Skip to main content

Obesity and the Metabolic Syndrome

  • Chapter
  • First Online:
Type 2 Diabetes, Pre-Diabetes, and the Metabolic Syndrome

Part of the book series: Current Clinical Practice ((CCP))

Abstract

The clustering of abnormal laboratory test data and body measurements, listed in 1, encompassing parameters that should be measured on a regular basis in physician offices, collectively referred to as “The Metabolic Syndrome” represents an important risk stratification determination with its awareness and applicability to primary care increasing worldwide. A recent review found that greater than 66% of physicians consider this syndrome in the diagnosis, treatment, and management of their patients. These physicians felt that greater than 20% of their patients had metabolic syndrome with over 94% of physicians expecting patients diagnosed with metabolic syndrome to increase within the near future [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Liu S, et al. Dietary carbohydrates, physical inactivity, obesity and the metabolic syndrome as predictors of coronary heart disease. Curr Opin Lipidol 2001;12:395–404.

    Article  PubMed  CAS  Google Scholar 

  2. Grundy SM. Coronary plaque as a replacement for age as a risk factor in global risk assessment. Am J Cardiol 2001;88(2A):8E–11E.

    Article  PubMed  CAS  Google Scholar 

  3. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988;37:1595–1607.

    Article  PubMed  CAS  Google Scholar 

  4. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356–359.

    Article  PubMed  Google Scholar 

  5. Ford ES, Giles WH. Prevalence of the metabolic syndrome among U.S. adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356–359.

    Article  PubMed  Google Scholar 

  6. Wilson PW, Kannel WB. Obesity, diabetes and risk of cardiovascular disease in the elderly. Am J Geriatr Cardiol 2002;11:119–123.

    Article  PubMed  Google Scholar 

  7. Ilanne-Parikka P, Laaksonen DE, Eriksson JG. Leisure time activity and the metabolic syndrome in the Finnish Diabetes Prevention Study. Diabetes Care 2010;33:1610–1617.

    Article  PubMed  CAS  Google Scholar 

  8. Lakka HM, Laaksonnen D, Lakka T, Niskanen L. The metabolic syndrome and total and cardiovascular mortality in middle aged men. JAMA 2002;288:2709–2716.

    Article  PubMed  Google Scholar 

  9. Burke J, William K, Gaskill S. Rapid rise in the incidence of Type-2 diabetes: the San Antonio Heart Study. Arch Intern Med 1999;159:1450–1456.

    Article  PubMed  CAS  Google Scholar 

  10. Lopez-Candales A. Metabolic syndrome X: a comprehensive review of the pathophysiology and recommended therapy. J Med 2001;32:283–300.

    PubMed  CAS  Google Scholar 

  11. Nash D. The metabolic syndrome: early clues, effective management. Consultant 2004;May:859–864.

    Google Scholar 

  12. Grundy SM, The American Heart Association National Heart, Lung and Blood Institute. Definition of metabolic syndrome. Report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issue related to definition. Circulation 2004;109:433–438.

    Article  PubMed  Google Scholar 

  13. Isomaa B, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683–689.

    Article  PubMed  CAS  Google Scholar 

  14. Deen D. Metabolic syndrome: time for action. Am Fam Physician 2004;69(12):2875–2882.

    PubMed  Google Scholar 

  15. Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women. JAMA 2007;297:611–619.

    Article  PubMed  CAS  Google Scholar 

  16. Wang J, Ruotsalainen S, Moilanen L. The metabolic syndrome predicts incident stroke. Stroke 2008;39: 1078–1083.

    Article  PubMed  Google Scholar 

  17. Cullen P, Shulte H. The Munster (PROCAM) Study. Circulation 1997;96:2128–2136.

    Article  PubMed  CAS  Google Scholar 

  18. Sattar N. Metabolic syndrome as a predictor of CHD and diabetes in WOSCOPS. Circulation 2003;108(4): 414–419.

    Article  PubMed  CAS  Google Scholar 

  19. Polonsky T, McClelland R, Jorgenson N. Coronary artery calcium score and risk classification for ­coronary heart disease prediction. JAMA 2010;303(16):1610–1616.

    Article  PubMed  CAS  Google Scholar 

  20. Ridker PM, Danielson E. Rosuvastatin to prevent vascular events in men and women with elevated ­hs-CRP. New Engl J Med 2008;359(21):2195–2207.

    Article  PubMed  CAS  Google Scholar 

  21. Danesh J, Wheeler JG, Hirschfield GM, Eda S. Reactive protein and other circulating markers of ­inflammation in predicting coronary heart disease. New Engl J Med 2004;350(14):387–397.

