Description |
Metabolic syndrome (MS) is a combination of clinical, biochemical and humoral abnormalities associated with impaired insulin action in glucose metabolism (insulin resistance). MS increases the risk of atherosclerosis and development and other complications (Rosolová, Matoulek, 2012). Relations of diabetes, obesity and high blood pressure are known for long time. Already in ancient times were observed forms of diabetes linked to obesity. The link between hyperglycemia, hyperuricemia and hypertension was first described in 1923. Logically, though very simply, is therefore considered that obesity is a risk factor for diabetes and other serious illnesses. Up in the eighties of the last century the coincidence of these diseases begun to be seen differently - as a state with a common cause and pathogenetic mechanisms (Snack, 2007; Sucharda, 2007b). The oldest term associated with the current MS, the term "hyperplastic syndrome" of the 60th in the last century. The term "metabolic syndrome" was first introduced to the scientific public by Herman Haller in 1975. In 1988, Gerald M. Reaven introduced the "syndrome X". In 1989 the Kaplan united coexistence of metabolic imbalances using the term "deadly quartet". In the last century, the term "Reaven's syndrome X” was preferably used. At present, "metabolic syndrome" or "insulin resistance syndrome" are prevailing notions (Perušičová, 2012; Snack, 2010). In the past, many professional organizations were trying to create a definition that takes into account the typical risk factors for MS. First of them was adopted by WHO in 1999. This definition is not applied in routine practice. New definitions were created for epidemiological and clinical needs. In 2001 the new NCEP ATP III definition was introduced for the first time, including abdominal obesity. In 2005 the youngest definition of MS by International diabetes federation (IDF) was published. Abdominal obesity expressed as waist circumference values had to be present (Sucharda, 2007a; Snack et. Al., 2006). In 2009, international medical organizations issued a joint harmonizing report. The five basic parameters of MS were based on the same level, while the waist circumference was evaluated according to ethnic specifics. In the Czech Republic the definition developed by the Czech Institute of the metabolic syndrome based on NCEP ATP III criteria (2001) and IDF (2005) is used (Perušičová, 2012, the Czech Institute of Metabolic Syndrome, 2005). Collectively, MS is not easy to define. This is not one disease, but represents a highly complex proatherogenic problems, pro-inflammatory and procoagulant status (Rybka, 2007). Over the years, the definition of MS has changed several times and parameters used have more stringent criteria. The current definition and characterization of components of MS includes > 60 events, although originally only 6 components were described by Reaven. It can be assumed that this trend will continue in the future (Brunch et. Al., 2011; Rosolová, 2006).
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