Bashk\u00ebekzistenca e faktor\u00ebve t\u00eb ndrysh\u00ebm t\u00eb rrezikut q\u00eb luajn\u00eb nj\u00eb rol n\u00eb zhvillimin e s\u00ebmundjeve kardiovaskulare dhe q\u00eb mendohet se ndajn\u00eb nj\u00eb etiopatogjenez\u00eb t\u00eb p\u00ebrbashk\u00ebt quhet sindroma metabolike. Sindroma metabolike \u00ebsht\u00eb nd\u00ebr shkaqet m\u00eb t\u00eb r\u00ebnd\u00ebsishme dhe m\u00eb t\u00eb zakonshme t\u00eb s\u00ebmundjeve aterosklerotike dhe diabetit t\u00eb tipit 2.<\/p>\n\n\n\n
P\u00ebr her\u00eb t\u00eb par\u00eb n\u00eb vitin 1988, Reaven t\u00ebrhoqi v\u00ebmendjen p\u00ebr bashk\u00ebjetes\u00ebn e shpesht\u00eb t\u00eb faktor\u00ebve t\u00eb ndrysh\u00ebm t\u00eb rrezikut dhe deklaroi se kjo lidhje, t\u00eb cil\u00ebn ai e quajti sindrom\u00eb \u00cbsht\u00eb sugjeruar se rezistenca ndaj insulin\u00ebs luan nj\u00eb rol qendror n\u00eb k\u00ebt\u00eb pamje. Ndjeshm\u00ebria ndaj insulin\u00ebs tregon reagimin e insulin\u00ebs ndaj marrjes s\u00eb glukoz\u00ebs n\u00eb inde t\u00eb ndryshme t\u00eb varura nga insulina, ve\u00e7an\u00ebrisht muskujt skeletor\u00eb, dhe aft\u00ebsin\u00eb e saj p\u00ebr t\u00eb shtypur lipoliz\u00ebn n\u00eb indin dhjamor dhe glukoneogjenez\u00ebn n\u00eb m\u00ebl\u00e7i. Obeziteti, m\u00ebnyra e jetes\u00ebs sedentare, duhani, pesha e ul\u00ebt n\u00eb lindje dhe kequshqyerja perinatale jan\u00eb shoq\u00ebruar gjithashtu me zhvillimin e rezistenc\u00ebs ndaj insulin\u00ebs. Indi dhjamor dhe hormonet e sekretuara nga ky ind, \u00e7rregullimet e boshtit hipotalamo-hipofiz\u00eb-veshkore, mosha e avancuar, arsye gjenetike dhe mjedisore jan\u00eb nd\u00ebr faktor\u00ebt e tjer\u00eb q\u00eb luajn\u00eb nj\u00eb rol. T\u00eb dh\u00ebnat e fundit tregojn\u00eb se inflamacioni i shkall\u00ebs s\u00eb ul\u00ebt \u00ebsht\u00eb i p\u00ebrfshir\u00eb n\u00eb komponent\u00eb t\u00eb ndrysh\u00ebm t\u00eb sindrom\u00ebs metabolike, t\u00eb tilla si obeziteti, rezistenca ndaj insulin\u00ebs, s\u00ebmundjet kardiovaskulare, diabeti i tipit 2 dhe hipertensioni.<\/p>\n\n\n\n
Frekuenca e sindrom\u00ebs metabolike rritet me rritjen e mosh\u00ebs dhe rritjen e pesh\u00ebs trupore, dhe gjithashtu ndryshon sipas shoq\u00ebrive t\u00eb ekzaminuara. N\u00eb Shtetet e Bashkuara t\u00eb Amerik\u00ebs, prevalenca e sindrom\u00ebs metabolike tek personat e mosh\u00ebs 20 vje\u00e7 e lart rezultoi 27%, dhe u konstatua se frekuenca e sindrom\u00ebs metabolike po rritej m\u00eb shpejt tek grat\u00eb.3 N\u00eb vendin ton\u00eb, sipas rezultateve t\u00eb METSAR (K\u00ebrkim p\u00ebr Sindrom\u00ebn Metabolike t\u00eb Turqis\u00eb) i kryer n\u00eb vitin 2004, sindroma metabolike n\u00eb t\u00eb rriturit e mosh\u00ebs 20 vje\u00e7 e lart u gjet t\u00eb ishte 27%. N\u00eb k\u00ebt\u00eb studim u zbulua se frekuenca e sindrom\u00ebs metabolike tek femrat ishte m\u00eb e lart\u00eb se tek meshkujt (41,1% tek femrat, 28,8% tek meshkujt).4 K\u00ebto rezultate bazohen n\u00eb t\u00eb dh\u00ebnat e marra nga vler\u00ebsimi i kufijve t\u00eb perimetrit t\u00eb belit prej 102 cm. tek meshkujt dhe 88 cm tek femrat. Kur merren parasysh kufijt\u00eb 94-88 cm t\u00eb pranuara sot, norma rritet edhe m\u00eb shum\u00eb.
