Syndrome X refers specifically to a group of health problems that can include:
- Insulin resistance, which is part of type II diabetes
- Abnormal blood fats (elevated cholesterol and triglycerides, low HDL cholesterol),
- Overweight, especially abdominal obesity, and
- High blood pressure.
Diagnostic criteria include three or more of the following:
Abdominal obesity: A waist/hip ratio >1.0 for men and > 0.8 for women
Triglycerides > 150 mg/dl
Low HDL cholesterol: Male <40 mg/dL, female <50 mg/dl
Hypertension: Systolic BP > 130 mm Hg or Diastolic BP > 85 mm Hg
Fasting glucose > 110 mg/dL
A central hypothesis is that metabolic syndrome is caused by a improper diet and lifestyle factors that set up a cycle of weight gain, insulin resistance and dysglycemia (pre-diabetes), and increased appetite.
Overweight people usually suffer from insulin impairment that prevents the proper cell uptake of carbohydrates (sugars). The consumption of simple carbohydrates (sugar, white flour, pasta, cereals, cookies, donuts, soft drinks, etc.) results in elevated glucose and insulin production, especially after meals. The excess serum glucose is converted into body fat.
Metabolic Syndrome X is also associated with stress. Elevated cortisol, particularly when combined with secondary inhibition of sex steroids and growth hormone secretions, may cause accumulation of fat in visceral adipose tissues as well as metabolic abnormalities
Fat cells secrete hormones that may contribute to insulin resistance and metabolic syndrome X, including: Adiponecti (improves insulin sensitivity), Resistin (reduces insulin sensitivity), Lepti (reduces appetite, increases metabolic rate) and Free fatty acids (reduce insulin and leptin sensitivity).
Disturbances in the hypothalamic-pituitary-adrenal (HPA) axis may also play a central role in Metabolic Syndrome X. This includes elevated cortisol (a hormone secreted by the adrenal glands) in combination with the diminished secretion of growth and sex steroid secretions, which in normal concentrations antagonize the cortisol effects. Blood pressure will also be elevated, which might be a consequence of central stimulation of the sympathetic nervous system, with added effects of insulin. What has developed is a hypothalamic arousal with the Metabolic Syndrome as a consequence.
Glucose levels are included in standard lab tests profiles. A better test is the glucose tolerance test, which measures the increase in glucose levels following ingestion of sugar. Unfortunately, these tests may not accurately asess pancreatic function, particularly in the case of insulin resistance.
A more accurate test is the measurement of insulin, in addition to glucose. Cutting-edge lab tests measure both glucose and insulin levels over a 4-hour period following the ingestion of glucose. The theory is that in insulin resistance the body secretes large amounts of insulin in order to maintain normal glucose levels in the blood.
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