Cor Vasa 2011, 53(4-5):249-252 | DOI: 10.33678/cor.2011.055

The metabolic syndrome and its role in the primary prevention of diseases frequently occurring in the population

Hana Rosolová

Centrum preventivní kardiologie, II. interní klinika, Lékařská fakulta Univerzity Karlovy v Praze a Fakultní nemocnice v Plzni, Plzeň, Česká republika

Primary prevention of preventable diseases commonly occurring in the population, i.e., primarily cardiovascular disease (CVD) secondary to atherosclerosis, type-2 diabetes (DM2), and some common malignancies has still been paid little attention to date. In individuals in primary prevention, global cardiovascular (CV) risk is determined using the SCORE risk chart. In individuals at low or moderate CV risk, the more recent risk factors related to insulin resistance, i.e., metabolic syndrome (MS) components, are also to be monitored. Individuals with MS are at high risk for all the above preventable conditions. The metabolic syndrome is a complex disorder currently referred to as a pro-atherogenic, pro-coagulant and pro-inflammatory condition. Particular attention is given to so-called atherogenic dyslipidemia. A number of laboratory studies have shown the effect of insulin resistance on endothelial dysfunction to be mediated by inflammation. The most readily available marker of systemic inflammation is high-sensitivity C-reactive protein (hs-CRP); increased hs-CRP levels are associated with increased risk for CVD and DM2. However, endothelial dysfunction also indicates impaired hemostasis. Decreased fibrinolysis is the main and most consistent disorder related to insulin resistance and MS. Impaired fibrinolysis in MS presents as increased levels of PAI-1 associated with elevated t-PA levels. Current recommendations for primary prevention of CVD, DM2, and common malignancies include lifestyle modification, in particular dietary habits, regular exercise, smoking cessation, weight reduction and, possibly, elimination of chronic stress.

Keywords: Primary prevention; Cardiovascular diseases; Metabolic syndrome; hs-CRP

Published: April 1, 2011  Show citation