Skip to main content
Top
Published in: Current Hypertension Reports 2/2018

Open Access 01-02-2018 | Hypertension and Obesity (E Reisin, Section Editor)

The Global Epidemic of the Metabolic Syndrome

Author: Mohammad G. Saklayen

Published in: Current Hypertension Reports | Issue 2/2018

Login to get access

Abstract

Metabolic syndrome, variously known also as syndrome X, insulin resistance, etc., is defined by WHO as a pathologic condition characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. Though there is some variation in the definition by other health care organization, the differences are minor. With the successful conquest of communicable infectious diseases in most of the world, this new non-communicable disease (NCD) has become the major health hazard of modern world. Though it started in the Western world, with the spread of the Western lifestyle across the globe, it has become now a truly global problem. The prevalence of the metabolic syndrome is often more in the urban population of some developing countries than in its Western counterparts. The two basic forces spreading this malady are the increase in consumption of high calorie-low fiber fast food and the decrease in physical activity due to mechanized transportations and sedentary form of leisure time activities. The syndrome feeds into the spread of the diseases like type 2 diabetes, coronary diseases, stroke, and other disabilities. The total cost of the malady including the cost of health care and loss of potential economic activity is in trillions. The present trend is not sustainable unless a magic cure is found (unlikely) or concerted global/governmental/societal efforts are made to change the lifestyle that is promoting it. There are certainly some elements in the causation of the metabolic syndrome that cannot be changed but many are amenable for corrections and curtailments. For example, better urban planning to encourage active lifestyle, subsidizing consumption of whole grains and possible taxing high calorie snacks, restricting media advertisement of unhealthy food, etc. Revitalizing old fashion healthier lifestyle, promoting old-fashioned foods using healthy herbs rather than oil and sugar, and educating people about choosing healthy/wholesome food over junks are among the steps that can be considered.
Literature
1.
go back to reference Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.CrossRefPubMed Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.CrossRefPubMed
2.
go back to reference National Center for Health Statistics, Division of Health Interview Statistics. Crude and age-adjusted percentage of civilian, noninstitutionalized adults with diagnosed diabetes, United States, 1980–2010. National Center for Chronic Disease Prevention and Health Promotion, Ed. Atlanta, GA, Centers for Disease Control and Prevention, Division of Diabetes Translation, 2012. National Center for Health Statistics, Division of Health Interview Statistics. Crude and age-adjusted percentage of civilian, noninstitutionalized adults with diagnosed diabetes, United States, 1980–2010. National Center for Chronic Disease Prevention and Health Promotion, Ed. Atlanta, GA, Centers for Disease Control and Prevention, Division of Diabetes Translation, 2012.
3.
go back to reference Palaniappan LP, Wong EC, Shin JJ, et al. Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. In J Obe. 2017;35:393–400.CrossRef Palaniappan LP, Wong EC, Shin JJ, et al. Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. In J Obe. 2017;35:393–400.CrossRef
4.
go back to reference Wang Y, Mi J, Shan X, et al. Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obesity. 2007;31:177–88.CrossRef Wang Y, Mi J, Shan X, et al. Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obesity. 2007;31:177–88.CrossRef
5.
go back to reference 2015 Obesity collaborators GBD. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017; 2015 Obesity collaborators GBD. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;
6.
go back to reference Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004), 2008. Arch Int Med. 168:1617–24. Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004), 2008. Arch Int Med. 168:1617–24.
7.
go back to reference Firmann M, Mayor V, Vidal PM, et al. The CoLaus study: a population based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord. 2008;8:6.CrossRefPubMedPubMedCentral Firmann M, Mayor V, Vidal PM, et al. The CoLaus study: a population based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord. 2008;8:6.CrossRefPubMedPubMedCentral
