From the Guidelines
Metabolic syndrome affects approximately 36.9% of the adult population in Mexico, with higher rates in women (41%) than men (32.3%) 1. The management of metabolic syndrome involves both lifestyle modifications and targeted medical interventions. The primary approach includes weight reduction through a Mediterranean or DASH diet with caloric restriction of 500-1000 calories daily, combined with regular physical activity (150 minutes of moderate exercise weekly). Specific pharmacological treatments are determined by which components of metabolic syndrome are present:
- Hypertension may require antihypertensives like ACE inhibitors (e.g., lisinopril 10-40 mg daily) or ARBs;
- Dyslipidemia often necessitates statins (e.g., atorvastatin 10-80 mg daily);
- Dysglycemia might require metformin (starting at 500 mg daily, increasing to 2000 mg daily as needed) 1. The high prevalence in Mexico is attributed to genetic predisposition, increasing urbanization, adoption of Western diets high in processed foods, and sedentary lifestyles. Regular monitoring of blood pressure, lipid profiles, and glucose levels is essential, with screenings recommended annually for at-risk individuals. Early intervention is crucial as metabolic syndrome significantly increases the risk of developing type 2 diabetes and cardiovascular disease. Some key considerations for pharmacotherapy include:
- Semaglutide, liraglutide, combination of naltrexone with bupropion, and orlistat can achieve a reduction of 5%–14% of total body weight and offer benefits in terms of improvement in obesity-related complications and comorbidities independent of weight loss 1.
- Pharmacotherapy should be individualized based on patients’ specific conditions, obesity complications, and comorbidities, as well as safety considerations.
- All approved medications for treating obesity are contraindicated during pregnancy, and following obesity treatment, there is an increased likelihood of pregnancy, necessitating careful planning and monitoring 1.
From the Research
Prevalence of Metabolic Syndrome in Mexican Adults
- The prevalence of metabolic syndrome in Mexican adults is not directly stated in the provided studies, which focus on the definition, diagnosis, and management of metabolic syndrome in general populations 2, 3, 4, 5, 6.
- However, the studies suggest that metabolic syndrome is a significant health concern in many countries, including the United States, where its prevalence is estimated to be around 34% of the adult population 2.
- The prevalence of metabolic syndrome is likely to be similar in other countries with similar lifestyle and demographic characteristics, but specific data for Mexico is not provided in the studies.
Definition and Diagnostic Criteria of Metabolic Syndrome
- Metabolic syndrome is defined as a cluster of cardiovascular risk factors associated with obesity, including elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose 3, 4.
- The diagnostic criteria for metabolic syndrome include at least three of the following five conditions: abdominal obesity, high blood pressure, abnormal high fasting plasma glucose, elevated serum triglycerides, and low HDL (high-density cholesterol) level 2, 4.
Management of Metabolic Syndrome
- The management of metabolic syndrome focuses on overall cardiovascular risk rather than single risk factors, with priority given to weight reduction and increased physical activity 4.
- Pharmacotherapy is typically needed for control of high blood pressure, hypercoagulability, and increased levels of blood glucose and triglycerides 3, 4.
- Lifestyle changes, including diet and exercise, are also important for preventing and managing metabolic syndrome 2, 3, 4.