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The Metabolic Syndrome by Ihor Magun, M.D., F.A.C.P. Medicine is an evolving science. In the past, most doctors focused on diagnosing and treating an individual disease. More recently, doctors have re cognized that an individual disease is often only a piece of the human health jigsaw puzzle and that that individual diseases, put together, create a synd rome. Thus, the mainstay of the practice of medi cine today is a focus on the unique emerging ag gregation of diseases-syndromes. One such syndrome is the metabolic synd rome (also known as Syndrome X, dysmetabolic syndrome or insulin resistance syndrome). The metabolic syndrome is actually a cluster of risk factors that can be present in a single individual. It is estimated that this cluster (or several of the factors that comprise this cluster) now affects ap proximately 50 million people in the United States. These individuals are at an increased risk for development of diabetes and major cardiovascular disease, but many of them are not even aware that they have this syndrome. The presence of at least three of the following risk factors clinches diagnosis of the metabolic syndrome: • A waistline of greater than 40 inches in males and 35 inches in females; • Blood pressure of 130/85 or greater or if you already are being treated for hypertension; • Fasting triglycerides (a fatty substance in the blood usually tested with a complete lipid profile panel) of 150, or more or if you already are on medications for elevated triglycerides; • Fasting blood sugar of more than 100, or if you already are being treated for diabetes; • HDL (High Density Lipoproteins—also obtained from the blood with a complete lipid profile panel) of less than 40 for men and less than 50 for women, or if you are taking medications for treatment of low HDL. The root causes of the metabolic syndrome include genetic predisposition, obesity, and lack of physical activity, and treatment consists of targeting these root causes. The preferred method to reduce insulin resistance in obese patients is weight loss and increased physical activity, something that most of us already recognize as a common sense ap proach to staying healthy. Both losing weight and increasing physical activity help in risk reduction and can make a big difference in current and future health status. The other obvious treatment recommenda tions include blood pressure control, triglyceride control, blood sugar control, and addressing some thing referred to as the "prothrombotic state." Ab normal levels in any of these sets the stage for potentially tragic results by predisposing the human body to additional complications, specifically blood clot formation. This, in turn, can lead to heart at tacks as well as strokes. Currently preventive meas ures for this cascading effect include a low dose aspirin regimen, sometimes in combination with a medication called Plavix. If any of the risk factors noted above apply to you, discuss these issues with your physician and formulate a treatment plan. Although most success is achieved through pharmacologic interventions, the greatest benefit comes from reversing the ten dency to obesity and inactivity by actively control ling what and how much you eat and by getting off the couch and exercising. Your doctor can help you make the adjustment to a new and improved lifestyle and will help you design a nutritional and exercise program that is appropriate for your age, gender, weight, and general health status. No time like the present, so get going. Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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