Recent Advances in Metabolic Syndrome - I - ECAB

Author: Kasliwal> R R  

Publisher: Elsevier Health Sciences APAC‎

Publication year: 2012

E-ISBN: 9788131232187

P-ISBN(Paperback): 9788131226865

Subject: R589 metabolic disease

Keyword: 基础医学

Language: ENG

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Description

India in particular and South-Asia in general have witnessed a rapid increase in the prevalence and incidence of cardiovascular disease over the past 25 years. Lifestyles changes, unhealthy diet, lack of regular physical exercise, and obesity have all led to rising prevalence of metabolic syndrome. It is of no wonder that metabolic syndrome is being increasingly recognized as a clinical entity which is believed to be associated with increased risk of cardiovascular disease beyond individual risk factors, though this is at times debated. This monograph addresses the total nuance of metabolic syndrome in its entirety and answers questions frequently asked on this subject. The authors are internationally respected investigators in their own right having made major contributions in the particular field and are revered teachers as well. The book itself has clear sections which makes it very user friendly and divided into two volumes. The first volume has the evaluation of metabolic syndrome and the vastness of the problem and how it leads to smouldering dysfunctional endothelium making such a patient vulnerable to vascular disease. It purely deals with clinical issues we face daily in metabolic syndrome and patients. It is fairly broad-based to answer most of the queries which arise in a busy clinician's head while dealing with metabolic syndrome on a day-to-day basis. Of special interest are chapters on metabolic syndrome in children, non-alcoholic fatty liver disease and hypogo

Chapter

Metabolic Syndrome and Related Disorders

Geographical Distribution

Metabolic Syndrome in Children and Adolescents

Conclusion

Subclinical Inflammation and Endothelial Dysfunction in the Metabolic Syndrome

ABSTRACT

KEYWORDS

Introduction

Subclinical Inflammation and Metabolic Syndrome

Obesity and Subclinical Inflammation

Revising the Definition of Metabolic Syndrome

Ethnic Disparities

Management of the Metabolic Syndrome

Conclusion

Case Study Subclinical Inflammation and Endothelial Dysfunction in the Metabolic Syndrome

Case 1

Discussion of Patient Profiles

Case 2

Non-Alcoholic Fatty Liver Disease

ABSTRACT

KEYWORDS

Introduction

Epidemiology of Non-Alcoholic Fatty Liver Disease

Global

Asian

Pathophysiology of Non-Alcoholic fatty Liver Disease

Pathophysiology of Non-Alcoholic Fatty Liver Disease: Dietary Fat and Hepatic Lipids

Excessive Dietary Fat

Insulin Resistance And Non-Alcoholic Fatty Liver Disease

Asian-Indians, Insulin Resistance, and Non-Alcoholic Fatty Liver Disease

Non-Alcoholic Fatty Liver Disease and Atherosclerosis

Diagnosis of Non-Alcoholic Fatty Liver Disease

Management of Non-Alcoholic Fatty Liver Disease

Lifestyle Modification

Dietary Modifications

Dietary Fatty Acids

Glycemic Index (GI) and Fiber

Protein

Insulin Sensitizer Drugs

Metformin

Thiazolidinediones

Antioxidants

Vitamin E (- tocopherol)

Ursodeoxycholic Acid

Betaine

Miscellaneous Drugs (Table 3)

Losartan

Pentoxifylline

Resveratrol

Probiotics

Suggested Recommendations

Summary

Case Study Non-Alcoholic Fatty Liver Disease

Case 1

Case 2

Obesity and Metabolic Syndrome

ABSTRACT

KEYWORDS

Introduction

Global

Variations in Body Fat and Fat-free Mass among Populations (Table 1)

Cardiovascular Risk Factor Profile and Metabolic Syndrome Indicators, BMI and Body Fat

Ethnic Differences in the Metabolic Syndrome and Body Fat in Children and Adolescents

