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XII. Treatment of the metabolic syndrome

It is clear that the MetS develops as a result of a very complicated system of physiological changes that interlock on multiple levels (Fig. 33).

Figure 33. Outline of the development of the MetS
(FFA = free fatty acid; ATII = angiotensin II; PAI-1 = plasminogen activator inhibitor-1; RAAS = renin-angiotensin-aldosterone system; SNS = sympathetic nervous system;
Jaspinder Caur: A Comprehensive review on metabolic syndrome, Cardiology Research and Practice; Volume 2014 article ID: 943162 Hindawi Publishing Corporation)

In practice, the patient will meet the doctor for the first time in connection with only one of the organ symptoms (Table 11).

Organ

Symptoms

Kidneys

microalbuminuria, filtration dysfunction (hypo- or hyperfunction),  sclerosis, chronic  renal failure

Liver

ALT ↑, NAFLD, NASH,

Skin

acne, blackhead, acanthosis nigricans, inflammation of the subcutaneous adipose tissue (lupus erythematosus), insulin resistance after a burn, psoriasis, androgen (dihydrotestosterone)-caused hair loss (androgenetic alopecia), skin cancer

Eyes

nondiabetes-caused retinopathy, clouding of the lens (cataract), retinal artery obstruction, glaucoma, paralysis of eye-moving muscle

Sleep

obstructive sleep apnoe (OSA)

Reproductive system

gonad hypofunction, polycystic ovary syndrome (PCOS), erectile dysfunction

Circulatory system

hypertension, coronary heart disease (CHD), heart infarct, stroke

Lungs

tumor

Pancreas

tumor

Prostate

tumor

Table 11. Systemic effects of the metabolic syndrome
(ALT = alanine aminotransferase, NAFDL = non-alcoholic fatty liver disease, NASH = nonalcoholic steatohepatitis
Jaspinder Caur: A Comprehensive review on metabolic syndrome, Cardiology Research and Practice; Volume 2014 article ID: 943162 Hindawi Publishing Corporation)

After detection of the MetS criteria, the following treatment possibilities are available: