The rates of people with metabolic syndrome are constantly increasing in the Western world. It is estimated that 25% of adults worldwide have metabolic syndrome.

Metabolic Syndrome is the combination (according to the International Diabetes Federation):

  • Central obesitythe presence of which is necessary to diagnose someone with metabolic syndrome
  • High triglyceridesabove 150 mg/dl or a history of treatment for high triglycerides
  • Low HDL cholesterolbelow 40mg/dl for men or below 50mg/dl for women, or a history of treatment for low good cholesterol
  • High blood pressureabove 130/85 mm Hg or history of hypertension treatment
  • High fasting blood sugarover 100 mg/dl or having a diagnosis of type 2 diabetes.

Causes of Metabolic Syndrome

“The exact cause of the syndrome is not yet known, but there are studies that show that both insulin resistance and central obesity play a key role. Also, depending on the different ethnic groups, various genetic factors, old age, sedentary life, smoking and inflammatory conditions can affect the expression of the syndrome”, points out Ms. Eleni Komnenou Rheumatologist Director of Autoimmune Rheumatic Diseases Clinic Metropolitan General.

“The interaction between the Metabolic and Immune systems has been of great interest recently. Adipokines (leptin etc.) are substances that exert a variety of metabolic activities in the Metabolic Syndrome and are involved in the regulation of both inflammatory processes and autoimmunity that occur in Autoimmune Rheumatic Diseases. Patients with auto-inflammatory diseases – such as gout – and those with Autoimmune Rheumatic Diseases (ARDs), such as Systemic Lupus Erythematosus, Rheumatoid Arthritis, Antiphospholipid Syndrome, Ankylosing Spondylitis and vasculitis among others, have an increased incidence Metabolic Syndrome. Despite recent advances in the treatment of A.P.N, the incidence of cardiovascular disease remains high. Metabolic Syndrome could be the link between cardiovascular diseases and A.P.N. The frequency of Metabolic Syndrome in some A.P.N is about 36%”, explains the rheumatologist.

Metabolic Syndrome and Gouty Arthritis

Gout is an auto-inflammatory disease caused by the deposition of monosodium urate crystals within the synovial joints. This disease has traditionally been associated with other comorbidities such as obesity, arterial hypertension, and abnormal lipid and glucose homeostasis, included in the metabolic syndrome. The incidence of Metabolic Syndrome in gout ranges between 37% and 51%.

Metabolic Syndrome and Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease associated with metabolic syndrome and increased risk for cardiovascular disease.
The frequency of Metabolic Syndrome in RA patients. ranging from 14 to 56%.

Metabolic Syndrome and Systemic Lupus Erythematosus

Systemic Lupus Erythematosus (SLE) is a prototypical autoimmune disease, characterized by the production of autoantibodies, which lead to systemic manifestations. SLE patients have a higher risk of cardiovascular disease with premature atherosclerosis and atherosclerosis. It is known that the risk of cardiovascular events in patients with SLE is 7 to 17 times higher than that in the general population.

Metabolic Syndrome and Spondyloarthropathies

Ankylosing spondylitis (AS) and psoriatic arthritis are chronic inflammatory rheumatic diseases that mainly affect the joints of the spine, the sacroiliac joints, as well as the peripheral joints.
“The treatment of Metabolic Syndrome moves along two main axes, primary intervention and secondary intervention (pharmaceutical treatment).
Primary intervention is about a healthier lifestyle:

  • moderate reduction in calories to achieve a 5-10% weight loss within the first year
  • increasing physical activity, exercise
  • change in eating habits
  • stop smoking.

In people for whom lifestyle changes are not enough and who have a high risk of cardiovascular disease, medication is needed. The medication is directed against the separate parameters of the metabolic syndrome, such as hyperlipidemia, increased blood pressure and insulin resistance with accompanying hyperglycemia,” emphasizes Ms. Komninou.

Conclusions:

  • The metabolic syndrome has a great impact on the quality of life of patients with A.P.N.
  • In patients with SLE as well as other ARDS, the metabolic syndrome is associated with new organ damage, new vascular events and increased mortality
  • The metabolic syndrome and A.P.N. share immunological mechanisms as a result, treatment of the metabolic syndrome should be a goal in the treatment of A.P.N.
  • We expect further improvements in its prevention and treatment.

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