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Metabolic Syndrome

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لمشاهدة المحاضرة بملء الشاشة اضغط على زر MENU بالشريط السفلي للعرض ثم VIEW FULLSCREEN وللخروج اضغط زر ESC من لوحة ...

لمشاهدة المحاضرة بملء الشاشة اضغط على زر MENU بالشريط السفلي للعرض ثم VIEW FULLSCREEN وللخروج اضغط زر ESC من لوحة المفاتيح

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 Metabolic Syndrome Metabolic Syndrome Presentation Transcript

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  • إدارة الرعاية الصحية الأولية إدارة البرامج الصحية والتدريب METABOLIC SYNDROME 2009 DR . MOUSA BIN SAMHAN AL ENAZY
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  • Diabetes Prevalence Change in the Gulf States
    • Type 2 Diabetes Mellitus
    • in Gulf States
    • Annual change of prevalence.
    • Incidence is  1%.
    • Increase in the risk factors:
      • Obesity: the most important.
      • Diet: More data needed.
      • Activity: No data.
    • The change is similar.
    • Data availability is variable.
    • Diabetes Care Vol,10 1987
    • Annals of Saudi Medicine Vol,12 1992
    • Acta Diabetol Vol, 1999
    • Diabetes Care, Vol, 26 2003
    1970’ S < 5% 1980’ S 5-10% 10-20% 1990’ S > 20% 2000’ S
    • Incidence of type 2 Diabetes
      • Calculated incidence.
      • Incidence could be variable with time.
      • No difference between the Gulf states.
  • The Prevalence of Diabetes Mellitus in Saudi Arabia: Previous Studies 2004 16917 30-70 years Overall 23.7% Males 26.2% Females 21.5% Al-Nozha et al 1999 14660 >14 years Males 9.7% Females 7% Warsy et al 1998 25337 2-77 years Males 5.86% Females 4.83% El-Hazmi et al 1997 13177 >15 years Urban Males 12% Females 14% Rural Males 7% Females 7.7% Al-Nuaim 1987 5222 15-65 Overall=4.3% Males 2.9% Females 5.9% Fatani et al Year published Sample size Age of subjects Prevalence Author
  • جريدة الرياض الجمعة 7 ذي الحجة 1429 هـ - 5 ديسمبر 2008 م - العدد 14774
    • السكري ينمو بشكل مخيف في الخليج
    •       احتلت ست دول عربية مراكز متقدمة ضمن قائمة تضم أكثر من عشر دول في العالم تحمل نسبا عالية للإصابة بمرض السكري، وفق الطبعة الثالثة من أطلس مرض السكري الذي تعده المنظمة الدولية لمرض السكري . وقد احتلت دولة الإمارات العربية المتحدة المرتبة الثانية على مستوى العالم فيما كانت المملكة العربية السعودية هي صاحبة المركز الثالث، وتلتها كل دول الخليج فيما عدا قطر التي لم يكن لديها احصائيات دقيقة عن المرضى وقت اعداد الدراسة
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  • METABOLIC SYNDROME 2009 DR . MOUSA BIN SAMHAN AL ENAZY CONSULTANT PHYSICION OF FAMILY MEDICINE HEAD OF DEPARTMENT OF HEALTH EDUCATION AND PROGRRAMS IN PRIMARY HEALTH CARE AT DIRECTORATE GENERAL OF HEALTH AFFAIRS RIYADH AREA MOH
  • كشف البروفيسور منصور النزهة أن 40% من السعوديين مصابون بمرض المتلازمة
    • كشف البروفيسور منصور النزهة أستاذ أمراض القلب المعروف، ومدير جامعة طيبة بالمدينة المنورة أن 40% من السعوديين مصابون بمرض المتلازمة الأيضية كما صرح لجريدة الوفاق . ودعا أفراد المجتمع السعودي إلى التنبه لأمراض نمط الحياة المعاصرة، وأخذ الحيطة والحذر منها، وإتباع سبل الوقاية، منها ومعرفتها والإلمام بها، موصيا بضرورة اتخاذ الإجراءات الجادة الكفيلة بالحد منها ومنع انتشارها، وأن ترصد الدول الإمكانات المادية والجهود لمواجهتها، مع استمرار التوعية السليمة عبر وسائل الإعلام المختلفة 00000
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  • What is the metabolic syndrome?
    • The metabolic syndrome is characterized by a group of metabolic risk factors . They include :
    • Abdominal obesity (excessive fat tissue in and around the abdomen)
    • Blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
    • Elevated blood pressure
    • Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
    • Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
    • Proinflammatory state (e.g., elevated C-reactive protein in the blood)
  • Clinical Identification of the Metabolic Syndrome
    • It is a cluster of cardiovascular risk factors, including
    • obesity dyslipidemia,
    • high blood pressure,
    • fasting glucose abnormalities.,
    • The obesity is not just any obesity. It is abdominal obesity,
    • central obesity.
    • And the dyslipidemia is not any dyslipidemia it is hyper tri glyceridemia & low HDL cholesterol
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  • Metabolic syndrome
    • Is a combination of medical disorders that increase the risk of developing cardiovascular diseases and diabetes .
    • It affects a large number of people, and prevalence increases with age.
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  • METABOLIC SYNDROME
    • New Survey Reports High Obesity Rate in Young People and Baby Boomers, as seen in this cartoon.
    • Obesity and metabolic syndrome are not just diseases of the elderly.
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  • Metabolic Syndrome Is Common Among Children and Teens
    • This PR report shows that metabolic syndrome was prevalent in 13% of all school children. And these findings have been duplicated amongst adolescents, teenagers, and other young adults
