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Definition
- At least 3 of these 5 criteria:
- Abdominal obesity (>40in in men, >35in in women)
- High triglycerides (>150mg/dL)
- Low HDLs (<40 in men, <50 in women)
- HBP (>130/85)
- High sugars (>100mg/dL)
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Metabolic syndrome causes
- decreased compliance of vessel bed (similar to diabetes)
- Increased inflammation & thrombosis
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Risk factors for development of metabolic syndrome
smoking, no alcohol, antipsychotics (clozapine - used for schizophrenia)
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Assessment
Every year if they're at high risk for metabolic syndrome. Assess their BP, waist circumference, serum cholesterol, fasting glucose and insulin level each time.
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Treatment
- DIET AND EXERCISE - may be best treatment
- Metformin (500 mg BID) - enhances insulin action, decreases glucose & LDLs. Risk of lactic acidosis so watch out for N/V/D. Contraindications - liver disease, COPD, low creatinine
- TZDs - enhances insulin action - increases risk for bladder cancer, weight gain & HF
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