Fast Five Quiz: How Much Do You Know About Metabolic Syndrome?

Romesh Khardori, MD, PhD

Disclosures

June 27, 2018

Metabolic syndrome is similarly prevalent in men (24%) and women (22%), after adjustment for age. However, several considerations are unique to women with metabolic syndrome; these include pregnancy, use of oral contraceptives, and polycystic ovary syndrome. Metabolic syndrome and polycystic ovary syndrome share the common feature of insulin resistance; they therefore share treatment implications as well. In addition, a modest association is apparent between metabolic syndrome and breast cancer, especially in postmenopausal women.

The distribution of adipose tissue appears to affect its role in metabolic syndrome. Fat that is visceral or intra-abdominal correlates with inflammation, whereas subcutaneous fat does not. Several potential explanations for this have been posited, including experimental observations that omental fat is more resistant to insulin and may result in a higher concentration of toxic free fatty acids in the portal circulation.

Insulin resistance appears to be the primary mediator of metabolic syndrome. Insulin promotes glucose uptake in muscle, fat, and liver cells and can influence lipolysis and the production of glucose by hepatocytes. Additional consequences of insulin resistance include abnormalities in insulin secretion and insulin receptor signaling, impaired glucose disposal, and the presence of proinflammatory cytokines. These abnormalities, in turn, may result from obesity, with related increases in free fatty acid levels and changes in insulin distribution (insulin accumulates in fat).

For more on the etiology and epidemiology of metabolic syndrome, read here.

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