Treatment and Prevention of Metabolic Syndrome

Treatment

The ultimate goal of treating metabolic syndrome is to prevent diabetes and cardiovascular disease. If metabolic syndrome is defined as a problem caused by insulin resistance, it can be divided into treatment for this cause and treatment for the components of metabolic syndrome.​

1. Lifestyle improvement

(1) Diet and nutrition

The most important explanation for the pathogenesis of metabolic syndrome is obesity and insulin resistance. Therefore, weight management through lifestyle improvement, especially management of abdominal obesity, is important. Weight loss is very important not only for insulin resistance, but also for improving dyslipidemia, hyperuricemia, thrombotic factors, and abnormal vascular conditions.

(2) Exercise therapy

Exercise helps not only with weight loss but also with reducing abdominal obesity, and it is very important for improving insulin resistance. Compared with people who exercise regularly, people with sedentary jobs have a 30-55% higher incidence of type 2 diabetes and heart disease. Even a single bout of exercise improves insulin resistance. Therefore, when exercise is continued consistently, the use of insulin increases and resistance improves.

2. Treatment of the components of metabolic syndrome

The components of metabolic syndrome include hypertension, dyslipidemia, and insulin resistance or hyperglycemia. Treatment of each factor must be accompanied by improvement of insulin resistance through lifestyle changes.

(1) Treatment of hypertension

For patients with metabolic syndrome who do not have vascular disease or diabetes, a blood pressure target of 130/80 mmHg or lower is appropriate. Mechanistically, taking medications that help reduce the risk of developing diabetes may be ideal. Drugs such as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers fall into this category, but since medication should be selected after considering various other factors, it is advisable to consult the attending physician.

(2) Treatment of dyslipidemia

The reason dyslipidemia is important in the treatment of metabolic syndrome is that increased triglycerides or decreased high-density lipoprotein cholesterol are independent risk factors that cause cardiovascular disease. Therefore, it is important to reduce alcohol intake to prevent triglyceride levels from rising, to reduce fat intake, and to decrease carbohydrate consumption. In addition, continuous exercise and other efforts are needed to increase high-density lipoprotein cholesterol. Although it is not included in the diagnostic criteria for metabolic syndrome, elevated low-density lipoprotein cholesterol increases the risk of cardiovascular disease and must be managed. If it cannot be adequately controlled through ongoing exercise or dietary habits alone, medication should be considered through consultation with the attending physician.

(3) Treatment of elevated blood sugar

In patients with metabolic syndrome who have type 2 diabetes, strict blood sugar control significantly improves dyslipidemia. Efforts should be made to control blood sugar by improving lifestyle habits, and the use of medications such as metformin may also be considered after consultation with the attending physician.

(4) Management of insulin resistance

Insulin resistance is the most important root of metabolic syndrome, and conditions such as non-alcoholic fatty liver disease and polycystic ovary syndrome are also closely related to insulin resistance. Managing these conditions and controlling inflammation in the body may be helpful, and some medications have been reported to improve insulin resistance. It would be good to set the direction of management in consultation with the attending physician.

Prevention

The prevalence of metabolic syndrome is rapidly increasing worldwide, and it is becoming a major threat to health. In Korea, metabolic syndrome in men is increasing rapidly, making it an important concern.

Since metabolic syndrome increases cardiovascular complications, treatment after onset is important, but prevention is also important. Accordingly, various methods have been proposed to reduce the occurrence of metabolic syndrome. As explained in the treatment section, increasing physical activity and reducing caloric intake are the most important factors in lowering abdominal obesity and insulin resistance.

According to some studies, there are reports that the consumption of milk or dairy products has a preventive effect, and there are also reports that a Mediterranean diet centered on seafood and olive oil has a preventive effect. Although there is still much debate about these claims, they are generally consistent in terms of being healthy lifestyle habits.

In the same context, smoking cessation and excessive alcohol consumption are items that must be avoided.

Maintaining a healthy lifestyle in this way can contribute significantly to preventing or delaying metabolic syndrome.

So far, I have explained the treatment and prevention of metabolic syndrome.

In the next installment, we will learn about stomatitis.

Source: Korea Disease Control and Prevention Agency National Health Information Portal