Metabolic syndrome is a bundle of cardiometabolic risk factors that develop in common genetic and environmental environments and are characterized by waist circumference, high blood pressure, qualitative and quantitative disorders in blood lipids, and high blood sugar. In people with metabolic syndrome, the risk of developing type 2 diabetes in the future is 5 times higher and the risk of developing atherosclerotic cardiovascular disease is 2 times higher than in people without metabolic syndrome.
Non-alcoholic fatty liver disease, polycystic ovary syndrome, sleep apnea syndrome, gallstones, gastroesophageal reflux, depression and asthma are also among the conditions associated with metabolic syndrome. In addition to classical findings such as high blood sugar, hypertriglyceridemia, low HDL cholesterol, high hepatic transaminase, hyperuricemia, microalbuminuria, high CRP and plasminogen activator inhibitor-1 are among the laboratory findings of metabolic syndrome.Considering metabolic syndrome, which is considered a global epidemic, as a clinical entity will be beneficial in identifying high-risk individuals for the development of type 2 diabetes and atherosclerotic cardiovascular disease and in determining common preventive approaches.
Diagnosis of Metabolic Syndrome
Metabolic syndrome has different definitions for different organizations. The basic components of these definitions are waist circumference, insulin resistance, high blood pressure and dyslipidemia (high triglyceride, low HDL cholesterol). The most recently agreed upon diagnostic criteria for metabolic syndrome are; increased waist circumference (society and country specific), high triglycerides, low HDL cholesterol, high blood pressure and high fasting blood glucose. For diagnosis, the presence of at least 3 of these parameters is required.
Metabolic syndrome in our country
Metabolic syndrome is an important public health problem affecting 20% to 30% of the adult population in many countries. Epidemiological studies show that the frequency of metabolic syndrome in Turkish adults is very high and tends to increase. In the Metabolic Syndrome Prevalence (METSAR) study, Turkish adults aged 20 and over; It was reported that 33.9% of the patients (39.6% in women, 28% in men) had metabolic syndrome according to ATP III criteria, and 42.6% (51.1% in women, 33.9% in men) according to the International Diabetes Federation (IDF) criteria.
Why is the Frequency of Metabolic Syndrome Increasing?
It is thought that the increase in the frequency of metabolic syndrome may be due to the increase in the frequency of abdominal obesity triggered by physical inactivity, sedentary lifestyle and overnutrition, as well as the high frequency of metabolic syndrome components such as hypertension, glucose metabolism disorder and dyslipidemia. In the PURE Turkey Health Study, it was observed that Turkish adults spend approximately 6 hours of the day sitting on weekdays and weekends, regardless of rural or urban areas, and their daily energy intake was found to be as high as 2483.7 kcal. These findings suggest that unhealthy lifestyles are the most important factors in the increase in metabolic syndrome and abdominal obesity in our population.
What’s the situation around the waist?
Increasing data reveal that waist circumference is one of the most important predictors of cardiometabolic risk. According to IDF criteria (waist circumference limit is taken as >94 cm in men and >80 cm in women), the frequency of waist circumference in our country was found to be 73.8% in women and 43.2% in men.
The frequency of metabolic syndrome is increasing rapidly: how should we take precautions?
Regulation of lifestyle is the most priority and effective approach in the prevention and treatment of metabolic syndrome.
Exercise: Regular exercise reduces body weight and fat, lowers HbA1c, LDL cholesterol and triglycerides, increases HDL cholesterol. Recommended exercises include swimming, cycling, brisk walking and running. For this purpose, it is recommended to do these moderate-intensity exercises for at least 30 minutes a day, most days of the week, ideally every day. The Diabetes Prevention Study showed that a 7% weight loss achieved through diet and moderate-intensity physical activity reduced the development of metabolic syndrome by 41%.
Nutrition: Regulation of nutrition is effective not only in the treatment of obesity, but also in correcting blood pressure, glycemia and lipid profile, and in preventing diabetes and cardiovascular complications. A diet limited in saturated fats and rich in complex carbohydrates is a recommended diet model for people with metabolic syndrome. Recently, it has been reported that balanced dietary patterns such as the Mediterranean diet are associated with a decrease in the frequency of metabolic disorders such as obesity, dyslipidemia and high blood pressure, as well as coronary heart disease and different types of cancer. The Mediterranean diet is a diet rich in fiber, complex carbohydrates and monounsaturated fats such as vegetables, fruits, legumes, olive oil, walnuts, hazelnuts and grapes, and low in saturated fats. Mediterranean diet reduces body fatIn addition to reducing blood lipid levels, it has been shown to have a positive effect on blood lipid profile (especially HDL cholesterol and oxidized LDL cholesterol), endothelial function and insulin resistance, reduce the risk of thrombosis and reduce plasma homocysteine levels. It has been shown that the Mediterranean diet reduces the development of MetS by 20%, regardless of age, gender, physical activity, lipid and blood pressure levels.
Conclusion:
Metabolic syndrome is an important public health problem. Approximately one-third of Turkish adults have metabolic syndrome, and the rate is higher in women.The goal of treating metabolic syndrome is to reduce the future risk of developing type 2 diabetes and cardiovascular disease. For this reason, the most reasonable solution seems to be to spread healthy life awareness to the whole society, which includes balanced nutrition and increasing physical activity.
