Síndrome metabólico

Abstract

Metabolic syndrome is a combination of risk factors, namely centrally distributed obesity, dyslipidemia, hypertension and insulin resistance, all of which are future predisposing factors for cardiovascular disease and type 2 diabetes. Most studies demonstrate that the prevalence of metabolic syndrome depends on the employed definition, and show a higher prevalence in the Mediterranean region than in north and central Europe. One of the main pathophysiological mechanisms is insulin resistance. Fasting glucose and insulin determinations are needed to detect abnormalities in glucose homeostasis, and indicate the secretion of insulin and its sensitivity in liver and peripheral tissues. The management of metabolic syndrome initially involves implementing an appropriate diet that leads to amelioration of the sensitivity to insulin and prevention/modification of the associated metabolic and cardiovascular abnormalities. This must be combined with regular exercise and adequate psychological support. In impaired glucose tolerance, the modification of life style will positively impact glycaemia and cardiovascular risk factors. Given the difficulty in modifying the lifestyle among adolescents, medication may need to be employed. Lastly, the strategies to prevent obesity and metabolic syndrome need to be initiated in the primary care setting, with programmes for families of children at risk of obesity, and with programmes implemented in schools.