The Metabolic Syndrome

What are the abnormalities associated with insulin resistance and the metabolic syndrome not included in diagnostic criteria?

-Diabetes or impaired glucose tolerance -Hyperinsulinemia (excess levels of insulin) -Atherogenic dyslipidemia (elevated triglycerides) -High level of postprandial lipemia -Prothrombotic factors (high fibrinogen, high viscosity) -High levels of markers for inflammation -Microalbinuria (abnormally high albumin in urine indicative of vascular damage of kidney) -High uric acid (Abnormally high uric acid in blood resulting from defects in insulin action on renal tubular reabsorption of uric acid) -Non-alcoholic fatty liver disease -Endothelial dysfunction (vasodilatation/constricting issue)

What are the characteristic abnormalities?

-Glucose intolerance -Dyslipidemia -Hypertension -Obesity -endothelial dysfunction that impairs the capability of blood vessels to respond to changes in the blood flow -Microalbinuria that indicates vascular damage affecting the glomeruli of the kidney -The presence of prothrombotic factors -Chronic, systematic low-grade inflammation known to be associated with CVD and type II DM

Australia: men and women who watched tv for more than 14 hours per week were ______ as likely and _____ as likely, respectively, to have metabolic syndrome compared with those who watched for half this time

1.5 time; twice

Men in the highest category for muscular fitness were around ______% less likely to develop metabolic syndrome

40%

What is the metabolic syndrome?

A cluster of conditions, such as increased blood pressure, high blood sugar, excess body fat around the waste, and abnormal cholesterol or triglyceride levels, that occur together and increase the risk of heart disease, stoke, and diabetes.

What is a syndrome?

A group of symptoms or abnormalities that occur together, making a pattern.

When would PA be a preventive and/or therapeutic intervention for the metabolic disease?

If it is beneficial for more than one component of the cluster.

_________ relationship between fitness and the prevalence of metabolic syndrome

Inverse relationship There is also a dose response

Why is it hard to treat people with the metabolic syndrome?

It suggests the existence of a common etiology. It makes it difficult to treat people because drugs are designed to target on pathology, not several

Endurance-trained athletes show a ______ postprandial rise in triglycerides after a high-fat meal than do sedentary controls

Lower

What are ways to measure inactivity?

Measurement of time spent in sedentary behavior (i.e. time watching T.V. or using a computer)

What are the trends of the metabolic syndrome?

Over the past two decades there has been a striking increase world-wide in the number of people with metabolic syndrome. Highly associated with the rise of obesity and diabetes. Prevalence estimates continue to differ as there is not a definitive definition.

Prior exercise (one bout of exercise) was found to significantly ______ postprandial hyperinsulinemia in obese men

Reduce

There is a __________ relationship between the amount of sedentary behavior and the prevalence of metabolic syndrome

Significant dose-response relationship

What is the body's largest insulin-sensitive tissue and the major influence on whole-body responsiveness to insulin?

Skeletal Muscle

Where does insulin reside largely to?

Skeletal Muscle

What is the post prandial period?

The period following a meal

What are the causal factors of the metabolic syndrome?

There is a controversy. It may be one of these three: 1) Defining feature is insulin resistance 2) Abdominal obesity, because it leads to the development of insulin resistance, is the primary causative component 3) Ectopic fat in the liver (Ectopic - coming from another source or a wrongly placed substance/stimulus)

What is the prevalence for the metabolic syndrome?

There is an increase of the prevalence on metabolic syndrome world wide due to the epidemics of obesity and diabetes. The prevalence in countries differs because of the different criteria used. Average value in developed countries: 20-25% Obese individuals: 2/3 exhibit core feature of the syndrome Prevalence is highly age-dependent (older people) - 7% in those aged 20-29 year olds - 44% in 60-69 year olds Genetic predisposition among some ethnic groups - Higher among Mexican-Americans vs non-Hispanic whites - In UK high prevalence of CHD and type II DM among Indian immigrants

What is it hard to diagnose people with the metabolic syndrome?

There is more than one definition.

In the US: people who watched tv for 4+ hours per day were ______ as likely to have metabolic syndrome as those who watched less than one hr per day

Twice

What are the risk factors for developing metabolic syndrome?

Western diet (high in fat and refined carbs) and physical inactivity

When will PA be effective when preventing the metabolic syndrome?

When it involves high levels of energy expenditure on most days of the week. Frequency of activity = important

People with high visceral adipose tissue have a _______ postprandial rise and people with low visceral adipose tissue have a ________ postprandial rise.

high; low

All-cause mortality is _________ as high in unfit men with metabolic syndrome than in fit men with metabolic syndrome

twice