Please take the term metabolic
syndrome out of you vocabulary. Replace it with
insulin toxicity. In this Metabolic Syndrome Course,
I marshall a large body of scientific information to
support my position.
How wide is the problem of the
metabolic syndrome among adults now? What may be
expected in the next two deacdes considering the
rising incidence of the syndrome among children?
Consider the following quote from the editorial in
June 4, 2004 issue of Science:
There is a growing public
health crisis that is global in scope, and
isn't another emerging infectious
disease....It is now estimated that that
over two-thirds of the U.S. adults are
overweight...Nor is it limited to the
developed world: Mayans in Guatemala, Siuth
Africans, aboriginal Asustralian, and
Pacific Islanders also show patterns of
emerging obesity. The Worl Health
Organization (WHO) is deeply concerned about
the issue, recognizing that nearly 1 billion
adults are overweight and at least 300
million are obese....a spokesperson (of the
food industry) suggested that more attention
be given "to the issue of individual
responsibility.19
It is not surprisng that the
spokesperson of food industry did not wish to talk
about direct toxicity of foods it serves. What
surprised me in that editorial was that the editors
of Science utterly failed to consider that
subject as well. They went on to laud WHO's formal
approval of Global Strategy on Diet, and wrote a few
words on "behavioral modification," which, we all
know, is code word for doing nothing, until the time
of writing the next editorial on the subject a year
or two later. How might the WHO modify the behavior
of one billion people in the world?, one might ask.
Relatedness among Clinical
Components of the Metabolic Syndrome
If the energetic-molecular basis
of the metabolic is cellular dysoxygenosis, one
would expect that every clinical components of the
syndrome will be found to be related to every. That,
indeed, is the case. The support for that view can
be drawn from diverse lines of evidence.20-24
In the metabolic syndrome,
oxidative-dysoxygenative insulin dysfunction (ODID)
perpetuates and intensifies the derangement in
signaling pathways of the syndrome.21 The
prevalence of the syndrome increases with the degree
of ODID. 23 In severely obese adults, the
risk of death from all causes is about twice that
among individuals with moderate obesity.25
Recent studies show that the
metabolic syndrome in children and adolescents is
far more common than previously reported and that
its prevalence increases directly with the degree of
obesity. Furthermore, the syndrome can develop
rapidly with rapd weight gain, each element of the
syndrome worsening with increasing obesity. Not
unexpectedly, each aspect of the syndrome worsens
with incremental weight, independent of age, sex,
and pubertal status.26 Waist
circumference correlates well with visceral
adiposity.27 However, changes associated
with puberty and variations among racial and ethnic
groups may significantly change that relationship.28
In an obesity-prone culture, one
could predict that the pathophysiological mechanisms
of the metabolic syndrome would be recognizable in
childhood. That, indeed, is borne out by recent
studies.3 As for racial and ethnic
groups, in one study the prevalence of the metabolic
syndrome was substantially lower in blacks than in
white subjects when criteria for serum lipid levels
were the same. But the differences disappeared when
lipid criterai specific to blacks were employed.
Biomarkers of the So-called
Metabolic Syndrome
If the energetic-molecular basis
of the metabolic is cellular dysoxygenosis, one
would expect that every biomarker of the syndrome
will be found to be related to every other. That,
indeed, is the case. The support for that view can
be drawn from diverse lines of evidence.
3,29,30
C-reactive protein and
interleukin-6 levels are biomarkers of cellular
inflammation, as well as of cellular dysoxygenosis.
The rise in those biomakers is usually concordant.
The adiponectin level, by contrast, may be seen as a
marker of insulin sensitivity and integrity of
insulin signaling as well as oxygen homeostasis.
Again, the falling levels of adiponectin correlate
wirth rising levls of CRP and interleukin-6.
Furthermore, the raised blood levels of C-reactive
protein in the metabolic syndrome are incrementally
higher with increasing number of components of the
syndrome.
Adiponectin levels are negatively
correlated with C-reactive protein, and are lower in
obesity individuals. When stratified according to
obesity group and insulin-resistance category, the
adiponectin levels are significantly associated with
the obesity category, as well as with the
insulin-resistance category. The lowest levels tend
to be seen in persons with the highest level of
insulin resistance. Interestingly, adiponectin
levels in the severely obese group do not vary
significantly according to the insulin-resistance
category. Persons with severe insulin resistance
have the lowest levels of adiponectin.
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* Why Internists Should Not Ever
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Course on Metabolism
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Metabolism
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Metabolic
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Metabolic
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Metabolic Syndrome in Children
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Why I Never Diagnose the Metabolic Syndrome? Nor
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