnosis, and More

  https://www.verywellhealth.com/metabolic-syndrome-1745266

  Metabolic syndrome is a constellation of conditions that together increase the risk of type 2 diabetes, stroke, and cardiovascular problems, including heart attack. […] It’s rare to have metabolic syndrome symptoms so the diagnosis depends on blood tests and other clinical measures. […] The diagnosis of metabolic syndrome is straightforward and based on specific criteria. Screening for the components of metabolic syndrome is part of a routine medical check-up. If you regularly keep up with your health maintenance appointments, your tests would likely show signs of the condition at an early stage. […] If you have three or more of these five clinical markers, you would be diagnosed with metabolic syndrome: A waist circumference of 40 inches or more for people assigned male at birth; 35 inches or more for people assigned female at birth; Triglyceride level of 150 milligrams per deciliter (mg/dL) or higher; High-density lipoprotein (HDL) levels (good cholesterol) lower than 40 mg/dL for assigned male at birth; lower than 50 mg/dL for assigned female at birth; Blood pressure of 130/85 mmHg or higher; Fasting glucose of 100 mg/dL or higher. […] Note that even if you have only one or two of these criteria, you may be at risk of metabolic syndrome and its complications. Getting treatment before you meet the criteria for metabolic syndrome can help prevent health issues from developing.

• #2 Symptoms and Diagnosis of Metabolic Syndrome | American Heart Association

  https://www.heart.org/en/health-topics/metabolic-syndrome/symptoms-and-diagnosis-of-metabolic-syndrome

  Metabolic syndrome is a cluster of conditions and is diagnosed by a health care professional. If you have a large waist circumference and other conditions that define metabolic syndrome including elevated triglycerides, high blood sugar or high blood pressure, be sure to discuss your risk for metabolic syndrome with your health care professional. […] Metabolic syndrome is diagnosed when you have three or more of these conditions: […] Central or abdominal obesity (measured by waist circumference) […] High triglycerides – 150 milligrams per deciliter (mg/dL) or more, or you’re taking medicine for high triglycerides […] Low HDL cholesterol, or you’re taking medicine for low HDL cholesterol […] High blood pressure – 130/85 millimeters of mercury (mm Hg) or more, or you’re taking medicine for high blood pressure […] High fasting glucose (blood sugar) – 100 mg/dL or more, or you’re taking medicine for high blood glucose.

• #2 AHA and NHLBI Review Diagnosis and Management of the Metabolic Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0915/p1039.html

  HDL cholesterol level of less than 40 mg per dL (1.05 mmol per L) in men or less than 50 mg per dL (1.30 mmol per L) in women, or receiving pharmacologic therapy for reduced HDL cholesterol levels […] Systolic blood pressure of at least 130 mm Hg or diastolic blood pressure of at least 85 mm Hg, or receiving pharmacologic therapy for hypertension […] Fasting glucose level of at least 100 mg per dL (5.6 mmol per L), or receiving pharmacologic therapy for elevated fasting glucose levels.

• #2 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  In the present work we discuss the importance of establishing clear criteria to define MetS, highlighting the latest research, which we use to provide a critical review of currently existing controversies in this field and expand on the childhood and adulthood aspect of the syndrome. […] The first attempt was made in 1998 by the WHO, which proposed that MetS may be defined by the presence of IR or its surrogates, impaired glucose tolerance (IGT) or DMT2, as essential components of the syndrome, along with at least two of the following parameters: raised BP, hypertriglyceridemia and/or low HDL-cholesterol, obesity (as measured by waist/hip ratio or body mass index (BMI)), and microalbuminuria. […] In 2005, the International Diabetes Federation (IDF) published newer criteria in an attempt to define the syndrome more precisely so that it could be used by different clinical and research groups.

