1.

Term Metabolic Syndrome and Common cause

Sindrom metabolik adalah istilah kedokteran untuk menggambarkan kombinasi dari sejumlah kondisi,
yaitu hipertensi, kadar gula darah yang tinggi, kadar kolesterol yang buruk, dan obesitas, yang dialami
secara bersamaan

Metabolic syndrome is a group of five risk factors that increase the likelihood of developing heart disease,
diabetes, and stroke. The five risk factors are:

 A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the
stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the
hips.
 A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of
fat found in the blood.
 A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is
called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol
level raises your risk for heart disease.
 High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of
blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high
over time, it can damage your heart and lead to plaque buildup.
 High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may
be an early sign of diabetes.

Having one of these risk factors does not mean that you have metabolic syndrome. However, having one will
increase your chances of developing cardiovascular disease. Having three or more of these factors will result
in a diagnosis of metabolic syndrome and it will increase your risk of health complications.

Apa penyebab sindrom metabolik?

Sindrom metabolik disebabkan terutama oleh kondisi obesitas dan kurangnya beraktivitas. Sindrom
metabolik berhubungan dengan suatu kondisi yang disebut resistensi insulin

2. Risk Factor metabolik syndrome

 central obesity, or excess fat around the middle and upper parts of the body
 insulin resistance, which makes it difficult for the body to use sugar

 Usia. pada 40 persen orang-orang yang berusia di atas 60 tahun.

Penyakit lain. memiliki penyakit kardiovaskular, penyakit hati nonalkoholik, atau sindrom ovarium
polikistik. gangguan keseimbangan kadar hormonal. Pada sindrom ini, tubuh wanita memproduksi
hormon laki-laki (androgen) secara berlebihan. Akibatnya wajah lebih berminyak dan rambut tumbuh
secara berlebihan, terutama di tangan dan kaki.
Gejala utama PCOS adalah gangguan haid. Hampir semua wanita dengan sindrom ini tidak mengalami
mengalami jadwal haid yang normal ketika remaja, bahkan ada yang berhenti haid sama sekali.
Kebanyakan wanita menyadari mereka menderita PCOS di usia dewasa muda atau sekitar usia 20-an, ketika
siklus haid mereka terganggu atau belum haid. PCOS juga bisa menyebabkan kesulitan hamil.
Wanita dengan PCOS pada umumnya juga menderita kegemukan dan kebotakan pada bagian puncak kepala.
Sindrom ini juga bisa meningkatkan risiko [[diabetes]tekanan darah tinggi, serta kolesterol tinggi.
Penurunan berat badan sangat disarankan untuk mengurangi kadar insulin dan hormon androgen.

 Diabetes. Anda memiliki risiko sindrom metabolik jika Anda memiliki diabetes selama kehamilan
(gestational diabetes) atau jika Anda memiliki riwayat keluarga yang memiliki diabetes tipe 2.
5. Clinical Manifestasion
 Hypertension 140/90 mmHg atau lebih.
 Hyperglycemia : Kadar gula darah puasa yang tinggi, yaitu 100 mg/dL ke atas.
 Hypertriglyceridemia 150 mg/dL atau lebih.
 Reduced high-density lipoprotein cholesterol (HDL-C) (kurang dari 40 mg/dL untuk pria dan 50
mg/dL untuk wanita).
 Abdominal obesity Lingkar pinggang yang melebihi batas normal, yaitu di atas 80 cm untuk
wanita dan 90 cm untuk pria.
 Chest pain or shortness of breath: Suggesting the rise of cardiovascular and other complications
 Acanthosis nigricans, hirsutism, peripheral neuropathy, and retinopathy: In patients with insulin
resistance and hyperglycemia or with diabetes mellitus
 Xanthomas or xanthelasmas: In patients with severe dyslipidemia
Xanthoma is a condition in which fatty growths develop underneath the skin. These growths can
appear anywhere on the body, but they typically form on the: joints, especially the knees and elbows.
feet. hands.
Xanthelasma are yellow plaques that occur most commonly near the inner canthus of the eyelid, more
often on the upper lid than the lower lid.

6. Diagnosis
According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart
Association (AHA), metabolic syndrome is diagnosed when a patient has at least 3 of the following 5
conditions:
 Fasting glucose ≥100 mg/dL (or receiving drug therapy for hyperglycemia)
 Blood pressure ≥130/85 mm Hg (or receiving drug therapy for hypertension)
 Triglycerides ≥150 mg/dL (or receiving drug therapy for hypertriglyceridemia)
 HDL-C <40 mg/dL in men or <50 mg/dL in women (or receiving drug therapy for reduced HDL-C)
 Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian American, ≥90 cm
(35 in) in men or ≥80 cm (32 in) in women
Complaints of chest pain, dyspnea, or claudication (symptoms of possible complications) may warrant
additional studies, including the following:
 Electrocardiography (rest/stress ECG)
 Ultrasonography (vascular, or rest/stress echocardiography)
 Stress single-photon emission computed tomography (SPECT) or cardiac positron emission
tomography (PET)
here have been various definitions of the metabolic syndrome since 1998. The International Diabetes
Federation (IDF) and American Heart Association (AHA) definition in 2009 was as follows[4]:

Any three (or more) of the following factors constitute a diagnosis of metabolic syndrome:

 Increased waist circumference: ethnicity-specific - eg, Caucasian men ≥94 cm and women ≥80 cm;
South Asian men ≥90 cm and women ≥80 cm.
 If body mass index is over 30 kg/m2, central obesity can be assumed and waist circumference does not
need to be measured.

