Metabolic syndrome

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  • Action of insulin
  • Role of insulin
  • In All cell ,

Transcript

  • 1. METABOLIC SYNDROME
  • 2. PREVALENCE: in Pakistan • 46 – 48 % in overall population • 27 – 54 % of population have dyslipemia and hyperlipidemia • 68 – 81 % of population has low levels of HDL. • 50% are at high risk of metabolic syndrome and hypertension. • the prevalence in reported to be from 18% to 46% of the population.
  • 3. SIGNS AND SYMPTOMS: • High blood sugar level : hyperglycemia • High cholesterol : hyperlipidemia, Dyslipidemia • Obesity, with body fat concentration around waist (visceral fat) • Increased blood pressure. • Atherosclerosis and high susceptibility of CVD • Gout
  • 4. SIGNS AND SYMPTOMS • Atherosclerosis and high susceptibility of CVD • Gout -side effect of high blood sugar, associated with high cholesterol and obesity • Other associated diseases and signs are: • Hyperuricemia, ketonuria and acidosis • Hyperinsulinemia • Wasting of skeletal muscles • Non Alcoholic Fatty liver
  • 5. DIAGNOSIS: presence of three or more of these components: • Central or abdominal obesity • Fasting blood triglycerides greater than or equal to 150 (mg/dL) of blood • Blood HDL cholesterol: – Men - Less than 40 mg/Dl – Women - Less than 50 mg/dL • Blood pressure greater than or equal to 130/85 mmHg • Fasting glucose greater than or equal to 100 mg/dL
  • 6. RISK FACTORS: • • • • Age. Race. Physical inactivity Diet. (high fructose drinks, high-fat diets) • Sleep apnea • Hormonal imbalance
  • 7. • Stress. (upsetting the hormonal balance of the hypothalamic-pituitary-adrenal axis (HPA-axis). • Obesity. • Genetics • Other diseases. schizophrenia or other psychiatric illnesses by exhausting the insulin secretion and its transduction • Smoking and narcotics addiction
  • 8. PATHOGENESIS : • Metabolic syndrome is a cascade of events indicating several metabolic anomalies occurring simultaneously in type II Diabetes Mellitus. • Clinical features resulting from Insulin resistivity
  • 9. INSULIN RESISTIVITY: • It is described as the gradual loss in the sensitivity of the insulin receptor which is a transmembrane receptor 4 insulin receptor substrate 1-4 and cytosolic domains of tyrosine kinase (part of 2nd messenger system) • lost expression of insulin receptors and distortion of signal transduction pathway of insulin in type II Diabetes. Less no. of receptors on cell surface in obese people is found as compared to lean individuals • hyperinsulinemia (high conc. of insulin in plasma) develops which is itself toxic.
  • 10. All functions reversed in Metabolic Syndrome
  • 11. In Liver and Muscles: • Reduced Glucokinase activity • reduced expression of Glut receptors and cotransporters • Limited uptake of glucose and and amino acid • Limited energy storing processes after meal • Decrease in Glycogenesis • Decrease in Lipid Kinase activity
  • 12. Energy crises in b/w meals • Activation of insulin antagonists • Glucagon • Lipase activation beta-oxidation of fats instead of glycolysis • Accetoacetic acid accumulation • Acidosis • Blood PH reduces • Ketonemia and microalbuminurea • Muscles undergo wasting • Liver secretes abnormal fats resulting Dyslipidemia
  • 13. In Adipose Tissue • • • • • • Reduced activation of Lipid Kinase Activation of Lipases Lipolysis FFAs and TGs in plasma Hypergylcemia Adipokines – leptin, TnF, IL-6, Resistin, adiponectin in plasma.
  • 14. In All Cells: • • • • • • • Long term reduction in gene expression DnA repair and synthesis Reduced insulin like growth factors Cell become prone to aging, inflammation Increased prothrombic factors and cytokines Reduce secretion of e nitric oxide Synthase Vasoconstriction and High blood pressure
  • 15. Special Thanks for illustrations and References: • http://www.revespcardiol.org/en/aterogenesisdiabetes-resistencia-insulina-e/articulo/90113980/ • http://www.medbio.info/horn/time%2034/homeostasis_2.htm • http://themedicalbiochemistrypage.org/insulin.php • http://biocadmin.otago.ac.nz/fmi/xsl/bioc2/learnbitslect ure.xsl?-db=BIOC2web.fp7&-lay=Lectures&recid=5263&-find= Presented by: Sara siddiqui