Over the past decade, metabolic syndrome has gained recognition as a significant contributor to cardiovascular mortality. Isolated metabolic syndrome, without diabetes mellitus, plays an increasingly essential role in the pathogenesis of Coronary Artery Disease (CAD). The risk factors for metabolic syndrome act synergistically to promote the development of Cardiovascular Disease (CVD); the more the risk factors, the higher the likelihood of developing CVD. Among these risk factors, obesity is the biggest culprit as it leads to an increase in the levels of free fatty acids (FFAs), thereby resulting in insulin resistance. This, in turn, causes impaired intracellular glucose metabolism and consequent production of free radicals that reduce nitrous oxide levels and cause endothelial dysfunction, leading to atherosclerosis. Also, visceral fat, being a source of C-reactive protein, indirectly promotes inflammation and atherosclerosis. However, in certain races, insulin resistance is fairly common, even in non-obese individuals. This implies the possibilities of multiple complex mechanisms at the microcellular level, causing insulin resistance over and above the aforementioned mechanisms occurring due to obesity. In spite of this fact, control of obesity still remains the first line of defense against metabolic syndrome and resulting cardiovascular mortality. Measures like proper diet and physical exercise, and medications such as statins, fibrates, niacin, and ACE inhibitors are the cornerstones of management of metabolic syndrome.
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Last date updated on July, 2014