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James C. Boyd, MD
Overweight and Metabolic Syndrome
St. Mary's Medical Associates

Overweight and Metabolic Syndrome

Are you overweight? Is your waist size 40 or greater if you're a male and 35 or greater if you're a female? You may have metabolic syndrome, a condition where your excess weight actually begins to impact your health in very serious ways. Known as a pre-diabetic condition, metabolic syndrome is associated with increasing body fat especially in the abdominal region, also known as the belly. It results in gradually increasing blood sugar and insulin levels, and a dramatic worsening of all lipid values, especially triglycerides and HDL, also known as the good cholesterol.
Metabolic syndrome untreated can lead to heart attack, stroke, peripheral vascular disease, and sexual dysfunction even before it leads to full-blown diabetes. As little as a 10-20 pound weight loss can sometimes take a person out of metabolic syndrome, while a 10-20 pound weight gain can place them in it.
Today America is having an epidemic of obesity. It is estimated that 50 million Americans have metabolic syndrome, yet less than 5% actually know they have this condition. The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance. Insulin resistance is a generalized metabolic disorder, in which the body can't use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.
If you feel you might have metabolic syndrome, the most important message to you is to get your numbers checked. A simple blood pressure check, weight, height, waist measurement and blood test (including fasting lipid panel, fasting glucose, cardiac CRP and hemoglobin AlC level) are recommended. These values will allow an adequate assessment of your current metabolic condition and potential for future medical problems.
Metabolic syndrome is characterized by a group of identifiable metabolic risk factors in one person. They include
Abdominal obesity (excessive fat tissue in and around the abdomen)
Atherogenic dyslipidemia (blood fat disorders high triglycerides, low HDL cholesterol and high LDL cholesterol that foster plaque build-ups in artery walls)
Elevated blood pressure
Insulin resistance or glucose intolerance (the body can't properly use insulin or blood sugar)
Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor-l in the blood)
Proinflammatory state (e.g., elevated C-reactive protein in the blood)
People with metabolic syndrome are at an increased risk of coronary heart disease and other diseases related to plaque build-ups in artery walls, including stroke and peripheral vascular disease. They are also at risk for developing Type 2 diabetes mellitus.
Other conditions associated with the syndrome include physical inactivity, aging, hormonal imbalance and genetic predisposition. .
Some people are genetically predisposed to insulin resistance. Acquired factors, such as excess body fat and physical inactivity, can elicit insulin resistance and metabolic syndrome in these people. Most people with insulin resistance have abdominal obesity. The biologic mechanisms at the molecular level between insulin resistance and metabolic risk factors aren't fully understood and appear to be complex.

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