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How is the metabolic syndrome diagnosed?
There are no well-accepted criteria for diagnosing the
metabolic syndrome. The criteria proposed by the Third Report of the
National Cholesterol Education Program (NCEP) Expert Panel on Detection,
Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult
Treatment Panel III) are the most current and widely used.
According to the ATP III criteria, the metabolic syndrome
is identified by the presence of three or more of these components:
Which component below is false?
* Central
obesity as measured by waist circumference:
Men - Greater than 40 inches
Women - Greater than 35 inches
* Fasting blood triglycerides
greater than or equal to 150 mg/dL
* Blood HDL cholesterol:
Men - Less than 40 mg/dL
Women - Less than 50 mg/dL
* Blood pressure greater
than or equal to 130/85 mmHg
* Fasting glucose greater than
126mg/dL
The ATP III panel did not find evidence to recommend routine measurement
of insulin resistance (e.g. increased fasting blood insulin), prothrombotic
state or proinflammatory state.
AHA Recommendation
More studies are needed to understand the relationship between metabolic
risk factors and the efficacy of drug therapy in people who have the
metabolic syndrome.
To gain the most benefit from modifying multiple metabolic risk factors,
the underlying insulin resistant state must become a target of therapy.
The safest, most effective and preferred way to reduce insulin resistance
in overweight and obese people is weight loss and increased physical
activity.
Other steps for managing the metabolic syndrome are also important
for patients and their doctors:
** Routinely monitor body weight (especially the index for central
obesity), blood glucose, lipoproteins and blood pressure.
** Treat individual risk factors (hyperlipidemia, hypertension and high
blood glucose) according to established guidelines.
** Carefully choose anti-hypertensive drugs because different agents
have different effects on insulin sensitivity.
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