Without the White Coat
By Florentino Alerta II M.D.

SYNDROME X… obesity as a risk factor

Being on the heavy side of life had its danger points, and obesity is one of them. The previous articles had discussed how obesity is killing us slowly, with a special emphasis on our kids. It will simply show that chubby (ka-ulumol) kids ain't healthy, but will have a bigger risk of these kids to have an earlier cardiovascular event like formation of atherosclerotic plagues (remember the formation of foam cells earlier in life, studies had shown that as early as three to four years of age they already had seen the presence of foams cells in these children). As the saying goes “the outcome of children is what we feed them”. (The more fast food value meals we feed our children the greater the risk and chance their cholesterol levels will increase).

Syndrome X also called in the medical community as “Metabolic Syndrome” and is also called by our endocrine specialist (diabetologist) as “Insulin Resistance Syndrome” is a group of risk factors or abnormalities that includes diabetes mellitus, obesity, hypertension (increase in blood pressure > 130/85 and dyslipidemia (“fats, elevated levels cholesterol and triglycerides). The diagnosis of this syndrome will either have 3 or more of the following risk factors that are present. Abnormal obesity (waist circumference) for men the measurement should not be more than 102cm or a 40 inches waist line, and for the female sex it should not exceed 88 cm or 35 inches of their waist line. The triglycerides level should not be more than 150 mg/dl, and HDL-C (good cholesterol) levels should not be less than 40mg/dl for males, and 50mg/dl for females. The blood pressure should not be more than 130/85 mmHg and the fasting blood glucose should not be more than 110mg/dl. With the five risk factors all you need is only three (3) of these factors in order to satisfy the clinical criteria of “Syndrome X”. Hopefully this will scare us to our bones, but it will also open up all the realities in life that there should be a greater change for healthy lifestyle and get ourselves on a good, sensible, balance and healthy diet coupled with a planned exercise for a good cardiovascular work out. Studies show that there is a high prevalence of Metabolic Syndrome among Filipinos of 1 out 5 or approximately 18%. (Sy, FNRI-DOH-HDL group, 2002). Surveys always show that there is always an elevated triglyceride level coupled with low HDL (good cholesterol) levels. A triad ( LIPID or Atherogenic (plague made of fats) seen among diabetic patients with Metabolic Syndrome, this is an elevated triglyceride level, low HDL levels and an increase in the sd-LDL (bad cholesterol) levels.

The tasks that are presented before our practicing physicians in this community is to address the dreaded “Lipid Triad” in Metabolic Syndrome, a therapeutic preparation that could lower the triglyceride levels 20 to 50 %, a shift to a larger and more buoyant LDL-c particles, and an increased in the good cholesterol (HDL) at 10 to 35% and will further decrease prothrombotic state decreases the proinflammatory state, and will finally reverse atherogenic dyslipidemia. This is were one therapeutic agent will come in, the “FENOFIBRATE”, an agent that reduces the angiographic progression of coronary artery disease in patients with type 2 diabetes, a preparation with a safety profile and well tolerated and finally will ensure better patient compliance (200mg once daily). Your choice… Fenofibrate (FIBRAFEN 200 M).