9.
go back to reference Delvari A, Forouanafar MH, Alikhani S et al. First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East. Delvari A, Forouanafar MH, Alikhani S et al. First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East.
10.
12.
go back to reference Benrick A, Chanclon B, Micallef P, et al. Adiponectin protects against development of metabolic disturbances in a PCOS mouse model. Proc Natl Acad Sci U S A. 2017:E7187–96. Benrick A, Chanclon B, Micallef P, et al. Adiponectin protects against development of metabolic disturbances in a PCOS mouse model. Proc Natl Acad Sci U S A. 2017:E7187–96.
13.
go back to reference Jing Y, Wu F, Li D et al. Metformin improves obesity associated inflammation by altering macrophage polarization. Mol cell Endocrinol 2017; epub PMID 28935544. Jing Y, Wu F, Li D et al. Metformin improves obesity associated inflammation by altering macrophage polarization. Mol cell Endocrinol 2017; epub PMID 28935544.
17.
go back to reference Everard A, Belzer C, Geurts L. Crosstalk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity. Proc Natl Acad Sci U S A. 2013;110:9066–71.CrossRefPubMedPubMedCentral Everard A, Belzer C, Geurts L. Crosstalk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity. Proc Natl Acad Sci U S A. 2013;110:9066–71.CrossRefPubMedPubMedCentral
21.
go back to reference • Cox RL. Rationally designed PPARdelta-specific agonists and therapeutic potential for metabolic syndrome. Proc Natl Acad Sci USA. 2017;114:3284–5. While PPAR alpha and PPAR gamma activators are successfully being used in treatment of hyperlipidemia and type 2 diabetes, their use and benefits are limited. The third PPAR receptor PPAR delta is widely expressed in different tissues and activation in animal models improved lipid homeostasis and insulin sensitivity. Wu et al recently developed a highly selective set of chemicals that target PPAR delta paving the way of human use of a PPAR delta agonist to combat metabolic syndrome. CrossRefPubMedPubMedCentral • Cox RL. Rationally designed PPARdelta-specific agonists and therapeutic potential for metabolic syndrome. Proc Natl Acad Sci USA. 2017;114:3284–5. While PPAR alpha and PPAR gamma activators are successfully being used in treatment of hyperlipidemia and type 2 diabetes, their use and benefits are limited. The third PPAR receptor PPAR delta is widely expressed in different tissues and activation in animal models improved lipid homeostasis and insulin sensitivity. Wu et al recently developed a highly selective set of chemicals that target PPAR delta paving the way of human use of a PPAR delta agonist to combat metabolic syndrome. CrossRefPubMedPubMedCentral
26.
go back to reference Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med. 2017;2:2000143.CrossRef Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med. 2017;2:2000143.CrossRef
29.
go back to reference National Diabetes Statistics Report 2017 CDC publication. National Diabetes Statistics Report 2017 CDC publication.
30.
go back to reference Okla M, Kim J, Koehler K, et al. Dietary factors promoting brown and beige fat development and thermogenesis. Adv Nutr. 2017:473–83. Okla M, Kim J, Koehler K, et al. Dietary factors promoting brown and beige fat development and thermogenesis. Adv Nutr. 2017:473–83.
31.
go back to reference Ono K, et al. Intragastric administration of capsiate, a transient receptor potential channel agonist, triggers thermogenic sympathetic response. J Appl Physiol. 2011;10:789–98.CrossRef Ono K, et al. Intragastric administration of capsiate, a transient receptor potential channel agonist, triggers thermogenic sympathetic response. J Appl Physiol. 2011;10:789–98.CrossRef
32.
go back to reference Yoneshiro T, Aita S, Kawai Y, et al. Nonpungent capsaicin analogs (capsinoids) increase energy expenditure through the activation of brown adipose tissue in humans. Am J Clin Nutr. 2012;95:845–50.CrossRefPubMed Yoneshiro T, Aita S, Kawai Y, et al. Nonpungent capsaicin analogs (capsinoids) increase energy expenditure through the activation of brown adipose tissue in humans. Am J Clin Nutr. 2012;95:845–50.CrossRefPubMed
33.
