Metabolic Syndrome Case Study

Metabolic Syndrome

Also known as Syndrome X, insulin resistance syndrome, and American syndrome. A cluster of diseases– mainly includes obesity, Hypertension, DM, Hyperlipidemia, etc.

Metabolic Syndrome Risk Factors

Stress, sedentary lifestyle, obesity, coronary artery diseases, aging etc.

Metabolic Syndrome Laboratory Tests

1. Glucose tolerance test.
2. Lipid profile– TG, Cholesterol, VLDL, LDL, HDL.
3. Measurement of insulin resistance.
4. Urine microalbumin.

Metabolic Syndrome Diagnostic Criteria

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International Diabetes Federation (IDF) Criteria

Central obesity (BMI > 30 Kg/m2) with any two of the following:

1. Raised triglycerides > 150 mg/dL.
2. Reduced HDL cholesterol < 40 mg/dL in males, < 50 mg/in females.
3. Raised blood pressure (BP) > 130/85.
4. Raised fasting plasma glucose (FPG) > 100 mg/dL.

WHO Criteria

Diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance, and any two of the following:

1. Blood pressure ≥ 140/90 mmHg.
2. Dyslipidaemia.
3. Central obesity; waist-to-hip ratio > 0.90 (male); > 0.85 (female), or body mass index > 30 kg/m2.
4. Microalbuminuria- urinary albumin excretion ≥ 20 µg/min or albumin: creatinine ratio ≥ 30 mg/gm.

Prevention and Management

1. Lifestyle modifications.
2. Diet management.
3. Moderate exercise.
4. Treatment of high BP, DM, Dyslipidemia, etc.

Case 1: Hypertension

Mr. Smith 60 years of age with a past history of Hypertension came to OPD with a chief complaint of dyspnoea on exertion. He is an office clerk and does not get much physical activity during the day. On examination His BMI was 31 (overweight); His waist circumference was 41.5 inches, BP-140/90 mmHg. Laboratory tests showed total cholesterol- 300 mg/dl, Triglyceride- 210 mg/dl, and fasting glucose was 120 mg/dl.

Question 1. What is your probable diagnosis?
Answer: Metabolic syndrome