The Metabolic Syndrome in Clinical Practice

Presently, there is so much focus on diabetes and cardiovascular disease, that the clinical intervention that is required towards its precursor, metabolic syndrome, is often not realised. 'œMetabolic Syndrome in Clinical Practice' will draw the attention of clinicians towards the importance of diagnosing metabolic syndrome, and therapeutic (including lifestyle) intervention that could be enforced earlier on to prevent its consequences and complications. In doing so, the understanding of present diagnostic criteria and how various metabolic risk factors play their role in its pathogenesis is crucial.

Dr Satish Mittal MBBS is a General Medical Practitioner and former General Practice Principal, East Molesey, East Surrey Health Authority, Surrey, UK; and Clinical Governance Lead and Chairman of Clinical Governance Committee, East Elmbridge Primary Care Group, Esher, Surrey, UK. He previously worked as a registrar in cardiology and general medicine. He also previously published books entitled Coronary Heart Disease in clinical Practice (Springer), Heart Disease and its Risk Factors (Ajanta International), 501 Women's Questions Answered (Ajanta), Everyday Child Care (Ajanta), and Women and Their Health Clarewood).

Preface
Introduction	p. 1
Prevalence	p. 1
Insulin	p. 6
The Thrifty Geno- and Phenotype Hypothesis	p. 16
Components of Metabolic Syndrome	p. 21
Insulin Resistance	p. 23
Obesity	p. 26
Dyslipidemia	p. 30
Proinflammatory State	p. 36
Prothrombotic State	p. 57
Endothelial Dysfunction	p. 61
Hypertension	p. 64
Glucose Intolerance	p. 67
Chronic Kidney Disease (Microalbuminuria)	p. 71
Smoking	p. 72
Physical. Inactivity	p. 73
Advancing Age	p. 74
Hyperuricemia	p. 75
Oxidative Stress	p. 75
Pathogenesis of the Metabolic Syndrome	p. 83
The Role of Genes	p. 83
Glucocentric View	p. 96
Lipocentric View	p. 97
The Role of Free Fatty Acids	p. 98
Mechanism of Lipid Accumulation in Skeletal Muscle and Liver	p. 101
Hypertriglyceridemia	p. 103
Postprandial Glycemia	p. 109
Growth Hormones	p. 110
Clinical Diagnosis of the Metabolic Syndrome	p. 115
World Health Organization Criteria	p. 117
International Diabetes Federation Criteria	p. 118
American Heart Association and National Heart Lung, and Blood Institute Statement	p. 120
American Association of Clinical Endocrinologist Criteria	p. 120
European Group for Study of Insulin Resistance Criteria	p. 122
Glucose Intolerance	p. 124
Cardiovascular Disease Risk and the Metabolic Syndrome	p. 128
Consequences of the Metabolic Syndrome	p. 131
Cardiovascular Disease and Diabetes	p. 131
Excess Adiposity	p. 136
Nonalcoholic Fatty Liver Disease	p. 141
Polycystic Ovary Syndrome	p. 146
Sleep Apnea	p. 149
Clinical Management of the Metabolic Syndrome	p. 154
Risk Assessment	p. 154
Goals for Clinical Management	p. 156
Management of Underlying Risk Factors	p. 158
Management of Metabolic Risk Factors	p. 180
The Metabolic Syndrome and Obesity in Children and Adolescents	p. 224
Prevalence	p. 224
Pathogenesis	p. 224
Assessment	p. 226
Cardiovascular Disease	p. 227
Type 2 Diabetes	p. 229
Obesity	p. 229
Index	p. 235
Table of Contents provided by Blackwell. All Rights Reserved.

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The Metabolic Syndrome in Clinical Practice

Summary

Author Biography

Table of Contents

Supplemental Materials