#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Metabolic syndrome in older patients


Authors: H. Matějovská Kubešová;  J. Matějovský;  I. Bychler;  Z. Čejglová;  F. Dvorský;  I. Leixner;  M. Navratilova;  P. Tomeček;  H. Meluzínová
Authors place of work: Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno
Published in the journal: Čes Ger Rev 2009; 7(3-4): 110-116

Summary

The paper provides a summary of metabolic syndrome definitions and criteria defining the dia­gnosis. Pathological and physiological aspects of the component parts of metabolic syndrome – insulin resistance and type 2 diabetes mellitus, hypertension, atherogenic hyperlipidaemia – are explored; the association between hyperuricaemia and metabolic syndrome is also discussed. The paper further includes our own research results – studies on metabolic syndrome incidence in senior populations living in their own homes. Collaboration between general practitioners of the south-western Moravian regions and the Internal Medicine, Geriatric and General Medicine Clinic of the Faculty of Medicine Masaryk University and University Hospital Brno enabled assessment of 147 seniors; the diagnosis of metabolic syndrome, as defined by the IDF, was confirmed in the total of 23 clients, i.e. 15.7% of the sample. In addition, a significant proportion of the sample fulfilled 3 criteria - 18 clients, 12.1%. A notable correlation was identified between the incidence of metabolic syndrome and age – r = –1.10, p > 0.05 – i. e. a trend towards lower incidence in higher age. The incidence of metabolic syndrome showed significant negative correlation with cognitive functioning (MMSE) - r = –0.44 and self-sufficiency (ADL) – r = –0.44. Depending on the applied clinical criteria, the incidence of metabolic syndrome in older patients is about 20–40 %. The incidence of metabolic syndrome in older population is significantly negatively associated with cognitive functioning, self-sufficiency and incidence of depression.

Keywords:
metabolic syndrome – hypertension – insulin resistance – diabetes mellitus – obesity – hyperlipidaemia – cognitive impairment – self-sufficiency – depression


Zdroje

1. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37(12): 1595–1607. Review.

2. Fisher NDL, Williams GH. Hypertensive Vascular Disease. In: Kasper DL, Fauci AS, Longo DL et al (eds). Harrison‘s principles of internal medicine. 16th ed. New York: McGraw-Hill 2005.

3. Klener P et al. Vnitřní lékařství. Praha: Galén. 2. dopl. vyd. 2001: 711– 731.

4. Pelikánová T. Syndrom inzulinové rezistence. Postgrad Med 2002; 1: 7– 13.

5. Expert Panel on Detection, Evaluation, and treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP). Expert Panel on Detection, Evaluation and treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 344 (19): 2486–2497.

6. Ding XY, Mi J, Chen, H et al. The relationship between serum leptin level and metabolic syndrome among a middle-aged Chinese population. Zhonghua Yu Fang Yi Xue Za Zhi 2007, 41 (4): 281– 284.

7. Reaven G. The metabolic syndrome: is this diagnosis necessary? Am J Clin Nutr 2006; 83 (6): 1237–1247.

8. Nagaoka T, Kuo L, Ren Y et al. C-reactive protein inhibits endotelium-dependent nitric oxide-mediated dilation of retinal arterioles via enhanced superoxide production. Invest Ophthamol Vis Sci 2008; 49 (5): 2053–2060.

9. Kalvach Z, Zadák Z, Jirák R et al. Geriatrie a gerontologie. 1. vyd. Praha: Grada 2004.

10. Santhanam L, Christianson DW, Nyhan D et al. Arginase and Vascular Aging. J Appl Physiol 2008; 105 (5):1632–1642.

11. Scuteri A, Morrell CH, Najjar SS et al. Longitudinal paths to the metabolic syndrome: can the incidence of the metabolic syndrome be predicted? The Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci 2009; 64 (5): 590–598.

12. Denys K, Cankurtaran M, Janssens W et al. Metabolic syndrome in the elderly: an overview of the evidence. Acta Clin Belg 2009; 64 (1): 23–34.

13. Alexander MP, Patel TV, Farag YM et al. Kidney pathological changes in metabolic syndrome: a cross-sectional study. Am J Kidney Dis 2009; 53 (5): 751–759.

14. Can AS, Bersot TP, Gönen M. Anthropometric indices and their relationship with cardiometabolic risk factors in a sample of Turkish adults. Public Health Nutrition 2009; 12 (4): 538–46.

15. Beck E, Scheen AJ. Metabolically obese with normal weight individuals: an intriguing phenotype. Rev Med Liege 2009; 64 (1): 16–24.

16. Bouchard L, Faucher G, Tchernof A et al. Comprehensive genetic analysis of the dipeptidyl peptidase-4 gene and cardiovascular disease risk factors in obese individuals. Acta Diabetol 2009; 46 (1): 13–21.

17. Svendsen M, Helgeland M, Tonstad S. The long‑term influence of orlistat on dietary intake in obese subjects with components of metabolic syndrome. J Hum Nutr Diet 2009; 22 (1): 55–63.

18. Kemmler W, Von Stengel S, Engelke K et al. Exercise decreases the risk of metabolic syndrome in elderly females. Med Sci Sports Exer 2009; 41 (2): 297–305.

19. Straznicky NE, Lambert GW, McGrane MT et al. Weight loss may reverse blunted sympathetic neural responsiveness to glucose ingestion in obese subjects with metabolic syndrome. Diabetes 2009; 58 (5): 1126–1132.

20. Ďurovcová V, Haluzík M, Wenchich L et al. Mitochondrie a patogeneze diabetes mellitus 2. typu na úrovní pankreatu a jednotlivých inzulin senzitivních tkání. Diebatologie, metabolismus, endokrinologie, výživa 2009; 2: 65–70.

21. Hokanson JE, Austin MA. Plasma triglyceride level as a risk factor for cardiovascular disease independent of high‑density lipoprotein cholesterol level: a meta‑analysis of population based prospective studies. J Cardiovasc Risk 1996; 3 (2): 213–219.

22. Kubešová H, Holík J, Šipr K et al. Odraz vědeckých poznatků v léčbě starších klientů praktického lékaře. Praktický lékař 2000; 9 (80): 509–513.

23. Rizzo M, Rizvi A, Rini GB et al. The terapeutic modulation of aterogenic dyslipidemia and inflammatory markers in the metabolic syndrome: What is the clinical relevance? Acta diabetol 2009; 46 (1): 1–11.

24. McIntyre RS, Rasgon NL, Kemp DE et al. Metabolic syndrome and major depressive disorder: co-occurence and pathophysiologic overlap. Curr Diab Rep 2009; 1 (1): 51–59.

25. Jurašková B, Solichová D, Bláha V et al. Význam monitorování antioxidační kapacity a metabolizmu lipidů v procesu stárnutí. Čes Ger Rev 2006; 4 (2): 72–76.

26. Bo S, Rosato R, Ciccone G et al. What predicts the metabolic syndrome occurence in a population based kohort of adult healthy subjects? Diabetes Metab Res Rev 2009; 25 (1): 75–82.

27. Wortmann RL. Disorders of purine and pyrimidine metabolism. In: Kasper DL, Fauci AS, Longo DL et al (eds). Harrison‘s principles of internal medicine. 16th ed. New York: McGraw-Hill; 2005.

Štítky
Geriatrics General practitioner for adults

Článok vyšiel v časopise

Czech Geriatric Review

Číslo 3-4

2009 Číslo 3-4
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#