THE METABOLIC SYNDROME Web Conference Paris, December 2006

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THE METABOLICSYNDROMEWeb Conference Paris,
December 2006

• Metabolic Syndrome a Key Target for
  Cardiovascular Prevention

Scott GRUNDY, MDChairman, Department of Clinical
Nutrition University of TexasSouthwestern
Medical Center, Dallas (TX USA)
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Conditions Associated with the Metabolic Syndrome

• Atherosclerotic cardiovascular disease
• Type 2 diabetes
• Fatty liver and non-alcoholic steatohepatitis
• Sleep apnea
• Cholesterol gallstones
• Polycystic ovarian disease

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Metabolic Syndrome Components

• Abdominal obesity
• Elevated triglyceride-rich lipoproteins
• Reduced high-density lipoproteins (HDL)
• Elevated blood pressure
• Elevated plasma glucose

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Risk Associated with the Metabolic Syndrome

• Atherosclerotic cardiovascular disease
• Two-fold increase in risk for ASCVD
• Type 2 diabetes
• Five-fold increase in risk for T2DM

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Role of Metabolic Syndrome in Pathogenesisof
ASCVD
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Abdominal Obesity

• Dysfunctional adipose tissue due to combined
  disorders
• Excess fat accumulation (obesity)
• Deficiency of lower body subcutaneous fat
• Products of dysfunctional adipose tissue
• Elevation in
• Non-esterified fatty acids ? insulin resistance
  dyslipidemia
• Cytokines ? proinflammatory state
• PAI-1 ? prothrombotic state
• Angiotensinogen ? elevated blood pressure
• Resistin ? insulin resistance
• Reduced adiponectin ? insulin resistance,
  dyslipidemia, and proinflammatory state

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Clinical Approach to the Metabolic Syndrome