ABSTRACT
Introduction ...................................................................................................................................... 70 Denition of Metabolic Syndrome .................................................................................................. 70
Evolution of the Current Denition ............................................................................................ 70 Current Denition .................................................................................................................. 72
Prevalence of Metabolic Syndrome ................................................................................................. 73 United States ............................................................................................................................... 73 International ................................................................................................................................ 74
Socioeconomic Impact of Metabolic Syndrome .............................................................................. 74 Health Care Expenditure ............................................................................................................. 75 Lost Wages .................................................................................................................................. 75 Longevity .................................................................................................................................... 76
Pathogenesis and Metabolic Derangements ..................................................................................... 76 Insulin Resistance........................................................................................................................ 76 Visceral Adiposity .......................................................................................................................77 Inammation ............................................................................................................................... 78
Glucose Intolerance ................................................................................................................80 Dyslipidemia ...............................................................................................................................80 IR and Hypertension ...................................................................................................................80 Thrombosis .................................................................................................................................. 82 Vitamin D Deciency .................................................................................................................. 82
Obesity-Associated Conditions ........................................................................................................ 83 Cancer ......................................................................................................................................... 83 Cognitive Decline ........................................................................................................................84 Stroke ..........................................................................................................................................84 Nonalcoholic Fatty Liver Disease ...............................................................................................85 Polycystic Ovarian Syndrome .....................................................................................................85 Obstructive Sleep Apnea .............................................................................................................86
Patient Evaluation ............................................................................................................................86 Waist Measurement .....................................................................................................................87 Laboratory Testing ......................................................................................................................87
