2020–2021 BCSC Basic and Clinical Science Course™
1 Update on General Medicine
Chapter 4: Hyperlipidemia and Cardiovascular Risk
Metabolic syndrome comprises a constellation of lipid and nonlipid risk factors of metabolic origin. In 2006, the International Diabetes Federation developed a consensus definition for metabolic syndrome that includes central (abdominal) obesity (as measured by waist circumference), elevated triglyceride levels, high blood pressure, reduced HDL cholesterol, and elevated fasting blood glucose.
Metabolic syndrome is closely linked to insulin resistance. Excess body fat (particularly abdominal fat) and physical inactivity promote impaired responses to insulin; these impaired responses may also result from genetic predisposition. The risk factors for metabolic syndrome are highly concordant; in aggregate, they increase the risk of CHD at any given LDL level. Management of metabolic syndrome includes those measures previously discussed for elevated LDL and triglyceride levels, as well as treatment of hypertension and the use of aspirin to reduce the prothrombotic state in CHD patients. For further discussion of metabolic syndrome, please see Chapter 2.
Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120(16):1640–1645.
The IDF consensus worldwide definition of the metabolic syndrome. International Diabetes Federation website. www.idf.org/e-library/consensus-statements. Published 2006. Accessed February 21, 2019.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.