The Metabolic Syndrome E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1074

Veröffentlichungsjahr: 2011

Beschreibung

The Metabolic Syndrome is a valuable reference text, covering all aspects of the metabolic syndrome and its constituent diseases including inflammation, oxidation and adipocytokines. This book explains the aetiology, pathogenesis and clinical treatment of all risk factors as well as the relationship with diabetes, non alcoholic fatty liver disease, polycystic ovary syndrome and coronary heart disease. The Metabolic Syndrome has been further improved from the 1st edition that was highly commended in 2006 Annual British Medical Association medical books competition. All chapters from the first edition are fully updated and this new edition contains an increase in international contributions and five new chapters on: * Childhood obesity and metabolic syndrome * Bariatric surgery for obesity * Fitness * Brain insulin resistance and appetite * The nature of the insulin resistance seen in metabolic syndrome. This brand new edition of The Metabolic Syndrome will be an indispensable resource for all clinical researchers, physicians and scientists requiring detailed up-to-date information on the metabolic syndrome to further their own research or to treat and manage the syndrome and its complications. Specifically, the text will be of particular relevance to those involved and working in the fields of diabetes, endocrinology, obesity, cardiology, vascular disease and hepatology.

Leseprobe

Contents

Contributors

Foreword

Preface

CHAPTER 1 The Epidemiology of the Metabolic Syndrome and its Association with Diabetes, Cardiovascular Disease and Other Conditions

Introduction

Definitions of the metabolic syndrome from 1988 to 2010

Available data on prevalence of the metabolic syndrome

Factors that influence prevalence of the metabolic syndrome and variation between populations

Interpretation of data on prevalence of the metabolic syndrome

Consequences of the metabolic syndrome

Conclusions

CHAPTER 2 Metabolic Syndrome and Ethnicity

Introduction

Ethnic variation in individual components of the metabolic syndrome

Africans and African Caribbeans

Native Americans, Mexican-Americans and Pacific Indigenous populations

Migrant Chinese populations

Composite definitions of the metabolic syndrome

Metabolic syndrome in ethnic groups in the UK

Metabolic syndrome in ethnic groups in North America

Epidemiology of ethnic differences in the risk for cardiovascular disease

The associations between metabolic syndrome, CVD and ethnicity

Potential mechanisms for ethnic differences in metabolic syndrome

Obesity and body fat distribution

Pro-inflammatory markers and adipocytokines

Physical activity and diet

Vitamin D

Psychosocial and socioeconomic factors

Lessons and challenges of study of ethnicity-disease risk

Clinical implications

Conclusions

CHAPTER 3 Developmental Origins of Endothelial Dysfunction: a Key Step in Cardiometabolic Disease

Introduction

Endothelial dysfunction in metabolic syndrome

Nitric oxide, endothelial function and the metabolic syndrome

Peripheral vascular endothelial biology

Developmental origins of endothelial dysfunction

Translational evidence of developmental origins in humans

Priming, early presentation and possible interventions

Conclusion

CHAPTER 4 Developmental Origins of Insulin Resistance and Type 2 Diabetes

Epidemiological studies linking fetal growth to type 2 diabetes and insulin resistance

Effects of early postnatal growth on type 2 diabetes and insulin resistance

The thrifty phenotype hypothesis

Evidence from human studies for developmental programming of type 2 diabetes and insulin resistance

Evidence from animal models for developmental programming of type 2 diabetes and insulin resistance

Mechanisms of insulin signaling

Mechanisms of insulin resistance

Developmental programming of insulin signaling in animal models

Developmental programming of insulin signaling in humans

Conclusions and future perspectives

CHAPTER 5 The Metabolic Syndrome in Childhood

Defining the metabolic syndrome in childhood

Pathophysiology of the metabolic syndrome in childhood

Does the presence of the metabolic syndrome in childhood predict adult disease?

