Treatment Of Metabolic Syndrome

The treatment of metabolic syndrome is one specially designed for the control of those diseases derived –as its name indicates– from the metabolic disorder in the body. For this, its main objective is to control the  risk factors that can cause these diseases.

In general, the goals of the treatment of metabolic syndrome include the reduction of cardiovascular risk factors, as well as the following aspects:

• Reduction of the underlying causes of metabolic syndrome, which are generally the following:
  • Obesity.
  • Smoking
  • Bad hygiene habits.
  • Unhealthy eating habits.
  • Sedentary lifestyle (or lack of activity or physical exercise), among others.
• Treatment of risk factors. This focuses on improving insulin sensitivity, so it merits changes in the patient’s lifestyle. For this reason, it is recommended both to lose weight and to increase physical activity (if the person has a problem with these aspects).

How does physical activity influence metabolic syndrome?

Among the benefits of doing physical exercise regularly and constantly, the following are evident:

• HDL increased.  It is the high-density lipoprotein, better known as “good cholesterol” because they are lipoproteins that transport cholesterol from the arteries to the liver for excretion.
• Decrease in VLDL and in some of LDL-c. These are the atherogenic lipoproteins.
• Decreased blood pressure.
• Reduction of insulin resistance, therefore it has a favorable influence on cardiovascular function.

What about diet?

As for weight reduction by controlling the diet, it should be based on the intake rich in fruits, vegetables, monounsaturated or polyunsaturated fatty acids. Likewise, a diet rich in fiber and low in saturated fat is recommended to avoid complications such as atheroma plaques.

When there is a decrease in LDL-c, there is evidence of improvement in the patient and a considerable decrease in all risk factors, including those of a cardiovascular type in general.

In short, it is recommended to combine a good diet with a proper physical exercise routine. Above all, because they provide multiple benefits to our body and, therefore, improve our quality of life.

Healthy lifestyle habits have multiple benefits, such as lowering lipids and controlling blood glucose.

However, it is necessary to remember that all these measures must be complemented (as the case may be and according to the doctor’s guidelines) with a type of pharmacological treatment. In this way, the treatment will be complete and can benefit the patient with the desired efficacy to improve their quality of life.

Treatment of metabolic syndrome

To combat the metabolic syndrome, the recommended treatment is pharmacological. Since it is aimed at reducing insulin resistance, thus increasing sensitivity to it in peripheral tissues.

Although this treatment does not have a single drug to treat the patient, there are a series of drugs that, taken together, are beneficial. For example:

• Obesity.
• Dyslipidemia
• Sedentary lifestyle.
• Elevated triglycerides.
• Control blood glucose.
• Arterial hypertension.
• Aspirin treatment.

Like many others, these drugs can pose certain risks to our health, so it is very important that the doctor carefully evaluates the risk-benefit ratio.

Treatment of dyslipidemia

Dyslipidemia is an alteration of lipid metabolism. In addition, it causes the alteration of the levels of lipids and lipoproteins. This is a risk factor in cardiovascular diseases, which are characteristic of patients with metabolic syndrome.

Treatment of dyslipidemia should begin with the administration of statins, and if this is not enough, combine them with fibrates and nicotinic acid derivatives. Why? Because fibrates and statins have antiatheroscleotic and antithrombotic properties.

Treatment to lower triglycerides

Since people with metabolic syndrome have high triglycerides,  treatment should also be aimed at lowering these values ​​in the patient.  Especially in high-risk cases, in which a series of LDL-lowering drugs would be used, as well as fibrates or nicotinic acid.

Glycemic control

Hypoglycemic drugs are used to control blood glucose, such as:

• Metformin. This is an antidiabetic drug that significantly improves insulin sensitivity and modestly lowers cholesterol and triglyceride levels. It is a first-choice drug in diabetics with a BMI greater than 27.
• Glitazones or thiazolinendiones. These are new oral antidiabetic drugs. Its therapeutic effects apart from glycemic control and improving insulin sensitivity are: an improvement in endothelial function, a decrease in the levels of free fatty acids and blood pressure. Therefore, they are of choice in patients with D2 with diabetic syndrome. The most commonly used glitazones are rosiglitazone and pioglitazone.

Control of high blood pressure

Pharmacological treatment for arterial hypertension must always be accompanied by the corresponding non-pharmacological measures. The most commonly used antihypertensive drugs with ACEIs and ARBs. Other hypotensive drugs used are diuretics.

Treatment of obesity and sedentary lifestyle

Weight loss should be one of the basic therapeutic goals in the treatment of metabolic syndrome.

Apart from the recommended measures to combat this point, they can be supported by different drugs to reduce weight, such as metformin that manages to reduce up to 5% of weight, or orlistat. The use of the latter together with the recommended measures reduces the incidence of diabetes by 9%.

Sibutramine is another drug used for obesity. It is a central reuptake inhibitor of chemicals known as serotonin and adrenaline. Thanks to this, he achieves weight losses, up to 11.6 kilograms in a period of approximately 6 months.

The only con that sibutramine has is a small increase in heart rate and blood pressure. For this reason, it would not be a first-line drug for the treatment of metabolic syndrome.

Aspirin treatment

Prescribing low-dose aspirin (325 mg / day or even less) may be a secondary prevention strategy. Especially of cardiovascular complications in patients with metabolic syndrome.

In conclusion, healthy lifestyle habits benefit both the patient and society, since it also allows control of both morbidity and mortality.