go back to reference • Cheng CW, Villani V, Buono R, et al. Fasting mimicking diet promotes Ngn3-driven beta-cell regeneration to reverse diabetes. Cell. 2017;168:775–88. Low-calorie, low-protein and low-carb but high fat diet fasting mimicking ketogenic diet for 4 days increased the generation of pancreatic beta cells and reversed both T1D and t2D phenotypes in mouse models. CrossRefPubMedPubMedCentral • Cheng CW, Villani V, Buono R, et al. Fasting mimicking diet promotes Ngn3-driven beta-cell regeneration to reverse diabetes. Cell. 2017;168:775–88. Low-calorie, low-protein and low-carb but high fat diet fasting mimicking ketogenic diet for 4 days increased the generation of pancreatic beta cells and reversed both T1D and t2D phenotypes in mouse models. CrossRefPubMedPubMedCentral
35.
go back to reference Borgeson E, Johnson AMF, Lee YS, et al. Lipoxin A4 attenuates obesity-induced adipose inflammation and associated liver and kidney disease. Cell Metab. 2015;22:1–13.CrossRef Borgeson E, Johnson AMF, Lee YS, et al. Lipoxin A4 attenuates obesity-induced adipose inflammation and associated liver and kidney disease. Cell Metab. 2015;22:1–13.CrossRef
36.
go back to reference Orchard TJ, Temprosa M, Goldberg R, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the diabetes prevention program. Ann Intern Med. 2005;142:611–9.CrossRefPubMedPubMedCentral Orchard TJ, Temprosa M, Goldberg R, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the diabetes prevention program. Ann Intern Med. 2005;142:611–9.CrossRefPubMedPubMedCentral
37.
go back to reference • Ruderman NB, Carling D, Prentki M, et al. AMPK, insulin resistance and the metabolic syndrome. J Clin Invest. 2013;123:2764–72. Dysregulation of the fuel-sensing enzyme AMP-activated protein kinase (AMPK) is a central pathogenetic factor for insulin resistance and metabolic syndrome. Increasing AMPK either by caloric restriction, exercise or through use of activator drugs like metformin, thiazolidinediones, adipocyte derived hormone adiponectine, GLP1 agonists all improves the insulin resistance/metabolic syndrome. CrossRefPubMedPubMedCentral • Ruderman NB, Carling D, Prentki M, et al. AMPK, insulin resistance and the metabolic syndrome. J Clin Invest. 2013;123:2764–72. Dysregulation of the fuel-sensing enzyme AMP-activated protein kinase (AMPK) is a central pathogenetic factor for insulin resistance and metabolic syndrome. Increasing AMPK either by caloric restriction, exercise or through use of activator drugs like metformin, thiazolidinediones, adipocyte derived hormone adiponectine, GLP1 agonists all improves the insulin resistance/metabolic syndrome. CrossRefPubMedPubMedCentral
40.
go back to reference Jain SG, Puri S,Misra A etal. Effect of oral cinnamon intervention on metabolic profile and body composition of Asian Indians with metabolic syndrome: a randomized double-blind control trial. Lipids Health Dis 2017: 16:113–116, 1, DOI: https://doi.org/10.1186/s12944-017-0504-8. Jain SG, Puri S,Misra A etal. Effect of oral cinnamon intervention on metabolic profile and body composition of Asian Indians with metabolic syndrome: a randomized double-blind control trial. Lipids Health Dis 2017: 16:113–116, 1, DOI: https://​doi.​org/​10.​1186/​s12944-017-0504-8.
41.
go back to reference Lee J, Liu J, Feng X, et al. Withaferin A is a leptin sensitizer with strong antidiabetic properties in mice. Nat Med. 2016;22:1023–36.CrossRefPubMed Lee J, Liu J, Feng X, et al. Withaferin A is a leptin sensitizer with strong antidiabetic properties in mice. Nat Med. 2016;22:1023–36.CrossRefPubMed
42.
go back to reference Choudhary D, Bhattacharyya S, Joshi K. Body weight management in adults under chronic stress through treatment with Ashwagandha root extract: a double blind randomized, placebo controlled trial. J Evid based complementary altern med. 2017;22:96–106.CrossRefPubMed Choudhary D, Bhattacharyya S, Joshi K. Body weight management in adults under chronic stress through treatment with Ashwagandha root extract: a double blind randomized, placebo controlled trial. J Evid based complementary altern med. 2017;22:96–106.CrossRefPubMed
43.
go back to reference Consolim-Colombo FM, Sangaleti CT, Costa FO, et al. Galantamine alleviates inflammation and insulin resistance in patients with metabolic syndrome in a randomized trial. JCI Insight. 2017;20:93340. ( epub ahead of print)CrossRef Consolim-Colombo FM, Sangaleti CT, Costa FO, et al. Galantamine alleviates inflammation and insulin resistance in patients with metabolic syndrome in a randomized trial. JCI Insight. 2017;20:93340. ( epub ahead of print)CrossRef
44.