Conclusion

CHAPTER 6 Assessment of Insulin Sensitivity

Introduction

Current techniques for the in vivo assessment of whole body insulin sensitivity

Conclusion

CHAPTER 7 Recent Progress in Identifying Genes Contributing to Type 2 Diabetes and Metabolic Syndrome

Introduction

Implicating type 2 diabetes genes

Implicated pathways: beta-cell function vs. insulin resistance

Genetic variants associated with fasting glucose are often different from type 2 diabetes variants

Type 1 and type 2 diabetes loci do not overlap

Type 2 diabetes genes and birthweight

Genetic variants identified for other components of the metabolic syndrome

Loci with multiple independent disease associated variants

Clinical utility: disease prediction

The problem of the missing heritability

Conclusion

CHAPTER 8 Endocrine Aspects of the Metabolic Syndrome

Introduction

The hypothalamic-pituitary-adrenal (HPA) axis

Growth hormone

CHAPTER 9 Brain Insulin Resistance

Brain insulin resistance

Brain control of food intake

What are the effects of insulin on the brain?

Does brain insulin resistance exist in humans?

How might brain insulin resistance arise?

Insulin resistance and cognitive function

Insulin resistance and mood

Conclusions

CHAPTER 10 Cardiorespiratory Fitness and the Metabolic Syndrome

Definition of cardiorespiratory fitness

Cardiorespiratory fitness and metabolic syndrome prevalence

Cardiorespiratory fitness and metabolic syndrome incidence

Effects of exercise training on metabolic syndrome status

Influence of cardiorespiratory fitness on the mortality risk associated with the metabolic syndrome

Should low cardiorespiratory fitness be considered as a component of the metabolic syndrome?

Potential mechanisms by which cardiorespiratory fitness ameliorates the health hazards of the metabolic syndrome

Conclusions

CHAPTER 11 Metabolic Syndrome and Mental Illness

Introduction

Depression

Psychotic illnesses

Conclusion

CHAPTER 12 Atherothrombosis and the Metabolic Syndrome

Introduction

Obesity, insulin resistance and atherothrombosis

The role of endothelium and platelets in atherothrombosis

Platelets, insulin resistance and the metabolic syndrome

The effect of insulin on platelets

Early atheroma formation

Plaque rupture, thrombin generation and thrombus formation

The pleiotropic effects of thrombin

The fluid phase of coagulation in the metabolic syndrome

Implications for anti-thrombotic approaches

CHAPTER 13 Inflammation and Metabolic Syndrome

Metabolic syndrome

The metabolic syndrome and cardiovascular disease

The metabolic syndrome and diabetes

Inflammation and atherosclerosis

Inflammation and the metabolic syndrome

Pro-inflammatory cytokines and the metabolic syndrome

CRP and the metabolic syndrome

Adipokines and metabolic syndrome

Monocyte chemoattractant protein-1 (MCP-1)

Serum amyloid A

PAI-1 and the metabolic syndrome

Endothelium, EPCs and metabolic syndrome

Therapeutic modulation of metabolic syndrome

Statins and metabolic syndrome

PPAR gamma agonists and metabolic syndrome

CHAPTER 14 Adipocytokine Dysregulation, Obesity and the Metabolic Syndrome

Introduction

Adipocytokines and the metabolic syndrome

Leptin

Adiponectin

Resistin

Retinol binding protein-4

Tumor necrosis factor-alpha

Interleukin-6

Macrophage and monocyte chemoattractant protein-1

Plasminogen-activator inhibitor-1

Proteins of the renin-angiotensin system

Conclusion

CHAPTER 15 Non-Alcoholic Fatty Liver Disease

Introduction

Epidemiology

Diagnosis and biochemical markers

NAFLD, metabolic syndrome and diabetes

NAFLD and postprandial hyperlipidemia and hyperglycemia

Sleep apnea syndrome and NAFLD: a possible role for hypoxia as an etiological factor in NAFLD

NAFLD and it is association with cardiovascular disease

Pathogenesis*

Developmental origins: altered early development in the pathogenesis of NAFLD

Factors that accelerate progression of NAFLD to NASH

Treatment

Conclusions

CHAPTER 16 Polycystic Ovary Syndrome

Introduction

PCOS – laboratory investigations

Insulin resistance in polycystic ovary syndrome and its role in reproductive abnormalities