• #2 Metabolic Syndrome – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/metabolic-syndrome/diagnosis

  If you have any risk factors for metabolic syndrome, your healthcare provider will do blood tests to screen for this condition. […] Your provider will diagnose metabolic syndrome based on your medical and family history, a physical exam, and diagnostic tests. […] To diagnose metabolic syndrome, your provider will check your blood pressure and do blood tests to measure your blood sugar, cholesterol, and triglyceride levels. […] You may have high blood pressure, one of the conditions of metabolic syndrome, if your blood pressure is consistently 130/85 mmHg or higher. […] If your fasting blood sugar level is 126 mg/dL or higher, you may have diabetes, a condition of metabolic syndrome. […] You may have high blood cholesterol, one of the conditions of metabolic syndrome, if your HDL cholesterol levels are lower than 50 mg/dL for women and lower than 40 mg/dL for men. […] You may have high blood triglycerides, one of the conditions of metabolic syndrome, if your triglyceride levels are consistently more than 150 mg/dL.

• #2 Metabolic Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/165124-workup

  Hyperuricemia appears to be much more common in patients with metabolic syndrome than in the general population, and this is attributed to the inflammatory effects of metabolic syndrome. […] Imaging studies are not routinely indicated in the diagnosis of metabolic syndrome. […] However, they may be appropriate for patients with symptoms or signs of the many complications of the syndrome, including cardiovascular disease. […] Investigation into other causes or exacerbating factors should be considered. […] For example, sleep-related breathing disorders, such as obstructive sleep apnea, are becoming increasingly relevant and novel risk factors for metabolic syndrome. […] The difficulty in clarifying the associations between obstructive sleep apnea and metabolic syndrome lie in part with the confounding effect of obesity.

• #2 Metabolic Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/165124-workup

  Nevertheless, patients reporting significant sleep disturbances, snoring, possible pauses, and/or daytime drowsiness may benefit from further investigation for a treatable sleep-related breathing disorder, including through polysomnography. […] New guidelines on the assessment of cardiovascular risk, released in late 2013 by the American Heart Association/American College of Cardiology (AHA/ACC), recommend use of a revised calculator for the risk of developing a first atherosclerotic cardiovascular disease (ASCVD) event, which is defined as one of the following in a person who was initially free from ASCVD. […] The calculator uses 9 clinical and laboratory risk factors to determine 10-year and lifetime risk. […] For patients 20-79 years of age who do not have existing clinical ASCVD, the guidelines recommend assessing clinical risk factors every 4-6 years.

• #2 Metabolic Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/165124-workup

  For patients with low 10-year risk ( 7.5%), the guidelines recommend assessing 30-year or lifetime risk in patients 20-59 years old. […] Regardless of the patients age, clinicians should communicate risk data to the patient and refer to the AHA/ACC lifestyle guidelines, which cover diet and physical activity. […] For patients with elevated 10-year risk, clinicians should communicate risk data and refer to the AHA/ACC guidelines on blood cholesterol and obesity.

• #2 Metabolic Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/165124-overview

  To address variation between professional guidelines, the NHLBI, AHA, International Diabetes Foundation (IDF), and others have proposed a harmonized definition of metabolic syndrome. […] Under 2005 revised guidelines by the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), metabolic syndrome is diagnosed when a patient has at least three of the following five conditions: Fasting glucose 100 mg/dL (or receiving drug therapy for hyperglycemia), Blood pressure 130/85 mm Hg (or receiving drug therapy for hypertension), Triglycerides 150 mg/dL (or receiving drug therapy for hypertriglyceridemia), HDL-C 40 mg/dL in men or 50 mg/dL in women (or receiving drug therapy for reduced HDL-C), Waist circumference 102 cm (40 in) in men or 88 cm (35 in) in women; if Asian American, 90 cm (35 in) in men or 80 cm (32 in) in women. […] To address variation between professional guidelines, the National Heart, Lung, and Blood Institute (NHLBI), American Hearth Association (AHA), International Diabetes Foundation (IDF), and other organizations have proposed a harmonized definition of metabolic syndrome.

