The Double Jeopardy Of The Metabolic Syndrome

1
THE METABOLICSYNDROMEA Reversible
Life-Threatening Condition

• The Double Jeopardy Of The Metabolic Syndrome

2
The Double Jeopardy of The Metabolic Syndrome

• Metabolic syndrome and risk of future diabetes
• Metabolic syndrome and cardiovascular risk
• Which threat for countries with developped
  economies
• Which threat for countries with developping
  economies
• The metabolic syndrome is a major health issue
  worldwide

3
The Global Menace of The Metabolic Syndrome

• The metabolic syndrome is a predictor of type 2
  diabetes
• The metabolic syndrome is a risk factor for
  cardiovascular disease (CVD)

4
Metabolic Syndrome And Risk of Type 2 Diabetes
Incident diabetes after stratification by age or
BMI, IGT,and the metabolic syndrome (San Antonio
Heart Study)
Lorenzo, et al. Diabetes Care. 2003263153-3159.
5
Metabolic Syndrome And Risk of Type 2 Diabetes
Risk of type 2 diabetes per unit change in risk
trait levelsSan Antonio Heart Study
Stern MP, et al. Ann Intern Med 2002136575-581.
6
Metabolic Syndrome and Cardiovascular Risk
Individuals without diabetes or CVD, but with the
metabolic syndrome are at increased risk for
long-term CV outcomes
Schmidt MI, et al. (ARIC study) Diabetes Care
200528385-390.
7
Metabolic Syndrome and CHD Risk
Prevalence of CHD in patients with the metabolic
syndrome(Botnia Study)
Adapted from Isomaa B, et al. Diabetes Care.
200124683-689.
8
Metabolic Syndrome and Cardiovascular Vital
Prognosis
Metabolic syndrome influences the cardiovascular
vital prognosis in each category of patients
according to revised ATP-III recommendations
Ardern CI, et al (ACLS study). Circulation
20051121478-1485.
9
Metabolic syndrome has a major impact on coronary
risk in a population with low cholesterol levels
Onat A, et al (TARFS). Atherosclerosis
2002165285-292.
10
Increased CVD and All-cause Mortality
1209 Finnish men
Lakka H, et al. JAMA 20022882709-2716.
11
Association Between The Number of Metabolic
Syndrome Components and Incident CVD
Klein BEK, et al. (Beaver Dam Study). Diabetes
Care 2002251790-1794.
12
Whatever The Definition, The Metabolic Syndrome
Increases 1.5 to 2-fold The Risk of CV Events
Dekker JM, et al. (Hoorn study). Circulation
2005112666-673.
13
With the WHO definition the metabolic syndrome
has a stronger predictive value for the risk of
CV event than any of its components
Metabolic Syndrome Predictive of CV Events
Isomaa B, et al ( Botnia study). Diabetes Care
2005 683-689.
14
Which Threat for Countries With Developped
Economies?

• A significant proportion of the population of
  industrialised countries is affected by the
  metabolic syndrome
• Prevalence of the syndrome
• Increases with age
• Varies with sex and ethnicity

15
Metabolic Syndrome Prevalence Increases with Age
47 million or 23 of US adults have the metabolic
syndrome
Adapted from Ford ES, et al. JAMA
2002287356-359.
16
Ireland
Villegas, et al. Diabetes Care. 2003263198-3199.
17
France
Cameron, et al. Diabetologia. 200346A3068.
18
Italy
Meigs, et al. Diabetologia. 2003522160-2167.
19
Sweden
Balkau, et al. Diabet Metab. 200228364-376.
20
United States
Meigs, et al. Diabetes 2002522160-2167.
21
Which Threat for Countries With Developing
Economies?

• With urbanisation and adoption of Western
  lifestyle, the metabolic syndrome affects an
  increasing proportion of the populations of
  countries with developing economies

22
Turkey
Villegas, et al. Diabetes Care.
2003263198- 3199.
23
Iran
Azizi, et al. Diab Res Clin Pract 20036129-37.
24
India
Deepa, et al. Indian J of Med Res 200260199-204.
25
A Major Health Issue WorldwidePrevalence of the
metabolic syndrome (ATP III)
Obesity criteria adjusted to waist circumference
appropriate for an Indian population