Kriteret m\u00eb t\u00eb pranuara gjer\u00ebsisht t\u00eb p\u00ebrkufizimit p\u00ebr sindrom\u00ebn metabolike jan\u00eb:<\/p>\n\n\n\n
Obeziteti abdominal: perimetri i belit >94 (ose >102) cm tek meshkujt, >80 (ose >88) cm tek femrat,<\/p>\n\n\n\n
Trigliceride t\u00eb larta (\u2265150 mg\/dl),<\/p>\n\n\n\n
Kolesteroli i ul\u00ebt HDL (<40 mg\/dl tek meshkujt, <50 mg\/dl tek femrat),<\/p>\n\n\n\n
Sheqeri i lart\u00eb i gjakut (glukoza e plazm\u00ebs s\u00eb agj\u00ebrimit \u2265100 mg\/dl), Presioni i lart\u00eb i gjakut (\u2265135\/80 mmHg)<\/p>\n\n\n\n
Prania e \u00e7do tre prej k\u00ebtyre kritereve te nj\u00eb person konsiderohet si sindrom\u00eb metabolike.5 N\u00eb p\u00ebrkufizimin e Federat\u00ebs Nd\u00ebrkomb\u00ebtare t\u00eb Diabetit, nj\u00eb nga k\u00ebto tre kritere duhet t\u00eb jet\u00eb obeziteti abdominal. 6 N\u00eb vendin ton\u00eb \u00ebsht\u00eb m\u00eb e p\u00ebrshtatshme t\u00eb merret si kufi p\u00ebr obezitetin abdominal perimetri i belit prej 94 cm p\u00ebr burrat dhe 84 cm p\u00ebr grat\u00eb.
Edhe pse nuk \u00ebsht\u00eb nd\u00ebr kriteret diagnostikuese, kushtet proinflamatore dhe protrombotike p\u00ebrfshihen gjithashtu n\u00ebn titullin e sindrom\u00ebs metabolike.<\/p>\n\n\n\n
Qasja par\u00ebsore n\u00eb sindrom\u00ebn metabolike, e cila \u00ebsht\u00eb nj\u00eb s\u00ebmundje q\u00eb shfaqet n\u00ebn ndikimin e faktor\u00ebve mjedisor\u00eb si dhe t\u00eb karakteristikave gjenetike, duhet t\u00eb jet\u00eb rregullimi i stilit t\u00eb jetes\u00ebs. Q\u00ebllimi \u00ebsht\u00eb parandalimi i diabetit dhe s\u00ebmundjeve kardiovaskulare. Humbja e pesh\u00ebs e arritur p\u00ebrmes nj\u00eb programi t\u00eb duhur t\u00eb ushqyerjes dhe st\u00ebrvitjes ka nj\u00eb efekt korrigjues n\u00eb t\u00eb gjitha \u00e7rregullimet e v\u00ebrejtura n\u00eb sindrom\u00ebn metabolike. \u00cbsht\u00eb treguar se vdekshm\u00ebria e p\u00ebrgjithshme dhe kardiovaskulare mund t\u00eb reduktohet me k\u00ebt\u00eb qasje.7<\/p>\n\n\n\n
\u00cbsht\u00eb e qart\u00eb se pirja e duhanit dhe p\u00ebrdorimi i alkoolit n\u00eb pacient\u00ebt me sindrom\u00eb metabolike do t\u00eb rris\u00eb komplikimet kardiovaskulare, metabolike dhe hepatike. Prandaj, kur shpjegohen ndryshimet e stilit t\u00eb jetes\u00ebs, duhet theksuar edhe \u00e7\u00ebshtja e pirjes s\u00eb duhanit dhe alkoolit.<\/p>\n\n\n\n