Insulin resistance and metabolic features in women with polycystic ovary syndrome

Mechanisms to lessen diabetes and vascular risk in women with polycystic ovary syndrome

Future research questions in relation to long-term diabetes and vascular risk in polycystic ovary syndrome

Conclusion

CHAPTER 17 Nutrition: Its Relevance in Development and Treatment of the Metabolic Syndrome

Introduction

Weight loss and energy balance

Carbohydrate restriction

Reduced carbohydrate, relatively high fat diets

Reduced carbohydrate and relatively high protein diets

Carbohydrate quality

Dietary fat

Phytochemicals

Vitamin D and calcium

Magnesium

Dietary patterns

Summary

CHAPTER 18 Treatments for the Metabolic Syndrome

Introduction

Targets for treatment

Treatment by lifestyle modification

Lifestyle intervention in obesity

Lifestyle intervention in prediabetes and type 2 diabetes

Lifestyle intervention and dyslipidemia

Lifestyle intervention in hypertension

Lifestyle intervention on hypercoagulability and low-grade inflammation

Medical treatment of metabolic syndrome

Medical treatment of obesity in patients with metabolic syndrome

Medical treatment of prediabetes/type 2 diabetes in patients with metabolic syndrome

Medical treatment of dyslipidemia in patients with metabolic syndrome

Medical treatment of hypertension in patients with metabolic syndrome

Polypharmacy in the treatment of metabolic syndrome

Conclusions

CHAPTER 19 Metabolic/Bariatric Surgery Therapy for the Metabolic Syndrome

Metabolic surgery

Bariatric surgery

Obesity

Diabetes

Dyslipidemia

Hypertension

Non-alcoholic steatohepatitis (NASH)

Polycystic ovary syndrome

Metabolic syndrome

Research opportunity

Working together

Index

This edition first published 2011, © 2005, 2011 by Blackwell Publishing Ltd.

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ISBN: 9781444336580

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Contributors

Mohamed H. Ahmed, MBBS, PhDChemical Pathology Department,Southampton General Hoaspital, Tremona Road, Southampton, UK

Stephanie A. Amiel, BSc, MD, FRCPRD Lawrence Professor of Diabetic MedicineDiabetes Research GroupKing’s College London School of MedicineWeston Education CentreLondon, UK

Steven N. Blair, PEDProfessorDepartments of Exercise Science and Epidemiology and BiostatisticsArnold School of Public HealthUniversity of South CarolinaColumbia, SC, USA

Henry Buchwald, MD, PhDProfessor of Surgery and Biomedical EngineeringUniversity of MinnesotaMinneapolis, MN, USA

Christopher D. Byrne, FRCP, FRCPath, PhDProfessor of Endocrinology & MetabolismInstitute for Developmental Sciences Southampton General HospitalSouthampton, UK

Sonia Caprio, MDDepartment of PediatricsYale UniversityNew Haven, CT, USA

Yee Seun Cheah, MA, MB, BChir, MRCP(UK)Clinical Training Fellow and Specialist RegistarDiabetes Research GroupKing’s College London School of MedicineLondon, UK

Geraldine F. Clough, BSc, PhDProfessor of Vascular PhysiologyInstitute of Developmental SciencesSchool of MedicineUniversity of SouthamptonSouthampton, UK

Sridevi Devaraj, PhDProfessorLaboratory for Atherosclerosis and Metabolic ResearchUniversity of California Davis Medical Center Sacramento, CA;The VA Medical CenterMather, CA, USA

Nita Gandhi Forouhi, MRCP, PhD, FFPHMRC Programme LeaderMRC Epidemiology UnitInstitute of Metabolic ScienceAddenbrooke’s HospitalCambridge, UK

Timothy M. Frayling, PhDProfessor of Human GeneticsGenetics of Complex TraitsPeninsula College of Medicine and Dentistry University of ExeterExeter, UK

