Síndrome Metabólico

Definición y Epidemiología

Definición

El síndrome metabólico es un grupo de anormalidades bioquímicas y fisiológicas asociadas con el desarrollo de enfermedades cardiovasculares y diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus tipo 2.

Epidemiología

Prevalencia:

• 22%–24% en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria Estados Unidos
• 32% en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum México-americanos
• Mayor prevalencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres afroamericanas y méxico-americanas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum comparación con hombres de la misma etnia
• Aumenta con la edad → hasta 44% en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas > 60 años

El síndrome metabólico duplica el riesgo de desarrollar enfermedades cardiovasculares.

Fisiopatología

Con la obesidad, el exceso de tejido adiposo libera las siguientes sustancias, con efectos considerables en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el organismo.

Ácidos grasos no esterificados

• Sobrecarga lipídica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria músculos y el hígado
• ↑ Resistencia a la insulina

Citoquinas proinflamatorias

• ↑ Niveles de PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)
• ↑ Resistencia a la insulina
• Aterogénesis

Sustancias protrombóticas

• ↑ Inhibidor del activador del plasminógeno plasmático – 1 ( PAI-1 PAI-1 A member of the serpin family of proteins. It inhibits both the tissue-type and urokinase-type plasminogen activators. Metabolic Syndrome, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
• ↑ Fibrinógeno (reactante de fase aguda como PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR))

Adiponectina

• Una hormona proteica y adipoquina.
• Involucrada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la regulación de los LOS Neisseria niveles de glucosa.
• Involucrada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la degradación de ácidos grasos

Contribución a la hipertensión

Existen múltiples factores que contribuyen al AL Amyloidosis desarrollo de hipertensión con la obesidad, entre ellos:

• Deterioro de la señalización de la insulina → disfunción endotelial y del músculo liso → ↑ rigidez arterial.
• Activación inapropiada del sistema renina-angiotensina-aldosterona (SRAA).
• ↑ Señalización del sistema nervioso simpático (sobre todo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el riñón).
• ↑ Masa adiposa → compresión renal → deterioro de la natriuresis por presión.

Presentación Clínica y Diagnóstico

El síndrome metabólico se define como la presencia de ≥ 3 de las siguientes afecciones:

• Obesidad central, abdominal o visceral (caracterizada por acumulación de tejido adiposo predominantemente alrededor de la cintura y el tronco):
  • Circunferencia de la cintura: ≥ 102 cm (40 pulgadas) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres
  • Circunferencia de la cintura: ≥ 88 cm (35 pulgadas) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres
• Triglicéridos séricos elevados: ≥ 150 mg/dL
• Niveles de colesterol HDL reducidos:
  • < 40 mg/dL en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres
  • < 50 mg/dL en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres
• Presión arterial elevada: ≥ 130/85 mm Hg (o uso de antihipertensivos)
• Glucosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ayuno elevada: ≥ 100 mg/dL (o uso de agentes antihiperglucémicos)

Tratamiento

Modificaciones de estilo de vida

Dieta:

• Restricción calórica para la reducción de peso.
• Restricción de carbohidratos: < 55% de la ingesta diaria de calorías para reducir los LOS Neisseria niveles de glucosa.
• Dieta mediterránea:
  • Alto contenido de frutas, verduras, nueces, cereales integrales y aceite de oliva
  • Beneficios: pérdida de peso, disminución de los LOS Neisseria valores de la presión arterial, mejoría en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el perfil lipídico, disminución de la resistencia a la insulina, niveles reducidos de marcadores inflamatorios
• Dieta rica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum fibra:
  • Aproximadamente ≥ 30 g/día de fibra
  • Beneficios: pérdida de peso, disminución de las concentraciones lipídicas, disminución de la hiperinsulinemia.

Ejercicio:

• ≥ 30 minutos de ejercicio moderado 5 días a la semana
• Mejora la presión arterial
• Ayuda a revertir la resistencia a la insulina.
• Promueve la pérdida de peso.

Tratamiento farmacológico y quirúrgico

• Inhibidores de la enzima convertidora de angiotensina o antagonistas del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de angiotensina II y diuréticos tiazídicos para la hipertensión (según indicación clínica)
• Estatinas para la dislipidemia
• Agentes antihiperglucémicos, incluida la metformina, para la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus tipo 2
• Cirugía bariátrica:
  • Puede considerarse para la obesidad refractaria
  • Banda gástrica
  • Bypass gástrico

Relevancia Clínica

El síndrome metabólico está asociado con varios trastornos relacionados con la obesidad, los LOS Neisseria más importantes incluyen:

• Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus tipo 2: afección crónica caracterizada por niveles anormalmente altos de glucosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sangre debido a la resistencia a la insulina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuerpo. Los LOS Neisseria pacientes presentan poliuria, polidipsia y polifagia. El tratamiento incluye modificaciones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el estilo de vida, medicamentos para la modulación de la resistencia a la insulina y, en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum última instancia, sustitución de la insulina. Una hiperglucemia continua comúnmente resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum angiopatía (que a menudo se manifiesta como úlceras en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el pie y cicatrización deficiente de heridas), neuropatía, retinopatía (pérdida de visión) y nefropatía (ERC).
• ERC: pérdida gradual de la función renal durante meses o años, más comúnmente causada por diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus, hipertensión, glomerulonefritis y enfermedad renal poliquística. La mayoría de los LOS Neisseria pacientes desarrollan solo síntomas inespecíficos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una etapa tardía, que incluyen confusión y cansancio, pérdida de apetito y edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema de los LOS Neisseria miembros inferiores. El tratamiento incluye inhibidores de la enzima convertidora de angiotensina y un control adecuado de la glucosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sangre y la presión arterial. En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum última instancia, se requiere diálisis o trasplante de riñón. El síndrome metabólico aumenta el riesgo de padecer enfermedad renal crónica.
• Síndrome de ovario poliquístico (SOP): afección en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la que los LOS Neisseria ovarios producen una cantidad anormal de andrógenos. Las pacientes presentan ciclos menstruales irregulares, infertilidad, acné e hirsutismo y síndrome metabólico. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la detección de anovulación, niveles elevados de andrógenos y múltiples quistes ováricos. El tratamiento incluye modificaciones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el estilo de vida y fármacos antiandrogénicos.
• Apnea obstructiva del sueño: afección respiratoria relacionada con el sueño caracterizada por episodios recurrentes de obstrucción total o parcial de las vías respiratorias superiores. Los LOS Neisseria pacientes se presentan con respiración reducida o parcialmente ausente durante el sueño, que a menudo se asocia con ronquidos fuertes, dolores de cabeza y somnolencia diurna. El tratamiento incluye pérdida de peso para pacientes obesos, así como presión positiva continua en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las vías respiratorias ( CPAP CPAP A technique of respiratory therapy, in either spontaneously breathing or mechanically ventilated patients, in which airway pressure is maintained above atmospheric pressure throughout the respiratory cycle by pressurization of the ventilatory circuit. Noninvasive Ventilation, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y dispositivos de adelantamiento mandibular.
• Gota: tipo de artritis inflamatoria que causa ataques dolorosos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las articulaciones, más comúnmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la base del primer dedo del pie. La hiperuricemia crónica conduce al AL Amyloidosis depósito de cristales de ácido úrico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum articulaciones y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria tendones. La prevención incluye evitar la ingesta de alcohol, fructosa, carnes rojas y mariscos con alto contenido de purinas. Los LOS Neisseria ataques agudos se tratan con AINE, colchicina y glucocorticoides.