• #2 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  This is attributed to the different focus of each definition, from the glucocentric WHO definition to an obesity-centric IDF one, and to a collection of statistically related CVD risk factors by the NCEP:ATPIII definition. […] The need to precisely define MetS stems from the need to detect accurately individuals at high risk for CVD and DMT2. […] All the components of the various MetS definitions are involved in conferring risk for CVD and DMT2. […] The presence of MetS predicting the incidence of DMT2 also varies depending on how MetS is defined. […] The application of the MetS model has not been fully validated in children and adolescents as yet, suggesting that prevention and treatment in childhood and adolescence should better focus on established risk factors rather than the diagnosis of MetS.

• #2 Criteria in the diagnosis of Metabolic Syndrome | DMSO

  https://www.dovepress.com/criteria-in-the-diagnosis-of-metabolic-syndrome-in-children-a-scoping–peer-reviewed-fulltext-article-DMSO

  Currently, there is no consensus on the criteria for identifying metabolic syndrome in children, as observed in the diversity of research developed. […] The most commonly used criteria for identifying MetS since 2015 are those of Cook et al, IDF, NCEP ATPIII, and De Ferranti et al, in that order. Specific criteria, such as those proposed by Cook et al, are being chosen to enhance the accuracy of identifying MetS in children. […] The NCEP-ATP III considered as criteria for MetS in children central obesity with WC 90th percentile in both sexes, TGs 110 mg/dL, cHDL 40 mg/dL; Blood pressure (systolic or diastolic) 90th percentile and fasting blood glucose (FBG) 110 mg/dl. […] The existing information since 2015 was reviewed in relation to the criteria used for the diagnosis of MetS in children, to know the trends of its application; determine the general averages for the risk factors of MetS in children within the included studies, the average percentage for each of the risk factors of MetS in children diagnosed with MetS, and finally determine the prevalence of MetS in children according to diagnostic criterion, age and sex.

• #2 Biological age and lifestyle in the diagnosis of metabolic syndrome: the NHIS health screening data, 2014–2015 | Scientific Reports

  https://www.nature.com/articles/s41598-020-79256-4

  The present study demonstrated methods of quantitatively measuring the effects of lifestyle factors, such as smoking, drinking, and physical activity, on MS-BA. […] The MS-BA model accurately reflects the MS status relative to the individuals age and sex. Thus, it can be a supplementary tool for evaluating and managing MS, quantitatively measuring the effect of lifestyle changes on MS, and motivating patients to maintain a healthy lifestyle.

• #2 Metabolic syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/212

  Metabolic syndrome is a cluster of common abnormalities, including insulin resistance, impaired glucose tolerance, abdominal obesity, reduced high-density lipoprotein (HDL)-cholesterol levels, elevated triglycerides, and hypertension. […] The main utility of diagnosing metabolic syndrome is the identification of people at high risk of CVD beyond low-density lipoprotein (LDL)-cholesterol levels. […] Multiple criteria, all with slight differences, exist to define metabolic syndrome; no single definition is accepted as the international standard. […] The precise pathogenetic mechanisms unifying all of its components are as yet unknown, although insulin resistance certainly plays a key role. […] Key diagnostic factors include hypertension, increased BMI, and increased waist and hip circumferences. […] Other diagnostic factors include hyperglycemia, metabolic dysfunction-associated steatotic liver disease (MASLD), and angina. […] 1st tests to order include fasting blood glucose, fasting triglycerides, fasting total cholesterol, fasting HDL-cholesterol, and fasting LDL-cholesterol.

• #2 Metabolic Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25039

  Metabolic syndrome is an accumulation of several disorders that raise the risk of atherosclerotic cardiovascular disease, including myocardial infarction, cerebrovascular accidents, peripheral vascular diseases, insulin resistance, and type II diabetes mellitus. The diagnosis of metabolic syndrome requires the presence of 3 or more metabolic abnormalities: […] Patients with metabolic syndrome are estimated to have a 2-fold increased risk of atherosclerotic cardiovascular diseases and a 5-fold increased risk of diabetes mellitus, as compared to the general population. […] The clinical presentation of metabolic syndrome is variable and depends on the underlying atherosclerotic cardiovascular disease. […] The prevalence of metabolic syndrome is rising, and through intervention, the progression can be halted and potentially reversed.