go back to reference Liu J, Lee J, Hernandez MAS, et al. Treatment of obesity with Celastrol. Cell. 2015;161:999–1011. (Celastrol, a pentacyclic triterpene extracted from the roots of Tripterygium wilfordii (Thunder god vine) suppresses food intake increase energy expenditure and leads to ~45% weight loss in hyperleptinemic diet induced obese mice. CrossRefPubMedPubMedCentral Liu J, Lee J, Hernandez MAS, et al. Treatment of obesity with Celastrol. Cell. 2015;161:999–1011. (Celastrol, a pentacyclic triterpene extracted from the roots of Tripterygium wilfordii (Thunder god vine) suppresses food intake increase energy expenditure and leads to ~45% weight loss in hyperleptinemic diet induced obese mice. CrossRefPubMedPubMedCentral
45.
go back to reference Rosa DD, Grzeskowiak LM, Ferreira CL, et al. Kefir reduces insulin resistance and inflammatory cytokine expression in an animal model of metabolic syndrome. Food Func. 2016;10:3390–4.CrossRef Rosa DD, Grzeskowiak LM, Ferreira CL, et al. Kefir reduces insulin resistance and inflammatory cytokine expression in an animal model of metabolic syndrome. Food Func. 2016;10:3390–4.CrossRef
46.
go back to reference • Primeau V, Coderre L, Karelis AD, et al. Characterizing the profile of obese patients who are metabolically healthy. Int J obesity. 2011;35:971–81. While obesity is often associated with metabolic syndrome, Obesity is NOT synonymous with MS. These so-called metabolically healthy obese (MHO) are characterized by high levels of insulin sensitivity, absence of hypertension and hyperlipidemia and other features of MS. Epidemiological evidence suggests that MHO may account for as much as 3/5 of the obese population. CrossRef • Primeau V, Coderre L, Karelis AD, et al. Characterizing the profile of obese patients who are metabolically healthy. Int J obesity. 2011;35:971–81. While obesity is often associated with metabolic syndrome, Obesity is NOT synonymous with MS. These so-called metabolically healthy obese (MHO) are characterized by high levels of insulin sensitivity, absence of hypertension and hyperlipidemia and other features of MS. Epidemiological evidence suggests that MHO may account for as much as 3/5 of the obese population. CrossRef
48.
go back to reference • Yamaoka K, Tango T. Effects of lifestyle intervention on metabolic syndrome: a systemic meta-analysis. BMC Med 2012; The relative proportion of patients with resolved MetS was around 2 times greater in the intervention group than the control group. Mean decrease in fasting blood sugar, triglycerides, waist circumference were 11.5 mg/dl, 12.0 mg/dl and 2.7 cm. Systolic and diastolic BP decreased by 6.4 and 3.3 mmHg. There was nonsignificant increase in HDL of 1.3 mg/dl. • Yamaoka K, Tango T. Effects of lifestyle intervention on metabolic syndrome: a systemic meta-analysis. BMC Med 2012; The relative proportion of patients with resolved MetS was around 2 times greater in the intervention group than the control group. Mean decrease in fasting blood sugar, triglycerides, waist circumference were 11.5 mg/dl, 12.0 mg/dl and 2.7 cm. Systolic and diastolic BP decreased by 6.4 and 3.3 mmHg. There was nonsignificant increase in HDL of 1.3 mg/dl.
49.
go back to reference Damsgaard CT, Biltoft-Jensen A, Tetens I, et al. Whole-grain intake, reflected by dietary records and biomarkers, is inversely associated with circulating insulin and other cardiometabolic markers in 8-11-year-old children. J Nutr. 2017;147:816–24.CrossRefPubMed Damsgaard CT, Biltoft-Jensen A, Tetens I, et al. Whole-grain intake, reflected by dietary records and biomarkers, is inversely associated with circulating insulin and other cardiometabolic markers in 8-11-year-old children. J Nutr. 2017;147:816–24.CrossRefPubMed
51.
go back to reference • Bray GA, Nielsen SJ, Popkin BM. Consumption of high fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr. 2004;79:537–43. This influential and frequently cited article created a false belief that the use of high fructose corn syrup (HFCS) causes MetS more than the cane sugar. This created a false sense of security in consuming sweetened food not using HFCS. The assumption was refuted late but it took a decade before the myth was refuted. CrossRefPubMed • Bray GA, Nielsen SJ, Popkin BM. Consumption of high fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr. 2004;79:537–43. This influential and frequently cited article created a false belief that the use of high fructose corn syrup (HFCS) causes MetS more than the cane sugar. This created a false sense of security in consuming sweetened food not using HFCS. The assumption was refuted late but it took a decade before the myth was refuted. CrossRefPubMed
52.