    Article  Google Scholar 

  22. Lakka HM, Laaksonen DE, Lakka TA. The metabolic syndrome and total and cardiovascular mortality in middle aged men. JAMA 2002;288:2700–2716.

    Article  Google Scholar 

  23. National Heart Lung and Blood Institute. Third report of the National Cholesterol Education Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults. Circulation 2002;106:3143.

    Google Scholar 

  24. Raggi P, Gongora MC, Gopal A, Callister TQ. Coronary artery calcium to predict all cause mortality in elderly men and women. J Am Coll Cardiol 2008;52(1):17–23.

    Article  PubMed  Google Scholar 

  25. Linton MF, et al. A practical approach to risk assessment to prevent coronary artery disease and its complications. Am J Cardiol 2003;92(1A):19i–26i.

    Article  PubMed  Google Scholar 

  26. Carulli L, Mazzi F, Rondinella S. Olanzapine metabolic side effects: a weight gain issue? Intern Emerg Med 2008;3(3):237–240.

    Article  PubMed  Google Scholar 

  27. Corella D, et al. The metabolic syndrome: a crossroad for genotype-phenotype associations in atherosclerosis. Curr Atheroscler Rep 2004;6:186–196.

    Article  PubMed  Google Scholar 

  28. Vega Gl. Obesity, the metabolic syndrome and cardiovascular disease. Am Heart J 2001;142:1108–1116.

    Article  Google Scholar 

  29. Despres JP. The insulin resistance-dyslipidemic syndrome of visceral obesity: effect on patient’s risk. Obes Res 1998;6:8S–17S.

    Article  PubMed  Google Scholar 

  30. Haffner SM, Stern MP, Hazuda HP, Pugh J. Obesity and the metabolic syndrome. The San Antonio Heart Study. Am J Epidemiol 1984;120(5):831–834.

    Google Scholar 

  31. Wei M, Gaskill SP, haffner SM, Stern MP. Effects of diabetes and level of glycemia on all cause and cardiovascular mortality. The San Antonio Heart Study. Diabetes Care 1998;21:1167–1172.

    Article  PubMed  CAS  Google Scholar 

  32. Festa A, D’Agastino R, Mykkanen L. LDL particle size in relation to insulin, proinsulin, and insulin sensitivity. The Insulin Resistance Atherosclerosis Study. Diabetes Care 1999;22:1688–1693.

    Article  PubMed  CAS  Google Scholar 

  33. Ovalle F, Bell DS. Clinical evidence of thiazolidinedione induced improvement of pancreatic beta cell function in patients with type-2 diabetes mellitus. Diabetes Obes Metab 2002;4:56–59.

    Article  PubMed  CAS  Google Scholar 

  34. Knowler WC, Barrett-Conner E, Fowler SE, Diabetes Prevention Program Research Group. Reduction in the incidence of type-2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346: 393–403.

    Article  PubMed  CAS  Google Scholar 

  35. Bjorntorp P. Heart and soul: stress and the metabolic syndrome. Scand Cardiovasc J 2001;35:172–177.

    Article  PubMed  CAS  Google Scholar 

  36. Hackam DG, et al. Emerging risk factors for atherosclerotic vascular disease: a critical review of the ­evidence. JAMA 2003;290:932–940.

    Article  PubMed  Google Scholar 

  37. Ginsberg HS. Treatment for patients with the metabolic syndrome. Am J Cardiol 2003;91:29E–39E.

    Article  PubMed  CAS  Google Scholar 

  38. Hooper L. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev 2004;2:CD002137.

    Google Scholar 

  39. Egan JW, Lebrizzi R. Geerlof JS. The long term effect of pioglitazone as monotherapy or combination therapy on glucose control in patients with type-2 diabetes. Diabetes 2000;49(Suppl 1):A357.

    Google Scholar 

  40. Hackman DG, Anand SS. Merging risk factors for atherosclerotic vascular disease: a critical review of the evidence. JAMA 2003;290:932–940.

    Article  Google Scholar 

  41. Aizawa-Abe M, Ogawa Y, Mazuzaki H. Pathophysiological role of leptin in obesity related hypertension. J Clin Invest 2000;105(9):1243–1252.

    Article  PubMed  CAS  Google Scholar 

  42. Farooqi A, Matarese G, Lord G. Beneficial effects of leptin on obesity. J Clin Invest 2002;110(8): 1093–1103.

    PubMed  CAS  Google Scholar 

  43. Wilson PW, Grundy SM. The metabolic syndrome: practical guide to origins and treatment. Circulation 2003;108:1422–1424.

