Metabolic Syndrome

The Metabolic Syndrome

Metabolic syndrome is a name for a group

of risk factors of metabolic origin that occur
together and increase the risk for
cardiovascular disease and type 2 diabetes.

Prevalence of Metabolic Syndrome

24% of whole population
34% of adult population
40% of people > 60 years
80% of patients with type 2 diabetes
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Significance of Metabolic Syndrome

People with metabolic syndrome are 2x as likely to
die from CVD and 3x as likely to have a heart attack
or stroke
People with metabolic syndrome have a 5x greater
risk of developing type 2 diabetes

Up to 80% of the 200 million people with diabetes

globally will die of cardiovascular disease
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Women

Men

Relative Risk

2.5

n=5,127

2
1.5
1
0.5
0
50

100

150

200

250

300

350

400

Triglyceride Level, mg/dL

Castelli WP. Epidemiology of triglycerides: a view from Framingham American Journal of Cardiology. 1992;70:3H-9H.

Risk of CHD

3,0

2,0

1,0
25
0,0

65
100

160

220

45

85

LDL-C (mg/dL)
Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against
coronary heart disease. The Framingham Study. American Journal of Medicine. 1977;62:707-14.

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Mechanism of Metabolic Syndrome

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Sindrom metabolik:

Definisi NCEP ATP III*

Diagnosis sindroma metabolik harus memenuhi tiga atau
lebih dari lima faktor risiko berikut:
Faktor risiko

Kadar definisi

Obesitas abdominal
Pria
Wanita

Lingkar pinggang
>102 cm (>40 in)
>88 cm (>35 in)

Trigliserida

150 mg/dL (1.7 mmol/L)

HDL cholesterol
Pria
Wanita

<40 mg/dL (1.04 mmol/L)

<50 mg/dL (1.29 mmol/L)

Tekanan darah

130/ 85 mmHg

*2001, updated 2005

Glukosa puasa

100 mg/dL (5.6 mmol/L)

IDF consensus definition

(2005)
Obesitas sentral
Lingkar pinggang

- Tergantung etnik*
- untuk Eropa:

Pria 94 cm
Wanita 80 cm

Ditambah dua dari berikut:

Kenaikan Trigliserida

150mg/dL (1.7mmol/L)
Atau sedang dalam pengobatan

Kolesterol HDL rendah

<40mg/dL (1.03 mmol/L) pada pria

<50mg/dL (1.29 mmol/L) pada wanita
Atau sedang dalam pengobatan

Kenaikan tekanan
darah

Systolic : 130 mmHg

atau
Diastolic: 85 mmHg
atau
Atau sedang dalam pengobatan

Kadar gula darah

puasa terganggu

Gula darah puasa 100 mg/dL (5.6 mmol/L)

Atau sudah didiagnosis diabetes tipe II

Managing the Metabolic Syndrome

Reduce the risk for cardiovascular disease and type 2 diabetes

- Lifestyle Risk factors

- Metabolic risk factors

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Examples of Lifestyle Modifications

Low glycemic index foods (vegetables, broccoli, cabbage, cauliflower, cucumber)
Higher fish intake
Higher consumption of vegetables
Mediterranean-style diet (increased consumption of who grains, fruits, vegetables, nuts,
and olive oil)
A lifestyle of 10% fat whole foods vegetarian diet, aerobic exercise, stress
management, training, smoking cessation, group psychosocial support
The DASH (Dietary Approaches to Stop Hypertension) eating plan (reduced calories
and increased consumption of fruit, vegetables, low-fat dairy, and whole grains and
lower in saturated fat, total fat, and cholesterol intake restricted to 2,400 mg NA)
Low fat intake and increased physical activity
Aerobic exercise
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Mediterranean Diet Pyramid

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Examples of Moderate Physical Activity

Gardening for 30-45 minutes

Raking leaves for 30 minutes
Walking 3 kms in 30 minutes
Stair walking for 15 minutes
Wheeling self in wheelchair for 30-40 minutes
Bicycling8 kms in 30 minutes
Water Aerobics for 30 minutes

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Only YOU can take care of yourself!

MAKE good choices!

TEACH good choices!