Metabolic syndrome in Community Medicine

1,824 views

Published on

Published in: Health & Medicine
1 Comment
1 Like
Statistics
Notes
No Downloads
Views
Total views
1,824
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
131
Comments
1
Likes
1
Embeds 0
No embeds

No notes for slide

Metabolic syndrome in Community Medicine

  1. 1. Metabolic Syndrome Prepared by Dr.Anees AlSaadi Community Medicine Residents 1
  2. 2. • History and Definition. • Criteria of Diagnosis. • Epidemiology. • Risk Factors. • Complications • Etiology. • Group Exercise. • Prevention. 2
  3. 3. Changing Diagnostic Criteria. 1988 Reaven 1998 WHO 1999 EGIR 2001 NCEP ATPIII 2005 AHA/NHLBI Agreement on One criteria Many Definitions. History of the Diseases Definition 3
  4. 4. Definition • Clustering of Risk Factors: – Impaired Glucose test. – Hyperinsulinemia. – High Triglycerides. – Low HDL. – HyperUricemia. – High PAI-1 Coronary Heart Dr. Reaven “ Syndrome X” 1988 Disease. DMII. Hypertension. 4
  5. 5. Insulin Resistance. BMI ≥ 30kg/m² Hypertension 140/90mmHg Microalbumineuria • WHO 1998 Insulin Resistance Syndrome. Excluding DMII. fasting Insulin. Obesity By Waist Circumference. Hypertension. Dyslipidemia. Coronary Heart Disease. Metabolic Syndrome. • European Group for the Study of Insulin Resistance 1999 • NCEP/ATPIII 2001 • IDF/AHA/NHLBI 2005 5
  6. 6. Definition Diabetes Mellitus Hypertension Central Obesity Dyslipidemia Metabolic Syndrome 6
  7. 7. Definition Central Obesity Abdominal Waist Circumference ≥102 cm (40 in) in men ≥ 88 cm (35 in) in women 7
  8. 8. Definition Dyslipidemia Serum Lipids • TG ≥ 150 mg/dl (1.7 mmol/L) • HDL ˂ 40 mg/dl (1.03 mmol/L) in men ˂ 50 mg/dl (1.30 mmol/L in women ) 8
  9. 9. Definition Diabetes Mellitus Fasting Glucose ≥ 100 mg/dl (5.6 mmol/L) 9
  10. 10. Definition Hypertension Blood pressure ≥ 130 mm Hg systolic blood pressure. ≥ 85 mm Hg diastolic blood pressure. 10
  11. 11. 11
  12. 12. Epidemiology International Burden • U.S. prevalence adults (22% - 34.6%) [IDF 2006] • Sweden prevalence (24% m &19% f)[IDF 2007] • India prevalence of (19.52%) [ATPIII 2010] 12
  13. 13. Epidemiology Regional Burden • Turkey 33.9% (28% m & 39.6% f) [ATP III/ 2007] • Iranian (34.7%m &37.4%f) [ ATPII, IDF/ 2007] • Tunisia (24.3%m, 45.5%f) [ ATPIII, IDF/2007] 13
  14. 14. Epidemiology Regional Burden 14
  15. 15. Epidemiology Regional Burden • Jordan 37.4% (31.7% m & 41.0% f)[ATPIII/ 2007] • Oman 21.0% [ATPIII/ 2003] 15
  16. 16. Situation in Qatar 16
  17. 17. 17
  18. 18. 18
  19. 19. 19
  20. 20. Epidemiology Situation in Qatar • Overall prevalence of among obese patients was 46.3%. • [IDF/ 2010] • The prevalence was higher in females (50%) than in males (42.4%). 20
  21. 21. Epidemiology Situation in Qatar • Overall prevalence 3.0% in children aged 6–12 years. • The prevalence 9.5% in overweight and obese subjects. • Increased TG frequent abnormality (28.4%) . • Low HDL-C (19.4%) . 21
  22. 22. Where Can You Find The Highest Metabolic Syndrome ….? 22
  23. 23. 23
  24. 24. WHAT ARE THE RISK FACTORS FOR METABOLIC SYNDROME? 24
  25. 25. Epidemiology Risk Factors • Age. • More than 40% of individuals 60 years. • Gender. • Increasing prevalence among women. • Race. • African American and Mexican American populations. 25
