In the United States, 40 to 45% of those over 60 years of age have the metabolic syndrome (1, 2, 3), and this percentage, based on estimates of the increasing prevalence ofexcess body weight and the more comprehensive diagnostic criteria for the syndrome, is likely to exceed 60% in newer survey analyses. Children and adolescents, too, are being affected by the metabolic syndrome, in parallel with the increasing prevalence of overweight in young people, now estimated to include 16% of those age 6 to 19 years. Clinicians see with increasing frequency that routine office visits demonstrate the meta bolic syndrome, a constellation of discrete but closely related metabolic disturbances indicative of increased risk for (or presence of) cardiovascular disease and/or diabetes. All estimates suggest the increasing impactof the metabolic syndrome on mortality and morbidity (4). Our aim in developing this new synthesis and analysis of the metabolic syndrome has been to bring together the viewpoints of the epidemiologists, the physiologists, the molecular biologists/biochemists, and the clinicians toward understanding the current state ofknowledge ofboth the causes and the consequences of the metabolic syndrome. These writers aim to stimulate new thinking concerning underlying mechanisms and to encourage heightened efforts to develop new therapeutics, potentially targeting uniquely intersecting pathways or points of intervention. This book is an extended call to action to slow or halt the rising tide of the metabolic syndrome (5).
Table of Content
Metabolic Syndrome—Past and Future.- Metabolic Syndrome—Past and Future.- Epidemilogy And Clinical Treatment: Issues In Defining And Treating The Metabolic Syndrome.- Metabolic Syndrome.- The Role of Obesity in Insulin Resistance.- Treatment of the Metabolic Syndrome with Weight Loss, Exercise, Hormones, and Surgery.- Insulin Resistance, Metabolic Syndrome, and Cardiovascular Disease.- The Sympatho-Adrenal System in the Metabolic Syndrome.- Endothelial Function, Inflammation, and Dyslipidemia.- Insulin Action and Endothelial Function.- Macro- and Microvascular Disease in an Insulin-Resistant Pre-Diabetic Animal Model.- High-Sensitivity C-Reactive Protein and the Metabolic Syndrome.- Insulin Signaling in Adipocytes and the Role of Inflammation.- Insulin Resistance and Dyslipidemia.- Insulin—Secretion and Action: Underlying Mechanisms of the Metabolic Syndrome.- Pancreatic Islet Pathophysiology and Pathology in Obesity.- Glucagon-like Peptides and Insulin Sensitivity.- The Relationship Between the Insulin Receptor Substrates and Metabolic Disease.- Insulin Resistance and Inhibitors of the Insulin Receptor Tyrosine Kinase.- Fat Feeding and Muscle Fat Deposition Eliciting Insulin Resistance.- Alterations in Atypical Protein Kinase C Activation in Insulin Resistance Syndromes.- The Liver, Glucose Homeostasis, and Insulin Action in Type 2 Diabetes Mellitus.- Chronomics of the Metabolic Syndrome.