[ Diabetes Type 2 ]

IDF definition of the metabolic syndrome: Frequently asked questions

The metabolic syndrome is a constellation of risk factors of metabolic origin that are accompanied by increased risk for cardiovascular disease and type 2 diabetes. A clinical study called EDIC (Epidemiology of Diabetes Interventions and Complications) showed that tight blood glucose control is key to preventing heart disease. Diabetes is also becoming increasingly common and currently consumes approximately 10% of NHS resources. The control group comprised 20 subjects without NAFLD matched for age, sex, and adiposity. In addition to the 8 cages from Columbus Instruments, we are currently installing and optimizing a 16‐cage system of metabolic cages from TSE systems, Germany (www.tse‐systems.com). Dr. This puts metabolic syndrome and diabetes way ahead of HIV/AIDS in morbidity and mortality terms yet the problem is not as well recognized.

Finally, content validity of 51 questions has been approved by the experts’ panel. Metabolic and Neuroendocrine Responses to RXFP3 Modulation in the Central Nervous System. There was a need for a single, universally accepted diagnostic tool to address both clinical and research needs. This step was in response to the increasing prevalence of obesity and its metabolic complications in the U.S. The new EDIC data, however, shows very strong evidence that tight blood glucose control has the same benefits for large blood vessels as it does for small blood vessels. This tool enables clinicians to identify patients with metabolic syndrome in the practice setting more quickly. Early and aggressive action will inevitably reduce the increased risk to the patient of developing cardiovascular disease and/or type 2 diabetes.

Put simply, we have the potential to stop the cardiovascular disease time bomb. When a health intervention works at such a profound level, it creates more profound changes on the gross level of the human physiology as well. The key to tackling the metabolic syndrome lies in a better understanding and early diagnosis and treatment of the metabolic syndrome. However, little is known about their relationship and whether this is mediated through central obesity as one of the defining components of the MetS. In people for whom lifestyle change is not enough and who are considered to be at high risk for cardiovascular disease, drug therapy may be required to treat the metabolic syndrome. While there is a definite need for a treatment that can modulate the underlying mechanisms of the metabolic syndrome as a whole and thereby reduce the impact of all the risk factors and the long term metabolic and cardiovascular consequences, these mechanisms are currently unknown and specific pharmacological agents are therefore not yet available. The major underlying risk factorsare obesity and insulin resistance.

However, new therapies are on the horizon which may address several of the risk factors concurrently and this may have a significant impact on reducing both cardiovascular and diabetes morbidity and mortality. The first IDF consensus worldwide definition established criteria to identify metabolic syndrome in adults. In the mean time, the IDF Task Force on Epidemiology and Prevention has established criteria to identify metabolic syndrome in children and adolescents. The values came from a report and based on data from Japan comparing computed abdominal tomography (CAT) and magnetic resonance imaging (MRI) to waist circumference. Sandeep Chaudhary: Yes, for the same reason that it does in obesity. See: The Examination Committee of Criteria for ‘Obesity Disease’ in Japan, Japan Society for the Study of Obesity: New criteria for ‘obesity disease’ in Japan. Circulation Journal 2002; 66: 987-992.

The official Japanese position is accurate if healthcare professionals and scientists only look at waist measurement as an accurate expression of visceral adiposity measured by computerized tomography. However, it would seem that revised Japanese values conforming with the rest of Asia best reflect the onset of risk factors such as heart disease and diabetes. Cardiovascular epidemiologists generally have not referred to this clustering as a syndrome. However, there have been a number of recent publications which point out that the waist circumference figures for Japan, with respect to determining the risk of heart disease and diabetes, are similar to the rest of Asia. On this basis, the IDF Task Force on Epidemiology and Prevention decided to deal with all of Asia in the same way until more data are available from other countries in the region. The Task Force intends to review all the data and information within the next 12 months to see what the final outcome would be. Computerized tomography is not always available, particularly in primary healthcare settings, and it may well be that within Japan there will be two positions depending on the availability of the technology.

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