2 - Metabolic Syndrome

Question 1

IDF definition of Metabolic Syndrome

Answer 1

A cluster of the most dangerous heart attack risk factors: diabetes and prediabetes, abdominal obesity, high cholesterol and high blood pressure.

Question 2

Metabolic syndrome is defined by the presence of what and how many risk factors?

Answer 2

3 of: increase in fasting plasma glucose, increased blood pressure, low levels of plasma cholesterol bound to HDL, increased concentration of plasma triglycerides, and/or abdominal or central obesity.

Question 3

Waist circumference thresholds

Answer 3

102cm in men, 88cm in women

Question 4

Cardiometabolic risk factors are factors that can increase your risk of….

Answer 4

heart disease and diabetes

Question 5

Examples of cardiometabolic risk factors

Answer 5

High triglycerides, high LDL-c, low HDL-c, inflammatory markers, elevated blood glucose, insulin resistance, high blood pressure, and intra-abdominal adiposity.

Question 6

Global cardiometabolic risk factors (classical)

Answer 6

High blood glucose, high LDL, hypertension and smoking.

Question 7

Global cardiometabolic risk factors (emerging)

Answer 7

Insulin resistance, low HDL, high triglycerides, inflammatory markers.

Question 8

What concept is cardiometabolic risk based on?

Answer 8

Risk continuum.

Question 9

Global cardiometabolic risk

Answer 9

The overall risk of developing type 2 diabetes and/or cardiovascular diseases, due to a cluster of modifiable risk factors.

Question 10

Where is insulin produced?

Answer 10

the pancreas

Question 11

What does insulin do?

Answer 11

Allows cells to take in glucose and use it for energy.

Question 12

Insulin resistance

Answer 12

Cells no longer respond to insulin and therefor glucose can’t enter the cell.

Question 13

Is CVD mortality decreased or increased in a person with metabolic syndrome?

Answer 13

Increased

Question 14

What components of metabolic syndrome can predict coronary heart disease?

Answer 14

Thrombosis, hypertension, insulin resistance, atherosclerosis, and coronary artery disease.

Question 15

What two diseases does metabolic syndrome increase the risk for?

Answer 15

Diabetes mellitus and cardiovascular disease.

Question 16

What does visceral adipose tissue refer to?

Answer 16

Belly fat

Question 17

What is visceral adipose tissue associated with?

Answer 17

High triglycerides, low HDL-C, small dense LDL particles, high insulin/glucose, high blood pressure, prothrombotic state, endothelial dysfunction, and atherosclerosis.

Question 18

What are the two most significant risk factors for metabolic syndrome?

Answer 18

Insulin resistance and central obesity

Question 19

In what way is age a risk factor for metabolic syndrome?

Answer 19

The prevalence of metabolic syndrome increases with age.

Question 20

What races or ethnic groups have a higher risk of metabolic syndrome?

Answer 20

African-american and mexican-american.

Question 21

What BMI and what type of obesity is a risk factor for metabolic syndrome?

Answer 21

BMI 25+ and abdominal fat.

Question 22

What types of histories can be a risk for metabolic syndrome?

Answer 22

Family history, history of type 2 diabetes, and/or a history of diabetes during pregnancy.

Question 23

What other diseases can increase your risk for metabolic syndrome?

Answer 23

Hypertension, CVD, polycystic ovary syndrome.

Question 24

Why is belly fat specifically a risk factor as opposed to all fat?

Answer 24

Belly fat secretes inflammatory substances.

Question 25

With insulin resistance, what parts of your body can't use the insulin?

Answer 25

Muscles, fat, and liver cells.

Question 26

How does the pancreas respond to insulin resistance?

Answer 26

It produces more and more insulin.

Question 27

What happens to glucose if a person has insulin resistance?

Answer 27

Glucose builds up in the blood stream

Question 28

What levels of glucose after an overnight fast is considered to be an indicator of prediabetes?

