Sindrome Metabólico

SINDROME METABÓLICO

El Síndrome Metabólico (SM) descrito inicialmente el Dr. Gerald Reaven, representa una serie de trastornos metabólicos que incluyen a la obesidad central, intolerancia a la glucosa, hiperinsulinemia, disminución de lipoproteínas de alta densidad (HDL), e hipertensión.  Las personas con SM tienen un mayor riesgo de desarrollar diabetes tipo 2 y enfermedad cardiovascular, así como una mayor probabilidad de mortalidad por eventos coronarios (1). Las manifestaciones clínicas del SM tienen una variada expresión clínica, los factores principales de riesgo para desarrollarlo son la obesidad central y la resistencia a la acción de la insulina. Los criterios clínicos que puedan definir a una persona que pueda tener SM son parámetros comunes, sin embargo, los valores de cohorte, la combinación y la prioridad que se da a estos son específicos para cada criterio. Con lo anterior se utilizan algunas clasificaciones para su diagnostico, el de La Organización Mundial de la Salud (OMS),  ATP III y la Federación Internacional de Diabetes (IDF). La OMS para definir el SM utiliza la relación de cintura cadera, >0.90 para hombres y >0.85 para las mujeres, y el índice de masa corporal (IMC) > o igual a 30kg/m2 para ambos géneros (2). El Programa Nacional de Educación en Colesterol  (NCEP) introdujo una modificación al programa de tratamiento denominado Panel III de tratamiento para adultos (ATP III), el cual utiliza como referencia que la circunferencia de cintura para hombres sea >102 cm y >88 cm para mujeres.(3) Esta última es la de mayor uso tanto en la investigación como en la clínica por su simplicidad y utilidad. Por último La IDF sugiere que la obesidad central es esencial para definir el síndrome metabólico en diferentes grupos étnicos.

Bibliografía:

1.- Ford, Earls. MD MPH; Giles , Wayne H MHD, Prevalence of the Metabolic Syndrome Among US adults: Findings from the Thirs National Health and Nutrition Examination Survey. JAMA 2002;287 (3) : 356-359.

2.- Alberti KG, Zimmet PZ. Definition, Diagnosis and its Complications, part I; Diagnosis y classification of Diabetes Mellitus Provisional Report of a WHO Consultation. Diab Med. 1998;15:539-553.

3.- Executive summary of the Third Report of the National Cholesterol Education Program (NCEP). Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97. 

Initially described in 1988 by Dr. Gerald Reaven syndrome X, now known as metabolic syndrome is now a pandemic of the twenty-first century, however, there are notable differences in their definition, classification, disclosure and even in its nomenclature has been difficult establish criteria to determine the prevalence and consistency of it. Currently, the metabolic syndrome (SM), represents a series of metabolic disturbances including central obesity, glucose intolerance, hyperinsulinemia, decreased high-density lipoprotein (HDL) and hypertension. People with SM have a higher risk of developing type 2 diabetes and cardiovascular disease and greater likelihood of mortality from coronary events (1). Clinical manifestations of SM have a varied clinical expression; the major risk factors for developing obesity are central and resistance to insulin action. The clinical criteria that can define a person who may have SM parameters are, however, values for cohort, the combination and the priority given to these are specific to each criterion. With the above classifications are used for diagnosis, The World Health Organization (WHO), ATP III and International Diabetes Federation (IDF). WHO to set the SM uses the waist to hip >0.90 for men >0.85 for women, and body mass index (BMI);> or equal to 30kg/m2 for both genders (2). The National Cholesterol Education (NCEP) introduced an amendment to the treatment program called Panel III treatment for adults (ATP III), which uses as a reference to the men circumference is >102 cm and >88 cm for women. (3) The latter is the greater use of both research into the clinic because of its simplicity and usefulness. Finally The IDF suggests that central obesity is essential for defining the metabolic syndrome in different ethnic groups.

Bibliography:

1.- Ford, Earls. MD MPH; Giles , Wayne H MHD, Prevalence of the Metabolic Syndrome Among US adults: Findings from the Thirs National Health and Nutrition Examination Survey. JAMA 2002;287 (3) : 356-359.

2.- Alberti KG, Zimmet PZ. Definition, Diagnosis and its Complications, part I; Diagnosis y classification of Diabetes Mellitus Provisional Report of a WHO Consultation. Diab Med. 1998;15:539-553.

3.- Executive summary of the Third Report of the National Cholesterol Education Program (NCEP). Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.