Metabolic syndrome: Early identification prevents type II diabetes and cardiovascular disease.

Abstract

The global prevalence of type 2 diabetes is expected to double in the period 2000 to 2025 and may reach a level of almost 300 million people i.e. 5-7.6% of the total global population by the year 2025. Patients with type 2 diabetes are at increased risk of coronary heart disease and stroke, which are the most common causes of cardiovascular disease. Atherosclerotic cardiovascular disease is the principle cause of death, disability and excess health care cost in diabetes. The patients with diabetes are more likely to die from first event of cardiovascular disease than their non-diabetic counter parts. Thus the efforts for early diagnosis and prevention of type 2 diabetes may prevent its costlier complications i.e. cardiovascular and renal diseases. The association of type 2 diabetes and cardiovascular disease has led to the hypothesis that both arise from common antecedent or common factors like Insulin resistance, Obesity, Dyslipidemia, Hypertension etc. It is rare to see type 2 diabetes, dyslipidemia, obesity or hypertension in isolation. Initially Gerald Reaven in 1988 described this as Syndrome X, and proposed that resistance to insulin mediated glucose disposal and consequent hyperinsulinemia is the pathological interface of several complex metabolic alterations and diseases (1). This concept was later codified by World Health Organization (WHO) as Metabolic Syndrome. In 1998 WHO proposed a definition of metabolic syndrome which states that a person has metabolic syndrome if he or she has diabetes, impaired glucose tolerance, impaired fasting glucose or insulin resistance, plus 2 or more of the following abnormalities: Blood Pressure > 160/90 mmHg, Triglycerides > 150 mg/dl (1.695 mmol/L) & or HDL Cholesterol 0.90 male, > 0.85 female & or BMI > 30 kg/m 2 , Urinary albumin excretion rate > 20 μg/min and or Albumin/Creatinine