    Article  PubMed  Google Scholar 

  44. Wilson PW, Grundy SM. The metabolic syndrome; a practical guide to origins and treatment. Circulation 2003;108:1537–1540.

    Article  PubMed  Google Scholar 

  45. Snow V, Barry P, Fitterman N. Pharmacological and surgical management of obesity in primary care. Ann Intern Med 2005;142(7):525–531.

    Article  PubMed  Google Scholar 

  46. Physicians’ Health Study Research Group. The Physicians’ Health Study. New Engl J Med 1989;321(3): 183–185.

    Article  Google Scholar 

  47. Stamler R, Stamler, Lindberg HA. Asymptomatic hyperglycemia and coronary heart disease in middle aged men in two employed populations in Chicago. J Chronic Dis 1979;32:805–815.

    Article  PubMed  CAS  Google Scholar 

  48. Hanefield M, Fischer S, Julius U. Risk factors for myocardial infarction and death in newly detected NIDDM; the Diabetes Intervention Study. 11 year follow up. Diabetologia 1996;39:1577–1583.

    Article  Google Scholar 

  49. Donahue RP, Abbott RD, Reed DM, Yano K. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program. Diabetes 1987;36:689–692.

    Article  PubMed  CAS  Google Scholar 

  50. Jackson CA, Yudkin JS, Forrest RD. A comparison of the relationships of the glucose tolerance test and the glycated hemoglobin assay with diabetic vascular disease in the community. The Islington Diabetes Survey. Diabetes Res Clin Pract 1992;17:111–123.

    Article  PubMed  CAS  Google Scholar 

  51. Hsueh WA, Law RE. Cardiovascular risk continuum: implications of insulin resistance and diabetes. Am J Med 1998;105(1A):4S–14S.

    Article  PubMed  CAS  Google Scholar 

  52. Groop L, Forsblom C, Lehtovirta M. The Botnia study-metabolic consequences of a family history of NIDDM. Diabetes 1996;95(11):1585–1593.

    Article  Google Scholar 

  53. United kingdom Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type-2 diabetes (UKPDS 33). Lancet 1998;352:837–853.

    Article  Google Scholar 

  54. Arcaro G, Cretti A, Balzano S. Insulin causes endothelial dysfunction in humans; sites and mechanisms. Circulation 2002;105:576–582.

    Article  PubMed  CAS  Google Scholar 

  55. Blackburn GI. The obesity epidemic: prevention and treatment of the metabolic syndrome. Etiology of the metabolic syndrome: potential role of insulin resistance, leptin resistance, and other players. Ann NY Acad Sci 1999;84:11–14.

    Google Scholar 

  56. Cooper-DeHoff R, Pepine C. Metabolic syndrome and cardiovascular disease. Clin Cardiol 2007;30(12): 593–597.

    Article  PubMed  Google Scholar 

  57. Lindstrom J, Louheranta J, Mannelin M. The Finnish Diabetes Prevention Study. Diabetes Care 2003;26:12.

    Google Scholar 

  58. Malhotra S, Mcelroy S. Associations between metabolic syndrome and psychiatric disorders. Prim Psychiatry 2003;10:37–44.

    Google Scholar 

  59. Grundy SM. Atherogenic dyslipidemia and the metabolic syndrome. Circulation 1997;95:1–4.

    Article  PubMed  CAS  Google Scholar 

  60. Rao G. Office based stateges for the management of obesity. Am Fam Physician 2010;81(12):1444–1455.

    Google Scholar 

  61. Klein KM. Zonisamide and epilepsy. JAMA 2003;289:1820.

    Article  Google Scholar 

  62. Bray GA, Hollander P, Klein S. A 6 month randomized, placebo controlled dose ranging trial of topiramate for weight loss in obesity. Obes Res 2003;11:722–733.

    Google Scholar 

  63. Luna B, Feinglos MN. Oral agents in the management of type-2 diabetes mellitus. Am Fam Physician 2001;63:1747–1756.

    PubMed  CAS  Google Scholar 

  64. Heine RJ, Van Gaal LF. Exenatide vs. insulin glargine in suboptimally controlled type-2 diabetics.Ann Intern Med 2005;143:559–569.

    Article  PubMed  CAS  Google Scholar 

  65. Astrop A, Rosner S. Effects of liraglutide in the treatment of obesity. Lancet 2009;374(9701):1606–1616.

    Article  Google Scholar 

  66. Buse J, Rosenstock J, Sistei G, Blonde L. Liraglutide once daily vs. exenatide twice daily for type 2 diabetes. Lancet 2009;374(9683):39–47.