Peter J. Grant, MD, FRCPProfessor of MedicineHonorary Consultant PhysicianDivision of Cardiovascular and Diabetes ResearchLight LaboratoriesUniversity of Leeds;Leeds Teachings Hospitals NHS TrustLeeds, UK

Markolf Hanefeld, MD, PhDProfessor and LecturerCentre for Clinical StudiesTechnical University DresdenDresden, Germany

Mark A. Hanson, MA, DPhil, PGcertEdBHF Professor of Cardiovascular SciencesVascular Biology Group Institute of Developmental Sciences, School of MedicineUniversity of SouthamptonSouthampton, UK

Richard I.G. Holt, MA, MB BCHIR, PhD, FRCP, FHEAProfessor in Diabetes and EndocrinologyEndocrinology and Metabolism Sub-DivisionDevelopmental Origins of Adult Health and Disease DivisionSouthampton General HospitalSouthampton, UK

Katharine F. Hunt, BA, MBBS, MSc, MRCP(UK)Clinical Research Associate and Specialist RegistrarDiabetes Research GroupKing’s College London School of MedicineLondon, UK

Ishwarlal Jialal, MD, PhDRobert E. Stowell Endowed Chair in Experimental Pathology.Director of the Laboratory for Atherosclerosis and Metabolic Research,Professor of Internal Medicine (Endocrinology, Clinical Nutrition and Vascular Medicine)VA Medical CenterSacramento, CA, USA

Jim Mann, CNZM, MA, DM, PhD, FRACP, FRSNZProfessor of Human Nutrition and MedicineEdgar National Centre for Diabetes Research andDepartment of Human NutritionUniversity of OtagoDunedi, New Zealand

Paul A. McAuley, PhDAssistant Professor of Health EducationDepartment of Human Performance and Sport SciencesWinston-Salem State UniversityWinston-Salem, NC, USA

Susan E. Ozanne, BSc(Hons), PhDBritish Heart Foundation Senior FellowMetabolic Research LaboratoriesUniversity of CambridgeInstitute of Metabolic ScienceCambridge, UK

Robert C. Peveler, MA, DPhil, BM, BCh, FRCPsychProfessor of Psychiatry Clinical Neurosciences DivisionUniversity of Southampton School of Medicine,Southampton, UK

Esther Phielix, PhDGerman Diabetes CentreClinical DiabetologyDuesseldorf, Germany

Michael Roden, MDProfessor of Medicine and DirectorGerman Diabetes Center Department of Metabolic DiseasesUKD Heinrich Heine UniversityDüsseldorf, Germany

Naveed Sattar, MBChB, PhD FRCP, FRCPathProfessor of Metabolic MedicineBHF Glasgow Cardiovascular Research CentreUniversity of GlasgowGlasgow, Scotland, UK

Frank Schaper, MDDiabetologistCenter of Clinical StudiesDresden, Germany

Ulrike Schatz, MDRegistrarUniversity Hospital DresdenDresden, Germany

Kenneth Siddle, MA, PhDProfessor of Molecular EndocrinologyUniversity of CambridgeDepartment of Clinical BiochemistryMetabolic Research LaboratoriesInstitute of Metabolic ScienceAddenbrooke’s HospitalCambridge, UK

David Siegel, MD, MPHChief of MedicineVA Northern California Health Care System;Professor and Vice ChairDepartment of MedicineUniversity of CaliforniaDavis, CA, USA

Ulf Smith, MD, PhDProfessor of Internal MedicineThe Lundberg Laboratory for Diabetes Research Center of Excellence for Metabolic and Cardiovascular ResearchDepartment of Molecular and Clinical MedicineThe Sahlgrenska Academy at the University of GothenburgGothenburg, Sweden

Peter H. Sönksen, MD, FRCP,Visiting ProfessorSchool of MedicineUniversity of Southampton The Institute of Developmental Sciences (IDS Building)(University of Southampton), MP 887Southampton General HospitalTremona RdSouthampton, UK

Kristina F. Standeven, PhDResearch FellowDivision of Cardiovascular and Diabetes ResearchUGHT LaboratoriesUniversity of LeedsLeeds, UK

Julia Szendroedi, MD, PhDGerman Diabetes CenterDepartment of Metabolic DiseasesUKD Heinrich-Heine UniversityDüsseldorf, Germany

Lisa Te Morenga, BSc, BForSc(hons)Research FellowDepartment of Human NutritionUniversity of OtagoDunedin, New Zealand

Thérèse Tillin, MSc, MBBSLecturerInternational Centre for Circulatory HealthImperial College LondonLondon, UK

Christopher Torrens, BSc(Hons), PhDLecturer in PhysiologyVascular Biology GroupInstitute of Developmental SciencesSchool of MedicineUniversity of SouthamptonSouthampton, UK

Michael N. Weedon, PhDLecturerGenetics of Complex TraitsPeninsula College of Medicine and Dentistry University of ExeterExeter, UK

Ram Weiss, MD, PhDDepartment of Human Nutrition and MetabolismHebrew University School of MedicineJerusalem, Israel

Sarah H. Wild FRCPE, FFPH, PhDReader in Epidemiology and Public HealthCentre for Population Health Sciences University of Edinburgh Edinburgh, Scotland, UK

Weijia Xie, BScBSc studentGenetics of Complex TraitsPeninsula College of Medicine and Dentistry University of Exeter Exeter, UK

Xiaolin Yang, MD, PhDAssociate Professor Molecular Medicine & Associate ResearcherThe Lundberg Laboratory for Diabetes ResearchCenter of Excellence for Metabolic and Cardiovascular ResearchDepartment of Molecular and Clinical MedicineThe Sahlgrenska Academy at the University of GothenburgGothenburg, Sweden

Foreword

K.G.M.M. Alberti

Senior Research Investigator, Imperial College, London, UK

It is 5 years since the first edition of this book. The exponential increase in interest and publications to which I referred last time has continued. Five years ago there were still questions as to whether the metabolic syndrome was a real entity, and if was how it should be defined. Some of these questions still continue. A highly sceptical commentary appeared from the World Health Organization – which was partly explained by the composition of the reporting group! In most eyes however the metabolic syndrome has proved a useful concept and is fertile territory for research. There is still some confusion between the metabolic syndrome and the insulin resistance syndrome. These are different entities, although with much common ground. The latter is a pathophysiological concept with insulin resistance as the unifying etiological factor. The metabolic syndrome is by contrast a practical tool, comprising easily measurable variables which occur together more often than dictated by chance alone – and it identifies people at increased risk of cardiovascular disease and diabetes. Its strength is that it goes beyond the conventional risk factors of LDL-cholesterol, smoking and family history. There are no implications regarding etiology, although it has been suggested that both central adiposity and insulin resistance play a role and that cytokines and prothrombotic factors may also be significant.

Five years ago there were two separate sets of diagnostic criteria which although closer than previous versions were still distinct. One from the International Diabetes Federation had an enlarged waist circumference as a sine qua non, together with two out of the following: raised fasting glucose; raised triglycerides (TG); low HDL-cholesterol; and raised blood pressure. The modified National Cholesterol Education Program ATP III definition treated all five components identically, just requiring three to be abnormal. There was also a difference in the waist cut-off points used, although the same cut-off points were employed for the other four variables. Since then the two groups have come together and produced what is known as the Harmonized Definition, which follows the ATPIII definition with increased waist girth no longer obligatory – and the waist girth used depending on both ethnicity and country of residence! No doubt further modifications will occur in the future, but hopefully in the interim meaningful epidemiological studies and comparisons will be made using a single definition, and the endless comparisons between IDF, ATP III and WHO will cease!

The many advances in our knowledge, beyond diagnostic criteria, are displayed admirably in the current volume. After an introduction on epidemiology of the syndrome the impact of ethnicity is discussed. Insulin resistance is covered both with regard to developmental origins, its assessment and its impact on the brain. There is also a series of chapters on the broader aspects of the syndrome which may be effect or may be implicated causally: these include atherothrombotic factors, inflammation, dysregulation of adipocytokines and hepatosteatosis. The relation of the metabolic syndrome to polycystic ovary syndrome has also been updated.

The final section of the book focuses on treatment. There is a thoughtful account of the role of nutrition in both etiology and treatment, whilst pharmacological approaches are dealt with as well. There has long been a search for the holy grail of a single drug which could deal with all aspects of the syndrome – it was felt that one of the mixed PPAR agonists might fulfil this role, but so far only lifestyle change or bariatric surgery have been successful, as discussed in the final chapter. The latter could not be more timely as it has taken a long time for physicians to accept that surgery might be a beneficial approach to metabolic disease!

Overall the time is ripe for an update of the metabolic syndrome and its many implications. This edition is even more successful than the last in providing an account of the many advances that have occurred and will provoke much thought and discussion. A highly commended read!

Preface

In 2005, Wiley published the first edition of this book just after the International Diabetes Federation (IDF) had published new criteria for identification of metabolic syndrome. In defining new criteria, the IDF placed the focus on central obesity as an essential requirement, combined with two other features (from raised blood pressure, glucose, and triglyceride and decreased high density lipoprotein cholesterol concentrations). In the last five years the value of defining and identifying the metabolic syndrome continues to generate a huge amount of interest and controversy amongst the scientific community. A search using the term “metabolic syndrome” of PubMed in October 2010, showed that there have been an astonishing 17,364 publications that mentioned metabolic syndrome since 2005. Despite the considerable amount of scientific interest in the metabolic syndrome, there remains a lack of agreement relating to its definition and pathogenesis.

In 2009, controversy surfaced again when the American Diabetes Association and the European Association for the Study of Diabetes failed to endorse the consensus statement on the metabolic syndrome that was endorsed by the IDF, National Heart, Lung, and Blood Institute, World Heart Federation, International Atherosclerosis Society, and the American Heart Association. It is ironic that two major diabetes organizations failed to sign up to the consensus statement when the justified concerns about the effect of categorizing continuous variables and the failure to identify a single causal pathway also apply to glucose levels and the definition and etiology of type 2 diabetes. In our opinion, these concerns should not detract from the clinical utility of identifying people with evidence of ectopic fat accumulation at risk of cardiometabolic diseases and offering them effective interventions.

In 2006 the first edition of this book was awarded a highly commended prize certificate in the Annual British Medical Association Medical text book competition. Five years after publication of the first edition, we have attempted to make the second edition even more comprehensive. This edition includes updated versions of 13 chapters and six completely new chapters. The majority of the original structure of the first edition has been retained and there are new chapters on metabolic syndrome in children, brain insulin resistance, bariatric surgery, psychological and psychiatric illness, fitness and measurement of insulin sensitivity. As for the first edition, this book has been written to appeal to both clinicians and scientists and we have included chapters that range from etiology and pathogenesis to complications, treatment and management. There is a focus on exciting new areas of research that are likely to have considerable impact on both scientific understanding of the metabolic syndrome and its clinical outcomes.

Since Gerald Reaven’s description of the insulin resistance syndrome (IRS) in 1988, a consensus has emerged that visceral and liver fat accumulation is key to the IRS and to the metabolic phenotype. In 2010, with improvements in our understanding of the metabolic syndrome, it could be referred to as a condition of ectopic fat accumulation associated with increased risk of cardiometabolic diseases. Perhaps such an ungainly term would generate less controversy!

This book is the culmination of 12 months of enjoyable collaboration with colleagues and friends who have written the chapters, and to whom we owe a debt of thanks for their hard work. We have valued their enthusiasm for their topics and the contributions they have made to the book. Just as both of us have developed a passion for research in the metabolic consequences of modern lifestyles over the last 20 years, we hope that this book will stimulate some members of future generations of researchers to work in this important area of science, policy and medicine.

Christopher D. Byrne & Sarah H. WildSouthampton & Edinburgh