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    • Burgers, fries, diet soda : metabolic syndrome blue - plate special
    • American Heart Association rapid access journal report
    • DALLAS, Jan . 22 — 2008
    • Western diet pattern 'promotes metabolic syndrome
    • Datamonitor estimates that approximately 115 million individuals suffer from metabolic syndrome in the seven major markets
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    • Soft Drink Consumption and Risk of Developing Cardio - Metabolic Risk Factors and the Metabolic Syndrome in Middle Aged Adults in the Community,” was published online in “Circulation” on July 23, 2007 .
  • From Ancient to Modern ..... Diets
  • From Ancient to Modern ..… Work
  • From Ancient to Modern ..... Transport
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  • CVD and All-cause Mortality are Increased in Men with the Metabolic Syndrome
    • Regardless of the cause, in men the presence of metabolic syndrome increases coronary heart disease mortality, cardiovascular disease mortality, and all-cause mortality by 2.5 to 3.8 times. Shown above is 13-year follow-up. As you can see, over time, this differential actually increases
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  • Associated diseases
    • elevated uric acid levels, fatty liver (especially in concurrent obsity ), progressing to non-alcoholic fatty liver disease , polycystic ovarian syndrome , hemochromatosis (iron overload); and acanthosis nigricans (a skin condition featuring dark patches).
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  • Pathophysiology
    • Commonly there is development of visceral fat after which the adipocytes (fat cells ) of the visceral fat increase plasma levels of TNFα and alter levels of a number of other substances (e.g., adiponectin, resistin, PAI-1). TNFα has been shown not only to cause the production of inflammatory cytokines , but possibly to trigger cell signalling by interaction with a TNFα receptor that may lead to insulin resistance.
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  • Overweight Criteria
    • So too have criteria for overweight included not only BMI, but now, also, waist circumference
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  • METABOLIC SYNDROME
    • with apples having more central obesity, a greater amount of subcutaneous fat, and more cardiovascular risk factors and higher cardiovascular risk.
    • In other words, treat the apples and leave the pears alone is what we were taught
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  • METABOLIC SYNDROME
    • How does one measure, how does one designate an apple from a pear?
    • That really involves the proper measurement of waist circumference.
    • I would measure people’s arm spans to try and diagnose Marfan syndrome prior to actually measuring their waist circumference
    • The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance Insulin is a hormone that produces to turn sugar from food into energy. If you are insulin resistant, too much sugar builds up in your blood, setting the disease.
  • Insulin resistance
    • is a generalized metabolic disorder, in which the body can’t use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.
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  • AHA Recommendation for Managing the Metabolic Syndrome:
    • Weight loss to achieve a desirable weight (BMI less than 25 kg/m2 )
    • Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week 
    • Healthy eating habits that include reduced intake of saturated fat, trans fat and cholesterol
  • AHA recommendation
    • . Routinely monitor body weight (especially the index for central obesity), blood glucose, lipoproteins and blood pressure.
    • Treat individual risk factors (hyperlipidemia, hypertension and high blood glucose) according to established guidelines.
    • Carefully choose anti-hypertensive drugs because different agents have different effects on insulin sensitivity .
  • New guidelines for the management of arterial hypertension have been issued at the European Society of Hypertension (ESH) meeting in Milan, Italy June 20, 2007
    • TREATMENT OF HYPERTENSION ASSOCIATED WITH METABOLIC SYNDROME
    • ACE inhibitors
    • Angiotensin receptor blockers
    • Calcium antagonists
    • Calcium, Vitamin D, and the Metabolic Syndrome in Middle - Aged and Older Women
    • Recent studies have shown that dairy can help prevent the metabolic syndrome and type 2 diabetes .
    • Both calcium and vitamin D are found in dairy products. Calcium helps to prevent becoming overweight, high blood pressure, and heart disease. Vitamin D has been shown to improve the body's ability to use insulin and the function of -cells, which produce insulin; a lack of vitamin D in the body has been shown to lead to higher chances of getting type 2 diabetes.
  • THANK YOU