Indian Perspective

Prevalence of Obesity in India

Urban

Rural

Abdominal Obesity

Obesity in Women

Obesity in Children/Adolescents

Body Composition of Asian-Indians and Phenotype Obesity

Body Fat

Truncal and Abdominal Adiposity

Deposition of Fat at Ectopic Sites

Hepatic Fat

Muscle Triglycerides

Other Ectopic Sites of Fat Deposition

Adipocyte Size

Prediction Equations and Cut-offs of Fat Depots

For Insulin Resistance

For Body Fat Depots

For Fatty Liver

Cut-offs for Abdominal Adipose Tissues

Revised Guidelines for Body Mass Index and Waist Circumference

Summary

Case Study

Obesity and Metabolic Syndrome

Case Presentation

Case Study Obesity and Metabolic Syndrome

Case Presentation

Hypertension and Metabolic Syndrome

ABSTRACT

KEYWORDS

Introduction

Definition of Metabolic Syndrome

Mechanism of Hypertension in the Metabolic Syndrome

Obesity and Adipose Tissue Cytokines

Insulin Resistance

Sympathetic Nervous System and Renin-Angiotensin System Overactivity

Endothelial Dysfunction

Prognostic Value of the Metabolic Syndrome in Hypertension

Management of Hypertension in the Presence of Metabolic Syndrome

Targeting the Mechanisms of Metabolic Syndrome

Lifestyle Measures

Drug Therapy

Antihypertensive Therapy

Summary

The Dyslipidemia of the Metabolic Syndrome

ABSTRACT

KEYWORDS

Normal Cholesterol Metabolism

Dyslipidemia of the Metabolic Syndrome

Therapy of the Dyslipidemia of the Metabolic Syndrome

Lifestyle Changes

Drugs

Statins

Fibrates

Niacin

Intestinal Acting Drugs

Conclusion

Cardiovascular Risk and Evaluation

ABSTRACT

KEYWORDS

CVD Risk in Metabolic Syndrome

The Evidence

Should Metabolic Syndrome be Given Importance as a Cardiovascular Risk Marker?

Ten-year Risk Versus Lifetime Risk

Age of Onset of Disease

Cardiovascular Risk Evaluation in Individuals with Metabolic Syndrome

Lipids

Lipoprotein (a)

Inflammatory Markers

Subclinical Atherosclerosis

Carotid Intima Media Thickness

Brachial Artery Flow-mediated Dilatation

Pulse Wave Velocity

Coronary Calcium Scoring

Role of Subclinical Atherosclerosis Testing in Metabolic Syndrome

Other Factors

Conclusions

Case Study

Cardiovascular Risk and Evaluation

Case Presentation

How Should His Cardiovascular Risk be Assessed?

Prevention of Cardiovascular Disease

ABSTRACT

KEYWORDS

Underlying Risk Factors

Metabolic Risk Factors

Clinical Diagnosis Of Metabolic Syndrome

Metabolic Syndrome And Cardiovascular Disease

Prevention Of Cardiovascular Disease In Metabolic Syndrome

Management of Underlying Risk Factors

Weight Reduction

Physical Inactivity

Physical Activity Recommendations for Healthy Adults Aged 18–65 Years—200715

Atherogenic and Diabetogenic Diets

AHA 2006 Diet and Lifestyle Recommendations for Cardiovascular Disease Risk Reduction13

Management of Dyslipidemia

Elevated Blood Pressure

Elevated Fasting Glucose

Conclusion

Stress, Depression and Metabolic Syndrome

ABSTRACT

KEYWORDS

Pathophysiological Effects of Chronic Stress

Sequelae of Hypothalamic-Pituitary-Adrenocortical Dysfunction Over Time

Increased

Decreased

Potentiation of Insulin Effect and Insulin Resistance

Stress-Induced Insulin Resistance

Direct Mechanisms

Indirect Mechanisms

Overweight

Insulin and Leptin Resistance, and Increased Sympathetic Tone

The Renin-Angiotensin-Aldosterone System

Co-Existence of Diabetes and Psychiatric Illness: Indian Perspective

Psychiatric Co-Morbidity in Type 1 Diabetes Mellitus

Worldwide Burden of Depression

Effect of Depression on Glycemic Control and Risk for Diabetes Complications

Effect of Depression on Medication Adherence

Effect of Depression on Diabetes Self-Care Behaviors (TABLE 4)

Effect of Depression on Mortality (TABLE 5)

Causal Pathways Between Diabetes and Depression

Evaluation Methods of Co-morbid Depression in Patients of Diabetes Mellitus

Immediate Memory and Attention

Psychomotor Efficiency

Stroop Test and Digit Symbol Substitution test (DSST)

Verbal Memory

Visuospatial Memory

Correlation of Depression With Glycemic Control

Review of Depression Treatment Interventions in Individuals who Have Diabetes

Barriers to Effective Treatment of Depression in Individuals who Have Diabetes

Improving the Quality of Care: The Need For Integrated Care

The Best Treatment for Depression in Diabetes

Psychological Interventions

Pharmacological Interventions

Mixed Interventions

What do we Need to Know to Improve Treatment of Depression in Diabetes?

Ongoing Research on Depression Treatment in Diabetes

Pharmacological Trials

Psychological Treatments

Mixed Interventions

Conclusion

Metabolic Syndrome in Children

ABSTRACT

KEYWORDS

Introduction

Epidemiology

Relationship Of Pediatric Metabolic Syndrome With Adult Outcomes

Pathophysiologocal Mechanisms Underlying Pediatric Metabolic Syndrome

Childhood Obesity and Body Fat Patterning

Insulin Resistance

Hypertension

Lipid Abnormalities

Adipocytokines and Subclinical Infl ammation

Other Factors Related to Metabolic Syndrome in Children

Influence of Ethnicity

Screening For Metabolic Syndrome In Children And Adolescents

Management Of Metabolic Syndrome In Children

Diet and Physical Activity

Drug Therapy of Metabolic Syndrome

Summary

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