Answer 28

6.1 - 6.9 mmol/L (according to guidelines) | 99-120mg/dl (According to Dr. Pollard)

Question 29

Most people diagnosed with prediabetes will develop diabetes in how many years?

Answer 29

10 years

Question 30

How does hypertension lead to atherosclerosis?

Answer 30

High blood pressure exerts mechanical stress on the arteries. This results in chronic endothelial damage and the onset of atherosclerosis.

Question 31

Thrombogenicity

Answer 31

The tendency of a material in contact with the blood to form a blood clot.

Question 32

Pro-thrombotic state

Answer 32

Endothelial dysfunction, enhanced coagulation, impaired fibrinolysis, platelet dysfunction, and a higher risk for venous thrombosis.

Question 33

Fibrionolysis

Answer 33

Clot prevention

Question 34

How do macrophages trigger inflammation?

Answer 34

Macrophages invade excess adipose tissue, resulting in the release of cytokines. Cytokines trigger inflammation.

Question 35

How does inflammation trigger CVDs?

Answer 35

Inflammation increases the likelihood of plaque rupture.

Question 36

What is endothelial dysfunction?

Answer 36

Damage to the insides of arteries.

Question 37

What is the primary clinical outcome of hyperglycemia?

Answer 37

Microvascular disease (chronic kidney disease and diabetic retinopathy)

Question 38

What does microvascular disease excellerate?

Answer 38

Development of congestive heart failure. Also contributes to atherogenesis.

Question 39

Atherogenesis

Answer 39

Development of plaques inside blood vessel walls.

Question 40

How does metabolic syndrome progress without treatment?

Answer 40

Metabolic syndrome -> Pre-diabetes -> Diabetes/CVD

Question 41

Complications of metabolic syndrome

Answer 41

Type 2 diabetes, essential hypertension, PCOS, nonalcoholic fatty liver disease, sleep apnea, CVDs, and cancer.

Question 42

Odds ratio

Answer 42

A measure of association between an exposure and an outcome. The OR represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure.

Question 43

Risk ratio.

Answer 43

The ratio of the probability of an event occurring in an exposed group to the probability of the event occurring in a comparison, non-exposed group.

Question 44

A risk ratio of less than 1 means...

Answer 44

A reduction in risk in the exposed group.

Question 45

A risk ratio of more than 1 means...

Answer 45

Exposed group has a higher risk than unexposed group.

Question 46

Odds ratio equals 1

Answer 46

Exposure does not affect odds of outcome

Question 47

Odds ratio less than 1

Answer 47

Exposure associated with higher odds of outcome

Question 48

Odds ratio greater than 1

Answer 48

Exposure associated with lower odds of outcome

Question 49

Risk ratio equals 1

Answer 49

Exposure associated with the same odds of outcome.

Question 50

What is the #1 risk factor for metabolic syndrome?

Answer 50

Age

Question 51

What percent of the population has metabolic syndrome?

Answer 51

20%

Question 52

Incidence of metabolic syndrome increases with...

Answer 52

Age and increase in obesity

Question 53

Is there any specific pharmacotherapy for metabolic syndrome?

Answer 53

No.

Question 54

What are the 3 underlying causes responsible for the epidemic of metabolic syndrome?

Answer 54

Environmental causes, insulin resistance, and inflammation.

Question 55

Primary prevention of metabolic syndrome

Answer 55

Lifestyle changes: weight reduction, change in dietary choices, and an increase in physical activity.

Question 56

Secondary prevention of metabolic syndrome

Answer 56

Screening and public education.

Question 57

Types of secondary prevention screening for metabolic syndrome

Answer 57

Screening for blood sugar/A1C, lipids, blood pressure.

Question 58

Tertiary prevention

Answer 58

Minimize risk of type 2 diabetes and CVD, by treating each component/risk factor, such as obesity, glucose intolerance, insulin resistance, lipid disorders and hypertension.

Question 59

Determinants that can influence how hungry a person is...

Answer 59

Biological, ecological, physical, social, psychological, and attitudes/beliefs/knowledge about food.