 Raised triglycerides:
 >150 mg/dL (1·7 mmol/L).
 Or specific treatment for this lipid abnormality.
  Reduced HDL-cholesterol:
 <40 mg/dL (1·03 mmol/L) in men.
 <50 mg/dL (1·29 mmol/L) in women.
 Or specific treatment for this lipid abnormality.
 Raised blood pressure:
 Systolic ≥130 mm Hg.
 Diastolic ≥85 mm Hg.
 Or treatment of previously diagnosed hypertension.
 Raised fasting plasma glucose:
 Fasting plasma glucose ≥100 mg/dL (5·6 mmol/L).
 Most people with type 2 diabetes will have metabolic syndrome based on these criteria.

The IDF proposed a definition for children and adolescents in 2007[5]:

 Aged 6-9 years: waist circumference 90th percentile; however, metabolic syndrome cannot be
diagnosed but further measurements should be made if there is a family history of metabolic syndrome,
type 2 diabetes, dyslipidaemia, CVD, hypertension and/or obesity.
 Aged 10-15 years: waist circumference ≥90th percentile or adult cut-off if lower:
 Triglycerides ≥1.7 mmol/L (≥150 mg/dL), HDL-C <1.03 mmol/L (<40 mg/dL)
 Systolic blood pressure ≥130 or diastolic blood pressure ≥85 mm Hg
 Fasting blood glucose ≥5.6 mmol/L (100 mg/dL)
 Aged 16+ years: use existing IDF criteria for adults.

7. Complication
The complications that may result from metabolic syndrome are frequently serious and long-term (chronic).
They include:

 hardening of the arteries (atherosclerosis)

 diabetes
 heart attack
 kidney disease
 stroke
 nonalcoholic fatty liver disease
 peripheral artery disease
 cardiovascular disease

If diabetes develops, you may be at risk for additional health complications, including:

 eye damage (retinopathy)

 nerve damage (neuropathy)
 kidney disease
 amputation of limbs
8. Lifestyle advice for people with metabolic syndrome
Lifestyle modifications are effective in resolving metabolic syndrome and reducing the severity of related
abnormalities (fasting blood glucose, waist circumference, systolic and diastolic blood pressure, and
triglycerides) in people with metabolic syndrome[14].

Exercise

 An increase in overall levels of sustained physical activity and avoidance of prolonged sedentary
behaviour are important for reduction of CVD risk.
 Emphasise walking, cycling and other aerobic physical daily activities, at moderate intensity, as part of
an active lifestyle, for at least 150 minutes per week in bouts of at least ten minutes, or 75 minutes per
week of vigorous physical activity, or a combination of the two.
 Muscle-strengthening activities performed on at least two occasions per week.
 Exercise training, incorporating a warm-up and cool-down period, should be performed at moderate to
high intensity two to three times per week for 30-40 minutes each time.
 The mode of exercise should be aerobic and where possible, continuous, allowing for a steady
progression in effort - eg, walking programmes, cycling, jogging, swimming.
 The time spent exercise training contributes to meeting the 150 minutes per week of physical activity
recommendation.

Weight loss
Weight reduction is important for those with abdominal obesity and the metabolic syndrome. See also
separate Obesity in Adults and Obesity in Children articles.

Diet composition

 Consume five portions per day of fruit and vegetables.

 Consume at least two servings of fish (preferably oily) per week.
 Consider regular consumption of whole grains and nuts..
 There is evidence showing that subjects adherent to a Mediterranean diet have lower prevalence and
incidence rates of metabolic syndrome than those non-adherent[15].
 Fats:
 'Low fat' is too simplistic and may even be detrimental. The composition of dietary fats is more
important.
 Keep intake of saturated fat to less than 10% of total fat intake (preferably in lean meat and low-
fat dairy products).
 Replace saturated fat with poly-unsaturated fat where possible.
 Avoid 'trans fats' (often labelled as 'hydrogenated' or 'partially hydrogenated' vegetable oils) as
they are harmful and linked to cardiovascular disease.
  Avoid/reduce consumption of processed meats or commercially produced foods which tend to be
high in salt and trans fatty acids.
 Increase the proportion of mono-unsaturated fats (eg, olive oil).
 Increase the amount of omega-3 polyunsaturated fatty acids (PUFAs) compared with a Western
diet.
 Carbohydrates: avoid or reduce consumption of refined carbohydrates, such as white bread, processed
cereals, sugar-sweetened beverages, and calorie-rich but nutritionally poor snacks, such as sweets,
cakes and crisps.
 Keep salt consumption below 6 g per day.

Other lifestyle factors

 Smoking cessation.
 Avoid excessive alcohol consumption.

Drug treatment

 The manifestations and complications of metabolic syndrome should be treated according to

established guidelines for the treatment of hyperlipidaemia, CVD, hypertension and diabetes. This may
therefore involve the use of:
 Low-dose aspirin.
 Antihypertensives.
 Statins and/or fibrates.
 Antidiabetic drugs.