Journal List > J Korean Med Assoc > v.48(12) > 1080476

Koh and Woo: Prevention of Metabolic Syndrome

Abstract

The metabolic syndrome is a constellation of interrelated risk factors of metabolic origin that appear to directly promote the development of cardiovascular disease. The syndrome is also strongly associated with type 2 diabetes mellitus or the risk for this condition. In this article, we propose preventive measures for the metabolic syndrome through reviewing recent clinical studies for diabetes prevention.
Randomized, controlled trials conducted in 3 countries have established that the maintenance of modest weight loss through diet and physical activity reduces the incidence of type 2 diabetes in high-risk persons by about 40% to 60% over 3 to 4 years. Drug therapy to prevent or delay diabetes appears to be much less beneficial than lifestyle modification. The Diabetes Prevention Program shows that interventions that prevent diabetes will also reduce the development of the metabolic syndrome. Consequently, lifestyle interventions should be primarily considered for the prevention of the type 2 diabetes and metabolic syndrome.

Figures and Tables

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References

1. Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004. 109:433–438.
2. Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol. 2002. 156:1070–1077.
crossref
3. Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the "metabolic syndrome" and incidence of type 2 diabetes. Diabetes. 2002. 51:3120–3127.
crossref
4. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program(NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults(Adult Treatment Panel III). JAMA. 2001. 285:2486–2497.
5. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation. 2002. 106:3143–3421.
6. Grundy SM, Hansen B, Smith SC Jr, Cleeman JI, Kahn RA. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation. 2004. 109:551–556.
7. Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005. 142:611–619.
crossref
8. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002. 346:393–403.
crossref
9. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997. 20:537–544.
crossref
10. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001. 344:1343–1350.
crossref
11. Eriksson KF, Lindgarde F. Prevention of type 2(non-insulin-dependent) diabetes mellitus by diet and physical exercise. The 6-year Malmo feasibility study. Diabetologia. 1991. 34:891–898.
crossref
12. Eriksson J, Tuominen J, Valle T, Sundberg S, Sovijarvi A, Lindholm H, et al. Aerobic endurance exercise or circuit-type resistance training for individuals with impaired glucose tolerance? Horm Metab Res. 1998. 30:37–41.
crossref
13. Sarkkinen E, Schwab U, Niskanen L, Hannuksela M, Savolainen M, Kervinen K, et al. The effects of monounsaturatedfat enriched diet and polyunsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. Eur J Clin Nutr. 1996. 50:592–598.
14. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet. 2002. 359:2072–2077.
crossref
15. Buchanan TA, Xiang AH, Peters RK, Kjos SL, Marroquin A, Goico J, et al. Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk hispanic women. Diabetes. 2002. 51:2796–2803.
crossref
16. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000. 342:145–153.
crossref
17. Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004. 363:2022–2031.
crossref
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