Metabolic syndrome
what is the pathophysiology of metabolic syndrome?
- decrease in mitochondrial density, size, and function - proinflammatory cytokines( TNF-α, IL-6) formation and secretion is increased -pro-thrombic factors (PAI-1, fibrinogen)
Metabolic syndrome what are some of the things that need to be present to be diagnosed?
-elevated waist circumference -elevated triglycerides - reduced HDLs -Elevated fasting glucose -elevated blood pressure
what is the intended goal for aerobic exercise
1200-2000 kcal pf expenditure per week
what is a reasonable goal of weight loss in the 1st year?
2-10%
patients with this condition are often prescribed medications based off of what?
co-morbidities, such as diabetes and lipid abnormalities
what is the formation and secretion of pro-inflammatory cytokines increased by?
ectopic adiposity
what really puts people at risk of metabolic syndrome?
ectopic adiposity
is there a singular explanation for metabolic syndrome development?
no
is there one single drug that can treat metabolic syndrome?
no
will weight bearing exercises feel comfortable for them?
no
is there a specific list of signs and symptoms?
no because there is an overlap from the variety of clinical conditions
can graded exercise confirm metabolic syndrome?
no, but it can be used diagnostically to confirm something else typically used for the exercise piece not the diagnostic piece
of the five risk components what seems to be the most prevalent with metabolic syndrome?
obesity
what is often prevalent with metabolic syndrome?
obesity and diabetes
what are most people with metabolic syndrome be stratified as risk wise?
moderate or high risk
what does their risk status most likely prompt them for?
additional screening and specific decisions about the prescribed intensity of testing and exercise
what seems to be a significant contributor to metabolic syndrome?
abdominal obesity
what is the main driver for metabolic syndrome?
abdominal obesity so treatment should focus on reducing this first
for exercise prescription what will you need?
graded exercise for clearance for exercise.
Elevated fasting glucose
greater than 100 mg/dL
elevated blood pressure
greater than 130/85mmHg
Elevated triglycerides
greater than 150 mg/dL
ectopic adiposity such as IMAT appears to independently contribute to?
impaired glucose metabolism and decreased insulin sensitivity
what is microalbuminuria?
increased amount of albumin in the urine
what does the ectopic adiposity lead to?
increased triglycerides, cholesterol, reactive oxygen specises, CRP, decreased HDLs
what is ectopic adiposity
it is the fat accumulation out side of fat tissue. fat accumulation in the muscle
reduced HDLs
less than 40-50 mg/dL
what type of intensities and protocols are often well tolerated by patients?
low intensity treadmill and bike protocols
what is abdominal obesity measured by? and what is it representative of?
measured by waist circumference and representative of ectopic adiposity
what are the primary goals of treatment for metabolic syndrome?
to reduce the risk of CVD and type II diabetes
how can treatment be accomplished of the main driver?
via physical activity, exercise, surgery, and drugs
are all risk components of metabolic syndrome modifiable?
yes
does aerobic exercise FITT have a does response relationship?
yes