    Article  PubMed  CAS  Google Scholar 

  67. Despres JP, Golay A, Sjostrom L. Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia. N Engl J Med 2005;353:2121–2134.

    Article  PubMed  CAS  Google Scholar 

  68. Brody F. Minimally invasive surgery for morbid obesity. Cleve Clin J Med 2004;71(4):289–298.

    Article  PubMed  Google Scholar 

  69. Nguyen NT, Goldman C, Rosenquist CJ. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg 2001;234:279–291.

    Article  PubMed  CAS  Google Scholar 

  70. Higa KD, Tienchen H, Boone KB. Laparoscopic Roux-en-Y gastric bypass: technique and 3 year follow up. J Laparoendosc Adv Surg Tech 2001;11:377–382.

    Article  CAS  Google Scholar 

  71. Crookes PF. Surgical treatment of morbid obesity. Annu Rev Med 2006;57:243–264.

    Article  PubMed  CAS  Google Scholar 

  72. Buchwald H, Avidor Y, Braunwald E. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292:1724.

    Article  PubMed  CAS  Google Scholar 

  73. Boucher JL, Shafer KJ, Chaffin JA. Weight loss, diets, and supplements; Does anything work? Diabetes Spectr 2001;14:169–175.

    Article  Google Scholar 

  74. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult treatment Panel III). Executive summary of the third report of the National Cholesterol Education Program (NCEP). JAMA 2001;285:2486–2497.

    Article  Google Scholar 

  75. Genuth S, Alberti KG, Bennett P. Follow up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26:3160–3167.

    Article  PubMed  Google Scholar 

  76. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States. Int J Obes Relat Metab Disord 1998;22(1):39–47.

    Article  PubMed  CAS  Google Scholar 

Supplementary Readings

  • Bray GA, Hollander P, Klein S. A 6 month randomized, placebo controlled, dose ranging trial of topiramate for weight loss in obesity. Obes Res 2003;11:722–733.

    Article  PubMed  CAS  Google Scholar 

  • Fenlieb M, Kannel WB, Garrison RJ, McNamara FP. The Framingham Offspring Study. Prev Med 1975;4(4):518–525.

    Article  Google Scholar 

  • Gadde KM, Franciscy DM, Wagner HR, Krishman KR. Zonisamide for weight loss in obese adults; a randomized controlled trial. JAMA 2003;289:1820–1825.

    Article  PubMed  CAS  Google Scholar 

  • Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 2004;291:210–215.

    Article  PubMed  CAS  Google Scholar 

  • Meigs JB, Nathan DM, Wilson PW. Metabolic risk factors worsen continuously across the spectrum of nondiabetic glucose tolerance. The Framingham Offspring Study. Ann Intern Med 1998;128:524–533.

    Article  PubMed  CAS  Google Scholar 

  • Oparil S. Controlled release phentermine/topiramate (Qnexa) improves blood pressure, weight, and ­glycemic control. P T 2010;35(6):336, 343.

    Google Scholar 

  • Ridker PM, Hennekens CH, Buring JE. C-reactive protein and other markers of inflammation in the ­prediction of cardiovascular disease in women. N Engl J Med 2000;342:836–843.

    Article  PubMed  CAS  Google Scholar 

  • Serdula MK, Mokdad AH, Williamson DF, Galuska DA, Mendlein JM, Heath GW. Prevalence of attempting weight loss and strategies for controlling weight. JAMA 1999;282:1353–1358.

    Article  PubMed  CAS  Google Scholar 

  • The Diabetes Prevention Program Research Group. The diabetes Prevention Program: baseline characteristics of the randomized cohort. Diabetes Care 2000;23:1619–1629.

    Article  Google Scholar 

  • Vague P, Rudnichi A, Fontbonne A. The effect of metformin on the metabolic abnormalities associated with android type body fat distribution. Results of the BIGPRO trial. Diabetologia 1994;37(Suppl 1):236.

    Google Scholar 

  • Wallace TM, Matthews DR. The assessment of insulin resistance in man. Diabet Med 2002;19:527–534.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Diplomate American Board of Internal Medicine

Diplomate American Board of Clinical Lipidology

Diplomate American Board of Vascular Medicine

Clinical Hypertension Specialist (American Society of Hypertension Certified)

Vascular Ultrasound (American Registry of Diagnostic Sonography Certified)

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Codario, R.A. (2011). Obesity and the Metabolic Syndrome. In: Type 2 Diabetes, Pre-Diabetes, and the Metabolic Syndrome. Current Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-441-8_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-441-8_5

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-440-1

  • Online ISBN: 978-1-60327-441-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics