Paper Information

Title: 

COMPLEXITIES OF THE METABOLIC SYNDROME: FOCUS ON SOUTH ASIANS AND MIDDLE EAST

Type: PAPER
Author(s): MISRA ANOUP*
 
 *DEPARTMENT OF DIABETES AND METABOLIC DISEASES, FORTIS HOSPITAL, VASANT KUNJ, NEW DELHI 110070
 
Name of Seminar: INTERNATIONAL CONGRESS OF METABOLIC SYNDROME, OBESITY & DIABETES
Type of Seminar:  CONGRESS
Sponsor: 
Date:  2010Volume 2
 
 
Abstract: 

THE METABOLIC SYNDROME IS DEFINED AS CLUSTERING OF SEVERAL CARDIOVASCULAR RISK FACTORS ALONG WITH OBESITY, OCCURRING IN A SINGLE INDIVIDUAL. GENERALLY, INSULIN RESISTANCE IS THE CENTRAL FEATURE OF THE METABOLIC SYNDROME. SEVERAL CONDITIONS AND DISEASES ARE LINKED TO INSULIN RESISTANCE, AND THOSE WITH METABOLIC SYNDROME ARE MORE PREDISPOSED TO DEVELOP THEM.
THE PREVALENCE OF OBESITY AND THE METABOLIC SYNDROME IS RAPIDLY INCREASING GLOBALLY, IN INDIA, SOUTH ASIAN COUNTRIES, AND MIDDLE EAST, LEADING TO INCREASED MORBIDITY AND MORTALITY DUE TO TYPE 2 DIABETES MELLITUS (T2DM) AND CARDIOVASCULAR DISEASE (CVD). THE MAIN DRIVERS ARE RAPID NUTRITION, LIFESTYLE AND SOCIO-ECONOMIC TRANSITIONS, CONSEQUENT TO INCREASING AFFLUENCE, URBANIZATION, MECHANIZATION, AND RURAL-TO-URBAN MIGRATION IN MANY COUNTRIES OF THIS REGION.
LESS INVESTIGATED DETERMINANTS OF THE METABOLIC SYNDROME INCLUDE PSYCHOLOGICAL STRESS IN URBAN SETTING, GENETIC PREDIPOSITION, ADVERSE PERINATAL ENVIRONMENT, AND CHILDHOOD. CATCH UP OBESITY.
DATA SHOW ATHEROGENIC DYSLIPIDEMIA, GLUCOSE INTOLERANCE, THROMBOTIC TENDENCY, SUBCLINICAL INFLAMMATION, AND ENDOTHELIAL DYSFUNCTION ARE HIGHER SOUTH ASIANS THAN WHITE CAUCASIANS.
MANY OF THESE MANIFESTATIONS ARE MORE SEVERE IN EVEN AT AN EARLY AGE IN SOUTH ASIANS THAN WHITE CAUCASIANS. METABOLIC AND CARDIOVASCULAR RISK IN SOUTH ASIANS IS ALSO HEIGHTENED BY THEIR HIGHER BODY FAT, TRUNCAL SUBCUTANEOUS FAT, INTRA-ABDOMINAL FAT, AND ECTOPIC FAT DEPOSITION (LIVER FAT ETC.). FURTHER, CARDIOVASCULAR RISK CLUSTER MANIFESTS AT A LOWER LEVEL OF ADIPOSITY AND ABDOMINAL OBESITY. THE CUT-OFFS OF BODY MASS INDEX AND WAIST CIRCUMFERENCE FOR DEFINING OBESITY AND ABDOMINAL OBESITY, RESPECTIVELY, HAVE BEEN LOWERED AND DEFINITION OF THE METABOLIC SYNDROME HAVE BEEN REVISED FOR ASIAN INDIANS IN A RECENT CONSENSUS STATEMENT, SO THAT PHYSICIANS COULD INTERVENE EARLY WITH LIFESTYLE MANAGEMENT.
DATA FROM A MAJOR INTERVENTION PROGRAM CONDUCTED BY US ON URBAN ADOLESCENT SCHOOLCHILDREN IN NORTH INDIA FOR PREVENTION OF OBESITY (PROJECT. MARG.) HAS SHOWN ENCOURAGING RESULTS, MAKING IT A MODEL FOR ANY FUTURE INTERVENTION PROGRAM IN SOUTH ASIANS AND IN OTHER COUNTRIES AS WELL.
THE SCOURGE OF THE METABOLIC SYNDROME CONTINUES IN SOUTH ASIA AND MIDDLE-EAST. PRIMARY

PREVENTION PROGRAMS SHOULD BE DIRECTED TO SCHOOLCHILDREN, AS HAS BEEN DONE IN INDIA, UAE

AND IRAN.

 
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