go back to reference • Coleman KJ, Huang YC, Koebrick C, et al. Metabolic syndrome is less likely to resolve in Hispanics and non-Hispanic blacks after bariatric surgery. Ann Surg. 2014;259:279–85. After multivariate adjustment MetS was less likely to resolve in patients with higher BMI, older, male and either Hispanic or non-Hispanic black. CrossRefPubMed • Coleman KJ, Huang YC, Koebrick C, et al. Metabolic syndrome is less likely to resolve in Hispanics and non-Hispanic blacks after bariatric surgery. Ann Surg. 2014;259:279–85. After multivariate adjustment MetS was less likely to resolve in patients with higher BMI, older, male and either Hispanic or non-Hispanic black. CrossRefPubMed
54.
go back to reference Barres R and Zierath JR. The role of diet and exercise in the transgenerational epigenetic landscape of T2DM. Nature reviews Endocrinology. 2016: 12:441–451. The review discusses the current understanding how life style factors affect the epigenetic landscape in MetS and diabetes. Barres R and Zierath JR. The role of diet and exercise in the transgenerational epigenetic landscape of T2DM. Nature reviews Endocrinology. 2016: 12:441–451. The review discusses the current understanding how life style factors affect the epigenetic landscape in MetS and diabetes.
55.
go back to reference • Newcomer JW. Metabolic considerations in the use of antipsychotic medications: a review of recent evidence. J Clin psychiatry. While many clinicians noticed the weight gain and increased incidence of diabetes with use of second generation antipsychotic drugs like Clonazapine, Olanzapine, CATIE (Clinical antipsychotic trails of intervention efficacy) and other studies confirmed that use of these drugs are associated with substantial weight gain and associated metabolic disturbances. • Newcomer JW. Metabolic considerations in the use of antipsychotic medications: a review of recent evidence. J Clin psychiatry. While many clinicians noticed the weight gain and increased incidence of diabetes with use of second generation antipsychotic drugs like Clonazapine, Olanzapine, CATIE (Clinical antipsychotic trails of intervention efficacy) and other studies confirmed that use of these drugs are associated with substantial weight gain and associated metabolic disturbances.
57.
go back to reference • Cimino I, Coll AP, Yeo HS. GDF15 and energy balance: homing in on a mechanism. Nat Med. 2017;23:1119–20. Editorial comments on the 3 recent studies in mice that identified a specific receptor, GFRAL, for the known anorectic peptide GDF15, elaborated on the understanding of its mechanism of action and paved the way for development of novel therapy for obesity and metabolic syndrome. CrossRefPubMed • Cimino I, Coll AP, Yeo HS. GDF15 and energy balance: homing in on a mechanism. Nat Med. 2017;23:1119–20. Editorial comments on the 3 recent studies in mice that identified a specific receptor, GFRAL, for the known anorectic peptide GDF15, elaborated on the understanding of its mechanism of action and paved the way for development of novel therapy for obesity and metabolic syndrome. CrossRefPubMed
58.
go back to reference Salas-salvado J, Bullo M, Estruch R, et al. Prevention of diabetes with Mediterranean diet—a subgroup analysis of a randomized diet. Ann Intern Med. 2014;160:1–10.CrossRefPubMed Salas-salvado J, Bullo M, Estruch R, et al. Prevention of diabetes with Mediterranean diet—a subgroup analysis of a randomized diet. Ann Intern Med. 2014;160:1–10.CrossRefPubMed
Metadata
Title
The Global Epidemic of the Metabolic Syndrome
Author
Mohammad G. Saklayen
Publication date
01-02-2018
Publisher
Springer US
Published in
Current Hypertension Reports / Issue 2/2018
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-018-0812-z

Other articles of this Issue 2/2018

Current Hypertension Reports 2/2018 Go to the issue

Hypertension and Emergency Medicine (T Rainer and P Levy, Section Editors)

New Developments in Hypertensive Encephalopathy

Secondary Hypertension: Nervous System Mechanisms (M Wyss, Section Editor)

Integrative Physiological Aspects of Brain RAS in Hypertension

Hypertension and the Brain (R Wainford, Section Editor)

Hypothalamic Ion Channels in Hypertension

Hypertension and the Brain (R Wainford, Section Editor)

Vasopressin, Central Autonomic Control and Blood Pressure Regulation

Pathogenesis of Hypertension (W Elliott and R Santos, Section Editors)

Angiotensin-(1–7) and Alamandine on Experimental Models of Hypertension and Atherosclerosis

Mechanisms of Hypertension (M Weir, Section Editor)

Pros and Cons of Intensive Systolic Blood Pressure Lowering