N\u00eb rastet kur ndryshimet n\u00eb stilin e jetes\u00ebs jan\u00eb t\u00eb pamjaftueshme, k\u00ebrkohet trajtim farmakologjik. Ulja e kolesterolit LDL \u00ebsht\u00eb q\u00ebllimi kryesor n\u00eb trajtimin e dislipidemis\u00eb. Statinat p\u00ebrdoren p\u00ebr k\u00ebt\u00eb q\u00ebllim.8 Terapia me fibrate mund t\u00eb konsiderohet p\u00ebr trigliceridet e larta dhe kolesterolin e ul\u00ebt HDL.9<\/p>\n\n\n\n
Metformina dhe tiazolidinedionet kan\u00eb efekte n\u00eb uljen e rezistenc\u00ebs ndaj insulin\u00ebs. Efektet e tiazolidinedioneve q\u00eb shkaktojn\u00eb shtim n\u00eb pesh\u00eb parandalojn\u00eb p\u00ebrdorimin e tyre n\u00eb sindrom\u00ebn metabolike. Metformina mund t\u00eb jet\u00eb e p\u00ebrshtatshme p\u00ebr p\u00ebrdorim klinik.<\/p>\n\n\n\n
Megjithat\u00eb, trajtimi farmakologjik ende nuk rekomandohet vet\u00ebm p\u00ebr t\u00eb reduktuar rezistenc\u00ebn ndaj insulin\u00ebs tek individ\u00ebt pa hiperglicemi.<\/p>\n\n\n\n
Studimet e kryera me rimonobant, i cili synon receptor\u00ebt endogjen\u00eb kanabinoid\u00eb, treguan humbje peshe dhe p\u00ebrmir\u00ebsim n\u00eb parametrat metabolik\u00eb.10 Megjithat\u00eb, ky medikament u t\u00ebrhoq nga p\u00ebrdorimi klinik p\u00ebr shkak t\u00eb efekteve an\u00ebsore t\u00eb tij psikiatrike.<\/p>\n\n\n\n
N\u00eb pacient\u00ebt me sindrom\u00eb metabolike, duhet t\u00eb merren parasysh efektet e barnave antihipertensive n\u00eb parametrat metabolik\u00eb, si dhe efektet e tyre n\u00eb presionin e gjakut. Presioni i gjakut i trajtimit antihipertensivPritet t\u00eb kontrolloj\u00eb presionin e gjakut, t\u00eb parandaloj\u00eb d\u00ebmtimin e organeve t\u00eb synuara, t\u00eb ndikoj\u00eb pozitivisht n\u00eb parametrat metabolik\u00eb ose t\u00eb pakt\u00ebn t\u00eb mos ndikoj\u00eb negativisht n\u00eb to.
P\u00ebr t\u00eb parandaluar komplikimet aterotrombotike, rekomandohet doza e ul\u00ebt, 75-100 mg aspirin\u00eb n\u00eb dit\u00eb p\u00ebr pacient\u00ebt me rrezik t\u00eb lart\u00eb.<\/p>\n\n\n\n
BURIMET
1 Reaven GM. Roli i rezistenc\u00ebs ndaj insulin\u00ebs n\u00eb s\u00ebmundjet njer\u00ebzore. Diabeti 37:1595-1607, 1988
2 Das OKB. Minireview: A \u00ebsht\u00eb sindroma metabolike X nj\u00eb gjendje inflamatore? Exp Biol Med 227: 989-997, 2002
3 Earl S. Ford ES, Giles WH, Mokdad AH. Prevalenca n\u00eb rritje e Sindrom\u00ebs Metabolike n\u00eb SHBA T\u00eb rriturit. Kujdesi p\u00ebr Diabetin 27(10):2444-2449, 2004
4 Grupi K\u00ebrkimor i Sindrom\u00ebs Metabolike. Rezultatet e METSAR. Kongresi i XX-t\u00eb Komb\u00ebtar i Kardiologjis\u00eb. Antalia, 2004.