• #2 Metabolic syndrome: uncovering a biological signature to guide diagnosis | INRAE

  https://www.inrae.fr/en/news/metabolic-syndrome-uncovering-biological-signature-guide-diagnosis

  The researchers developed a specific signature of 26 metabolites, robust for future diagnosis. […] This proof of concept study opens the door to new, more robust and precise diagnostic tools. Better diagnosing this syndrome will help limit the risks of serious complications such as strokes, cardiovascular problems and type-2 diabetes.

• #2 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  The aim of this new definition was to enable comparisons between study results, in the hope that it would be a better predictor of risk particularly for CHD, stroke and DMT2. […] Currently, the two most widely used definitions are those of the NCEP:ATP III and IDF focusing specifically on waist circumference, which is a surrogate measure of central obesity. […] In view of these difficulties and until more evidence that can elucidate the cause of MetS accumulate, the Joint Interim Statement (consensus definition in Appendix 1) highlighting that there should be no obligatory component for MetS but rather all individual components should be considered important on risk prediction, is currently mostly accepted. […] Although prevalence estimates for the syndrome have been mostly similar in any given population regardless of the definition used, different individuals are identified.

• #3 Metabolic Syndrome – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/metabolic-syndrome/diagnosis

  If you have any risk factors for metabolic syndrome, your healthcare provider will do blood tests to screen for this condition. […] Your provider will diagnose metabolic syndrome based on your medical and family history, a physical exam, and diagnostic tests. […] To diagnose metabolic syndrome, your provider will check your blood pressure and do blood tests to measure your blood sugar, cholesterol, and triglyceride levels. […] You may have high blood pressure, one of the conditions of metabolic syndrome, if your blood pressure is consistently 130/85 mmHg or higher. […] If your fasting blood sugar level is 126 mg/dL or higher, you may have diabetes, a condition of metabolic syndrome. […] You may have high blood cholesterol, one of the conditions of metabolic syndrome, if your HDL cholesterol levels are lower than 50 mg/dL for women and lower than 40 mg/dL for men. […] You may have high blood triglycerides, one of the conditions of metabolic syndrome, if your triglyceride levels are consistently more than 150 mg/dL.

• #3 Metabolic syndrome: definitions and controversies | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-48

  The aim of this new definition was to enable comparisons between study results, in the hope that it would be a better predictor of risk particularly for CHD, stroke and DMT2. […] Currently, the two most widely used definitions are those of the NCEP:ATP III and IDF focusing specifically on waist circumference, which is a surrogate measure of central obesity. […] In view of these difficulties and until more evidence that can elucidate the cause of MetS accumulate, the Joint Interim Statement (consensus definition in Appendix 1) highlighting that there should be no obligatory component for MetS but rather all individual components should be considered important on risk prediction, is currently mostly accepted. […] Although prevalence estimates for the syndrome have been mostly similar in any given population regardless of the definition used, different individuals are identified.

• #3 Metabolic syndrome: What is it and how useful is the diagnosis in clinical practice? | Revista Portuguesa de Cardiologia (English edition)

  https://www.revportcardiol.org/en-metabolic-syndrome-what-is-it-articulo-S2174204912001389

  The metabolic syndrome (MS) has been recognized for several decades, although under different names and with different definitions, but in recent years controversy has arisen concerning its definition and significance. The term does not refer to a specific disease, but to a cluster of metabolic risk factors that tend to occur together: central (or abdominal) obesity, elevated triglycerides, low HDL cholesterol, glucose intolerance and hypertension. […] Although the concept is well established, there are differences in the criteria for a diagnosis of MS published by various organizations, including the World Health Organization (WHO), the European Group for Study of Insulin Resistance (EGIR), the International Diabetes Federation (IDF), the National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATPIII), the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE).

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