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Metabolic Syndrome
Dr Nandakishore Dukkipati
 
Are you worried about being overweight, and not being able to lose it? Have you gone through diets, exercise programs, medicines for weight loss without success? Have joint pains or back pain due to excess weight? Are you having menstrual irregularities, infertility or polycystic ovarian syndrome while being overweight? Have been told by your doctor regarding your high blood fat content, high blood pressure and diabetes?
If you do, then, this article is meant for you. More than being just overweight, even more dangerous is the obesity related metabolic syndrome. It is an inflammatory reaction that occurs in the body due to excess fatty tissue.It is a danger lurking in shadows; it is not as well known as the other conditions like heart disease, high cholesterol or high blood pressure. But, this certainly is a more destructive condition which affects several body organs and leads to many diseases.
What is metabolic syndrome?
Abdominal obesity (excessive fat tissue in and around the abdomen)
Blood fat disorders —
  1. High triglycerides,
  2. Low HDL cholesterol and
  3. High LDL cholesterol
These conditions increase plaque buildups in artery walls.
  1. Elevated blood pressure
  2. Insulin resistance or glucose intolerance (the body can't properly use insulin or blood sugar)
  3. Pro-thrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
  4. Pro-inflammatory state (e.g., elevated c-reactive protein in the blood)
Other associated diseases and signs are:
  1. Fatty liver (especially in concurrent obesity) progressing to non-alcoholic fatty liver disease,
  2. Polycystic ovarian syndrome (in women), and
  3. Acanthosis nigricans (a brown to black, hyper-pigmentation of the skin. Usually found in body folds, such as the folds of the neck, the axilla, groin, umbilicus, etc.)
How is the metabolic syndrome diagnosed?
The American Heart Association and the National Heart, Lung, and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:

1. Elevated waist circumference:
  • Men — Equal to or greater than 40 inches (102 cm)
  • Women — Equal to or greater than 35 inches (88 cm)
     
2. Elevated triglycerides: Equal to or greater than 150 mg/dL
3. Reduced HDL ("good") cholesterol:
  • Men — Less than 40 mg/dL
  • Women — Less than 50 mg/dL
4. Elevated blood pressure: Equal to or greater than 130/85 mm Hg
5. Elevated fasting glucose: Equal to or greater than 100 mg/dL
How do you manage metabolic syndrome?
The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. For that,
  1. Stop smoking
  2. Reduce LDL cholesterol
  3. Reduce blood pressure and glucose levels to the recommended levels.
  4. Weight loss to achieve a desirable weight (BMI less than 25 kg/m2)
  5. Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week
  6. Healthy eating habits that include reduced intake of saturated fat, Trans fat and cholesterol If above measures fail, the next treatment is weight loss surgery (bariatric surgery).
The consensus statement from world renowned organizations such as National Institute of Health, American Society for Metabolic and Bariatric Surgery is that, "mounting evidence suggests bariatric (weight loss) surgery may be among the most effective treatments for metabolic diseases and conditions including type-2 diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea. Surgery for severe obesity goes way beyond weight loss. This surgery results in the complete remission or significant improvement of type 2 diabetes and other life-threatening diseases in most patients.

Do not let the overweight and related problems steal the quality of life from you. Every day counts; enjoy the little pleasures in life. Live life to the fullest and do what it takes to make it better.
 
Dr Nandakishore Dukkipati, Consultant – Advanced Laparoscopic & Bariatric Surgery, Apollo Heath City, Hyderabad.
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