5 Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F; Shoqata Amerikane e Zemr\u00ebs;<\/p>\n\n\n\n
Instituti Komb\u00ebtar i Zemr\u00ebs, Mushk\u00ebrive dhe Gjakut. Diagnoza dhe menaxhimi i sindrom\u00ebs metabolike: Nj\u00eb Deklarat\u00eb Shkencore e Shoqat\u00ebs Amerikane t\u00eb Zemr\u00ebs \/ Instituti Komb\u00ebtar i Zemr\u00ebs, Mushk\u00ebrive dhe Gjakut. Qarkullimi 2005; 112 (17): 2735-52. Bashk\u00ebekzistenca e faktor\u00ebve t\u00eb ndrysh\u00ebm t\u00eb rrezikut q\u00eb luajn\u00eb nj\u00eb rol n\u00eb zhvillimin e s\u00ebmundjeve kardiovaskulare dhe q\u00eb mendohet se ndajn\u00eb nj\u00eb etiopatogjenez\u00eb t\u00eb p\u00ebrbashk\u00ebt quhet sindroma metabolike. Sindroma metabolike \u00ebsht\u00eb nd\u00ebr shkaqet m\u00eb t\u00eb r\u00ebnd\u00ebsishme dhe m\u00eb t\u00eb zakonshme t\u00eb s\u00ebmundjeve aterosklerotike dhe diabetit t\u00eb tipit 2. P\u00ebr her\u00eb t\u00eb par\u00eb n\u00eb vitin 1988, […]<\/p>\n","protected":false},"author":1,"featured_media":28152,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[117],"tags":[],"class_list":["post-29160","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-sq"],"_links":{"self":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts\/29160","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/comments?post=29160"}],"version-history":[{"count":0,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts\/29160\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/media\/28152"}],"wp:attachment":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/media?parent=29160"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/categories?post=29160"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/tags?post=29160"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
6 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. Sindroma metabolike: nj\u00eb problem global i sh\u00ebndetit publik dhe nj\u00eb p\u00ebrkufizim i ri. J Trombi i aterosklerit. 2005; 12 (6): 295-300
7 Gregg EW, Cauley JA, Stone K, Thompson TJ, Bauer DC, Cummings SR, et al., p\u00ebr Studimin e Grupit K\u00ebrkimor t\u00eb Frakturave Osteoporotike. Marr\u00ebdh\u00ebnia e ndryshimeve n\u00eb aktivitetin fizik dhe vdekshm\u00ebris\u00eb tek grat\u00eb e moshuara. JAMA; 289: 2379-86, 2003
8 Grundy SM et al. p\u00ebr Komitetin Koordinues t\u00eb Programit Komb\u00ebtar t\u00eb Edukimit p\u00ebr Kolesterolin. Implikimet e sprovave klinike t\u00eb fundit p\u00ebr udh\u00ebzimet e Panelit III t\u00eb Trajtimit t\u00eb t\u00eb Rriturve t\u00eb Programit Komb\u00ebtar t\u00eb Edukimit p\u00ebr Kolesterolin. Qarkullimi 13 korrik; 110:227-39, 2004
9 Rubins HB, Robins SJ, Collins D, et al. Gemfibrozil p\u00ebr parandalimin dyt\u00ebsor t\u00eb s\u00ebmundjeve koronare t\u00eb zemr\u00ebs tek burrat me nivele t\u00eb ul\u00ebta t\u00eb kolesterolit lipoprotein me densitet t\u00eb lart\u00eb. Grupi i Studimit t\u00eb Nd\u00ebrhyrjes s\u00eb Kolesterolit me Lipoprotein\u00eb me Dend\u00ebsi t\u00eb Lart\u00eb t\u00eb \u00c7\u00ebshtjeve t\u00eb Veteran\u00ebve. N Engl J Med.;341:410-418, 1999
10 Pi-Sunyer FX, Aronne LJ, Heshmati HM, etj. Efekti i rimonabantit, nj\u00eb bllokues i receptorit kanabinoid-1, n\u00eb pesh\u00ebn dhe faktor\u00ebt e rrezikut kardiometabolik n\u00eb pacient\u00ebt mbipesh\u00eb ose obez\u00eb. RIO-Amerika e Veriut: Nj\u00eb prov\u00eb e kontrolluar e rast\u00ebsishme. JAMA 295:761-775, 2006.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"