  26. 26. Epidemiology Risk Factors 22% Overweight. 5% Normal Weight. 60% Obese. 26
  27. 27. Epidemiology Risk Factors • Low socioeconomic status. • Lack of physical activity. • High carbohydrate diet. • No alcohol intake. • Smoking. 27
  28. 28. What are the Complications of Metabolic Syndrome? 28
  29. 29. Complications 7 X DMII Metabolic Syndrome 2 X CVD 1.5 X Mortality 29
  30. 30. Complications – Cognitive decline (elderly). – Fatty liver disease, – Polycystic ovary syndrome. – Obstructive sleep apnea. – Gout. – Chronic Kidney Disease. 30
  31. 31. Etiology Genetic Susceptibility Metabolic Syndrome Environmental Factors 31
  32. 32. Prevention Fighting The Related Risk Factors. 32
  33. 33. Group Exercise Outline Prevention Program For Obesity …. 33
  34. 34. Primary Prevention Promotion of Healthy Eating. Promotion of Physical Activity Healthy School Initiatives 34
  35. 35. Secondary Prevention Screening for Obesity. Management of Healthy life style Medications/ Surgery 35
  36. 36. Medications : BMI ˂27 + comorbidity OR BMI ˂30 OR/and If no weight loss after (3-6 months) of life style changes. 36
  37. 37. Bariatric Surgery BMI ˃35 + Co -morbidity. BMI ˃ 40. 37
  38. 38. References : • • • • • • • • • • • • • Study in Americans: Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey.J Am Med Assoc 2002;287(3):356– 9. Maggi S, Noale M, Gallina P, et al. Metabolic syndrome, diabetes, and cardiovascular disease in an elderly Caucasian cohort: the Italian longitudinal study on aging. J Gerontol A Biol Sci Med Sci 2006;61(5):505–10. Patel A, Huang KC, Janus ED, et al. Is a single definition of the metabolic syndrome appropriate? A comparative study of the USA and Asia. Atherosclerosis 2006;184(1):225–32. Study in Sweden: Halldina M, Rosella M, de Fairea U, et al. The metabolic syndrome: prevalence and association to leisure-time and work-related physical activity in 60-year-old men and women. Nutr Metab Cardiovasc Dis 2007;17(5):349–57. Study in Saudi Arabia: Bahijri SM, Al Raddadi RM. The importance of local criteria in the diagnosis of metabolic syndrome in Saudi Arabia. Saudi: Ther Adv Endocrinol Metab; 2013;4(2) 51–59. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632005/pdf/10.1177_2042018813483165.pdf 38
  39. 39. References : • • • • • • • • • • Study in India: Sawant A, Mankeshwar R, Shah S, Raghavan R, Dhongde G, Raje H, et al. Prevalence of Metabolic Syndrome in Urban India. India: Hindawi Publishing Corporation; 2011. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114375/pdf/CHOL2011-920983.pdf South Asian Countries: P. Nestel, R. Lyu, P. L. Lip et al., “Metabolic syndrome: recent prevalence in East and Southeast Asian populations,” Asia Pacific Journal of Clinical Nutrition, vol. 16, no. 2, pp. 362–367, 2007. D. Eapen, G. L. Kalra, N. Merchant, A. Arora, and B. V. Khan, “Metabolic syndrome and cardiovascular disease in South Asians,” Vascular Health and RiskManagement, vol. 5, pp. 731–743, 2009. Jordan Study: Yasein N, Masa'd D. Metabolic syndrome in family practice in Jordan: a study of high-risk groups. Jordan: East Mediterr Health J; 2011 Dec;17(12):943-8. 39
  40. 40. Thank You 40

×