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- May 11, 2008 |
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"Markers of the Metabolic Syndrome and CHD Risk: Evidence from the Québec Cardiovascular Study"Prof. Jean-Pierre Després (biography)
English - 2002-10-28 - 24 minutes
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Summary :
The worldwide increase in the prevalence of Type 2 diabetes represets a tremendous challenge for our health-care system, especially if we consider that this phenomenon is largely explained by the epidemic of obesity. Despite the devastating impact of Type 2 diabetes as a cardiovascular disease risk factor, of equal concern is the fact that the hyperglycemic state of Type 2 diabetes only represents the tip of a huge iceberg of metabolic alterations substantially increasing the risk of cardiovascular disease. This cluster of metabolic activities has been referred to as the metabolic syndrome and this condition is largely the consequence of abdominal obesity, especially when accompanied by a high accumulation of visceral adipose tissue. Studies from Prof. Despres' group found that the “hypertriglyceridemic waist” phenotype (waist circumference greater than or equal to 90 cm combined with triglycerides greater than or equal to 2.0mmol/L) was associated with a high likelihood of the patient being characterized by an atherogenic triad of metabolic abnormalities. Therefore, despite the clinical benefits of pharmacotherapy of the atherogenic dyslipidemia, hypertension and hyperglycemia, it seems that optimal management of cardiovascular disease risk will not be achieved until the reduction in waist circumference is identified as another therapeutic target.
Bibliographic references :
1. Després JP, Lemieux I, Prud’homme D. Treatment of obesity : need to focus on high risk abdominally obese patients. BMJ 2001; 322:716-20
2. Lamarche B, Tchernof A, Mauriège P, et al. Fasting insulin and apolipoprotien B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA 1998; 279;1955-61
3. Lemieux I, Pascot A, Couillard C, et al. A. Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad (hyperinsulinemia, hyperapoB, small , dense LDL) in men? Circulation 2000; 102:179-84
4. Lemieux I, Pascot A, Prud’homme D, et al. Elevated C-reactive protein : another compnent of the athero-thrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol 2001; 21:961-7.
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